Living in poor neighborhoods has been linked to increased heart risk and a new U.S. study suggests the lack of access to fresh, healthy foods may be to blame.

“Previous studies have found relationships between neighborhood characteristics and cardiovascular disease,” said lead author Jeffrey Wing of Grand Valley State University in Grand Rapids. “Finding that the density of healthy food stores was the only factor among those tested that consistently was related to slowing the progression of coronary calcium build-up was interesting in that we didn’t see the same relation with other neighborhood features,” like recreation centers.

Coronary artery calcium buildup hardens the arteries and causes atherosclerosis, which underlies many cases of heart disease. Heart disease is the leading cause of death in the U.S., responsible for one in every four deaths, according to the Centers for Disease Control and Prevention.

The researchers analyzed data from a large multiethnic study of atherosclerosis, in which 6,000 adults had CT scans for coronary artery calcium at the start, and at least once more after a 12-year follow-up period. Almost 90 percent of participants had three CT scans over time, with an average of three to four years between each scan.

Researchers also recorded neighborhood features like recreational facilities, healthy food stores, walking environments, healthy food stores and social environment.

They found that people with healthy food stores within one mile of their homes had slower coronary artery calcium buildup over time than those who lived further away from fresh food sources, according to the results in Circulation.

“Previous studies have found that predominantly Black neighborhoods have fewer supermarkets compared to predominantly White neighborhoods in the U.S.,” said co-lead author Ella August of the University of Michigan School of Public Health in Grand Rapids.

Dr. Eliseo J. Perez-Stable, director of the National Institute on Minority Health and Health Disparities, said the findings suggest that “points of intervention on a neighborhood level that may be particularly impactful for improving health outcomes of its residents.”