The Stroke Belt Connection: Southern High Salt and High Fat Diets

What is the “Stroke Belt?”"Stroke Belt: Southern diet explains the increase in high blood pressure among African Americans and others living in the stroke belt region."

The South is known as the “stroke belt,” and a new study reinforces one of the key reasons why: its diet.

According to researcher Suzanne Judd, PhD, a nutritional epidemiologist at the University of Alabama at Birmingham, those who ate a “Southern diet” about six (6) times a week had about a 30%,  or one third higher risk of stroke than those who ate it about once a month.

Two main reasons for high stroke risk are hypertension (high blood pressure), which occurs more with high salt (sodium) diets, and arteriosclerosis (atherosclerosis), which occurs more with high fat and cholesterol diets. In other words, these diets are the key connection to ”The Stroke Belt”.

The study included more than 30,000 people ages 45 and older, and there were an equal number of African-American and white people.

Study participants filled out detailed food questionnaires. From these responses, researchers came up with five (5) dietary patterns:

  • Convenience: Mexican and Chinese food, and mixed dishes with both meat and beans.
  • Plant-based: fruit, vegetables, fruit juices, cereal, fish, and poultry.
  • Sweets: added fats, bread, chocolate, desserts, and sweet breakfast foods.
  • Southern: added fats, fried foods, organ and processed meat, and fatty milk.
  • Alcohol: beer, wine, liquor, green leafy vegetables, salad dressings, nuts and seeds, and coffee.

In addition to being high in fried foods like chicken, liver, ham, and potatoes, the Southern diet includes lots of high-fat dairy, eggs, added salt, and sweetened beverages.

Previous studies have shown a 2 to 4 times-higher risk of stroke among young African-Americans compared to young whites, Judd says. In this new study, the Southern diet explains about 63% (or nearly two-thirds) of the racial differences in stroke risk.

Judd says, “To me, the really interesting part of the study is that diet explains so much of the racial differences in stroke risk between African-Americans and whites.”

Judd and her colleagues also ranked people according to how well they maintained a plant-based diet. The groups that followed this diet the most showed a 20% lower risk of stroke. “As long as you were eating some (of the plant-based diet), it looked like it was protective,” she says.

What can all of us do to lessen the risk of stroke?

  • Only enjoy fried chicken, collard greens in bacon grease, and other traditional Southern foods, once a month.
  • Eat more vegetables, without the added meat or grease.
  • Grill, don’t fry!
  • When you eat out, remember that “sautéed” means “fried.”
  • Avoid  Chinese/Asian “all-you-can-eat buffets”, because those foods are stir-fried or deep –fried in oil.
  • Likewise, avoid or seriously limit fried fast food .  Yes, that means fried chicken, hamburgers, chicken fingers, and other high-fat, high-salt choices.

Here are links on the Health Power website for more information to help you adopt and maintain a healthy lifestyle:

Healthy High Blood Pressure Recipes


Heart Disease


Food and Fitness Channel

Tip Sheets for Healthy Living


Health Power Questions:

What do you think?  How can we honor our roots and still live healthier?  Do you have any hints to share?

What two other conditions do you think are closely linked to Southern diets?

What areas in the U.S. other than the South have large numbers of residents that eat high salt, high fat and high cholesterol diets?

Remember, Knowledge + Action = Power®

By Guest Blogger, Connie Jones

Source of report on Dr. Judd’s research:, as presented at the International Stroke Conference in Honolulu, Hawaii.

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