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.