Chicken-fried steak. Deep-fried gizzards. Candy-sweet tea.
Consider these delicacies, and it's easy to see how the Deep South garnered its unfortunate distinction as the "Stroke Belt."
Now, researchers have drawn the strongest link yet between these kinds of foods and risk of stroke.
University of Alabama at Birmingham researchers found that people who regularly ate foods traditionally found in the southern diet had a whopping 41 percent increased risk of stroke -- and in African-Americans, it was 63 percent higher risk.
The researchers presented these results Thursday at the annual International Stroke Conference in Hawaii.
"Diet is an understudied risk factor for stroke," said lead study author Suzanne Judd, PhD, of the University of Alabama at Birmingham. "What was surprising about what we found was that when eating certain foods in the southern diet -- fried foods, organ meats, gizzards, sweet tea -- even when you account for other factors such as smoking, obesity, and physical activity, people still experienced a 30 percent increase in stroke risk."
The researchers looked at more than 20,000 black and white study participants who were over 45 years old as part of the study, termed the Reasons for Geographic and Racial Differences in Stroke -- or REGARDS for short. They asked subjects to detail their weekly diet habits, focusing on 56 different types of food.
The subjects then underwent a complete medical evaluation, including a physical exam and blood tests. They were followed over a period of nearly five years at regular six-month intervals, during which researchers tallied the number of strokes these people experienced.
What they found was that foods common in the southern-style diet, such as deep fried foods, processed meats, and sugary beverages, significantly increased stroke risk.
"We've known that diets high in saturated fats and deep fried foods and low in fruits and vegetables are tied to greater health risks," said Keith Ayoob, director of the nutrition Clinic at Rose F. Kennedy Center, who was not involved with the study.
The good news, however, is that the Southern diet is not all bad -- and some staples of Deep South cuisine may even cut stroke risk.
"There are other foods in the Southern-style diet which are good," study author Judd said. "Collard greens, for example. Just having a little more whole grains, fruits and vegetables, and lean protein sources -- chicken without the skin, fish that isn't fried -- gives you an across-the-board 20 percent reduction in stroke risk."
Ayoob said no matter the cuisine, the advice remains the same.
"What would I tell my patients? Eat plenty of fruits and vegetables, whole grains and low fat dairy, because those are things people are missing from their diets," he said. "People are not getting in trouble for what they're eating, they're getting in trouble for what they're not eating."
REGARDS is funded by the National Institute of Neurological Disorders and Stroke (NINDS).