Structural food access inequalities and aging transitions: A geospatial, multistate and longitudinal analysis of UK Biobank.

Authors

May A Beydoun, Jordan Weiss, Hind A Beydoun, Ana I Maldonado, Sri Banerjee, Michael F Georgescu, Mustapha Bouhrara, Nicole Noren Hooten, Jack Tsai, Minkyo Song, Tianyi Huang, Lenore J Launer, Michele K Evans, Alan B Zonderman

Published in

Social science & medicine (1982). Volume 412. Pages 119991. Oct 31, 2026. Epub Oct 31, 2026.

Abstract

The food environment may influence neurodegeneration and mortality. This study examined associations of food deserts (FD) with brain health and survival using UK Biobank data.
We analyzed 262,847 participants aged ≥50 years at baseline (2006-2010) with linked geospatial (2018-2020), neuroimaging (2014-2023; 2019-2023), dietary, biological, and health data. FD exposure was aggregated at the local authority (LA) level. Outcomes included incident dementia, Parkinson's disease (PD), and all-cause mortality (ACM) from January 1, 2020, to January 1, 2024. Neuroimaging sub-analyses (n = 2429) assessed brain volumes and white matter microstructure (WMM) using diffusion MRI metrics (FA_mean, MD_mean, ICVF_mean, ISOVF_mean, OD_mean). Cox, multistate survival, and mixed-effects models were used. Spatial clustering examined co-localization between FD and outcomes. Area-level FD was examined as the primary exposure, with FI evaluated mainly as a secondary effect modifier.
Women had lower FD and FI scores and better cardiovascular and social health. FD (per SD increase) was associated with higher ACM risk (HR = 1.06; 95% CI: 1.02-1.09) after adjustment for demographics and deprivation, attenuating after full adjustment. FD also predicted faster WMM decline among women (OD_mean β = +0.1124; p = 0.028), though neuroimaging associations did not survive FDR correction. Spatial analyses revealed threefold higher odds of concordance between FD and ACM, and between FD and FA_mean decline. FI did not modify FD-ACM associations.
Living in food deserts was linked to higher mortality and faster white matter decline, particularly among women. Findings highlight the role of area-level food environments in brain health and aging.

PMID:
42994222
Bibliographic data and abstract were imported from PubMed on 07 Nov 2026.

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