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Appalachian Americans love the culture of our ancestors. We are proud of our heritage and especially proud of those family recipes. Unfortunately, we love the ways of our ancestors when it comes to our dietary habits even though technology has dramatically changed our work habits. Appalachian Americans are much less active now and our lives are considered sedentary for the most part. Appalachian Americans were perhaps the hardest working people in the United States. This true grit brought on sweat from the constant physical demands necessary to meet daily needs. Technology has eliminated a lot of the physical demands; however, our diet has not changed.
While studying at Frontier Nursing University, I once had an instructor from the mountains of Eastern Kentucky. She said, “You know, the shelves in our small country stores haven’t changed much in my ninety years. Back then, stores primarily had flour, meal, sugar, lard, and canned processed commodities or fancy foods. Today, although not sold as often in bulk, most small country stores still have foods using the same ingredients of sugar, flour, meal, processed foods and fats.”
That conversation with my professor led me to adopt Non-Alcoholic Fatty Liver Disease as my Master’s Research Project, and I was astonished to discover how prevalent the disease is in my fellow Appalachian Americans. With between 50-60% of our population at risk, we are double the national average for developing non-alcoholic fatty live disease contributed to dietary habits which lead to obesity. The long-term consequence of fatty liver disease is cirrhosis of the liver. I’ve had patients diagnosed with cirrhosis who were in denial because they never consumed any alcohol or very minimal alcohol. Alcohol has been perceived as the cause of cirrhosis even though fatty liver can stem from our diet in lieu of alcohol consumption. However, when the two are combined together, the development of fatty liver followed by cirrhosis is very likely.
Let’s try to get active, exercise, and sweat. Or better yet, let’s find ways to sweat by bringing back the ways of our ancestors. Let’s raise family gardens. Let’s incorporate more physical labor into our daily regimens. Appalachia is known as the gravy belt by the rest of the country, and gravy I do enjoy. However, we now know it’s not the best thing for us. While in Maine completing a pediatric internship, I had to go 8 weeks without gravy. Even the Cracker Barrel didn’t sell gravy. I thought I had left and entered a foreign land. However that summer, I lost 15 pounds and was in the best physical condition I had been in for many years. I exercised daily and stayed busy sweating all summer. That is what we all need to do now to secure a healthier tomorrow.