I can think of no other food more polarizing than chitlins. Chitlins, also known as chitterlings, are fried or boiled pig intestines. In some circles, chitlins are a delicacy with a rich cultural history. In other circles, chitlins are a polarizing source of marital discord during the holidays. As a black gastroenterologist, my take on chitlins is both nuanced and complex. Ultimately, chitlins are offal (notice the shamelessly placed pun). In this post, I’ll break down the history, cultural aspects, and health concerns associated with chitlins.
My first exposure to chitlins
My earliest recollection of eating chitlins probably occurred during Thanksgiving or Christmas when I was 4 or 5 years old. I vividly remember my grandmother opening a chitlin-filled bucket. Once the pungent aroma wafting from the chitlins hit my nose, I thought someone clogged the toilet without the courtesy of closing the door and switching on the bathroom fan. The smell emanating from that bucket was beyond horrible. It was like the chitlin bucket was a gateway to the underworld.
Their taste was a combination of umami, funk, and salt
I remember my mother asking me if I wanted to try some. Against my better judgment, I tried a forkful with a smattering of Lousiana hot sauce. The chitlins had the texture of an egg scrambled hard. Their taste was a combination of umami, funk, and salt. I can’t accurately put their taste into words. Ultimately, I didn’t think they tasted bad until my mother explained what chitlins are. Once she said pig intestines, I knew that I was never going to be a chitlin advocate.
Chitlins: A brief history lesson on their culture significance
Although most people associate chitlins with African-Americans, people all over the world have eaten animal innards for centuries. Classic ethnic dishes such as Menudo (a Mexican stew) and Haggis (a Scottish dish banned in the U.S. since 1971) include animal entrails. How did chitlins become connected with African-Americans? Well…there was a peculiar institution called “Slavery”. Yes, that “Slavery”. In the United States, slaves were not given select cuts of meat such as tenderloin, baby back ribs, and the Boston butt. Have you heard of the phrase, “High on the hog?” The colloquial phrase has its origins in the location of these fancy cuts of meat towards the back (spine) of the pig. The meat that sustained “slaves” came from lower, lesser cuts such as entrails (ie chitlins and hog maws), pig’s feet, and pork belly. People often cite the transformation of these undesirable pig parts into delicacies as a testament to the culinary ingenuity that occurred in the kitchens of slaves.
The chitlin circuit
Nonetheless, the association of Caitlin’s with African-Americans grew after slavery ended. For instance, during the era of Jim Crow, the collection of auditoriums and theaters that allowed Black performers was affectionately called the ‘chitlin circuit.’ As a nod to this history and their southern roots, one of my favorite raps groups, Little Brother, released an album in 2006 entitled, “The Chitlin’ Circuit.”
As an African-American, I can appreciate cooking chitlins as reverence to our history and culinary traditions. As a man married to a woman who enjoys a bowl of chitlins during the holidays, I can even respect the fact that some people just like the way they taste. For practitioners of the nose-tail philosophy, I can also respect not letting edible parts of food go to waste. However, as a black, board-certified gastroenterologist, I feel like there’s some pig $hit we definitely need to talk about.
Chitlins and health concerns
Am I advocating for an all-out ban on chitlins like the U.S. banned Haggis? No. Are chitlins healthy? Like many comfort foods, I wouldn’t call chitlins healthy. Are chitlins dangerous? They can be if not properly prepared.
Here are two videos about preparing chitlins. One reminds me of my grandmother. The other reminds me of gentrification.
Nonetheless, improperly prepared chitlins provide the opportunity for feces to end up on your plate. You don’t have to be a gastroenterologist to know that eating poop is bad. In the case of poorly prepared chitlins, how bad is it?
Well…try googling chitlins and safety. The first hit that pops up is an article from the CDC (I’m mad they used big momma as the cover pic). The article points out that chitlins can lead to a gastrointestinal infection with a bacteria called Yersinia enterocolitica. This infection can cause severe bloody diarrhea, vomiting, and cramping. It can even mimic appendicitis. Astonishingly, Yersinia enterocolitica can cause a long term condition called reactive arthritis in individuals with a genetic variation called HLA-B27.
Chitlins and Yersinia Enterocolitica
I first encountered Yersinia enterocolitica in real life when I was training as a gastroenterology fellow. At that time, an African-American woman from the West Side came to the ER during the holidays with bloody diarrhea and abdominal pain. Her stool studies revealed Yersinia enterocolitica. I remember several medical students asking the patient if she lived on a farm, worked in a petting zoo, or traveled to a foreign country. I’m not sure if the students didn’t know the right question to ask or if they were uncomfortable asking her if she ate some chitlins due to political correctness. For medical students reading this, asking anyone who tests positive for Yersinia enterocolitica about chitterlings or undercooked pork is 100 percent reasonable. However, assuming that every black person with diarrhea has Yersenia from chitlins would be egregiously inappropriate. Back to the patient, she claimed she only cleaned the chitlins without actually eating them.
After reviewing articles on Pubmed about Yersinia enterocolitica and Chitlins, I found that both the preparation and consumption of chitlins can present health hazards.
Outbreaks of Yersinia in infants exposed to chitlins
The first outbreak of Yersinia from chitlins I could find was published in 1899. In this study, 42 individuals with a mysterious gastrointestinal illness bought chitlins from the same English butcher on the same day. They weren’t the only people who bought chitlins from that butcher on the same day. However, only the people who did not re-boil the chitlins after they were originally cooked became ill. Tip #1 – reheat your chitlins before eating them #IJS.
Fast forward 100 years, there was an outbreak of Yersinia enterocolitica amongst Black infants in Tennessee. Researchers investigated the outbreak found that the infants were exposed to chitlins, not through actually consuming chitlins’, but through the contamination of pacifiers, baby bottles, and other items with bacteria containing chitlin juices. Tip #2 Keep the baby and baby bottles out of the kitchen when prepping chitlins #IJS.
Similarly, in my hometown of Chicago, there was an outbreak of Yersinia in 8 infants. All of the infants were exposed to chitlins or were in a household where chitlins were prepared. Tip #3 Clean your kitchen thoroughly after preparing or consuming chitlins.
Other tips for avoiding illnesses from chitlins
Tip #4 Don’t eat chitlins. (This should have been Tip #1. A little shade goes a long way.)
Tip #5 Use vinegar during the preparation process. Although not perfect, acetic acid (active ingredient of vinegar) may kill off Yersinia by lowering the pH of the chitlins. This whole time I thought my grandmother used vinegar for the taste.
Tip #6 Check out these tips on the CDC’s website
- Buy already cooked or pre-cooked chitlins, when possible, because they should be safer to handle.
- If you will prepare raw chitlins, freeze them unless you plan to clean and cook them within 2 days.
- Thaw frozen raw chitlins in the refrigerator in a completely covered bowl or bucket to prevent drips. Drips can contaminate your refrigerator and any food or containers in it. Cook raw chitlins within 2 days after thawing them.
- Boil raw chitlins in water for at least 5 minutes before cleaning. This will reduce germs that may get on your hands, counter, and utensils while you are cleaning the chitlins.
- Boil and simmer chitlins until well cooked and tender before frying or serving. Do not taste them until they are well cooked.
- Refrigerate or freeze leftovers within 2 hours (or within 1 hour if the temperature outside is higher than 90°F).
Tip #7- Recognize that chitlins are typically loaded with salt. THIS means be careful eating them if you have salt sensitive conditions such as high blood pressure, cirrhosis, chronic kidney disease, or heart failure.
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I am a physician and trained chef. I specialize in gastroenterology and nutrition. Currently I work as the Associate Director of Adult Nutrition at the University of Chicago.
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