How Soul Food Stymies African-Americans' Low-Salt Efforts

Sept. 19, 2012— -- "I can't eat food that has no taste!" exclaims one too many of my patients with high blood pressure in my weekly clinic.

As an internal medicine resident at a large hospital in Atlanta, Ga., my patients love that what they eat is filled with a cultural tradition that reminds them of their moms. And as an African-American who is familiar with the foods of the South, I can understand the draw.

Mouth watering Southern fried chicken, mac 'n' cheese and collard greens are some of the dishes that make up the genre of food that spells Americana for so many -- it's Soul Food. Its history is deeply rooted in the African-American community, handed down from generation to generation with oral histories and maybe even a funny family story that accompanies each recipe.

But these recipes often come steeped in much more than tradition.

More often than not, they are filled with unhealthy oil, fat, salt and other ingredients that increase the risk of high blood pressure, stroke, heart attacks and diabetes.

So, oddly enough, while I'm interning on the Medical Unit at ABC News, I come across a study that kind of hits home.

Researchers at Duke University examined the factors that would affect a person's choice to follow the Dietary Approaches to Stop Hypertension, or DASH, diet. The DASH diet recommends that patients with hypertension completely cut certain foods out of their diet with a goal of decreasing the amount of salt, fat and high sugar content, thus decreasing blood pressure.

The study, which is published in the Journal of the Academy of Nutrition and Dietetics, noted that prior to beginning the diet, many of 144 overweight subjects preferred less healthy food regardless of ethnic background. However, once the study subjects began the DASH diet, African Americans in the program, although highly motivated, noted preference for traditional soul food as the reason why they did not follow all of the dietary restrictions.

My patients, who are largely an African-American population, battle high blood pressure at staggering numbers. Even my family members who battle high blood pressure could lower their blood pressure if they just changed their diet. Why is it so hard?

The study's researchers said the root of this problem may be that cultural influences on food preference are difficult to shake.

"Families will now need to pass down new recipes to the next generation," said lead study author James A. Blumenthal, professor of behavioral medicine in the Departments of Psychiatry and Behavioral Sciences at Duke University Medical Center.

In short, he explained, the African-American community is not unlike many others in the United States which have traditions that surround food and family. These traditions make it hard to stop using grandmother's recipes baked beans without throwing in the high-sodium bacon pieces.

"Taking into account the ethnic differences and the cultural differences that exist, adapting the recipes to make them more friendly, can be difficult," Blumenthal notes.

I know grandma made that delicious Sunday dinner with love. But with its conventional ingredients, you will have a harder time getting your blood pressure under control. Uncontrolled blood pressure increases the risk for deadly strokes and heart attacks. Previous studies have shown that the DASH diet works. It helps to lower blood pressure and with exercise can even lead to weight loss. In some cases, there may be no need to take blood pressure medication at all.

So maybe there is a solution after all. When I was a child, my mom decided to change the diet of the entire household. Sunday dinners no longer included table salt and we began using olive oil to sauté vegetables. Baked chicken quickly replaced fried chicken. Mom not only averted blood pressure medications, she completely changed the course of my life.

Could the DASH diet be incorporated into soul food recipes in order to create a healthier diet while helping patients to stick to the diet? I think there is a strong possibility. The reward can be great tasting food and longer life.

So the next time my patients -- and my family -- tell me that the bland DASH diet is too difficult to follow, I'm going to have a clever rebuttal and a great suggestion.