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Why ‘Healthy’ Eating for Type 2 Diabetes Needs to Include Cultural Foods

Diet and Nutrition

November 16, 2022

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Photography by Nadine Greeff/Stocksy United

Photography by Nadine Greeff/Stocksy United

by Sydney Williams

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Medically Reviewed by:

Kathy W. Warwick, R.D., CDE

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by Sydney Williams

•••••

Medically Reviewed by:

Kathy W. Warwick, R.D., CDE

•••••

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Food is such an important part of our day-to-day lives. This Q&A features the founders of EatWell Exchange, an organization led by two dietitians that educate their community about nutrition with a focus on culture.

“You can’t eat that.”

“Are you sure you can eat that?”

There’s a ton of emphasis on nutrition after receiving a diabetes diagnosis, and with good reason. Some foods will contribute to positive outcomes for people living with diabetes, while other foods can send your blood sugar skyrocketing.

But between the portions on your plate, the order in which you eat your food, interactions with the medications you’re taking, how you’re moving your body, stigma and misunderstandings about type 2 diabetes, and the stress you may be navigating in your daily life, a diabetes diagnosis can feel like a personal attack on the choices we’ve made.

We can’t quit food — we need it to survive. And while most doctors and nutritionists who give us a list of foods that are “good” or “bad” are usually well-intentioned, the truth is that how we nourish ourselves is one of the most personal decisions we make every day.

Influenced by culture, traditions, and access, food is one of the most integral parts of our lives. It’s how we show and receive love, it’s how we fuel our bodies for excellent adventures, and it can serve as a potent reminder of powerful memories from various occasions.

Influenced by culture, traditions, and access, food is one of the most integral parts of our lives.

I’ve certainly felt all of this. Immediately following my diabetes diagnosis, I went to nutrition classes at my local hospital and learned which foods were acceptable and which weren’t. Sitting in a diverse classroom of other people with diabetes, I heard a lot of questions about specific dishes during our first class.

After all, food is such an important part of our day-to-day lives. It makes sense that in the face of “eat this, not that,” we’d have questions about the staple foods in our pantries.

There were the obvious questions — “What about cake? Can I never have cake again?” — and there were questions that indicated an area that I was embarrassingly unaware of:

“What about my mom’s famous enchiladas? She makes them every Christmas Eve for my friends and family.”

“What about beans and rice? That’s a staple in our home.”

“What about all the delicious tropical fruits I grew up eating on the island? Are those off-limits now?”

I had been around the diet block since I was diagnosed with type 2 diabetes. I tried it all: Atkins, South Beach, keto, plant-based, Weight Watchers, frozen meals. I was familiar with many of the ingredients shared on the “good” list and recognized the foods on the “no-no” list as ones I enjoy a handful of times per year.

My insatiable curiosity for understanding my fellow humans led me down a beautiful rabbit hole on Instagram in 2021. In preparation for our Take a Hike Diabetes campaign, I was reading up on organizations around the United States making diabetes management easier to understand in their local communities.

It was in this search that I found EatWell Exchange.

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Q&A with the founders of EatWell Exchange

Founded by Ashley Carter, RD/LDN, and Jasmine Westbrooks, MS, RD/LDN, CDCES, EatWell Exchange exists to educate the local community about nutrition with a focus on culture.

A quick scroll through their Instagram feed showcases their mission by sharing inspirational affirmations, community updates, and educational posts like “Name That Fruit,” which introduces their followers to food from around the world.

I had the privilege to sit down with Ashley and Jasmine to talk about EatWell Exchange, diversifying dietetics, and how that signature dish your mama makes when you’re feeling sick is always allowed on your diabetes management nutrition plan.

Sydney Williams (SW): Why did you start EatWell Exchange?

Jasmine Westbrooks (JW): EatWell Exchange started as an idea, as we always say. We were having girl time, talking about a problem we saw in the healthcare system. At the time, we were working for the health department and noticed that People of Color, specifically Women of Color, would come in and weren’t really happy or empowered about changing their eating habits. They felt like they couldn’t relate to the foods they were told to eat and couldn’t find them in their local grocery store.

So, Ashley and I created EatWell Exchange with the first mindset of “OK, we’ll just provide nutrition education to People of Color, but focus on culture and foods that they’re already accustomed to and highlight the benefits of those foods.”

But then some of the people we were serving were like, “Jasmine and Ash, that’s great, but we don’t have access to this food.” So that led us to understand that food deserts and food insecurity are big problems for many communities, even before COVID happened.

That grew into our next pillar, which is like culinary medicine or culinary nutrition, where we teach people how to make different foods from their culture in a beneficial way. It’s simple and easy, something they can do, and they can start wherever they are in their health journey.

The cool part is that we’ve been able to serve people with diabetes and people who may have prediabetes but don’t understand that they’re at risk for diabetes. That brought upon our prediabetes culinary program, where we educate people about nutrition but also bring in the component of being in the kitchen with them and teaching them how to cook a healthy meal based on their culture.

It’s been a journey, and we’re excited to see it grow, especially into prediabetes, diabetes, and other medical conditions.

SW: Why is nutrition education important across different cultures?

Ashley Carter (AC): It’s not optional to consider culture when we talk about food because for all of our foods, it’s very relative to where we grew up geographically, the income status of our parents, and more.

The food you eat tells an entire story about you, your family, and your traditions, values, and religion. So we always have to consider culture whenever we talk about food. This is one of those areas that we feel should be deeply woven into the field of dietetics — to always consider culture.

It doesn’t have to be a culture-focused conversation, but dietitians should always think about the culture of the clients that they serve and meet people where they are when it comes to the foods they eat.

JW: The similarity of culturally relevant foods and how the field of dietetics isn’t as diverse is simple: They’re not exposed.

When you look up different foods, look up “healthy.” You don’t see those culturally rich foods as the first thing on your Google search, right? It’s the same thing with a dietitian — you look for one, but you’re not going to find a dietitian of color.

One of the reasons we share “Name That Fruit” posts on Instagram is because it highlights that exposure is a problem — and those posts are ways to fix it. You may not have seen it before, but that doesn’t mean it’s not a great fruit. Same thing with a dietitian. There are very few Black dietitians, and we need more exposure to increase the number of dietitians.

SW: What are some ways to stick to a diabetes-friendly nutrition plan while still embracing cultural foods?

JW: Portion sizes. No matter how “healthy” anything is for you, it’s all about portion sizes. I’m thinking about cultural food in its entirety. I often have Dominican clients, and they’ll say, “Oh, I can’t eat any Dominican foods.” We have Black or African American clients who say, “Well, I can’t eat any soul foods.”

It’s this idea that our food is generalized by a population and that all of it is bad. Patients have told me stories of their physicians saying, “Oh, you can’t eat any of your Haitian foods because they say all of your foods are starchy.” They generalize foods by different cultures and make it seem like you can’t eat anything you’re familiar with.

Every nutrition plan has a lot of variety, even with the Mediterranean diet. There are carbs in there, too. There are starches. It doesn’t mean we throw the diet away. It means we learn how to use the foods within that diet.

SW: What does ‘healthy’ eating really look like?

AC: I would say choosing foods you enjoy, a lifestyle you will enjoy, and your overall habits. What can you do today that you can continue for the rest of your life and be satisfied with?

What’s something that’s going to nourish my body and give me the energy and fuel I need that also provides me the happiness, comfort, and all those other great things we get from our food?

There’s an emotional component when you’re with friends and family, too. What can you do that’s going to fulfill all of these areas every single day? Of course, [it’s also about] foods you have access to. What is nearby? What’s regional for you? What can you eat?

Take a look at all those different components to structure a lifestyle in which you can continue to be satisfied and happy and find joy.

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The bottom line

Not everyone eats the same plate of food — but this doesn’t mean that different plates aren’t healthy. Thanks to organizations like EatWell Exchange, more people are coming to understand that cultural foods aren’t off-limits and can be part of a well-rounded diabetes management protocol.

And while we’ve come a long way, we have a long way to go — just 3% of dietitians are Black or African American. Jasmine and Ash reminded me that even as Black dietitians, they have to do more research frequently because cultural understanding wasn’t taught in the classroom. After all, most of the nutrition curriculum available is based on studies done on white people — and is taught by mostly white professors.

Hopefully, as we diversify the foods we put on our plates, we can also encourage more diversity in the field.

Medically reviewed on November 16, 2022

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About the author

Sydney Williams

Sydney Williams is an adventure athlete and author based in San Diego, California. Her work explores how trauma manifests in our minds and bodies, and how the outdoors can help us heal. Sydney is the founder of Hiking My Feelings, a nonprofit organization on a mission to improve community health by creating opportunities for people to experience the healing power of nature. Join the Hiking My Feelings Family, and follow along on YouTube and Instagram.

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