Better Off Podcast: What makes a meal healthy?
What does a plate of healthy food look like? Everyone has an opinion – from doctors to dieticians to wellness experts. But advice on what to eat often ignores a big factor in how and why we make meals: Culture. Americans who trace their heritage back to Latin America or Africa often get messages that discourage them from seeing their home foods as healthy. In this episode, we’ll ask: Are we better off when diet and nutrition advice is informed by culture?
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Guests
Josiemer Mattei, Donald and Sue Pritzker Associate Professor of Nutrition, Harvard T.H. Chan School of Public Health
- Read about her latest research projects.
- Read reports Josiemer and colleagues have generated for communities, including a 2020 report on cultural perceptions of diet and health among Latinos in Boston.
Dalina Soto, registered dietician, Your Latina Nutritionist
Credits
Host/producer: Anna Fisher-Pinkert
The Better Off team: Kristen Dweck, Elizabeth Gunner, Stephanie Simon, and Ben Wallace
Audio engineering and sound design: Kevin O’Connell
Additional research: Kate Becker
Full Transcript
Anna Fisher-Pinkert: From the Harvard T.H. Chan School of Public Health, this is Better Off. A podcast about the biggest public health problems we face today. . .
Dalina Soto: A lot of what I see is this shame and guilt around our foods.
Anna Fisher-Pinkert: And the people innovating to create public health solutions.
Josiemer Mattei: Even us, as Latino researchers, and for those of us who have worked in this field, sometimes we have even contributed to these notions that the Black diet or the Latino diet is unhealthy. And that is not true.
Anna Fisher-Pinkert: I’m your host, Anna Fisher Pinkert.
This season on Better Off, we’re talking about how to make a healthy home. And in this episode, we’re going back to the kitchen.
This is a weird time of year for food. I’m staring down a fridge full of turkey and mashed potato leftovers from Thanksgiving while also trying to figure out when I’m going to fry up latkes for Hanukkah and how many apple strudels I need for Christmas. Sometimes it feels like participating in these traditions is completely at odds with healthy eating.
I know that come January 1, my social media feed is going to be flooded with articles telling me what to eat and what not to eat. So, is there a middle ground? Can we have healthy meals that also feel like home? To try and get at that answer. I spoke to Josiemer Mattei, a researcher and an associate professor at Harvard Chan School.
Josiemer is Puerto Rican and she identifies as Latina. She combines community-based collaborations with research on the links between nutrition and chronic disease.
Josiemer Mattei: Stop for two seconds and ask yourself what is healthy eating to you? Stop thinking about what we tell you that it is, but what do you think is healthy eating? What do you think is a healthy plate? What do you think is a healthy body? The definition of health and the definition of healthy eating is a very subjective construct.
Anna Fisher-Pinkert: What we choose to eat is the result of a lot of different factors working together. Is there a good grocery store nearby? Can I afford the foods I want to eat? Do I live with someone with a dietary restriction? Do I even have time to cook a full meal? But personal choice does play a role in how we eat.
Those choices are shaped by many things. The foods you personally find tasty or comforting, foods you think are particularly good for your body. And that, quite often, is shaped by culture.
Josiemer Mattei: If I ask you right now Anna what, what you would you say, I’m gonna put you on the spot. What is healthy eating for you?
Anna Fisher-Pinkert: Oh, God. I mean, I think it’s, I think it’s a day where, I eat, I eat a vegetable or a fruit with every meal and I, I don’t probably, I don’t eat cookies.
Josiemer Mattei:I love it, Anna. See, I think this is where everybody’s mind goes. The first thing that everybody would say is fruit and vegetables. And I think it’s because it has been so ingrained in us. And to me, if you ask me, and I am a nutritionist. . . Yeah, fruit and vegetables, and yeah, no cookies, no sugar, but. . . but I have to say that you know, putting in sugar and putting in that cookie might make it a healthy, happy meal for me and a healthy, happy meal for my kids. What I have to say at the end of the day is moderation. And that is my definition of healthy eating. You can definitely have that cookie, but you have to be moderate about it. Just don’t eat ten cookies, Anna. [Laughter]
Anna Fisher-Pinkert: Josiemer asked Latino people from various cultural backgrounds how they define healthy eating. And she got some really different responses.
Josiemer Mattei: When we were talking to participants, we ended up hearing two big things. One was relating healthy eating as nutrients and foods. So, healthy eating was eating low fat, low sodium, no carbs, small portions, not eating too much. Interestingly, that construct was mostly mentioned by people of Caribbean heritage. So people from Puerto Rico, people from the Dominican Republic, people from Cuba. The second big theme was healthy eating defined as fresh, whole food. People saying, “Healthy eating to me is going to my backyard and grabbing an avocado.” Eating like a big, nice salad, stuff that I just grab from my backyard. Like, not eating from a box.
Anna Fisher-Pinkert: That answer tended to come from people who had moved from South America.
Josiemer Mattei: To me, it precisely reveals that, you know, healthy eating means something different to all of us.
Anna Fisher-Pinkert: Here’s where culture and access to healthy food starts to intersect. Most new immigrants arriving in Boston aren’t going to be able to pick avocados from a backyard tree. Many may not have access to affordable, fresh produce with the flavors they’re used to from home. So they may need to find whole new ways to eat healthy. Unfortunately, there’s not a ton of guidance that outlines how someone should go about constructing a healthy meal in America
Josiemer Mattei: The Dietary Guidelines for Americans is a blanket statement. It’s the general statements provided for all the people residing in the United States. And they have a statement encouraging people to customize their healthy choices to address personal choice and cultural traditions. But they stop there. There’s really no guidance on how to do that. So, I guess that if the experts at the Dietary Guidelines for Americans can really not figure this out, then we have a problem here.
Anna Fisher-Pinkert: It’s not easy to find advice on cooking and eating healthy that accounts for cultural tradition and personal preference. And at least some of that has to do with who is generating and disseminating nutrition advice.
Dalina Soto: In a country that’s very diverse and speaks multiple languages it’s important to have someone that understands you, understands your culture, understands your food, so that we can look at health in, in a whole picture and not just numbers.
Anna Fisher-Pinkert: That’s Dalina Soto. She’s a bilingual Latina registered dietician. Only 6% of registered dieticians in the U.S. are Latino and only 3% are Black. 76% are white. Dalina says this lack of representation translates to a lack of culturally competent nutrition care for marginalized people.
Dalina Soto: When I educate dieticians, when I talk to other people in the medical field, I’m always like, “You’re there to educate, but also you’re there to learn.”
You’re there to learn about this person’s life, about this person’s experience. Their lived experience matters so much more than food, sometimes. Like, are they gonna be able to get this food that you are telling them to eat? Do they have the ability to cook? Do they have access to these foods? Their lived experience is going to really make or break their health at that moment.
Anna Fisher-Pinkert: Dalina says that her own education in nutrition was imbued with cultural bias.
Dalina Soto: I often say my education was very stereotypical and biased because it only showed me one lens of health, and that was a Eurocentric way. It did not teach me how my foods can nourish people because it only focused on one way of eating. But the world is so diverse, and we eat so differently. I’m not going to sit here and say that the science isn’t there about how a carb is broken down or how a protein is broken down, or fats, or everything else that’s happening inside of our body. But the carbs and proteins and fats that were presented to me in school were completely different than the carbs and proteins that I was eating, or fruits and veggies that I was eating at home. And so, I had to bridge both of those worlds to look at food in a more positive way.
Anna Fisher-Pinkert: Dalina tries to bring these insights to her patients, who have often heard messaging that leads them to think that their own culture’s food isn’t healthy enough.
Dalina Soto: You know, I want my kids to grow up as Dominican as I grew up. I want them to continue to, to pass that on. And so, a lot of what I see is this shame and guilt around our foods. This idea that they can’t possibly be healthy for you, because unfortunately, lot of what we see in the media, in public health campaigns, in the doctor’s office is telling us that our foods are bad.
Anna Fisher-Pinkert: In popular media, nutrition research often gets boiled down to something like: “We should all eat like people in Japan or Greece or Norway.” But Josiemer thinks this is an oversimplification, and one that ignores the reality of how people eat around the world.
Josiemer Mattei: The whole world eats healthy and the whole world eats horribly. That’s my bottom line to it. Think of it this way, I’m Latina and whenever we’re talking about, and I’m very mindful of this because even us as Latino researchers, and for those of us who have worked in this field, sometimes we have even contributed to these notions that the Black diet or the Latino diet is unhealthy. And that is not true. That is not correct. And I think that is time to flip that thought that our diets are unhealthy because it is not true. There are a lot of foods in some of the minority diets that are very healthy. Beans are an example. Beans are very highly consumed in the Latino diet. Root vegetables are very consumed. Some of the fruits and vegetables, tropical fruits and vegetables in our diet are extremely rich in minerals and vitamins that are sometimes not found in some of the more temperate environments here.
Anna Fisher-Pinkert: Dalina points out that some trendy health foods like acai and quinoa come from Latin America. Though, she’s quick to say that food trends are not necessarily helpful to Latin American people.
Dalina Soto: I think we need to talk about the exploitation that happens in a lot of these countries. If we need that acai we’re gonna go to Brazil to get it. That’s where it’s at. They’re buying it in bulk at very cheap, exploiting the community, and then they’re coming here and they’re selling it for $7, $8.
Anna Fisher-Pinkert: But many nutritious ingredients from around the world are ignored or labeled as unhealthy.
Dalina Soto: The way that wellness culture works is that we elevate certain foods and then we demonize certain foods. And it sadly goes back racism and bias. Like kale: If we look at it from a nutrition standpoint, it’s gonna have the same nutrition as a collard green. Collard greens are considered a Southern food that’s very popular in Black communities, and it’s cooked in like butter, or fat, bacon or however it is that it’s cooked, and it’s automatically deemed bad. But a kale is elevated because one, it’s more expensive, so only a certain amount of people can get to it. People eat it with absolutely like zero seasoning and flavor. And it’s like this idea of “raw eating,” “clean eating,” “closest to the form that it came eating.” And all of that is tied to a lot of eugenics and racism, and we’re still perpetuating a lot of those ideas now.
Anna Fisher-Pinkert: Butter or bacon might not make the list of healthiest foods, but if a little bacon encourages you to eat your greens, that doesn’t mean your overall diet isn’t healthy. Josiemer thinks that if you want people to eat healthy, you can’t tell them to chuck all their cultural traditions in the trash and take on a different culture’s eating patterns. For example, nutrition experts often advise eating a Mediterranean diet because it has scientifically proven health benefits.
Josiemer Mattei: I agree. It has a lot of components that are very healthy, but whenever you go and ask somebody to eat a Mediterranean diet, they’re gonna tell you: “I’m not Mediterranean,” if they are not coming from Spain or Greece or Iran or any of these countries that are in the Mediterranean sea.
Anna Fisher-Pinkert: One of her projects is to take apart the Mediterranean diet and put it back together using ingredients that are easier for Puerto Ricans to access.
Josiemer Mattei: So we have done that in Puerto Rico, to give you an example. The Mediterranean diet is very rich in nuts, almonds, vegetable oil, and plant-based oils, and the number one is olive oil. Having said that, in Puerto Rico, olive oil is very expensive. Most of the oil that is consumed Puerto Rico is vegetable oil, it’s canola oil or corn oil. The same thing with legumes. Almonds are very expensive, especially raw, pure almonds. So, what we eat instead are legumes. They’re everywhere and they have a very similar nutritional profile. So something that we’re doing in Puerto Rico is precisely to promote these foods and to do interventions and community programs around these foods that are Mediterranean-like, and will fill that pattern without having people to switch their cultural background or their cultural background or their cultural attitudes for a Mediterranean diet.
Anna Fisher-Pinkert: I realized that I also carry a lot of shame around the foods that I love that aren’t on anyone’s approved diet list. But a healthy meal isn’t solely defined by vitamins, minerals, or calories.
Dalina Soto: So for me, from a nutrition standpoint, a healthy meal is going to be something that is going to be a little bit more complete, right? We wanna think about like, does it have a carbohydrate? Does it have a protein? Does it have some fiber? Does it have some fat, right? But more than that, to me, it’s a food that is satisfying, a food that tastes good, a food that not only nourishes your body, but nourishes your soul.
Josiemer Mattei: To me a healthy meal, and a healthy home, is a happy home. To me it’s really the social connection of cooking and eating. However your family looks like, whatever your household looks like. Even if it’s you alone, sitting there in your house, make it a social connection. Make it a happy meal. No connection to McDonald’s. Just make it a social connection whatever that may be. That is as important to health as what’s in your plate.
Dalina Soto: I always say there’s not one culture that doesn’t mourn with food or celebrate with food. That is of the biggest differences that we have from animals. We’re able to gather, we’re able to cook, we’re able to add flavor and spices. [Laughs] We’re able to nourish ourselves, not just from a, “what does my body need” perspective, but also, “what does my soul need.”
Anna Fisher-Pinkert: If my soul needs a triple-decker Thanksgiving leftover sandwich, then that’s what I’m going to do. At least this week. And I’m going to share it with someone I love.
Thanks for listening to Better Off. We’re better off with our team: Kristen Dweck, Elizabeth Gunner, Stephanie Simon, and Ben Wallace. Audio engineering and sound design by Kevin O’Connell. Additional research from Kate Becker. I’m host and producer Anna Fisher-Pinkert. Thanks to our guests, Josiemer Mattei and Dalina Soto. We will have more information about their work on our website, hsph.me/better-off. If you liked this episode, please rate and review us on your favorite podcast app and tell your friends about the podcast too. That’s it for this week. Thanks for listening.
