For African Americans, many of our best holiday memories center around food for the soul and the hands that prepared it — mother’s coconut cake, grandma’s sweet potato pie, Auntie’s collard greens with ham hocks and cornbread.

At the same time, we hear from everyone from first lady Michelle Obama to Patty Labelle to our doctors that too much sugar, fat and salt in these foods and in fast foods are slowly killing us.

More than 14 percent of African Americans 20 and older have diabetes, some 3.7 million, or twice the national average, according to the American Diabetes Association. One in four black women over 55 has diabetes. Blacks are also more likely to suffer from complications of the disease, including amputations, late stage kidney disease and heart disease. The statistics also mean that most African Americans have a family member with diabetes or have lost someone from these complications.

Given the abundance of information about the risks, the dos and don’ts, why are the numbers so high? Physicians and nutrition experts who treat and counsel African Americans say many factors contribute. They also say that while lowering those statistics will be a long, hard slog, there is hope.

Dr. Nelson Adams, of Metro-Miami OB/GYN Associates in North Miami Beach, has been an ob-gyn for more than 30 years and is the past president of the National Medical Association (NMA). Established in 1885, the NMA is the largest and oldest organization representing physicians of African descent in the U.S. During his term as president in 2007, the organization produced a report titled “Diabetes in the African American Community” that looked at causes for the high numbers and offered recommendations.

Adams, who is also the former president of the Dade County Medical Association, says the root of the problem may be found in the community’s attitude about the disease for generations.

“As we got older it was anticipated that we would gain a little weight … that we would go to the bathroom a little bit more, and truth be told in many families it was anticipated that you would get a ‘touch of sugar.’ This was not necessarily something bad.

“Also, the complications associated with diabetes (heart disease, kidney disease, stroke, amputations) were not linked to diabetes.”

The stigma came, he said, only from being “on the needle.”

Because the onset of the disease and its effect can be gradual, people tend to live in denial, downplaying the dangers, said Dr. Orlando Rodriguez, medical director at Jackson Memorial Hospital’s internal medicine specialist group. By contrast, he said, “Someone gets diagnosed with cancer of the skin, they wear all kinds of sunscreen.

“With diabetes they don’t have the same kind of consciousness,” he said, although “the main killers today are the complications that it brings.”

Patients must be 100 percent compliant, but many may skip or not take their medication if they feel good, said Rodriguez, 36.

Adams also attributes the high numbers to lifestyle and environment — also factors in obesity and diabetes in the population as a whole, but more prevalent in the black community.

“Some people don’t visualize themselves as healthy,” he said, because they are raised by family members who live in neighborhoods where large numbers of people are overweight and sedentary. “There are 20-year-olds who act like they’re 60. The person they relate to most is a person who walks slow, talks slow … That’s who they want to be.”