As a non-Hispanic RDN who works with Latino and Hispanic populations in Philadelphia, I understand the unique challenges dietitians in bilingual communities face. In fact, I'm the chair of the Latino and Hispanics in Dietetics and Nutrition (LAHIDAN) member interest group.
I see how many Latinos and Hispanics face "acculturation," which is when a population, such as immigrants to a new country, lose elements of their original culture while incorporating parts of a new culture. The transition between traditional Latino and Hispanic cultural diets and the modern American diet raise the risks of several chronic diseases in this growing population.
Dietitians and other health care providers who serve members of the Latino and Hispanic population must be aware of the following five trends to better understand their patients and the challenges they face.
Food Deserts Exist
Food deserts — parts of the country where there is limited access to fresh fruits, vegetables and other whole foods, usually due to lack of grocery stores or farmers markets — are real. And, they are more common in lower socioeconomic areas, which sometimes have large Latino-Hispanic populations.
What RDNs Can Do
Recognize this as a barrier and suggest realistic changes. For instance, many food deserts do have quick-service and fast-food establishments. Familiarize yourself with the choices available in these stores and find healthy options there to recommend to your clients. But don't stop there. Does your state or local government have programs that allow SNAP benefits to be used to purchase fresh foods from farmers markets? Find out which locations are close to your clients' homes or places of work and map the easiest way they can get there by walking or public transportation.
Our Current Food System Feeds Chronic Disease
Processed and packaged foods take up the largest space in grocery stores. These foods often are laden with sodium and added sugars and provide little fiber and protein. Not only are these foods taking up the most space, they also are the ones that are inexpensive and often on sale. In a traditional Hispanic diet, these foods are not common and would be considered "treats." When once-in-a-while foods are so commonly available they become everyday foods, nutrition-related diseases such as obesity, Type 2 diabetes, hypertension and kidney disease can follow.
What RDNs Can Do
Teach your Spanish-speaking clients how to read food labels and navigate an American food market. In addition, use models that demonstrate the amount of fat or sugar found in common processed foods. This helps visualize consumption and has great impact among this population.
Food- and Nutrition-Related Knowledge Deficits
Barriers of language, literacy and lack of nutrition education impede understanding of how to choose the right foods. Many older Spanish-speaking people find they can live comfortably in the U.S. without learning English. Plus, literacy rates among Latino and Hispanic children are much lower compared to their English-speaking counterparts.
What RDNs Can Do
Learn some Spanish and teach some English! If we are going to help Spanish-speaking people, we need to reach them where they are. Learning some conversational Spanish builds rapport, respect and trust, which are all foundations to change. And, by teaching a few key nutrition phrases (such as "low fat," "low sodium" and "light") in English, we empower making better choices. When using handouts, utilize resources that have already been developed in Spanish or are bilingual. Translating materials yourself can result in grammar mistakes and may confuse the intended message. You might even mistakenly say or write something offensive without meaning to.
Working Families Have Little Time to Cook
In many traditional Hispanic and Latino cultures, mothers are in charge of all the shopping and cooking involved in feeding their families. But, in the U.S., many women in these communities work outside the home. Then, when they come home, they don't have time to stop by the market to get fresh groceries and prepare a nutritious meal for their families. Many of those whom I work with often routinely rely on takeout or fast food, which can result in large intakes of fat, sodium, added sugar and calories.
What RDNs Can Do
Knowing how to teach quick and healthy recipes is essential. Invite clients to purchase frozen vegetables or fresh vegetables that can be frozen. Teach how to steam in the microwave, how to grill, and other cooking methods that are quick and healthy. Provide tips that promote cooking a few times during the week and storing leftovers. Discuss the economic and nutritional benefits of cooking at home.
Latino and Hispanic People Are More Likely to Have Specific Chronic Diseases
According to the CDC, obesity rates are disproportionally greater in this population than others. In addition, the top 10 leading causes of death among Hispanics include heart disease, diabetes and kidney-related diseases. The CDC Health Disparities and Inequalities Report also shows that obesity, diabetes and hypertension are all increased concerns for the Latino and Hispanic population.
What RDNs Can Do
Join health fairs and other events that offer "teaching moments." Many of these events require participants to volunteer. And, consider becoming a preceptor for dietetic interns or offering supervision for nutrition student volunteers looking to work with these populations.
Only together can we truly make a difference in Latino and Hispanic communities.
