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“Correlates of a southern diet pattern in a national cohort study of blacks and whites: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study” by Catharine A Couch et al., 2021: “Abstract: The Southern dietary pattern, derived within the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort, is characterised by high consumption of added fats, fried food, organ meats, processed meats and sugar-sweetened beverages and is associated with increased risk of several chronic diseases.

The aim of the present study was to identify characteristics of individuals with high adherence to this dietary pattern.

We analysed data from REGARDS, a national cohort of 30239 black and white adults ≥45 years of age living in the USA. Dietary data were collected using the Block 98 FFQ. Multivariable linear regression was used to calculate standardised beta coefficients across all covariates for the entire sample and stratified by race and region.

We included 16781 participants with complete dietary data. Among these, 34.6 % were black, 45.6 % male, 55.2 % resided in stroke belt region and the average age was 65 years.

Black race was the factor with the largest magnitude of association with the Southern dietary pattern (Δ = 0·76 SD, P < 0·0001).

Large differences in Southern dietary pattern adherence were observed between black participants and white participants in the stroke belt and non-belt (stroke belt Δ = 0·75 SD, non-belt Δ = 0·77 SD).

There was a high consumption of the Southern dietary pattern in the US black population, regardless of other factors, underlying our previous findings showing the substantial contribution of this dietary pattern to racial disparities in incident hypertension and stroke.

Key words: Diet patterns: Nutritional epidemiology: Southern diet: Race”

Note that according to the article, “History of diabetes and living in a food desert were not associated with Southern diet pattern adherence in either the stroke belt or non-belt region.” (C. A. Couch et al., 2021, p. 4)

The “Southern diet” organ meat food choice appears to be a remnant of earlier times when poor people were more likely to eat organ meats. However, it doesn’t explain why older participants were less likely to adhere to the “Southern diet”. Is it because of health concerns? More time to cook? Is there, perhaps, more adherence to an even more traditional southern diet of boiled food, especially boiled chicken (e.g. chicken and dumplings), and greens (turnip, collard, mustard)? “For black participants only, older age was significantly associated with being LESS adherent to the Southern dietary pattern. Residence in a rural region and higher BMI were only associated with greater pattern adherence in white participants. Additionally, for white participants only, history of hypertension and history of diabetes were both associated with greater adherence to the Southern dietary pattern. In both the stroke belt region and elsewhere, black race, male sex, being a current smoker, living in a disadvantaged neighbourhood, reporting no physical activity and greater waist circumference were all associated with greater adherence to the Southern dietary pattern. Having greater than a high school education level and an income >$75 K were associated with less adherence to the dietary pattern in both regions. Only in the stroke belt region, older age was associated with LESS adherence to the Southern dietary pattern and residence in a rural region, higher BMI and history of hypertension were associated with greater pattern adherence. History of diabetes and living in a food desert were not associated with Southern diet pattern adherence in either the stroke belt or non-belt region.” (C. A. Couch et al., 2021, p. 4)
See the entire article further below.

See too: “Ethnicity-specific BMI cutoffs for obesity based on type 2 diabetes risk in England: a population-based cohort study” The Lancet, Vol. 9, Issue 7, pp 419-426, July 01, 2021 By Rishi Caleyachetty, PhD † Thomas M Barber, DPhil Nuredin Ibrahim Mohammed, PhD † Prof Francesco P Cappuccio, DSc Prof Rebecca Hardy, PhD Rohini Mathur, PhD et al. Open AccessPublished:May 11, 2021 DOI:https://doi.org/10.1016/S2213-8587(21)00088-7

US CDC: “Obesity, Race/Ethnicity, and COVID-19 Obesity is a common, serious, and costly chronic disease. Having obesity puts people at risk for many other serious chronic diseases and increases the risk of severe illness from COVID-19. Everyone has a role to play in turning the tide against obesity and its disproportionate impact on racial and ethnic minority groups.

Adult Obesity is Increasing
The 2019 CDC Adult Obesity Prevalence Maps show that obesity remains high – twelve states now have an adult obesity prevalence at or above 35 percent: Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia. This is up from nine states in 2018.

Obesity Worsens Outcomes from COVID-19
Adults with excess weight are at even greater risk during the COVID-19 pandemic:

Having obesity increases the risk of severe illness from COVID-19. People who are overweight may also be at increased risk. Having obesity may triple the risk of hospitalization due to a COVID-19 infection.

Obesity is linked to impaired immune function.

Obesity decreases lung capacity and reserve and can make ventilation more dicult.

A study of COVID-19 cases suggests that risks of hospitalization, intensive care unit admission, invasive mechanical ventilation, and death are higher with increasing BMI. The increased risk for hospitalization or death was particularly pronounced in those under age 65. More than 900,000 adult COVID-19 hospitalizations occurred in the United States between the beginning of the pandemic and November 18, 2020. Models estimate that 271,800 (30.2%) of these hospitalizations were attributed to obesity.

Obesity Disproportionately Impacts Some Racial and Ethnic Minority Groups
Combined data from 2017-2019 show notable racial and ethnic disparities:

Non-Hispanic Black adults had the highest prevalence of self-reported obesity (39.8%), followed by Hispanic adults (33.8%), and non-Hispanic White adults (29.9%).

6 states had an obesity prevalence of 35 percent or higher among non-Hispanic White adults. 15 states had an obesity prevalence of 35 percent or higher among Hispanic adults.

34 states and the District of Columbia (D.C.) had an obesity prevalence of 35 percent or higher among non-Hispanic Black adults.

Hispanic and non-Hispanic Black adults have a higher prevalence of obesity and are more likely to suer worse outcomes from COVID-19… https://www.cdc.gov/obesity/data/obesity-and-covid-19.html

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“Correlates of a southern diet pattern in a national cohort study of blacks and whites: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study” by Catharine A Couch1*, Marquita S Gray2, James M Shikany3, Virginia J Howard7, George Howard2, D Leann Long2, Leslie A McClure4, Jennifer J Manly8, Mary Cushman5, Neil A Zakai5, Keith E Pearson6, Emily B Levitan7 and Suzanne E Judd, British Journal of Nutrition doi:10.1017/S0007114521000696 © The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.