Enhancing health outcomes and nutrition with Janet Reid-Hector

In today’s edition of Health IQ, Munson Steed engages in a compelling conversation with Janet Reid-Hector, Ed.D, RD, an assistant professor and director for the MS Degree in Healthcare Management & Leadership at Rutgers University, and past president of the National Organization of Blacks in Dietetics and Nutrition (NOBIDAN). With a profound background in clinical nutrition and organizational leadership, Dr. Reid-Hector shares her invaluable insights on the pivotal role of nutrition in improving health outcomes, particularly within communities of color. Her extensive experience and dedicated focus on maternal health complications and advocacy for better access to nutritious food make her an essential voice in this ongoing dialogue. Join us as we delve into the systemic challenges, cultural nuances, and practical solutions that can help transform health disparities into health equity.

Munson Steed: This is Munson Steed, and welcome to another edition of Health IQ, where we bring to you some of the most dynamic intellectuals, those who are dedicated to changing the lives and the health IQ of our community. Hopefully, tuning in today, you can meet and greet a dear sister who has truly dedicated both her life and her intentions to healing and helping our community. Dr. Reid-Hector, welcome to Health IQ.

Janet Reid-Hector: Thank you, Munson. It’s great to be here.

MS: When we think about associations, and I’m sure you’ve been a past president of an association. What associations do we need to think about that are organized to help increase both our agency and advocacy in the areas of both nutrition and diet?

Janet Reid-Hector: That’s a great question. The organizations that I’m most familiar with from the medical point of view are the National Medical Association. That is an awesome organization comprised primarily of physicians of color. They focus on improving the health and well-being of the underserved population of the United States. They also focus quite heavily on policies and procedures, working at the local, national, and federal levels with Congress and the White House to do everything in their power as healers and educators to improve the overall health of communities of color.

So, that’s an organization that I’m very familiar with. I have collaborated with them in my role as the chairperson for the National Organization of Blacks in Nutrition and Dietetics, which brings me to the second organization, the Academy of Nutrition and Dietetics. This is our national organization comprised of the nation’s experts in nutrition and dietetics, the home of all registered dietitians in the United States.

MS: It’s beautiful for you to say that the home of particularly Black dietitians. When you think of the role that a dietitian plays, it’s rare that we really understand what their missions are. They’re so much needed, and their insight is so valuable to our community. Can you at least educate those of us who are watching and listening on why we should have a closer relationship to both the dietitians that are there and the nutritionists that can help save our lives?

JRH: Exactly. Another great question and comment, Munson. So, the Academy of Nutrition and Dietetics is the largest organization in the United States comprised of all registered dietitians. Registered dietitians are educated and trained in the science of nutrition, how humans use the nutrients that are in food to improve our overall health, to prevent diseases, chronic diseases that are related to nutrition, and to manage those diseases when they unfortunately occur in us humans.

So, it is a field that is a STEM field because it is heavily based in the science of biology, chemistry, biochemistry, anatomy and physiology. Registered dietitians work in all areas of health care and also in education. We are the people that practice in hospitals and clinics. We also work in health care policy and in the food industry to ensure a very good supply of nutrient-dense foods to meet the nutritional needs of the entire population of the United States. Of course, we also work in education. We are the health and nutrition experts that produce future health care nutrition professionals.

MS: Well, I love that, and that leads me to the next question about understanding and changing our diet as a community. Given the history of our parents, who may not have had as many choices or access, what would you say, from a historical perspective to what we know today, should be some of the first things we approach change with, as it relates to increasing the health of the black community?

JRH: Yeah. So, I think you already know this. I see from the other interviews that you have done that you and others who care about the health of the underserved and minority population know that there are multiple factors that negatively impact the ability of communities of color to get access to adequate food. That is a major issue that all of us, all health care professionals, but especially nutrition and dietetics professionals, need to become more highly cognizant of and to become fully engaged in and not just provide lip service to it.

Just as an example, a person’s ZIP code in the United States, their geographic location, is a social determinant of their health. It is mind-boggling to think that your ZIP code impacts and influences 60 to 80% of your health. Where you live. One of the reasons that happens is that in the United States, a country that is one of the richest countries on the planet, has over 6,500 food deserts and food swamps.

You may think, well, what is a food desert and a food swamp? Why does it matter? How does that impact the overall nutrition status and health of the U.S. population, especially its most vulnerable population? A food desert is a place, usually an urban area or a rural area, and what they have in common is low socioeconomic status. They have very limited access to grocery stores and supermarkets where they can get fresh, whole, nutrient-dense foods. On the flip side, they have almost limitless access to cheap, overly processed food that lacks nutrients. Those food deserts, unfortunately, represent where a significant number of people of color reside, and that has a huge impact on that person’s overall nutritional status, their overall health status, adults and children.

As you know, a child that does not receive adequate nutrition takes a heavy toll on that child’s development, their brain, their coordination, every single part of the child is affected by poor nutrition. In terms of adults that live in these food deserts and food swamps, it takes a heavy toll. As you probably already know, Munson, the underserved population of the United States, comprised of brown and black brothers and sisters, carry a heavy disease burden. We have significantly higher amounts of chronic diseases that are directly related to nutrition, such as multiple forms of cardiovascular diseases, diabetes, chronic renal failure, and the egregiously high rate of Black maternal mortality and preventable complications and mortality.

So, what you have is a confluence of factors that have a significant negative effect on the overall health and well-being of communities of color. We have a high disease burden, and we have significant numbers of our brothers and sisters that just do not have access to affordable, nutrient-dense foods where they live, and that has a heavy toll. In this country, we’re very good. We’ve gotten very good at blaming people for what they’re going through. We’re very good at blaming the victims because they think it makes people feel good. They say, “Oh yeah, they’re like that because they didn’t do this, and they didn’t do that.” And then, of course, we forget all about the structural racism. We forget all about these structures and institutions and policies and procedures that we have allowed to be in place that keep people of color and underserved populations in these communities and environments that allow a heavy disease burden to foster.

So, those are some of the major factors, both historically and currently, that are having such a negative impact on the overall health and well-being of people of color in our country.

MS: How should we train our eyes, our minds, and our tongues to a new reality, as it relates to fresh food and vegetables, and the need to consume much more raw vegetables and fruit. How do we educate our community, about eating habits, and the new habits that we want to adapt for our children?

JRH: Yeah, that’s a great question. Of course, that is the ideal. What you just described, the ideal is that we have educators in place in our community that can help our brothers and sisters to acquire and develop just those habits. But we also have to keep in mind, Munson, that our brothers and sisters live in these environments that have very limited access to those foods that you just talked about, that you just described, Munson, are the absolute best for us. Whole, healthy, nutritious, dense foods. Whole grains, beans, vegetables, fruits, and so on. Those are the foods that nourish our bodies, nourish our souls, and keep us the healthiest. Keep our organs healthiest. Unfortunately, they also tend to be the most expensive foods. So, we have this flip in our country where the foods that are the least nutrient-dense tend to be the cheapest, and the foods that are the absolute best for us, like you just described, Munson, tend to be more expensive, and many of our brothers and sisters do not have the economic means or the access to get these foods.

Yes, we can definitely train people to alter recipes and do all sorts of wonderful things, but we have to make sure that they can access these foods. So, if you look at places where there’s a lot of emphasis on markets, farmers’ markets that are readily available to people where they don’t have to take three buses and a train to get there. In those areas, people go crazy about fresh fruits and vegetables.

Something that we tend to forget is that in our culture, we hear a lot about the foods that we have and how bad they are because they’re not very Eurocentric, but a lot of the foods that we have, whether you’re from the Caribbean or you’re from any part of the continent of Africa, where we have large segments of our population from the African diaspora, we have foods historically that have nourished us, nutritiously and spiritually, for centuries.

We have fallen into this trap where, if it’s not a Eurocentric food, it’s not good for you. So, one of the things that we have to do is to make sure that we not just talk about what foods you can’t eat, but the foods, the cultural foods. That’s why cultural sensitivity and cultural competence are so important because people have these wonderful foods from the Caribbean and all over the continent of Africa that are nutrient-dense. To hear other people talk about it, you would think that every food that is not Eurocentric, everything that is not lettuce, is not healthy.

We know that’s not absolutely true, which is why our organization is so focused on making sure that we get the message, or that we educate our brothers and sisters that, whether you’re from the Caribbean or you’re from any part of the continent of Africa, you have foods in your culture that are nutrient-dense. That message does not come across. So, it’s not just about training people to cook differently, use different seasons, and so on. That’s absolutely critical. But more importantly, we need to move away from having people think that their cultural foods, those foods that have nourished our ancestors for centuries, are not good for us.

People that are telling us that don’t understand the nutrient content of those foods. They don’t understand the science of those foods because, unfortunately, Munson, we have a huge gap in concordance in our field. We have large amounts of registered dietitians in this country, but a very small percentage of those registered dietitians, though they’re well-educated, don’t get me wrong, they are. Someone of the professors that educate them, but they do not understand the cultural competence, the cultural sensitivity, and don’t understand how to engage with people of color to appreciate their cultural foods because they don’t know.

I’ll give you an example. You have people talk about things like rice. “Oh, rice is so bad for people.” You look at rice as an example. Rice is a carbohydrate food that is the staple. It feeds people on this entire continent of Asia, well-nourished. By the way people talk about rice, you would think that it is the most evil food in the world. That’s because people don’t understand the nutrient composition of rice and how it’s used in a balanced way to nourish the continent that has the largest amount of humans in the world. Over a billion people have this carbohydrate as a staple in their diet, and they’re very good at balancing that out with fruits and vegetables.

You also have, in other parts of Africa, that a lot of registered dietitians are unaware of. We have red rice, we have black rice. People know about brown rice, for instance. Red rice, purple rice, and black rice are some of the most nutrient-dense foods on the planet. But how many in our profession know about that? How many of us can teach people of color how to incorporate a nutrient-dense food, like the variety of rices that we have, into their diets? That is a significant gap in our ability to have people appreciate the foods that they have, be knowledgeable about the nutrients that are in them, and how they can incorporate them into a healthy diet that is not Eurocentric.

The lack of concordance in our profession is rather steep. 13.6% of the U.S. population is Black. 2.6% of registered dietitians are Black. 6% of physicians and nurses are Black. So, we have a huge gap in our concordance. We have a large amount of Blacks with a population that’s rising, and we have a very small percentage of highly educated, highly trained registered dietitians that understand Black cultural foods and Brown cultural foods because I don’t want to leave out our Brown sisters and brothers, because I’m partially Brown. That is a significant issue. Yes, Munson, it’s important that we teach people how to alter their taste, but more importantly, we need to show an appreciation when we counsel and educate people not to other them and make their foods that they and their ancestors have consumed since the beginning of time as something that’s not good and not healthy for them. We have such a large amount of registered dietitians that simply have no knowledge about the nutrient density, the nutrient content, and the health benefits of people’s cultural foods. That is something that we have to work on.

MS: Well, I love that you talked about cultural foods. I think the vision that you have is often not shared aloud. I remember my grandparents. My grandma said, “You’ll never be hungry as long as you have a bag of beans and a bag of rice.” It used to be one of those things that obviously, my grandmother didn’t eat pork, so the beans never got pork, but she’d have that pork on the stove if that’s what my grandfather chose to eat. She would do the same with yams. It was one of those things that there always was a cooked yam in the refrigerator. So, if somebody came by and they were hungry, it was kind of like, well, you’re going to get some yams and some greens, and there might be a piece of meat, but if not, it’s going to be yams, greens, and then rice. They were very Louisiana-based.

When we think about even prepping for food, given that there’s this travel distance between how you get fresh, how important is it to be able to prep your food and to buy foods that are sustainable toward not being so one meal-centric but kind of meals that, like you said, with rice and beans and a pot of greens versus a can of greens? We can do a pot of greens, so you’re not hungry. What do say you about being able to plan your meals and to organize your approach and add nutrition to your plan?

JRH: Absolutely. You just touched on something that is really important. Those of us, for instance, that are parents of children and we work full time, one of the things that we learn to do is plan out our meals for the week. Number one, it saves money. That is one of the things that we do when we work with communities of color, is to plan their meals. For instance, if you can get people in lower socioeconomic status communities to get access to a farmer’s market, one of the things that we did when I worked at the University of Medicine and Dentistry in New Jersey is that we would have a farmer’s market in our parking lot between the medical school and the dental school. We would get people, the farmers and middlemen who have fresh fruits and vegetables to bring all of that once a week to our parking lot and set up a farmer’s market.

We also have gardens in schools and in a lot of communities. We would help to get gardens in any open space that is not being used to start gardens. One of the great things about that is having children involved in that. When you have children involved in going to the farmer’s market with you, picking out the fruits and vegetables and whole grains and so on that they would like, and then when you get home, you involve them in cooking and preparing for the whole week. So, it makes it a family event, and that absolutely helps because it really saves money when you plan ahead. That is something that we encourage people to do.

The other thing that we also need to remember is that fresh fruits and vegetables are wonderful. Yes, they are going to have the highest amount of nutrients in them. But one of the things that we also have to keep in mind is that foods that are frozen, and sometimes people forget about this also, carry a big bang for your buck when it comes to nutrition because frozen foods, especially produce and so on, the way they’re flash-frozen now, immediately after picking, the nutrients are sealed in. So, that’s one of the things that we have to always make sure we don’t forget. So, you can have a combination of fresh and frozen foods together.

One of the things that people are unaware of is that when you test the nutrient content of frozen foods, it’s mind-blowing. Sometimes the nutrient content is even higher than fresh fruits and vegetables, not the ones that you get from a farmer’s market that had a very short journey from the farm to the farmer’s market, but we live in a global economy. A lot of our foods travel thousands of miles from Mexico and even further away to come to us. During travel over oceans and different temperatures and so on, nutrients are wonderful, but in the end, they are biochemicals, and they lose their potency and also lose the amount of them that are in foods as they travel and are exposed to different temperatures and so on. So, that’s something that people often don’t realize is that fresh fruits that come from far away, especially when they come from outside the United States, lose nutrients that are in them.

When you have a combination of fresh produce and frozen vegetables, you can get the most nutrient-dense foods, and you can also incorporate that in your planning as well. So, it doesn’t have to be only fresh foods. Frozen foods have a tremendous amount of nutrients in them, sometimes even higher. When you combine those with planning for your meals over a week, you save time, and you save money, and you have a very nutrient-dense meal for the entire family.

Editor’s note: This is an extended interview, errors will occur.