The concept of food deserts defines people who don’t have access to healthy foods, and usually, that would be disadvantaged populations in urban settings less than a mile and in rural settings greater than 10 miles.
However, it’s always been a question, ‘how do you separate this concept of food deserts from the concept of disadvantaged socioeconomic environments unrelated to simple food access?’
So, this study attempted to tease out what component of the food desert concept was most important in terms of predicting CV events.
Well, I think it’s clear that simply having a supermarket or access to healthy foods is not going solve the problem of high levels of CV events in low socioeconomic environments.
The social determinants of health are real, but it’s a mixture of various conditions and not simply having less access to healthy foods.
One of the reasons why it’s important to recognize that healthy food access itself is not going to be the final defining factor is because people must make positive choices.
There have been some data to indicate, for instance, in the southeastern part of the United States that one of reasons for the higher rates of hypertension and stroke are food choices in the so-called “Southern diet,” consisting of fried foods and foods with a high-sodium content.
So even if there were, for instance, a supermarket with appropriate foods available, patients would have to be educated on what are healthy eating patterns such as the DASH eating plan and the Mediterranean-style diet.
Then, after being educated about these would have to have ways to accept them in a culturally appropriate matter.
There have been some efforts to make a DASH-Southern diet with appropriate modifications such that they would be desired and accepted by patients.
For clinical practice, I don’t think it’s enough for CV specialists including cardiologists, internists and nurse practitioners to simply wait for patients to have acute events or develop HF before we make efforts for prevention. Prevention and education must start prior to the manifest presence of CVD.
Keith C. Ferdinand, MD, FACC, FAHA, FNLA, FASH
Cardiology Today Editorial Board Member
Tulane University School of Medicine
Disclosures: Ferdinand reports no relevant financial disclosures.