Shari Belafonte's Eating Tips: Cut the Fat (review)

396 Review SHARI BELAFONTFS EATING TIPS: CUTTHEFAT By Michael F. Jacobson, Ph.D., Jayne Hurley, R.D., and Bonnie F. Liebman, M.S. Poster. Washington, DC: Center for Science in the Public Interest, 1990. $4.95 (paper, folded), $9.95 (laminated), plus $1 shipping. THIS COLORFUL POSTER is designed to provide Af rican-Americans with timely information on high-fat foods, risk factors associated with high-fat diets, and ways to decrease fat intake. It is the product of the Center for Science in the Public Interest, a Washington, D.C.-based nutrition advocacy group, in conjunction with the auxiliary to the National Medical Association, a professional organization representing 16,000 black physicians. The poster explains that African-Americans suffer high rates of heart attacks, stroke, diabetes, and cancer, and spotlights a number of high-fat foods—greens and ham hocks, fried chicken, scrapple—that are popular in the black community. For some of these fatty items, the poster suggests such lowfat alternatives as water-packed tuna for oil-packed, and whole-wheat rolls for biscuits. Likewise, troublesome fast foods (e.g., Burger King's Croissan'wich with Sausage, at nine teaspoons of fat and 538 calories) are accompanied by leaner alternatives (McDonald's pancakes with butter and syrup, at two teaspoons of fat and 410 calories). The poster presents several low-fat meals, and suggests low-fat preparation methods. Here well-rendered illustrations convey nutritional information quickly. For example, to show the difference between a fatty meal of fried fish and french fries, versus broiled fish and baked potato, the fat content of both meals is represented graphically in actual teaspoons of fat (10 vs. two). As a parting note, the poster reminds readers that health means more than simply eating low-fat foods, and suggests such lifestyle tips as "good health means no tobacco" and "cut back on beer, wine, coolers, and liquor." To help evaluate this poster, I asked dieticians, health educators, and other health care providers at our comprehensive health center to critique it in light of the needs of our clients, who are largely low-income Af rican-Americans and Hispanics with fifth- or sixth-grade-level reading skills. Everyone said that Journal of Health Care for the Poor and Underserved, Vol. 2, No. 3, Winter 1991 ___________________________________________________________397 the poster contains too much information. While the brief handwritten explanations next to the illustrations (example: "Burgers are healthier without the mayonnaise, bacon, or cheese" ) are beneficial because the messages are simple, the majority of our clients would neither read the more detailed text of the poster nor would they understand the bar graph of death and disease rates among blacks. Among people who sometimes lack basic nutrition information, some items in the poster may be misleading. One is the statement that "fatty foods raise your blood pressure." Cholesterol is one of several kinds of fatty materials that can coat the walls of the arteries, causing plaque. Plaque, in turn, can accumulate and eventually harden the arteries. In general, the higher the level of cholesterol in the blood, the greater the risk of cardiovascular disease. But there are a number of risk factors for developing high blood pressure, including being overweight, consuming a high-sodium diet, and smoking cigarettes. Some of our clients might assume from the poster that in the control of hypertension, these factors are less important than consuming a low-fat diet. Likewise, the headings that punctuate each section are valuable because they are brief, emphatic, and colorful, and therefore likely tobe read. (Examples: "Fried Means Fatty!" "Fast Food, Not Fat Food!") But one such heading ("Beans & Bread, Not Beef!") might be misinterpreted as an unconditional warning. A more appropriate heading might be "Beans & Bread, and Less Meat!" The text underneath the heading explains the value of eating more chicken and fish, and less beef and pork, but again, a person who does not read the text may miss this point. Our clients might view several items as out of sync with the black community. For example, the poster advises that greens be steamed with smoked turkey necks or Liquid Smoke. These seasonings are useful replacements for table salt, but the only leafy green vegetable traditionally...