Cultural tweeking

An RD at my work passed along a most interesting article highlighting the benefits of culturally-based nutrition education. Specifically, this article was summarizing research performed on a very specific cultural group: Native Americans (the Cheyenne River Sioux Tribe, most specifically). Why of such interest to me? I work with a Native American population, predominantly Cherokees.

Upon moving to Oklahoma, I accepted my current position working with this most unique population, native to Oklahoma following the Trail of Tears. While I’m not a history guru by any stretch of the imagination, I’ve learned a lot about Native Americans, Cherokees, Indian culture, and of most importance to me, the food-based practices surrounding this population.

If you’ve never heard of fry bread, Indian tacos, or goulash, you’re on par with my prior knowledge of Cherokee food preferences. While I’m still not quite clear on goulash, I have the basics down. In addition, popular Cherokee foods include: black-eyed peas, fried potatoes, poached eggs, fried okra, cornbread and beans, beets, turnips, and much, much more. I’ve received a thorough first-hand education on Cherokee food culture and I find it fascinating…being the Yankee that I am. Cherokees like pizza, too, don’t worry!

My advice to fellow nutrition providers is to expand your cultural awareness and meet the needs of your patients. I’ve converted the word “refrigerator” to “ice box”… and “lunch” to “dinner” …and “dinner” to “supper” …and “morning” to “of a morning” …and “evening” to “of an evening”. While such dialect, if you will, if not native to me, I consider it a form of cultural sensitivity. I have far fewer patients asking me today if I’m Indian compared to my first few days in my role…and my hair remains blonde and my eyes remain blue. I do believe my “dialect” and “cultural awareness” have enabled me to appear more credible to my patients.

Somewhat similarly, culturally adapted diabetes education was associated with a reduction in both weight and BMI among type 2 diabetics from the Cheyenne River Sioux Tribe, according to research published in the September issue of the Journal of the American Dietetic Association. A six-month study performed by Kendra K. Kattlemann, PhD, RD at South Dakota State University in Brookings revealed said results. The study included 114 type 2 diabetic Northern Plains Indians from the Cheyenne River Sioux Tribe aged 18 to 65 years. The participants were randomized to receive either standard care diabetes education or diet education based on the components of the traditional Medicine Wheel which includes foods common to the tribe including: water, teas, corn, bread, potatoes, seeds, nuts, greens, elk, buffalo, and rabbit [1].

When compared with the control group receiving traditional diabetes care education, the culturally-adjusted group had significant weight loss and a decrease in BMI at the 6-month mark [1].

This research speaks volumes on the importance of knowing your patient culture. While I was largely familiar with African American and Hispanic cultures of Chicago, I am widening my span of cultural practice with the Cherokees…learning, loving, and having a blast!

What cultural make-up do you work with in your practice? Do you adapt your message based on the recipient? Age group? Gender? Diagnosis? Prognosis?

And I’ll take this opportunity to show-off my office and my FOOD MODELS! How COOL are they? Other employees are so jealous of my fun, colorful office. I think it’s super inviting and non-threatening to patients. What do you think?

 Food models galore!

My food products for label reading 

Indian Fry Bread (food model)

My favorite poster!

More nutrition posters in my office!

[1]. Culturally Based Nutrition Education Helps Weight Loss. Modern Medicine; Health Day News. September 16, 2009.

Food Tip of the Day is on Vacation!

Food tip of the day is on vacation people, so instead I am going to share something very different with you today in this part of, "What should I have for dinner tonight?" I am going to tell you about The Five Dollar Vacation and The Five Dollar Feast (the latter represented by the picture to the left.)

The Five Dollar Vacation is a worldwide charity project, quite literally sending five dollar bills on a trip to visit a great many interesting places, have their photograph taken and actually raise money in a variety of original ways. The Five Dollar Feast is my contribution to the project in my capacity as Food and Drink Channel Steward on Helium.com.

As The Five Dollars have been made to represent in turn Faith, Hope, Charity, Freedom and Love, I decided to prepare a humble meal with ingredients made to represent same. The ingredients I used are all in the picture to the above left.

Dollar One is Faith

I used the broken bread in representation of the Communion celebration, where the bread represents Faith that the broken body of Christ on the cross means salvation for mankind.

Dollar Two is Hope

I used the wine in representation of Christ's blood spilled at his crucifixion to offer the Hope of Eternal Life to all of mankind.

Dollar Three is Charity

Maize is one of the crops which Charity organisers teach people who are starving in the Third World to grow.

Dollar Four is Freedom

The chicken is from a free range bird, which knew Freedom in life and was not cruelly confined.

Dollar Five is Love

Chocolate is the foodstuff often associated with an expression of Love.

The meal which I crafted is a long way from being the most appetising I have ever made but on this occasion that was not the prime concern. I still managed to make a corn and chicken salad with croutons and the chocolate and wine served as dessert.

I hope you enjoyed our little deviation from normal today and food tip of the day will be back with us very soon.