Diet Differences in African Americans

Diet Differences in African Americans

There are a number of important diet differences in African Americans that need to be considered prior to offering advice regarding improvements or adjustments.  To tell someone to “eat better” without first knowing their current diet is a waste of everyone’s time.

Some of the basic foundations of African Americans’ diet stem from slavery days, but there are also more recent adaptations that have slowly weaved into the fabric of the African American diet.   Some of the changes were economic and others more convenience and culture-related.  To sum up the African American diet by only referring to slave influences is to ignore one and a half centuries of added impacts that made the African American diet what it is today.   Food availability, storage, financial independence, health literacy, and a sense of history and heritage all contribute to the ever changing components of the widening African American diet.

More Cultures Adding Diet Changes

With the ever changing make-up of African Americans, their diet is equally changing. More Africans, Caribbeans, and mixed races folds in a number of cultural nuances that need to be considered.  Even within the African American community, the diets vary greatly. Some sub-cultures eat more rice while others prefer pasta.  Some avoid pork for religious reasons, while other avoid beef due to poor digestion or its increasing cost.

These considerations aside, the basics of the African American diet mirror an American diet.  The “average” meal will have meat, starch, and vegetables in varying proportions.

Adding Meat to Your Vegetables??

African Americans more frequently will have their vegetables cooked rather than fresh.  Because of the scarcity of meat as a main course in slavery days, seasoning these cooked vegetable dishes with fatty cuts of low preference meat (whether smoked or not) quickly became a mainstay in the African American diet.  Having the lean cuts reserved exclusively for the more affluent, African Americans became accustomed to other cuts of meat (ham hocks, neck bones, and ox tails, etc.).

Now that the scarcity of meat is much less of a logistical problem, the ‘habit’ or custom of adding meats to vegetables is now merely a standard way to cook them. String beans, collard/mustard/turnip greens almost always have a smoked (and/or salted) cut of meat in the pot.  Because of a growing aversion to pork products in some circles, a significant number of African Americans use smoked turkey to season cooked vegetables and beans.

African Americas Do Eat More Chicken

The breakdown in terms of specific meats preferred by African Americans show a predominance of chicken and turkey, as well as relatively more fish and pork, but less beef than white or Hispanic American diets.

Diet Differences in African Americans

Overall, African Americans eat less grains, fewer eggs, less vegetables, and much less milk, but they consume significantly more meat and fruits.  By increasing the amount of vegetables, particularly fresh uncooked in the form of salads, more nutritional balance can be brought to the African American diet fairly easily. The increased consumption of fish and poultry (both chicken and turkey) already represents a beneficial existing tradition.

Diet Differences in African Americans

Although African Americans eat relatively fewer vegetables, there are also distinct differences within this category with an increased consumption of fresh green beans, fresh cabbage, and fresh greens when compared with other vegetables.

African Americans Prepare More Meals “From Scratch”

African Americans prepare more meals “from scratch” when compared to majority populations.  This diet difference in African American home cooking leads to comparatively more purchases of cooking items including spices, seasonings, oils, and preparation items including baking powder, flour, extracts, and sugars in multiple forms.

Diet Differences in African AmericansThe more “home cooking” done in African American kitchens leads to less consumption of pre-processed or ready-to-eat foods which is considerably beneficial.  Conventionally, when people think of processed and ready-to-eat foods, they generally equate them with poor nutritional quality and lower socio-economic status.  Poti, Mendez, and colleagues looked at the nutritional value of “processed foods” and found they have “higher saturated fat, sugar, and sodium content” when compared to lesser processed foods.  Because of the higher proportion of African Americans that are poor, many assumed that they too consume more ready-to-eat foods, but studies reveal that, in fact, African Americans buy less overall ready-to-eat and/or highly processed foods when compared to European Americans.

More Sugary Sweetened Drinks

By PepsiCo, designed by Edward F. Boyd – Downloaded from https://www.usatoday.com/money/books/reviews/2007-01-22-pepsi-book_x.htm?csp=34, Fair use, https://en.wikipedia.org/w/index.php?curid=11103395

One glaring exception in the purchasing of pre-processed foods was African Americans’ tendency to purchase a much higher proportion of pre-processed sugary beverages when compared to white Americans, and a much lower volume of milk and dairy purchases.  Marketing campaigns targeting African Americans like the one to the right from the 1940’s is just one of many that drove up the consumption of surgery beverages.

Other exceptions include a significantly higher consumption of bacon and sausages.  Finally, there was also an increased purchasing of processed sweeteners including sugar, syrups, jams and jellies in African American consumers.

While there is far more diet differences in African Americans to cover, the best way to advise a patient on their diet is to first know their specific diet . . . don’t generalize . . . interview.  Find out what, exactly, they eat, and then devise an alternative plan with suitable substitutions.  Very few people will be able to completely change their diet, and providers should not expect this because it is unrealistic.  But we should be able to give helpful advise based on a detailed interview.

Check out this great video on cooking oils and the dangers of reusing oils !!

Laser Tattoo Removal on Dark Skin

As you have probably heard, laser tattoo removal on dark skin is a real challenge.  The process takes longer, is frequently more expensive (because you have to go more often), and can be more plagued by less perfect outcomes.  Because African American “keloid” more easily than white Americans, the laser result can (and frequently does) show this ‘build-up’ of skin.

Laser Tattoo Removal on Dark SkinIn deciding whether to have laser treatments, you will have to decide if you would be “okay” with a scarred outcome rather than a tattoo.  The current lasers on the market are not ideal for darker skin colors and the outcomes are frequently not what people expected.

The key is to treat skin of color differently than white skin. Not better or worse, simply different.  In these cases, laser tattoo removal on dark skin has to be approached delicately and with great care.  Slow and steady is always the best approach and wait 6 weeks at least between sessions to allow your skin to heal.

Genetic Clues Are Ignored By Too Many Doctors

Genetic Clues Ignored

With the availability of home genetic testing kits from companies such as “23andMe” and “Ancestry DNA,” more people will be getting information about their genetic lineage and what races and ethnicities of the world are included in their DNA. Geneticists, meanwhile, are also getting more tailored information about disease risk and prevalence as genetic testing in medical research centers continues. Physicians accept that cystic fibrosis, for example, is much more common in people with Northern European ancestry and that sickle cell disease occurs dramatically more often in people with African origins. These commonly accepted racial and ethnic differences in disease prevalence are just the tip of the iceberg when looking at clinical differences that vary based on genetics. But there’s a problem, a recent study from the National Institutes of Health found. Many physicians and other providers are uncomfortable discussing race with their patients, and also reticent to connect race or ethnicity to genetics and clinical decision-making, the study suggested. Overall, physician focus groups “asserted that genetics has a limited role in explaining racial differences in health,” the authors added. As a primary care physician who teaches urban health to medical students and as a state minority health commissioner who advocates for health equity, I see this as a problem that health care systems, and their providers, need to address.

The state of the science

Commercial DNA tests, such as those provided by 23andMe, not only give people their racial and ethnic lineage but also can provide a weighted risk for diabetes, stomach ulcers, cancer and many other diseases. In April, the FDA granted approval to 23andMe to sell reports to consumers that tell them whether they may be at heightened risk. These companies already have the data that describe the risks for health problems based on the percentage of their ancestry composition. Those differences have been published and known in academic circles for many years. With the widespread availability of DNA tests, patients will now know their increased individual risks. For example, Ashkenazi Jews, a specific Jewish ethnic population originating from Central and Eastern Europe, are known for having a disproportionate occurrence of a number of diseases, including Tay-Sachs disease, amyloidosis, breast cancer, colon cancer and many more. The BRCA1/2 gene mutation greatly increases the propensity for breast and colon cancer and occurs in 1 in 40 people of Ashkenazi Jewish heritage, whereas 1 in 800 Americans in general carry that mutation. This 20-fold increased risk should prompt more aggressive screening for the gene, and more frequent and earlier mammography and colonoscopies in Ashkenazi Jews compared to the general population. Relatively higher rates of these cancers occur in certain populations, such as Ashkenazi Jews, and demonstrates the need for more nuanced care based on data that is already available. But this information is too infrequently accessed by providers.

Genetics knowledge growing fast

African-Americans are another group with higher rates of certain genetically driven diseases. African-American men have an increased occurrence of prostate cancer, kidney failure, stroke and other health problems. Prostate cancer in African-American men, for example, grows faster and metastasizes four times as often than in European-Americans.
African-American men are at higher risk for prostate cancer. pixelmedia/From www.shutterstock.com
But despite this increased risk for prostate cancer, doctors’ use of the PSA (prostate specific antigen), a test that works well with identifying prostate cancer in African-Americans, has steadily decreased due to recommendations aimed at majority patients who come from European-related heritage. In European-Americans, prostate cancer can be more indolent and occurs at a lower rate than African-Americans. Also, certain types of blood pressure medications – ACE inhibitors, for example – lead to worse outcomes in African-Americans when used singularly as first-line therapy for high blood pressure, yet these medications work very well in Americans of European decent, a large study of hypertension therapy found. A follow-up study that looked at subsequent clinical practices – which was done in response to changed recommendations based on race – showed nearly a third of African-American hypertensive patients continued to be prescribed medications that cause worse outcomes. African-Americans also have a four-fold increased risk for renal disease leading to dialysis. Geneticists suspect that they have identified the gene that drives this difference yet most clinicians do not have the resources to test for this gene and identify the 30 percent of African-Americans that carry it. And a gene that greatly increases the risk for Alzheimer’s disease, APOE-4, has also been identified and occurs disproportionately higher in European-Americans yet is almost nonexistent in African-Americans and is inconsistent in Hispanic-Americans. Great controversy exists surrounding the testing for this gene, given the devastating impact it could have on a patient or family. (Hispanic and African-Americans still have a very significant risk for Alzheimer’s disease, but it is not driven by this gene).

Genetically different responses to medications

Patient response to medications vary according to the presence or absence of genetic variants, which can impact the dose and the effect of many pharmaceuticals. Some of these differences can be anticipated based on race or ethnicity. For example, Warfarin is a commonly used medication in the treatment of a number of cardiovascular disorders including atrial fibrillation, deep vein thrombosis and heart valve replacement. It shows wide variations in dosing, with Americans of Asian descent requiring less medication and African-Americans requiring more to achieve equal effects. European-Americans have a variant gene that make having a major bleed on Warfarin much higher.
Some types of medications affect different groups of people in different ways. Maoyunping/From www.shutterstock.com
A popular cholesterol-lowering medication, Rosuvastatin, better known as trade name Crestor, is twice as powerful in patients of Asian descent, and their manufacturing label indicates starting at a much lower dose in this population. In fact, the highest manufactured pill dose of Crestor is “contraindicated in Asian patients.”

Patient-centered care is the key

Because of the “patient-centered” movement in hospitals, clinics and insurance plans, providers are now feeling increased pressure to improve the quality of care provided to individual patients. Many outcomes and patient cost of care are now tracked by providers. And countless well-designed studies have validated verified differences in the clinical care of a number of pervasive diseases based on ancestry. Providers need to educate themselves about the important differences that exist in their patient populations. Health disparities, while driven by a number of social factors, are also the result of some clinicians not applying known nuances in the care of special populations. The ConversationAs home genetic testing grows, patients will be bringing their results to physicians for reaction and response. Physicians will need to be proactively prepared. Greg Hall, Assistant Clinical Professor, Case Western Reserve University This article was originally published on The Conversation. Read the original article.  

STD Testing and Treatments

STD testing and treatments Dr. Greg Hall can perform STD testing and treatments can be given at the time of your visit. If you think you may have a sexually transmitted disease (STD), call the office for a quick appointment. You can be tested and treated during your one visit. Common STD’s like chlamydia, gonorrhea (GC), trichomoniasis (Trich), syphilis, and chancroid can be diagnosed and effectively treated. For more information on sexually transmitted diseases go HERE

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If you have a vaginal or penis discharge, or burning with urination, or simply “the area doesn’t feel right” call for a quick appointment, get seen and treated, in the same visit.

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Many times people are sent to large public health clinics for STD testing and treatment where you wait awkwardly to be seen and are sometimes treated like you did something wrong. Dr. Greg Hall will treat you calmly, expertly, and will answer all of you questions.

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