And the people it has subsequently hurt.
I’ve lost count of how many times I’ve heard a patient tell me that their doctor told them to “stay away from anything white.”
It’s a seemingly harmless statement, one coming from a place of good intention, hopeful that it will help someone become healthier. In truth, during the early days of my nutrition practice, I am likely guilty of making similarly judgmental statements. But today, I want to right that wrong and apologize for any times I may have crossed that line.
Although there are many foods I could apologize to, today I want to particularly apologize to white rice and the people who enjoy it. In western culture, we have a long history of deciding that our way is the “right” way, and anyone who deviates from what we are comfortable with is wrong. White rice is a perfect example of this.
People in Asian countries have consumed rice for over 8,000 years. Let that sink in. Eight thousand years. For reference, America has only been around for 244 years. Looking objectively at the data, it can also be argued that individuals living in Asian countries have significantly better health markers than most western countries. Now, I’m not saying that rice is the key to health and longevity. But what I’m saying is that clearly, health is more complicated than “stay away from anything white.”
From what I’ve observed, western society seems intent on systematically telling people from other cultures that their way of eating is wrong. So wrong, in fact, that it is causing their disease. With our in-and-out-the-door medical approach an overly simplistic “stay away from (insert culturally important food),” we have created harm instead of preventing it.
Years of true, objective nutrition research show there is nothing wrong with white rice. Or tortillas. Or pasta. Or etc. Nutrition and health are significantly more complex than singling out a food. Health has more to do with our relationship with foods, choosing convenience over preparation, and sitting instead of walking. This is a conversation for another time, but you get the idea.
We have to change our dialogue around how we address nutrition with our patients. People come from many diverse backgrounds and have deep cultural roots in eating particular foods. Instead of dismissing our patients, take the time to work with them collaboratively.
Here is an example of a patient encounter to use for guidance:
A patient comes into your office who has diabetes. She shares that she notices her blood sugar increases significantly after eating rice, and she is worried and distraught about what to do.
Step 1: Gather info
Ask her if rice is something she eats as a staple in her current diet- this will give you a sense of how she views the food.
“I hear you saying that when you eat rice, your blood sugar increases. Is rice something you and your family enjoy eating regularly?”
Step 2: Ask for permission
“I can tell that you are worried about your blood sugar. I have some suggestions that might help. Is it ok if I share them with you?”
Step 3: Offer science-based and patient-centered advice
1: Take a walk after eating
2: Adjust the portion size
3: Reduce carbohydrates somewhere else
4. Adjust the medication
“Do any of these options sound like something you might be interested in trying?”
The patient’s primary concern was addressed. We didn’t shame her for eating rice. She feels in control of her health and trusts you.
We need to break ourselves of our rigidity and allow an openness with our patients. Humans are more interconnected than ever, and a true scientist can view the world with an open and questioning mind. We have much to learn from other cultures and need to embrace our different food heritages.
So my dear white rice, we are sorry for wronging you. Please accept a place at our table.