You may have heard the saying, “You are what you eat.” Science shows that this may not be too far from the truth: what you eat greatly impacts your health. Michael Fuller, a graduate research assistant for the University of Central Arkansas’s Master of Science in Dietetics & Nutrition Therapy program, has learned more about the interesting connection between food and health. As a physician, understanding this research will help you provide resources and support to patients with diabetes, cardiovascular disease, and obesity, three of Arkansas's most common disease states.
For Some, Finding Healthy Food Can Be Challenging.
People living in food deserts often buy their meals from corner stores that stock frozen, processed meals instead of fresh produce.Food deserts
Every county in Arkansas has a food desert. Food deserts are low-income areas with high levels of food insecurity — little to no access to healthy foods like fresh fruit, veggies, and low-fat milk.
According to an Arkansas Center for Health Improvement (ACHI) report, 136 out of 526 census tracts in Arkansas have at least 50% of the population with limited access to healthy food sources.
“Some families have to drive 20+ miles just to get fresh produce,” Michael says. “To some, this may not seem very far, but when you think about how often you may need groceries, a 40+ mile round trip can be a real challenge.”
The cost of gas to drive to the grocery store, plus the total cost of groceries, can quickly drain the family budget. Arkansans in rural areas must deal with financial struggles, low access to healthy food, and transportation challenges. These preventable factors lead to fewer opportunities for patients in our rural communities to achieve optimal health.
Effective Nutrition Interventions Utilize Mindfulness and Collaboration.
Consider cultural differences.
Like any state, Arkansas is full of diverse cultures with different beliefs about what type and how much food to eat. “Sometimes, nutritional recommendations and interventions can come from a perspective that may not consider cultural differences,” Michael says. “Culturally relevant and respectful recommendations can improve engagement and effectiveness in diverse communities.”
Social determinants of health lead to health disparities.
Health disparities are often influenced by social determinants of health, such as income, education, housing, and neighborhood environment. “Nutrition interventions must address these broader social factors to effectively improve health outcomes in underserved populations,” Michael says.
Community involvement makes a difference.
“Meaningful community involvement in developing and implementing nutrition interventions is crucial for ensuring their relevance, acceptability, and sustainability,” Michael says. “Encouraging communities to advocate for their own health needs and resources can help address disparities from the grassroots level.”
A Well-Balanced Meal Provides Health Benefits.
The Center for Disease Control and Prevention’s (CDC) latest Behavioral Risk Factor Surveillance System finds that 38.7% of Arkansas adults are obese (the sixth worst rate in the nation). CDC data (2022) also reveals that around 10% of the Arkansas population (307,400 adults) have diabetes, with around 7% of those (21,600 adults) being new cases. A healthy, diverse diet is one proven key to lowering these numbers.
A well-balanced meal usually includes a colorful blend of fruits, veggies, proteins, and grains.“Research tells us that eating a well-balanced meal (contributing to a healthy diet) provides numerous health benefits that support overall quality of life,” Michael says. “Eating a well-balanced meal that includes vegetables, whole grains, and lean (complete) protein provides your body with the necessary vitamins, minerals, and nutrients it needs to function.”
Daily meals consisting of each of the five food groups lower your risk of:
- Heart disease.
- Type 2 diabetes.
- Obesity.
- Cancer.
For help developing a balanced diet, see a local Registered Dietician at UCA’s Community Care Clinic or visit MyPlate.gov. AFMC’s Resources to Address Health Disparities make it easy for physicians to find tools they can use to help patients make healthy choices.
Be Aware of the Misconceptions.
A cup of blueberries contains the same calories as a chocolate bar but offers many more nutritional benefits.Not All Calories Are Created Equal.
While there is a time and a place for all food options, nutrient-dense foods (packed with essential vitamins and minerals) greatly differ from calorie-dense foods.
“For example, a cup of blueberries (a nutrient-dense food) and a Hershey’s candy bar (a calorie-dense food) both roughly contain the same amount of sugar,” Michael says. “However, blueberries provide significantly more fiber, vitamin C, vitamin K, manganese, and potassium than the candy bar.” The calories you gain from processed or fast food differ from those you gain from whole foods.
There Is No One-Size-Fits-All Approach.
Another dangerous misconception is that nutrition recommendations apply to all individuals. This overlooks the unique qualities of a person that influence their dietary needs and preferences, such as culture, socioeconomic status, and physiological health. “Applying a universal recommendation without considering the unique differences can lead to disparities in access to appropriate nutrition guidance and resources tailored to an individual’s specific needs,” Michael explains.
Healthy Foods Are Affordable.
“While it’s true that some healthier foods may be more expensive, the belief that eating a nutritious diet is prohibitively costly perpetuates the misconception that eating healthy is unattainable for individuals with limited financial resources,” Michael says. “In reality, there are many affordable ways to incorporate nutritious foods into one’s diet with careful planning and resourcefulness.” Resources like MyPlate can direct individuals to recipes and meal plans that are affordable and easy to prepare.
Be Careful What You Read on Social Media.
Some social media influencers or viral fad diets tend to eliminate entire food groups, such as carbohydrates or gluten-containing grains. This oversimplifies complex nutritional science and can contribute to dietary restrictions that may be unnecessary or detrimental. This misconception may disproportionately affect individuals with limited access to diverse food options, leading to unbalanced diets and nutrient deficiencies.
Personalize Your Meal Plan.
Individuals with diabetes should focus on a well-balanced diet that includes whole foods and limited sugary, high-calorie, and processed foods.
“It’s important to work with a Registered Dietician to develop a personalized meal plan that meets individual needs and promotes healthy blood sugar control and overall health,” Michael says.
Individuals with diabetes and other comorbidities can still enjoy a variety of foods while limiting processed, high-calorie, or sugary foods:
- Fruits and vegetables. Eat as many non-starchy vegetables as you want. Non-starchy vegetables include broccoli, carrots, and peppers. You can also enjoy your favorite fruits like apples or bananas.
- It’s important to make sure your diet includes plenty of protein. You can choose an animal-based source like chicken or turkey or a plant-based source like tofu.
- High- or low-fat foods. It’s best to limit high-fat foods. But, you can still enjoy your favorite items in a low- or non-fat version. If you need cream cheese for your favorite chicken alfredo recipe, try out non-fat cream cheese!
- Pasta. It’s important to limit your serving size for grains and pasta. Consider choosing a whole wheat pasta. This also applies to all grains: instead of choosing white rice, which is okay, try brown rice!
- Sweets. Sweets often get a bad rap, but as long as you’re eating a healthy diet, it’s okay to enjoy a treat from time to time.
Cooking with olive oil instead of canola or vegetable oil is a great way to incorporate healthy fats into your diet.
- Salty foods. If you have been diagnosed with diabetes, heart disease, or obesity, your doctor may have recommended that you limit the salty foods in your diet. Try to find low-sodium foods instead. If you use seasonings, try herbs and spices like parsley, peppercorns, dill, or green onions to add some new flavors to your meals. Even with sauces like ketchup or barbecue sauce, the low-sodium options are great to choose.
- Oils. The oils you find in your typical grocery store “vegetable oil” bottle are usually the least nutritious. On the other hand, extra virgin olive oil or avocado oil are high in healthy fats and will give your food a tasty flavor and pleasant aroma when cooking.
“Even with conditions like obesity, diabetes, and heart disease, individuals can still enjoy most of the foods they’re used to eating,” Michael says. “It’s just a matter of being more aware of what you shop for and making the necessary substitutions to keep the symptoms associated with those conditions at bay.”
It Doesn't Have to Be Hard to Make Healthy Food Choices.
Managing diabetes and obesity can present challenges, but patients can effectively improve and maintain good health with mindful dietary choices and help from a Registered Dietitian.
Read the Nutrition Label.
Nutrition labels on the foods at the store show the ingredients in the items we eat. “You can find out if foods are high in sodium, sugar, or carbohydrates,” Michael says. “If you were to read the label on a frozen, ready-to-eat meal, you’ll see that it has a large amount of sodium, carbs, and saturated fats.”
Packaging can be deceiving, so paying attention to food labels is important. Some products are marketed to appear healthier than they actually are. Generally, a short ingredient list is better.
Lose That Extra Scoop.
Portion sizing is also an important way to prevent overeating. “Often, people (including myself) may want an extra scoop of mashed potatoes, ice cream, or pasta,” Michael says. “Although it tastes good, it’s not always the best decision.”
Start with small portions and eat slowly, taking small sips of water between bites. This can prevent overeating. “We should also frequently check in on how full we feel and stop when we feel full,” Michael adds. “This is especially important with diabetes, as overeating can cause blood sugar spikes, which could lead to further health complications.”
A healthy plate includes 50% fruits and veggies, 25% protein, and 25% grains.Manage Portion Size.
Your portion sizes (using a 9-inch plate) should follow these three general rules:
- Non-starchy vegetables (green beans, peppers, cauliflower, tomatoes) should take up half the plate.
- Protein (lean meats, fish, tofu) should take up a quarter of the plate.
- Starches (rolls, beans, corn, or potatoes) should take up the other quarter of the plate.
Use measuring cups, scales, or visual cues to help you learn the right portion sizes for your health and well-being. Visit with a Registered Dietician, check out MyPlate.gov, or take a glance at WebMD’s Portion Size Guide for reference.
Stay hydrated.
Drink plenty of water throughout the day. Limit sugary beverages and choose to drink water, herbal tea, or other low-calorie or caffeine-free options instead. Monitor your blood sugar levels, adjust your diet and medication as needed, and consult your healthcare provider. Keeping track of your blood sugar levels can help you identify patterns and make informed decisions about your diet and lifestyle.
Research Initiatives Drive Improvement.
Michael is involved in USDA research as a graduate research assistant through UCA. Through this initiative, researchers look into food and nutrition insecurity and the relationship between dietary intake and cardiometabolic risk factors.
“Essentially, we are analyzing diet quality through focus groups and dietary recall interviews to give us data to create a tool to accurately assess diet quality,” Michael says. “The goal is for this tool to help identify those at risk for cardiovascular diseases and those who are nutrition insecure. Food insecurity can put people at risk for health disparities, so it’s important to be able to accurately measure this.”
Changes Start in Education.
Nutrition curriculum in early childhood helps raise awareness of the connection between good food and good health.
Establishing a solid education nutrition curriculum from early childhood to high school would help raise awareness of the correlation between dietary intake and cardiometabolic risk factors. “It is important to provide culturally relevant and community-based education from an early age,” Michael says.
“We have worked in Head Start classrooms and elementary schools to inform children about the importance of eating a balanced diet, reading food labels, and making healthy choices every day.”
Children are often the ones who lead a household to healthier habits. If they ask for fruits and vegetables, parents may be more likely to purchase these items.
“We also work with school meal programs, like the National School Lunch Program and School Breakfast Program, to provide affordable and nutritious foods that can be accessed by children during their school days,” Michael adds.
“Improvement is all about providing the knowledge and tools to practice outside the classroom, make more conscious, food-related decisions, and be comfortable with these skills.”
Policy Change Can Also Strengthen Impact.
“Making nutrition counseling and other nutrition-related services more available to the general public through Medicare would help fight the health disparities we face as a society,” Michael says. “From my understanding, you must already have a comorbidity, such as diabetes or kidney disease, for nutrition counseling to be covered by Medicare.”
Our patients should not have to wait until they are diagnosed to receive counseling services and nutrition support. Expanding existing services to all individuals as early as possible (and preferably before they’re diagnosed) is key to creating better health outcomes statewide.
“We must strengthen policies related to meal access and nutrition standards and incorporate nutrition education across the curriculum,” Michael says. “We need to address geographic disparities across this region to help develop accessible nutrient-dense foods that are available in rural and low-income areas.”
Working together collaboratively is the best way to make changes. We can leverage resources, expertise, and collective action toward common goals through partnerships with public health agencies, healthcare providers, educators, policymakers, community organizations, and industry stakeholders.
Healthy food choices lead to better health outcomes. While individuals in rural areas still struggle to access healthy foods, USDA research will provide evidence that diet and overall health are connected. In the future, this research may lead to positive changes in healthcare policy, insurance coverage, and enhanced funding opportunities.
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Michael Fuller grew up in the small town of Fairfield Bay, Arkansas, and is currently a Conway resident with his wife, Josie. He will be graduating from UCA with a Master of Science in Dietetics in August of 2024 and then will be able to sit for the RD exam. He likes to spend time with his Labrador, Zeus, play pickleball, and watch movies in his free time. His career goals are to become a registered dietitian and work in a clinical setting. He hopes to eventually specialize in renal nutrition, obesity and weight management, or pediatrics.
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