Food, Culture and the Secret Ingredient to Address Lack of Diversity in Nutrition Field

Michael Merschel wrote . . . . . . . . .

You are what you eat. And what you eat is a reflection of who you are – your family, your history, your traditions.

But for many people who need guidance on eating, finding an expert with a common background can be a challenge. Most dietitians – 81% of them according to the credentialing agency for the Academy of Nutrition and Dietetics – are white. Nearly 94% are women.

That lack of diversity is a problem, said Deanna Belleny Lewis, a registered dietitian nutritionist and public health practitioner in Hartford, Connecticut.

“Food is very much a part of culture, and you can’t really take the culture out of food – you shouldn’t at least,” said Belleny Lewis, co-founder of the nonprofit group Diversify Dietetics. “We think we just need more dietitians who can relate to the diverse clients and the diverse communities that we serve.”

The academic world tends to take a Eurocentric approach to nutrition, she said. The quinoa-and-kale crowd gets the spotlight, while foods from non-white cultures get overlooked.

The problem is slowly being acknowledged at high levels.

The latest federal Dietary Guidelines for Americans acknowledge that a healthy diet should “reflect personal preferences, cultural traditions and budgetary considerations.” A 2019 report from the American Diabetes Association said that a “one-size-fits-all” approach to nutrition therapy is unrealistic.

But dietitians, who can play a crucial role in teaching healthy habits, often take just such an approach.

Ka Hei Karen Lau is a registered dietitian and certified diabetes care and education specialist at the Joslin Diabetes Center’s Asian American Diabetes Initiative in Boston. Most of her patients come from a Chinese background. Many arrive from other clinics with a common complaint: “They don’t understand the food that I’m eating.”

For example, rice. Textbook advice, Lau said, frowns on white rice, and people often are counseled to avoid it because regular consumption may increase the risk of Type 2 diabetes. But “that’s a big thing in our culture,” said Lau, who is originally from Hong Kong. Rice is woven into the language: People greet one another by asking, “Have you had rice yet?” So the idea of giving it up sounds laughable.

But Lau’s shared background helps her say, “Hey, we can respect tradition, we can respect the culture and work around it.” Instead of counseling someone to abandon rice, she might suggest using whole-grain rice, trying smaller portions, or balancing it with vegetables and proteins.

Whitney Brooks, a registered dietitian nutritionist from the Seneca Nation in western New York, said dietitians who lack cultural awareness also can overlook the deep, systemic roots of problems.

Native Americans have the highest diabetes rates among racial and ethnic groups in the U.S., according to the Centers for Disease Control and Prevention. Dietetics textbooks emphasize individual choice and eating less, but Brooks said “a lot of those things don’t apply when you don’t understand the historical trauma. There’s no getting around that in the Native population.”

When driven from their land, Indigenous people lost more than territory. Traditional foods were replaced with government rations, which included processed white flour, oil and salt pork.

“That puts the historical context on the high rates of diabetes that Native communities face,” she said. “It’s not just, ‘Oh, we’re choosing badly for ourselves.’ We’re coming from a place where we had no choice. It was survival.”

She and Belleny Lewis both said colleges should improve at recruiting dietitians from diverse backgrounds. Brooks, whose path to a degree took a decade, said she was championed and mentored by people who saw her worth when traditional professors did not.

To help change the system in the short term, they said, health care professionals can practice “cultural humility.”

The concept emphasizes a patient’s perspective, Belleny Lewis said, and requires constant self-reflection and self-awareness by the clinician. “It’s recognizing that yes, everybody does have biases, but how can you unlearn those biases?

“I think the part of being a culturally humble practitioner is knowing that if you don’t know the foods, let people describe it to you,” she said. Humility means that instead of rejecting such food out of hand, a dietitian could say, “Tell me about that,” then find ways to make it part of a healthy diet.

It takes courage to unlearn biases, Lau said. It also can be fun. Lau’s clinic focuses on Asian Americans, but that gives her many countries, cultures and nuances to explore. So, she educates herself by reading and by trying unfamiliar restaurants. “I have friends in all those different cultures,” and she’s “shameless” about asking them about their choices.

“I’m still learning,” Lau said. “I think everyone is still learning. Even people of color, we’re still learning.”

It can simply come down to empathy. Brooks recalled a Black working-class patient who juggled two jobs and a family. After Brooks praised her for all she was doing, the woman broke down in tears and opened up to the idea it was time for self-care.

Brooks adjusts her advice to fit a patient’s background. She usually emphasizes a plant-based diet. But she knows that in the Navajo Nation, many people lack running water. “So how can I tell them, ‘Oh yeah, just grow your own garden’?” Similarly, she wouldn’t tell someone from the hunting-based Inuit culture to go vegan.

“You can have all the best knowledge, you can know everything about everything, but if you don’t know how to relate to that person, whoever you’re speaking to on a deep level, it’s going to be hard to communicate these ideas,” she said. “Especially if you’re addressing issues of change, especially changing diet, which is so personal.”

Source: American Heart Association

Time to Shift from “Food Security” to “Nutrition Security” to Increase Health & Well-Being

In the 1960s, a national focus on hunger was essential to address major problems of undernutrition after World War II. In the 1990s, the nation shifted away from hunger toward “food insecurity” to better capture and address the challenges of food access and affordability. Now, a new Viewpoint article argues that today’s health and equity challenges call for the U.S. to shift from “food insecurity” to “nutrition insecurity” in order to catalyze appropriate focus and policies on access not just to food but to healthy, nourishing food.

The Viewpoint, by Dariush Mozaffarian of the Friedman School of Nutrition Science & Policy at Tufts University, Sheila Fleischhacker of Georgetown Law School, and José Andrés of World Central Kitchen, was published online in JAMA.

The concept of food security focuses on access to and affordability of food that is safe, nutritious, and consistent with personal preferences. In reality, however, the “nutritious” part often has been overlooked or lost in national policies and solutions, with resulting emphasis on quantity, rather than quality, of food, say the authors.

“Food is essential both for life and human dignity. Every day, I see hunger, but the hunger I see is not only for calories but for nourishing meals. With a new focus on nutrition security, we embrace a solution that nourishes people, instead of filling them with food but leaving them hungry,” said Chef José Andrés, founder of World Central Kitchen.

The authors define nutrition security as having consistent access to and availability and affordability of foods and beverages that promote well-being, while preventing — and, if needed, treating — disease. Nutrition security provides a more inclusive view that recognizes that foods must nourish all people.

“‘Nutrition security’ incorporates all the aims of food security but with additional emphasis on the need for wholesome, healthful foods and drinks for all. COVID-19 has made clear that Americans who are most likely to be hungry are also at highest risk of diet-related diseases including obesity, diabetes, heart disease, and many cancers – a harsh legacy of inequities and structural racism in our nation. A new focus on nutrition security for all Americans will help crystallize and catalyze real solutions that provide not only food but also well-being for everyone,” said first author Dariush Mozaffarian, dean of the Friedman School of Nutrition Science & Policy at Tufts University.

“It’s the right time for this evolution,” said Sheila Fleischhacker, adjunct professor at Georgetown Law School, who has drafted food, nutrition and health legislation and campaign positions at the local, state, tribal and federal levels. “By prioritizing nutrition security, we bring together historically siloed areas – hunger and nutrition – which must be tackled together to effectively address our modern challenges of diet-related diseases and disparities in clinical care, government food and food assistance policies, public health investments, and national research.”

“The current approach is not sufficient,” the authors write, and “traditionally marginalized minority groups as well as people living in rural and lower-income counties are most likely to experience disparities in nutrition quality, food insecurity, and corresponding diet-related diseases.”

Source: Tuffs University

Update on Osteoporosis — What You Should Know About Dietary Recommendations and the Latest Therapeutics

Densie Webb wrote . . . . . . . . .

In the midst of a pandemic, it’s easy for clients to forget about other pressing medical conditions they urgently need to focus on for prevention or treatment. These may include osteoporosis and low bone mass, which, according to the National Osteoporosis Foundation (NOF), affect about 54 million Americans. Of those, an estimated 10 million have osteoporosis, and 34 million people have low bone mass, putting them at future risk of osteoporosis.

To further emphasize the gravity of the disease, the NOF points to studies suggesting that approximately 1 in 2 women and up to 1 in 4 men aged 50 and older will break a bone at some point in their lives due to osteoporosis. Virtually all hip fractures are attributed to osteoporosis and are most common in people older than 65, with women having twice the rate of hip fractures of men. In fact, 71% of all osteoporotic fractures occur among women. After a hip fracture, only a subset of women regain their pre-fracture quality of life—up to 17% end up in a nursing facility. As much as 23% will die within two years post fracture, and that proportion increases significantly with age—as high as 32% for women aged 85 and older. These alarming statistics make osteoporosis prevention a health priority.

Osteoporosis 101

Osteoporosis literally means “porous bone.” In severe cases, the bone can have a Swiss cheese appearance on X-ray. In such severe cases, bones may become so fragile that something as simple as opening a window, coughing, or sneezing can cause bones to fracture. But before a client or patient reaches that stage of osteoporosis, they may be diagnosed with osteopenia or thinning bone, which simply means they’re losing bone faster than they can replace it, and it needs to be addressed.

Aside from gender and age, many factors determine osteoporosis risk, such as smoking, alcohol consumption, chronic treatment with glucocorticoids, long-term treatment with estrogen blockers, gastrointestinal disorders, type 1 and type 2 diabetes, rheumatoid arthritis, liver disease, gluten enteropathy, and hematologic disorders. Even air pollution has been suggested to contribute to risk.

Some unchangeable risk factors, such as age, gender, and race, determine up to 75% of peak bone mass. However, changes in diet and activity beginning at an early age can affect the 25% that’s within an individual’s control. So, it’s important to remember that risk actually begins in childhood. In fact, the office of the Surgeon General states that “prevention of bone disease begins at birth and is a lifelong challenge.” During childhood and adolescence, much more bone is deposited than is lost. Up to 90% of peak bone mass is acquired by age 18 in girls and by age 20 in boys.6 That makes healthful eating and physical activity in childhood and adolescence an important step toward prevention in adulthood. This holds true for both boys and girls.

One of the biggest misconceptions about osteoporosis, says Isabel Maples, MEd, RDN, a spokesperson for the Academy of Nutrition and Dietetics (the Academy) based in Washington, D.C., is that it doesn’t affect men, but statistics paint a different picture. It’s true that far more women than men are affected, but according to the NOF, approximately 2 million American men have osteoporosis and about 12 million are at risk. Each year, about 80,000 men will break a hip. A fact that’s likely to come as a shock is that men older than 50 are more likely to break a bone due to osteoporosis than they are to develop prostate cancer.

According to Maples, the other common misconception is that Black women don’t get osteoporosis. It’s true that white and Asian American women have a greater incidence, and Black women tend to have greater bone density than white women to start, but the NOF estimates that about 5% of Black women older than 50 have osteoporosis and another 35% have low bone mass. Lactose intolerance is common among Black women (about 70%), so many eliminate or limit calcium-rich dairy foods from the diet. Black women also are far less likely to be screened for low bone mass.

Dietary Recommendations for Prevention

Recommendations for osteoporosis prevention haven’t changed much over the years. Experts still recommend engaging in regular weight-bearing exercise, eg, walking, and getting enough calcium (1,200 mg/day) and vitamin D (600 to 800 IU /day). “About 99% of the body’s calcium stores exist in the skeleton,” Maples says.

Protein makes up about 50% of bone volume and approximately one-third of its mass. High-protein diets were once thought to leach calcium from bones but now are thought to play an important role in building bone. Epidemiologic studies show greater protein intake to be beneficial to bone health in adults, especially older adults. Moreover, randomized controlled trials show that protein’s positive effect on bone health is the result of its ability to increase intestinal calcium intake.

Low calcium and vitamin D intakes are associated with increased risk, but it can be difficult for some, especially older patients, to get enough of either in the diet. In these cases, taking a calcium/vitamin D supplement may be the only way to get enough. Dairy foods are the richest sources of calcium and vitamin D (in the case of fortified milk), but there are nondairy milk products fortified with both nutrients, which is important for vegans and some vegetarians. Still, there exists some controversy over how effective calcium and vitamin D are in preventing bone loss, as well as a lack of clarity about other nutrients, such as selenium, magnesium, and vitamin K, and the roles they play in bone formation.

Magnesium is a mineral involved in the laying down of bone, but, according to the American Association of Clinical Endocrinologists, there are no randomized controlled studies showing a benefit of magnesium supplements on bone. Furthermore, “assessing magnesium status is difficult because blood levels of magnesium are not a true representation of magnesium status, since serum levels represent only 0.8% of total body stores,” says Melissa Majumdar, MS, RD, CSOWM, LDN, bariatric coordinator at Emory University Hospital Midtown in Decatur, Georgia, and a spokesperson for the Academy. The Recommended Dietary Allowance (RDA) for magnesium is between 310 and 420 mg per day, depending on age and gender. Good to excellent sources include pumpkin seeds, almonds, spinach, cashews, peanuts, black beans, and edamame.

Several studies support a critical function of vitamin K in improving bone health. Although the vitamin is required for bone building, and several observational and interventional studies have examined the relationship between vitamin K and bone metabolism, there’s no clear evidence on its role in bone formation and prevention of bone loss. The predominant dietary form, phylloquinone (vitamin K1), is found in spinach, broccoli, iceberg lettuce, and soybean and canola oils. Few foods are fortified with vitamin K.

The mineral selenium also may play an important role. There are antioxidant selenoproteins believed to be vital in maintaining bone health. In fact, plasma selenoprotein concentrations have been found to be associated with better bone mineral density in older women. A cross-sectional study from China found among middle-aged and older subjects that those with lower levels of dietary selenium had a higher prevalence of osteoporosis, in a dose-response manner. The RDA for selenium is 55 mcg/day. Good to excellent sources of selenium include Brazil nuts, sardines, shrimp, chicken, and macaroni.

Alcohol intake can affect calcium status by reducing its absorption and by inhibiting enzymes in the liver that help convert vitamin D to its active form, but the amount of alcohol required to affect calcium status and whether moderate alcohol consumption is harmful to bone is unknown. The 2020–2025 Dietary Guidelines for Americans recommend that if alcohol is consumed, it should be consumed in moderation—limiting intakes to one drink or less per day for women and two drinks or less per day for men. This isn’t an average over several days but rather the amount consumed on any single day. A meta-analysis is underway to determine whether there’s a dose response to alcohol’s effect on bone.

Studies on the relationship of sodium to osteoporosis are contradictory. High intakes of sodium increase urinary calcium excretion. It has been believed that this suggests a loss of calcium from bone and an increased risk of osteoporosis and fractures. However, a study conducted with data from the Women’s Health Initiative found that sodium intakes greater than 2,300 mg/day weren’t associated with changes in bone mass density at any skeletal site. In fact, higher levels of sodium intake were associated with significantly fewer hip fractures. Calcium intake didn’t alter the association between sodium intake and fractures. Notably, these findings were the result of dietary intake surveys, not a clinical study. But sodium intake of less than 2,300 mg/day is recommended for hypertension and CVD management and prevention, so it remains a prudent dietary recommendation for clients and patients, although perhaps not for osteoporosis prevention.

Research also suggests a possible association between antioxidant nutrients and osteoporosis prevention. Studies in animals, cell cultures, as well as epidemiologic studies, suggest a positive effect of diets high in vitamin C on bone density. However, clinical studies are lacking. Polyphenol-rich foods, including olive oil, fruits and vegetables, tea, soy, and even dark chocolate, seem to be beneficial for preventing osteoporosis and its progression, but more research is needed before specific dietary recommendations can be made.21,22

Calcium and Vitamin D Contention

Maintaining an adequate intake of calcium and vitamin D is all but universally recommended for osteoporosis prevention, and supplements often are required to get to an optimal level of intake. However, there are some dissenters. Ian Reid, MD, at the University of Auckland in New Zealand, says the use of calcium supplements arose at a time when there were no other effective interventions for osteoporosis prevention or treatment. Today, there are several prescription therapies. Reid has long stated there’s no clear evidence that either calcium or vitamin D supplementation helps prevent fractures, but such supplementation potentially may have a downside, such as increased risk of kidney stones. He does recommend dietary sources of the two nutrients, such as dairy products. However, it’s possible for vegetarians and vegans to meet recommendations for calcium with judicious planning and the addition of some calcium-fortified foods, including bok choy, broccoli, kale, calcium-set tofu, and calcium-fortified juice.

In his most recent article on the subject, Reid says calcium supplements produce a 1% increase in bone density in the first year of use but provide no additional benefits thereafter. He also says clinical trials show that vitamin D supplements improve bone density only in those with baseline levels of 25-hydroxyvitamin D of less than 30 nmol/L. According to the National Institutes of Health Office of Dietary Supplements, vitamin D levels below 30 nmol/L are associated with vitamin D deficiency; between 30 and 49 nmol/L is considered inadequate for bone and overall health.

Weight and Bone Loss

While being overweight can strengthen bones, much as weight-bearing exercise does, there are other health risks associated with overweight or obesity. However, weight loss, which can be an effective treatment for type 2 diabetes and hypertension, can aggravate bone loss. These effects appear to be modest following a single weight loss attempt but may persist over the long term and possibly during subsequent weight loss efforts.

The effect is especially severe in patients who have undergone bariatric surgery. “For over 10 years, I counseled bariatric surgery patients, who are at an increased risk for osteoporosis related to weight loss and risk of vitamin deficiency,” Majumdar says. “We know that weight loss can result in reduced bone mineral density as a result of mechanical unloading, changes in hormones, and loss of lean muscle mass.” Clients and patients who are losing weight or have lost weight should speak with their health care providers about screening for bone loss.

Therapeutics for Osteoporosis

For decades, patients diagnosed with osteoporosis had few options to stop the progression of bone loss or reverse the course of the disease. In fact, until about 24 years ago, there was no effective treatment for osteoporosis aside from the advice to get plenty of calcium and vitamin D and engage in regular, weight-bearing physical activity. The FDA approved the drug Fosamax in 1996, a drug designed to stop bone loss. It’s now available in generic form (alendronate, a bisphosphonate). Medications that increase bone mass, such as Forteo and Prolia, came several years later, as well as the drugs Actonel, Bonivia, and Evista. Even with these medications, the dietary and physical activity recommendations still stand.

Bottom Line

The debilitating nature of osteoporosis doesn’t manifest overnight, but over a period of years without symptoms. “Osteoporosis is called a silent disease for a reason,” Maples says.

Many people experience pain or fractures only once the disease is advanced; that’s why screening is so important. The US Preventive Services Task Force recommends screening for osteoporosis with bone measurement testing in women aged 65 and older and in postmenopausal women younger than 65 who have been determined to be at increased risk. “Our health care system is in need of a shift from treatment to prevention,” Majumdar says. That’s especially true for osteoporosis.

Majumdar adds that it’s important to remember that risk factors for osteoporosis often don’t exist independently of other risk factors. In other words, someone whose diet is low in calcium also is likely to be low in other bone-building minerals. And someone whose diet falls short of recommendations for bone-building nutrients also may be more likely to avoid physical activities that benefit bone.

Source: Today’s Dietitian

What Is the GAPS Diet?

Alyssa Pike wrote . . . . . . . . .

Basics of the GAPS diet

The GAPS diet is an elimination diet that involves cutting out grains, pasteurized dairy, starchy vegetables and refined carbohydrates. The GAPS diet theory argues that the omission of certain foods will improve gut health, which can ultimately improve some conditions of the brain, including autism, Attention-Deficit/Hyperactivity Disorder (ADHD) and dyslexia.

GAPS stands for Gut and Psychology Syndrome. According to the GAPS theory, a leaky gut—a term used to describe an increase in the permeability of the gut wall—allows chemicals and bacteria to enter your bloodstream, causing a host of health consequences ranging from “brain fog” to autism. It is important to stress that there is currently little evidence to suggest these conditions are caused by a leaky gut.

Guidelines for the GAPS diet

Following the GAPS diet can be a very lengthy process. There are three phases:

Introduction phase: The GAPS diet

This is the most restrictive part of the diet. It is called the “gut healing phase” and can last from three weeks to one year, depending on a person’s symptoms. In this phase, grains, pasteurized dairy, starchy vegetables and refined carbohydrates are eliminated, and broths, stews, and probiotic foods make up much of a person’s eating patterns. The GAPS diet recommends that you move from one phase to the next once you can tolerate the foods you have introduced. You are considered to be tolerating a food when you have a normal bowel movement.

Maintenance phase: The full GAPS diet

The full GAPS diet can last 1.5–2 years. During this part of the diet, people are advised to base the majority of their eating patterns on the following foods:

  • Fresh meat, preferably hormone-free and grass-fed
  • Animal fats, such as lard, tallow, lamb fat, duck fat, raw butter, and ghee
  • Fish
  • Shellfish
  • Organic eggs
  • Fermented foods, such as kefir, homemade yogurt and sauerkraut
  • Vegetables
  • Moderate amounts of nuts
  • GAPS-recipe baked goods made with nut flours

Additional recommendations while following the GAPS diet include:

  • Do not eat meat and fruit together.
  • Use organic foods whenever possible.
  • Eat animal fats, coconut oil, or cold-pressed olive oil at every meal.
  • Consume bone broth with every meal.
  • Consume large amounts of fermented foods, if you can tolerate them.
  • Avoid packaged and canned foods.

Reintroduction phase: Transitioning away from GAPS

The GAPS diet suggests that the reintroduction phase may begin after you have experienced normal digestion and bowel movements for at least six months. However, this reintroduction phase may take a long time, as it involves slowly reintroducing foods back into your diet.

The diet doesn’t detail the order of reintroduction or the exact foods you should reintroduce. However, it states that you should start with potatoes and fermented, gluten-free grains.

Even once you’re off the diet, you’re advised to continue avoiding all highly processed and refined high-sugar foods.

The GAPS diet and your health

To date, there is no research to support that the GAPS diet can help treat the conditions it claims to. The diet has not been scientifically tested, and the only claims in support of this diet are anecdotal. In addition, the introduction and maintenance phases are so restrictive that adherers could be at serious risk for malnutrition.

It is true that there is emerging evidence to show that our gut health and brain are connected. However, that research has been mostly centered around conditions like anxiety and depression. Research on the gut microbiome is still in its infancy, but to date evidence suggests that certain foods (think fruits and vegetables and probiotics and prebiotics) could positively impact our gut microbiome.

The bottom line

It’s important to acknowledge how challenging dietary needs can become when you or someone close to you is diagnosed with a health condition. However, the GAPS diet is too restrictive and lacks scientific evidence to justify its implementation. Research examining the gut-brain connection is continually evolving. If you have concerns about your health or diet, we recommend working with your doctor and/or a local registered dietitian.

Source: Food Insight

Trendy Microgreens Offer Flavor You Can Grow at Home

Will Pry wrote . . . . . . . . .

As one of the trendiest foods in the produce aisle, microgreens are known for adding a splash of color to a dish, a spicy kick to a salad – and a chunk of change to a grocery bill.

Known for a variety of flavors, textures and aromas, microgreens originated as a product of the California restaurant scene in the 1980s. Smaller than baby greens, they are harvested just one to two weeks after germination – typically later than sprouts, which don’t have leaves. They usually are 1 to 3 inches tall and often are sold with the stems attached.

Most microgreens are rich in concentrated vitamins and antioxidants. A 2012 study in the Journal of Agricultural and Food Chemistry looked at 25 commercially available microgreens and found they contained nutrient levels up to 40 times higher than more mature leaves. Other research also has shown microgreens contain a wider variety of antioxidants and micronutrients called polyphenols.

Nutrient content aside, microgreens are not a replacement for leafy and other greens in one’s diet, said Christopher Gardner, director of nutrition studies at the Stanford Prevention Research Center in California. Instead, they serve a better purpose as a way to add variety to a regular salad or other healthy meal.

According to the federal dietary guidelines, an adult consuming 2,000 calories a day should eat 2 1/2 cups of vegetables each day, and the key is variety. Yet almost 90% of the U.S. population fall short of that number, the guidelines say.

“I’ve been working more and more with chefs these days and one of the points that I’ve been trying to help people walk away with is that food really should bring them joy and pleasure,” said Gardner, vice-chair of the American Heart Association’s nutrition committee. Microgreens are “tasty with this sharp spice, that taste in the back of your mouth that you’re not accustomed to.”

Microgreens – sometimes called “vegetable confetti” – are grown from the seeds of a wide array of plant families, with varieties including cauliflower, broccoli, cabbage, arugula, radicchio, carrot, celery, quinoa, spinach, melon, cucumber and squash. They can be eaten on their own, blended into a smoothie, added to a wrap or salad, or as a garnish on soups and other dishes.

As the COVID-19 pandemic has changed people’s attitudes about their food shopping habits, do-it-yourself microgreens have offered a sustainable alternative. Growing them at home also may be an antidote to high prices at the grocery store or farmers market. They can be grown year-round, indoors or outdoors, without requiring much time, equipment or expertise.

“Is there something about being in a New York apartment and being able to grow a little backyard tray of microgreens and add it to your food?” Gardner said. “It might not be the meal, it might be just something that you add to what you’re eating for the taste.

“So maybe the actual scale of it makes it more accessible to some people to grow on their own – thereby getting them feeling like they’re a little more in touch with the food that they’re eating because they’re producing it.”

Source: American Heart Association