Establishing a cultural foodways foundation in nutrition care

We live in a culturally diverse society where nutrition care is an increasingly valuable part of healthcare. Registered dietitian nutritionists (RDNs) often find themselves providing nutrition counseling to someone who has a different culture and foodway than they do. If you’re ready to bridge the cultural gap and provide more tailored care to your patients and clients, we have practical tips ready for you. 

Where to start  

Understanding a person’s nutritional foundation through the lens of their culture is essential to providing comprehensive and effective nutrition care. This is one step beyond finding out what a person usually eats, although starting with a 24-hour-recall is a great way to gather initial information.

Before effective medical nutrition therapy can be provided, learn about a client’s nutritional cultural foundation. The term “foodways” refers to how people in every culture select, procure, prepare, distribute, consume, store, and dispose of their food.  

Selection: How is food chosen? What type of food is available? Is it easy to find the food the client needs?  

Procurement: How is food brought to the home? What types of markets are available and who does the grocery shopping? Does the client use food assistance programs, food banks, or community kitchens? Are there gaps in the diet due to lack of availability? 

Preparation: How is food prepared? Who cooks at home? Are cooking skills well-developed or lacking? 

Distribution: How is the meal served? In the client’s family, do some people eat first? Do all members of the family eat at the same time or different times? Do all members eat the same foods?  

Consumption: How and where is a meal consumed? Does the client eat at home at a table or in front of the TV or elsewhere? How frequently do they dine out and where?  

Storage: How and where is food kept? Does the client meal prep and eat leftovers? Is there refrigerator and freezer space to plan ahead or store leftovers?  

Disposal: How is food disposed of? Does the client keep leftovers and eat them the next day or toss them out?  

Apply these tips in your next nutrition consultation 

When culturally unique foodways are likely to impact your nutrition assessment or plan of care, remember these tips. 

• Different doesn’t mean bad or wrong. A diet different than yours doesn’t equate to inadequate or poor food choices. When evaluating diet quality, keep in mind that what may be unfamiliar to you is commonplace to your client and vice versa.  
• Ask clarifying questions. Did your client mention a traditional dish or recipe that you’re unfamiliar with? There’s no harm in asking what ingredients or cooking techniques are included for that recipe so you can better understand. 
• Keep an open mind. Let’s say you are working with a Muslim client with diabetes who is fasting for Ramadan. Get creative with your solutions rather than shutting down choices that don’t fit into your typical nutrition plan of care. 
• Allow your client to choose realistic nutrition-related changes. Working within the confines of what your client is willing and able to do is a skill that all dietitians must perfect. This is especially true when serving a diverse clientele. When your client helps to set their own goals and choose actions to meet those goals, they are more likely to succeed. 
• Incorporate familiar foods into meal plans and educational materials. Your client may not respond to your standard handout for carb counting that recommends baked or grilled meats if they follow a vegetarian diet. Instead, focus on the makeup of foods (i.e., how much protein, how much sodium, etc.) to build the meal plan. Ask for input from your client so the plan will be well-received

Respecting your client’s cultural foodways is important and will help them receive the recommendations you’re giving if they know you’re taking their cultural preferences into consideration.  

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