Fresh Focus #88: Spotlight on the Juneteenth Flag

Welcome to a special episode of Fresh Focus. I am your host, Dr. Joel Hamilton. I have been a Registered Dietitian (RD) since 2019 and began working at the VA in 2021.
Over the past few years, I have made cooking videos to highlight Juneteenth. If you missed them, check them out on the Marion, IL VA’s YouTube Page. Last year I made a red-centric recipe celebrating the red of the Juneteenth flag. Each year I hope to bring awareness to another element of the Juneteenth flag. The symbolism in both its colors and symbols are too rich to not be discussed. This year, I will address the arc, which represents a new horizon.
In my experience, most conversations about African American/Black health cover what is lacking and what healthcare needs to achieve. However, I believe it is appropriate to look back and see all the good that has come from these conversations. To patients, this will ideally give you hope that we are making progress. To providers, I hope this encourages you to continually practice cultural humility; a constant commitment to learning.
According to the American Health Association, from 2008 to 2018, rates of death by stroke in African American/Black individuals dropped from 59.9 to 52.3 per 100,000 individuals. Additionally, rates of death from stoke in African American/Black individuals dropped from 340.1 to 289.9 per 100,000 individuals.1 We are slowly moving toward a new horizon.
Concerning patent experience, according to the Pew Research Center, 47% of polled African American/Black individuals say healthcare for African American/Black individuals has gotten better of the years.2 I find this to be very encouraging and in my own experiences, I agree, we are moving toward a new horizon.
Yes, of course, our generation has taken steps toward this new horizon. However, let us not forget about the contributions of those who came before us, those who took the first steps toward this new horizon we look to.
Let us not forget Daniel Hale Williams who opened the first Black owned and interracial hospital in the United States (U.S.) in 1891. Let us not forget Jocelyn Elders, who was the first Black individual to act as a surgeon general of the US in 1993.3 These giant steps in history have allowed me, an African American/Black male, to take smaller steps, such as being a Registered Dietitian. African American/Black individuals make up 3% of all RDs and 8% are male.4 Add those odds together and throw in the odds to have a PhD and you will be faced with a fraction. However, we are slowly shifting toward a new horizon. Representation means more encouragement which means more interest which means more applications, which means by the time my works are added to the history books, we may be looking at a new horizon.
Concerning a new horizon on food, there has been a growing adoption and/or re-adoption of vegan diets in African American/Black individuals. According to the Academy of Nutrition and Dietetics, vegan diets exclude foods of “the flesh.” eggs, dairy products, and honey (dependent on individual perceptions.5
When food groups are excluded from the diet that can open the door for possible nutrient deficiencies. So, we must be vigilant. This includes protein, iron, iodine, calcium, vitamin D, and vitamin B-12, as well as others.5
Concerning protein, an individual’s needs can be met by following a vegan diet. It is key to obtain a variety of plants that contain protein to allow your body to meet its needs. With iron, those who follow plant-based diets commonly consume more of it. However, the bioavailability, meaning how much your body can absorb, is lower when coming from plants (non-heme iron). Try pairing sources of iron with vitamin C to help boost its absorption (tomatoes, kiwi, peppers, etc.). Concerning iodine, making sure to include food sources that contain it, like seaweed or iodized salt, can make sure you easily meet your nutrient needs. Try to compare calcium sources and select foods that are fortified to make sure you are meeting your needs. Aside from getting some sunshine, try to include foods like mushrooms treated with ultraviolet light, cooking with yeast, or fortified foods to meet your vitamin D needs. For B12, a supplement, fortified foods, and fermented foods may help you avoid a deficiency.5
With those concerns aside, we can focus on the health-benefits of following a vegan, or plant-centric diet, and how this can push our health toward a new horizon. Plant-centric diets are associated with greater weight loss compared to omnivore diets. These diets are also associated with a reduced risk of cardiovascular disease, more desirable management of heart disease, blood pressure, lipids, and blood sugars. They also assist in reducing inflammation and oxidative stress.5 These are all things that can help reshape your health and point you toward a new horizon.
One point I would like to voice my professional opinion on are pre-made plant-based foods. In some instances, these food items contain more additives than the original product. Preparing your own plant-centric recipes, using whole foods, would be a more health-conscious choice. Remember, the more you are invovled in how your food is prepared, the more control you have over what is/is not added.
Furthermore, in my own experience, following a plant-centric diet has reduced my grocery costs. The cost of food, especially meat, has been skyrocketing. If you have a keen eye, you can select low-cost plant-based foods. Small tips include avoiding prechopped vegetables. They are convenient, but convivence comes at a price. Simply buying the produce item and cutting it yourself can help reduce costs. Also, if you find that your produce spoils, try selecting food items that don’t spoil quickly, like various forms of winter squash. When buying items with stems (herbs, greens, etc.), wrap a damp papertowl at the bottom to help them last longer. These are little tips to help change the horizon we are moving toward.
Again, to patients, we are slowly advancing. To providers, your work is not in vain. To those who are no longer with us, look and see how far we’ve gotten. Stay patient but never drop your standards and see how far we will go. The new horizon may soon be steps away.
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