After spending a year as president of the Academy of Nutrition and Dietetics, the nation’s largest organization of food and nutrition professionals, Evelyn Crayton had to take a step back. “We’re in a state of denial,” she said in a recent interview. “We think that if we don’t talk about race, we won’t have to deal with it.”
Crayton laments a problem that in recent years has drawn attention: In the U.S., the field of dietetics and nutrition — and, accordingly, the corps of professionals who shape how Americans understand dietary health, in part by helping draft the national dietary guidelines — has a diversity problem. Over 71 percent of the country’s registered dietitians are white, according to Academy data, and unpaid internships and high tuition costs create barriers to entry that have made the field an increasingly elite profession.
As the U.S. population diversifies, inching toward becoming a “majority-minority” society, the disparity seems more glaring than ever. In 2018, the number of foreign-born people living in America was a record 44.8 million, with more than a million immigrants arriving each year — mostly from China, Mexico, India, and the Philippines but also from the Middle East, Central and South America, and Africa. In other words, from everywhere. If current trends continue, immigrants and their descendants are projected to account for 88 percent of U.S. population growth by 2065.
The lack of diversity in the nutrition field isn’t only a crisis of representation, critics say. It also constrains American notions of what constitutes healthy eating, with consequences for the Dietary Guidelines for Americans — the government’s principal source of dietary advice, which is renewed every five years — and for federal food assistance programs, which overwhelmingly serve low-income families of color.
“The people at the federal level making these policies, they’re part of this structural issue,” Crayton said. “They don’t look like the people on reservations, or the people living in urban communities.”
One example is MyPlate, a USDA database that offers recipes based on the Dietary Guidelines, which overwhelmingly lists recipes classified as “American” cuisine— more than 100, compared to just 28 under “Asian” and 19 under “Middle Eastern.” And as The New York Times pointed out, while there are 125 “Latin American/Hispanic” recipes, they’re not always the most culturally relevant, with a “skinny pizza” — pizza toppings on a tortilla — as a notable example.
“When I was studying nutrition, I thought MyPlate was fabulous; unlike the food pyramid [which preceded it], it would actually show people what to eat,” said Kameron Rowe, a New York-based nutritionist. “But when I started thinking more critically about it, I realized a lot of the recipes don’t make the most sense for people who don’t eat a standard American or Eurocentric diet.”
Rowe, who is Black, pointed to examples like “fruity Thai pita pockets” as a clumsy stand-in for more authentic dishes.
Ailin Liu of Public Health Solutions, which assists low-income communities in New York, stressed the importance of offering ingredients — at food pantries, for example — and suggesting recipes that reflect different cultural tastes. She recalled distributing Farm Share food boxes that contained “very specific American vegetables, like kale or beets,” that many recipients didn’t know how to incorporate into their meals. “When someone is food-insecure, they have to rely on these options, but they end up with something they don’t know how to prepare and that they don’t really enjoy,” she said. “That creates another barrier to food security.”
Now Public Health Solutions “very intentionally includes cultural sensitivity” in its nutrition-education programs, geared specifically to SNAP recipients. Where MyPlate’s “Asian” recipes often feature brown rice, Liu has found that many Chinese participants are reluctant to cook with brown rice, noting that black sticky rice is a much better fit. “It’s helpful to ask, ‘Where do you come from, what is your food culture, and what do you like to eat?’ ”
Messaging plays a huge role in making people feel comfortable, said Rowe. If someone doesn’t see familiar ingredients on recipe lists, “that might signal to them that their food isn’t healthy enough, or good enough,” she explained. “Food is more than a source of nourishment; it’s a connection to your heritage, your homeland; there are stories around it, it brings people together. Unfortunately, because the field of nutrition and dietetics lacks diversity, the message — unintentionally, I think — is that a more Eurocentric palate is healthier than others.”
A USDA spokesperson told FERN that the department is “currently reviewing and updating all of its nutrition-education materials — including its MyPlate recipes — to help meet the personal, cultural, and traditional preferences of Americans today, particularly those that are most vulnerable and chronically underserved.”
Across different federal food programs, advocates have pushed for greater cultural representation, but they say structural barriers — notably, insufficient diversity among dietetics and nutrition professionals — have stalled progress.
Doug Greenaway, president of the National WIC Association, has for years urged greater cultural sensitivity in the WIC food package, which serves pregnant women, new moms, infants, and young children. And while there’s been some progress — in the past decade, whole-grain items have been expanded to include whole-wheat tortillas, brown rice, teff, and buckwheat — there’s much room for improvement.
“It’s really a no-brainer that we need to consider the communities we serve,” said Greenaway. “We’ve been pushing the envelope, to change the landscape of nutrition and the dietetic community, but that’s a really hard thing to do.” It’s especially difficult, he added, in light of recent changes to the eligibility requirements for becoming a registered dietitian: Starting in 2024, a master’s degree will be a prerequisite for taking the qualifying exam.
“We said, ‘Whoa, by doing this you’re narrowing the field, not expanding it,’ ” Greenaway said. “You’re creating new barriers, with the potential to narrow who gets to carry that alphabet soup behind their name.”
Crayton agreed: “What is the new rule going to do for people of color, but also for people from poor, rural communities?”
Contacted by FERN, the Academy of Nutrition and Dietetics pointed to its new Diversity and Inclusion Hub, which provides links to membership groups geared toward Asian-American, Indian, Latino, and Black dietitians. This year it launched a series of awards and grants geared toward aspiring dietitians of color, along with a $25,000 scholarship for two “aspiring registered dietitian nutritionists of diverse backgrounds and cultures.”
But Rowe thinks the Academy hasn’t gone far enough — and should have taken last summer’s protests around race and racism as a signal to open up the field to more racial and socioeconomic diversity. “The Academy definitely missed the mark when it comes to equity and inclusion,” she said.
Much of the push for greater diversity and cultural sensitivity in the field has come from grassroots entities, with the emergence of nonprofits such as Diversify Dietetics, a group of nutritionists and dietitians working to make the industry more accessible to people of color.
Morgan McGhee, director of school nutrition leadership at FoodCorps, a nonprofit that promotes healthy eating in school meal programs, says the conversation is shifting, at least at the grassroots level. “With all the reckoning the U.S. has had over the past two years, a lot of the conversation has turned to, what do we mean by representation and diversity, and what do we mean when we talk about the ‘American diet’?” she said.
But she worries that, in policy circles, not much has changed. “It’s great to have all these different organizations, but my question is, who is at the table creating policy? True equity is not having Black organizations and Latino organizations, but building together, collectively.”