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Fortifying Our Health: The Role of Dairy in Black Americans' Diets

Wednesday, September 25, 2024   (0 Comments)

Fortifying Our Health: The Role of Dairy in Black Americans' Diets 


As medical students from ethnic backgrounds underrepresented in medicine, we have a unique opportunity to advocate for the health and well-being of our communities. The relationship between African Americans and dairy is shaped by a complex history of higher rates of lactose intolerance, limited access to healthcare, and dietary patterns influenced by systemic inequities1,2 For many African Americans, lactose intolerance has led to widespread misconceptions about the need to avoid dairy entirely3. These beliefs, coupled with generational mistrust of the healthcare system, have contributed to lower dairy consumption, despite its significant health benefits.

As future physicians, it’s essential that we not only challenge these myths but also understand their historical and social roots. Lactose intolerance does not always require complete avoidance of dairy, as many individuals can still consume forms that are easier to digest, such as yogurt and cheese4. By highlighting the nutritional benefits of dairy products like milk, cheese, and yogurt, we can empower our communities to make informed dietary choices that enhance their health. These foods provide essential nutrients and, when consumed appropriately, can play a crucial role in addressing health disparities, including those related to bone health, cardiovascular health, and diabetes prevention5,6.

 

Addressing Health Disparities 

Nutritional disparities among Black Americans are influenced by a combination of socioeconomic factors, discrimination, and food insecurity. These challenges contribute to higher rates of chronic diseases and nutritional deficiencies6. For instance, Black communities often have lower intakes of calcium and vitamin D, which are crucial for bone and cardiovascular health6.



Socioeconomic Factors: Limited access to affordable and nutritious foods, including dairy, can hinder our ability to maintain a balanced diet. Educating ourselves and our communities on budget-friendly dairy options and government programs like WIC (Women, Infants, and children) that provide dairy products can help mitigate these barriers6.

Discrimination and Misinformation: Historical mistrust in the healthcare system and misinformation about dietary needs have also impacted our dietary choices. This is a key role that Black medical students can play in building trust within healthcare practices. This includes providing accurate information about the benefits of dairy6.

 

The Nutritional Benefits of Dairy 

Milk, cheese and yogurt offer unique nutrition and health benefits that other food groups don’t. Real dairy milk provides high-quality protein and essential vitamins and minerals, including calcium, potassium, phosphorus, zinc, selenium, iodine, and vitamins A, D, B12, riboflavin (B2), niacin (B3), and pantothenic acid (B5), delivering key nutrients that many Americans lack in their diets7.These nutrients are vital for maintaining bone health, muscle function, and immune support5.  Black Americans and people of African heritage often face higher rates of chronic diseases like hypertension and diabetes. Including milk, cheese and yogurt in our diets can provide significant health benefits5.

Brain development: Research indicates that adequate dairy intake during early childhood is associated with improved cognitive outcomes, particularly in areas such as language development and memory function. Research suggests that consuming milk and dairy products contributes to better brain development due to bioactive peptides that influence cognitive processes8. Additionally, dairy consumption has been linked to higher levels of vitamin B12, which is crucial for the formation of the myelin sheath that protects neurons9. Ensuring an adequate intake of dairy products may, therefore, support optimal neurodevelopment in children, although further studies are needed to clarify the long-term effects.



Bone Health and Child growth and development: Calcium and vitamin D are critical for bone density and strength, helping to prevent osteoporosis, a condition prevalent in older adults. Regular dairy consumption can help ensure we get enough of these nutrients, reducing the risk of fractures and improving overall skeletal health10. In addition, while dairy milk provides important nutrients for bone health, it also provides many other essential nutrients important to nutrition security and other public health benefits for children such as brain development in the first 1,000 days.

Muscle Maintenance: The high-quality protein in milk, cheese, and yogurt supports muscle repair and maintenance, which is particularly important for aging adults who are at risk of sarcopenia (age-related muscle loss). Including these dairy foods in our diets can help preserve muscle mass and strength, enhancing mobility and quality of life10.

Cardiovascular Health: Potassium in milk, cheese, and yogurt helps regulate blood pressure. High blood pressure is a major concern given the higher incidence of hypertension in black communities. By balancing sodium levels, potassium can aid in maintaining heart health and reducing the risk of stroke6.

Diabetes risk reduction: Recent research has examined the relationship between dairy consumption and the risk of developing type 2 diabetes, highlighting a potentially protective effect. A dose-response meta-analysis and systematic review of cohort studies found that higher dairy consumption was associated with a reduced risk of type 2 diabetes mellitus, particularly with the intake of low-fat dairy products. The study by Feng et al. suggests that the consumption of dairy, especially yogurt and low-fat options, may contribute to lower diabetes risk due to favorable effects on glucose metabolism and body weight management11. This evidence supports the notion that incorporating dairy into a balanced diet may be beneficial for diabetes prevention, although the specific impact may vary depending on the type and quantity of dairy consumed.

 

Debunking Myths and Overcoming Barriers 

One of the most common barriers to dairy consumption is lactose intolerance, which is more prevalent among us. However, lactose intolerance does not require the complete elimination of dairy from our diets. There are various strategies to manage this condition while still reaping the benefits of dairy5.

Lactose-Free Options: Lactose-free milk and lower lactose options such as yogurt, cheese and kefir provide the same essential nutrients without causing digestive discomfort. These products are widely available and can be easily incorporated into daily meals5.

Fermented Dairy: Yogurt and kefir contain beneficial probiotics and often have lower lactose content, making them more digestible for those of us with lactose intolerance. These products support gut health and can be incorporated in various recipes5.

Small Portions and Gradual Introduction: Starting with small portions of dairy and gradually increasing intake can help our bodies adapt and reduce symptoms of lactose intolerance5.

Plant-based milk alternatives, while popular, do not provide the same nutritional benefits as dairy milk and are not suitable substitutes, especially for young children12. Leading health organizations across North America, such as the Academy of Nutrition and Dietetics and the American Academy of Pediatrics, caution against their use. They highlight concerns about nutrient inadequacy, the uncertain bioavailability of fortified nutrients, and the potential risks to growth and development in children citing concerns with nutrient inadequacy, uncertainty around fortified nutrient bioavailability and potential harm to growth and development.


Practical Strategies for Daily Dairy Intake 

Incorporating dairy into our diets can be simple, accessible, affordable and delicious. Did you know that dairy milk is a source of 13 essential nutrients for just 23 cents per 8-ounce serving, or 55 cents per serving of lactose-free dairy milk?  Here are a few practical tips:

Breakfast: Add milk to cereals, oatmeal, or smoothies. Another option is yogurt with fresh fruit and nuts for a nutrient-packed start to the day. 

Lunch: Include cheese in sandwiches or salads. Enjoy a glass of milk with your meal. 

Dinner: Use dairy in cooking, such as adding cheese to casseroles or incorporating milk into soups and sauces. 

Snacks: Choose yogurt or cheese sticks as convenient and healthy snack options.  

Conclusion 

Educating ourselves about the importance of dairy can empower us to make informed dietary choices and advocate for better health within our communities. By understanding the nutritional benefits, addressing health disparities, debunking myths, and providing practical strategies, we can improve health outcomes and enhance the quality of life for Black Americans across their lifespans. As future doctors, we have the power to drive change and promote a balanced, nutrient-rich diet that includes dairy, contributing to healthier, more vibrant communities.

 

Preparing Creamy Spaghetti Carbonara Recipe12

Ingredients:

  • 8 ounces spaghetti
  • 4 ounces pancetta, diced
  • 2 garlic cloves, minced
  • 1 cup half and half
  • 2 large egg yolks
  • 1 cup grated Parmesan cheese
  • Black pepper and red pepper flakes, to taste
  • Fresh parsley, chopped

Steps:

  1. Boil pasta: Cook spaghetti in salted water for 8-10 minutes until al dente. Drain, reserving ½ cup of pasta water.
  2. Cook pancetta: Sauté pancetta over medium heat for 4-5 minutes until crispy. Remove from the pan and set aside.
  3. Make the sauce: Sauté minced garlic in the pancetta fat for 1 minute. Add half and half, simmering for 2-3 minutes. Whisk the egg yolks in a separate bowl and slowly whisk in some hot cream to temper them. Then, return the egg mixture to the pan and cook for another 2-3 minutes until the sauce thickens. Stir in Parmesan cheese, black pepper, and red pepper flakes.
  4. Combine and finish: Add the cooked spaghetti to the sauce, tossing to coat. Stir in the pancetta and some reserved pasta water if needed for consistency. Garnish with fresh parsley and additional Parmesan. Serve hot.
 


Citations

1. African American Health Disparities and Dairy Consumption. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/32299794.
2. Lactose Intolerance in African Americans: Historical and Cultural Context. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/20404392.
3. Matthews SB, Waud JP, Roberts AG, Campbell AK. Systemic lactose intolerance: A new perspective on an old problem. Postgrad Med J. 2005;81(953):167-173. doi:10.1136/pgmj.2004.026443.
4. Shaukat A, Levitt MD, Taylor BC, et al. Systematic review: Effective management strategies for lactose intolerance. Ann Intern Med. 2010;152(12):797-803. doi:10.7326/0003-4819-152-12-201006150-00241.
5. Mitchell E, Comerford K, Knight M, McKinney K, Lawson Y. A review of dairy food intake for improving health among Black adults in the US. J Natl Med Assoc. 2024;116(2 Pt 2):253-273. doi:10.1016/j.jnma.2024.01.018.
6. Comerford K, Lawson Y, Young M, et al. The role of dairy food intake for improving health among Black Americans across the life continuum: A summary of the evidence. J Natl Med Assoc. 2024;116(2 Pt 2):292-315. doi:10.1016/j.jnma.2024.01.020.
7. National Dairy Council. What’s in Your Glass? U.S. Dairy. January 2024. Accessed August 17, 2024. https://www.usdairy.com/news-articles/whats-in-your-glass
8. Heaney RP, Layman DK. Dairy intake, dietary protein, and bone health. J Nutr. 2018;148(3):329S-333S.
9. Allen LH. Vitamin B12 metabolism and status during pregnancy, lactation, and infancy. Adv Nutr. 2012;3(3):201-207.
10. Mitchell E, Comerford K, Knight M, McKinney K, Lawson Y. A review of dairy food intake for improving health among black geriatrics in the US. J Natl Med Assoc. 2024 Apr;116(2 Pt 2):274-291. doi: 10.1016/j.jnma.2024.01.017.
11. Feng Y, Zhao Y, Liu J, Huang Z, Yang X, Qin P, et al. Consumption of dairy products and the risk of overweight or obesity, hypertension, and type 2 diabetes mellitus: a dose-response meta-analysis and systematic review of cohort studies. Adv Nutr. 2022;13(6):2165-79.
12. Lott M, Callahan E, Welker Duffy E, Story M, Daniels S. Healthy Beverage Consumption in Early Childhood: Recommendations from Key National Health and Nutrition Organizations. Consensus Statement. Durham, NC: Healthy Eating Research, 2019. Available at http://healthyeatingresearch.org
13. Hess JM, Cifelli CJ, Fulgoni Iii VL. Energy and Nutrient Intake of Americans according to Meeting Current Dairy Recommendations. Nutrients. 2020;12(10):3006.
14. Hinton PS, Rector RS, Donnelly JE, et al. Total body bone mineral content and density during weight loss and maintenance on a low- or recommended-dairy weight-maintenance diet in obese men and women. Eur J Clin Nutr. 2010;64(4):392-399.
15. Palacios C, Bertrán JJ, Ríos RE, et al. No effects of low and high consumption of dairy products and calcium supplements on body composition and serum lipids in Puerto Rican obese adults. Nutrition. 2011;27(5):520-525.
16. U.S. Dairy. Creamy Spaghetti Carbonara Recipe. U.S. Dairy. Accessed August 17, 2024. https://www.usdairy.com/recipes/creamy-carbonara
17. Healthy Eating Research. Dairy Milk vs. Plant Milks for Toddlers & Young Kids [Internet]. Available at: https://healthydrinkshealthykids.org/app/uploads/2022/09/Dairy-Milk-vs-Plant-Milks-for-Young-Kids.pdf

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