The Relationship Between the Supply of Fast-food Chains and Cardiovascular Outcomes
Open accessAbstract
Objective To examine the extent to which inter-regional differences in fast-food concentrations account for variations in all-cause mortality and acute coronary syndromes throughout Ontario, Canada.Methods Nine distinct fast-food chains were selected based on top sales data in 2001. The per capita rate of fast-food outlets per region was calculated for each of 380 regions throughout Ontario. Outcome measures, obtained using 2001 vital statistics data and hospital discharge abstracts, included regional per capita mortality rates and acute coronary syndrome hospitalization rates; head trauma served as a comparator. All regional outcomes were adjusted for age, gender, and socio-economic status, and were analyzed as continuous and rank-ordered variables as compared with the provincial average.Results Mortality and admissions for acute coronary syndromes were higher in regions with greater numbers of fast-food services after adjustment for risk. Risk-adjusted outcomes among regions intensive in fast-food services were more likely to be high outliers for both mortality (Adjusted Odds Ratio (OR): 2.52, 95% confidence intervals (CI): 1.54 - 4.13, p < 0.001) and acute coronary hospitalizations (Adjusted OR: 2.62, 95% CI 1.42 - 3.59, p < 0.001) compared to regions with low fast-food service intensity. There was no relationship between the concentration of fast-food outlets and risk-adjusted head-trauma hospitalization rates.Interpretation Inter-regional cardiac outcome disparities throughout Ontario were partially explained by fast-food service intensity. Such findings emphasize the need to target health promotion and prevention initiatives to highest-risk communities.
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A regional analysis in Canada found higher per capita density of fast-food restaurants was associated with higher total mortality and admissions for acute coronary syndromes.
“A regional analysis in Canada found that higher per capita density of fast-food restaurants was associated with higher total mortality and admissions for acute coronary syndromes.311”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [311]
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- Authors
- Alter, D. A., & Eny, K.
- Affiliations
- Sunnybrook Health Science Centre (CA)
- Institute for Clinical Evaluative Sciences (CA)
- Corresponding author
- Alter, David A.
- Venue
- Canadian Journal of Public Health
- Published
- 2005-05
- Volume
- 96
- Issue
- 3
- Pages
- 173-177
- ISSN
- 0008-4263 (ISSN-L)
- 1920-7476
- PMC
- PMC6976214
- OpenAlex
- W2156174140
- Cited by
- 117
- References
- 34
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 7 · 2017: 5 · 2016: 4 · 2015: 7 · 2014: 4 · 2013: 5 · 2012: 6
- FWCI
- 4.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Canadian Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- fast food chains, food environment, cardiovascular outcomes, all-cause mortality, acute coronary syndrome, hospitalization, regional disparities, head trauma, Ontario, health promotion targeting
- MeSH terms
- Cardiovascular Diseases, Dietary Fats, Food Supply, Geography, Craniocerebral Trauma, Hospitalization, Humans, Ontario, Restaurants, Prevalence, Logistic Models, Odds Ratio, Risk Assessment
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