According to a study commissioned by the Academy of Nutrition and Dietetics, 80% of registered dietitian nutritionists (R.D.N.) self-identify as white.
Melissa Abraham says it can be a problem if your dietitian isn't familiar with your background and what that means for your diet and health goals.
"Personally, I was looking for someone that looked like me because I wanted them to understand me, to understand my background," she said.
"Whether it's Cuban food or African food, or any type of different types of food. My parents are Caribbean."
"So those foods are part of me."
"When you have different cultures and your culture mainly eats seasoned rice or some type of let's say, like a soy meatball or something like that, and you have someone who is of a different race and they're telling you to eat, you know, just basically like flat vegetables and you know, raw and things of that nature, it's not gonna work."
Abraham joined a free app last year called Cultured Health to find a dietitian who would be a good fit.
Abraham is based in Atlanta. Her dietitian is in Chicago. They meet virtually every one to two weeks.
"He really, really understood my lifestyle. And he's like, Okay, let's try to make this work."
He also accepts her insurance, so there are no out-of-pocket costs incurred.
Cultured Health launched at the end of 2022.
"So the intention for the app is to connect clients to dietitians who are not just experts in their food and nutrition, but experts in their particular culture," said co-founder of the app and registered dietitian, Sue Ellen Anderson-Haynes.
Anderson-Haynes says there are hundreds of dietitians on the app representing cultures from all continents.
"So, a dietitian will go on and create a profile and answer questions about their expertise, their background, and expertise in certain areas, not just in dietetics, but in their culture. So culture, specific cuisines, language, and religion, if it impacts food choices. And those seeking dietitians answer similar questions on their side. So they both create profiles. And then essentially, it's like a matchmaking engine," said Anderson-Haynes' husband and app co-founder, Michael Haynes.
"Then they can connect through the app, get to know one another, and proceed from there."
The couple shared how the disconnect in cultural backgrounds impacted one of their family members who is Jamaican. He had prediabetes and sought help from a dietitian, who told him to better manage his carb intake (i.e. potatoes, pasta, and rice).
"He's like, 'No problem!' Right. But I'll put those things to the side. But I'm still having yam and green banana and dasheen and plantain and all these other things that, you know, Jamaicans and West Indians eat that are all in the same category that he should have been made aware of," said Michael Haynes.
"I'm sure she had all the great intentions, but unfortunately, maybe didn't get enough information from his background, and culture, and didn't understand. And so there's a gap, there's a miss there, right?" said Sue Ellen Anderson-Haynes.
"Diverse communities, particularly minority communities are disproportionately impacted by lifestyle diseases," she added.
"I've been a registered dietitian for a little over 15 years, and I work in a variety of settings. I've worked in hospital settings, clinical wellness centers, and now my private practice. So I've had the opportunity to work with patients with cultures from all over the world. And while a registered dietitian is a food and nutrition expert, we are not experts in all cultures. So formal training in school, we explore cultural diversity and continuing education that helps the dietitian become culturally competent, but however, this is not enough."
According to an article published in 2021 by the Harvard Medical School Center for Primary Care, the number of Black Americans admitted into dietetic internship programs dropped by 58% in the last decade.
The Academy of Nutrition and Dietetics is doing its part to address the lack of diversity in this field. It developed the "Inclusion, Diversity, Equity and Access (IDEA)" action plan. One of those goals is to "increase recruitment, retention, and completion of nutrition and dietetics education and leadership at all levels for underrepresented groups."
According to the plan, the "goals and strategies were carefully developed from member and professional feedback gathered from listening sessions, stakeholder communications, and representatives of Academy organizational units and groups, as well as from benchmarking with other healthcare organizations. Tactics and metrics have been developed for each strategy, and outcomes from the initiatives will be measured and the plan modified accordingly over time to ensure continuous positive change."
"When you're able to speak the same language as a person. It makes a huge difference on whether or not they're gonna take your advice because you sat in their shoes, and you know what their culture is like," said Abraham.