Field Notes

Southern-Style Diet Patterns Increase Heart Disease Risk

Previous research from the University of Alabama at Birmingham has shown that regularly consuming a “Southern-style” diet of fried foods, processed meats, foods high in fat, and sugar-sweetened beverages can lead to an increased risk of both stroke and death for chronic kidney disease patients.

The latest research, published in Circulation, an American Heart Association journal, reaffirms that regularly consuming such a diet also could raise the risk of heart disease—including heart attack and heart disease-related death.

Using data from the Reasons for Geographic and Racial Differences in Stroke, or REGARDS, study, a national, population-based, longitudinal study of white and black adults, the research team derived five dietary patterns using data from 17,418 participants: convenience, plant based, sweets, Southern, and alcohol and salad.

Participants were placed into categories of adherence to these dietary patterns, and comparisons were made between those who consumed each pattern the most to those who consumed each pattern the least. The Southern-style dietary pattern saw the biggest increase in risk of heart disease.

“People who most often ate foods conforming to the Southern-style dietary pattern had a 56% higher risk of heart disease compared with those who ate it less frequently,” says lead study author James M. Shikany, DrPH, a professor in the division of preventive medicine.

Shikany adds that no other dietary pattern was associated with heart disease risk.

“I’m not surprised regular consumption of a Southern-style diet impacts heart disease, but the magnitude of the increased risk for heart disease was surprising,” Shikany says. “However, I was surprised we didn’t see a protective effect of the plant-based dietary pattern.”

Participants with a higher consumption of the Southern dietary pattern typically were younger than 65 years, male, and a resident of the Stroke Belt (the states of Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee).

“For anyone eating a lot of the main components of the Southern dietary pattern, I’d recommend they scale back their consumption,” Shikany says. “If you’re eating bacon every morning, cut back to only two or three days per week, or if you’re drinking four glasses of sweet tea or several sugar-sweetened soft drinks per day, reduce that to one a day and replace some with nonsweetened beverages.”

Shikany says smaller dietary changes—rather than going all in all at once—are more likely to be adhered to. “I don’t like to recommend people completely eliminate foods because people don’t like that, and often they won’t do it,” Shikany says. “I advise gradual changes and not completely eliminating things that people enjoy eating. I think there’s plenty of room for people to make changes and not completely eliminate a food item, while still improving their heart health.”

— Source: University of Alabama at Birmingham


Vitamin D Supplementation in Teens: Don’t Overdo It

Dosing obese teens with vitamin D shows no benefits for their heart health or diabetes risk, and could have the unintended consequences of increasing cholesterol and fat-storing triglycerides. These are the latest findings in a series of Mayo Clinic studies in childhood obesity.

Seema Kumar, MD, a pediatric endocrinologist in the Mayo Clinic Children’s Center, has been studying the effects of vitamin D supplementation in children for 10 years, through four clinical trials and six published studies. To date, Kumar’s team has found limited benefit from vitamin D supplements in adolescents. The latest study, “Effect of Vitamin D3 Treatment on Endothelial Function in Obese Adolescents,” was published online in August in Pediatric Obesity.

“After three months of having vitamin D boosted into the normal range with supplements, these teenagers showed no changes in body weight, body mass index, waistline, blood pressure, or blood flow,” Kumar says. “We’re not saying the links between vitamin D deficiency and chronic diseases don’t exist for children—we just haven’t found any yet.”

One-fifth of adolescents in the United States are obese, and more than one-third are overweight, according to the Journal of the American Medical Association. Several observational studies also have noted links between vitamin D deficiency and a host of weight-related medical complications, including cardiovascular diseases and insulin resistance. As a result, caregivers and providers often start high-dose supplementation in an attempt to slow or reverse some of the clinical complications associated with obesity.

“I’m surprised that we haven’t found more health benefits,” Kumar says. “We’re not saying it’s bad to take vitamin D supplements at reasonable doses, and we know most obese teens are vitamin D deficient. We’re just saying the jury is still out on how useful it is for improving overall health in adolescents.”

This is the first of Kumar’s studies to report increased cholesterol and triglycerides during vitamin D supplementation, a finding she says might be attributed to the smaller number of children who participated in the study and the relatively short timeframe. She calls for larger, placebo-controlled studies to examine the long-term effects of vitamin D supplementation on teens and children.

Parents and providers often put obese adolescent children on vitamin D regimens—sometimes at more than five to 10 times the recommended daily intake—because some studies have shown a link between vitamin D in the blood and improved vascular function, Kumar says. She opted to study vitamin D in overweight teens because this population is at increased risk of chronic disease, and because of the compound’s increasing popularity as a homeopathic or complementary treatment for obesity.

Kumar notes that it’s possible to ingest too much vitamin D, a condition called vitamin D toxicity or hypervitaminosis, which can result in poor appetite, nausea, vomiting, and kidney complications.

— Source: Mayo Clinic