Convenience meals and fast foods have slowly worked their way into the rural Appalachian diet, playing a major role in increased obesity and food-related ailments. Increasing future health providers’ knowledge of historical Appalachian dietary patterns and how health is perceived by rural residents may lead to the development of culturally sensitive nutrition interventions for rural populations. This article describes the historical Appalachian diet and validates the Traditional Central/Southern Appalachian Diet Pyramid (TADP) to inform future nutrition interventions. Fourteen historical cookbooks, five ethnographic articles, and twenty-six oral history interviews were qualitatively analyzed. The four largest categories of the traditional Appalachian diet were homegrown produce (25.8 percent), added fats and sugars (25.5 percent), sources of protein (20.1 percent), and sources of carbohydrates (13.9 percent). Within these individual categories, corn, wheat, potatoes, green beans, fatback, butter, soup beans, and pork were some of the ingredients most commonly mentioned. Findings reveal that the traditional Appalachian diet was primarily based on homegrown or gathered produce with the addition of added fats and sugars, protein, and carbohydrate sources.

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