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LOCATION, LOCATION, LOCATION: According to a new provincial study, if you live in a neighbourhood with many fast-food restaurants, you are also likely to be living in a place with more heart disease and more deaths. This week's study, from the Toronto-based ICES (Institute for Clinical Evaluative Sciences), indicates that mortality and hospital admissions for acute coronary syndromes were higher in regions with greater numbers of fast-food services. If a region had 10 to 19 fast-food outlets per 100,000 people, the mortality rate went up 35 per 100,000. For regions with 20 or more fast-food outlets, mortality went up 62 per 100,000 or almost doubled. The relationship between fast-food and poor heart health was equally bad in both poor and affluent neighbourhoods. I thought this was an important study until Dr. David Alter, an ICES scientist, noted that there needs to be "disincentives put in place to curtail fast-food demand and promote the consumption of healthier food in high-mortality regions." Then I thought, reality check! Even though fast-food outlets have heart- healthy food available, families who are pressed for time are not going to choose a salad when a fill-me-up pizza or burger and fries are available at the same price -- no matter what kind of tax-based initiatives or other disincentives are in place. Fat tastes good is the God-awful truth.

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