Correlates of a southern diet pattern in a national cohort study of blacks and whites: the REGARDS study.

BACKGROUND The Southern dietary pattern, derived within the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort, is characterized 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. DESIGN We analyzed data from REGARDS, a national cohort of 30,239 black and white adults ≥ 45 years of age living in the US. Dietary data were collected using the Block 98 Food Frequency Questionnaire (FFQ). Multivariable linear regression was used to calculate standardized beta coefficients across all covariates for the entire sample and stratified by race and region. RESULTS We included 16,781 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 to 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). CONCLUSION 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.