“That whole BMI thing is a lie; it doesn’t include us!” Sound familiar?
Dr. Khadijah Breathett, MD, MS, FACC a Black female advanced heart failure/transplant cardiologist can’t remember how many times her Black friends have lamented to her about the body mass index (BMI), which they attribute mainly to White standards of weight and body types. “At a community health event, a Black woman inquired, “Why are doctors always asking me about my weight and BMI the minute I walk into their office?” However, Dr. Breathett, who is Assistant Professor of Medicine at the University of Arizona Sarver Heart Center, believes that Black women’s sizes have grown over the years, largely due to our lifestyles and eating habits. “I show my patients and community members maps of obesity over the decades, and we have been getting wider. Just look at photos of your great and great-great grandparents and their more slender physiques: we have been getting wider overtime.”
When it comes to heart disease, family history plays a big role: many of us know an aunt, grandparent, or close family friend that has succumbed to heart disease. From family cookouts to funerals— we like our fried chicken, mac n cheese, yams, and all that delicious southern food. “But by eating in an unhealthy manner, you add more fuel to the fire if heart disease runs in the family,” says Dr. Breathett. “Heart disease is the leading cause of death in African-Americans, particularly African-American women and it is a preventable disease!”
Dr. Breathett refers to the American Heart Association for much of her research in her practice and looks to the “Simple 7,” which are known ways to reduce risk of developing cardiovascular disease. They include developing healthy nutrition, exercising regularly, stopping smoking, achieving target blood pressure, cholesterol, blood sugar, and healthy weight.
In Dr. Breathett’s world, healthy nutrition means: 6-8 daily servings of whole grain products (yes, give us strength to pass by that white Wonder Bread in the bread aisle). She recommends choosing grains that are brown, like wheat bread, brown rice, and multigrain pastas or bean pasta.
Also, be sure to stack your plate with 3-5 daily servings of vegetables of different colors. “I tell patients to prepare half of their plate with vegetables that are still recognizable after cooking,” smiles Breathett. That means choosing greens that are sautéed on a skillet, steamed, or raw to know that you are not cooking away all of your nutrients. She also recommends 4-5 daily servings of fruit, 3-6 daily ounces of lean meats (oily fish 2x per week), and 3-5 servings per week of unsalted nuts/legumes. “Stick to the outer perimeter of the grocery store, where the fresh produce is stored.”
As for dairy, Dr. Breathett advises her patients follow the American Heart Association’s recommended 2-3 daily servings of fat-free or low fat dairy products. “Since many African-American are lactose intolerant, it may be difficult to obtain calcium/vitamin D from dairy.” “You can get your calcium from cereals, some leafy greens vegetables like collard greens, spinach, and kale and vitamin D from oily fish, in addition to over-the-counter supplements. Yogurt is also sometimes tolerated a little better than other dairy” says Dr. Breathett.
“As a pescatarian, my favorite foods include mixed greens (kale/arugula/spinach) and legumes like black-eyed peas/chickpeas cooked in a skillet or slow cooker with carrots, onions, and bell peppers .” Also, Dr. Breathett enjoys quinoa in moderation since high fiber content can sometimes be hard on digestive tract for some. Salmon; bananas (inexpensive, great source of vitamins/fiber); oatmeal (her staple breakfast), oranges and apricots are also high on her list.
Instead of jumping on the Instagram bandwagon of the latest diet fad and ending up on a yo-yo diet where you discipline yourself for a period of time and then revert back to bad habits, slowly make changes to your lifestyle. “For example, use herbs to help season food rather than seasonings with salt or sodium,” says Dr. Breathett. “Make little tweaks overtime, like adding turkey meat to your ground beef, and then supplementing it overtime entirely. In the long run, your taste buds won’t miss or crave some of those unhealthy foods.”