Shireen: Teresa Turner is a registered dietician in school nutrition specialists who manages the food service operations of six programs for fort needs. Army, Child and Youth Services. While also functioning as their Child and Adult Care Food Program, administrator, Teresa is committed to enriching public health via equity and justice initiatives. Welcome. Thank you. Such a pleasure being here. Such a pleasure to have you on. So with that, Teresa diving in, I want to ask you, what sparked your interest in becoming a registered dietitian? 

Teresa: I love this question, because I can never pinpoint the exact moment. All I know is, I applied for college for biology, pre-med. And I got a pamphlet from the food nutrition department that was talking about double majors with biology and nutrition or biology and food science. And then I saw something about dietetics. And I was like, well, this is interesting, it has to do with food. And it dawned on me that everyone eats and everyone drinks, no matter how old no matter where they are, eating and drinking is what people do. And the impact that I could have on helping people be healthy, or lead better lives through food, and also because of the food related illnesses, and my family, with my mother and my grandmother and my grandfather. So it's everybody, my family had been sick, you know, growing up, and so it called out to me. So that's what I had to do.

Shireen: Lovely, and so why childhood nutrition?

Teresa: Mainly, because that's the beginning point, when I always tell this story too, I didn't even hear about food was the food guide pyramid back then. But I didn't know anything about food groups or anything until probably about sixth grade and health class, that's when I first started to really dig into it, I was already 11 years old at the point. And once you reach into your teenage years and older, you've already made up your mind about things. If you don't have that basic knowledge, then you're missing a basic point of life, something that can enrich your life. And I believe that children should be learning about food, and where it comes from and how they get it from the same age, they learn the ABCs, 123, colors, shapes, all of that I believe it all needs to start that early. And so that's really working for my passion for it. Now, I'm going to switch gears to your article in The New York Times, in which you're mentioned and the article's name is, is American dietetics, a white bread world, these dietitians think so. And so it mentions that you're a part of a group called Audit the Academy, and what do you seek to accomplish as a part of this group? Before I answer that question, I do want to say as far as the article, we don't know the name of the article until it comes out. So never know. But with that, I joined the group, I was invited into the group probably mid in the mid summer. And at that point, it was two prong one, it was usually when people, when you don't let people know what they're doing. Either they claim they don't know or they actually don't know, or no one sees what's happening, then it's easy for people to not be held accountable. I felt it was important that it was known that places that they were lacking that the Academy is lacking. And this is not to say that the academy doesn't have benefits, the Academy has benefited me that's not the issue. But you can't conflate issues you can't say because they're great at 123, ABC things that they can just slide on this thing, especially given what the field is, it's a health field where we're talking about transforming people's lives in the world through food and nutrition. But there's a barrier that's based on race between food and not having food. And if they can do something about it and choose not to or not taking the proper steps to do so it's important that that's known for one after two so that other people can be aware and become advocates for what's right and for the right thing for our profession to other colleagues who might not be aware of the changes that need to be made so that we can be the best organization we can be the best profession we can be as thorough as people the best we can. We can skip on. So that was my main reason. 

Shireen: So here, here's a loaded question for you, Teresa, how do we approach diminishing systemic racism in the healthcare field? 

Teresa: This answer, I don't consider myself a harsh person, I consider myself a straightforward person. So on some aspects, especially on this aspect, accountability, and I say that to me, people continue to tiptoe around it and to, want to cuddle, I want to be polite. When people do things that are against human life or against human rights or against social justice, it's always swept under the rug as either they didn't know or they're nice or they have like friends or it's always an excuse to escape accountability. If you have people who are providing health care, it is not about punishment or canceled culture people. People also love throwing that out. If someone commits a grievous offense and you say, well, we don't want to deal with that anyone. We want that person out of our lives because they're hurting people. Oh, you're canceled culture. That's ridiculous. I think people who harm others should be canceled. Call me out fashion, I don't know. But letting people who have who have no records of harm, or have not implicit bias, but explicit bias, but just blatant discrimination or blatant racism or harm, you need to have licenses stripped, they need to be out of the system, because the system is the problem, we need to take the bad things out of it, to let the people who want to do the right thing work and make it stronger. People are getting away with crimes, people are literally getting away with taking lives in emergency rooms and labor rooms, the amount of black women that die during childbirth, outrageous. And there's no accountability whatsoever, because we don't want to cancel them or hurt their feelings. Or I read something the other day, I said, How could you punish their family to try to get them fired and take food out of their mouth? So you're aware that they're responsible for the death of a person? It's beyond me? I think that is, that is the number one thing if there's no accountability, then what is the if there's no consequence, if you don't lose anything, by causing harm? What is your motivation to not cause harm? Because it's not your morals? Because he would be causing harm in the first place? That's not going to stop? 

Shireen: You know, specifically in the nutrition field, you know, how can it be made more inclusive for the future?

Teresa: I believe, as far as this formula, we hear a lot about diversity and inclusion, or the diversity equity inclusion. In IRD, I think it's really important to not, I believe that sometimes the way we see it is the way we envision it working. And I think that looking at it backwards would be a better idea, diversity will not just come out of the blue. And also if you want to reach your quota, for lack of a better time, you can get all the diversity, you want diversity of culture, diversity of sexuality, diversity of religion, diversity of anything, you can get all you want. But if you don't make it a safe, fair, just place full of accountability and full of honesty, they're not going to stay. And you're not going to get new ones, because they're going to have bad experiences. And they're going to share it as they keep going on and on. As you can see, bad news spreads, good news spreads as well. But you have to give somebody that new they're not going to make it up for you. Some people will, but some people are kind of making up good news when it's, it's bad news. I really think that's part of it. Instead of saying we just want to get diversity, we just want to bring in and recruit and retain people of color and people of different demographics. How about be equitable, be fair, be just do the right thing. sanction people who are doing the wrong thing, and then you'll have diversity, because then people will say, Oh, this is a nice place to go, they will treat me well. But you're not gonna just gonna get diversity and not change the way you're doing things. Because that's the way you're doing things is why you don't have diversity now.

Shireen: What tips do you have for healthcare practitioners to ensure they're taking a client's identity and culture into account when prescribing nutrition advice or meal plans?

Teresa: Number one thing, self reflection, um, you have to be honest with yourself, if nothing else, you have to be honest with yourself about how you're viewing this person and why cultural humility is something that I have a colleague that we've been working on presentation about that and something that she focuses on, that's extremely important. Knowing that because we've talked about being humble, but cultural humility, realizing that the way that you were taught in school, the way that your textbooks say the way that you eat, what your family does not reflect on everyone else. And you have to ask those questions. You can't assume anything about a person also with the historical data. This is, I always look at it from two different ways historical data is very important. That's where statistics and things come from, but you have to discern when to use it and when not to use it, when to apply to the situation and when to look at a situation for an individuality that it has. You can't go into, look into a person and look at their community and say, Oh, well, I know for a fact before you start talking, you have this issue, or you're going to have this issue where this is how your community lives. Because that person can be an anomaly. There's outliers everywhere, you don't know where they grew up, or what just because of what their last name or background is. So be you know, be conscientious about the labels that you're attaching to people because of what you've read, or saw because everyone's an individual. 

Shireen: Can you give me an example of what that conversation may look like? 

Teresa: Open ended questions, and definitely no assumptions. Don't and when I say open ended, it's especially not questions that kind of almost lead them into something that you're already thinking. Like, if it's somebody that's from a Latino or Hispanic background, don't ask them questions about beans or rice because you don't know that they eat that you don't you don't have any idea of that. Don't ask them questions about that more. Ask them. What's a typical meal for you look like? Like it's really keeping it neutral. Because people should be treated neutral. And when you have implicit bias or when you have things about yourself that you haven't looked into, or even that you haven't you just haven't attacked yet, then you're less likely to be neutral. And it's important to be neutral when you're meeting patients or clients or community members or anybody, depending on what your walk of life is. 

Shireen: Now, let's flip the sides. And what, what recommendations do you have for patients to ensure that their healthcare providers are addressing their needs in a way that is consistent with their identity and culture? 

Teresa: Trust your instincts for one. And I say that everybody's instincts are not always right all the time. But the point is, one you'd rather be safe than sorry, to, if you're uneasy, even if there's no reason to be uneasy, the cares not going to go well, and the report is not going to go well, you're not going to get the right chair anyway, because you're not going to be easy about it. So if you're uncomfortable, that's one thing. If it's somebody that you work with, and like you don't have a choice or anything like that, make sure that they're listening, you can ask questions back and make sure you ask questions to the other bank, ask anything you want to know, they are in there to help you to serve you. Don't ever, ever be afraid to ask something about your own care about your own life, you have one life you have one body, speak, speak up for yourself the best you can in every aspect the entire time, if that's really the best way and be comfortable. 

Shireen: In an environment where, you know, a clinician may be seeing as many patients, you know, sort of crammed in an hour, how do you find the comfort to ask as many questions? How do you sort of bring yourself to that because you understand that this person, while they have a very limited amount of time with you, there are only so many questions you can squeeze in that timeframe, you know, how do you open up? Or how do you have the space to have those dialogues, then?

Teresa: Even if you have to have a follow up call, even if you have to say I understand you have you know, you have to back up, I know this my appointment time is really important to me, though, for my care that I speak with you about a, b and c and give them a summary. Um, can we set up a time and if that doctor does not set up a time, then that's a problem, that would be a concern because they have it again, if they're a health care professional, they should understand that you have one light and they should care about your life in your health enough to want to ease you, and people don't don't look at it that way. People are always still at the mercy, you can't be at the mercy, you should never have to be at the mercy of someone else for your life and health. And then just we weren't even talking about disparities. But it rolls right back in the mercy that people are at with their lives not knowing when they're going to get their next fresh vegetable or fruit, not knowing when they're going to get groceries period cuz they may or may not have transportation not knowing ABCD because of what's happening, and what's always been happening and what the influences are that are outside of them. It's something that people shouldn't have to doing. If you were in control, you have enough power to do that. If you have the moment to do that. I absolutely think you take every opportunity. 

Shireen: What resources can patients and healthcare practitioners use to find culturally inclusive meals and nutrition advice?

Teresa: I would say my number one answer, and this is not a bias. This is truly I mean, hey, that's why we're here, I would absolutely recommend reaching out and trying to locate a registered dietician. That's specifically for what you need, because we're very dynamic. And a lot of people feel like they're all of us just make menus and tell people what to eat. There are so many different facets of what dietitians do so find one that specializes or just aligned with what you need and what you feel you need and start there. And you know, if they're trusting in you, and you're trusting in them for care, and they're trusting you to, to talk to them and build that rapport, then you can work together for whatever you need.

Shireen:  

In building that rapport with a dietitian, what are the, you know, I'm just gonna say number three, but what are the top three things that I should talk to my dietitian about?

Teresa  

Food access. Number one, I'll let them know what your situation is, like, if you want to talk to him, it's just all their understanding. So they're not offering you suggestions or remedies that are not feasible for you or that they can't bridge the gap to. We don't want that will make we The last thing you want. If you're in a situation where you feel you need a health care intervention or provider is to feel helpless in the process. So make sure you, you know, discuss your access, discuss, you know, people don't mention mental and emotional health enough and i don't i mean lately, I mean, definitely and people have but I believe it's a lot everything is a lot more. There's a spotlight on the world, you know, sent over the past year. So that's everything. But let them know if there's a reason that you might have an issue with food that's, that's outside of a physical health reason. I think it's important that they know that I think it's important that people know that when certain things happen in my life and not my life. But if I'm talking to a dietician, well, there's things that happen in my life that make me want to binge eat, if this had ever happened, I think that's important for them to know so they can navigate that properly and not cause harm in that way. And see, the third thing, ask your dietitian about that. Food is very personal food is very intimate food is we put it inside of our bodies that makes us who we are, it's connected to our traditions and everything. I think if someone's helping me decide something to put inside my body to live a better life, I'd like to know a little bit about them. So those would be my top three, your access any issues you have related to outside of physical issues, and ask about the person giving you this care. 

Shireen: I love it. So with that, Teresa, we're toward the end of the episode. At this point, I'd love for our listeners to know how can they connect with you and learn more about your work. 

Teresa: But social media is the easiest and quickest. And you can always reach me there. And then you can reach me all the other ways. But you can find me on either Instagram or Twitter at TTURNDIETITIAN at t turn dietitian. And then you'll find me there. And then we can talk and you can be me, you can email me and we can work together and we can change the world. And I'm available.

Shireen: I love that. Thank you so much. And we're, we're going to do is for listeners, we're going to link all of this in our show notes, you can click and get connected over to three. So pretty quickly there. So with that, thank you so very much Teresa for your time. It was a pleasure having you on.

Teresa: Thank you so much. It was like I said it was very much a pleasure to be here with you. This was awesome. I really appreciate the opportunity.

Shireen: I love it. And so to all of our listeners here, thank you so much for joining us again, I do want to pose a question to you. Do you feel the nutrition advice that you have received has been culturally relevant for you. So go to our social media on our Facebook or Instagram. We'll have social posts there. interact with us, tell us what you think, how relevant advice Have you received and what you've really done with it. So with that, thank you again for tuning in. We'll see you at the next one.

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