Don’t Stop Eating Tortillas: A Lack of Diversity in Dietary Guidelines

If you want to improve your health or reduce your risk of chronic diseases, you’re often told you have to give up certain foods. You’re told to eat a certain way, typically based on the Dietary Guidelines for Americans (DGA).

Even though the federal government updates the DGAs every 5 years (with the most recent version released in 2020), there is a major problem with our current dietary recommendations: They don’t reflect the rich cultural foods of many Americans.

The current nutrition recommendations is one more way the system says to people of color and minority groups, “our way is better”.

A person with Hispanic heritage told me they had to give up tortillas in order to get their diabetes in control. A health coach told them to replace the tortillas with lettuce.

This health coach isn’t the only one recommending giving up specific ingredients and flavors that connect you to your family, community, ancestors, and tastebuds. The DGA are the guiding principles for the National School Lunch Program, WIC, and other government nutrition support programs. The guidelines dictate how $100 billion is spent on these programs.

The DGA is a powerful influence on policy and most media outlets, healthcare practitioners, and health educators label it as the gold standard.

Food is a big part of culture. We can’t continue to encourage guidelines that are completely incompatible and insensitive to ingredients that bring us closer to one another.

There are groups and companies promoting nutrition information that is more inclusive, which we need. And you’ll find a few statements like “consider ethnic variations” in the 164-page guidelines. But that’s the extent of recommendations for ethnic eating patterns.

We need more cultural representations in the guidelines. So why isn’t there more cultural representation in the guidelines?

The process for creating and updating the guidelines is elaborate and bias.

The CDC conducts the National Health and Nutrition Examination Survey (NHANES) The survey attempts to outline what people are eating and how their nutrition habits affect their health. Every survey has limitations and a major limitation for NHANES is they only interviewed in English and Spanish.

A separate government committee studies the results from the NHANES. They also conduct “food pattern modeling “, which looks at how different food groups and nutrients in each group affect our health at specific age groups and by gender. Currently, the modeling doesn’t include other variables, such as geography, food access, or ethnicity.

The committee also reviews current research. But they can’t evaluate research that isn’t there. There are major gaps in cultural representation in peer-reviewed research.

You might notice that the current guidelines include many principles from the Mediterranean diet. That’s because they have rigorously examined this diet.

But there aren’t many peer-reviewed studies reviewing Native American, Indian, or West African eating habits.

This isn’t for a lack of interest from researchers or consumers. There hasn’t been enough funding for peer-reviewed nutrition research.

Plus, nutrition science is NOT unbiased.

A paper published in 2020 reviewed the involvement of the food industry in nutrition research. They reported:

• Over 28% of articles published in The Journal of Nutrition had involvement and connection to the food industry.
• They involved highly processed food manufacturers in nearly 40% of articles.
• Pediatric Obesity peer-reviewed journal had the lowest proportion of food industry involvement, just under 4%.
• Over 55% of the published articles with food industry involvement reported findings favorable to the interests of the food industry involved.

Take notice of where funding comes from the next time you review a peer-reviewed article.

Race, ethnicity, gender identity, socio-economic status, and family status inform our perspectives on health. Yet, the guidelines fall short of considering these factors.

Like other healthcare recommendations, nutrition guidelines continue to ignore the diverse cultures of various immigrant groups and people of color that have helped shape what American food is today.

All nutrition professionals should automatically embrace cultural preferences and include these foods in their recommendations. Stop encouraging more people to eat dry chicken and broccoli. Instead, counsel people to eat a healthy lifestyle on the foods they grew up with and love.

Even more, the long-term goal is to get the Dietary Guidelines for Americans to look less white and better reflect our cultural foods.