For good health and longevity, eat what your ancestors ate. That's the lesson of the "Hawaiian Paradox." Though the general population in Hawaii lives longer than in any other state, native Hawaiians have the nation's highest rate of death from chronic diseases.
What's to blame? You guessed it -- our old scapegoat, the "typical American diet." For when native Hawaiians ate the traditional island diet as part of an experiment at the University of Hawaii School of Medicine, they not only felt better, they were better.
In one startling case study, an insulin-dependent diabetic woman was able to give up insulin after only four days on the traditional diet and has needed no diabetes drugs for more than two years.
The woman, who looked healthy and said she felt great, appeared at "Food Choices 2000: Sustainable Diets for the Next Century," a symposium held this summer at the Ritz-Carlton Hotel on the Big Island of Hawaii.
Other study participants also showed improved blood sugar, blood pressure and cholesterol levels. And while they ate more food, they lost weight.
Such improvements are significant in the face of native Hawaiians' high rates of obesity, diabetes (688 percent higher than the general population), heart disease (278 percent higher), stroke (245 percent higher) and cancer (226 percent higher), study director Terry Shintani said.
Food Choices 2000 was the third symposium on eating patterns for the next century organized by Oldways Preservation & Exchange Trust as part of a continuing attempt to evaluate the health benefits of ancestral foodways of diverse cultures. Speakers also reported on the traditional Mediterranean, Japanese and Chinese diets as models for healthy eating choices and consequent low rates of chronic disease and high life expectancy.
Traditional diets have in common plant-based foods at the center of the plate -- with meat, poultry, fish and dairy foods as supplementary sources of flavor and nourishment.
"The message is more plant food, less animal food," said Cornell's T. Colin Campbell, American director of the China Diet and Health Study. His Chinese counterpart, Junshi Chen, reported that "even when consumption of animal foods is low, it correlates with increases in chronic diseases."
The University of Hawaii diet, for example, centered on taro, a starchy root vegetable, mashed into poi, the traditional staple food. Also included were breadfruit, sweet potatoes, greens, seaweed, bananas, small amounts of fish and, occasionally, poultry.
No dairy foods were allowed. And only 7 percent to 12 percent of calories came from fat.
For most Americans, the classic Mediterranean diet is probably the most adaptable model for healthy eating because it is most familiar, suggested K. Dun Gifford, Oldways president.
It places heart-healthy emphasis on grains and legumes, fruits and vegetables, olive oil, wine in moderation with meals and low consumption of red meat, poultry, fish and dairy foods, according to Antonia Trichopoulou, professor of nutrition and biochemistry at the Athens School of Public Health.
So if, as the Oldways symposium demonstrated, there is international consensus on the proper diet for good health, why do Americans continue to eat high-fat, low-fiber, meat-centered diets? And why do immigrants abandon their national diets when they move to the United States?
Maybe we just don't know any better. Studies show that only one in four adults knows that federal dietary guidelines recommend a maximum of 30 percent of calories from fat. And a 1993 Gallup survey conducted for the Wheat Foods Council showed that only 3 percent of adults surveyed claimed to be "very familiar" with the 1990 U.S. Department of Agriculture Food Guide Pyramid, which replaces the old "four food groups."
A majority (59 percent) still believes there are just four basic food groups.
The wrong ideas
The survey also revealed that 50 percent of respondents incorrectly think bread is fattening, only 33 percent consider bread a good source of fiber and 93 percent said they eat less than the federal guidelines minimum of six daily servings of bread and grain foods daily.
Further, many people get the health-diet message completely wrong.
"To let them know what the priorities should be," Rick Bayless, chef/owner of the Frontera Grill and Topolobampo restaurants in Chicago and a conference panelist, told of a prank he sometimes plays on "sauce-on-the-side" customers. He sends out the sauce on the large dinner plate and the meat on a small side dish. Sometimes diners get the point; sometimes they just get angry.
Jerianne Heimendinger, who runs the National Cancer Institute 5-A-Day for Better Health program, has studied consumer resistance to dietary change.
People are unwilling to sacrifice taste, she reported, and many have a "why-bother?" attitude. They mistrust scientific data, wonder whether change will make any real difference to their health and worry about how it might affect relationships with others.
The right direction
Nevertheless, "people are making changes in the right direction," Ms. Heimendinger said, citing evidence of the decline in fat consumption and increase in carbohydrates consumption since the 1960s.
Anyone doubting that healthy eating is delicious eating might think in terms of a luncheon menu served at the symposium, prepared by Ritz-Carlton executive chef Amy Ota and a host of visiting chefs.
It included grilled bread topped with white bean puree and wilted greens from Italy; chickpeas in a spicy tomato sauce from Algeria; fava bean soup with fennel from Sicily; green lentils with roasted vegetables from Provence; tamales with pumpkin and smoked chipotle peppers from Mexico; papaya and black bean salad from the Caribbean; and puree of yellow split peas with dill and capers from Greece.
Here are some recipes from the chefs to get you on the road to healthy eating.
Pureed split pea dip
The recipe for yellow split pea puree -- a delicious hummos substitute -- comes from Joyce Goldstein, chef/owner of Square One in San Francisco. To serve, spread it on a flat plate, sprinkle with a little olive oil, shavings of raw red or green onion and freshly ground black pepper. Put out lemon wedges and pita bread, olives and feta cheese for a complete appetizer.
8 ounces dried yellow split peas
1 small onion, chopped
3 tablespoons olive oil
1 3/4 pints water
1 teaspoon salt
Pepper to taste
Wash beans and combine with onion, oil and water in a 2-quart pot. Bring to a boil over moderate heat. Reduce heat to a simmer, cover pan and cook for about 1 hour or until peas are so soft that they have disintegrated.
Puree in a food processor or push through a coarse strainer. Season with salt and pepper. Transfer puree to a serving plate, cover with plastic wrap and allow to cool and thicken.
George Mavrothalassitis, executive chef at the Halekulani hotel in Honolulu, served this salad with crumbled bacon and slices of sauteed rabbit. It would also taste good with chicken breast. But since it was the vegetables and dressing that captured me, I've adapted it as a vegetarian recipe.
If you've forgotten to soak beans overnight, cover them with hot tap water, bring them slowly to a boil, simmer for 2 minutes and soak one hour longer before draining and cooking. And in a pinch, even canned beans taste good in this salad.
For the vegetables
1/2 pound dry cannellini (white kidney) beans
1 medium zucchini, diced
1/2 cup dry fava beans
For the dressing:
1/4 cup extra-virgin olive oil
3 tablespoons fresh lemon juice
2 tablespoons chopped fresh basil
2 large garlic cloves, minced
1 teaspoon cracked coriander seeds
1 teaspoon chopped shallot
salt and cayenne pepper to taste
For the salad
4 mache or other lettuce leaves
1 tomato, peeled, seeded and chopped
1/2 Vidalia or other sweet onion, diced
2 tablespoons chopped green onion
Place cannellini beans and fava beans in separate saucepans, add enough tepid water to cover by 3 inches and soak overnight. Drain and rinse. Add enough water to cover beans and bring to a boil. Reduce heat and simmer until beans are just tender, about 40 minutes. Drain. Remove skins from fava beans.
Cook zucchini in a large saucepan of salted boiling water for 1 minute. Using a slotted spoon, transfer to a bowl of ice water to cool. Drain.
To make dressing, combine all ingredients. Toss mache with enough dressing to coat. Place beans, zucchini, tomato, sweet onion and green onion in a large bowl. Add enough dressing to coat and toss well. Divide mache among 2 plates and arrange vegetable mixture in center.