Hush puppies on a diet?
The Med-South diet study led by Carolina researchers will determine if healthier versions of traditional Southern dishes can help obese people lose weight and keep it off.
Eat hush puppies while on a weight-loss diet? It’s true.
Healthier versions of mainstay Southern foods such as golden-fried hush puppies chock full of vegetables and collards cooked in healthful oils, peanut butter and mayonnaise are part of a new research study based at Carolina that aims to help obese North Carolinians achieve sustained weight loss.
Borrowing from the popular Mediterranean diet, the Med-South diet uses healthful oils, whole grains, plentiful fruits and vegetables. The Mediterranean dietary pattern has been shown to deliver health benefits such as lower blood pressure and improved heart health. Now, Carolina researchers want to find out if obese patients on the Med-South diet can sustain weight loss over a two-year period.
The study will enroll patients referred by doctors in two or three primary care clinics around Chapel Hill and will seek more participants from towns in eastern North Carolina, possibly through the next year and half.
Thomas Keyserling, physician and professor in the UNC School of Medicine’s Department of Medicine/Division of General Medicine and Clinical Epidemiology, and Carmen Samuel-Hodge MPH ’93, PhD ’03, associate professor of nutrition in the Gillings School of Global Public Health and Evaluation Core director at the Center for Health Promotion and Disease Prevention, will co-direct the study. Both bring years of experience in evaluating ways people can lose weight and keep the weight off.
The goal: sustainable weight loss
“We all know that the Mediterranean dietary pattern, even without weight loss gives you all these health benefits,” Samuel-Hodge said. “The question is can you take that pattern, restrict caloric intake and get weight loss that’s sustainable?”
The study uses tried-and-true components from previous studies, but differs in that it focuses on sustained weight loss, following participants over two years, rather than the more common six-to-twelve months. In addition, the study promotes a healthful dietary pattern associated with lower blood pressure and reduced risk for dementia, diabetes, stroke, heart attack, neurodegenerative diseases and cancer in general.
Keyserling and Samuel-Hodge want to enroll 360 patients seen in primary care clinics who have a body mass index (BMI) greater than 30, which is the medical definition of obesity, and who may or may not have diabetes.
“We want to include 40% African-American and 40% male because most weight-loss studies tend to be predominantly women,” Samuel-Hodge said.
They will use electronic health records to identify patients who meet inclusion criteria, which include BMI, age, kidney function and whether patients have been seen by their doctor in the past two years.
Thomas Keyserling.
Carmen Samuel-Hodge.
“We will present lists of these patients to primary care clinicians and ask them if they will refer the patients to the study,” Keyserling said. The study will choose people who can complete the study, who don’t have major illness and don’t have an underlying medical condition that might affect their weight.
The researchers are affiliated with the University’s Center for Health Promotion and Disease Prevention, which received grant funding that could total $3.8 million over five years from the National Heart, Lung and Blood Institute to fund the research
Keyserling said that participants will begin by focusing on diet quality, rather than consuming fewer calories as most weight-loss studies do. They will eat more healthy fats found in nuts, olive oil, most vegetable oils and fish. They will also eat beneficial carbohydrates such as whole grain, fruits, vegetables and legumes.
“Most people enjoy eating these foods. We will also recommend full-fat salad dressing, mayonnaise and tartar sauce as the fat composition in these foods is vegetable oils, considered high quality,” Keyserling said. “People like dietary patterns with higher good-quality fat content, which are more flavorful. There is good scientific evidence that they are not associated with weight gain, due in part to greater satiety than with high-carbohydrate diets.”
Focus on maintained weight loss
Keyserling hopes that participants will maintain weight loss into the second year with a goal of about 5% of body weight. “We want it to be a reasonable percentage of their body weight,” Keyserling said. “If they weigh 200 pounds, we hope they’ll lose 10 pounds or more and keep it off.
The first four months in the study primarily focus on dietary pattern, then patients are to keep a healthy diet while beginning to reduce energy intake, in part by reducing carbohydrates such as sugars and those in highly processed foods. Keyserling said that studies suggest that a diet with 20-30% of calories from carbohydrates can help sustain weight loss. “That’s modestly low carbohydrate intake, especially compared to ketogenic and the Atkins diet, which is 10%,” he said.
Patients will be encouraged to eat lots of non-starchy fruits and vegetables during this component of the study.
Med-South, born in eastern North Carolina
The study continues 30 years of the center’s work in eastern North Carolina. In fact, the Med-South diet was created during heart-healthy intervention studies in largely rural Lenoir County in 2010. Cookbooks have been a part of the studies, and this one is no different. A revised version will contain recipes that focus on healthful versions of familiar foods such as tuna and chicken salad, greens and roasted vegetables, including sweet potatoes.
Not everybody wants to cook, so the study will offer options such as easy breakfasts, all-purpose salad dressings, easily roasted vegetables, snacks. They also plan to teach participants how to prepare and cook food.
It will be at least three years before the research begins to yield data, Keyserling said. But, when it all comes together, study participants could be on their way to potentially life-changing weight loss, while providing a roadmap to healthier living for others.
Bowls of ingredients for heart-healthy hush puppies include chopped broccoli, cabbage, peppers, onions, garlic and nuts. (Photo by Alice Ammerman)
Heart Healthy Hush Puppies
- 1 cup yellow cornmeal
- 1 cup yellow grits
- 1 cup flour (half white/wheat)
- 2 tbsp. sugar
- 2 eggs
- 1 and 1/4 cup buttermilk
- 1/2 tsp. salt
- ½ tsp. pepper
- 1 tsp. baking powder
- 2/3 tsp. baking soda
- 1/8 cup vegetable oil
- 1/3 cup nuts, finely chopped
Oil for deep frying – use any kind of vegetable oil, NOT solid shortening or lard. Safflower, corn, sunflower, peanut, soybean are best for hot temperatures (vs. olive, canola).
A mixture of vegetables finely chopped – about 1-1 ½ cups total. Choose anything you like but include onions and garlic. Good options: red or green bell peppers (or hot peppers if you dare!), eggplant, sweet potatoes, beets, zucchini or yellow squash, okra, cabbage, broccoli. Experiment with your favorites.
Begin heating the oil for deep frying (medium to high heat) – about 1 ½ inch depth.
Mix dry and wet ingredients separately and then combine in a bowl – don’t overmix.
Add chopped nuts and vegetables.
Drop batter into the heated oil using a small spoon. The oil should bubble vigorously around the dough. Turn puppies with a slotted spoon to brown them on all sides. It should take only 2-3 minutes to cook.
Remove from oil and drain on a paper towel. Enjoy!
