March 16, 2012 (San Diego, California) — Location, gender, race, income, and age are all associated with differences in diet that may help explain differences in cardiovascular health [1].

At EPI|NPAM 2012, the Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism Scientific Sessions 2012, Dr Suzanne Judd (University of Alabama–Birmingham) presented results of the REasons for Geographic And Racial Differences in Stroke (REGARDS) study of demographic patterns in Americans' diets. "The study overall is designed to look at racial and regional differences in stroke, and it turns out that Southerners and African Americans are at much higher risk of dying from stroke," Judd explained. "We wanted to look at diet as a whole."

Responses to a 150-item food frequency questionnaire were analyzed from 21 636 black and white adults. About half of subjects live in the Southeastern US, the so-called "stroke belt." Statistical analysis of the survey results identified five dietary patterns, which they labeled:

  • Southern: A lot of fried and processed meats, and sugar-sweetened beverages.

  • Traditional: Common Chinese or Mexican dishes, pasta, pizza, soup, and other mixed dishes.

  • Healthy: Primarily fruits, vegetables, and grains.

  • Sweets: Excessive sweet snacks and desserts.

  • Alcohol: Proteins, alcohol, and salad.

The Southern diet was most common in African Americans, men, people earning less than $35 000 a year, and people without a college degree. The alcohol diet was relatively uncommon in African Americans, and the traditional diet was more common in those aged 45–54 than in older people.

"We didn't assume any type of dietary pattern whatsoever. We just looked at the data and we asked, 'What foods are different groups of people eating?'" Judd explained. "When we saw that 'sweets' pattern, we thought 'Oh, my goodness, what are these people doing, just going to the vending machine and getting a honeybun every day, and that's all they're eating? But that's it. It's just literally sweets and deserts and sugar beverages." Judd also noted that the alcohol dietary group is characterized by people who are usually moderate drinkers and eat mostly salads, some fats, and coffee to restrict their calories. This diet only occurred in people making more than $75 000 a year.

There are "clear and meaningful dietary patterns" in this large cohort with variability in diet across demographic factors that underscore the importance of understanding how these factors contribute to differences in the risk of stroke and other chronic diseases, according to Judd et al. "We hope that understanding these patterns will be informative in understanding the role of diet in health and disease disparity," Judd said.

"This was a methodological paper because we had such a diverse group of people. . . . We took a very rigorous statistical approach to make sure that the patterns we identified would be applicable across age and race," she said. The next step in this research will be to study how factors such as where a person was born and grows up influences diet. The study is funded primarily to look at the risk factors for stroke, but Judd and colleagues will also measure risk of cardiovascular disease, kidney disease, and death.

The REGARDS study was co-sponsored by the National Institutes of Health and General Mills.


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