Go Easy on Southern-Style Fare to Avoid Strokes


With all the hoopla over the Mediterranean diet, you might have missed the news about what might be called the Southern diet: While eating the traditional fare of Mediterranean countries promotes heart health, consuming fried foods, sweet tea and other typical foods of the Southern United States has the opposite effect, sharply increasing the risk of stroke. Diet, researchers say, could help explain why seven Deep South states have long been characterized as the Stroke Belt.

These results are further confirmation that adhering to a healthy dietary pattern, one high in vegetables, fruits, low and non-fat dairy products, fish (baked or broiled), whole grains and legumes is important, says Alice H Lichtenstein, DSc, director of Tufts HNRCA Cardiovascular Nutrition Laboratory. Although small deviations are fine, a healthy dietary pattern should be the rule rather than the exception. And of course, it is important to achieve and maintain a healthy body weight.

The new study, presented at a recent International Stroke Conference, found that people who ate the most Southern-style food were 41% more likely to suffer a stroke over a five-year span than those eating the least. Even after adjusting for other factors such as smoking and physical activity, adherence to a Southern diet was still associated with a 30% greater risk.

SEEKING STROKE ANSWERS: Researchers have long sought explanations for why residents of the southeastern US have historically suffered about 20% more strokes than other Americans. These significantly higher stroke rates are found in seven states: Alabama, Arkansas, Georgia, Mississippi, North Carolina, South Carolina and Tennessee.

In the new study, Suzanne Judd, PhD, of the University of Alabama-Birmingham, and colleagues examined data on 20,480 people age 45 and older enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007. All 48 contiguous states were represented. Participants completed food-frequency questionnaires and were interviewed every six months about their overall health and stroke incidence. Almost 500 strokes were reported over five years.

Based on their self-reported diets, participants were divided into five eating styles:

    • Southern: Fried foods such as chicken and fried vegetables, processed or salty meats such as lunchmeat and jerky, red meat, eggs, sweet drinks such as sugared ice tea, whole milk.
    • Convenience: Mexican and Chinese food, pizza, pasta.
    • Plant-based: Fruits, vegetables, juice, cereal, whole-grain bread as well as fish, poultry and yogurt.
    • Sweets: Chocolate, desserts, sweet breakfast foods, breads plus added fats.
  • Alcohol: Beer, wine, liquor, green leafy vegetables, salad dressings, nuts and seeds, coffee.

Researchers noted that the categories were not mutually exclusive-hamburgers, for example, fit into both the Southern and convenience diets. Only the Southern dietary pattern and plant-based diet were associated with clear patterns of stroke risk, with those in the plant-based group experiencing fewer strokes.

TRIPLE WHAMMY: People in the top one-quarter of favoring the Southern-style diet tended to eat such foods almost every day-averaging six times a week-while those in the lowest one-quarter ate typical Southern fare only about once a month.

Judd noted that the Southern eating pattern combines three factors known to raise risk of cardiovascular disease: Foods high in saturated fat contribute to unhealthy cholesterol levels. Salty foods are linked to high blood pressure. And sugary drinks boost the risk of diabetes- the disease that celebrity chef Paula Deen, the queen of Southern cooking, revealed she has last year. Foods high in fat and sugar are also high in calories, leading to obesity.


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