Live. Magazine

“Fried chicken is a big thing,” says Terry Thornton, Pastor of Sweet Hope Free Will Baptist Church in Baltimore as he reflects on the culinary importance of this beloved soul food as well as its impact on health.

In his role as a director of the Novartis-sponsored heart health program Engage with Heart, one of his focus areas is to help educate his congregation to protect their heart health. This means changing some of their daily eating and fitness habits, as well as finding leaner ways to prepare one of the region’s most beloved dishes.

“Not everybody can fry chicken well and people take pride in this dish. They would rather have fried chicken than baked, barbecued, roasted, rotisserie, or any other way you want to prepare it,” he said. “But we know that our food is our medicine. If you eat a lot of the bad foods, the greasy foods, the cholesterol-building foods, and so forth, then that makes you sick.”

America’s love affair with fried foods is not the only culprit behind cardiovascular diseases. But it highlights how closely food, culture, community, and health are intertwined. The all-American cheeseburger with fries and a milkshake is a little piece of the nation’s culture and identity. Food also represents cherished recipes that have been passed down for generations, as well as local dishes that are the pride of the region, and these meals are shared with family and one’s community.

Beyond that, another major challenge in changing what people eat is that the world has seen an explosion of fast food and convenience store staples that are quick, inexpensive, easy and available nearly everywhere. These are also typically low in nutrients and high in sugar, salt and processed ingredients, which have all been associated with poor health outcomes.

Although the health consequences of these foods are particularly apparent in the United States, many countries around the world are following similar trends. The health toll is even worse in cities like Baltimore, where the average life expectancy in marginalized, largely Black neighborhoods is about 20 years lower than in more affluent neighborhoods. Due to a history of racism, these neighborhoods suffer from food insecurity and injustice – also called food apartheid – where it is difficult to find and afford enough healthy food to stay well.

This is part of the reason why Baltimore was selected as the pilot location for the Engage with Heart program, which is working with a broad network of local partners to improve heart health in the city. Focusing on seniors, it is incorporating exercise programs, increased access to healthy food, education about nutrition, and community events.

“Cardiovascular disease, obesity, and their associated diseases are the cusp of a non-viral pandemic and nutrition is at the center of these diseases,” said Cheryl Abbas, an executive director of Cardiovascular Medical Affairs at Novartis and an advisor for the program. “It’s a huge issue and if we don’t tackle it more from a societal perspective, we’re never going to prevent disease – and that is a failure of our society.”

Solving food insecurity

One of the first steps has been removing barriers to getting healthy, fresh foods – particularly fruits and vegetables. “Looking at Baltimore and the food apartheid there, you see just blocks on blocks of corner stores or fast food,” said Will McCabe, Director of Social Impact at Hungry Harvest, a Baltimore-based partner of the Engage with Heart program. “You don’t see grocery stores that have fresh produce, or if they do, it’s not that fresh or the prices aren’t very favorable.”

Hungry Harvest is one of the largest of several organizations working to solve food insecurity in Baltimore and elsewhere. Other groups, like the Black Church Food Security Network, are bringing together Black farmers and churches to coordinate frequent local farmer’s markets. As an alternate approach, Hungry Harvest has a dual mission of simultaneously fighting food insecurity and food waste by distributing farm-fresh produce that would otherwise be thrown out for cosmetic reasons, or never be harvested at all.

“Sometimes acres of produce might be left in the fields to rot because farmers grew more than they had a contract to sell,” said McCabe. “We live in an agriculturally rich and abundant country, but we have 40 percent of our food going to waste and 35 million people experiencing food insecurity – that doesn’t line up.”

Working directly with local farmers, Hungry Harvest has distributed nearly 30 million pounds of produce since they began in 2014. The produce is sold at discounted prices and offered through home-delivered produce box subscriptions as well as community-based markets at schools, hospitals, and other public facilities.

“We’ve partnered with over 100 community organizations and it’s really exciting to make fresh food affordable and accessible and to combine that with all of the wonderful resources through Engage with Heart – particularly nutrition education,” said McCabe.

Trust me, it will work

Although Hungry Harvest provides storage guides and recipe ideas with their produce, incorporating unfamiliar foods into what one eats can be another barrier.

“I encourage people to see what’s on their menu already and to see how we can make it a little bit healthier, like by adding more vegetables,” said Cheryl Frazier, a clinical dietician in the Baltimore area.

For nearly 20 years, Frazier has been working in acute and long-term care hospital settings, as well as teaching the community how to prevent diseases by eating better foods. She is now also partnering with Engage with Heart to give nutrition advice through the program.

“I think the biggest fear is that if they start making healthier things, people are not going to eat them,” said Frazier. “But I go through how to change recipes, even cultural soul food recipes – that we all love so much – using a couple of ingredients to make them a little bit more heart-healthy.”

“I tell them, I know it’s a fear people won’t like it, but trust me, it will work.” For example, in one presentation she talked through a heart-healthier version of a popular dish – meatloaf. The group that Frazier was working with that day knew that they could make the dish leaner by using turkey instead of beef. But Frazier further encouraged them to get more fiber, vitamins and minerals by adding fresh herbs and vegetables likes onions, greens and carrots.

Another part of her work is breaking down myths that people may have heard or seen on social media. One common misconception in the community is that pork is unhealthy. But Frazier clarified that it is not the meat that is unhealthy, so much as how it is cooked – a baked pork chop isn’t nearly so fatty as a fried one.

Among her recommendations, Frazier also reminds people to try more plant-based proteins like beans, make sure to stay hydrated with water and avoid sugary drinks, and to pay attention to what is in processed foods if people do choose to eat them.

“I tell them, I don’t want to totally change your menus – I want to meet you where you are,” Frazier added. “I want people to still enjoy it, but change a couple things. And I feel like after we talk, people do want to know more.”

Changing together

The Black congregations of Baltimore have been complementing these activities with one more tactic for making lasting change – helping their communities make these shifts together.

“The Engage with Heart program is going directly to the core of the community through the worship centers and that’s really the best way to engage with them,” said Chef Jared Banks, who is the owner of the local company Comfort Caterers and who recently joined the Engage with Heart program as a Community Healthy Food Ambassador.

“And culturally, every Sunday after church everyone goes to a multipurpose room and a meal is prepared for the entire congregation.”

Banks has catered these Sunday meals for Pastor Thornton’s congregation for many years. When he heard about Engage with Heart, he saw this as an invaluable opportunity to introduce healthier recipes and especially cooking techniques, such as substituting air-frying for deep-frying.

He was so enthusiastic about these ideas that he prepared a presentation for the program’s organizers, including Pastor Thornton. In addition to preparing healthier meals and teaching healthier cooking methods, Banks is also promoting cooking classes as a way of fostering social engagement for seniors – another component of healthy aging.

And, even though they are not the target of the current program, Banks thinks it is important to include younger generations as well. “The younger generations are often the caretakers of their families and so we have had classes where the grandparent and the grandchild were cooking together and sharing family recipes,” said Banks.

Although the reception of his plant-based meals was initially mixed, Banks has been learning what people are most open to, and the feedback about his heart-healthier menus has been steadily getting more enthusiastic.

“The first meal that we shared was very heart-healthy and a total departure from what we traditionally eat, and everyone was like, ‘What is this? We don’t eat that. This is foreign to us,’” said Pastor Thornton.

“But the chef prepares a baked chicken now, he makes it so tasty that, even though it doesn’t get the crunch and flavor of fried chicken, it’s still delicious and it’s one of the things they ask for again.”