August 12, 2015
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Southern diet may raise risk for CHD

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A dietary pattern similar to that consumed in the southern United States was associated with increased risk for CHD, according to new findings from the REGARDS study.

Researchers analyzed 17,418 white and black adults aged 45 years or older without known CHD at baseline who were enrolled in the REGARDS study from 2003 to 2007.

Five dietary patterns were observed: convenience; plant-based; sweets; Southern; and alcohol and salad. They defined the Southern diet as one with high levels of added fats, fried food, eggs, organ and processed meats and sugar-sweetened drinks. The researchers stratified participants by quartiles in each dietary pattern and analyzed the risk for nonfatal MI or acute CHD death associated with consumption of each pattern. Median follow-up was 5.8 years.

Diet and CHD risk

After adjustment for sociodemographics, lifestyle factors and energy intake, those in the highest quartile of Southern dietary pattern consumption were at elevated risk for CHD compared with those in the lowest quartile (HR = 1.56; 95% CI, 1.17-2.08; P for trend = .003). When the researchers added anthropometric and medical history variables to the analysis, the association remained, but was not as strong (HR = 1.37; 95% CI, 1.01-1.85).

The other four dietary patterns were not associated with increased risk for CHD after adjustments.

James M. Shikany, DrPH

James M. Shikany

“Regardless of your gender, race or where you live, if you frequently eat a Southern-style diet, you should be aware of your risk of heart disease and try to make some gradual changes to your diet,” James M. Shikany, DrPH, from the division of preventive medicine of the school of medicine at the University of Alabama at Birmingham, said in a press release. “Try cutting down on the number of times you eat fried foods or processed meats from every day to 3 days a week as a start, and try substituting baked or grilled chicken or vegetable-based foods.”

According to the researchers, those in the highest quartile of Southern diet consumption were more likely to be aged younger than 65 years, black, not have a high school diploma, have an annual household income of less than $20,000 and reside within the “stroke belt.” Compared with low consumption of the Southern pattern, those with high consumption were more likely to smoke; have dyslipidemia, hypertension, diabetes; and have a higher BMI and waist circumference.

Additional insights needed

In a related editorial, Susan M. Krebs-Smith, PhD, MPH, and colleagues noted that the researchers “did indeed identify distinct factors which explain the variability of food intakes into this sample, and one of those factors was related to CHD in this sample.”

However, Krebs-Smith, from the epidemiology and genomics research program of the National Cancer Institute, Bethesda, Maryland, and colleagues wrote, “Questions remain regarding how those factors relate to the overall pattern of eating, whether those factors could be identified in other samples, and whether those factors are the most important with regard to CHD. If this study was re-examined with different methods, we would have additional insights regarding the relationship between diet and CHD in this population.” – by Erik Swain

Disclosures: The researchers and editorial writers report no relevant financial disclosures.