Study underlines hazards of Southern diet, but there are ways to cut back

What's so bad about Southern food? All the fried and high-fat foods, processed and organ meats, eggs and egg dishes and sugary drinks.

You know the ones: fried chicken, ribs, ham, bacon and sausage; fried liver and onions; deviled eggs; cheese grits; buttered biscuits and corn bread; greens and beans seasoned with ham hocks or drippings; fried okra and gravy-smothered mashed potatoes, all washed down with tall glasses of sweet tea or soda.

Eat these foods almost every day and you increase your risk of heart disease or a heart-related death within five to six years, according to the heart association study, which tracked the effects of the Southern diet on whites and African-Americans ages 45 and older.

Earlier research also linked a Southern diet with an increased risk of stroke. "It's not shocking that Southern fare might lend itself to a higher risk of heart disease, we've known that," said St. Anthony's Hospital-BayCare registered dietitian Dianna Thomas. "But now we can say this new study followed a large group of people over time, and their diet correlated with higher risk for heart disease."

Study participants who frequently ate the Southern way had a 56 percent higher risk of heart disease compared to those who ate it less frequently. The study, published in August in the AHA journal, Circulation, followed 17,000 people for almost six years.

Thomas says the results could prompt people to make important changes that will benefit their hearts and waistlines.

"It's not that you have to eliminate traditional Southern fare, it's practice moderation," she said. "Some of these foods would be best if they were special occasion foods."

Thomas also recommends that people adopt a few small changes in the way they cook, such as choosing low-sodium canned or packaged foods, reducing consumption of Southern favorites from daily to a few times a week, then less often, and generally eating less fat and sugar. Simple changes can have a big impact.

"A healthy diet and lifestyle are the best weapons to fight against heart disease," Thomas said.

Here's a look at the Southern diet and how it can hurt you:

MEATS AND FISH

There is no shortage of protein on the Southern table -- from crispy fried chicken and golden fried fish fillets to country fried steak, sweet glazed ham, ribs, sausages (including hot dogs) and deli meats.

Benefits: Most lean cuts trimmed of visible fat start out as a healthy choice and provide important nutrients that may include iron, vitamins A, B and D, magnesium, niacin, folic acid, potassium, selenium and zinc.

What goes wrong: Once you cover the meat with a traditional Southern "dip" in egg or buttermilk, flour, crumbs or cornmeal -- and then cook it in an inch or so of fat -- you've created a less-healthy, high-calorie grease bomb. Cured and smoked sausages and regular processed meats may also be loaded with fat, sodium and cholesterol.

VEGETABLES

Green beans, black-eyed peas, fresh corn, mashed potatoes, sweet potatoes, rice, greens, tomatoes, okra.

Benefits: All vegetables start out good for you -- low in calories, virtually fat- and cholesterol-free, naturally low in sodium and high in fiber and nutrients.

What goes wrong: In the Southern kitchen they're likely to be cooked with ham hocks, fat back or bacon. Or breaded and fried like chicken. Or sweetened with sugar (coleslaw, greens, stewed tomatoes, sweet potato casserole). Or mixed with whole milk, gobs of butter, mayonnaise, plenty of seasoned salt and served with gravy.

BEVERAGES

Two words: sweet tea. A staple on the Southern table.

Benefits: Plain tea starts out as a calorie-free cooler with properties and antioxidants that may ward off cancer, heart disease and dementia, especially if you're partial to green tea.

What goes wrong: Too often, tea ends up as a tall glass of flavored brown sugar water, with a slice of lemon on top. Sodas -- whether cola, grape, orange or cherry -- are just as sweet with no health benefits and loads of sugary calories. Diet beverages aren't much better because research suggests they actually make you crave and consume more sweets and more calories later in the day. Drinking juice instead may make you feel better about your beverage choice, but it can be higher in calories than soda. (Eat the whole fruit.)

ALCOHOL

When you're not sipping sweet tea or soda, it's not uncommon to find beer, wine and those now popular cider-laced alcoholic beverages in the cooler. Nearby, there may be a bottle of bourbon or rum. Captain and Coke anyone?

Benefits: While fat-free and often low in added sugar, a small amount of alcohol a few times a week has been touted as heart healthy for its HDL cholesterol-lowering properties. A small glass of red wine each day is also thought to help the heart and digestion.

What goes wrong: One drink turns into several. Sweetened mixers are loaded with calories and carbs. Too much alcohol is bad for your liver and raises triglycerides -- as do excess carbohydrates and sugar. Triglycerides, like cholesterol, are a type of fat in your blood that contribute to heart disease and stroke risk. Think of alcohol as calories without nutrients.

BREADS

You can't get more Southern than a buttery biscuit dripping with honey. Unless it's corn bread dripping with butter and honey.

Benefits: Even if you opt for a simple white dinner roll, the bread basket usually delivers some nutrients, including fiber, potassium, B vitamins and a little calcium.

What goes wrong: It's generally what you put on top that packs on the pounds. (Use margarine rather than butter? It's still fat and adds 70 to 100 calories to an already 200-plus-calorie biscuit or square of corn bread.) And, don't be smug about choosing that cupcake masquerading as a healthier muffin. There's a reason it's so moist, sweet and delicious.

DESSERTS

Banana pudding, fruit, pecan and sweet potato pies, red velvet cake, rocky road brownies, pralines and peanut brittle. Southerners love their sweets.

Benefits: Many of these treats actually contribute some important vitamins and nutrients, including fiber, calcium and potassium -- thanks to ingredients like nuts, milk, pumpkin, sweet potatoes and zucchini. But make no mistake: Desserts are not health foods.

What goes wrong: Fillings, frostings and crusts are laden with cups of sugar, butter and whole eggs. Whipped cream and ice cream are often considered a must. And many recipes call for puffy, bronzed marshmallows to dot the top.

The Fix 

You don't have to give up your favorite Southern foods. (Even I can't imagine life without fried chicken.) Just make a few easy swaps and limit how often you indulge. Here are some tips:

* Go for the leanest cuts of beef, chicken and pork -- meat with the word loin in its name. Tenderloin or sirloin, for example, is usually a good bet. So is skinless, white-meat poultry.

* Limit bacon, ham, sausage, bologna and other processed, cured or smoked meats to special occasions or about four to six times a year. If you don't want to go that far, try reduced-sodium varieties and choose lean ham or, even better, Canadian bacon instead of bacon and sausage.

* Add flavor to the cook pot with low-sodium ham-flavored bouillon cubes, or choose smoked turkey necks or wings instead of whole ham hocks, fat back, bacon and drippings. Herbs and salt-free spices are often underused and provide lots of flavor.

* Limit fried foods to one meal, once a week -- or, better yet, just twice a month. Included in that quota are french fries, fried chicken, fried okra, fried eggs and chips. You get the idea.

* Can't imagine giving up butter? At least cut the amount in half or switch to whipped butter. When you're ready, try a heart-healthy margarine and use just a dab.

* Make friends with fresh fruit. Southerners love ice cold watermelon. It's a keeper. Learn to enjoy peaches that aren't in a pie, strawberries without the shortcake, bananas sans vanilla wafers and pudding. While we're on the subject, fruit is almost always a better choice than juice. But juice diluted with sparkling water may help you kick a soda habit.

* When faced with a bread basket devoid of whole grains, the standard white dinner roll probably does the least damage, followed by corn bread. Treat biscuits as a special treat. Then, it's all about what you put on top. Try it plain. (You can do it.) And watch out for muffins, which really are naked or streusel-topped cupcakes that can rack up 200 to 300 calories each, if standard size. Those oversized monsters are closer to 500 calories.

* If you can't resist traditional desserts, then learn portion control. Stick to just one slice or one moderate serving of one dish, and find someone to share it with. Go topless (meaning no dollop of ice cream or whipped cream), and never allow yourself more than one dessert at a meal.

Spicy Oven-Fried Chicken 

I have to admit this wasn't my favorite dish, and it won't take the place of real fried chicken, but some of you might like it, or might want to tinker with it to make it your own lower-impact alternative. Skinless chicken cutlets or tenders (about 2 per serving) are an easy way to get 4-ounce portions of chicken breast. I found boneless, skinless chicken thighs juicier and worth the extra calories and fat grams. Also, the chicken came out a little more crispy when baked in a 400-degree oven on a rimmed baking sheet with low sides, and when I substituted panko crumbs for the cornflakes, again, for a few extra calories. In my home oven, the chicken was done in 20 minutes.

Cooking spray

¼ cup low-fat buttermilk

¼ cup cornflake crumbs (place flakes in a closed zip-top bag and crush with a rolling pin, then measure the crumbs)

¼ cup yellow cornmeal

2 tablespoons all-purpose flour

1 teaspoon salt-free spicy seasoning blend

1 teaspoon garlic powder

½ teaspoon paprika

¼ teaspoon cayenne, or to taste

¼ teaspoon salt

1/8 teaspoon dry mustard

4 boneless, skinless chicken breast portions, 4 ounces each, all visible fat discarded, or 4 (4-ounce) well-trimmed boneless, skinless thighs

Preheat oven to 375 degrees. Line a low-sided, rimmed baking sheet with parchment paper and spray paper with cooking spray.

Pour buttermilk in a shallow dish or pie pan.

In another shallow dish, stir together the cornflake crumbs, cornmeal, flour, seasoning blend, garlic powder, paprika, cayenne, salt and dry mustard.

Dip chicken in buttermilk and run fingers down the sides of the chicken to remove excess. Then dip chicken in crumb mixture, pressing coating so it sticks. Place chicken pieces on prepared baking sheet. Spray with cooking spray. Bake 20 to 30 minutes, turning once after 12 minutes. Bake until the chicken is no longer pink in the center or reaches an internal temperature of 165 degrees.

Serves 4.

Nutrition information per serving, using cornflake crumbs and chicken breast (using chicken thighs adds about 25 additional calories per serving; panko crumbs add about 25 additional calories per serving): 195 calories, 1.5g total fat, 0.5g saturated fat, 66mg cholesterol, 264mg sodium, 16g carbohydrates, 1g fiber, 28g protein.

Source: adapted from Low-Salt Recipes, 2013, American Heart Association, published by Publications International, Ltd.

Pork Chops With Balsamic-Peach Glaze

Roasted Sweet Potatoes and Broccoli 

Nonstick cooking spray

¼ cup balsamic vinegar plus 1 tablespoon balsamic vinegar, divided use

2 cloves fresh garlic minced or 2 teaspoons jarred, minced garlic

1 tablespoon olive oil

4 thinly sliced top loin pork chops, about 4 ounces each

1 small head broccoli cut into bite-sized pieces, about 2 cups of florets

2 small sweet potatoes, peeled and cut into small chunks, about 2 cups

¼ teaspoon chili powder

½ teaspoon black pepper plus ½ teaspoon, divided use

1 cup thawed and chopped, unsweetened frozen peaches (see note)

½ cup sugar-free peach preserves

Cayenne pepper, to taste (optional)

1 tablespoon fresh thyme leaves or 1 teaspoon dried thyme

Preheat oven to 350 degrees.

Line a large rimmed baking sheet with parchment paper and coat with cooking spray.

In medium mixing bowl, whisk together ¼ cup balsamic vinegar, garlic and olive oil. Measure out half of this mixture and set aside for vegetables. To remaining half of vinegar mixture, add pork chops. Turn to coat with marinade. Cover and chill for 15 to 30 minutes.

In large mixing bowl, combine vegetables, chili powder, ½ teaspoon black pepper and reserved vinegar mixture. Toss thoroughly to coat all vegetables. Spread vegetables in one layer on prepared baking sheet. Transfer to oven and roast for 35 to 40 minutes or until potato is soft and broccoli begins to crisp. (Cover loosely with foil if vegetables are browning too quickly.)

In medium pan over medium-low heat, stir together 1 tablespoon of balsamic vinegar, peaches, peach preserves, cayenne pepper, if using, and thyme. Heat, stirring frequently until sauce begins to simmer. Set aside and keep warm.

Remove chops from marinade and discard remaining liquid. Season chops with remaining black pepper. Heat a large skillet over medium heat. Coat with cooking spray and add pork chops, cooking 2 to 3 minutes on each side until cooked through.

Serve one chop with 1 cup vegetables and ¼ of sauce drizzled over each.

Serves 4.

Note: You can use fresh peaches in this recipe in place of frozen. Just peel and remove the pit first and cook the peaches in the sauce until softened.

Nutrition information per serving: 346 calories, 6g total fat, 1.5g saturated fat, 75mg cholesterol, 113mg sodium, 44g carbohydrates, 4g fiber, 28g protein.

Source: adapted from the American Heart Association's Simple Cooking With Heart Program, 2015

Baked Cajun Catfish and Easy Collard Greens 

For the catfish:

1 tablespoon vegetable or olive oil

½ teaspoon garlic powder

½ teaspoon onion powder

¼ teaspoon black pepper

½ teaspoon cayenne pepper, or to taste

1½ teaspoons paprika

1 teaspoon fresh thyme leaves or ½ teaspoon dried thyme

Nonstick cooking spray

4 catfish fillets or any white fish such as tilapia

For the collard greens:

1 bunch collard greens (see note)

1 tablespoon vegetable or olive oil

½ small onion, thinly sliced

1 teaspoon jarred, minced garlic

½ teaspoon sugar

½ teaspoon red pepper flakes, or to taste

1 tablespoon cider vinegar

2 tablespoons water

1 slice cooked Canadian bacon, diced (may be cooked briefly in microwave)

For the fish: Preheat oven to 425 degrees. In a shallow bowl, combine oil, garlic powder, onion powder, pepper, cayenne, paprika and thyme. Line a rimmed baking sheet with low sides with parchment paper and spray paper with cooking spray. Dip fish fillets in seasoning mixture and place on baking sheet. Sprinkle remaining seasoning over top.

Bake at 425 degrees for 15 minutes or until fish flakes.

For the collard greens: Rinse greens under running water. Blot lightly with paper towels. Remove stems or central rib from larger leaves by cutting down each side of the tough rib and pulling the leaf off. You can skip this step with tender, inner leaves, if desired. Stack 8 or so leaves together, roll up tightly and slice into 1-inch pieces.

Heat oil in large skillet on medium heat. Add onion and cook until translucent, about 3 minutes, stirring occasionally. Add garlic and cook about 30 seconds more. Add greens, sugar, red pepper, vinegar, water and Canadian bacon. Stir together. Cover and cook until tender, about 20 minutes.

Divide among 4 plates and serve with baked fish.

Serves 4.

Note: You can substitute one bag of prewashed chopped greens for fresh collard greens.

Nutrition information per serving: 218 calories, 11g total fat, 1.5g saturated fat, 69mg cholesterol, 235mg sodium, 7g carbohydrates, 4g fiber, 22g protein.

Source: adapted from the American Heart Association's Simple Cooking With Heart Program, 2015