McDonald’s is an American staple. Around one in eight people in the US have worked in one of the chain’s locations in their lifetime, and there are more than 14,300 locations across the country. It’s a cornerstone of the US food landscape, alongside other popular fast-food franchises, like KFC, Burger King, Pizza Hut, and Dairy Queen. But living close to many of these could be a threat to health, research suggests.

A new study published by the American Heart Association, but based on UK data, suggests that those who live closer to bars, pubs, and fast-food restaurants may be at a higher risk of heart failure. It is one of the first studies to connect the food environment with the likelihood of developing the condition, which happens when the heart muscle struggles to pump blood around the body properly.

Some of the biggest risk factors for heart failure include diabetes, high blood pressure, and coronary heart disease, all of which, research suggests, can be linked to poor diet in many cases. For example, in 2018, research from the American Heart Association noted that animal fat consumption could increase the risk of death from heart disease by 21 percent.

Animal products are, of course, a key menu item at fast-food restaurants. In the US, McDonald’s sells more than 550 million Big Macs, which include two processed beef patties and American cheese, per year. In the UK, 382 million portions of fish and chips—a pub and fast-food staple that is usually ultra-processed—are sold every year.

“Most previous research on the relation between nutrition and human health has been focused on food quality while neglecting the impact of the food environment. Our study highlights the importance of accounting for food environment in nutrition research.” —Lu Qi, MD, PhD, senior author and a professor in the epidemiology department at Tulane University in New Orleans, said in a statement.

The study found that those who lived within a one-kilometer (or 0.6 miles) distance of 11 or more ready-to-eat food outlets had a 16-percent greater risk of heart failure compared with those who had no ready-to-eat food outlets near their home. The researchers also found that the risk was higher for individuals without a college degree, as well as people who lived in places with little access to gyms and other similar facilities.

The researchers noted that improving access to healthy foods, physical fitness facilities, and making education more accessible, could make a difference to heart health.


Heart health, food access, and inequality across the US and the UK

In the US and the UK, not everyone has the same level of access to healthy foods right now. In the US, for example, more than 23 million live without easy access to nutritious foods. These areas are commonly referred to as food deserts (although this framing has been contested by some, who prefer to refer to the issue as “food apartheid”).

One in every five Black households in the US is situated in one of these areas, where fast-food outlets are common but healthy, fresh produce is hard to find. In the UK, one study from 2015 also suggested that more than 40 percent of KFC locations and 40 percent of McDonald’s locations were in the country’s poorest areas, making cheap, processed foods one of the most convenient options. Again, this impacts people of color disproportionately, with research suggesting that people of color in the UK are far more likely to be in poverty than white people.

Research has also found that incidences of heart disease, diabetes, and high blood pressure are more common among people of color.

“Given the clear association between Black race and high incidence of heart failure as compared to white patients, as well as associations with worse heart failure outcomes, attention to food environment in this high-risk population is of the utmost importance,” Elissa Driggin MD, MS, and Ersilia M. DeFilippis, MD, both of Columbia University Medical Center in New York, wrote of the new findings.

“It has already been demonstrated that compared to predominantly white neighborhoods, there are significantly fewer supermarkets in predominantly Black neighborhoods, which are likely to be inversely associated with ready-to-eat food environments.” —Elissa Driggin MD, MS, and Ersilia M. DeFilippis, MD

Another recent study, published in the American Heart Association’s 2024 Go Red for Women journal issue, assessed more than 400 predominantly low-income, pregnant Hispanic and Latina women living in Los Angeles. It suggested that those with a diet high in solid fats, refined grains, and dairy cheese may have a higher risk of developing pre-eclampsia during pregnancy.

According to the European Society of Cardiology, people with pre-eclampsia may have an elevated risk of heart attack and stroke for 20 years after pregnancy. Research suggests that women with pre-eclampsia are four times more likely to have a heart attack within 10 years of delivery.


A whole-food, plant-based diet is not a magic cure for any condition, but it is linked with a lower risk of pre-eclampsia, heart disease, type 2 diabetes, and high blood pressure.

Because of this, some researchers have suggested that introducing produce prescriptions, which would enable physicians to prescribe patients discounted or free fruits and vegetables in addition to medications, may help improve access and help more people live healthier lives. Read more about the study here. And you can also find out more about the health benefits of plant-based whole foods here.

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