Don’t Forget The Beans: The Importance of Providing Culturally Relevant Dietary Advice

By Virgilia Zabala Korus, MBA, MSPH, RDN, LDN

This edition covers:

• Biases in published nutritional guidelines
• Approaching person-centered care with cultural humility
• Achieving culturally-tailored care in a virtual setting

When I was teaching a Diabetes Self Management and Education Support course in person, one of my students had a revelation that beans count as carbs. She was a woman in her late sixties who had been diagnosed with diabetes 22 years prior; and in her culture, beans and rice were staple foods. She took my class to get a better understanding of how to manage her diabetes since her glucose values had been trending up. “I’ve had diabetes for 22 years, and I was always told not to eat a lot of rice. I didn’t know that I also had to watch my beans!”

Yet when it comes to training, education, and some government-sponsored nutrition assistance programs, the available dietary advice is given to support the general population and majority culture. It is up to the individual provider to learn how to make that advice culturally relevant in the absence of guidelines on how to do so.

During my time as a dietitian for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in Baltimore, MD, I worked in a clinic that served a diverse population. While we mostly served minorities from the local area (Black, Hispanic, and Asian) we were also in the unique position of serving international refugees.

We had a large Burmese, Nepali, and Congolese population. Not only did our sessions with refugees take longer due to our use of an interpreter to overcome language differences, we also had to take the time to explain what the foods in their benefits package were. Packaged foods like cereals or breads available to WIC recipients were often unfamiliar to the refugee families, especially if they had only arrived in the US a few days prior. Our clinic would ensure that we had the necessary time blocked off when a refugee family was coming in, as we knew the pursuit of health equity requires time and intentionality.

The Dietary Guidelines for Americans, and educational tools such as MyPlate, provide science-based advice to promote health and reduce the risk of chronic disease, yet they are frameworks which are intended to help individuals make tailored choices to meet their personal, cultural, and traditional preferences.

For my student with diabetes, she may have assumed beans did not count as carbs as they are classified as either vegetables or protein foods in these guidelines. 

As a Venezuelan-American, I cannot assume that I am familiar with all cultural food practices of US-based Hispanic and Latino communities, let alone food cultures from around the world. It is with cultural humility that I constantly seek ways to expand my knowledge and understanding of others, so that I may provide better, more tailored advice.

At Omada, our coaches receive ongoing training to ensure that they are providing culturally appropriate recommendations that take into account a person’s life circumstances (SDOH) in order to evoke change in lifestyle behaviors, regardless of the type of diet a member chooses to pursue.

We leverage our Omada Insights Lab to surface member-specific insights to our coaches so that they may efficiently recognize patterns and address them in the appropriate way. We marry population learning with each individual member’s context to provide person-centered care, so that regardless of their cultural, ethnic, or social background, they receive the right kind of support. We strive to understand each of our members to provide them with a holistic educational and self-efficacy building experience –  beans, rice and all.