(CNN) – You don’t have to be a Southerner to love fried chicken, shortbread, hot dog sauce, sweet tea, or any of the other fried, fat- or sugar-laden foods typical of this American region.
But a new study found that eating a consistent diet of traditional southern food can make you 46% more likely to die from sudden cardiac death – that is, when the heart suddenly stops – compared to people who they don’t usually eat those foods.
Sudden cardiac death is a common cause of death and “accounted for 1 in 7.5 deaths in the United States in 2016, or nearly 367,000 deaths,” according to a statement from the American Heart Association (AHA). When this type of heart attack occurs, says the AHA, death usually occurs within an hour.
The study, published Wednesday in the Journal of the American Heart Association, also examined the impact of eating a Mediterranean-style diet on the risk of sudden cardiac death.
The researchers found that people who followed the traditional Mediterranean diet more closely had a 26% lower risk of sudden cardiac death than people who rarely ate the Mediterranean way. However, this was only true for people with no history of coronary heart disease at the start of the study.
«Improving the diet – through a diet rich in fruits, vegetables, whole grains and fish like the Mediterranean diet – and low in fried foods, organ meats and processed meats, characteristics of the southern-style dietary pattern, can decrease the risk of sudden cardiac death “Said lead author James Shikany in a statement.
Shikany is a professor of medicine and associate director of research in the Division of Preventive Medicine at the University of Alabama at Birmingham.
Heart attack belt
In what the researchers call the first observational study to assess the role of dietary patterns in sudden cardiac death, the team analyzed data from a national study called Regards (Reasons for Racial and Geographical Differences in Stroke).
Sponsored by the National Institutes of Health, Regards was designed to discover why “Southerners and African Americans have higher rates of stroke and related diseases that affect brain health.” The study recruited 30,239 black and white participants between 2003 and 2007 and followed them for 10 years.
Shikany and her team examined data from about 21,000 people. More than half were from the “stroke belt,” an 11-state area in the Southeast where stroke rates are traditionally high. For this study, those states included North Carolina, South Carolina, Georgia, Tennessee, Alabama, Mississippi, Arkansas, and Louisiana.
According to the U.S. Centers for Disease Control and Prevention (CDC), people living in the stroke belt are two to four times more likely to die from a stroke than in other regions of the country . Previous studies have shown that people who eat a predominantly Southern diet had a higher risk of death from any cause and a higher risk of coronary heart disease.
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The study raised some interesting concerns about health equity and food safety, said Dr. Stephen Juraschek, a member of the American Heart Association Committee on Nutrition, who was not involved in the study.
“The authors describe the ‘southern diet’ based on the American geography associated with this dietary pattern, however it would be a mistake to assume that this is a diet of choice,” Juraschek said in a statement.
“The gap in healthy eating between those with and without means continues to grow in the United States, and there is an incredible need to understand the complex social factors that have led and continue to perpetuate these disparities,” he added.
Five dietary patterns
The study looked at five dietary patterns: people who ate sweets regularly; those who ate primarily fast food and other convenience items; a “salad and booze” pattern that mixes beer, wine, and booze with salad sides; a plant-based diet (such as the Mediterranean); and the traditional southern diet.
“All the participants had some level of adherence to each pattern, but generally they were more adherent to some patterns and less to others,” Shikany said. “For example, it would not be unusual for an individual who strongly adheres to the southern pattern to also adhere to the plant-based pattern, but to a much lesser degree.”
In addition to the decreased risk of sudden heart attack from a plant-based diet, the study also found something unusual: People with a history of heart disease who ate a lot of sweets had a 51% lower risk of sudden cardiac death than those who ate some sweets.
Why happens? The researchers had no idea and said that “there was no viable explanation for the inverse association of the dietary pattern of sweets with the risk of sudden cardiac death in those with a history of coronary heart disease.”
Not surprisingly, a plant-based diet has been shown to be healthier for the heart. Three plant-based diets, the Mediterranean, the Ornish and the DASH diet, tied for first place in the US News and World Report 2021 ranking of the best heart-healthy diets.
The Ornish diet was created in 1977 by Dr. Dean Ornish, founder of the nonprofit Preventive Medicine Research Institute in California. Ornish calls the diet the only scientifically proven program to reverse heart disease in a randomized clinical trial without drugs or surgery. However, experts have said that the diet is restrictive and difficult to follow.
The DASH diet is often recommended to lower blood pressure. Studies have shown that following the DASH diet can lower blood pressure in a matter of weeks.
Its premise is simple: Eat more vegetables, fruits, and low-fat dairy products while reducing your consumption of foods high in saturated fat and limiting your salt intake.
The meal plan includes three whole grains each day, four to six servings of vegetables, four to six servings of fruits, two to four servings of dairy products, and several servings of lean meats and nuts / seeds / legumes.
The Mediterranean diet features simple plant-based cuisine, with most of each meal focusing on fruits and vegetables, whole grains, beans, and seeds, with some nuts and a heavy emphasis on extra virgin olive oil.
Say goodbye to refined sugar and flour, except on rare occasions. Fats other than olive oil, such as butter, are rarely, if ever, consumed.
Red meat can look odd, usually just to add flavor to a dish. Instead, meals can include eggs, dairy, and poultry, but in much smaller portions than in the traditional Western diet. Fish, however, is a staple food.
Numerous studies have found that the Mediterranean diet can reduce the risk of diabetes, high cholesterol, dementia, memory loss, depression, and breast cancer. Foods from the sunny Mediterranean region have also been linked to stronger bones, a healthier heart, and a longer life.
“Whenever possible, people should evaluate the number of servings of fruits and vegetables they consume each day and try to increase the amount to at least 5-6 servings per day, as recommended by the American Heart Association.” Juraschek said in the statement. “The optimum would be 8 to 9 servings a day.”