Eating a southern-style diet rich in fried food, eggs, organ meats – such as liver – and sugar-sweetened beverages could increase the risk of coronary heart disease, according to the findings of a new study.

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The Southern dietary pattern in the study was characterized by fried food, eggs, organ meats, processed meats and sugar-sweetened beverages.

The study, published in Circulation, explores the relationship between heart disease risk and dietary patterns.

“While individual foods and nutrients (e.g., red meat and saturated fat) have been studied extensively in relation to CHD [coronary heart disease] risk, the relationship between overall diet and CHD risk may be more informative because foods typically are eaten in combination, not in isolation,” the authors write.

Heart disease is currently the leading cause of death in the US. Deaths from coronary heart disease in the US fell by 36% between 1999-2001 and 2008-2010. Despite this decrease, around 1 in 6 deaths in the US in 2010 were attributable to coronary heart disease.

For the study, the dietary habits of more than 17,000 white and African-American adults aged 45 and older were compared using data obtained from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.

Participants were enrolled between 2003 and 2007. Each participant was screened by telephone before undergoing a physical exam and completing a food frequency questionnaire about their food consumption over the previous year. People with pre-existing heart disease were excluded from the study.

Over the course of the study, participants were followed up every 6 months with a phone interview, during which they were questioned about their health status. The follow-up period ran for nearly 6 years.

The researchers grouped different types of food regularly eaten by the participants into five different dietary patterns:

  • “Convenience” – pasta dishes, pizza, Mexican and Chinese food
  • “Plant-based” – vegetables, fruits, cereal, beans, fish, poultry and yogurt
  • “Sweets” – sugars, desserts, chocolate, candy and sweetened breakfast foods
  • “Alcohol/salads” – beer, wine, liquor, green leafy vegetables, tomatoes and salad dressing
  • “Southern” – fried food, eggs, organ meats, processed meats, added fats and sugar-sweetened beverages.

The Southern diet is so called as it reflects a culinary pattern often observed in the southeastern US, particularly around states that comprise the Stroke Belt: Alabama, Arkansas, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Virginia.

In the Stroke Belt – which also includes the state of Indiana – stroke death rates are more than 10% higher than the national average. The Southern diet has also been associated with an increased risk of stroke in previous research.

The researchers found that participants who ate foods from the Southern dietary pattern the most had a 56% higher risk of coronary heart disease than those who ate these foods less frequently. None of the other dietary patterns were linked with the risk of heart disease in any way.

Participants most likely to follow the Southern diet were male, African-American, people who had not graduated from high school and the residents of the Stroke Belt.

Lead researcher James M. Shikany, a nutritional epidemiologist at the University of Alabama at Birmingham, says that people who frequently eat a Southern-style diet should be aware of the risk of heart disease and try to make gradual changes to their diet, regardless of gender, race or where they live.

“Try cutting down 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,” he suggests.

Last month, a report from the Centers for Disease Control and Prevention (CDC) concluded that Americans are not meeting national recommendations for consumption of fruits and vegetables. Specifically, they found that 13.1% of adults eat enough fruits and 8.9% eat enough vegetables.