Experts: Southern diet serves up health risks
Chandra Hill, a member in Palmetto, Fla., says she gained 60 pounds since moving from Canada to Florida seven years ago. Much of that she owes to changes in how she eats, including fattier fare at home and in restaurants, in addition to being more car reliant, and walking less than when she lived in Canada.
At upwards of 257 pounds, Hill says she recently sustained compression fractures in her spine because of excess weight. In February, she underwent bariatric surgery after six months of preparation, which included dietary changes. She hopes to shed a total of 100 pounds in the next couple of years. “I needed the surgery ... because the more I weighed, the more chance [my spine] would break,” Hill says. “I really didn’t want to end up in a wheelchair.” The procedure was just the beginning as Hill says she’s made dramatic dietary changes to meet her lofty weight-loss goals, along with working out and walking her dog daily. That includes trading in barbecue, beefy lasagna and the like for baked fish and veggie soup.
In February, researchers from the University of Alabama at Birmingham presented a study at the American Heart Association’s International Stroke Conference in Hawaii showing traditional Southern fare, from potatoes and okra to bacon, ham hocks, and sweet tea, significantly raises the risk of stroke. This punctuated a point that the high fat, high salt, high sugar diet can lead to a wide range of problems, from heart attack and diabetes to ulcers and even cancer. Stopping short of calling for complete abandonment of regional culinary customs, dietitians, neurologists, cardiologists and other health professionals say a major overhaul of the diet is required.
“A diet based on Southern food is not going to be a healthy diet,” says Avary Kerestes, a registered dietitian with highly rated Florida Hospital Carrollwood in Tampa, who sees the ill-effects of a poor diet firsthand. She recommends a diet that’s mostly plant-based, but remains realistic about the difficulty of changing old recipes, adding that minor tweaks — such as replacing a portion of oil in baking recipes with applesauce — can help, too.
“There are strategies to enjoy regional and ethnic foods, but there are healthier ways to go at it,” adds Dr. Patrick Cambier, a highly rated interventional cardiologist at The Heart & Vascular Institute of Florida in Clearwater. Still, he takes some issue with the study’s framing and targeting the Southern diet, emphasizing that just because a person doesn’t eat fried fish and the like doesn’t mean they’re off the hook. “We don’t want to impugn a region as bad eating ... An unhealthy diet is rampant, and not just in the Tampa Bay area, but across the United States,” Cambier says, pointing to the nation’s struggles with obesity.
Even so, dietary findings go a long way toward explaining Reasons for Geographic and Racial Differences in Stroke, or REGARDS, the larger study within which the UAB research fits, says study leader Suzanne Judd. Along with regional differences, African-Americans report a higher rate of adherence to the traditional Southern diet and suffer higher rates of stroke. While the effect extends across state and regional lines, the diet, not surprisingly, remains rooted in the Southeast, a region that sees a disproportionately high number of strokes. “The South is known as the Stroke Belt,” says Dr. Michael Franklin, a highly rated neurologist with St. Anthony’s Medical Group in St. Petersburg. He says diet plays a significant role in that.
“The food’s good ... I eat it,” he says. But as a physician who sees stroke patients, Franklin can’t stress enough the need to change diet as a preventive measure. “I’ve seen the worst. We don’t want to see you die, we don’t want to see you disabled … Stroke is the No. 1 physically disabling illness in the United States,” Franklin says.
Experts say it’s important to identify problematic foods, such as processed meats like bacon and sausage — which are also associated with an increased risk of cancer — and limit how often you eat them, as well as reducing portion sizes. Judd says the Southern diet doesn’t appear harmful in small amounts. “But it’s important to [only] consume it once or twice a month — the group with the highest risk consumed it about every single day,” she says.
Judd recommends cutting back slowly at first to cement long-term change, and focusing on food preparation methods. “The Southern diet is high in fish ... [which] can be very heart healthy,” she says, if they’re baked as opposed to fried.
Chandra Hill remains committed to eating healthier and continues to shed pounds following laparoscopic band surgery that cost an insurance-negotiated rate of $14,973, of which she paid $1,747 out-of-pocket. It physically restricts what and how much she’s able to eat. But it’s up to her to follow-through on dietary changes. “My husband is prepared to help me by eating what I eat,” she says. “That support will be my biggest tool to change how I eat and see food.”