Spotlight on the African Heritage Diet
The African Heritage Diet centers around traditional foods and plant-based dishes common in Africa, the Caribbean, South America, and the American South.
Are you looking for a more diverse meal plan with cultural influences from around the world? You may need to look no further.
Oldways, a nonprofit organization perhaps best known for creating the Mediterranean Diet Pyramid and other evidenced-based, culturally specific dietary guidelines, developed the African Heritage Diet. The African Heritage Diet is a way of eating based on the healthy food traditions of people with African roots.
Editor’s Note: A healthy eating plan looks different for every person with diabetes based on their cultural background, the food and resources they have access to, and their individual health needs. At diaTribe, we advocate for a low-carb way of eating that encourages people to eat between 100-150 g of carbs per day, though we recognize that this may not be a plan that works for everyone. You can learn more about our nutrition principles here.
The need for a new approach
Despite continuous advancements in scientific knowledge and technology in health care, the health status of the African American community still disproportionately lags behind other racial and ethnic groups.
According to the Department of Health and Human Services' Office of Minority Health, African Americans are twice as likely to die of diabetes as their white counterparts. They are three times as likely to end up hospitalized for diabetes-related complications. They are more than twice as likely to undergo diabetes-related leg or foot amputation. And they are more than three times as likely to have end-stage kidney disease.
Although many factors contribute to these disparities, experts often blame the proverbial “Soul Food” diet – comprised of dishes that are often deep-fried or cooked all day, soaked in fat, and laden with salt and sugar, and calories.
However, African Americans in the United States are not culturally uniform, coming from many different regions throughout the world. 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. As a result, what and how they eat may differ significantly.
Oldways brought together a team of experts to examine foods Africans ate in Africa, how they adapted their diet when they were brought to the Americas during the slave trade, and the health of African descendants. The outcome of their research is a cultural model for healthful eating based on the traditional diets of Africa, the Caribbean, South America, and the American South.
The African Heritage Diet and Diabetes
Can a diet with an abundance of starchy vegetables such as cassava (yuca), yam, taro (cocoyam), plantains, sweet potato, and white potato be safe for people with diabetes?
All too often, these starchy vegetables, the foundation of many global cuisines, are classified as "bad" because of their high carbohydrate content. Yet, studies show traditional diets that include these vegetables are more healthful than the standard American diet, and can be safely included in a diabetes meal plan in moderation.
For example, a study in The American Journal of Clinical Nutrition found that Black and Hispanic adults with diagnosed diabetes who maintained a traditional Caribbean starch dietary pattern, which included yuca/cassava, starchy green banana, plantains, and yautia, had a more healthful dietary pattern than those who followed other dietary patterns.
Numerous studies show the benefit of vegetarian and vegan (plant-based) diets, like the African Heritage Diet, in managing and preventing type 2 diabetes. A large research study with over 300,000 participants, published in 2019, assessed how plant-based diets (including both vegan and vegetarian diets) relate to type 2 diabetes risk. Those following a plant-based diet that included fruits, vegetables, whole grains, legumes, and nuts, had a 30 percent lower risk of developing type 2 diabetes.
Researchers from each of these studies concluded that a plant-based dietary pattern may be beneficial for the prevention of type 2 diabetes. Additionally, they advise that nutrition interventions for people who are Black and Hispanic with diabetes should provide strategies for maintaining healthy aspects of traditional diets.
Claiming health through heritage
The African Heritage Diet features familiar foods prepared in easy and affordable ways, but remember, small gradual changes always work best. Rather than drastically changing your eating habits in a day, start with setting just a few small, achievable goals that you can stick with.
And always speak with your diabetes health care provider before you make changes to your diet.
Steps for health through heritage
Ditch the salt shaker and boost flavor with curries, peppers, coconut, fresh herbs, garlic, onions, fresh lemon. These spices are low sodium and add incredible flavors to whole grains, beans, vegetables, and seafood. Start by trying a different herb every week.
Make vegetables the star of your plate. Steamed, sauteed, roasted, grilled, or raw, eat non-starchy vegetables like okra, cabbage, green beans, or eggplant in larger portions than the other parts of your meal.
Change the way you think about meat. Use lean, healthy meats in smaller amounts for flavor. For example, replace ham-hocks with smoked turkey or fish.
Make rice and beans your new staple – but be mindful of the high-carb content of white rice in particular. You can learn more about eating rice with diabetes here. Add African Heritage whole grains like millet, sorghum, and teff to your soups, or partner them with peas.
Enjoy mashes and medleys. Bake or boil sweet potatoes or yams, or mash them with eggplants, beans, grains, onions, and seasoning. Try okra, corn, and tomatoes in a "Mix Up," or add extra color and flavor to your greens with purple cabbage and leeks.
Try choosing whole foods in their natural state such as fresh fruit, veggies, and beans instead of processed and packaged "convenience foods."
Seek family support and food fellowship. Food is meant to be shared, and so is good health. Think of your dinner table as a “healing table,” a place where people come to share beautiful, fresh foods and reinforce a long, happy and healthy life.
Make room for celebration foods. We all have special foods that have always been in our families. Some of these foods may fall outside the guidelines of the African Heritage Diet. Save these foods of meaning and memory for special occasions. Enjoy them infrequently, but enjoy them wholeheartedly when you do have them!
Jazz up fruits for dessert. Fresh or frozen fruits like melons, peaches, berries, and mangos – plain or sprinkled with chopped nuts or coconut – add a sweet taste of satisfaction at the end of a meal.
If you are more of a visual learner, Oldways developed the African Heritage Diet Pyramid to show these recommendations in a helpful diagram.
Reclaiming Traditional Cultural Cuisine
Every person deserves the opportunity to improve their health through foods that are familiar and culturally significant. Unfortunately, that's not always the message people receive from nutritional experts.
Christina Sithole, a Zimbabwean immigrant living in Corona, California was diagnosed with type 2 diabetes three years ago. Shortly after her diagnosis, she was referred to a registered dietitian nutritionist (RDN), who gave her a list of suggested snacks during the consultation, such as raw celery stuffed with peanut butter or cottage cheese.
"It was difficult for me to eat those foods because they are not in my diet,” she said. “They were distasteful to me."
However, Sithole was later able to find a culturally-competent RDN. "She [the RDN] suggested that I make a list of cultural foods I ate, and then she recommended some substitutions," she said. "For example, I liked sadza [a porridge] made of cornmeal, and she suggested that I substitute sorghum or millet for the cornmeal."
Sithole was also encouraged to eat more traditional leafy greens such as pumpkin leaves, tsunga (mustard greens), and dried munyovi (spider flower leaf). She now eats matemba (dried fish) as a snack or peanut butter and pumpkin as a main dish.
“I still eat cultural foods I enjoyed before being diagnosed with diabetes,” Sithole said, adding that she’s now mindful of her portions and no longer fries her food. As a result, she has reduced her diabetes medication and is almost at her target A1C.
Sithole’s experience is not unique. Priya, a Guyanese school counselor living in Florida who asked only to be identified by her first name, was diagnosed with type 1 diabetes in 2001. Like Sithole, Priya was referred to nutritional resources that did not take into account her personal or cultural food preferences.
About seven years ago, Priya's younger sister became an RDN, and since then, she's been able to help Priya incorporate their family’s cultural foods into her diet. Priya's typical meals consist of dhal (yellow lentil/split peas), with brown rice, spinach, a type of fish, bitter melon, cucumbers, and lettuce on the side.
"I think it's important to have a balanced meal that includes foods from most, if not all, of the food groups," she said.
Of course, some adjustments may have to be made. For example, Priya enjoys roti (flatbread) but finds her glucose levels are easier to manage when she doesn't eat them.
"If I do eat roti or naan, I have to make sure I pre-bolus and continue to check my levels for a delayed rise to take more insulin two to four hours later,” she said. “I have personally found that there are many ways we all can enjoy our cultural foods and still maintain healthy blood sugar levels. I don't think I could ever stop eating my cultural foods, and I'm glad I don't have to."
Having diabetes does not mean completely giving up the food you’ve grown up with. Eileen Chesson, an African American woman who resides in Glen Allen, Virginia, has a history of gestational diabetes and, 18 years ago, was diagnosed with type 2 diabetes. Chesson has seven siblings also living with diabetes, and her mother died from complications of the condition. Eileen, who generally eats traditional southern food, met with an RDN right after her diabetes diagnosis.
The RDN advised her to eat what she wants, but to eat “small portions, limit pork fat, substitute with turkey and limit salt,” said Chesson.
“Enjoy traditional southern foods but go easy on carbs and sugars; learn to prepare them differently and season them differently,” Chesson said. “For example, use natural fresh herbs and spices, don't overcook food, sautéed vegetables, eliminate pork fat but select good fat like olive oil.”
Reclaiming traditional, cultural cuisines and making small substitutions can help you find a healthy eating pattern, such as the African Heritage Diet, that doesn’t require you to give up the food you love.
As you can see, there is plenty of room within the broad guidelines of the African Heritage Diet to develop an individual dietary plan that works best for you. Taking into account many different factors like your glucose levels, blood pressure, cholesterol, and whether you are meeting those targets, work with your healthcare team to find the right diet to keep you healthy.
Nutritional experts can and should work with you to incorporate traditional, culturally-relevant foods into your meal plan. This can play a crucial role in improving your health as an individual, and in reducing health disparities at the population level.
Constance Brown-Riggs was part of the African Heritage Advisory Committee.