July 9, 2021 -- A large study shows that eating a diet high in fat, fried foods, processed meats, and sugary drinks is linked to a higher risk of sudden cardiac death, a common cause of death in the U.S.

The research, published June 30 in the Journal of the American Heart Association, examined the dietary patterns of more than 21,000 people 45 years old and older. The research took place over 18 years in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.

In the study, the dietary patterns were named for the groupings of various foods that dominated the pattern. For example, the "Convenience" pattern relied on mixed dishes, pasta, pizza, Mexican, and Chinese food. The "Plant-based" pattern favored vegetables, fruits, fruit juice, cereal, beans, fish, poultry, and yogurt. The "Sweets" pattern loaded up on added sugars, desserts, chocolate, candy, and sweetened breakfast food. The "Southern" pattern included added fats, fried food, eggs and egg dishes, organ meats, processed meats, and sugar-sweetened beverages, reflecting a culinary pattern observed in the Southeastern U.S. Finally, an "Alcohol and Salad" pattern loaded highly on beer, wine, liquor, green leafy vegetables, tomatoes, and salad dressing.

These patterns weren’t mutually exclusive; those who had an affinity for the Southern-style diet also ate fewer plants, for instance.

After adjusting for other factors that may impact risk, the study authors found that those who ate a Southern-style diet showed a trend toward a higher risk of sudden cardiac death at 46% compared to those who ate this kind of diet the least. Meanwhile, the study also revealed that eating a traditional Mediterranean diet was associated with a 26% lower risk for sudden cardiac death.

Lead study author James Shikany, DrPH, professor of medicine at the University of Alabama at Birmingham, says the results suggest that diet is a factor we have some control over when it comes to reducing the risk of sudden cardiac death.

“I hope this is another piece of the puzzle that will help people make changes,” he says. “So instead of eating meat once or twice a day they’ll cut down to two or three times a week; I like small, incremental changes as those are more likely to last.”

­­­To make lasting changes, however, Stephen Juraschek, MD, PhD, a member of the American Heart Association’s Nutrition Committee of the Lifestyle and Cardiometabolic Health Council, suggests focusing on two areas.

“We should all think about ways we can increase the number of servings of fruit and vegetables we eat each day,” he says. “We [also] need to cut down our salt exposure by eating more meals at home and avoiding high-salt products or meal preparation with a lot of salt.”

Juraschek says the study results also reveal disparities in dietary patterns that may result from supply chains, access to healthy foods, and cultural practices.

“In order to improve diet population-wide, we need to look beyond individual choices and focus on the population drivers of unhealthy eating,” he says. “Access to healthy fruits and vegetables is a major challenge for rural and urban communities, as well as communities with lower socioeconomic status where processed, comfort foods are often less expensive than fruit and vegetables.”

This latest research is the last of a three-part series exploring links between the Southern-style diet and potential health risks.

In 2018, Shikany and his colleagues reported that adults ages 45 and older with heart disease who had an affinity for the Southern-style diet had a higher risk of death from any cause. Opting for a Mediterranean diet, meanwhile, resulted in a lower risk of death from any cause.

In a 2015 study, the Southern-style diet was linked to a greater risk of coronary heart disease in the same population.

Show Sources


Stephen Juraschek, MD, PhD, American Heart Association’s Nutrition Committee of the Lifestyle and Cardiometabolic Health Council.

Dietary Patterns, and Risk of Sudden Cardiac Death in the REGARDS Study," "Southern Dietary Pattern Is Associated With Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study," "Dietary Patterns and Mediterranean Diet Score and Hazard of Recurrent Coronary Heart Disease Events and All‐Cause Mortality in the REGARDS Study."

James Shikany, DrPH, professor of medicine, University of Alabama at Birmingham. 

© 2021 WebMD, LLC. All rights reserved. View privacy policy and trust info