Are recommended dietary patterns equitable?

Abstract

Objective: Dietary recommendations (DRs) in the U.S. may be inadequate at improving diets in racial/ethnic minority communities and may require redesign of the systems driving their development over the long term. Meanwhile, cultural adaptation of evidence-based DRs may be an important strategy for mitigating nutrition disparities, but less is known about the adaptability of these recommendations to meet the needs of diverse groups. We examined the content and origin of major DRs—aspects that provide context on their potential universality across populations and evaluated their potential for cultural adaptation. Design: Case studies of Dietary Approaches to Stop Hypertension (DASH), the Mediterranean diet (MD), the EAT-Lancet diet (EAT), and the NOVA classification system. Setting: United States. Participants: Racial/ethnic minority populations. Results: Current DRs differ in their origin/evolution but are similar in their reductionist emphasis on physical health. DASH has been successfully adapted for some cultures but may be challenged by the need for intensive resources; MD may be more beneficial if applied as part of a broader set of food procurement/preparation practices than as just diet alone; EAT-Lancet adaptation may not honor existing country-specific practices that are already beneficial to human and environmental health (e.g., traditional/plant-based diets); evidence for cultural adaptation is limited with NOVA, but classification of levels of food processing has potential for widespread application. Conclusions: For DRs to equitably support diverse populations, they must move beyond a Eurocentric or ‘general population’ framing, be more inclusive of cultural differences, and honor social practices to improve diet and reduce disparities.

Perceptions and self-management of a healthy diet among middle-aged adults with risk of stroke in North China: a qualitative exploration

“…Traditional dietary patterns, 37 regional cooking styles and cultural norms surrounding food consumption all influence individuals’ dietary choices and preferences. When it came to managing their diet, many participants showed some variation in their daily eating habits, which were largely shaped by local dietary customs and preferences.…”

Perspective: Promoting Healthy Aging through Nutrition: A Research Centers Collaborative Network Workshop Report

“…To date, most dietary recommendations and nutrition education programs, overall and those focused on older adults, have not sufficiently included minoritized racial and ethnic populations, especially immigrants and those with limited English language fluency [ 94 ]. This gap presents an opportunity to expand diet recommendations and improve education programs for cultural, migratory, and dietary experiences among the rapidly growing and diverse aging population.…”

Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet

“…It should be noted that the causal evidence linking unprocessed red meat to noncommunicable disease mortality is reportedly weak [53] and adherence to the EAT-Lancet diet has not, thus far, been linked to reduced mortality from cardiovascular disease and cancer [54]. In fact, it has been argued that the EAT-Lancet diet may contribute to the increasing burden of mental illness [55] and that the guidance offered is not feasible [56,57] on a global basis and may exacerbate food inequity. Meat consumption has been linked to lower rates of depression and anxiety, which may be reflective of select nutrients and amino acids within the whole food [58][59][60][61].…”