The association between Stroke Belt residence, colorectal cancer incidence, and diet

In a recent study published in Nutrients, researchers assessed the consumption of plant and animal foods in regions with a high incidence of colorectal cancer and stroke.

Study: The Consumption of Animal and Plant Foods in Areas of High Prevalence of Stroke and Colorectal Cancer. Image Credit: Kei Shooting/Shutterstock


Processed and red meat consumption has been identified as a significant risk factor for colorectal cancer. Since there are several ethnic and racial differences in colorectal cancer cases, trends in food intake, and regions of residence, extensive data is required regarding the association between living in areas having high colorectal cancer incidence and stroke levels and consumption of red and processed meat.

About the study

In the present study, researchers explored the correlation between residing in Stroke Belt states and the incidence quartiles of colorectal cancer with dietary consumption.

The databases employed for the study produced a total of 1069 records. The final sample cohort included 923 participants, including 661 women with a median age of 38.3 years and 261 African American and non-Hispanic Black, 278 Hispanic, and 384 non-Hispanic White participants.

Incidence data for colorectal cancer was derived from colorectal cancer rates observed per 100,000 persons from data collected in 2015. The team divided the states into quartiles according to the incidence of colorectal cancer, which comprised the following:

  • Q4: Alabama, Alaska, Arkansas, Kentucky, Louisiana, Mississippi, Nebraska, Ohio, Iowa,  Illinois, North Dakota, and West Virginia with the highest incidence of colorectal cancer;
  • Q3: Delaware, Indiana, Georgia, Montana, Missouri, New York, New Jersey, Oklahoma, Pennsylvania, Tennessee, South Dakota, and South Carolina with the second-highest incidence of colorectal cancer;
  • Q2: California, Idaho, Minnesota, Missouri, Texas, Wisconsin, North Carolina, Michigan, Connecticut, Maryland, Massachusetts, Maine, and Hampshire with the second lowest incidence of colorectal cancer; and
  • Q1: Arizona, Colorado, Florida, Nevada, New Mexico, Oregon, Vermont, Virginia, Utah, Wyoming, and Washington lowest incidence of colorectal cancer.

Participants were given a list of food types and asked to indicate the number of days they had consumed each food in the previous week. The team categorized the foods as follows: (1) meat, including pork, beef, fish, chicken, and venison; (2) red meat, including only pork, venison, and beef; and (3) healthy foods, including leafy green vegetables, fruits, starchy vegetables, seeds and nuts, grains, seitan, tofu, and tempeh.

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 The total number of days for which each food type was consumed throughout the previous week was estimated. This indicated that a person's score on the test increased as they reported consuming more foods from each category on more days during the previous week.

Participants were queried if they had ever received a diagnosis of diabetes, heart disease, hypertension, renal illness, high cholesterol, or liver disease. The proportion of "yes" replies was added to obtain an overall score of health conditions. The final metric was calibrated from zero to three based on the amount of previously established health issues linked to meat consumption.


The study results showed that participants reported the consumption of an average of 6.95 meat servings, with red meat consumed at 3.42 servings over the past week. Also, around 15.4 servings of healthy foods were ingested in the past week. The team noted that residence in a Stroke Belt state was substantially associated with greater red meat intake but not with the consumption of healthy foods. Residing in colorectal cancer states was not notably related to red meat or meat consumption. However, residing in Q2 colorectal cancer states was significantly related to the highest consumption of healthy foods.

There was also a significant association between living in a Stroke Belt state and consuming more meat and red meat in the prior week. Furthermore, there was no correlation between states in the Stroke Belt and the consumption of healthy foods. The colorectal state quartiles did not display a significant association with any food intake outcome, except residing in Q2 was associated with a higher intake of healthy food; however, when covariates were taken into account, this association did not show significance. Both overall meat intake and red meat consumption were strongly linked with an increase in the number of reported health problems.

Independent-sample t-tests revealed a significant variation between sample sources with respect to the frequency of healthy food intake. There was no statistically significant difference across sample sources in terms of meat consumption or red meat consumption. Age, sex, ethnicity/race, and income were significant predictors of meat and red meat intake, while only income significantly impacted healthy food intake.


The study findings revealed that both total and red meat intake are influenced by geographic location. Public health interventions targeting lowering diet-related health disparities must consider the interaction of geography and meat consumption.

The researchers believe that the association of dietary habits with structural and systemic influences underscores the significance of continuing to assess the relationship between diet choices and diet-related health problems and identifying protective variables that can be employed in public health interventions.

Journal reference:
  • Mayfield, K. et al. (2023) "The Consumption of Animal and Plant Foods in Areas of High Prevalence of Stroke and Colorectal Cancer", Nutrients, 15(4), p. 993. doi: 10.3390/nu15040993.

Posted in: Medical Science News | Medical Research News | Disease/Infection News | Healthcare News

Tags: Cancer, Cholesterol, Colorectal, Colorectal Cancer, Diabetes, Diet, Fish, Food, Frequency, Health Disparities, Heart, Heart Disease, High Cholesterol, Liver, Liver Disease, Meat, Nutrients, Public Health, Stroke, Vegetables

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Written by

Bhavana Kunkalikar

Bhavana Kunkalikar is a medical writer based in Goa, India. Her academic background is in Pharmaceutical sciences and she holds a Bachelor's degree in Pharmacy. Her educational background allowed her to foster an interest in anatomical and physiological sciences. Her college project work based on ‘The manifestations and causes of sickle cell anemia’ formed the stepping stone to a life-long fascination with human pathophysiology.

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