Southern diet could be deadly for people with heart disease

July 12, 2018, American Heart Association
Credit: CC0 Public Domain

People with a history of heart disease who eat a traditional Southern diet are more likely to die than those who follow a Mediterranean dietary pattern, according to new research.

The large-scale study, published Thursday in the Journal of the American Heart Association, adds to the growing body of evidence on and its association with dietary patterns from different parts of the world.

Researchers defined the U.S. Southern as high in added fats, fried food, eggs, processed meats and sugar-sweetened beverages. By contrast, the Mediterranean diet was defined as high in vegetables, fruits, fish, whole grains and legumes, and low in meat and dairy.

The study is among the first to zero in on people who already had a history of coronary disease, such as a previous heart attack or surgery. Researchers examined data from 3,562 white and African-American men and women ages 45 and older living in different parts of the United States. Participants were first given an exam and dietary assessment, and then called every six months to ask about new coronary heart disease events.

Seven years later, 581 people had experienced a second coronary heart disease event, and 1,098 people had died from a variety of causes. After looking closely at an assortment of dietary patterns, researchers found a clear association between death and people who ate a Southern diet.

"The greater someone adheres to the Southern dietary pattern, the higher the risk of all-cause mortality," said James Shikany, the study's lead author and a nutritional epidemiologist at the University of Alabama at Birmingham's Division of Preventive Medicine. "But with the Mediterranean diet, the greater they adhere, the lower the risk of recurrent and all-cause mortality."

The study was a follow-up to research published in 2015 that found a higher risk of acute heart attack or heart-related death among participants without a history of heart disease at the start of the study.

Shikany said it's important to note that the research – both the new study and the 2015 study – looked at , not specific foods. "We do not know which individual components of the Southern pattern confer the most risk," he said.

Still, he noted, these latest results should be a wake-up call for anyone with heart disease who eats a traditional Southern diet.

"We believe it is prudent to add more fruits and vegetables, and switch to more unsaturated fats, such as olive oil, as opposed to butter," he said.

Marie-Pierre St-Onge, associate professor of nutritional medicine at Columbia University in New York, called it "a unique study that shows how important it is to consume a healthy diet." Yet she also called for future studies to examine how people with heart fare after they improve their diet.

"A cardiovascular event is a scary thing, and it can be a high motivator for people to eat more healthfully and exercise more," said St-Onge, who wasn't involved in the study. "I'd like to know how making lifestyle changes after the first event might prevent secondary events and death."

Shikany said he hopes the study underscores the importance for doctors to counsel patients on nutrition and offer suggestions for changing their diet. He also recommends patients work with a registered dietitian to plot out concrete ways to eat healthier.

Federal dietary guidelines recommend a healthy eating pattern that features fruits, vegetables, whole grains, legumes, nuts, seeds and fish, and that limits added sugars, sodium and saturated fats.

The key for all health care providers, Shikany said, is taking a slow-and-steady approach to get patients to improve their diets for the long-run.

"Instead of eating processed meats every day, perhaps recommend they start out by cutting that down to twice a week," he said. "If you recommend a radical change, all at once, people … are less likely to make changes."

Explore further: Vegetarian and Mediterranean diet may be equally effective in preventing heart disease

More information: James M. Shikany et al. Dietary Patterns and Mediterranean Diet Score and Hazard of Recurrent Coronary Heart Disease Events and All‐Cause Mortality in the REGARDS Study, Journal of the American Heart Association (2018). DOI: 10.1161/JAHA.117.008078

Related Stories

Vegetarian and Mediterranean diet may be equally effective in preventing heart disease

February 26, 2018
A lacto-ovo-vegetarian diet, which includes eggs and dairy but excludes meat and fish, and a Mediterranean diet are likely equally effective in reducing the risk of heart disease and stroke, according to new research in the ...

Plant-based diet associated with lower heart failure risk

November 14, 2017
Eating a mostly plant-based diet was associated with less risk of developing heart failure among people without previously diagnosed heart disease or heart failure, according to preliminary research presented at the American ...

Southern diet could raise your risk of heart attack

August 10, 2015
If your dinner plate often includes fried chicken, gravy-smothered liver, buttered rolls and sweet tea—your heart may not find it so tasty. Eating a Southern-style diet is associated with an increased risk of heart disease, ...

Plant-based diets improve cardiometabolic risk factors in diabetes patients

June 18, 2018
Plant-based diets improve glycemic control, lead to weight loss, and improve cholesterol in people with type 2 diabetes, according to a new review published in the journal Clinical Nutrition.

Not all plant-based diets are created equal

July 17, 2017
Plant-based diets are recommended to reduce the risk of heart disease; however, some plant-based diets are associated with a higher risk of heart disease, according to a study published today in the Journal of the American ...

High protein diet associated with small increased heart failure risk in middle-aged men

May 29, 2018
For middle-aged men, eating higher amounts of protein was associated with a slightly elevated risk for heart failure than those who ate less protein, according to new research in Circulation: Heart Failure, an American Heart ...

Recommended for you

Bullying and violence at work increases the risk of cardiovascular disease

November 19, 2018
People who are bullied at work or experience violence at work are at higher risk of heart and brain blood vessel problems, including heart attacks and stroke, according to the largest prospective study to investigate the ...

Genetic analysis links obesity with diabetes, coronary artery disease

November 16, 2018
A Cleveland Clinic genetic analysis has found that obesity itself, not just the adverse health effects associated with it, significantly increases the risk of Type 2 diabetes and coronary artery disease. The paper was published ...

Non-coding genetic variant could improve key vascular functions

November 15, 2018
Atherosclerotic disease, the slow and silent hardening and narrowing of the arteries, is a leading cause of mortality worldwide. It is responsible for more than 15 million deaths each year, including an estimated 610,000 ...

Study of two tribes sheds light on role of Western-influenced diet in blood pressure

November 14, 2018
A South American tribe living in near-total isolation with no Western dietary influences showed no increase in average blood pressure from age one to age 60, according to a study led by researchers at Johns Hopkins Bloomberg ...

Heart failure patients shouldn't stop meds even if condition improves: study

November 13, 2018
(HealthDay)—There's bad news for heart failure patients with dilated cardiomyopathy who'd like to stop taking their meds.

Bypass beats stents for diabetics with heart trouble: study

November 13, 2018
(HealthDay)—People with both diabetes and multiple clogged heart arteries live longer if they undergo bypass surgery rather than have their blood vessels reopened with stents, according to follow-up results from a landmark ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.