the Experts: Creative Solutions for Local Providers
by Local Providers
Diversity as Part of
Nutrition Education and Counseling
cultural competence important in nutrition education and counseling?
significant challenges dietitians and nutritionists face today and in
the immediate future are: the increasingly diverse population of this
country and increased emphasis on patient/client behavioral changes as
evidence of effectiveness. Sensitivity to cultural differences in ourselves
and in those of different ethnic backgrounds is an important aspect of
competence in reaching a diverse population. Nutrition counselors are
now and will be evaluated on their ability to produce desirable behavioral
changes in patients/clients (1).
nutrition counseling, where many therapeutic interventions are on a personal
level, sensitivity to the strong influence of culture on an individual's
food intake, attitudes, and behaviors is especially imperative."
Nutrition counselors should not view multicultural competence as a luxury
or as a specialty but as a requirement (1).
are important for multicultural nutrition counseling?
nutrition counseling occurs when a nutrition professional and client are
from different cultures. Ethnicity, religion, group affiliation, socioeconomic
status, and world-view may all influence clients' needs (1). Gaining insight
into what competencies are important for multicultural nutrition counseling
can help ensure cultural proficiency in counseling.
and Haughton developed and tested a model for multicultural nutrition
counseling competencies for registered dietitians (2). From their model,
28 competencies emerged in 3 groups as listed below:
nutrition counseling skills
ability to differentiate between individual and universal similarities.
- Be experienced
in application of medical nutrition therapy and nutrition-related
health promotion/disease prevention strategies that are culturally
ability to use cultural knowledge and sensitivity for appropriate
nutrition intervention and materials.
responsibility of collectively working with community leaders or members
about unique knowledge or abilities for benefit of the culturally
- Be able
to evaluate new techniques, research, and knowledge as to validity
and applicability in working with culturally different populations.
- Be aware
of how own cultural background and experiences and attitudes, values,
and biases influence nutrition counseling.
- Be able
to recognize limits of own cultural competencies and abilities.
moved from being culturally aware to being aware and sensitive to
own cultural heritage and to valuing and respecting differences.
food and nutrition counseling knowledge
food selection, preparation, and storage with a cultural context.
knowledge of cultural eating patterns and family traditions such as
core foods, traditional celebrations, and fasting.
self with relevant research and latest findings regarding food practices
and nutrition-related health problems of various ethnic and racial
should also be paid to nutrition education materials. "Ideally, written
materials in other languages should reflect the dialectic and cultural
nuances of the target population (3)." Nutrition education resources
that reflect an awareness of these details and the educational and literacy
level of the target audience require a more sensitive approach than mere
text translation. The best process involves developing materials from
scratch in the target language based on discussions with focus groups
representing the target population. The material should reflect an appreciation
of the cultural norms of that population. When materials are to be used
to motivate behavior change, this process is especially important (3).
Where can I find information and resources regarding cultural diversity?
Administration on Aging
American Dietetic Association
and Regional Food Practices: A Series
- Increase your clients'
adherence to new diets by including their favorite traditional foods
recipes. The Exchange Lists have been expanded to 11 ethnic and regional
groups. They contain information about important cultural and dietary
customs for helping clients develop meal plans.
State University, Nutrition
Education for New Americans
- Language sets contain black line masters (for ease in reproduction)
of Food Pyramids plus four handouts for healthy adults, mothers and
babies, mature adults, and children, which may be used individually
or as a package. All are bilingual and copyright free. You are encouraged
to make copies and distribute these materials freely.
of Nutrition Materials - Contains all 37 language handouts, plus
Partnering for Cultural Competency: A Resource Guide of Culturally
Relevant Nutrition Education Materials and Counseling Strategies in
Microsoft Word and Adobe PDF format.
State University, Extension Family and Community Development
Policy and Resource Center on Nutrition and Aging
Special Populations section lists current research articles on
Special Populations section lists many nutrition education and counseling
resources in International/Multicultural, African American, Alaska
Natives & American Indian, Asian American & Pacific Islander,
Hispanic American, and Rural Populations
Counseling: A Guide for Nutrition and Health
This guide contains tips on how counseling different cultural
groups and how to approach a diet change; applies to all cross-cultural
Food Guide Pyramid: Handout from California Milk Advisory
Board in consultation with Asian-American dietitians working in
California. Comes in 5 languages: Chinese, Japanese, Korean, Talalog,
and Vietnamese; gives the number and size of servings recommended
for each food groups for optimum daily health.
Hispanic Foods CD-ROM: This CD-ROM includes illustrations
of a wide range of Mexican foods, as well as popular Latin and
Caribbean foods, many of which have regional variations in Cuba,
Puerto Rico, the Dominican Republic, Guatemala, El Salvador, and
other Latin countries. While many of the foods depicted are healthy
ones, the CD-ROM also includes images in a special "low-fat,
healthy" category for use by nutritionists.
Nutrition Services/Aging Advocacy Organizations section links to various
This website is maintained by Four Winds Food Specialists, a partnership
between Pamela Goyan Kittler, MS and Kathryn P. Sucher, ScD, RD. "Cultural
foods and nutrition is our profession... and our passion!" It has
received an Arbor Nutrition Guide Site Award. Resources include Food
Videos, Newsletter, Books, Traditional and Holiday Foods, Links, and
K. Multicultural competence in dietetics and nutrition. J Am Diet
E, Haughton B. Model for multicultural nutrition counseling competencies.
J Am Diet Assoc. 2000;100:1178-1185.
Health Best Practices Overview. Diversity Rx, www.diversityrx.org.
by Amy J. Sindler RD, LD/N, Masters Candidate and Graduate
Research Assistant, and staff of the National Policy and
Resource Center on Nutrition and Aging, Florida International University,
Miami, FL. Contact: firstname.lastname@example.org
project is supported, in part, by a grant from the Administration on Aging,
Department of Health and Human Services (DHHS). Grantees undertaking projects
sponsorship are encouraged to express freely their findings and conclusions.
Points of view or opinions do not, therefore, reflect official DHHS policy.
Posted on: 09/28/01