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.”
Roniece Weaver is a dietician, author and national nutrition advocate. She is a founding partner and executive director of Orlando-based Hebni Nutrition Consultants, and developer of the Soul Food Plate, a culturally sensitive food guide that emphasizes healthy nutrition choices and portion control. Weaver, based in Orlando, is a Miami native, who grew up in Brownsville, where she has deep roots.
With her business partner Fabiola Demps Gaines, she co-wrote The Family Style Soul Food Diabetes Cookbook and The New Soul Food Cookbook for People with Diabetes.
She argues that African Americans can change, but the message must be delivered in a way that is culturally relevant.
“We have to take a hard look at ourselves, what we’re eating, what’s the reason behind it,” she said. “Is it strictly pleasure or for the nourishment and benefit of our bodies?”
Weaver, 52, said she focuses her clients on the difference between “eating good and eating well.” Eating good to them, she said may be “a four piece from Popeyes, a biscuit and slaw.”
Hebni, a nonprofit, has four commercial kitchens in its offices, and targets at-risk minority communities for cooking and wellness classes. In a recent eight-week program in Orlando, the participants lost weight, and learned how to make healthy food they enjoyed.
“When they’re actually doing it, and they eat what they cook, that light bulb goes off and they say, ‘I can change,’ ” Weaver said. “People learn better together and they share and care about each other.”
Her dream is to see the classes in neighborhoods like Brownsville and communities in Hialeah, as well as in major cities across America. Prevention, she argues, is cheaper than treating the disease.
Nicole Treanor, 28, is a dietician at Baptist Hospital in Homestead.
“A lot of people are cooking for families,” Treanor said. “They tell me I can’t change my diet, because I’m changing my family’s lifestyle.”
Like the majority of Americans, African Americans consume too much, and many have no idea what a serving really looks like, she said. To educate people, the Department of Agriculture developed “My Plate” which replaced the food pyramid.
“We actually developed the Soul Food plate so we can teach in culturally sensitive ways how to eat and keep soul food in our diet,” she said. “Soul food is not going to go away. It just needs a facelift.”
Like My Plate, the Soul Food Plate emphasizes portion sizes of food groups — a smaller portion of meats and starches and a much larger helping of fruits and vegetables.
Many of Weaver’s clients receive food stamps and live in a “food desert” similar to her old neighborhood in Brownsville. With no Publix or other larger supermarkets in the neighborhood, they often buy from smaller local markets with little or no fruits and vegetables and fattier cuts of meat. People on food stamps can eat healthy if they are taught how, she said.
Both Adams and Weaver argue that like smoking and wearing seat belts, the case for healthy eating in the black community and in America as a whole is going to take a multifaceted approach that combines health and nutrition professionals on the front lines, government, schools and a large helping of personal responsibility.
“The reason I became an ob-gyn 31 years ago is because women are the healthcare decision makers for families,” Adams said, “and I thought if I could educate and train women, I would have a better chance of being impactful, changing the health status of families, which changes the health status of communities.”
“I still believe that is the case,” said Adams, who is also a minister, “but I must admit that this is not an endeavor for the faint of heart.”
Adams, 59, said he had a health scare of his own, and was diagnosed with diabetes on a visit to his physician right before a scheduled vacation to Africa. Since then he has lost 45 pounds by changing his eating habits including getting rid of the jar of ginger mints he consumed each day as he ran from patient to patient. With a family history of the disease, and with a diagnosis of his own, he understands his patients’ challenges. However, he said, while managing a chronic disease may not always be easy, it’s doable if they follow doctor’s orders. Most patients can eat what they love in moderation or with healthy recipe modifications.
“Two words we don’t hear as much anymore are self control,” Adams said. “It’s about you controlling you. It’s not about the doctor controlling you, or your mama controlling you. It’s self control.”