Study: Southern diet may raise risk of sudden cardiac death

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WATCH: ICD implant saves man's life after cardiac arrest

Switching to a Mediterranean diet might reduce that risk, study finds

The good news is that a Southern diet is delicious and makes us happy.

The bad news is that it might raise the risk of our dying early.

The other good news is that switching to a Mediterranean diet might reduce that risk.

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Sudden cardiac death, which is the abrupt loss of heart function that leads to death within an hour of symptom onset, accounted for 1 in every 7.5 deaths in the United States in 2016, or nearly 367,000 deaths, according to 2019 American Heart Association statistics.

The traditional Southern diet is characterized by added fats, fried foods, eggs, organ meats (such as liver or giblets), processed meats (such as deli meat, bacon and hotdogs) and sugar-sweetened beverages. The Mediterranean diet, on the other hand, is high in fruits, vegetables, fish, whole grains and legumes and low in meat and dairy.

“While 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 that we have some control over,” said James M. Shikany, Dr.P.H., F.A.H.A., the study’s lead author and professor of medicine and associate director for research in the Division of Preventive Medicine at the University of Alabama at Birmingham.

“Improving one’s diet — by eating a diet abundant in fruits, vegetables, whole grains and fish such as the Mediterranean diet and low in fried foods, organ meats and processed meats, characteristics of the Southern-style dietary pattern, may decrease one’s risk for sudden cardiac death,” he added.

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Researchers analyzed data from more than 21,000 people ages 45 and older who were enrolled in an ongoing national research project called Reasons for Geographic and Racial Differences in Stroke (REGARDS), that is examining geographic and racial differences in stroke victims. Participants in this analysis were 56% women; 33% Black adults; and 56% living in the Southeast, which is recognized as the Stroke Belt because of its higher stroke death rate. The Stroke Belt states in this study were Georgia, North Carolina, South Carolina, Tennessee, Alabama, Mississippi, Arkansas and Louisiana.

After nearly 10 years of following up every six months to check for cardiovascular disease events, more than 400 sudden cardiac deaths had occurred among the 21,000 study participants.

The study found:

  • Overall, participants who ate a Southern-style diet most regularly had a 46% higher risk of sudden cardiac death than people who had the least adherence to this dietary pattern.
  • Participants who most closely followed the traditional Mediterranean diet had a 26% lower risk of sudden cardiac death than those with the least adherence to this eating style.
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“These findings support the notion that a healthier diet would prevent fatal cardiovascular disease and should encourage all of us to adopt a healthier diet as part of our lifestyles,” said Stephen Juraschek, M.D., Ph.D., a member of the American Heart Association’s Nutrition Committee of the Lifestyle and Cardiometabolic Health Council. “To the extent that they can, people should evaluate the number of servings of fruit and vegetables they consume each day and try to increase the number to at least 5-6 servings per day, as recommended by the American Heart Association. Optimal would be 8-9 servings per day.

“This study also raises important points about health equity, food security and social determinants of health,” he continued. “The authors describe the ‘Southern Diet’ based on the U.S. geography associated with this dietary pattern, yet it would be a mistake for us to assume that this is a diet of choice. I think American society needs to look more broadly at why this type of diet is more common in the South and clusters among some racial, ethnic or socioeconomic groups to devise interventions that can improve diet quality. The gap in healthy eating between people with means and those without continues to grow in the U.S., and there is an incredible need to understand the complex societal factors that have led and continue to perpetuate these disparities.”

In a 2018 analysis, Shikany and colleagues reported that adults ages 45 and older with heart disease who had an affinity for the Southern diet had a higher risk of death from any cause, while greater adherence to the Mediterranean diet was associated with a lower risk of death from any cause. And in a 2015 study, the Southern diet was linked to a greater risk of coronary heart disease in the same population.

The study was published Wednesday in the Journal of the American Heart Association.

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