Reshaping the foods of our ancestors
Background: African American dishes are part of a rich cultural food tradition, but these dishes, often high in sodium and saturated fats, may contribute to high rates of chronic disease. Insufficient research has focused on factors influencing these food choices or the potential for adapting them to be more healthful. Objective: This dissertation examines the eating behaviors of African American women in New Orleans; describes how behaviors are shaped by tradition and culture; and develops healthful and acceptable variations of frequently consumed recipes using culturally responsive methods. Methods: A purposive sample of African American women (N=67) was drawn from three churches in New Orleans. A modified Food Frequency Questionnaire (FFQ) was used to collect information on dinner dishes. Frequently consumed dishes were assessed for healthfulness using the sodium and fatty acid sub-components of the Healthy Eating Index (HEI). Focus groups were conducted to study the interconnection of individual, cultural, and environmental factors that influence dish choice, and the facilitators and barriers to healthful eating. Building on previous steps, dishes were redesigned to better align with Dietary Guidelines for Americans. Results: Garden salad was consumed an average of 1.6 times per week. The other most frequently consumed dishes were gravy and rice (0.9); fried chicken (0.9); beans and rice (0.6); fried fish/shrimp (0.6); and meatballs and spaghetti (0.6). Emerging themes of focus group discussions were that food served as a cultural unifier; participants learned to cook from elder females; and the importance of social bonds when eating. Facilitators and barriers of healthy eating were ease; tradition; and access to culturally relevant recipes. Of the collected participants' recipes, 43% had a sodium content low enough to score the maximum on this HEI subcomponent, and about a fifth had the HEI maximum subcomponent score for saturated fats. Redeveloped recipes averaged 13% to 55% lower in sodium density and 3% to 66% lower in calories from saturated fat. Conclusion: Tradition and cultural connections facilitate the continued use of established meal preparation methods, but these traditions can be modified. A redesign of the most consumed dishes to better align with nutrition standards while maintaining cultural salience can allow for increased adoption which could ultimately lead to improved health outcomes.