Adults who chow down on traditional Southern foods — such as fried chicken, gravy-smothered liver, buttered rolls and sweet tea — may be at an increased risk of acute heart disease, a new study finds. 
 
 Researchers examined the diets of more than 17,400 white and black adults living in the United States, and asked how frequently they ate foods typically considered Southern, including fried foods; fatty foods; processed meats such as bacon and ham; organ meats such as liver; eggs; and sugary drinks. 
 
 During the study, there were 536 cases of acute heart disease, which included fatal and nonfatal heart attacks. After controlling for other factors that may influence people's risk of heart disease — such as their level of education, income, physical activity, smoking and age — the researchers found that the people who frequently ate Southern fare were 56 percent more likely to have a heart attack or die from heart disease during the almost six-year study than those who ate it less. [6 Easy Ways to Eat More Fruits and Vegetables] 
 
 Other research has tied the Southern diet to an increased risk of stroke, the researchers said. 
 
 "Regardless of your gender, race or where you live, if you frequently eat a Southern-style diet, you should be aware of your risk of heart disease and try to make some gradual changes to your diet," Dr. James Shikany, the study's lead researcher and a nutritional epidemiologist at the University of Alabama at Birmingham, said in a statement. "Try cutting down the number of times you eat fried foods or processed meats from every day to three days a week as a start, and try substituting baked or grilled chicken or vegetable-based foods." 
 
 This new study is one of the first studies to look at the relationship between diet and heart disease risk that included people from across the United States and from different socioeconomic backgrounds, the scientists said in their report, published online today (Aug. 10) in the journal Circulation. 
 
 About 30 percent of the participants lived in the so-called Stroke Belt (North Carolina, South Carolina, Georgia, Tennessee, Alabama, Mississippi, Arkansas and Louisiana), and about 20 percent were from the Stroke Buckle (the coastal plain of North Carolina, South Carolina and Georgia). The other 50 percent lived elsewhere in the continental United States, the researchers said. 
 
 The participants were part of an ongoing study called the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, which includes white and black adults age 45 and older. None of the study participants had heart disease when they enrolled in the study, from 2003 to 2007, the researchers said. 
 
 Each participant was given a physical examination and completed a questionnaire to rate how often and how much he or she ate certain foods. The researchers followed up with the participants for nearly six years, asking about their general health and any hospitalizations they had experienced. 
 
 People who frequently ate more Southern food were more likely to live in the Stroke Belt, as well as be male, black and not have graduated high school. They also tended to earn an annual household income of less than $20,000, and were more likely to smoke, have a higher body mass index (BMI) and waist circumference, and a lower likelihood of exercising, the researchers found. Moreover, greater consumption of Southern food was associated with a higher prevalence of hypertension and diabetes, they said. 
 
 The study had limitations, the researchers noted. As with any study based on people's own reports of what they eat, it's possible that the participants didn't accurately remember what types of foods they ate and how often they ate them, the researchers said. 
 
 It's not clear exactly why the Southern diet might increase people's risk of heart disease, but the authors offered several ideas. For one, processed meats have high amounts of sodium and nitrate preservatives, which can lead to increased plaque in blood vessels, they said. 
 
 What's more, drinking sweetened drinks is linked with having a higher BMI, and can increase inflammation and the risk of diabetes, they said. 
 
 Follow Laura Geggel on Twitter @LauraGeggel. Follow Live Science @livescience, Facebook & Google+. Original article on Live Science. ||||| Breaking News Emails Get breaking news alerts and special reports. The news and stories that matter, delivered weekday mornings. 
 
 / Updated 
 
 Americans are killing themselves with very bad food choices, a panel of experts said Thursday. 
 
 New dietary guidelines for Americans should aim to get people to eat more vegetables, less fat and salt and to exercise more, the panel says. And they said people shouldn’t worry about cholesterol itself, which means an occasional egg should be all right. 
 
 The U.S. government issues new dietary guidelines every five years and enlists an independent panel of experts to advise on what they should be. The public gets 45 days to weigh in and then Health and Human Services Department and the U.S. Department of Agriculture use the report as the basis for new guidelines to be issued by the end of the year. 
 
 For the most part, the new recommendations “reaffirm” the 2010 guidelines, the committee says in its 570-plus page report. It doesn’t paint a pretty picture of the U.S. diet. Some key differences are easing up the restrictions on cholesterol-rich foods and, for the first time, advising children and adolescents to avoid consumption of high-caffeine energy drinks. 
 
 The panel also urges the federal government to do more to get Americans to actually follow the recommendations. 
 
 “On average, the U.S. diet is low in vegetables, fruit and whole grains and too high in calories, saturated fat, sodium, refined grains and added sugars." 
 
 “On average, the U.S. diet is low in vegetables, fruit and whole grains and too high in calories, saturated fat, sodium, refined grains and added sugars,” the report reads. 
 
 Americans eat too little vitamin D, calcium, potassium and fiber and eat way too much fat and salt. 
 
 And these bad eating habits are making us sick. 
 
 “About half of all Americans—117 million individuals — have one or more preventable chronic diseases that relate to poor dietary patterns and physical inactivity, including cardiovascular disease, hypertension, type 2 diabetes and diet-related cancers,” the report says. 
 
 “More than two-thirds of adults and nearly one-third of children and youth are overweight or obese.” 
 
 None of this should come as news, but despite sustained and dedicated education campaigns, Americans still eat too much white flour and sugar, drink too many sugary soft drinks and eat too much animal fat. 
 
 “These devastating health problems have persisted for decades, strained U.S. health care costs, and focused the attention of our health care system on disease treatment rather than prevention. They call for bold action and sound, innovative solutions,” the report reads. 
 
 The panel doesn't say what those solutions should be. It'll take some research to figure out how to get through to Americans, says Dr. Alice Lichtenstein of Tufts University, one of the panel members. In past years it's clear people misread the messages, she told NBC News. 
 
 "We somehow got the word across better about what you should be eating more of instead of what you should be eating less of," Lichtenstein said. So many Americans ate less fat but stoked up on processed carbohydrates instead. 
 
 "We need to understand more about why people make food choices so we can move people more towards these guidelines that are evidence based," she said. 
 
 The report does suggest cutting back red and processed meat, something welcomed by the American Institute for Cancer Research. "There is convincing evidence that if Americans moderate their intake of red meat, processed meat and added sugar today, it will lead to fewer cancers tomorrow," said AICR's Susan Higginbotham. 
 
 The most widely leaked part of the report concerns cholesterol. As a specific nutrient, past guidelines have mistakenly focused too closely on cholesterol, the experts suggest. 
 
 “Previously, the dietary guidelines for Americans recommended that cholesterol intake be limited to no more than 300 mg a day,” the report says. The new report is dropping that recommendation. “Available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol,” it says. 
 
 And most Americans eat less than that already, Lichtenstein said. 
 
 But this is a tricky issue. Cholesterol itself is not found in very many foods -- mostly egg yolks, liver, and crustaceans such as shrimp and crab. 
 
 And it doesn't mean you can eat all the bacon and eggs you want. "No," said Lichtenstein. "Especially not the bacon." 
 
 “Water is the preferred beverage choice.” 
 
 Many foods can and do raise cholesterol and they should be limited. They include saturated fat, including the fat found in meat and dairy products as well as palm oil. 
 
 “Partially hydrogenated oils containing trans fat should be avoided,” the report says. And people should not replace fats with processed carbs. 
 
 Other recommendations: 
 
 The dangers of mercury and other heavy metals do not outweigh the benefits of eating fish 
 
 A little alcohol is OK but no one should start drinking alcohol if they don’t already 
 
 Up to 400 mg of caffeine —3 to 5 cups of coffee—are all right. Moderate coffee consumption may offer some protection against type 2 diabetes and Parkinson's, the panel suggests 
 
 Kids should avoid energy drinks 
 
 Eat less salt. Americans get an average of 3,478 milligrams a day, far above recommendations 
 
 “Water is the preferred beverage choice.” 
 
 Kids should exercise an hour a day and adults should exercise at least an hour and a half a week 
 
 The panel looked closely at caffeine, particularly with recent concerns about energy drinks and questions about coffee. “There doesn’t seem to be anything with coffee that causes concern," Lichtenstein said. "For decades we have been looking for something that is bad about it, but we haven’t really found that,” she says. 
 
 Unlike energy drinks, coffee contains phytochemicals -- natural plant products that have been increasingly shown to benefit health. 
 
 The report also talks about sustainable diets that make sure there is plenty of food for everyone now and in the future. 
 
 “A diet higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts and seeds and lower in calories and animal-based foods is more health-promoting and is associated with less environmental impact than is the current U.S. diet,” the report says. ||||| By Steven Reinberg 
 
 HealthDay Reporter 
 
 MONDAY, Aug. 10, 2015 (HealthDay News) -- Fried chicken, sweet tea and greens cooked in bacon fat -- delicious hallmarks of a Southern diet -- may increase your risk for a heart attack, a new study suggests. 
 
 Lead researcher James Shikany, a professor of nutritional epidemiology at the University of Alabama in Birmingham, said that regularly eating Southern-style dishes was linked to a 56 percent increased risk for heart attack during the almost six years of the study. 
 
 However, it's important to note that the study wasn't designed to prove a cause-and-effect relationship between these foods and heart disease, only an association. 
 
 Still, Shikany said, "there are many possible mechanisms that increase risk." These include excess saturated fats and nitrates in processed meats and sugar, which increase cholesterol, insulin resistance and body weight, all of which are linked to an increased risk for heart disease, he added. 
 
 For the study, Shikany's team collected diet data on more than 17,000 people from around the United States who took part in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study of white and black men and women aged 45 or older enrolled from 2003 to 2007. 
 
 The researchers compared the Southern diet with other diet patterns. Patterns included the "convenience" pattern made up of pasta dishes, Mexican food, Chinese food and pizza; the "plant-based" pattern included mostly vegetables, fruits, cereal, beans, yogurt, poultry and fish; the "sweets" pattern consisting of added sugars, desserts, chocolate, candy and sweetened breakfast foods; and the "alcohol/salads" pattern, which included beer, wine, liquor, green leafy vegetables, tomatoes and salad dressings. 
 
 Those who regularly ate a typical Southern diet tended to be men, blacks and people who had not graduated from high school, the study found. The researchers also found -- unsurprisingly -- that people who regularly consumed Southern fare tended to live in the so-called "Stroke belt." This includes North Carolina, South Carolina, Georgia, Tennessee, Alabama, Mississippi, Arkansas and Louisiana, the researchers said. 
 
 No other dietary pattern the researchers looked at was associated with the risk for heart disease. The "Southern" pattern included added fats, fried food, eggs and egg dishes, organ meats, processed meats and sugar-sweetened drinks, the researchers said. 
 
 The report was published online Aug. 10 in the journal Circulation. 
 
 Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center in New York City, said, "It would seem that just about everyone knows that eating fried pork chops and gravy, butter-drenched, lard-laden biscuits and bacon-infused everything is not a healthy diet." 
 
 However, what people choose to eat is based on cultural, emotional, social, economic, psychological, physiological and environmental influences, she said. 
 
 "This is clear in the findings of this study as the South is known for heavily meat- and dairy-based dishes, fried foods and rich sauces," Heller said. "The deep South is often referred to as the Stroke Belt and the Diabetes Belt because of the high prevalence of dietary-related stroke, type 2 diabetes, obesity and heart disease," she added. 
 
 Trying to shift the culture around a certain style of eating, in this case shifting the Southern style to a healthier, more plant-based approach, can be daunting, Heller explained. 
 
 "As much as I try to convince patients that collards can still taste great without a pound of smoked ham hocks, butter and tons of salt, it's a tough sell," she said. "Still, it is necessary for nutrition education and support to be brought to the communities and populations most at risk." 
 
 One way may be to approach the shift from a slightly different angle, Heller said. "Instead of making substitute dishes such as 'healthy fried chicken' -- since it will not taste anything like its deep-fried namesake -- alternate dishes may be a better approach. Thus, one might encourage Southern food eaters to opt for oven-fried nut-crusted chicken. Or New York-style collard greens simmered with extra virgin olive oil, tomatoes, garlic and organic vegetable stock," she said. 
 
 Shikany doesn't think people have to completely eliminate these foods from their diet. "I tend to be a moderation person," he said. "I don't like to tell people 'don't eat this, don't eat that,' because it doesn't work. People get frustrated." 
 
 He would rather encourage people to modify their diet. For example, he suggests not having bacon or ham every day for breakfast, but limiting it to a couple of times a week. "It's probably best to cut it out, but I tend to be realistic, so I try to get people to cut down," he said. 
 
 More information 
 
 For more on a healthy diet, visit the Harvard School of Public Health.
– Have a favorite food you find yourself eating day in and day out? If it's healthy, new research suggests you should stop feeling guilty about it, because eating "everything in moderation" may not be as healthy as we think. Reporting in the journal PLoS ONE, researchers say that based on a survey of the number of foods that 6,814 white, black, Hispanic, and Chinese Americans eat in a week, people who ate the greatest variety of food actually had the worst metabolic health and diets. Those achieving greater diversity "were eating less healthy foods, such as fruits and vegetables, and more unhealthy foods, such as processed meats, desserts and soda," says the lead researcher. Not surprisingly, these were the people with thicker waistlines and higher risks of developing type 2 diabetes 10 years later. "Americans with the healthiest diets actually eat a relatively small range of healthy foods," one author at Tufts University says in a press release. "These results suggest that in modern diets, eating 'everything in moderation' is actually worse than eating a smaller number of healthy foods." Meanwhile, recent research shows that processed, red meats likely increase the risk of certain cancers, while low-fat diets don’t necessarily result in weight loss. In other words, "The way we’re used to eating is wrong," reports Forbes. (If you really want to lose weight, research says, don't eat animals.)