Setting a New Table
Best Health|October/November 2021
Nutrition experts like Rosie Mensah are leading the way for a more diverse, inclusive and culturally specific approach to healthy eating.
Abigail Cukier

OSIE MENSAH LOVED the richness and diversity of growing up in Toronto. She remembers days of playing at the park, meeting friends at the community center, chatting with seniors she passed during walks, and getting takeout from local Jamaican and Vietnamese restaurants. But throughout the vibrant community in her Jane and Finch neighborhood, there were many food banks, several fast-food spots and neighbors in their 30s and 40s suffering from chronic illnesses, like diabetes and heart disease.

The produce at the local grocery stores was “quite poor,” recalls Mensah, and her family’s budget was tight. “I remember going to school and all the kids would only have $2 for lunch. I remember going to the mall and getting fast food because that was all we could afford,” she says, adding that healthier options were just not available.

Mensah uses the term “food apartheid” to describe where she grew up, which reframes the concept of a “food desert”—a community where residents have limited access to affordable, healthy food options. Instead of grocery stores or farmers’ markets, these areas often have convenience stores, fast-food restaurants, and gas stations. Referring to these neighborhoods as food apartheids is intended to highlight the racist policies that systemically limit access to healthy food in racialized communities. Is healthy produce sold at an accessible price? Are the fruits and vegetables available appropriate for the cultural cuisines being prepared at home? Are locals able to grow their own food? In food apartheids, the answer to these questions is typically no.

Looking back, Mensah realizes her childhood experiences led to a flawed sense of what constitutes a “healthy” diet. The nutritional advice she learned in school and from healthcare professionals wasn’t geared toward families or communities like hers—a glaring health gap that only recently started being addressed.

In Canada, diversity in dietetics is severely lacking. While there is a shortage of comprehensive data, Canada’s more than 10,000 registered dietitians are predominantly middle- and upper-class white women. In a 2020 survey, 96 percent of recent dietetic program graduates from across Canada identified as female, and 79 percent identified as white, while only 12 percent identified as Chinese, three percent as South Asian, and 1.7 percent as Métis. Dietitians of Canada only recently began collecting data regarding the diversity of its members but confirmed that, at present, dietitians are not as diverse as the population they serve—a population in which one out of every five people identifies as a visible minority.

Mensah is a Ghanaian Canadian. Growing up, she never encountered dietitians, doctors or nurses in her community who were people of color. So she decided to become a healthcare provider herself. “I felt like we always needed to see white people to fix us or make us better because that’s all I saw. I wanted to become a health practitioner and serve people in my community,” she says.

Research shows that patients have better health outcomes when they interact with diverse health professionals and culturally specific approaches, such as receiving care in their preferred language or a diet plan tailored to their cultural cuisine. Adapting dietary advice for diverse populations has been shown to help patients make healthier choices, reduce the risk of cardiovascular disease and help diabetes patients better manage their disease.

“As a dietitian, you have the opportunity to change lives through food and to increase health equity,” says Mensah, who is now a registered dietitian in Toronto. She has heard clients from the Caribbean, South Asia and parts of Africa describe traditional foods with shame because their cultural cuisine is not included in depictions of a nutritious diet. For example, white rice, a staple food in many cultures, is often branded as an unhealthy choice.

If someone doesn’t follow nutrition recommendations, dietitians frequently label them as non-compliant, says Mensah, but that thinking glosses over important questions: Are the dietary recommendations aligned with their religious traditions? Do they live close to a grocery store?

“Food insecurity is a huge issue in Canada, among Black and Indigenous communities in particular, and we often see those groups portrayed as having the worst health outcomes,” says Mensah. “But we’re not doing the work to actually support them.”

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