Cuban cuisine, a vibrant blend of Spanish, African, and Caribbean influences, is celebrated for its rich flavors and comforting dishes. But is Cuban food healthy? This article delves into the nutritional aspects of Cuban cuisine, examining its ingredients, cooking methods, and potential health benefits and drawbacks. By understanding the components of Cuban dishes and how they can be prepared in a balanced way, it's possible to enjoy the delicious flavors of Cuba while maintaining a healthy lifestyle.
The Building Blocks of Cuban Cuisine
Cuban cuisine is characterized by its use of fresh, whole ingredients. A staple in many Cuban dishes is the abundant use of fresh fruits and vegetables. These include tomatoes, peppers, and citrus fruits, which provide a burst of color and essential nutrients like vitamins A and C. Protein is another crucial component of Cuban meals, helping to build and repair tissues in your body. Lean meats, fish, and beans are common sources of protein in these dishes. These protein-rich ingredients are combined with fresh produce to create meals that pack a nutritional punch.
Beans and Rice: One of the most popular Cuban foods, don’t be surprised if you see black beans and rice somewhere on a Cuban Restaurant’s menu In Cuba, the tiny black beans from the nearby Yucatán are preferred over red beans, which are mixed with rice in Creole, Haitian, and Jamaican Cuisine. Beans and rice are used as a cheap, healthy source of protein in the Caribbean, as an alternative to animal products. Beans alone are not a complete protein, and rice isn’t either, but when combined they supplement each other, and thus, create a complete protein. Beans and rice are so nutritious that you can live on them alone for quite some time!
Root Vegetables: Try to replace grains with root vegetables, especially refined grains such as white bread. Root vegetables are a good carbohydrate alternative to fulfill your energy needs, and they also provide important antioxidants and minerals like potassium, magnesium, vitamin C, and vitamin A. Not all comfort food needs to be unhealthy! Why not make some yuca con mojo, puré de malanga, or mashed green plantains during this quarantine?
Plantains: Plantains are Banana’s older cousin. They’re larger, starchier, and have a slightly less sweet flavor. These qualities make them excellent for frying, baking, mashing, and even grilling, but you can use them as you would normal bananas, like in a smoothie or in baked goods. Plantains are healthy because they contain plenty of vitamins, like A and C, lots of potassium, magnesium, and manganese, and they contain plenty of antioxidants.
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Guava: The Guava; a sweet, green, and juicy fruit! Guavas, like plantains, can be used in either sweet or savory dishes. They can be made into deserts, blended into a smoothie, and even made into a barbecue sauce! (Try it on wings!) Guavas can also be eaten alone, but just know that they can be quite sour. Another reason to eat guavas is that they are an extremely healthy food. They contain lots of potassium, fiber vitamin C, and antioxidants!
Sweet Potatoes: Sweet potatoes are a well known health food. They contain plenty of vitamin, A, potassium, fiber, and antioxidants. They’re not only super nutritious, but also very versatile. Sweet potatoes can be used in either sweet or savory dishes, whether that be a sweet potato pie or sweet potato fries. They were commonly eaten in Cuba because impoverished people could not afford other starches like rice or beans.
Fish: Fish is a great, lean source of protein. And fresh caught fish makes it taste all the better! Even if you don’t live near the ocean, getting fish in your diet can bring some serious health benefits. It can help your muscles recover with all of its essential amino acids, and it can also give you plenty of vitamins and minerals from the sea water to support daily functions. Fish are a great source of B vitamins, helping to keep your energy going strong.
Cassava: Cassava is a root vegetable that is very similar to potatoes and yams. It is commonly grown in tropical regions and eaten in impoverished areas. Yet, don’t let that fact fool you. Cassava is a great, tasty, and healthy food! Cassava is rich in vitamins and minerals, like B Vitamins, potassium, magnesium, and manganese. It contains plenty of antioxidants to rid your body of free radicals. Cassava is also gluten free, which can make it a viable option for people with Celiac disease. Cassava even contains prebiotic fibers, which can help support a healthy gut! It can be used just like potatoes; mashed, fried, and baked. Cassava can even be made into desserts like cake and pudding! Get your hands on some Cassava, and try it as a side dish or dessert at your next meal.
Limes: Limes are lemons’ younger but fiercer little sister. They have a very strong, distinct flavor, and they add a pop to anything you squeeze them on. Limes can boost your immune system, clear up your skin, and keep your vision healthy with their plenty of vitamin C. They also aid digestion with their flavonoids, and they have even been shown to lower blood pressure. Try squeezing a little bit of lime juice onto your fish and veggies. Try making salsa or guacamole to give your tortilla chips a friend!
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Traditional Cooking Methods
The healthy aspect of Cuban cuisine isn’t solely found in its ingredients; it also shines through in its cooking methods. Traditional techniques such as grilling and steaming help preserve the natural nutrients present in the food. Grilling is a popular method used in Cuban cooking. It allows the natural flavors of meats and vegetables to come through while keeping them juicy and tender. Grilling also means using less oil, allowing for a healthier dish that’s lower in calories. Steaming, on the other hand, is often used for vegetables, helping them retain their crispness and vibrant color.
Balancing Flavors and Nutrition
Cuban cuisine is a wonderful demonstration of how to combine various food groups into balanced meals. Each dish is carefully crafted to include proteins, carbohydrates, and healthy fats, ensuring a well-rounded diet. A key component of achieving this balance is the clever use of herbs and spices. Ingredients like garlic, cilantro, and oregano add depth and complexity to Cuban dishes without adding extra calories. These natural flavor boosters help reduce the need for salt and sugar, supporting a healthier lifestyle. By understanding how Cuban cuisine uses different food groups and spices, you can create meals that are both delicious and nutritious.
Potential Health Concerns and How to Mitigate Them
While Cuban cuisine offers many health benefits, some traditional dishes may pose potential health concerns if consumed in excess.
High Fat Content: Some traditional meat dishes, such as ropa vieja and lechón asado, tend to be high in fat and eaten in large quantities. COVID-19 seems to pose a special danger to those suffering from cardiovascular conditions, hypertension, and diabetes. So, it is especially important to re-evaluate our meat choices at home, regardless of our medical history.
Refined Grains: The Cuban diet is not known for plentiful portions of diverse vegetables. If fact, if you see a colorful dish with green, yellow, and red, it probably just has 3 types of bell peppers or lettuce, tomato and avocado.
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Portion Sizes: Do not forget to eat both the recommended quality of protein and the recommended portion. As a rule of thumb, add two cups of chopped vegetables for every 4 ounces of meat/chicken/fish.
Cuban Life-Hacks for Healthier Eating
So, let’s try to re-think that “mala fama” that Cuban foods are not diabetes-friendly, by introducing some Cuban life-hacks into our food preparation:
Resistant Starches: Have you heard about resistant starches? They are carbohydrates inaccessible to human digestive enzymes in the small intestine, and so they don’t raise blood glucose levels as sharply as easily digestible sugars. Instead, they are fermented by bacteria in the colon and used to produce many beneficial substances for your metabolism. Some of these resistant starches occur naturally, in green bananas, oats, nuts, and legumes. They may also be formed by cooling and reheating food. Have you ever had ensalada fría de papa con huevo, or ensalada fría de codito con pollo? What about that rice leftover that you reheated next day? Well, those are resistant starches. When you cook, cool, and reheat these starchy foods, you change some of their chemical composition such that your digestive enzymes cannot break them down as easily-thereby lessening their impact on your blood glucose and insulin secretion, and “flattening the curve.” When eating rice, cook, cool, and reheat it, then mix it with your favorite vegetables (½ cup cooked rice to ½ cup of vegetables) and keep in mind the rainbow of colors. Maybe try it with some quimbombó (okra stew), which is very rich in fiber! Make sancocho or ajiaco with root vegetables - squash, yucca, yams, potatoes - cooked, cooled and re-heated. Try fufú de plátano (green plantains are naturally rich in resistant starches) with some fricasé de pollo orCauliflower rice. This one may not sound Cuban, but picadillo used to be “stretched” in Cuba during el periodo especial by adding textured soy protein. Same concept applies here! Why not “stretch” our rice with some finely chopped cauliflower or cabbage?
Incorporate More Vegetables: You should try to eat at least one cup of cruciferous vegetables like broccoli, brussels sprouts, and cauliflower per day. Prepare yours with sabor criollo and incorporate them into your favorite stew, imbuing them with the familiar flavors of a sofrito using garlic, cumin, onion, green peppers, oregano, and bay leaves. Remember to wash fresh produce before use with hot water and soap, but never with commercial cleaning products like bleach or disinfectants.
Healthy Protein Choices: You can mix animal protein with vegetables and prepare versatile chicken, fish, or meat stews like fricasé, picadillo con verduras, or fufú con carne. Or perhaps you are lucky enough to remember abuelas and abuelos who used to make remedios of caldo (broth) when we were sick. You can use grass-fed animal bones (chicken or beef) with vegetables for an incredibly delicious, nutrient-rich broth.
Plant-Based Options: You can also make plant-based protein dishes using legumes, nuts, and seeds which contain a healthier mixture of fat and protein. We Cubans have mastered the art of cooking and eating any type of beans. If you are my age (47 years old) you grew up eating arroz, chícharo y huevo, potajes con viandas, and sopa de lentejas con plátano. These popular dishes are rich in protein and fiber, and better for your cardiovascular health than most meats.
Simple Swaps for Healthier Cuban Dishes
Common Cuban cuisine includes meals such as Yuca Con Mojo, Lechon Asado, and Flan. Although these dishes may be delicious, many of them could be nutritionally improved.
Try sweet potato instead of yuca or mix in sweet potato along with the yuca. Sweet potatoes have anti-inflammatory properties. They are high in beta-carotene, vitamin C, and magnesium.
Replace the ground beef with ground turkey, which has a lower fat content. To lower the fat content even more, avoid using margarine in the potato mix.
Stuff the croquetas with ground chicken or turkey, instead of using ground beef. Use 100% whole wheat bread to add fiber. Replace the ham with turkey for less added fat. Use chicken or turkey instead of pork. Replace the beef or pork with chicken or turkey.
Add vegetables to the sauce such as peppers, onions, mushrooms, etc. Add non-starchy vegetables to the mix to lower the amount of carbohydrates consumed. Replace the ground beef with ground turkey. If you want to keep the ground beef, look for the kind that is 96% lean and only 4% fat. Also, if you have the extra time, use fresh tomatoes for the sauce, rather than the canned tomatoes.
To increase the amount of fiber in your diet, instead of white rice, pick whole grains like brown rice, quinoa, buckwheat, or barley, to name a few. Also, rather than adding sugar for sweetness, try stevia or monk fruit sugar.
Replace 1 cup of sweet, condensed milk with 1 cup of pumpkin puree for added benefits such as fiber, vitamin A and C, potassium, and iron. If making the pastelito from scratch, replace the butter used to make the dough with equal amounts of applesauce.
The Impact of Lifestyle on Cardiovascular Health in Cubans
Cardiovascular disease is the leading cause of mortality in Cuba. Lifestyle risk factors for coronary heart disease (CHD) in Cubans have not been compared to risk factors in Cuban Americans. Articles spanning the last 20 years were reviewed. The data on Cuban Americans are largely based on the Hispanic Health and Nutrition Examination Survey (HHANES), 1982-1984, while more recent data on epidemiological trends in Cuba are available. The prevalence of obesity and type 2 diabetes mellitus remains greater in Cuban Americans than in Cubans. However, dietary preferences, low physical activity, and tobacco use are contributing to the rising rates of obesity, type 2 diabetes mellitus, and CHD in Cuba, putting Cubans at increased cardiovascular risk. Comprehensive national strategies for cardiovascular prevention that address these modifiable lifestyle risk factors are necessary to address the increasing threat to public health in Cuba.
Dietary Preferences
In a recent survey of Cuban food preferences, red meat, ham, white bread, soft drinks, and processed food were identified as preferred food items. Ham and red meat were considered healthy by 85% and 90% of participants. This survey also reproduced earlier findings that the fruit and vegetable intake of most Cubans was inadequate [6, 7]. While cost was identified as a major factor in dietary choices, this survey demonstrates that if the barrier of cost was removed, food preferences would remain a barrier to healthy eating in Cuba. Data on Cuban American dietary preferences are less available. While there are no recent surveys of Cuban American dietary patterns, the 1982-84 HHANES survey describes dietary trends at that time. Seventy-three percent of Cuban American men and 75.7% of Cuban American women reported high “junk food” consumption [8]. While these data are based on self-reporting, they suggest that food preferences in Cuban Americans may not be that different than in Cubans.
Physical Inactivity
Physical inactivity is associated with a 19% increased risk of CHD when compared to individuals who regularly engage in vigorous physical exercise [9]. Physical inactivity in the elderly has been the subject of several studies in Havana. In a 2008 study of elderly patients in a polyclinic in Havana, physical inactivity was the most prevalent risk factor present in 74% of the sample [10]. Eighty-two percent of elderly women in another Havana study in 2011 reported low physical activity, a much greater percentage when compared to elderly women in Bridgetown, Barbados [11]. Another study of 1,905 elderly people in Havana found that decreased physical activity was a significant risk factor for overweight [12]. Some sources have estimated that presently 53-69% of all Cubans are sedentary [13]. Not only are adults inactive, but children are also becoming increasingly inactive with television and video games cited as the primary causes [14]. In a 2002 study of preschool children, only boys in rural areas and small towns met the minimum recommended daily physical activity as recommended by the Center for Disease Control (CDC) [15]. Physical inactivity is also common among Cuban Americans. The Miami Community Health Study examined CAD risk factors in African Americans, Cuban Americans, and white Americans living in Dade County, Florida, from 1991-1995. Self-reported physical activity varied according to sex. Forty-seven percent of Cuban American men reported physical activity less than 1000 kcal a week, which was greater than that reported in African American and White American men. However, Cuban American women reported less physical inactivity than African American and white American women with 51.6% undergoing less than 1000 kcal of physical activity per week [16].
Obesity
The global trends of poor dietary habits and low physical activity have resulted in the rising prevalence of obesity worldwide. Similar to the rest of the world, obesity has become a public health concern in Cuba. A 2001 national survey of a representative sample found that 29.7% of men and 31.5% of women were overweight and 7.9% of men and 15.4% of women were obese [17]. Other studies have suggested that 24.6% of women and 14.9% of men are obese [14]. These data suggest that obesity more greatly affects Cuban women than Cuban men. In examining obesity in rural Cuba, a 2008 study in the Isla de la Juventud province found that 31.3% of the adult population was estimated to be overweight and 13.4% was obese [18]. These data are similar to other studies done in rural Cuba, suggesting that while obesity is less prevalent in rural Cuba, it remains a public health concern throughout the island. Obesity in elderly Cubans has been compared to that in elderly populations in Latin America and the Caribbean. A 2003 study of the elderly population in the rural Cuban province of Pinar del Rio Cubans showed that they had lower body mass index (BMI), lower measurement of skin folds, lower waist circumference, and higher physical activity levels compared to elderly people in rural Chile and Mexico [19]. The average waist circumference in this small sample of elderly Cuban men was 81.3 cm and 80.5 cm in elderly Cuban women. This contrasts greatly to rural elderly Mexican men and women who had an average waist circumference 88.3 cm and 93.1 cm. In 2000, another study examined obesity in a larger sample of elderly Cubans in Havana and elderly Barbadians in Bridgetown [11]. The elderly Cubans had lower prevalence of obesity compared to elderly Barbadians affecting 12.7% of men and 30.7% of women. This comparison suggests that although obesity remains a public health concern throughout Cuba, urban and rural elderly Cubans are less obese than their counterparts in Latin America and the Caribbean. Obesity is increasingly affecting young adults and children. Cuba was among the four Latin American countries with the highest rates of obesity among 20-29-year olds in 1994, which of note was during the most difficult years of the Special Period [20]. In examining contemporary childhood obesity, the Comprehensive Childhood Study of 2004-2005 found that 10.2% of children are overweight and 8.8% are obese [14]. In 2005, the prevalence of excess weight in children <19 years of age in Havana was similar to that of 1972. However, there was a significant increase in high adiposity in children, many of whom had a normal BMI [21]. In the 1982-84 HHANES survey, nearly 30% of Cuban American men and 34% of Cuban American women were classified as overweight [22]. These data are similar to those seen in Mexican American men and women (30% and 39% resp.) and Puerto Rican American men and women (25% and 37%) [22]. Nine percent of Cuban American men and 15% of Cuban American women were obese, also comparable to other Latinos [23]. Overweight prevalence was higher among hypertensive Cuban Americans [24]. Of note, increased BMI in Cuban Americans was not associated with income, education, acculturation, or socioeconomic status [25]. However, this may be a limitation of the population sample in the HHANES study which underrepresented the poor. There are no available recent data on obesity in Cuban Americans.
Tobacco Use
Similar to other countries, tobacco use in Cuba is greater among men than among women. It is estimated that 40% of all men smoke tobacco every day, with a higher rate of 60% in middle age men. Moreover, 25% of women and 32% of men age greater than 60 smoke tobacco, a figure much greater than other Caribbean and Latin American countries [7]. Elderly Cubans smoke at higher rates than the rest of the population. A large study in Havana from 2011 estimated that 46.5% of elderly men and 21.5% of elderly women smoked tobacco [11]. Moreover, in the same study, an additional 31% of men and 15% of women were former smokers. The prevalence of tobacco use in Havana in this study was much greater than in Bridgetown, Barbados. In a 2003 case control study of patients with acute MI in Cuba, smoking was responsible for a third of the burden of acute myocardial infarction in Cuba [26]. In the HHANES 1982-1984 survey, smoking was reported in 23.9% of Cuban American women and 45.1% of Cuban American men [8, 24]. Within this cohort, 27.3% of Cuban American men were heavy smokers (greater than 20 cigarettes a day) compared to 11.9% of Cuban American women [8]. Birth cohort analysis of HHANES (1982-1984) data revealed that smoking rates among successive birth-cohorts increased substantially in Cuban American women [27]. Subsequent studies from the early 1990's reported a lower prevalence of tobacco use. Smoking rates among men ranged from 21.4 to 30.3% and in women 11.6-25.9% [16, 28, 29]. Among smokers, Cuban American men had the highest mean daily cigarette use (17.8 cigarettes a day) compared to other Latino ethnic groups [29].
Type 2 Diabetes Mellitus and Metabolic Syndrome
With poor dietary habits increasing and physical activity declining, more Cubans are at risk for developing type 2 diabetes mellitus and the metabolic syndrome. The metabolic syndrome, which consists of hypertension, glucose intolerance, dyslipidemia, and abdominal obesity, is increasingly being recognized as an independent risk factor for CHD beyond the sum of the risk conveyed by its individual components [30]. There are few studies that have examined the prevalence of the metabolic syndrome in Cuba. A cross-sectional study in the city of Cienfuegos found the prevalence of the metabolic syndrome according to the NCEP ATP III definition in adults to be 22% (95% confidence interval 14.5-28.8) [31]. However, in adults greater than 40 years old, the prevalence of the metabolic syndrome is 44% [31]. Moreover, there are little data on the epidemic of type 2 diabetes mellitus in Cuba. In one survey of individuals age 60 and older, 15% of participants reported having type 2 diabetes mellitus [7]. Another study of elderly individuals in Havana reported type 2 diabetes mellitus was more prevalent in women compared to men [11]. While 19.9% of elderly women had type 2 diabetes mellitus, only 7.3% of men were diabetic. Other studies have estimated a national prevalence of type 2 diabetes ranging from 4.6 to 17% [6, 13, 31]. A few small observational studies have been done in order to gain insight into the impact of the metabolic syndrome on the health of Cubans. A 2005 observational study of patients in a Havana hospital examined the comorbidities of patients that died in the intensive care unit. Of the 149 patients that died during the study, 88 patients (32.9%) had the metabolic syndrome as defined by NCEP ATP III. Data from the 1982-84 HHANES reveal that 16% of Cuban Americans aged 45-74 had type 2 diabetes mellitus, which was slightly greater than non-Latino Whites (12%), but significantly less than Mexican Americans (24%) and Puerto Rican Americans (26%) [33]. When combining HHANES data with the National Health and Nutrition Examination Survey (NHANES), age-standardized prevalence of diabetes in Cuban Americans is only 9.3% [35]. A recent observational study demonstrated that among 161 nondiabetic Cuban Americans in South Florida, 41% met criteria for the metabolic syndrome as defined by NCEP ATP III [36]. Moreover, Cuban Americans with the metabolic syndrome had elevated high-sensitivity CRP levels that may also indicated an increased risk for type 2 diabetes mellitus and cardiovascular diseases [36]. This observation has yet to be further explored.