In a new study, researchers have found a positive association between the Southern diet — which involves more fried food and sugary drinks — and sudden cardiac death. They also linked the Mediterranean diet to a reduced risk of sudden cardiac death.
The research, which appears in the Journal of the American Heart Association, offers further evidence of the importance of diet to cardiovascular health.
Heart health and diet
Death certificates show that sudden cardiac death is a factor in 1 in 7.5 deaths in the United States. A key underlying cause is coronary heart disease.
According to the Office of Disease Prevention and Health Promotion (ODPHP)Trusted Source, a person can improve their heart health by changing their diet. The ODPHP suggests that people eat a variety of fruit and vegetables, low fat dairy, whole grains, a variety of proteins, and unsaturated fats.
Research has shown that the Mediterranean diet, which focuses on legumes, vegetables, fruits, fish, and grains, can be protective against cardiovascular disease.
Researchers have also identified an inverse link between the Mediterranean diet and sudden cardiac death. However, the study had significant limitations, as it included a hugely disproportionate number of white participants and focused primarily on women.
More than 20,000 participants
In the present study, the researchers drew on data from the Reasons for Geographic and Racial Differences in Stroke Study cohort in the U.S. This cohort consists of 30,239 African American and white adults aged 45 years or older, who all joined the study between 2003 and 2007.
The researchers excluded participants who were missing appropriate recorded information or were unavailable at follow-up. This left them with a sample size of 21,069 for the current analysis. Of these participants, 33% were Black, and 56% were women.
A total of 56% of the participants lived in the Southeastern United States. This area is known as the Stroke Belt because it has had a higher-than-normal rate of death due to stroke since the 1940s.
The researchers took background health and demographic information from the participants at baseline and asked them to complete a food frequency questionnaire each year to show how many of 110 different food items they had eaten during the previous 12 months.
Looking at this data, the researchers were able to give each participant a Mediterranean diet score, reflecting their adherence to the Mediterranean diet.
The researchers were also able to identify five dietary patterns:
- The convenience pattern: This dietary pattern primarily consisted of pasta, pizza, and Mexican and Chinese food.
- The plant-based pattern: People following this pattern ate lots of vegetables, fruits, cereals, legumes, yogurt, chicken, and fish.
- The sweets pattern: This pattern included high amounts of dessert, candy, chocolate, and sugary cereal.
- The Southern pattern: The Southern diet is high in fried foods, sweetened drinks, processed and organ meats, and eggs.
- The alcohol and salad pattern: People following this pattern consumed lots of leafy greens, dressings, tomatoes, and alcoholic drinks.
According to lead author Prof. James M. Shikany, who is a professor of medicine and associate director for research in the Division of Preventive Medicine at the University of Alabama at Birmingham, “All participants had some level of adherence to each pattern but usually adhered more to some patterns and less to others.”
“For example, it would not be unusual for an individual who adheres highly to the Southern pattern to also adhere to the plant-based pattern but to a much lower degree.”
The researchers attempted to contact the participants approximately every 6 months over a 10-year period, which enabled them to record any cardiovascular events, including sudden cardiac death. During this period, there were 401 recorded instances of sudden cardiac death.