Is Southern Food Unhealthy?

Along with fried chicken, some traditional Southern cooking serves up heart disease. But dishes with greens, sweet potatoes, and heirloom vegetables can be healthy.

Sitting down to a meal of fried chicken, mashed potatoes rich with butter and gravy, rolls served with gobs of butter, black-eyed peas cooked with salty pork fatback, and iced tea loaded with sugar is a Southern tradition. For many people, this type of fare is simply part of life.

The state of Alabama has loads of families and restaurants serving up Southern-style meals regularly. Unfortunately, heart disease is the number one cause of death in that state, according to the Alabama Department of Public Health. A diet relying on a lot of traditional Southern cooking likely plays an important role in this statistic.

YOU MIGHT ALSO LIKE: Dietary Guidelines for Americans Through 2025

Most cardiovascular disease is highly preventable, the Alabama public health officials note. A top way to lower the odds of being a heart attack statistic is to eat healthier, including giving up, or dramatically changing, much traditional Southern fare.

A study from the University of Alabama revealed some unappetizing facts about unhealthy meals that could hopefully inspire more people in the South — or anywhere — to make better dietary choices.

The researchers examined data on 17,000 people of diverse racial and economic backgrounds living in different areas of the U.S. who participated in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Surveys over the course of about six years documented what kinds of food and how much the research subjects ate.

The participants, who had no known heart disease at the start of the study, were also interviewed every six months over the course of the study about their health and whether they were hospitalized for any reason.

Several main dietary patterns emerged. Some people ate mostly convenience diets centered around pasta, Mexican and Chinese food, and pizza. Others had plant-based diets consisting primarily of fruits, vegetables, cereal, beans, yogurt, poultry, and fish. Some research participants ate diets heavy with desserts, chocolate, candy, and sweetened breakfast foods. Another group consumed a lot of green leafy vegetables, tomatoes, and salad dressings along with alcohol.

But it was the Southern diet — characterized by added fats, fried food, processed meats, organ meats, egg dishes, and sugar-sweetened beverages — that sounded an alarm for the researchers. It was the only dietary pattern strongly associated with risk of heart disease.

Southern-style eating boosted the risk of heart attacks by 56 percent. In fact, those who regularly ate the traditional Southern way were far more likely to have a heart attack or to die from a heart-related event over the next 5.8 years than people who ate typical Southern dishes rarely or not at all.

"Regardless of your gender, race, or where you live, if you frequently eat a Southern-style diet you should be aware of your risk of heart disease and try to make some gradual changes to your diet," said UAB cardiovascular and nutritional researcher James M. Shikany, DrPH, who headed the study.

"Try cutting down the number of times you eat fried foods or processed meats from every day to three days a week as a start, and try substituting baked or grilled chicken or vegetable-based foods."  

This isn’t the first time the South has been linked to a high risk health problem — and diet is suspected to play a role. The high sodium and high calorie Southern-style of eating can increase high blood pressure and add extra pounds, contributing to stroke risk. The incidence of stroke, the number five killer of Americans, is so elevated in the southeastern states that the region is known as the Stroke Belt.

The stroke risk associated with living in the South may start fairly early in life. A study funded by the National Institute of Neurological Disorders and Stroke found people who resided in the South between the ages of 13 and 18 had a 17 percent higher risk of stroke as adults than those who spent no time living in the region.

The explanation for the stroke risk developing in the teen years likely involves unhealthy lifestyles — including eating patterns — established while young people live in the South, according to the study’s lead investigator, UAB professor of public health Virginia J. Howard, PhD.

In addition to containing lots of salt and calories, another way traditional Southern dishes could be potentially dangerous to health involves how they are cooked, often by frying. Frequent consumption of fried chicken and other deep fried favorites increases your risk of high blood pressure, a study by researchers at the University of Navarra in Spain found. Harvard scientists have also linked eating fried foods to type 2 diabetes and coronary artery disease.

If you don’t want to give up favorite Southern dishes, there are ways to make healthy versions. Southern food does have roots in plant-based dishes. Greens, sweet potatoes, and heirloom vegetables never went out of style in non-fast-food restaurants and are increasingly listed on Southern menus.

The National Heart, Lung, and Blood Institute has a large online data base of free recipes, including healthier Southern favorites.

YOU MIGHT ALSO LIKE: Why Does Diet Advice Keep Changing?