Should Federal Dietary Guidelines Be More Diverse?

Does the federal government’s general guidance that people should eat more fruits and vegetables and…

Should Federal Dietary Guidelines Be More Diverse?

Does the federal government’s general guidance that people should eat more fruits and vegetables and consume fewer processed foods and less sugar contribute to systemic racism?

Several Black and Latina registered dietitians and a nutritionist interviewed by U.S. News say there’s nothing wrong, per se, about such broad nutritional guidance. However, a set of dietary recommendations that inform federal nutrition policy and a separate program aimed at individual consumers don’t take into account the country’s increasing diversity, they say. Latinos, the fastest-growing demographic group in the U.S., comprise about 20% of the country’s population. Blacks account for about 13% of all U.S. residents.

Nutrition Recommendations Should Take Culture Into Account

As currently written, nutritional recommendations on MyPlate – the nutritional guide put out by the U.S. Department of Agriculture Center for Nutrition Policy and Promotion – may not resonate with many Black, Latino, Asian and Native American consumers, according to several Black and Latina experts.

“Culture does matter when it comes to food,” says Tambra Raye Stevenson, a Black nutritionist based in the District of Columbia. She’s the founder of Women Advancing Nutrition Dietetics and Agriculture, a nonprofit in the District. “Food is one of the last things you can control.” She notes it’s difficult for diverse groups to accept dietary guidelines that don’t align with their traditional food regimens. “That leads to non-compliance among patients like the Nigerian grandma who eats okro soup and fufu.”

Many Latinos may also not connect with the MyPlate guidelines, says Janine Souffront, a registered dietitian supervisor at L.A. Care Health Plan in Los Angeles. Souffrant, from Puerto Rico, considers herself Latinoamericana.

MyPlate features a food circle, representing a plate, with sections for fruits, vegetables, grains and protein. A circle for dairy products is connected to the plate. The depiction shows the recommended division of types of foods people should consume.

Representations of Traditional Ethnic Diets Are Lacking

The MyPlate food circle icon is available in 21 languages, including English, Spanish, Arabic, Chinese (simplified and traditional), Filipino-Tagalog, French, German, Haitian-Creole and Indonesian. However, the MyPlate website doesn’t include examples of traditional diets consumed by many Latinos.

“MyPlate could be better tailored to reach people of different ethnicities and racial groups,” Souffront says. “Right now much of its messaging is geared toward ‘Middle America’ and people of middle incomes.”

The program would be more inclusive if it provided examples of healthy foods – like nopales, which are commonly used in traditional Latino diets. Nopales are cactus plants, and the edible fleshy pads (minus the needles) can be cooked or consumed raw.

It’s important to keep in mind that traditional Latino cooking is not homogeneous. “Latinos from Puerto Rico, Mexico and Peru will have different eating habits and consume different dishes,” Souffront says. “A one-size-fits-all messaging approach isn’t going to be effective.”

Plus, Souffant says the name of the program, MyPlate, suggests an individualistic approach to meal preparation and dietary habits. She notes that for many Latinos of different backgrounds, eating is a family activity. For a Latino audience, a title like “Our Table” might resonate better.

Liz Torres, a Latina registered dietitian based in Portland, Oregon, echoes Souffrant’s concerns. Torres, who’s the diversity and inclusion liaison for the Oregon Academy of Nutrition and Dietetics, works with clients who participate in the USDA’s Special Supplemental Program for Women, Infants, and Children. The WIC program provides federal grants to states to provide supplemental foods, health care referrals and nutrition education for low-income women.

Torres notes that more than 80% of Americans of all races are not consuming the recommended amount of vegetables, and about 70% fall short when it comes to eating the suggested volume of fruit each day.

Traditional Ethnic Diets Include Healthy Foods

“Some clients tell me they don’t enjoy eating the foods they see on MyPlate handouts,” Torres says. “They feel that these foods are not typical of their culture’s eating pattern. Therefore they do not find the foods on the MyPlate handout to be applicable to their dietary preference. I ask them what types of food they like to eat, and they are surprised to learn they can still eat that food, but maybe in smaller portions.”

For example, some of her Latino clients enjoy sopa de fideo, a Mexican soup that includes fried noodles, fresh tomatoes or tomato sauce and, often, chicken. Some clients believed they shouldn’t consume the soup because it has fried noodles; Torres advises them that they can still eat it, in smaller portions.

MyPlate isn’t the only federal nutrition recommendation program that doesn’t fully take into account the nation’s growing diversity, according to some registered dietitians.

The U.S. Dietary Guidelines for Americans – which are government recommendations for individuals older than age 2 – also aren’t geared to reflecting the nutritional needs and habits of many Blacks and other people of color, says Constance Brown-Riggs, a Black registered dietitian in Long Island, New York.

Based on nutrition research, these guidelines are updated and published every five years by the USDA in conjunction with the U.S. Department of Health and Human Services. The federal government is scheduled to officially release the 2020-2025 Dietary Guidelines for Americans before the end of the year. The website for the guidelines invites input from the public. These recommendations inform federal nutrition policies and are building blocks for governmental food programs.

The federal dietary guidelines espouse the benefits of the Mediterranean diet but say nothing about how traditional African, Latino or Asian eating regimens could be beneficial, Brown-Riggs says. Plus, they emphasize consuming more plant-based meals, but don’t explore the fact that many traditional ethnic diets are already geared that way, she says.

It’s important for nutritional guidelines to be relevant to communities of color because of the weight-related health issues some face. For example, as of 2018, non-Hispanic Blacks had the highest prevalence of self-reported obesity, at 39%. Latinos were not far behind, with a self-reported obesity rate of 33%, according to the Centers for Disease Control and Prevention.

Obesity is associated with an array of chronic conditions, including diabetes, heart disease, cancer and high blood pressure.

In response to a query from U.S. News, Larry Moore, a USDA spokesman, issued this statement: The Dietary Guidelines for Americans provide science-based recommendations on what Americans should eat and drink as part of a healthy diet and to prevent chronic disease. They are written for nutrition policymakers and health professionals and are intended to be applied to all Americans, as required by the National Nutrition Monitoring and Related Research Act, Section 301. For that reason, it would be outside the scope of the dietary guidelines to tailor them to specific groups or treat specific diseases.

However, he notes many government agencies, nonprofits, medical professionals, health organizations and other stakeholders build on the dietary guidelines to provide nutrition guidance tailored to a particular group’s needs or treat specific medical conditions and illnesses. In this way, the dietary guidelines serve as one piece of America’s larger nutrition guidance landscape.

While many foods that are staples for people of color aren’t included in the federal dietary guidelines, they may not be recognized by people outside specific ethnic and racial groups even if they were to be included, notes Sandra Arevalo, a registered dietitian who is the director of community and patient education at Montefiore Nyack Hospital in New York.

“I think there needs to be a good mix (in the guidelines),” says Arevalo, who’s a spokesperson for the Academy of Nutrition and Dietetics and the American Association of Diabetes Education. “In the meantime, it is the role of registered dietitians to help translate the different guidelines to different audiences.”

“I don’t think you can create one set of dietary guidelines to represent all cultures,” she says. “There’s always going to be someone left out. One of the functions of registered dietitians is to be able to translate science into practice so that the public can understand and follow.” For example, if she’s describing fish to a Latino patient, she’d use the term bacalao (dried and salted cod). With Asians, she’d use sushi. “Latinos (generally) don’t like uncooked fish, so sushi wouldn’t be a good example for that culture,” she says. “When we are talking about starches, we can use plantains and yucca for Latinx people; potatoes and bread for (non-Hispanic whites), and fufu and casava for people of African descent.” However, it’s important for registered dietitians to keep in mind that not all of Latino descent will like the same things, and that principle holds true for people of other cultures.

The challenge of educating consumers from diverse cultures and eating traditions is hindered by the dearth of registered dietitians from different racial and ethnic communities.

According to the Academy of Nutrition and Dietetics, 84% of practicing registered dietitians in the U.S. are white. Only 3% are Black, and 6% are Latino. Just 5% are Asian, according to the academy.

“The real problem is that not enough RDs might be able to (educate consumers from diverse backgrounds and eating traditions) because they don’t know the different cultures,” Arevalo says. “So we need more professionals in the field that are from different cultures or open to learn about them, to be able to counsel their patients in the most effective and culturally relevant way.”

Copyright 2020 U.S. News & World Report

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