Southern Diet May Raise Stroke Risk

Stroke likelihood increases for those who eat Southern diet but plants provide protection

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Fried chicken, ham, lots of butter and sweet tea are all staples of a traditional Southern diet. Although they're tasty, these foods may raise the risk of stroke.

Southern foods can be very high in fat, salt and sugar. 

Recent research has found that people who ate a Southern-style diet had a 30 percent greater risk of stroke than those who did not.

This study also found that this diet may be a contributing factor to the higher rate of stroke among African-Americans.

"Cut back on fat, salt and sugar."

Suzanne Judd, PhD, assistant professor at the University of Alabama at Birmingham (UAB) Department of Biostatistics and a program manager for the Reasons for Geographic and Racial Differences in Stroke (REGARDS), led the study.

Investigators used data from REGARDS (Reasons for Geographic and Racial Differences in Stroke), a national study of more than 30,239 black and white volunteers aged 45 or older. Participants completed detailed questionnaires about their eating habits.

Dr. Judd described Southern-style eating as a fairly high-fat diet, including a lot of fried foods, processed meats (chicken, liver and ham), foods with a high sodium content, an overabundance of dairy and sweet tea, consumed up to six days per week.

Judd pointed out that Southern cooking is often prepared using unhealthy bacon grease instead of olive oil. The diet also often includes meats that are high in saturated fats such as gizzards and other organ meat.

Sarah Samaan, MD, cardiologist and physician partner at the Baylor Heart Hospital in Plano, Texas, told dailyRX News that a typical "meat and three" lunch at many restaurants in the South includes meat and three "vegetables."

“This might sound healthy until you realize that the ‘vegetables’ are often mac and cheese, fried okra, cheesy broccoli casserole, or mashed potatoes,” said Dr. Samaan. “The meals are usually served with super sweet iced tea.”

Scientists noted that participants from 10 states—Delaware, Louisiana, Mississippi, Alabama, Illinois, Georgia, Missouri, Arkansas, Michigan and Maryland—were most likely to keep to the Southern diet.  Some have labeled the Southeastern United States and Mississippi Valley as the “Stroke Belt” because of the higher rate of stroke in that region.

Although the total number of stroke deaths in the US has dropped by more than half between 1978 and 2006, African Americans continue to have a greater risk of stroke.

“Between the ages of 45 and 65, African Americans have a stroke mortality (death rate) about two to three times higher than whites,” said George Howard, PhD, professor of biostatistics at the University of Alabama at Birmingham and REGARDS co-principal investigator, in a statement on StopAfib.org. ("Afib" is short for atrial fibrillation, the most common irregular heartbeat, which can lead to stroke.)

While a Southern diet appeared to be a contributing factor for stroke among African Americans, Dr. Judd’s research found that all people who ate Southern food had a 30 percent increased risk of stroke.

“This was common whether they were black, white, male or female, and it did not matter where they lived, in the South or not, ” Dr. Judd said.

Dr. Samaan added, “It's critical that we get the message out that a healthy diet is important for everyone, regardless of age, race or economic situation.”

On a positive note, subjects who regularly ate greens, such as collards, lowered their stroke risk by as much as 20 percent. Dr. Judd commented that those who followed some type of plant-based diet appeared to gain protection from stroke.

Next, Dr. Judd and her team want to further examine if it’s a lack of good foods or intake of bad foods that heightens stroke risk. Also, they hope to find out how a Southern diet may affect cognitive functioning.

The study was presented in February at the American Stroke Association 2013 International Stroke Conference. The REGARDS study was funded by the National Institute of Neurological Disorders and Stroke and a small grant from General Mills.

Reviewed by: 
Review Date: 
March 4, 2013
Last Updated:
August 15, 2013