For the first time in many decades, discussions about diversity are on the table (no pun intended) in nearly every area of American life.

Unfortunately, this topic has often been neglected during diet and nutrition conversations—and we’re not talking about the importance of eating a colorful variety of fruits and vegetables.

Typically, patients receiving nutrition guidance get handed a list of foods to try and foods to avoid, but most of the foods listed are part of a mainstream “American” diet and fail to incorporate cultural differences. This is something health coach and Fight CRC advocate Marsha Baker hopes to see improved in the future—diet recommendations tailored not only to the patients’ food preferences but their cultures as well.

“It’s important to remember that not everyone eats like you,” Baker said. “It’s not a one-size-fits-all situation, ever, but especially when discussing ethnic backgrounds and diversity.”

In America, it can be easy to assume the products lining our mainstream, chain supermarket shelves are what’s stocking everyone’s pantries. But talk to a Native American patient whose culture is preserved by cooking or an Asian family serving up traditional dishes at home and you’ll quickly learn a different story. Diets are as diverse as the people who eat, and remembering that is key when making and receiving food recommendations.

Acknowledgement is Key

Diversifying how, where, and when to offer inclusive nutrition guidance is not an easy task, but Baker offers this simple encouragement to both patients and providers who want to grow: acknowledge.

“A lot of plans presented don’t acknowledge the cultural differences of eating and that ethnic meals are cooked at home and at restaurants,” Baker said. “We need to recognize and acknowledge that different ethnicities may have different cultural foods: African American, Latinx, Asian, Native American—we need to acknowledge that these groups may eat unique meals and use different types of foods that are often not mentioned in recommended meal plans.”

For medical professionals, acknowledgement looks like asking a patient what foods they eat and recognizing that their diets may not consist of what’s found on most American menus. It means asking questions to learn more about what a patient likes to eat, and what modifications are and are not realistic for them to adopt.

For patients, acknowledgement looks like pushing past fear and opening up about what’s eaten and enjoyed, even if the foods are nowhere to be found on existing resources and materials.

“Patients have to advocate for themselves,” said Baker, who added, “and they need to take control and be willing to make choices.”

anjee-davis-bio-pic

One example is Fight CRC’s President Anjee Davis who was diagnosed with breast cancer last year. An avid cook and baker who enjoyed preparing a variety of traditional American dishes and Indonesian foods, cancer made Davis pause and reevaluate her diet. She and her family made a decision to become pescatarian (diet consisting of fish, vegetables, legumes, and sometimes dairy) and get more protein from plant-based sources, which meant approaching her favorite recipes differently.

She explained: “Our go-to dishes were beef curry and chicken fried rice. Making a veggie version sounds like a simple swap but we had to work at finding that balance of health and feeling satisfied (‘Umami’),” she said. “A dietary change forces you to be creative and open-minded.

Over the last year we have added kimchi, kombucha, jackfruit, tempeh, impossible burgers, and guava syrup to our diet, and we have said goodbye to processed sugars and ramen. As a family, we had to be intentional about our food choices and make sure to eat a balance of protein, fat, and sugar. Most importantly—we allow ourselves to cheat every Thanksgiving and Christmas dinner!”

Baker’s passion for food and coaching others toward health—incorporating a variety of cultural foods into recommended plans—is personal as she has also made dramatic changes to her nutrition over the years while finding ways to keep eating with her family and enjoying their favorite foods. She became an advocate with Fight CRC after her dad passed away from colorectal cancer. She credits her advocacy journey with teaching her about the connection between food and diseases like cancer. Now as a health coach, she’s helping people from a variety of backgrounds set realistic and optimistic goals and change their mindsets when it comes to healthy habits.

“I don’t want people to think you have to exclude certain foods to be healthy and that cultural foods will be unhealthy no matter what,” she said. “There’s certain foods I enjoyed before I began this journey, and I’ve tweaked them to make them healthier and cut down my portion sizes.”

For those inspired to take a wellness journey and focus on nutritious foods relevant to their individual taste and cultures, she offers this encouragement:

“It comes down to finding what works for you— take a piece of every plan you’ve ever tried. You can achieve long-term lifestyle change.”

Adaptation has always been key to our survival as humans, as have communication, acceptance, and embracing diversity. As we evaluate the role food plays in the lives of those affected by cancer, we must remember that no two patients eat exactly alike.

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Food. We can't live without it, but for many in the colorectal cancer community, it's hard to live with it. Yet as doctors, nutritionists, and research data all say: Diet and nutrition play an essential role in cancer prevention and treatment. Food is a topic we can't ignore.

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