Patients living in areas with limited access to healthy foods had higher rates of postoperative complications.
Patients undergoing breast reconstruction who live in areas with limited access to healthy foods may face a higher risk of certain postoperative complications, according to a study published in the April issue of Plastic and Reconstructive Surgery.
“Our findings suggest that access to healthy foods and nutritional status may influence the risk of complications after breast reconstruction surgery,” says Kenneth Fan, MD, of MedStar Georgetown University Hospital, Washington, DC, in a release. “Food insecurity might be an important social determinant of health for breast reconstruction patients.”
Are Complication Risks Higher for Patients Living in Food Deserts?
Food deserts are areas with high rates of food insecurity, where access to healthy foods is limited and unhealthy options are more prevalent. Prior research has identified poor nutrition—common among patients experiencing food insecurity—as a factor that can affect recovery after breast reconstruction.
Researchers analyzed data from 1,553 patients who underwent mastectomy between 2014 and 2018. Of those, 1,020 patients—about two-thirds—also received breast reconstruction. Overall, 43.5% of patients lived in areas classified as having low food access (LFA), based on distance to the nearest supermarket.
Patients in LFA areas were more likely to be Black (42% vs 37%) and had higher rates of diabetes and chronic kidney disease. Other characteristics were similar between groups.
Patients living in areas with low food access were more likely to experience complications overall (54.5% vs 38.5%) and major complications (12.3% vs 7.3%) compared to those in areas with better access to food.
Nutrition and Recovery After Breast Reconstruction
In a subanalysis, patients in low-income areas within the LFA group were more likely to experience complications requiring repeat surgery. After adjusting for factors including age, race, comorbidities, income, and type and timing of reconstruction, residence in a food desert remained an independent risk factor for overall complications and repeat surgery.
Although prior studies have linked socioeconomic factors such as income and insurance status to breast reconstruction outcomes, the authors wrote that “food desert status captures a separate issue…that is not fully accounted for by income alone.”
The study has limitations and does not establish a causal relationship between food deserts and postoperative complications.
“These findings emphasize the critical role of nutrition in recovery and suggest that geographic and socioeconomic disparities contribute to health outcomes,” Fan and coauthors wrote. They added that incorporating nutritional screening into preoperative assessments may help address risks associated with poor nutrition.
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