Purpose: To determine the degree of overlap between foods considered part of African American (AA) culture and those considered to be healthy. Methods: A total of 44 AA men and women were recruited from the Birmingham, AL area, 25 years of age and older to participate in four Nominal Group Technique (NGT) meetings. Participants from the first two groups generated 90 unique food items in response to the question " What are the foods you associate with being African American?" Participants individually ranked their top three most unhealthy foods. The next two groups generated 116 unique food items in response to the question " What foods do you consider to be healthy?" Participants individually ranked their top three foods that were considered most associated with AA. Results: The top five foods associated with AA were chitterlings, fried chicken, pig parts, greens prepared with ham hock, and pork ribs. Of the foods associated with AA, chitterlings, pig parts, fatback, fried chicken, and greens prepared with ham hocks were ranked as the unhealthiest. The top five healthy foods were broccoli, boiled greens, baked fish, grapefruit, and broiled fish. From these top five healthy foods, only boiled greens were considered to be associated with AA. Conclusions: Many of the foods AA consider as traditional foods are also perceived as unhealthy. On the contrary, foods perceived to have the most health value may not be a routine part of AA food patterns. Understanding AA perceptions of the healthfulness of foods can be informative for culturally appropriate nutrition intervention development. © 2009 Elsevier Ltd.