Analysis: Southern Diet Linked With Increased Hypertension in Black Men, Others

The Southern diet was among the major factors contributing to greater levels of incident hypertension in black men than other groups, according to a new analysis published in JAMA. 

The prospective cohort study, consisting of 6,897 individuals, was selected from a longitudinal cohort study of over 30,000 black and white participants who did not have hypertension at baseline. Participants participated in a follow-up visit 9.4 (median) years after baseline. The authors included 12 social and clinical factors, which included a score for the Southern diet (ranging from –4.5 to 8.2, with higher scores indicating higher fried and related food intake). The primary study outcome was incident hypertension (systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or antihypertensive medication) at the follow-up visit.

According to the results, 46% of black participants and 33% of white participants developed hypertension. Adjusted mean Southern diet scores were also higher in black men vs. white men (0.81 [95% CI, 0.72 to 0.90] vs. −0.26 [95% CI, −0.31 to −0.21], and black women vs. white women (0.27 [95% CI, 0.20 to 0.33] vs. −0.57 [95% CI, −0.61 to −0.54], respectively). According to the researchers, the Southern diet score was significantly associated with more incident hypertension in men and women. The Southern dietary pattern, they noted, was the largest mediating factor for differences in the incidence of hypertension, accounting for 51.6% (95% CI, 18.8% to 84.4%) of the excess risk among black men and 29.2% (95% CI, 13.4% to 44.9%) of the excess risk among black women. Other factors included education level, BMI, dietary ratio of sodium to potassium, and more.  

“In a mediation analysis comparing incident hypertension among black adults versus white adults in the United States, key factors statistically mediating the racial difference for both men and women included Southern diet score, dietary ratio of sodium to potassium, and education level,” the authors wrote. “These findings may provide insights into the sources of racial disparities in hypertension incidence.” 

Source: JAMA