Biased Food Guidelines Ignore African Americans

By Milton Mills, M.D., and Merlene Alicia Vassall, J.D.

For as long as we have lived in the Americas, we have strived hard for quality education, employment, housing, and health care. We are still battling on all of those fronts.

Add another front to that list: the fight against diet-related diseases and diet-related premature deaths. Compared with whites, African Americans have much more lactose intolerance, hypertension, diabetes, cancer, and obesity.

The current federal Dietary Guidelines for Americans, now under revision by an 11-member advisory panel to the U.S. Department of Agriculture and Department of Health and Human Services, purport to provide nutritional advice to keep Americans healthy. But, perhaps by neglect rather than intent, they contain racial bias. Their "one-size-fits-all" approach to diet poorly addresses the health needs and traditional food customs of African Americans and other racial minorities. And the Guidelines provide scant alternatives to let individuals make better personal choices.

During the last two years, the Physicians Committee for Responsible Medicine has closely studied these issues, and elicited the support of an array of leading individuals and organizations, such as former U.S. Surgeon General M. Jocelyn Elders, M.D.; U.S. Rep. Jesse Jackson, Jr. (D-Illinois); Martin Luther King, III; first African-American woman astronaut Mae C. Jemison, M.D.; Muhammad Ali; the Congressional Black Caucus Health Braintrust; and the National Black Nurses Association.

They and many more agree that several recommendations in the 1995 Guidelines could trigger or aggravate adverse health conditions—and that changes must be made in the revised edition to be released in mid-2000. For example:

• Lactose Intolerance. The Guidelines recommend consuming at least two to three servings of dairy products daily, despite the fact that about 70 percent of African Americans are lactose intolerant (compared with only 25 percent of whites) and may suffer from cramping, diarrhea, and bloating after eating dairy products. (Research done as far back as the mid-1960s documents this.) Further, the current Guidelines and the related Food Guide Pyramid do not recommend calcium-rich, nondairy foods—collard greens, broccoli, kale, beans—which are all low-fat, cholesterol-free, and high in fiber and vitamins. Dairy products, on the other hand, are generally high in fat, cholesterol, sodium, and animal proteins that can hinder calcium absorption.
• Hypertension. High blood pressure—a condition that can lead to stroke and congestive heart failure—afflicts about one-third of African Americans, compared to only about one-fourth the general population. Yet, the Dietary Guidelines fail to acknowledge that significantly cutting consumption of fatty foods and dropping meats can help prevent, control, or eliminate hypertension. The Guidelines continue to recommend consumption of meat and dairy products for all Americans, despite studies showing a vegetarian diet can reduce hypertension in perhaps 75 percent of hypertensive individuals.
• Diabetes. African Americans have diabetes—a disease that can cause blindness, atherosclerosis, and kidney failure—at a rate 70 percent higher than whites. However, the Guidelines recommend consuming fat and animal protein at levels that exacerbate the incidence of diabetes and other diseases.
• Cancer. African-American males incur cancer rates 25 percent higher than do white males. Prostate cancer—which affects African-American men under 65 at twice the rate of white men—is linked with a diet high in meat and dairy products. But vegetarians and those eating a diet high in rice, soy products, and vegetables have much lower cancer rates. Yet, the Dietary Guidelines do not encourage Americans to replace meat and dairy products with the vegetables, legumes, fruits, and grains that, according to the American Dietetic Association, could reduce the incidence of cancer and other diseases.
• Obesity. This remains a serious problem, especially among African-American women. Obesity engenders very serious health problems, including diabetes, stroke, coronary artery disease, kidney disorders, hypertension, and childbirth complications. Studies have shown that individuals on a diet rich in plant foods and low in fat are much less likely to be obese. But the Guidelines push meat and dairy products and only recommend a modest reduction in fat—to 30 percent of total calories, rather than a much healthier 10 percent.

The consequences of weak and racially biased dietary policies are not just higher health care bills, but also preventable suffering and lost human potential. The 2000 Dietary Guidelines for Americans must be much stronger and sensitive to the health needs of ethnic and racial minorities.

Nutrition specialist Milton Mills, M.D., who practices in Alexandria, Virginia, also serves as associate director of preventive medicine at the Washington, D.C.-based Physicians Committee for Responsible Medicine. Merlene Alicia Vassall is a lawyer and writer in Silver Spring, Maryland.

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