It was the fourth time that day that I drew a dinner plate and marked off one-half for fruits and vegetables, one-quarter for grains and one-quarter for meat and other proteins. In my pediatric clinic, I use this “plate method” to show my patients and their families how they can proportion a healthy meal. This time, though, they weren’t buying it.
Manuel and his mom shook their heads and smiled as they told me that rice was always at least half of every plate at dinner. Though Manuel said he could hardly imagine eating dinner any other way, I knew something had to change for him. His 15-year-old sister was being treated for obesity-related diabetes, and at age 8, Manuel already weighed what an average 12-year-old does.
In the back of my mind were some unsettling statistics from the new Health of Boston, an annual report prepared by the Boston Public Health Commission and released earlier this month by Mayor Thomas Menino.
Detailing the latest health trends of Boston’s residents, the report highlights a difficult challenge: Compared to the city’s white residents, blacks and Latinos have poorer health outcomes, including higher rates of obesity. While 16 percent of white adults in Boston are obese, that rate jumps to 26 percent for Latino residents and doubles to 32 percent for black adults in the city.
Helping Manuel and his family beat the odds was going to require more than my plate picture. I recalled what Vivien Morris, a registered dietician at the health commission, often says. “Healthy foods are part of every culture’s rich traditions.”
So I put down my pen and asked Manual what foods his family liked to prepare. To help him, my plate drawing had to be a picture he could recognize.
Framing the discussion of healthy foods in a way that speaks to each individual’s food traditions is gaining national momentum. Each year for the last four decades, the Academy of Nutrition and Dietetics has celebrated National Nutrition Month in March as an opportunity to raise awareness of healthy eating.
This year’s theme, “Eat Right, Your Way, Every Day,” draws on diverse ethnic traditions for healthy menu ideas and other nutrition education.
Here in Boston, we are constantly working to help our diverse residents make healthier choices for themselves and their families. Through our blog, Facebook page and Twitter account, we share information about healthy recipes and nutrition tips, free and low-cost physical activity opportunities in neighborhoods around the city, and links to other resources.
Manuel and his family realized that by increasing the amount of cooked dried beans in his favorite rice and beans dish, he could reduce the amount of rice on his healthy plate. He also agreed to give quinoa (say “KEEN-wah”) a try.
This fluffy seed with a mild nutty flavor was once a sacred food of the ancient Incans of Peru and still is a healthier alternative to white rice. There are other healthy changes that he and his family could make at mealtimes, too, like baking chicken instead of frying it, adding more veggies, and serving water or low-fat milk instead of soda.
Manuel’s story shows that taking individual responsibility for our health is important. But at the Boston Public Health Commission, we know that’s not the whole story.
We are committed to prioritizing strategies that focus on the larger community and on the societal factors that influence health. We attend community health fairs, and we support programming, like walking groups, cooking classes, community gardens and farmers markets throughout Boston.
To accomplish our mission of building a healthier Boston, we need engaged families like Manuel’s, but we also need engaged communities. There is a lot more work to do, but working together with our neighbors, we’re making progress every day.
Dr. Huy Nguyen is the medical director at the Boston Public Health Commission and a pediatrician at the Dorchester House Multi-Service Center.
