Healthy Choices

Through the uniting power of food, advocates committed to improving outcomes in Detroit


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/// EATING HEALTHY is something that many list as a goal, especially this time of year. But whether it's an issue of access, budget, knowledge, or readiness for change, it seems to be easier said than done.

As Detroit navigates its way through financial woes and battles blight and crime, a food movement, born out of necessity (No organic bakery? No fresh produce at the gas station? No problem, let's get it done!), has taken root. It builds momentum with the rise of food entrepreneurs, grocery stores opening within city limits, and urban agriculture.
Within that tight-knit community, from an emergency medicine doctor at the Detroit Medical Center to the restaurateurs at Detroit Vegan Soul, advocates are working toward not just a vibrant Detroit, but also a healthy one.

Barriers to healthy eating — which can be a challenge in itself to define in a world with mixed messages (Eat gluten-free! Eat local! Eat organic! Eat whole wheat! Don't eat whole wheat!) — include lack of knowledge and readiness to modify behavior, says Kristen Egger, a registered dietitian who lives on the east side of Detroit in Pingree Park.

Take fruits and vegetables. Everyone knows that eating them is key to any healthy lifestyle — but we struggle to meet that goal. According to the 2013 State Indicator Report on Fruits and Vegetables, the median daily consumption of fruits of vegetables among Michigan adults is 1.1 times for fruit, 1.6 for vegetables — short of the recommendation to make half your plate fruits and vegetables at every meal.

Diet as it relates to disease has been a well-documented public health problem. According to a scientist collaborative led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, poor diet is the No. 1 risk factor for disease and death, topping smoking, high blood pressure, and alcohol and drug use.

As obesity rates have ballooned, so have Michiganians. The state's obesity rate was pegged at 10th in 2012, at 31 percent, according to an annual report of the Trust for

America's Health and the Robert Wood Johnson Foundation. About a third of the nation is obese, the CDC says.

This rising chronic health problem prompted metro Detroit doctor Frank Patino to write The Age of Globesity. While at an area water park, he had an epiphany: Everyone he saw was "significantly overweight or clinically obese. Worse yet, what really horrified me was the overwhelming prevalence of obesity in the children," he writes in his book.

The issue is even more glaring in Wayne County — and Detroit. Wayne ranks the lowest of Michigan's 82 ranked counties in terms of health, according to the 2013 Robert Wood Johnson Foundation County Rankings. The obesity rate is 34 percent in Wayne County, compared with 27 percent and 31 percent in Oakland and Macomb, respectively.

Also, as of this writing, Congress is debating cuts to funding for the federal program Supplemental Nutrition Assistance Program, which offers nutrition assistance to millions of Americans. This is on top of reductions in November after a funding increase under the stimulus bill expired.

Yet despite these challenges, a number of health advocates are working toward a healthier Detroit.

/// ADDRESSING ACCESS

At center of Detroit's food culture is the historic Eastern Market, which has ties to several of the initiatives and people outlined in this story. America's oldest public market does more than offer foodstuffs — its "vision is to create the nation's most robust, resilient, and inclusive regional food hub," says Dan Carmody, president of Eastern Market Corporation.

Part of that vision is to increase access and affordability in Detroit, which has been labeled a "food desert." Fiona Ruddy, who oversees food access programs at Eastern Market, says that label implies the city is barren, devoid of food. Optimists point to the 100-plus independent grocers in the city, urban farming, and farmers markets to contradict the assessment by Mari Gallagher in her report Examining the Impact of Food Deserts on Public Health in Detroit.

According to an overview of the city's food landscape by Data Driven Detroit, there are pockets across the city where residents live more than 1 mile from the nearest grocer, which is deemed low accessibility by the USDA. Transportation, especially the lack of access to a car, can pose an added challenge.

Negative perceptions of what's inside stores are also an issue. The Detroit Economic Growth Corporation's Green Grocer Project and Fresh Corner Cafe initiatives aim to improve fresh food offerings.

Photographer Noah Stephens is putting a lens on the issue by visiting every grocery store in the city on his bike to show there are healthy foods available in Detroit, spur conversation on healthy eating, and promote bicycling as a means of transportation.

"Before I started this project I would see these stores in aesthetically unwelcoming neighborhoods and make assumptions — a lot of people do — without investigating [what's inside]," says Stephens. The project is on his thepeopleofdetroit.com website.

Last year he started visiting Detroit stores and was "completely floored" by what he found — well-stocked shelves with staple ingredients and fruits and vegetables, all in stores in "the hood." As someone who grew up eating a healthy diet in Detroit, he wanted to push back against the arguments that people don't know what healthy food is and that there are no healthy foods in the city.

"Everyone agrees you can't find healthy food in Detroit — except people who actually shop for healthy food in Detroit. That's the point of my project: to give these people a platform," he says.

Stephens thinks the problem with diet-related diseases and poor health outcomes is not about supply but rather about demand. People interested in good, healthy food — like Detroiters he meets at the stores — will look for it. "It easier to say build more stores; it's harder to change the way people think," he says.

/// LESSON LEARNED

Another piece of the Detroit food access equation is its gas stations and corner stores, where fresh produce may be hard to come by — but may be the closest retail outlet for residents.

Noam Kimelman learned the hard way that simply having more produce isn't the entire answer. In May 2010, he launched Get Fresh Detroit, a business to bring fresh produce to corner stores — many of which have a reputation for carrying low-quality fare. He conceptualized the idea during a class he took at the University of Michigan, where he was pursuing his master's in health policy.

The produce packs he and his business partner offered included ingredients to make a stew or stir-fry in the $1.99-$2.99 price range and emphasized convenience, in the goal of making a gas station a one-stop shop for those who don't live close to a grocery store or supermarket. Get Fresh Detroit's "stew packs" were in 15 corner stores on the northwest side of Detroit in the summer of 2010.

"We thought if we could figure out a model in these corner stores, we could quickly scale and ramp out" to other locations, he says.

But the model was very unprofitable, and Kimelman and his partner lost a lot of money — about $15,000 to be exact. "It wasn't the right fit," he says. "We came into the city thinking we knew a lot more than we actually did ... We totally misunderstood the food landscape here.

"From the outside looking in we were like, ‘Oh, people are so desperate for anything that they would love to find a salad no matter where it is.' That was our huge misstep, thinking ... if you simply put fresh produce in front of them, [people] would jump at it."

The "mission-driven, for-profit" has evolved from fresh produce in gas stations to prepared food at retail locations — including gas stations, liquor stores, grocery stores, and cafes. They redesigned the model, asking customers what they really wanted.

"They did want fresh and healthy but convenience was also a really important factor. People wanted grab and go but not a stew pack from a gas station," Kimelman says.
Contracting with two restaurants that prepare the food, Fresh Corner Cafe is a delivery, marketing, and logistics company connecting the food (wraps, salads, and the like) to retail locations; they are in about 20 at the moment. While the goal is to get healthy food out to the stores, that part of the business takes up a lot of resources, so the catering aspect was formed to generate the necessary revenue for their work in the corner stores.

The revamped model appears to be gaining traction. They're venturing out to the suburbs, which they initially were against since they were Detroit-centric, but realized it's far more lucrative; Kimelman says the suburban stores (about six at the moment) generate 50 percent more revenue. Total annual revenue is about $150,000. They also received a grant to pilot a program with larger equipment that could spur more sales.

"Our goal essentially is to make healthy and fresh food as prevalent and accessible and available as fast food and unhealthy food," he says.

/// PLANTING SEEDS AMONG YOUTH

At Detroit Leadership Academy on the west side of Detroit, Angela Hojnacki holds up a plush toy in the shape of an avocado and asks a class of fifth-graders if they've ever seen the fruit before.

"Do you know where the seed is?" Hojnacki asks.

"Oh yeah it's that big old round thing," a student answers.

"Yeah, it's kind of like a peach. It has really big pit or seed so that actually means it's actually a fruit, and it's one of the few fruits and vegetables that has fat in it. ... It's actually a really good kind of fat," she says.

Hojnacki continues with her lesson, discussing what constitutes a healthy plate using the USDA's MyPlate as a guide, stopping for a physical education break, and wrapping up with a healthy snack: pumpkin dip with graham crackers.

Hojnacki is one of two service members based in Detroit from FoodCorps, a national program connecting kids to real food through gardening, nutrition lessons, and fresh produce in the cafeterias. Hojnacki, whose experiences growing up in the Berkley/Royal Oak area with limited access to fresh produce helped shape her work in food today, graduated in June from Massachusetts Institute of Technology where she studied mechanical engineering. She is Detroit Leadership Academy's healthy school coordinator, through Wayne State University's Building Healthy Communities Program and in partnership with FoodCorps.

As the healthy school coordinator, she oversees a wide range of programs and initiatives. Aside from the nutrition lessons, there's an after-school walking club, a student leadership team, and the school garden, a prime focus of hers.

"I think that it has to start pretty young to learn about fruits and vegetables and especially about how food grows," Hojnacki says.

In the 2012-13 program year, FoodCorps reached more than 900 students in Wayne County with more than 600 pounds of produce harvested and donated through nine gardening projects, according to Daniel Marbury, a Michigan-based fellow with the program.

Detroit Leadership Academy's health programs, including its on-site garden, have helped kids look at food in a new way.

Ten-year-old Patrishia Travis asks during Hojnacki's lesson if there are foods that can make her feel better. Later, Patrishia says she's feeling sick, which gave her an idea about food.

"I wanted to know if I can go buy fruit so I can get better. Now I can look up some more foods and try to make a mixture of fruits to make medicine."

/// EDUCATION FOR ADULTS, TOO

Mary R. Lewis takes pills morning, noon, and night for various health conditions, including diabetes.

So after listening to a talk given by Akua Woolbright, senior healthy eating and wellness educator at the Midtown Whole Foods Market, Lewis is open to incorporating some of changes Woolbright advocated during a nutrition talk at Warren Plaza Apartments.

"I might not have to be on meds," says the 77-year-old Detroiter.

Woolbright came to Detroit in 2012 after Whole Foods announced it was opening a store in Midtown, making it the first national grocery store to open in Detroit in years. She created Whole Foods' healthy eating program, Health Starts Here. The Detroit store also plans to open a teaching kitchen soon.

Woolbright's four-pillar approach (whole foods, plant strong, healthy fats, and nutrient dense) deviates from the standard messaging in order to expand the conversation "to get more real," she says.

"I'm giving people information on making food medicine," says Woolbright, who delivers nutrition presentations several times a week throughout the community to talk about not only her four-pillar approach but also to discuss food cravings and label reading. "I'm moving beyond portion control, moderation, eat more fruits and vegetables," the usual tenets of mainstream nutrition advice.

She also doesn't mince words.

"Eating a smaller plate of mac and cheese is not going to do enough to repair cells," says Woolbright, who has a Ph.D. in nutritional sciences.

/// FOOD RX

While Woolbright points out food can heal, Dr. Reginald Eadie points out that food can also harm. Eadie is an emergency physician and the president of DMC hospitals Sinai-Grace, Harper University, and Hutzel Women's who has worked in recent years to advocate for healthier food choices. A few years ago he published How to Eat and Live Longer, geared toward the African-American community, and Eadie has finished writing his second book, Eating from the Tree of Life.

As part of his health activism, he issued a challenge to DMC employees and the community to stop drinking sugary beverages in 2012. It began after an employee asked him how she could lose weight, and he told her to ditch soft drinks. He says an average can of soda pop has 240-290 calories, so one a day can translate to gaining 30 pounds in one year.

Consumption of soft drinks has also been linked to obesity. According to the Harvard School of Public Health, two out of three adults and one out of three children are overweight or obese, with consumption of sugary drinks a major factor in the rise of obesity. Take a look at the sizes: Before the 1950s, a standard soft-drink bottle was 6.5 ounces. Today, it has been super-sized to 1.25 liters, which can pack more than 500 calories. To put it into perspective, that's five medium apples — or a double cheeseburger.

Among the leading causes of death in the county are heart disease, cancer, and stroke, and Eadie ties those health problems to obesity, which is usually brought on by excessive calorie intake. The American Medical Association now recognizes this diet-related condition as a disease.

Last year he expanded his challenge to the community to ditch not only soft drinks but also fried foods. Why fried foods? Frying creates a suspected carcinogen, he says, which can lead to cancer. Such foods are also high in saturated fat, the culprit in atherosclerosis (hardening of the arteries).

Eadie emphasizes he's not waging war on soda and fast food but rather war against lack of education on their harmful effects. Using Detroit's current financial situation as an analogy, he says people are not seeing their own health as an emergency.

"We pay [the emergency manager] top dollar to come in and correct the finances, spend thousands on political campaigns — no one seems to care about the emergency right in front of their faces," he says.

/// CULTIVATING TOMORROW'S ENTREPRENEURS

In Detroit's thriving food entrepreneur world, values and people are just as important as profit. "There is something really unique to Detroit, with a strong focus on a community-based food system," says Jen Rusciano, who co-founded Detroit Food Academy, a program that aims to empower students to launch their own food businesses.

"There's a lot of support and interest and a willingness to share experience, time, and resources.

"The more we all grow the more the city grows."

This mentality in part paved the way for Detroit Food Academy, which originally started as a summer program through Eastern Market and has expanded to a two-part yearlong program at five high schools. The first component, the Academy, allows the student to learn about and explore Detroit's food system, says Rusciano, who is also a former FoodCorps service member.

The students meet twice a week for lessons on entrepreneurship and nutrition as well as cooking classes. That's followed by Small Batch Entrepreneurship Camp during the summer when the students are partnered with a business mentor; they've worked with entrepreneurs such as the Batata Shop, Corridor Sausage, and Slow Jams, to name a few.
The program emphasizes making healthy choices, Rusciano says. In the first year, the students produced vegetable chips and healthy dip. The following year they produced Zucchini Muffins (made with applesauce and no butter) and granola Mitten Bites.

During the education component, students are challenged to take something that is unhealthy — such as soft drinks or salty snacks — and put on a healthier spin. The students created a less sugary pop out of fresh grape simple syrup and carbonated water as well as healthier versions of Cheetos and Fritos, their favorite snacks.

"Health is not something to be ashamed of — we want them to know that their favorite foods are not terrible. We talk about moderation, trying to make things on their own ... we really want to make health and wellness acceptable and friendly instead of scary and super technical," Rusciano says.

/// COOKING FOR HEALTH

A few years ago, Detroiter Erika Boyd was told she was pre-diabetic; her partner, Kirsten Ussery, was given a similar bill of health. After Boyd's father died from cancer in 2010, the couple decided to go vegan.

Fast forward to 2013 when the couple launched their own soul food vegan restaurant.

Detroit Vegan Soul's menu is full of familiar-sounding favorites that have been "veganized" to appeal to nonvegan palates. For meat lovers, the Seitan Pepper Steak, which is stir-fried with veggies and served with brown rice and sesame broccoli, has changed some opinions.

"People have argued us down that it's really meat," Boyd says. Another favorite is "Catfish" Tofu, which is cornmeal-battered tofu served with broccoli, corn, and redskin potatoes. The tofu gets the "fishy" flavor from a secret ingredient: sea vegetables. The DVS Burger is a departure from the typical lentil burger, using millet instead. Millet, an ancient seed used as a grain, provides more nutrients, Boyd says, but is also a good choice for a "burger" because it holds things together well and, by using the right spices, can give that satisfaction of biting into a burger.

Boyd says she became "obsessed" with the vegan lifestyle, learning as much as she could. She grew up surrounded by cooking, with a mom who worked as a food service manager and a dad who co-owned a soul food cafe. At age 11, Boyd was cooking dinner for her family.

After making the change to veganism, "being a new vegan [eater], I was missing those flavors I grew up with," Boyd says.

Starting with family recipes, she started applying vegan cooking techniques to favorite dishes. They started serving to family and friends. The concept to bring vegan soul food to Detroit grew from there.

Ussery participated in an entrepreneurship program by D:Hive, a one-stop shop in Detroit that offers tools and resources for Detroiters who live, work, and play in the city. While in that class, the pair got their first customer. That led to more customers, then they launched their meal delivery service in February 2012, delivering to downtown, Midtown, Corktown, and the Villages. Then came the successful pop-up events, leading up to the restaurant where the motto is "Soul food made from whole food."

Through their food, they aim "to break the cycle of diet related diseases in our families and community. Our mission is to help people live healthier lives by providing great-tasting, high-quality, nutritious vegan food that appeals to everyone."

Studies have shown the health benefits of a vegan diet. In a 2009 article in The American Journal of Clinical Nutrition, author Winston J. Craig wrote such diets are high in fiber and nutrients while re-ducing risk of diseases such as cardiovascular, type 2 diabetes, obesity, and some cancers.

Their goal isn't to turn meat lovers into vegans but show people vegan meals don't have to be bland — and can be a part of a healthy lifestyle. "The whole idea is we wanted to create a more accessible entry way to a plant-based diet, food people can relate to," Ussery says.

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