A registered dietitian is a trained expert who helps people tailor the science of nutrition into useful solutions for healthier living — whether that’s losing weight or managing a specific health condition. But less than 3% of registered dietitians are Black — and just over 80% are white, which means that most of the nutrition information that gets disseminated across mainstream and social media comes from white practitioners. For the most part, this advice doesn’t take into account cultural differences or social conditions that affect a person’s health status.
Here’s what four Black dietitians want you to know about how these disparities are affecting the way we all view nutrition, why it really matters and what needs to change.
1. It’s not our fault.
There’s an idea that Black people are to blame for the health problems they experience, Maya Feller, a registered dietitian in Brooklyn, told TODAY. “I recently had someone tell me that Black people need to take responsibility for their health and eat vegetables,” she said. “It's important for us to understand that Americans across the board are not meeting the recommended intakes for vegetables — not just Black people. Yet, we continue to be told that it's our fault when the country at large is deficient.”
Valerie Agyeman, a women’s health dietitian and founder of Flourish Heights, shared a similar observation. “Research often suggests that there are higher rates of diabetes, hypertension and heart disease in Black people,” she said, “and the sad truth is that they get blamed for it when in all actuality the health outcomes Black people face are linked to social determinants like socioeconomic status, employment, access to budget-friendly nutritious foods, health care and much more.”
In other words, it’s not a lack of willpower or a refusal to try; the real problem is that implicit biases (unconscious race-based stereotypes) in our health and social systems create health disparities and put Black people at higher risk of diseases. As Marisa Moore, a culinary and integrative dietitian in Atlanta, pointed out: “It would be a mistake to judge a person based on your own personal situation without fully understanding all that goes into the food choices and health status of Black people.”
2. The system needs work.
The ability to attain good health in the first place depends on a multitude of factors. Some of the factors that can make or break your health and well-being are:
- Neighborhoods that have low crime rates, as well as parks, playgrounds, bike paths and sidewalks where you can safely stay active.
- The availability of full-service grocery stores that are stocked with healthful and reasonably-priced foods.
- Access to health services for screenings and interventions.
- Well-funded public schools and employment opportunities that provide economic stability.
“Our communities tend to not only have fewer full-service grocery stores, more liquor stores and fast food outlets,” said Feller, “but we also have fewer safe spaces to engage in intentional physical activity. We have limited access to higher quality healthcare. We are over-policed and violently punished at astonishing rates. We have lower incomes — and tend to live in underperforming school districts.” Feller explained that when it comes to nutrition, health and dietitian advice, Black people aren’t just significantly disadvantaged, they’re literally being left behind. She noted that environmental conditions like these exacerbate high rates of chronic illnesses, driving 80% of health outcomes, and that it’s a vicious cycle. “Being trapped within a cycle increases the likelihood that the next generation will face the same roadblocks,” she said.
It’s inappropriate to talk about health problems in Black communities without mentioning these social and environmental problems. “Our language is the biggest issue here,” said Vanessa Rissetto, a registered dietitian at Culina Health in Hoboken, New Jersey. She explained that when we say things like Black people have a propensity towards obesity, we make it sound as though by being Black, you are going to be obese. “We leave out the social issues, such as Black people have lack of access, they are not treated the same way whites are when they see practitioners, perhaps there are language barriers or financial issues,” she said. When we talk about health, we have to add this context.
3. There’s a narrow view of healthy eating.
Google healthy eating and you’ll see pages of images with veggies — mostly salads — being prepped or eaten by white people. On Instagram, the hashtag balanced diet looks similar, with a few smoothie and grain bowls thrown in. Is that what it means to eat healthfully? Black dietitians say no, and they challenge you to think more broadly about what to eat to be healthy.
“When we see images of healthy people, they’re exercising and eating a salad. This reinforces the idea that being healthy looks a specific way and is mostly for white people,” said Feller. Moore added that cultural foods are often demonized. “The truth is our traditional foods are actually quite healthy,” she said. “Greens, okra, sweet potatoes are just a few — and we also have to respect that food and culture are connected."
Additionally, Moore indicated that our narrow view of healthy eating excludes many in the Black, indigenous and people of color (BIPOC) community. “If people are made to think they have to change to only eating brown rice, fresh and organic fruits and vegetables, drinking matcha lattes and going on exotic retreats to be healthy, while their greens and beans cooked with meat are labeled ‘bad,’ then healthy eating may seem inaccessible,” she said. “Giving up your cultural foods is not a prerequisite for health.”
Feller added that “when we begin to see images of people eating curries, dhals, tamales, pasteles, peas and rice, escovitch fish, soups and more, we will see that there are multiple ways to eat healthfully and that there are so many different faces and bodies that represent health.”
4. We need more diversity in the wellness space.
One of the biggest problems, said Feller, is that the media projects a one-size perspective. “The ideal body tends to be that of white, cis-gendered, able-bodied, thin and/or chiseled people,” she said.
Agyeman shared a similar viewpoint. “There is a lack of imagery in skin complexion, body shapes and even hair textures,” she said, adding that it’s critical for mainstream media to put more BIPOC at the forefront of wellness. “Healthy eating belongs to everyone — it is not one-sided.”
This article was originally published in July 2020.