DrChinese said:
"Realistic" in this context has a specific meaning, more or less the same as an "element of reality" per EPR (1935). For entangled Alice and Bob, that means:
Realism: Alice's X observable and Bob's non-commuting Y observable - either of which can be separately predicted with certainty - are both simultaneously well-defined even if they cannot both be simultaneously predicted in advance.
No. Realism, as far as necessary, is much weaker. It is the EPR criterion of reality. You have to add Einstein causality to be able to apply it to the experiment in question. Only Einstein causality, in a quite strong version (stronger than signal causality), allows making the conclusion that all the observables in question, given that they can be predicted without disturbing the system, have all definite values.
Usually one thinks that realism is what gives you the formula
$$E(AB|a,b) = \int_{\lambda\in\Lambda} A(a,b,\lambda)B(a,b,\lambda)\rho(a,b,\lambda)d\lambda.$$
Then the rejection of superdeterminism reduces this to
$$ E(AB|a,b) = \int_{\lambda\in\Lambda} A(a,b,\lambda)B(a,b,\lambda)\rho(\lambda)d\lambda$$
and Einstein causality reduces this to
$$ E(AB|a,b) = \int_{\lambda\in\Lambda} A(a,\lambda)B(b,\lambda)\rho(\lambda)d\lambda,$$
which is already all you need to prove Bell's inequality.
Unfortunately for those who like to reject realism to save Einstein causality, this space ##\Lambda## can be constructed explicitly for quantum theory, the construction has been given in the paper where Kochen and Specker have proven their theorem:
Kochen, S., Specker, E.P. (1967). The Problem of Hidden Variables in Quantum Mechanics, J. Math. Mech. 17(1), 59-87
While this somewhat trivial construction is rejected as not defining what people think is worth to be named "hidden variables", it does not change the fact that the formulas don't care about what people think about that space ##\Lambda##. Once that construction exists, however ugly, and you have Einstein causality and no superdeterminism, you can prove Bell's theorem. With this construction, realism reduces to nothing.