February 24, 2015
As obesity and chronic disease soar in many cultures around the world, African Americans seem to be the hardest hit. Black women have the highest rates of obesity compared with other ethnic groups in the United States. Specifically, about four of five African American women are categorized as overweight or obese.1
Along with the weight disparity come health disparities: Black adults are twice as likely as white adults to have a stroke,2 twice as likely to be diagnosed with diabetes,3 and 1.5 times as likely to have high blood pressure.4 African Americans not only experience higher prevalence rates of these health problems, but they’re also more likely to die from them. For example, black Americans are 2.3 times as likely to die from diabetes complications.3 And although black women are 10% less likely to be diagnosed with breast cancer, they’re almost 40% more likely to die from the disease.5
Is Soul Food Putting the “Die” in Diet?
Why are African Americans disproportionately affected by conditions that are so common but often preventable? Many experts blame the proverbial soul food diet—the cooking and eating traditions that often include dishes that are deep fried or cooked all day, soaked in fat, and laden with salt, sugar, and calories.
Such severe health problems can’t be attributed primarily to soul food, according to Sara Baer-Sinnott, president of Oldways, a nonprofit organization perhaps best known for creating the Mediterranean Diet Pyramid and other culturally specific dietary guidelines.
“These disparities go beyond eating soul food,” she says. “There are many factors that have led to poor outcomes—economics, changes in family structure, lack of access to healthful food, and perceptions about time needed for cooking and shopping.”
Still, she and her colleagues at Oldways understand that a healthful diet goes a long way in improving overall health. The organization developed a program for African Americans that emphasizes the relationship between diet and general health; educates them about the possibility of improving one’s health through a heritage diet; and promotes healthful, delicious, affordable meals to encourage people in black cultural communities to eat well.
The important word here is communities—plural. There are approximately 40 million people of African descent living in the United States. Some have been in the United States for many generations; others are more recent immigrants from Africa, the Caribbean, or other parts of the world.6 What and how they eat may differ significantly—at least until immigrants become acculturated.
“Scientific studies show that many chronic conditions now prevalent in African American communities appear in [black immigrant] populations as traditional diets are left behind,” Baer-Sinnott says. Studies have shown that when people adopt a more westernized diet, their susceptibility to health problems increases.
For example, research published in a 2010 volume of the Journal of Biomedical Sciencefound that the prevalence of metabolic syndrome in young Tanzanian men increased as they ate more nontraditional foods such as donuts and ice cream and less traditional foods. The same trend can be found in Botswana.7 As younger populations shift from traditional to nontraditional lifestyles, weight, blood pressure, and cholesterol levels—signs of metabolic syndrome—rise. The elderly, who are less inclined to change their eating habits, are actually healthier.
According to Sarah Dwyer, program manager at Oldways and the team leader for the African Heritage & Health Initiative, since Africans who eat traditional foods from Africa are healthier than those who adopt a typical Western diet, the research suggests that a healthful African American diet should go back to its roots. To help develop a cultural model for healthful eating based on the traditional diets of the African diaspora, Oldways brought together a team of culinary historians, nutrition scientists, and public health experts to examine foods Africans ate in Africa as well as how they adapted their diet when they were brought to the Americas during the slave trade.
Culinary historian and cookbook author Jessica Harris says the traditional African diet is largely vegetarian. “There wasn’t a lot of animal protein,” she says. “Dried or smoked fish was found in riverine or ocean areas, and wild game was used as a seasoning unless there was some degree of feasting or festivity.”
Across Africa, a variety of whole grains and starchy vegetables serve as the base for meals. “Millet and sorghum are found in the area around Mali; rice in Senegal, Guinea, Liberia, and Sierra Leone,” Harris says. “Further south in Ghana and the Ivory Coast you find yams.
“The Transatlantic Slave Trade was one of the major ways the food of Africa showed up in various inflections on the plate” throughout the diaspora, says Harris, also a member of Oldways’ advisory board. Enslaved Africans in the Americas cooked and ate in ways that were familiar to them, making do—and often making magic—with ingredients they found around them. In the southern United States, they were given some provisions such as cornmeal, beans, or a bit of pork, but Harris says, “They had to supplement their diet with foraging or growing their own food.” Cabbage, okra, tomatoes, peppers, and a variety of greens were abundant, so they were added to the pot.
“Because of the climate in the Caribbean, they had more opportunity to grow things that were closer to Africa, like yams,” Harris continues. The Caribbean diet included tropical fruits like papaya and guava as well as rice and pigeon peas. In South America, tubers such as yucca and cassava as well as okra, peanuts, and plantains were part of the plate.8
The result: a varied culinary legacy based on African retentions and the creative resourcefulness of Africans replanted in the Americas—all of which is reflected in the African Heritage Diet Pyramid that Oldways and its advisory team of experts introduced in November 2011.
Baer-Sinnott describes the pyramid as “an evidence-based practical tool designed to help African Americans reframe their daily diets based on the healthful eating patterns of their ancestors.”
As in other pyramids, the African Heritage Diet Pyramid illustrates which foods should be eaten in abundance and those that should be eaten less frequently. Based on staples from the African diaspora, the African Heritage Diet promotes beans and peas, whole grains, fruits, peanuts and nuts, vegetables, and tubers. Because of their nutritional benefit and overwhelming appearance throughout the diaspora, greens have been placed in a category all their own.
The pyramid suggests fish and seafood be added to the plate at least two times per week as a rich source of omega-3 fatty acids that can help lower blood pressure and protect against heart disease. Like other traditional heritage diets, this pyramid suggest that eggs, poultry, and other meats be eaten in small portions or used to garnish other dishes.
Herbs and spices also are given a prominent position in the pyramid to promote the use of homemade sauces and to boost flavor without adding salt. Healthful oils and dairy also are encouraged in small quantities, and sweets top the pyramid as foods to eat only occasionally.
The result is a plant-based diet low in unhealthful fats, sugars, and sodium; high in nutrient-dense whole foods; and robust in flavor. It naturally mirrors medical recommendations such as the 2010 Dietary Guidelines while fully embracing African-based food ways that are centuries old.
Putting the Pyramid Into Practice
To help black families apply the information from the pyramid to the plate, Oldways developed 12 “plates of expression”—examples of the kinds of savory, spicy dishes that have an important place in the realm of healthful soul food.
“These plates also depict real foods and real meals that translate the science of the pyramid into a healthful delicious plate,” Baer-Sinnott says. Examples include healthful recipes for Hoppin’ John from the American South, West African peanut soup, grilled snapper with mangoes from the Caribbean, and Moqueca de Peixe (Brazilian fish stew).
The pyramid doesn’t focus solely on food; it also advocates a holistic approach to a more healthful life. The base of the pyramid illustrates people engaged in enjoyable activities such as exercise, gardening, cooking, and sharing family meals—activities that go hand in hand with a nutritious diet to promote good health.
Claiming History, Claiming Health
Angela Ginn, RD, LDN, CDE, a spokesperson for the Academy of Nutrition and Dietetics, says the response among her patients has been most positive.
“I see people who are Guyanese, Trinidadian, Jamaican—from all areas,” she says. “When they see the African Heritage Diet Pyramid, their response is one of nostalgia: ‘This is what I ate when I was home’ or ‘This is what I ate when I went to my grandmother’s house. ‘”
Ginn believes that a diet option with cultural connections resonates more with her patients because, among African Americans, a meal isn’t just the food on the plate; it’s a whole experience. “If I can put an experience around healthful eating—feeling good about your past and bringing it to everyday—that will help make it more of a lifestyle,” Ginn says. Then it’s not just a diet; it’s a way of life patients can embrace, sustain, and be proud of.
Source: Today’s Dietitian