Shireen: Amber Charles-Alexis is a public health nutritionist and registered dietician located in Trinidad and Tobago. Through her blog and freelance writing, Amber shares culturally competent nutrition, and is fondly known as “The Cultural Dietician.” Stay tuned to hear Amber Charles discuss her No-Diet approach to nutrition therapy, rooted in body autonomy, and how you can effectively identify and avoid quick fixes and fad diets.

Podcasting from Dallas, Texas I’m 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.

Welcome Amber.

Amber: Thank you so much. Thank you for having me.

Shireen: An absolute pleasure. Diving right in, Amber, I’d like to learn more about what led you to work with nutrition and then focus specifically on culturally competent nutrition therapy.

Amber: Definitely. So my interest in nutrition began really in childhood after, um, my mom experienced a stroke.

However, my specific interests on culturally competent nutrition therapy grew during my dietetic internship. I came to the US, uh, to pursue my master’s in public health and my dietetic internship for training. And it was through this program that I realized that cultural competence in dietetics is something that can be improved on.

It’s something that, uh, patients or clients struggled with being able to receive information presented to their food, culture, traditions, and practices. And there was a communication barrier between these patients and the dietician. So I saw that this is fact. This is something that I am passionate about, and I wanted to focus my practice on how to approach it.

Shireen: I love that. You talk about a no-diet approach. Can you tell us what a no-diet approach to nutrition is?

Amber: So a no-diet approach is no counting of calories, no overly restrictive, uh, nutrition approaches to eating. And this is really because we’ve been told that diets, or dieting, is really the only way to improve your health.

The word diet itself has been misconstrued because it really originally meant just a pattern of eating. But right now we know that diet means so many restrictive things, and this can become an issue for someone. It’s a psychological issue because you’re thinking, oh my gosh, I can’t have something. It makes me want it even more.

It has been shown to lead to more disordered eating patterns. So my approach is to move away from that, uh, taking into consideration the mindset around food and really showing you how you can build nutritionally balanced, healthy, and nutritious meals using your cultural foods without all of the fanatics of dieting, or diet culture.

Shireen: And why is this no-diet approach, especially applicable for individuals with chronic conditions?

Amber: Sure. So we know that a chronic condition is any condition that you have that lasts beyond six months. And most times, these are conditions that you’re going to have to manage for the rest of your lives. Many of the diet trends that we see are short term.

So we want to be able to empower our patients and clients with nutrition knowledge, and information that helps them to make sustainable and long-term changes, so that they can continue to live in a way that’s going to support good management of their condition, whatever that may be, if it may be diabetes or high blood pressure, high cholesterol, while being able to enjoy their foods. Many times diets, because they’re short term, they bring you these really quick and nice results, but then you find yourself struggling back and forth between how can you really manage that chronic condition?

Shireen: You know, when you, when you talked about, um, sort of fad diets, um, how can individuals really identify those types of fad diets and really avoid the quick fixes that come with those? How do we go about navigating that?

Amber: Yeah. So these fad diets, I think it’s very easy to identify a fat diet because one it’s going to be very popular. That’s the first thing.

Shireen: So, so don’t go for the popular choice. So if it’s popular, it’s probably a fad.

Amber: Yes, most likely. So, uh, you know, the road less traveled sort of concepts here. So fad diets are quick fixes that promise rapid weight loss, maybe not like lose 10 pounds in a week or, you know, you’re going to lose 40 pounds in a month.

Something like really drastic. It usually encourages you to avoid a lot of foods or even food tips on the whole. And it may be something I can not really popularize. There are a lot of marketing that goes into it, or a lot of companies that are promoting this style of eating, because it’s really a money-making industry, compared to more sustainable, a more balanced approach, to nutrition.

So those fad diets, again, are going to be short term, maybe six weeks, maybe one month, or sometimes even seven days. We see like seven day detoxes. I find, uh, that’s good Jessup, just fans, little food, and then you return to a normal pattern of eating. So those are all quick fixes on fad diets that then, you know, have a long-term negative impact on your health.

Shireen: I see. How is the concept of body autonomy related to this no-diet philosophy?

Amber: The body autonomy, you know, is really someone’s ability to make a decision about their business, but it’s usually referred to in a space of safety and having, uh, it’s a human rights or social justice concept that as an individual, I need to be able to make decisions about my body without being forced to do something else.

And with respect, and it’s often highlighted with respect to violent crimes and agreed in the world of nutrition however, given the fact by the autonomy as being able to make a decision and being able to have equal and fair access to medical and nutrition interventions, regardless of your body size.

So it’s really linked to body weight. What we found is that a number of reasons, so maybe overweight or particularly obese, and that would be in this category. Do you experience a lot of systemic discrimination and prejudice bias that the, and not given equal and fair access to appropriate medical interventions. So when you say body autonomy, it’s, I am giving you the empowerment that you get to say, even if I’m overweight or obese, I don’t want to focus on my weight.

I want to focus on my chronic condition, or my medical condition, and I want to be able to receive advice that is more detail than “you need to lose weight”.

Shireen: And so how does this, um, sort of inherent bias? How is that shaping or, um, uh, you know, uh, sort of, um, uh, influencing, um, medical care and, and nutrition therapy interventions?

Amber: Yeah. So some studies have shown that persons who, uh, obese because of this systemic weight stigma and systemic, uh, or, or weight focused medical system are not receiving some of that appropriate care.

So instead of being able to access maybe certain surgeries or medication, they are being told lose weight to fix your condition. Now we know that these chronic conditions can not just go away. Even, if you lose weight, there is so much more that goes into managing them. So let’s take, for example, someone who may have diabetes.

We know that both some patients have been persons-and been persons who are larger and larger bodies or fat or obeseor overweight can both have diabetes type two diabetes, yet someone who’s thin that is most likely to receive, you know, an appropriate medication regimen or more detailed nutrition advice compared to someone who is larger.

So they are told, okay, you need to lose X amount of pounds or you need to lose weight and they may or may not receive the same you know, uh, intervention. They may or may not be seeing the same in detail of explanation given to them about what steps they need to take. So it seems that with this weight being the main focus of that medical system, that sometimes it almost surprised me rob some persons of the true medical intervention or steps needed to improve their situation because yes, you can lose weight. It’s not going to automatically make you diabetes free or no longer have high blood pressure. So being able to identify that these are chronic conditions, weight plays a role, but it’s not the only thing. Or it’s not sometimes the main thing to improve your health.

Same thing with respect to nutrition. Some patients may think, oh, I need to lose weight. I need to lose weight to manage my blood sugar and to anything, to lose weight, um, you know, your diet or weight cycle, which is going to create a lot of pressure on their liver, for example. So you want to be able to do things in a sustainable gradual manner.

You’re not doing the quick fixes. You’re not doing the rapid weight loss and you’re incorporating actually educating the person. This is what you need to add, because we’re often told we need to take out or to use of your strength by being able to pick on that information of this is what you need add, and this is why you are adding it so that they have an increased knowledge, understanding, and respect for what it is they are doing compared to “well, this is what the doctor told me,” or “this is what my dietician told me,” but actually being educated is going to really help them to make these long-term changes.

Shireen: I love that. What are, what are some examples of pieces of education that you see that have been lacking, perhaps that should be either common knowledge or that the doctor should have imparted on the patient, uh, that you’ve probably seen continuous gaps in, in your nutrition therapy when you provide it?

Amber: Definitely the fact that doctors have been telling patients a lot, that they need to avoid carbohydrates if they have that. And I think that’s a big one. And it was a major pop because it’s sending the wrong message that you cannot eat starchy foods. So you cannot have carbohydrates. Otherwise, you’re not going to be able to maintain your blood sugars.

And I think the, the piece that’s missing is being able to see this is how you can have it. Or these are the times that you need to focus on. Focus on complex carbohydrates, more than refined carbohydrates. Pair your carbohydrate foods with vegetables and protein and healthy fats instead of avoiding it completely. It’s almost like a band-aid solution of just avoiding carbohydrates. And we know that carbohydrates are not the same thing as just starchy foods. We get carbohydrates from your peas and beans. You get them from all starchy foods. When you think of bread, any flour products or pasta. We get them from your dairy products as well and fruits and a small amount from vegetables.

So if you really have to avoid carbohydrates, you’re practically cutting out most healthy food groups. So I think that is one of the major ones that I’ve seen. I’ve also heard a lot of gluten-free and dairy-free for PCOS management as a fairly standard and generic treatment. And really, and truly, there is no scientific evidence right now that suggests gluten-free and dairy-free as a standard PCOS diet.

There isn’t a standard PCOS diet, but what you found is that if someone has a lactose intolerance, trending to a dairy-free concept, what’s unimproved symptoms related to that, what it found does that also gluten-free. Because someone may adopt a gluten-free lifestyle, they naturally tend to eat less processed foods and more whole foods.

So you do see some improvement there. So I think that there are a lot of generic things out there that are really misinformed and continue to confuse clients about what it can and cannot do. And I really wish that sometimes we continue to use the pool, the massive pool of dieticians that we house, so that dieticians have continued to closely bide and monitor patients with respect to nutritional changes instead of continuing to instill food phase around managing chronic conditions.

Shireen: Coming back to cultural competence and, uh, you know, sort of talking and touching on that a little bit more, what are the dangers of nutritional therapy without cultural competence?

Amber: Yes. So I think the biggest danger is lack of compliance. Poor communication is going to be the second to that and assume lack of compliance, not because of the patient just not want to do what the digestion is saying, or what the doctor has recommended, but simply because it’s not feasible, it’s not practical. It’s not relatable. It’s not part of their current lifestyle or their food practices. So it’s very difficult to make changes on this sometimes they get confused about why isn’t my food healthy and how can I, or maybe in some, some traditions.

Maybe a mother-in-law’s preparing your foods for you or your relative is preparing your food for you. And how do you even with immigration, so you don’t make this anymore. We can’t eat this. It’s almost like really disregarding someone’s entire heritage to mix it in culinary changes. So compliance is going to be a major issue.

If they’re unable to, some people are able to stick to our visions of that. So then they become frustrated over time. So I would say compliance is a major thing. And then for communication, because if I believe that you are disregarding my culture, you’re not able to teach me how to eat within my food traditions.

Then I don’t think you really respect me or that you’re really seeing me as an individual. Maybe you’re just seeing that I have someone to sort of be tested and to end all just completely disregarding that side of things and giving an inferiority complex to another style of eating, which is usually through a Eurocentric lens.

Shireen: What tips and advice do you have for individuals wanting to include cultural foods into their meals, um, and still eat, eat well and eat, right? What do you would tend to have for them?

Amber: Yes. So I do always encourage patients to align yourself with a medical team of dieticians that share your values, because they’re going to undersign your food. They are going to be able to really zoom in and give you some personalized advice. Beyond that, everything, as an old time seeing is everything in moderation. We do want most of your foods to be nutrient-dense foods. We do want to focus on those unsaturated healthy fats that may come from that sense seeds and avocados.

And we do want to have complex carbohydrates when possible. But if you think about always having a variety of food groups on your plate, so if you do have some new carbohydrates foods and you can’t have more than one carbohydrate food at a meal, of course you want to be able to eat moderate amounts of each, you want to pair it with protein feeds.

So, and in meat, if you eat meat, if you don’t eat meat and you’re having peas and beans, or even if you having some vegetables, but vegetables doesn’t always have to be raw salads, it can be coleslaw or it can be cooked vegetables, depending on how you do that. And then you want to also combine that with eating mindfully.

So you pay attention to your eating habits. Are you eating and drinking sugary stuff at the same time? Are you constantly eating past fullness? Are you acknowledging when you are hungry and eating food, instead of like drinking water or something along those lines? You’d want to connect with a dietician who shares your values, your food, traditions, and practices, and someone who exemplifies cultural competence and nutrition, simply because they can acknowledge this and really combine that, along with nutritional balance and approaches to help you to manage your lifestyle and chronic conditions.

Shireen: I love that. And so what, what you’re really saying at the heart of this, Amber, is if you want to eat healthy, you do not have to let go of the foods that you’ve known that you’re familiar with. It isn’t all, or none.

Amber: Yes

Shireen: There is essentially this middle ground to where you can adapt the foods that you’ve culturally known in a healthier way that you can sustain and aim towards better health with.

Amber: Yes, that’s exactly what I’m saying.

Shireen: Perfect. Perfect. I love that, that, you know, that that is something that we harp on and on at a Yumlish ourselves. So it’s, it’s, it’s so nice to sort of hear that cultural competence is finally getting its, um, you know, it is getting its recognition because they feel it is so undervalued as a, as a tool for providing, um, you know, better, better health and you know, better health outcomes at the end of the day.

Amber: Definitely. It needs to be continued to push it to the forefront of nutrition and medical interventions for the best outcomes, I would say.

Shireen: So with that, Amber, we’re toward the end of the episode here today, but I would love for our listeners to learn more about how they can connect with you after this episode.

And just learn more about your work.

Amber: Thank you. You can connect with me by Instagram or Facebook @theculturaldietician. That’s T H E C U L T U R E A L D I E T I T I E N, the culturaldietcian. I also have a website and blog at ambercharlesrdn.com. Uh, the tagline for that is also the cultural dietician. If you Google me, you should find my site where you can get a lot of more information that I post on nutrition and culturally competent nutrition as well.

Shireen: Thank you so much again, Amber, for your time here with us today, certainly you got to learn a lot, uh, love to see this cultural competence and incorporated just broadly within nutrition therapy and the approach that you take. Um, thank you again for your time.

Amber: Thank you so much for having me.

Shireen: So to our listeners out there, let us know. What is your favorite way to incorporate cultural foods into your meals? Head over to our social media and find us there. Until the next time. Thank you for listening to the Yumlish podcast. Make sure to follow us on social media @Yumlish_ on Instagram and Twitter and @Yumlish on Facebook and LinkedIn for tips about managing your diabetes or other chronic conditions. You can also visit our website, Yumlish.Com for even more information, and to get involved with all of the exciting opportunities Yumlish has to offer. All of the links are in the show notes below, so please don’t hesitate to check us out. If you liked this week’s show, make sure to subscribe to the Yumlish Podcast. Give us a like comment or a five star review, and share us with a friend.

This is Shireen signing off. Thank you again, and we’ll see you next time. Remember your health always comes first. Stay well!

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