
In this episode, Dr. Katherine Burt delves into how the Mediterranean diet plan is a white diet that perpetuates racist systems of oppression through being framed as the gold standard of healthy eating. She also discusses the need to diversify the field of dietetics and better include culturally rich food into dietary recommendations.
Katherine Burt Gardner Burt, PhD, RD is an assistant professor and Undergraduate Program Director of the Dietetics, Foods, and Nutrition Program at Lehman College, City University of New York. Dr. Burt is a registered dietitian and culinary nutritionist who teaches courses in cultural humility, cultural foodways, and professional practice. Dr. Burt’s research explores how systemic racial bias and the normativity of whiteness impact the dietetics profession and dietary recommendations.
In this episode, Dr. Katherine Burt delves into how the Mediterranean diet plan is a white diet that perpetuates racist systems of oppression through being framed as the gold standard of healthy eating. She also discusses the need to diversify the field of dietetics and better include culturally rich food into dietary recommendations.
Shireen: In this episode, Dr. Kate Burt delves into how the Mediterranean diet plan is a white diet that perpetuates racist systems of oppression through being framed as the gold standard of healthy eating. She also discusses the need to diversify the field of dietetics and better include culturally rich food into dietary recommendations.
This episode is part of our series dedicated to addressing health inequalities in nutrition and diabetes for the month of January. During the series, we hope to educate listeners about how structural and cultural factors impact health care and nutritional practices. This month, we will bring in experts to discuss topics, including food sovereignty, the whiteness of the Mediterranean diet, reimagining Hispanic, Caribbean nutrition, and how public health food policy gives rise to chronic disease.
Podcasting from Dallas, Texas. I am Shireen and this is the Yumlish podcast. Yumlish is working to empower you, to take charge of your health through diet and exercise and reduce the risk of chronic conditions like type two diabetes and heart disease. We hope to share a unique perspective and a culturally relevant approach to managing these chronic conditions with you each week.
Dr. Burt: Thank you so much for having me. I'm so thrilled to be here.
Shireen: Incredible, the pleasure is ours. So starting this conversation, I would love to know what sparked your interest in challenging inclusivity and equity in nutrition.
Dr. Burt: Some of my earliest experiences in nutrition made it blatantly obvious to me that this profession was not inclusive. I was a program coordinator and worked for a farmer's market program in the city of New York, where we would go into farmer's markets and low-income neighborhoods in New York city and conduct nutrition, education workshops, combined with cooking demonstration for anybody who was shopping at the market that day, and people could attend our workshops and learn a little bit, our hope was learn a little bit about nutrition, um, and make some good choices while they were there.
So, you know, for your listeners who, who maybe can't see me, I am somebody of privilege of multiple kinds of privilege, white privilege is certainly one of them. And so here I was a 20 something white woman going into these high needs areas of New York city serving predominantly Latino women.
So one of the lessons that I was told to go teach was about how to cook beans. And if you know anything about Latino women and beans, you probably know that I learned a lot about how to cook beans while teaching them how to cook beans. So this huge mismatch was apparent from the beginning. And at the time it was kind of shameful and embarrassing to be showing up and I didn't quite get it.
That was what we were doing because we lacked inclusion because we didn't realize we at the highest levels didn't realize that that is a totally inappropriate lesson. And at the same time I was, or, or I guess shortly after I was becoming much more aware of my privilege and relative social advantage as I became more aware of the black lives matter movement.
And so that helped me really understand how privilege works in diversity and inclusion. And so while I was becoming more aware of the lack of diversity in the profession, I was also realizing the impact that that lack of diversity and inclusion had on our patients. And so that really sparked my interest in getting more involved with this work.
Shireen: Interesting. So help us understand. So we're going to start off with the Mediterranean diet first. What is a Mediterranean diet? And I know there's lots of information out there about it, right? If you had to simplify it for us, what is this Mediterranean diet? Why is everyone hopped up on it?
Dr. Burt: It's a good question because it is actually really hard to define. So the Mediterranean diet’s inception and the way that we really talk about it now. All it is is high carbohydrates which we're gonna use to describe whole grains, fruits, and vegetables. That's what we're really talking about with high carbs in the Mediterranean diet, whole grains, fruits, and vegetables, and low saturated fat. Saturated fat comes from animals. So we're really just talking about less meat. It's low meat and high fruits, vegetables, and whole grains.
Shireen: And so within the Mediterranean diet, how is it promoted by healthcare professionals as sort of this gold standard diet in the United States today? I've had physicians who talk about it. What is it about the diet that makes it that gold standard?
Dr. Burt: So part of it is the attention that it's received since the forties and fifties in the United States. It's been the focus of a lot of research on dietary research. This research really started at Harvard. And so you can imagine these were people who were very well-respected, who were very much involved in the public health crisis at the time, which was cardiovascular disease. And this seemed to have a positive effect on reducing cardiovascular disease for people. And so for that reason, it gained a lot of attention. But it kind of morphed into this gold standard diet when it became the sole focus. And so now it's the only diet that is promoted by the USDA other than, you know, recommendations like my plate.
So my plate is a current version of my pyramid which we had for a very long time. And about 10 years ago, we moved into my plate. So that essentially promotes the same things that the Mediterranean diet does. The high carbohydrates, high fruits, high vegetables, lots of whole grains and low meat. So these kinds of work in tandem to create these gold standard dietary recommendations, it's aspirational. That's what the federal government thinks we should be eating. Like that's what makes it golden.
Shireen: Interesting. Now, help us understand something you mentioned earlier and what got you sort of working in this space that you're in today? How has the lack of diversity in dietetics, especially specifically you're finding that most of the dieticians today are white influenced really this infusion of Mediterranean diet into sort of overall dietary recommendation?
Dr. Burt: Well, I think the fact that this diet was kind of masked as a cultural diet, I mean, it's been tied to a multi-ethnic region. Yet we're not including a lot of the foods from that from the Mediterranean region that are consumed by non-white cultures. So it's kind of not even representative of what people in the Mediterranean region actually eat.
And, and as a result, it kind of supports this white way of eating. A more European way of eating is another way to say it. Inherently that leaves some people out by focusing only on those foods that are commonly consumed by people of European descent. And so we've created a divide between who really identifies with this eating pattern and who doesn't,
Shireen: What issues exist with marketing of the Mediterranean diet as the healthiest possible?
Dr. Burt: That's also such a great question. That's also problematic because of the history of how it came to be what it is. And coupled with some of the problematic history that we have in this country with historically racist policies. So when we think about what's recommended by the Mediterranean diet, we're talking about things like whole grains, fruits, and vegetables. Those are pretty expensive and they're expensive in part because of the way that we grow food in this country. Maybe some people are not familiar with that. So just a quick background on, on what that looks like. The federal government gives money to farmers to grow certain foods. Those are predominantly corn, soy wheat, all of the things that get in the processed foods and that artificially deflates the cost of processed foods because they're subsidized. So it's, we've created an environment where processed foods are cheap and, um, and these foods that we want people to be having like fruits and vegetables and whole grains are more expensive.
So we have that problem within the food. Well, we have another problem too, where we have limited the opportunities for people of color to earn money and transfer that money between generations for a long time, there was a legal dispossession, so of a repossession by the federal government of land from black farmers. For instance. There's also been policies, limiting business loans and opportunities for people of color to start their own businesses. In essence, that has limited income, that has turned into a lack of, of wealth accumulation between generations and coupled with lack of access to healthcare.
We've created a social divide. People are now impoverished along racial lines because of these historically racist policies. So now we have, you know, white people tend to be more affluent than people of color, and you have to be more affluent to be able to eat this gold standard way.
So we've set up a system impossible for people of lower socioeconomic status to achieve. They can't eat the way that they might want to because fruits and vegetables are so expensive.
Shireen: I understand the way you said that and when you were talking, I just wanted to clarify when you're talking about corn, this is not the corn that you and I go grocery shopping at the grocery store, right?
Dr. Burt: No, not at all. This is not sweet corn. That’s sweet corn. And I, you know, love to eat it myself. This is a very different kind of corn and we just extract nutrients from it. We don't actually eat this kind of food.
Shireen: Gotcha. And so, when you're talking about subsidies that are applied, that essentially then goes to folks who are, you know, the sort of the companies of the world who are creating the Twinkies and the, you know, whatever it is. And so for them to create these ultra processed foods, a lot of the ingredients that they're using to make these foods are subsidized, which is why, when we talk about. Eating healthy. And this expensive will because eating poorly and going through sort of those processed food aisles at your local grocery store, a lot of that is being subsidized. Why is it so?
Dr. Burt: Exactly. And you know, many people are kind of familiar with corn syrup, this idea of corn syrup. That's the kind of corn that we're talking about and that's cheap. That's why people use it. That's why it's used in processed foods. So commonly, because it's so inexpensive. it's a good sweetener for that reason for companies who want to profit off of their profits, processed foods, they want to use the cheapest ingredients and then they want to sell it for the highest cost they can so that the return on their investment is good.
And it's not the same thing with fruits and vegetables, because who's going to market broccoli and really make a profit off of it. There's no food company that's going to benefit from selling more broccoli and no one company at least. And so, you know, there's, there's challenges to the way that foods are marketed and who's profiting as well. That extends beyond just the who's getting the money broccoli lobbyist. So that makes sense.
Shireen: So, how do nutrition guidelines constructed within the Mediterranean diet plan really perpetuate systemic racism and then also harm minority populations? Can you provide us specific examples here?
Dr. Burt: Well, I think it goes back to, I guess I want to elaborate on an earlier point. So, you know, when we're telling people when the federal government or dietetic professionals or health professionals generally are telling people the Mediterranean diet, that is the best way to eat, you should be, you should be striving for that.
And at the same time, People who are impoverished or of lower socioeconomic status simply cannot do that. Then we're creating a system in which it's totally unachievable to quote unquote eat healthy. So you're setting people up to fail simply because they can't afford it. So they're always going to be perceived by health professionals as having a poor diet. Not because anybody's interested in making unhealthy choices, but simply because they've been subject to marginalization, historically and currently for a long time. And so it's essentially a system where people are set up to fail and people are set up to not be able to eat a healthy diet no matter how much they want to try.
Psychologically this is extremely harmful. And then practically speaking, you know, we see that people of color and people from lower socioeconomic statuses in general, or with other marginalized identities are often less healthy than the average person. And so we have to look at what has contributed to forcing people into eating cheap foods that are unhealthy has contributed to where we are today in that case,
Shireen: Are there other dietary plans for healthy eating and specifically diabetes management that better include knowledge of diverse cultural communities that should be implemented?
Dr. Burt: That's such a great question too. You know I struggle with this, this idea all the time. Is there a diet plan? Probably not. There's not going to be a one size fits all approach because the choices that we make around food are so complex. It's about our personal family history, our cultural history, and what's available in our immediate environment.
What kind of time do we have to even prepare food? There are so many factors. So the reality is probably there's no one right or wrong way to eat no healthy or unhealthy way to eat. And so dietetic professionals really need to become better chameleons. We need to be able to change and adapt and serve our clients as individuals, rather than blanketly suggesting a pattern of eating that we think might promote.
But there isn't a go-to like select this because then again, we fall into like the one size fits all approach. Right? And so I actually, in my private practice, which has now closed, I used to work a lot with people with diabetes, mostly with women experiencing gestational diabetes. And I found in my private practice that the most effective care was really just responsive to that patient. I wasn't recommending any single diet plan and more often than not, I was recommending that my patients eat carbohydrates, but we had to do so in a careful way that fit with their lifestyle. And so that's really, you can't create a plan for that. You need to be able to work one-on-one with people and in doing so, I would recommend cultural foods regularly. If it was something that my client told me that they enjoy, that they wanted to eat, we would work it in.
Shireen: I think you answered part of the next question, which is, you know, how can healthcare and dietetics professionals in particular really work to create more, more of that inclusive food environment and then really incorporate nonwhite cultural diet?
Dr. Burt: Ah, that's my answer for this question alone. It could probably be a full podcast episode, but I think there's really three things that we need to do. The first one is that existing health professionals need to become more culturally humble cultural humility development requires. Understanding your own biases, understanding this profession, biases, understanding social biases, and really combating those. Because once we can kind of strip away all of our bias, we can develop more empathy for each other. We can connect with each other better and that's all about, uh, you know, what's truly going to help a patient is if their provider understands that.
So existing dietetic professionals, we need to develop cultural humility. We also need to bring more voices and opinions into this conversation. So we need to become more diverse. We need more people involved in this conversation that can't be limited to, um, you know, predominantly female white, upper middle class dieticians.
And then the third thing is all dieticians and health professionals I firmly believe should get behind changing subsidies, but more importantly, promoting a living wage for people, because if people can afford food, then we know that health outcomes change and. Dietetic professionals given the current food landscape and health environment that we're battling. It is so important that we advocate that our patients have enough money to eat in the way that they want to eat. Perhaps pulling some of those subsidies off of some of the processed foods and putting it to word, you know, just sort of reallocating that at any one has to be a whole nother budgetary battle. Perhaps it's pulling some of those funds out of the process, food Isles and moving it more to the fresh produce.
Yeah. And that's, you know, there's, there's a lot of lobbying that happens. This is not, you know, the conversations that happen in Congress are torn by all of the money that food companies and the power that food companies have.So dieticians often feel like the pole between, you know, food marketers and food companies, and what, what we know is best for health.
Shireen: Any other last comments that you have for our listeners here? Anything that we can do actionably today to be empowered in our health?
Dr. Burt: I think it's just important for more people to get involved in this conversation. The more people who are actively talking about the challenges that they experienced, the making demands for more diverse and inclusive providers, the more we're going to see this change.
And, especially for dieticians and patients of dieticians out there, ask the hard questions. Don't follow the diet plans that are just handed to you. You know, challenge your providers and make them rise to meet whatever your particular needs are. They should, and, I hope that you are as well.
Shireen: And with that, thank you so very much for your time. One last question for you though. How can our listeners connect with you and learn more about you?
Dr. Burt: Oh, that would be great. So I moderate a Facebook group called inclusive dietetics. I'd love to chat with anybody there. And if you're not a dietetic professional and you just want to follow me generally, I'm also on Instagram, but I am terrible with it, but you can find me at @disasterdietitian.
Shireen: Okay. Thank you so very much for your time, Dr. Burt, it was an absolute pleasure having you. Thank you so much for having me. It's a pleasure. Absolutely. And to our listeners out there after this episode, how to over to our social media, to our Facebook or Instagram and answer this question, what is one culturally rich food you would like to see incorporated into general dietary recommendations? Head over to social media and answer that question there.
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