The steep rate of death from stroke in a swath of Southern states often referred to as America's “stroke belt” may be linked to a higher consumption of fried fish in that region, new research suggests. A study published in the journal Neurology shows people living in the stroke belt — which comprises North Carolina, South Carolina, Georgia, Alabama, Mississippi, Tennessee, Arkansas and Louisiana — eat more fried fish and less non-fried fish than people living in the rest of the country, and African-Americans eat more fried fish than Caucasians. “Differences in dietary fish consumption, specifically in cooking methods, may be contributing to higher rates of stroke in the stroke belt and also among African Americans,” says study author Fadi Nahab, medical director for the Stroke Program at Emory University Hospital in Atlanta.
The research, part of a large government-funded study, Reasons for Geographic and Racial Differences in Stroke (REGARDS), involved 21,675 participants from across the country; the average age was 65. Of the participants, 21% were from the “stroke buckle,” the coastal plain region of North Carolina, South Carolina and Georgia where stroke mortality rates are even higher than they are in the rest of the stroke belt. Another 34% were from the rest of the stroke belt and 44% were from the other states.
Participants were interviewed by phone and then given an in-home physical exam. The questionnaire asked how often they ate oysters, shellfish, tuna, fried fish and non-fried fish. The American Heart Association recommends people eat fish high in omega-3 fatty acids—essential fatty acids humans get through their diet—at least twice a week, baked or grilled but not fried. Fewer than one in four overall ate two or more servings of non-fried fish a week. Stroke belt residents were 32% more likely to eat two or more servings of fried fish each week than those in the rest of the country.
African-Americans were more than 3.5 times more likely to eat two or more servings of fried fish each week than Caucasians, with an overall average of about one serving per week of fried fish compared with about half a serving for Caucasians. When it came to eating non-fried fish meals, stroke belt residents ate an average of 1.45 servings per week, compared with 1.63 servings eaten by people elsewhere.
“This is good stuff. It's a well-done study, but I think one thing to bear in mind is that it's not specifically a study of stroke risk. You're looking at a community and seeing how it's behaving on the whole,” says Daniel Labovitz, a stroke neurologist at Montefiore Medical Center in the Bronx. “This study can't tell you causation. It can't tell you there's a direct link between one thing and another, it just tells you they're associated,” says stroke neurologist Victor Urrutia, an assistant professor at Johns Hopkins University School of Medicine.
How might eating fried fish impact stroke?
It could be that frying the fish leaches out the omega-3s, says Jeremy Lanford, stroke director at Scott & White Healthcare in Roundrock, Texas. Or the increased fat calorie content from the frying oil may contribute to stroke, says author Nahab. He also notes that fish used for frying, such as cod and haddock, tend to be the types lower in healthy fats. More research is needed to tease out whether cooking methods affect stroke risk, Labovitz says. “In other words, is fried fish a problem, or is it another red herring?” he says.
The study was supported by the National Institute of Neurological Disorders and Stroke, the National Institutes of Health, and the Department of Health and Human Services. Funding was provided by General Mills for coding of the food frequency questionnaire.
Two specific eating patterns increase the risk of death for older adults, a 10-year study finds.Compared to people who ate healthy foods, men and women in their 70s had a 40% higher risk of death if they got most of their calories from high-fat dairy foods or from sweets and desserts. University of Maryland researcher Amy L. Anderson, PhD, and colleagues monitored the eating patterns of 2,582 adults aged 70 to 79. They found that these diets fell into six patterns or clusters.
After adjusting for risk factors such as sex, age, race, education, physical activity, smoking, and total calories, “the High-Fat Dairy Products cluster and the Sweets and Desserts cluster still showed significantly higher risk of mortality than the Healthy Foods cluster,” Anderson and colleagues found.
The six dietary patterns were:
- Healthy Foods: Higher intake of low-fat dairy products, fruit, whole grains, poultry, fish, and vegetables. Lower intake of meat, fried foods, sweets, high-energy drinks, and added fat.
- High-Fat Dairy Products: Higher intake of ice cream, cheese, and 2% and whole milk and yogurt. Lower intake of poultry, low-fat dairy products, rice, and pasta.
- Sweets and Desserts: Higher intake of doughnuts, cake, cookies, pudding, chocolate, and candy. Lower intake of fruit, fish and other seafood, and dark green vegetables.
- Meat, Fried Foods, and Alcohol: Higher intake of beer, liquor, fried chicken, mayonnaise/salad dressings, high-energy density drinks, nuts, snacks, rice/pasta dishes, and added fat. Lower intake of low-fat dairy products, fiber/bran breakfast cereal, and other breakfast cereal.
- Breakfast Cereal: Higher intake of fiber/bran and other breakfast cereals (especially the latter). Low intake of nuts, refined grains, dark yellow vegetables, and dark green vegetables.
- Refined Grains: Higher intake of refined grains (such as pancakes, waffles, breads, muffins, and cooked cereals such as oatmeal) and processed meat (such as bacon, sausage, ham, and other lunchmeats). Lower intake of liquor, breakfast cereals, and whole grains.
Several of the groups got an unusually large amount of their total calories from just one food group:
The sweets and desserts cluster got 25.8% of its total energy from sweets.The refined grains cluster got 24.6% of its total energy from refined grains.The breakfast cereal group got 19.3% of its total energy from cold cereals other than those full of fiber and bran.The high-fat dairy products group got 17.1% of its total energy from higher-fat dairy foods.
Overall, people in the healthy foods cluster had more years of healthy life and a lower death rate than all other groups. Moreover, their blood tests came back with significantly more indicators of health than the other groups.
But not all of the study findings were so predictable. “Unexpectedly, in this and in several other studies, a [dietary] pattern higher in red meat was not significantly associated with increased risk of mortality,” Anderson and colleagues note. It's also not entirely clear why the Meat, Fried Food, and Alcohol cluster didn't have a significantly higher death risk, as most diets warn people to limit or avoid such foods.
“In our study, the Meat, Fried Food, and Alcohol cluster did have a slightly higher percentage of total energy from vegetables, fruit, and whole grains than both the High-Fat Dairy Products and Sweets and Desserts clusters, which showed higher risk of mortality,” Anderson and colleagues suggest.
This was by far the most common eating pattern seen in the study: 27% of participants were in the meat, fried food, and alcohol cluster. But Anderson and colleagues do not recommend such a diet. Instead, they point to the fact that 14.5% of study participants were in the healthy foods cluster. “Adherence to such a diet appears a feasible and realistic recommendation for potentially improved survival and quality of life in the growing older adult population,” Anderson and colleagues conclude.
The study appears in the January 2011 issue of the Journal of the American Dietetic Association.
Older adults who eat a healthy diet tend to live longer than those who indulge in desserts and high-fat dairy products, according to a new study in the Journal of the American Dietetic Association. With the projected doubling of our older population by 2030, what people put on their plates may be even more important.
For 10 years, researchers followed the eating habits of 2,500 healthy seniors aged 70 to 79. They found people who ate ice cream, whole milk and other high fat-dairy items had a 40% higher risk of dying during the decade of study than those who ate a healthful diet. People who ate sweets such as doughnuts, cakes, and cookies had a 37% higher risk of dying in that same 10 year study period.
The seniors were placed into one of the following 6 dietary categories depending upon what they ate: 1) Healthy foods 2) High-fat dairy products 3) Meat, fried foods and alcohol 4) Breakfast cereal 5) Refined grains and 6) Sweets and desserts. The people with the more healthful diets not only lived longer they also reported having a better quality of life, for a longer period of time than others.
“Our study and several previous studies suggest that it may be important what people eat at any age and that people can perhaps increase their quality of life and survival by following a healthy diet,” explains lead author Amy Anderson, Postdoctoral Researcher with the University of Maryland's Department of Nutrition and Food Science.
Eating healthy meant including more low-fat dairy products, fruits and vegetables, whole grains, poultry and fish in the diet as opposed to meat, fried foods, sweets, highly sugared drinks and other fatty foods. The healthy group got only 3% of their calories from high-fat dairy products such as cheese and ice cream, for example, while the high-fat dairy group got 17% of their calories from these foods. The healthier group also ate fewer sweets with only 6% of their calories coming from these treats compared to 25% by those in the desserts group.
The study noted that in the past century, the leading causes of death were from infectious diseases. Now people are dying from chronic illnesses such as heart disease and cancer, which are often tied to what we eat.
“I think this research is important, especially now with the baby boomers entering these older age groups. So if people have a higher quality of life and survival , if they're healthier, this can reduce the cost of health care and improve people's daily lives in general,” says Anderson.
There are some tricks that can help make any fast food meal better for you and your family. Follow these tips to cut down on fat, sodium, sugar, overall calories and make your meal healthier:
- If you are ordering á la Carte items on the menu, find out if there is a child’s size available. Another option is to order the regular size and split the order and share it. Avoid ordering extra large portions just because they are a deal! These deals usually have the words jumbo, giant, super sized or deluxe in the name.
- Don’t be shy about making substitutions! Children love kid’s meals because it comes with a toy and it is usually in a cool looking box. Let them order it but ask to make substitutions for the fries and soda if possible. Many restaurants will offer milk or water as a beverage and apple slices instead of fries.
- Talk to your child before ordering a meal and give them a choice of milk, juice or water (make sure it is low fat milk or 100% fruit juice.) Explain to them that soda is high in empty calories that will just fill up their tummies.
- Let your child know that they can ask for items prepared a specific way. For example, salad dressing on the side, baked or grilled instead of fried, brown rice instead of white rice.
- Finally, set a good example by ordering a healthy meal for yourself.
What Can Parents Do?
By learning how the food is prepared, you will be able to make healthier choices ordering from a menu:
- Order foods that are not breaded or fried because they are higher in fat and calories. Foods that are breaded and deep fried include: chicken nuggets, fried chicken, fried fish sandwiches, onion rings and french fries.
- Order foods that are prepared by being steamed, broiled, grilled, poached, or roasted.
- Have gravy, sauces and dressings served on the side so you can control the amount you eat.
- Use salsa and mustard instead of mayonnaise.
- Use non-fat milk or low fat milk instead of whole milk or heavy cream.
- Order a salad with ‘lite’ or non-fat dressing instead of regular dressing.
- Choose a regular, single patty hamburger without mayonnaise and cheese.
Over the last few years, many chain restaurants have been adding healthier menu options. They also started providing nutrition information for all the foods on the menu, but you usually need to ask for it. Try checking their website as well for additional information.
Hamburger fast food restaurants are the most popular with children. However, other options are available such as Asian food, sandwiches, or Mexican grills. Keep in mind that every fast food restaurant has both healthy and less-healthy choices. Here are some pointers to remember that can help you make better choices when eating out at various fast food places:
- Choose grilled soft tacos or burritos instead of a crispy shell or gordita-type burritos.
- Black beans are a better choice because they have less fat than refried beans.
- Ahhh, the Mexican condiments! Salsa is low in calories and fat and it makes a great substitute for sour cream, guacamole and cheese.
- Choose lean meats such as chicken breast, lean ham or roast beef, instead of salami or bacon.
- Ask for 100% whole wheat bread for sandwiches. Skip the croissants and biscuits because they are high in fat.
- Add low fat salad dressings instead of special sauces or mayonnaise.
- Choose baked chips or pretzels instead of regular potato chips.
- Steamed brown rice has more nutrients and less calories than fried rice.
- Stir fried, steamed, roasted or broiled dishes are healthier choices than battered or deep fried.
- Sauces such as low sodium soy sauce, rice wine vinegar, wasabi, or ginger are better choices than sweet and sour sauce or coconut milk.
It’s OK to enjoy fast food once in a while, but try to limit the visits to no more than twice a month. An average meal at a fast food restaurant has around 1000 calories and does not have the vitamins, minerals and other important nutrients that your child needs to grow healthy and strong. While fast food consumption has greatly increased over the years there are several contributing factors why childhood obesity is becoming more and more prevalent. While all the above information is important, we need to keep things in perspective by understanding that the weight epidemic in this country is because of how much food children eat, rather than what food children eat.
If your family is going to have fast food for one meal, just make sure the other meals that day contain healthier foods like fruits and vegetables. Perhaps you could take an afternoon with your child and prepare a few homemade meals in advance that can be served quickly to avoid the temptation of getting fast food too often while at the same time teaching them some simple food preparation steps. Either way, just remember, it is not that difficult to eat healthy even when you don’t have much time.
This family wellness article is provided by Nourish Interactive, visitwww.nourishinteractive.com for nutrition articles, family wellness tips, free children's healthy games, and tools. Available in English and Spanish.
Copyright ©2009 Nourish Interactive – All Rights Reserved.
Want to eat well, but find it a challenge when you have to eat and run?
Luckily, many “fast food” restaurants are making it easier with healthier menu options. These tips will help you choose wisely!
Super-sized portions usually cost only a little extra, but can pack a whopping nutritional blow. Research shows the larger the serving in front of us, the more we tend to eat.Keep in mind: double the portion = double the calories.
|Compare the Calories,
Fat and Sugar
|Double patty hamburger
with dressing or mayonnaise
+ large fries + large drink
|Double patty hamburger
+ large fries + large soft drink
|Single patty hamburger
+ small fries + smll soft drink
|Single patty hamburger
+ side salad* + 2% milk
* with low fat dressing
Tip: If you can't bear to pass on a deal, consider splitting a large portion with someone else. Smaller serving sizes are especially important for young children.
Watch the “extras”
Those little “extras” like salad dressings, sandwich sauces, mayo, spreads nd gravy can add a lot of fat and calories to your meal. Choose:
veggies as a tasty garnish for sandwiches
lower-fat condiments like ketchup, mustards and relish
lower-fat salad dressings and use only a small amount
Design it yourself
Looking for more ways to keep the calories and fat in check? Want to boost your nutrient and fibre intake? Made-to-orderoptions are a great solution. When you order a sandwich, burger, wrap, salad or pizza, opt for:
Healthy eating is a matter of balancing your food choices over time. So if you overindulge at one meal, try to make healthier choices at your next meals.
Tip: Change your order to add some variety. Take your taste buds on a global adventure with sushi, shwarma or stir-fry.
Go for the grill
Grilled foods are usually much lower in fat and calories than deep fried foods. Go for grilled meats, poultry, fish and veggies rather than deep fried. For example, a battered and deep fried chicken sandwich may have more than twice as much fat as a grilled chicken sandwich.
Not all salads are created equal. The dressings can make them extra high in fat and calories. For example, a chicken Caesar salad with dressing can have about as many calories and as much fat as a deep fried chicken sandwich.
Large servings of soft drink and other sweetened beverages provide empty calories. A large soft drink typically contains about a third of a cup (85 mL) of sugar. Shakes can be very high in fat and calories too. Quench your thirst with water, milk, 100% fruit juices, fruit smoothies and vegetable cocktails.
Tip: Add milk to tea and coffee instead of cream to save calories and fat. Keep in mind that flavoured syrups and whipped cream added to some coffees and teas may net you as much as 200 to 300 calories or more.
Make wise breakfast choices to give you the energy and nutrients you need for a great start to your day. Choose at least 3 of the 4 food groups.
Tip: Try to limit higher fat options like doughnuts, pastries, muffins, croissants, bacon, sausages and fried hash browns.
Fill up on fibre
Make fibre-rich choices more often: whole grain breads; vegetables and fruit; beans, lentils and chickpeas (in chili, salads, and falafel); nuts and seeds.
Think fresh and light when it comes to dessert. Fresh fruit, frozen yogurts, ice milk and fruit sherbets are nutritious alternatives to baked or fried goods and ice creams. And be portion wise, some large cookies may add as much as 400 or more calories.
Get the facts
Ask for nutrition facts at the restaurant. Compare the calories, fat, sugar, fibre and key nutrients – you may be surprised!
Source: Dietitians of Canada. Reproduced with permission.