Racism in Dietetics and Nutrition

Hi all,
I know I haven’t written or posted anything for a while and there are many reasons at play for that but with the recent current events, inaction and silence are no longer an option.  The events surrounding George Floyd and systemic racism against BIPOC communities has caused many to pause and reflect about the systems and institutions that we participate in, including myself which sparked this post.  Some may think that my position is rather dramatic, I would argue those people who think so are proving my point; that Nutrition and Dietetics is systemically racist. 
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To be clear, I am not saying ALL Dietitians or Nutritionists are racist (although there are MANY that are knowingly or unknowingly engaging in overt or covert racist behaviours) I am saying that the way Dietetics is practiced is fundamentally & systemically racist which is the fault of the organization and in part the overall healthcare system.  Please understand the difference between overt racism and covert racism (Please see attached educational graphic developed by Safehouse Progressive Alliance for Nonviolence (2005) and adapted by Ellen Tuzzolo (2016))

The reality of racism in Healthcare is very real.  The Center for Disease Control examined pregnancy-related deaths in the United States from 2011 to 2015 and even more detailed data from 2013-2017 to show that black women at 3.3 times more likely than white women to suffer a pregnancy -related death.  Native American and Alaskan First Nations women were 2.5 times more likely to die than white women.  In 2005 the Institute of Medicine (Not-for-profit, non-governmental organization now known as National Academy of Medicine (NAM)) found that “Racial and ethnic minorities received lower-quality health care than white people – even when insurance status, income, age and severity of conditions are comparable.” The NAM Report goes on to quote a study of over 400 hospitals in America that showed black patients with heart disease receiving older, cheaper and more conservative treatments than their white counterparts.  They go on to state that Black patients are more likely to receive less desirable treatments. 

“Oh that’s America, Canada is MUCH Better” I can assure it’s not.

If you Google image search “nutrition” you will primarily find pictures of White Women eating salads. If you Google search “graduating class” images in nutrition programs across the country, you will find minimal diversity and any diversity that exists exhibits white-passing privilege.  If you Google search the current iteration of the food guide you will only find Euro-Centric and North American-Centric foods.  If you go on a Government funded website you can find behaviours and actions that fundamentally erase or minimize ethnicity or downright uses OFFENSIVE RACIAL SLURS!!!  (Yes, these are REAL screen grabs I took from this unnamed Government Funded website as of June 1, 2020 at 9:59am). 

Apparently it's okay to use Racist Slurs on Government Funded Website now

But wait! There’s more!
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There are two ways to become a Dietitian in Canada - An expensive Master’s/ Diploma Practicum program or a 9-month unpaid Postgraduate Practicum Program (Formerly known as the Dietetic Internship) followed by a standardized written exam.  That’s right folks! After 4 years of University and student debt our options are to go further into debt OR to try to survive for 9-10 months without an income OR realize that the degree that you now have doesn’t qualify you for anything.  Did I also mention that many of those Dietetic programs are in Toronto? Where we have INSANELY high cost of living rates?  Did I also mention that HUNDREDS of Dietitians were also told that if they were working a part-time job during their “Prestigious” unpaid internship that they weren’t taking it seriously and forced to quit?  Did I also mention that the Dietitians that are supposed to be teaching these “Prestigious Unpaid Internships” aren’t properly trained to be teachers at all? Why is that last one important? Well remember those racist Dietitians? They pass on racist thinking and ideals, whether it be overt or covert racism.  

*Let's play find the diversity, and not that "Practice Setting Diversity" bullshit in this LinkedIn profile picture

Want to see the height of systemic racism in Dietetics? Look at the cultural erasure in the practices of not only the screen grabs but look at Canada’s Food Guide.  NOT ALL CULTURES AND ETHNICITIES EAT USING A PLATE MODEL! By getting rid of portion sizes we lose a universal language to communicate; numbers and math.  Which is extremely important when counselling with a language barrier! If you want to justify the removal of portion sizes based on current research, then how do you possibly justify the reduction in numbers and frequency of foods and ingredients from other cultures visually represented on the plate model.  Oh, you like the food guide because it promotes mindful eating? Well have you considered what a LUXURY and PRIVILEGE it is that your food security is so good that you don’t have to worry about where your next meal is coming from? rather you worry about HOW you’re eating the foods and whether or not you’re enjoying them?  Have you also considered how privileged you are to be able to AFFORD to follow the advice on the Canadian Food Guide, which even when you follow does not meet all daily nutritional requirements? The problem here is that the individuals that designed this dumpster fire of a Government funded resource completely FAILED to think about anything other that a Euro and North American-Centric view of eating and food.  (To date, I still cannot find a list of the people that were responsible for their “expert” input into this back up single ply toilet paper document to see what the diversity was behind that panel because it’s my guess that, AGAIN, no one bothered to care about it).

Current Canadian Food Guide (2019)

Previous Food Canadian Food Guide (2007)

This is the example that takes the cake and it is my personal story that I have avoided making public until now.  Years ago, I accepted an extraordinary position, a position where I would be able to help diversify this profession and begin to undo the vast amount of damage done by a poorly run organization.  Unfortunately, like other POC, my position was an example of Tokenism.  Now to be clear, I KNEW that this is what they were doing, however (at the time) I felt it to be my responsibility to represent ACTUAL diversity in the profession and ADVOCATE and discuss those issues that were being ignored every single year.  As soon as that announcement went live and it was revealed that I would be representing Ontario, the biggest and most populated region in Canada, the complaints came.  Countless colleagues from across Ontario complaining that I do not represent “them” and that they were outraged.  To those that complained, I want you to read this very carefully; I DON’T CARE THAT I DIDN’T REPRESENT YOU!

I endured the stones thrown at me, because as a POC this is what we deal with OUR ENTIRE LIVES! But I finally snapped when over 2 years of my advocacy, volunteered time and efforts were COMPLETELY ignored when they chose to celebrate Nutrition Month with a COMPLETE LACK OF DIVERSITY promoting only images of White Women or women of White-Passing privilege for nutrition month.  The reason I was given was to celebrate the Award winners from last year and to give recognition.  Forgive me if I’m wrong, but they were already celebrated LAST YEAR, weren’t they? Their achievements were publicly well known, so why do it again?  Why not focus on other members and their achievements? The other explanation I was given tried claim that they were promoting diversity in PRACTICE SETTING – this is not only bullshit, it’s insulting.  Furthermore, when that project was announced 3 years ago, one of the markers of success would be 80% satisfaction amongst that organization’s members, that now means something VERY different to me.  Because that now means to me that 80% of your members satisfied with the systemic racism in your organization.
 
You think this is personal? I assure you it’s not.  There are MANY examples of Dietitians from marginalized communities and those that represent true diversity that have put in so much work to create free resources, webinars and materials only to have them be completely ignored.  Examples of male Dietitians putting together resources and action plans on how to attract more men to this profession to be able to better address Men’s health issues and to provide more options for counselling, only to be ignored.  Examples of BIPOC Dietitians having their resources appropriated by White counterparts without acknowledgement of their work.  White Dietitians using cultural events like Ramadan or Lunar New Year for their social media without acknowledging the culture and history just because that particular hashtag is trending.  Those Dietitians have shared their stories with me but haven’t spoken out for fear of losing their jobs or being ostracized or wanting to change the system from within.   I simply don’t care what anyone thinks of me anymore.  

“OH Ben! That was a few years ago, it’s much better now!”

Yeah, the promotional materials are now OUTRIGHT lying about the diversity that doesn’t exist in this profession.  Look at the image below and look at the LinkedIn image above and compare it to the images used on the Government funded website.  You could try to justify the idea of “Many people won’t know what these foods are”  OK fair, but then explain to me why Shakshouska, an Arabic dish, or Khao Tom, a Thai Rice Soup, maintains it’s cultural and ethnic identity when OVERTLY racist terminology like “Oriental” is used to describe recipes posted directly in-front of a culturally insensitive “Proudly Canadian Beet and Barley Salad” (It’s not like Beets or Barley are an ingredient native to Canada like the Fiddlehead, and “Proudly Canadian” carries many problematic First Nations implications, which is shocking to see considering the vast number of Canadian Dietitians that work in First Nations populations)  

Continuing to use Racist Slurs and highly problematic use of "Proudly Canadian" when the recipe literally has no ingredients unique to Canada

Why does Khao Tom and Shakshouska get to maintain their ethnic and cultural identity?

The reality is that Dietetics has avoided this much needed PUBLIC criticism for far too long.  Dietetics has been complicit in supporting Systemic Racism and cultural erasure.  Dietetics has become more elitist and privileged than EVER BEFORE.  My concerns when I first entered the profession around 10 years ago have all become reality.  We now see vulnerable populations getting worse health outcomes because communities don’t trust Eurocentric and Culturally irrelevant and insensitive information coming from predominantly White Dietitians.  We see worsening men’s health outcomes because we don’t have enough male Dietitians available.  We now see more and more requests for referrals due to cultural and language barriers.  We see higher and higher private practice costs to meet an individual’s sense of worth more than their need to be effective for their clients and communities.  I don’t care if you’re uncomfortable with the things I’m saying because they need to be said, and you should be uncomfortable.  I don’t care if you disagree with my methods, you want them to be peaceful so it can be ignored. 

Ever since the change in leadership of this organization following a GIANT pay scandal of the previous management and direction, there have been some improvements.  But as every other POC in the world knows, unless more consistent change is coming and planned, unless more people come out and speak about this without fear and without apology, unless you plan to change the systemically racist structure in Nutrition and Dietetics, we POC know that this “Change” is short lived and just a Public Relations move.  Prove us wrong because this systemic racism affects the health of all of Canada.  Black Indigenous People of Colour are being murdered in the streets by Police Officers but healthcare and Dietetics has been neglecting and devaluing their health and lives all along.

No more excuses 

DO BETTER, NOW

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Ben Sit, RD, Sports Dietitian
President of Evolved Sport and Nutrition 
Complete Lifestyle Optimization

Rest in Power

• Amaud Arbery
• Bothem Sean
• Atatiana Jefferson
• Jonathan Ferrel
• Renisaha McBride
• Stephon Clark
• Jordan Edwards
• Jordan Davis
• Alton Sterling
• Aiyana Jones
• Breona Taylor
• Mike Brown
• Tamir Rice
• The Charleston 9
• Trayvon Martin
• Sean Bell
• Oscar Grant
• Sandra Bland
• Philando Castile
• Corey Jones
• John Crawford
• Terrence Crutcher
• Keith Scott
• Terrence Crutcher
• Keith Scott
• Clifford Glover
• Claude Reese
• Randy Evans
• Yvonne Smallwood
• Amadou Diallo
• Walter Scott
• Eric Garner
• Freddie Grey
• Sammy Yatim
• Regis Korchinski-Paquet
• George Floyd
• AND ALL THE OTHER BIPOC THAT WERE MURDERED AND NOT FILMED FOR YOU TO SEE
• AND ALL THE POC THAT HAVE DIED DUE TO A HEALTHCARE SYSTEM THAT FUNDAMENTALLY FAILS THEM

P.S. Just for fun, here’s a list of just SOME of the prejudice, racism, sexism, elitism and discrimination I have experienced from my own colleagues.  (Read this list and understand it.  You do not get to tell a POC what is racist or how to feel)

• At a National Conference immediately after my face was seen by EVERYONE in a presentation – A Dietitian comes up to me and demands that I refill and restock the coffee station WHILE I WAS WEARING A CONFERENCE NAME BADGE AND NOT IN HOTEL WORKER UNIFORMS.  When I told her that I was a Dietitian she snarkly replied “Oh, well you don’t look like a Dietitian”
  
  Tell me, what are Dietitians SUPPOSED to look like then?
• In my 10-year career, I have met 3 Black Dietitians and 10 male Dietitians.  HOW IS THIS REMOTELY EXCUSABLE? Are you actually willing to tell me that no Men or No Black people are interested in nutrition? Or are you just failing to recognize that your system filters them out? This is important, we need more BIPOC Men in this field not only to help increase Diversity in this field but so they can better connect and promote health to Men that prefer to counsel with other Men! 
• A group of Dietitians OPENLY breaching confidentiality and openly mocking and discriminating against a sex worker looking for nutrition advice
• Being expected to help and consult with other Dietitians for free when White counterparts get paid
• White Dietitians using All Lives Matter hashtag in their tone-deaf “Positive Vibes Only” Social Media posts
• Dietitians CULTURALLY APPROPRIATING and WHITE WASHING other cultures for your followers or community!
  
  I don’t care if you’re followers or community don’t know what a certain ethnic or cultural dish is, it’s your opportunity to educate them not to white wash everything for your financial benefit
  
  You might think you’re being a really cool or unique “Foodie” by using “exotic” or “cultural” ingredients in your food, but not respecting where they came from is to say “I only like this part of your culture”
• An entire room of Dietetic Students openly mocking and judging a case study in class of an Exotic Dancer needing a feeding tube to meet her nutritional requirements via PEG tube
• Supporting the current Food Guide and seeing nothing wrong with the lack of Cultural diversity or the lack of translations for the Food Guide.  The previous Food Guide had portion sizes that spoke a universal language of math and science and was translated into 17 languages.  It wasn’t perfect but it made a far better effort than this embarrassment of a document. 
• Prejudice and Bias on what others are wearing or their appearance to meetings or work.  This is oppressive and culturally insensitive.  Especially when talking about another culture’s HAIR!
• Prejudice and Bias based on visible tattoos
  
  Your idea of “professional” is oppressive and sets up barriers between clinicians and clients/ patients. I have been told on MULTIPLE occasions that my clients sought me out BECAUSE of my tattoos.  When asked why, they all answered “Because we knew you would not be judgemental”
• Passive Aggressive communication – This is culturally insensitive and manipulative.  In order to get ACTUAL diversity (Not this practice setting diversity bullshit) WE NEED TO BE ABLE TO EFFECTIVELY COMMUNICATE TO OTHERS AND REMOVE LANGUAGE BARRIERS AS MUCH AS POSSIBLE.  If you think you’re being clear then use the actual words instead of tiptoeing around something for fear that you won’t be seen as “nice”
  
  It says a lot about someone when they value “Niceness” more than Social Justice Issues and Racial Equality
• Complete redesign of undergraduate programs to be more based on Quantitative research vs Qualitative research to help attract different populations more comfortable with definitive answers. 
  
  This point is very complex but there is a reason why immigrant students focus primarily more in studies surrounding Math and Science, because there is a fundamentally correct answer as opposed to an answer that is “open to interpretation.” This is because a teacher or institution CANNOT argue with Quantitative truth and therefore cannot take what a POC has earned away.  Qualitative answers are open to interpretation and therefore bias of the instructor. 
• STOP TRYING TO BE THE WHITE SAVIOUR!
  
  Your guilt and feelings may be compelling you to organize a group or a movement or whatever to help these marginalized communities but know that what this is ultimately doing is SILENCING the oppressed.  We do not need you to speak for us.  Believing that WE need YOU to amplify our voice and message is complete and utter bullshit, we need you to LISTEN when we speak and stand BEHIND US or SHOULDER TO SHOULDER if you support us. 
• Being told that my Sliding Fee scale is undervaluing the work of other Dietitians.  It’s not for you, it’s to help improve health measures in vulnerable populations and I end up volunteering my time with my clients more than anything else. 
• Having to hear “Oh you probably got the internship because you’re Asian and you’re a man” As if there was some sort of quota to meet on POC enrollment. 
• Being well advised before I started my UNPAID Internship, to keep my part time job a secret as hundreds of Interns were forced to quit their part-time job in order to prove that they are taking the program “seriously.” If I didn’t do this I wouldn’t have been able to eat or pay rent during the internship!
• ABOLISH THE DAMNED POSTGRADUATE PRACTICUM PROGRAM/ INTERNSHIP PROGRAM! This internship program reeks of entitlement! Think about the people that can afford to go a full year without pay, that’s a whole lot of privilege, how effective do you think that particular person will be in counselling the most vulnerable populations when they don’t even know what it’s like to be involuntarily hungry.   Furthermore, we are the ONLY Healthcare profession in Canada that requires additional training to write our standardized exam for our license to practice.  Change the curriculum to include Practicum Placements in 4th year and allow Students to write the exam out of graduation and TRAIN YOUR PRECEPTORS PROPERLY.
  
  This also increases public safety! Students that don’t get a Master’s program or Dietetic Practicum Program will go on to be Nutritionists and practice.  Dietitians CANNOT mock and attempt to regulate the Nutritionist title when Dietitians are partly response for unsafe training of Nutritionists!  If our Regulating Colleges were actually about protecting the public instead of policing Dietitians, then it would push for this reform. 
• LET THE ORGANIZATION DIE! The system is not broken, it was designed to only support one demographic and it’s working.  There is no fixing an organization that is run entirely by one demographic.  Furthermore, stop deceiving its members.  EVERY organization has the CEO accountable to the board of directors, not the other way around.  This is a dictatorship disguised as a democracy.  What good is electing a board member when the board member doesn’t even have the ability to vote on a topic that affects their region?
  
  It can’t be fixed.  Let it burn and from the ashes, we learn from the mistakes of the past and move forward. 

I could go on and on with this list but I hope I’ve made my point.  The only reason I’m still a Dietitian is because my BIPOC clients need the Dietitian title for their health insurance claims, which more and more people are losing their healthcare coverage now.  Whether or not I will still be a Dietitian by November 1, 2020 is still being decided.  

P.P.S. Re-read my words before commenting.  The nutrition world has recently had MULTIPLE cases demonstrating incapability to understand the written word.  I also fully understand that this does not position Dietitians and Nutritionists in a good light – This is my full intent.  It is unethical to continue to support a system that blatantly oppresses people based on their ethnicity and to discriminate them based on their economic status.  So, if you read my words and feel the need to organize a petition for me to take this post down, then all you’ve done is give me a list of Racist Dietitians.  We have a problem and there are FAR TOO MANY Dietitians that are silent and complicit in this racism.