State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.
University of the Chinese Academy of Sciences, Beijing, China.
J Am Heart Assoc. 2018 May 25;7(11):e007651. doi: 10.1161/JAHA.117.007651.
We explored whether higher densities of fast-food restaurants (FFRs) and full-service restaurants are associated with mortality from cardiovascular disease (CVD) and stroke and the prevalence of type 2 diabetes mellitus (T2D) across the mainland United States.
In this cross-sectional study county-level data for CVD and stroke mortality, and prevalence of T2D, were combined with per capita densities of FFRs and full-service restaurants and analyzed using regression. Mortality and diabetes mellitus prevalence were corrected for poverty, ethnicity, education, physical inactivity, and smoking. After adjustment, FFR density was positively associated with CVD (β=1.104, =2.3%), stroke (β=0.841, =1.4%), and T2D (β=0.578, =0.6%) and full-service restaurant density was positively associated with CVD mortality (β=0.19, =0.1%) and negatively related to T2D prevalence (β=-0.25, =0.3%). In a multiple regression analysis (FFRs and full-service restaurants together in same model), only the densities of FFRs were significant (and positive). If we assume these relationships are causal, an impact analysis suggested that opening 10 new FFRs in a county would lead to 1 extra death from CVD every 42 years and 1 extra death from stroke every 55 years. Repeated nationally across all counties, that would be an extra 748 CVD deaths and 567 stroke deaths (and 390 new cases of T2D) over the next 10 years.
These results suggest that an increased density of FFRs is associated with increased risk of death from CVD and stroke and increased T2D prevalence, but the maximal impact (assuming the correlations reflect causality) of each individual FFR is small.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT03243253.
本研究在美国本土范围内探索快餐店（FFR）和全方位服务餐厅的更高密度与心血管疾病（CVD）和中风死亡率以及 2 型糖尿病（T2D）患病率之间的关系。
在这项横断面研究中，我们将 CVD 和中风死亡率以及 T2D 患病率与 FFR 和全方位服务餐厅的人均密度相结合，并使用回归进行分析。使用贫困、种族、教育、缺乏身体活动和吸烟状况对死亡率和糖尿病患病率进行校正。调整后，FFR 密度与 CVD（β=1.104，P=2.3%）、中风（β=0.841，P=1.4%）和 T2D（β=0.578，P=0.6%）呈正相关，而全方位服务餐厅密度与 CVD 死亡率（β=0.19，P=0.1%）呈正相关，与 T2D 患病率（β=-0.25，P=0.3%）呈负相关。在多元回归分析（FFR 和全方位服务餐厅同时纳入同一模型）中，只有 FFR 密度具有统计学意义（且为正相关）。如果我们假设这些关系是因果关系，那么在一个县新开 10 家 FFR 将导致每 42 年多 1 例 CVD 死亡，每 55 年多 1 例中风死亡。在全国范围内重复计算，在未来 10 年内，将新增 748 例 CVD 死亡和 567 例中风死亡（以及 390 例新的 T2D 病例）。
这些结果表明，FFR 密度的增加与 CVD 和中风死亡率的增加以及 T2D 患病率的增加相关，但每一家 FFR 的最大影响（假设相关性反映因果关系）是较小的。
