When Sandra Tomlinson’s husband, Kelvin, was diagnosed with type 2 diabetes, she set about figuring out how to cook healthier Caribbean meals without compromising on taste.
Although she was offered education sessions on how to alter recipes to help him, she was concerned that serving them may lead to marital strife.
The south Londoner says: “What they were asking me to feed my husband would bring divorce in the family.”
But after their life changed overnight, something had to change. She set about finding help in creating healthier twists on traditional Jamaican dishes.
She says: “I knew I had to help my husband, but I didn’t know how. Suddenly, the meals we’d always loved together felt like they were off-limits, and I felt lost trying to figure out what was best for him.”
She knew that type 2 diabetes was linked to carbohydrate and sugar consumption, but did not understand the importance of controlling portion sizes and that she was serving portions to her family that were too large.
Despite trying to change the household’s shopping habits and alter existing dishes herself, Tomlinson felt she needed more information on retrofitting the Caribbean recipes she had always made. Eventually she came across a scheme offering just that.
The Heal-D programme was founded in 2016 by Prof Louise Goff, an academic dietitian at the University of Leicester, who was inspired to launch it after finding the diabetes education programme offered on the NHS did not include information on African and Caribbean foods.
Participants work over seven weeks through a curriculum of diet and lifestyle advice, with a specific focus on transforming high-carbohydrate foods eaten in African-Caribbean communities – such as yam, plantain and cassava – into something more diabetes-friendly.
Goff says: “People were talking to me about how these programmes don’t talk about relevant African or Caribbean foods, so they’ve enjoyed being in a room with other people with diabetes – but they come home and they can’t take that advice and apply it to their lifestyle.
“A lot of our patients felt that their foods were being villainised and were being told to stop eating their foods, which were traditional and important culturally, such as yams and cassava.”
Since its launch, the programme has had more than 300 participants take part in their curriculum and workshops, which have been based in London. Now, the pilot scheme is expanding to Birmingham and Manchester, in the hope that it will become part of the NHS’s official diabetes education programme.
“It’s been the best thing ever. And not only for my husband but for the family across the board because now everybody is eating in the right way,” Tomlinson said. “For me it’s been a lesson of a lifetime, and one I’m glad that the generations now here in my family have taken on.”
The programme is especially important given the ethnic disparity in regards to type 2 diabetes, with black people in the UK being twice as likely to develop the disease compared with their white counterparts.
Goff says: “We know that particularly for carbohydrate foods, portion sizes are traditionally very large in African and Caribbean cultures, so we really look at that and focus on replacing carbohydrates with vegetables and more protein. We also focus on cooking with less salt and oil, so look at seasonings which are typically used and encourage swapping the kind of package seasonings over to homemade seasonings.”
Emma Pike, the deputy head of care at Diabetes UK, says there is “an urgent and ongoing need to tackle inequalities in diabetes care”, and that “education programmes are a key part of supporting people with type 2 diabetes”.
She says: “It is vital that information about physical activity and healthy eating is culturally appropriate and Heal-D is a fantastic example of how working closely with communities to shape education can help ensure that information and support meets their needs. We look forward to seeing the trial results that will inform the wider rollout of the Heal-D programme.”
Goff believes the scheme goes beyond sugar or carbohydrate content, and helps people express who they are. “You should absolutely be able to carry on eating goods which are important to your identity, background and who you are,” she said.
Pounded yam and kale riro recipe from the Heal-D programme
Ingredients:
427g puna yam (new yam)
150g kale, prepped and washed
1 sweet yellow pepper, diced
1 sweet red pepper, diced
4 garden eggs (teardrop aubergine), chopped
Chopped tinned tomato, small tin
4 chopped mushrooms
1 red onion, diced
Dried crayfish powder (optional)
½ scotch bonnet pepper (optional)
2 tablespoons of washed locust bean
1 small Maggi cube (optional)
1 teaspoon of Season-All
1 teaspoon curry powder
Method
For the pounded yam:
Wash, slice and dice the yam. Place yam in a pan of water, ensuring the water fully covers the yam by 1cm. Boil for 15-20 minutes – it’s ready when the fork says it’s mashable. Drain when it’s mashable. Using the back of a wooden spoon, pound it into a smooth mash. Spoon a fist-sized lump on to clingfilm and form into a ball.
For the kale riro:
Add chopped tinned tomatoes to pan on a low heat. Slice in ½ scotch bonnet pepper (optional). Add the red onion, diced. Add the curry powder. Add the Maggi cube (optional). Add the washed locust bean. Add four garden eggs (teardrop aubergine), chopped. Add four chopped mushrooms, red pepper and yellow pepper. Simmer on a low heat for three minutes. Add 150g kale – prepped and washed. Add dried crayfish powder (optional). Serve kale riro with a pounded yam ball.
