The Southern diet – fried foods and sugary drinks – may raise risk of sudden cardiac death
DALLAS, June 30, 2021 – Eating regularly the Mediterranean-style diet can increase your risk of sudden cardiac death, while routinely following a Mediterranean diet can reduce that risk, according to a new study published today in the Journal of the American Heart Association. an open access journal from the American Heart Association.
The Southern Diet is characterized by added fats, fried foods, eggs, offal (such as liver or offal), processed meats (such as deli, bacon, and hot dogs), and sugar-sweetened beverages. The Mediterranean diet is rich in fruits, vegetables, fish, whole grain products and legumes and little meat and dairy products.
“Although this study was observational in nature, the results suggest that diet may be a modifiable risk factor for sudden cardiac death and therefore diet is a risk factor over which we have some control,” said James M. Shikany, Dr . PH, FAHA, lead study author and professor of medicine and assistant director of research in the Department of Preventive Medicine at the University of Alabama, Birmingham.
“Improve your own diet – a diet that is rich in fruits, vegetables, whole grain products and fish, such as the Mediterranean diet and low-fried foods, offal and processed meat, characteristics of the Mediterranean diet, can reduce the risk of sudden cardiac death”, he says.
The study examined data from more than 21,000 people aged 45 and over who were participating in an ongoing national research project called REasons for Geographic and Racial Differences in Stroke (REGARDS), which investigates geographic and racial differences in stroke. The participants were recruited between 2003 and 2007. Of the participants in this analysis, 56% were women; 33% were black adults; and 56% lived in the southeastern US, known as a region recognized as the stroke belt due to its higher stroke death rate. The stroke belt states included in this study were North Carolina, South Carolina, Georgia, Tennessee, Alabama, Mississippi, Arkansas, and Louisiana.
This study is the latest research into the relationship between cardiovascular disease and diet – which foods have a positive or negative impact on the risk of cardiovascular disease. It is possibly the only study to date that examines the link between dietary patterns and the risk of sudden cardiac death, which is the sudden loss of heart function that leads to death within an hour of the onset of symptoms. Sudden cardiac arrest is a common cause of death, accounting for 1 in 7.5 deaths or nearly 367,000 deaths in the United States in 2016, according to 2019 American Heart Association statistics.
The researchers included participants with and without a history of coronary artery disease at the start of the study and rated their diet using a food intake questionnaire completed at the start of the study. The participants were asked how often and in what quantities they had consumed 110 different foods in the previous year.
The researchers calculated a score for the Mediterranean diet based on certain food groups that are considered beneficial or harmful to health. They also derived five dietary patterns. In addition to the southern-style eating pattern, the analysis included a “sweet” eating pattern that includes foods with added sugar such as desserts, chocolate, candy, and sweetened breakfast items; a “convenience” eating pattern that relied on easy-to-prepare foods such as mixed dishes, noodle dishes, or items likely to be ordered to take away such as pizza, Mexican food, and Chinese food; a “plant-based” diet was classified as rich in vegetables, fruits, fruit juices, cereals, beans, fish, poultry and yogurt; and an “alcohol and salad” diet that was heavily dependent on beer, wine, brandy along with green leafy vegetables, tomatoes and salad dressing.
Shikany found that the patterns are not mutually exclusive. “All participants had some level of adherence to each pattern, but usually adhered more to some patterns and less to others,” he explained. “For example, it would not be uncommon for a person who adheres strongly to the southern pattern to also adhere to the plant-based pattern, but to a much lesser extent.”
After an average of almost 10 years of follow-up every six months to check for cardiovascular disease, the 21,000 study participants had more than 400 sudden cardiac deaths.
The study found:
Overall, participants who most frequently ate a Mediterranean diet had a 46% higher risk of sudden cardiac death than those who followed this diet the least. In addition, those who followed the traditional Mediterranean diet most closely had a 26% lower risk of sudden cardiac death than those who followed it least. The American Heart Association’s diet and lifestyle recommendations emphasize the consumption of vegetables, fruits, whole grains, lean protein, fish, beans, legumes, nuts, and non-tropical vegetable cooking oils such as olive and canola oils. Limiting saturated fats, sodium, added sugars, and processed meats is also recommended. According to the Centers for Disease Control and Prevention, sugary beverages are the primary source of added sugar in the U.S. diet, and the American Heart Association supports taxes on sugary beverages to help reduce consumption of these products.
“These results support the idea that healthier diets would prevent deadly cardiovascular disease and should encourage us all to adopt healthier diets as part of our lifestyle,” said Stephen Juraschek, MD, Ph.D., member of the American Heart Nutritional Committee of the Association of the Council on Lifestyle and Cardiometabolic Health. “As much as possible, people should evaluate the number of servings of fruits and vegetables they eat each day and try to increase the number to at least 5-6 servings per day as recommended by the American Heart Association. 8-9 servings per day would be optimal.
“This study also raises important issues related to health equity, food security and social determinants of health,” he continued. “The authors describe the Southern Diet based on the US geography associated with this diet, but it would be a mistake on our part to assume that this is the diet of choice. I think American society needs to expand Dealing with Why This Diet is more common in the South, bringing together some ethnic, ethnic or socio-economic groups to develop interventions that can improve nutritional quality. The gap between those with and without funds in healthy eating is growing in America continues, and there is an incredible need to understand the complex societal factors that have created and continue to create these inequalities. “
This current research extends previous studies on participants in the same national stroke project, REGUARDS. In a 2018 analysis, Shikany and colleagues reported that adults 45 years and older with heart disease who had an affinity for the Southern Diet had a higher risk of death from any cause, while more adherence to the Mediterranean diet was associated with a lower risk, Death for any reason. And in a 2015 study, the southern diet was linked to a higher risk of coronary heart disease in the same population.
The large sample of the population and the regional diversity, including a significant number of black participants, are considered strengths of the REGARDS research project. One of the possible limitations of this study, however, is that food intake was based on one-off, self-reported questionnaires and thus relied on the participants’ memories. Self-reported nutrition can contain inaccuracies that lead to biases that could reduce the strength of the associations observed.
A common association that remains unexplained is that among those with a history of heart disease, those who most adhered to the candy eating pattern had a 51% lower risk of sudden cardiac death than those who were least likely to follow this pattern . The researchers note that they have “found no viable explanation for the inverse association of candy eating patterns with the risk of sudden cardiac death in people with a history of coronary heart disease.”
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Co-authors are Monika M. Safford, MD; Orysya Soroka, MS; Todd M. Brown, MD, MSPH; PK Newby, Sc. D., MPH, MS; Raegan W. Durant, MD, MPH; and Suzanne E. Judd, Ph.D.
The study was funded by the National Institute of Neurological Disorders and Stroke, the National Institute on Aging, and the National Heart, Lung, and Blood Institute of the National Institutes of Health.
Additional resources:
Multimedia is available in the right column of the publication link https://newsroom.heart.org/news/the-southern-diet-fried-foods-and-sugary-drinks-may-raise-risk-of-sudden-cardiac- Tod ? Preview = 25c690ab159c83f181682192e6c51af3
You can view the manuscript online after June 30, 2021.
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