In the UK, health inequalities in diet and health are a significant concern across various population groups. People of African and Caribbean backgrounds experience higher rates of cardiovascular disease, type 2 diabetes, and obesity compared to Caucasian populations. These disparities are often linked to dietary intake, with many individuals not meeting government dietary recommendations for energy, saturated fats, sugars, salt, and fiber. To address these issues, culturally appropriate resources and interventions are crucial for promoting healthier eating habits.
The Eatwell Guide is a valuable tool for illustrating UK Government dietary recommendations using familiar foods commonly consumed by different ethnic groups, including those of African and Caribbean backgrounds. By providing food-based suggestions for diets and recipes, the Eatwell Guide helps individuals incorporate healthier eating practices into their daily lives.
A recent study evaluated the feasibility of a new brief culturally appropriate community intervention that aimed to introduce food-based healthy eating and recipe resources featuring African Caribbean foods, which were recently co-developed with people from these ethnic backgrounds.
The African Caribbean Eat Well Guide used in session 1.
Understanding the Eatwell Guide
The Eatwell Guide applies to most of the population, regardless of whether they eat meat or are vegetarian, and no matter what their ethnic origin. It simply outlines the proportions of each food group that we should aim for every day to achieve a balanced diet. For those who are vegan or vegetarian, the vegetarian Eatwell plate helps identify foods that better reflect their dietary choices.
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The Eatwell guide is simply the proportions of each food group that we should aim for every day. If you are vegan or vegetarian, you may find that the protein and dairy sections of the plate do not represent foods that you can or want to eat. The vegetarian Eatwell plate helps identify foods that may better reflect the foods in your diet.
From Senegal to Brazil to Savannah, GA, a wide range of foods are found in the African heritage tradition.
One way to support people with healthier eating is to provide guidance on how they could incorporate this into their daily lives by using practical “food-based” resources featuring commonly consumed familiar foods. This approach is also suggested ina recently published guidance collection for UK health professionals aimed at improving and personalizing care and population health.
As such, a common feature of healthier eating initiatives, such as those available from the UK NHS Healthier Families campaign, is to provide food-based suggestions for diets and recipes that deliver lower levels of energy (calories) or nutrients of public health concern.
Culturally appropriate, healthier eating interventions and food-based resources are ideally specifically adapted or tailored to meet the needs of different populations. As such, these may help address some of the barriers around food choice and preparation reported by people of different ethnicities.
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Addressing Health Inequalities
People of African or Caribbean heritage have a higher chance of developing diabetes, high blood pressure and heart problems. If diabetes or high blood pressure aren’t well controlled, they can lead to kidney disease.
Unfortunately, people of Black African and African‐Caribbean ethnicities in the United Kingdom continue to experience substantially poorer health outcomes and access to and use of health services compared to the White populations. Excess weight, cardiovascular diseases, type 2 diabetes and associated behavioural risk factors such as physical inactivity, are more common in some minoritised ethnic groups compared to Whites in the United Kingdom.
To support good kidney health, as well as overall health and wellbeing, starting with a balanced diet based on the Eatwell Guide can be a helpful foundation. This version of the Eatwell Guide has been adapted to reflect foods commonly enjoyed in African and Caribbean diets.
Key Dietary Recommendations
Here are some key dietary recommendations tailored for African and Caribbean diets, based on the Eatwell Guide:
- Carbohydrates: Choose high-fiber options like brown rice and wholewheat dumplings to help control blood sugar levels.
- Vegetables: Add vegetables like callaloo, cabbage, or green peas to stews and soups, and bulk up curries with carrots, bell peppers, or pumpkin.
- Protein: Opt for lean proteins like grilled fish, skinless chicken, or turkey, and incorporate more plant-based protein sources.
- Salt: Be mindful of hidden salt in snacks, processed meats, and shop-bought sauces, and use herbs and spices to boost flavor instead of salt.
- Fats: Choose to boil, bake, or roast instead of frying foods, use oils and fats sparingly, and limit meat with visible fat.
Aimed at supporting people to improve health outcomes via diet through education, skill development and behavioural change, various nutrition and health promotional interventions have been developed and reported to date.
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For example, in the United Kingdom, there are several major ongoing public health initiatives to promote healthy eating, including salt, sodium, sugar and saturated fat reduction, and increasing fruit and vegetable (i.e., 5‐A‐Day) and fibre intakes.
These are associated with a wealth of free ‘tips’, recipes, ‘food swaps’ and other food‐based guidance resources, aimed at supporting people in the United Kingdom to eat healthier diets. Such resources, including ‘healthier’ recipes, are already known to be a key part of effective interventions that support the development of cooking skills and enable healthier eating in specific low‐income populations and are used with people from diverse ethnic backgrounds.
In the United Kingdom, however, there are a very limited number of culturally adapted resources including recipes that reflect the characteristics, cultural customs, experiences, norms and beliefs of minoritised ethnic groups.
Emerging evidence shows that cultural tailoring of nutrition education led to greater knowledge and long‐term diabetes management improvements, compared to usual care.
Partnership working across communities, intended end‐users, staff and researchers can facilitate meaningful connections and dialogue to further understand service‐users' health and cultural needs.
In addition, partnership working has the potential to ensure health equity, especially in Black minoritised ethnic groups who are under‐represented in health research and professional practice.
Modifying Traditional Recipes
One of the key aspects of promoting healthier eating is adapting traditional recipes to reduce the content of key nutrients of concern, such as salt and free sugars, while increasing the intake of nutrients like iron and folate. This can be achieved through:
- Replacing white flour with wholemeal flour
- Enhancing traditional ingredients like fruits, vegetables, and fresh herbs
- Decreasing ingredients that contribute to salt, sodium, saturated fatty acids, total fat, and free sugars
Nutritional analysis software was used to theoretically modify the nutritional composition of popular traditional African‐Caribbean recipes using recently produced analytical food composition data. Twelve recipes were theoretically modified to reduce the content of key nutrients and ingredients of concern (i.e., salt/sodium, free sugars), or increase those nutrients known to be at risk of lower than adequate intakes (i.e., iron, folate) within the UK African‐Caribbean communities.
Modification resulted in a reduction in the overall energy (in the range of 23-188 kcal), fat (in the range of 0.1-13.7 g), saturated fatty acid (in the range of 0.1-2.9 g) and sugar (in the range of 0.2-8.3 g), provided by 100 g of the standard recipes.
It is feasible to modify African‐Caribbean recipes to be healthier and acceptable to consumers.
Examples of Healthier Recipe Modifications
Here are some examples of how traditional African and Caribbean recipes can be modified to be healthier:
- Rum Punch: Substitute alcoholic rum with rum essence to reduce sugar content.
- Cornmeal Porridge: Replace sweetened condensed milk with fresh semi-skimmed milk.
- Callaloo and Saltfish: Reduce fat content while maintaining acceptability.
- Meat Patties: Adjust fat content to meet healthier guidelines.
Illustration of the approach to fibre increment in the standard recipes.
Low-Carb African Cuisine: A Delicious and Healthy Option
African cuisine is celebrated for its bold flavors, vibrant colors, and nourishing ingredients. For those watching their carb intake, there are numerous ways to enjoy traditional dishes while keeping blood sugar in check. Low-carb African dishes prove you don’t have to sacrifice flavor for health.
Here are some examples of low-carb African dishes:
- Ghanaian-Inspired Chicken Stew: Loaded with aromatic ginger, jalapenos, and nutty peanut butter.
- Catfish Pepper Soup: Features chunks of fresh catfish simmered in a broth of uziza seeds, hot peppers, and fresh herbs.
- Ground Beef and Cabbage Stir-Fry: Ground beef and cabbage mingle with tomatoes, aromatics, and signature African spices for a quick, nutritious meal.
- Okra Soup: A Nigerian favorite that's naturally low in carbs and high in fiber.
- Efo Riro: Brings together leafy greens, tomatoes, peppers, and aromatic spices for a rich, satisfying stew.
- Cauliflower Jollof Rice: Use cauliflower rice as a perfect low-carb substitute for traditional jollof rice.
- Zaalouk: A slow-cooked blend of zucchini, eggplant, tomatoes, herbs, and North African spices.
- Grilled Fish: African recipes often feature lean grilled fish like tilapia or croaker, seasoned with pepper, garlic, fresh herbs, and a squeeze of lemon.
With bold spices, fresh herbs, and nourishing veggies, you can enjoy guilt-free traditional meals and feel full of energy.
Conclusion
By embracing the Eatwell Guide and adapting traditional recipes, individuals can enjoy the rich flavors of African and Caribbean cuisine while promoting better health outcomes. Culturally appropriate resources and interventions play a vital role in addressing health inequalities and supporting healthier eating habits for diverse populations.
