August 26, 2024. By Vaishnavi Siripurapu.
According to the CDC, heart disease is the leading cause of death in North Carolina and chronic heart disease rates are rising. Issues surrounding cardiovascular health have been a constant theme of my childhood. In my community, in the rural South, a diagnosis of heart failure is normalized. I saw my loved ones receive specialized diets to address health issues, but these interventions were rarely successful due to a lack of appreciation for the southern food that I ate growing up. As 2023-24 Schweitzer Fellows and ECU Brody School of Medicine students, my partner, Ella Whitfield, and I decided to do something about it by launching a heart healthy nutrition program for people with severe cardiovascular disease.
Allow me to introduce you to Sarah, a vivacious woman with a kind and generous heart. Raised on a diet of fried chicken, collard greens, and sweet tea, Sarah’s choices were rooted in the cultural traditions that had been passed down through generations. A pillar of her community, Sarah shared with me that she “Always had a pot of chili going” for neighbors, children, and passerby who “needed something in their bellies.” For Sarah and her community, food wasn’t just nourishment. Food was an act of love, a glue that brought people together, with eating as healing times spent with family and friends.
However, for Sarah, a routine checkup revealed that her cardiovascular health was in jeopardy. Within three years, she experienced multiple strokes and bodily changes due to poorly managed diabetes. These new health concerns forced her to confront the need for a dietary overhaul.
Unfortunately, traditional dietary advice, often rooted in culturally blind perspectives, may fall flat when attempting to connect with individuals like Sarah. This is where the importance of cultural competency in healthcare becomes glaringly apparent, and it is critical for healthcare providers to acknowledge and respect the diverse backgrounds and traditions that shape patients’ relationships with food. To encourage healthy eating and cultivate meaningful dietary change, it is vital to reimagine traditional, comforting Southern foods in a heart-healthy context.
A powerful strategy to encourage meaningful dietary change is pushing for food swaps, involving replacing less nutritious ingredients with healthier alternatives that mimic familiar tastes and textures. In this way, healthy alternatives can be identified which align with cultural tastes and promote cardiovascular well-being.
A popular example is the pulled pork sandwich, a staple at any Southern Barbeque gathering. Tofu is an unlikely but successful alternative. Tofu, with its versatile nature, absorbs the smoky, savory flavors of sugar-free barbecue sauce, offering a protein heavy alternative with reduced sodium, sugar, and cholesterol.
James, a self-described carnivore with a variety of recipes passed down across generations was the first to try out our tofu sliders. Though skeptical at first, soon he was shocked by the realistic taste and significant health benefits of a simple swap from pork to tofu, and vowed to serve it at his next community barbeque. By embracing such substitutions, individuals can enjoy the tastes of their heritage and their community without sacrificing their heart health.
In improving cardiovascular health in the South, cultural competency is one of the most important aspects that bridges the gap between medical recommendations and the realities of everyday life. Many organizations have come up with recipes that balance healthfulness and southern culture. One of these such organizations is the Med South program from UNC School of Medicine. Their DELISH cookbook features recipes that are healthful, and also honor the rich culture of food in the South. I urge fellow healthcare providers and communities to embrace healthful swaps and creativity, finding recipes not just for a healthier heart but for a richer, more fulfilling life.
Vaishnavi Siripurapu
2023-24 NC Schweitzer Fellow
ECU Brody School of Medicine, Class of 2026