Spilling The Tea About Living An Irresistibly Nourished Life
An interview with Shana Minei Spence, MS RD, and author of Lived Nourish, a weight-inclusive, non-restrictive, non-diet book focused on how the social determinants of health are experienced.
Inclusive Diabetes Care had the privilege of engaging in a profound conversation with Shana Minei Spence, the brilliant mind behind the Nutrition Tea newsletter and the author of the enlightening book Lived Nourish. In this interview, Shana generously shares her invaluable insights and wisdom, shedding light on the path to a more inclusive approach to nutrition.
Q. How can we increase a sense of belonging in healthcare and nutrition?
“For many professionals in public health or providing direct client care, there is a lot of pressure to see clients, which is a bit dehumanizing. If you aren’t careful, clients can stop being people and feel like a task or a number. It is unintentional, but it is easy to forget that everyone is a human.”
Q. What can be done to rehumanize the nutrition space?
“Shifting to asking about the person. This curiosity also gives us clues into the barriers and resources available to them.”
Q. What has helped you personally experience a sense of belonging?
“The dietitian groups have helped me feel that sense of belonging. I work in public health, and it is easy to feel alone in the community health space. Finding like-minded individuals has given me this essential sense of belonging.”
Q. What can healthcare providers and organizations do to create a sense of ease at a session?
“Food is more than nutrition. It is culture, so not knowing the cultural traditions or foods creates a gap. For example, if a healthcare professional suggests to a client from a rice-eating culture, ‘...just eat brown rice instead of white rice.’ it isn’t a reasonable request. It lacks cultural humility if brown rice isn’t typically part of their culture.
It is important to honor our client’s preferences. You aren’t morally wrong for liking or not liking certain foods. Yet a lot of people feel guilty for liking certain foods. I want to remind everyone that it doesn’t help anyone to feel guilty. Guilt is a barrier to care. If you think about it, this has a ripple effect. You don’t want to go back to see a healthcare provider that makes you feel guilty. Guilt harms clinical engagement. It also creates some expectations about what is covered at an appointment. Many clients and professionals think they know what the nutritionist or dietitian will say at a session. Typically, these assumptions perpetuate the idea that dietitians are the food police.”
This belief is false because inclusive care meets clients where they are. Being fully present with the person before you interrupts these preconceived notions about nutrition.
Q: How has the newsletter, The Nutrition Tea, fostered a deeper understanding of our nutritional needs?
“I work as a non-diet dietitian and the weight-inclusive is evolving. I want to explain each topic with empathy and highlight the nuance perspective missing in social media. So many posts and topics on social media are presented in a black-or-white way. I intend to create a weight-inclusive space for clients, even if they are interested in weight loss. I think it is essential to look at health from many viewpoints. I want to support readers' curiosity and expand their non-judgmental understanding of nutrition and health.
Q. If you had one wish for professionals working in the diabetes space to realize about weight-inclusive nutrition, what would that be?
Many professionals need to be aware of healthism and how it creeps into the conversation.
Readers Note: The definition of healthism was written about by Robert Crawford in 1980. “Healthism situates the problem of health and disease at the level of the individual. Solutions are formulated at that level as well. “
Q. Are you talking about the assumption that everyone ‘should’ try to be healthy?
“Yes. When a healthcare professional asks, “Why can’t they make different choices?” there are a lot of unspoken assumptions. For example, what systemic barriers are in place? Let me give you a clear example of how weight-centric care impacts clients. “When someone is in a larger body, has experienced stigma, or feels unwelcome, this becomes a barrier to care. Ask yourself, why would anyone go BACK somewhere where they feel unwelcome? It is just one systemic barrier to healthcare; there are many more. So when providers ask, “Why didn’t they see a doctor earlier?” It makes assumptions about the availability of nonjudgmental care that supports all bodies. Acknowledging body diversity and how body diversity is interrupted by healthism can help professionals see that the goal of health isn’t to move people to a specific body. It is to improve their overall health.
Q: Could you share more about your book Live Nourish?
It was published in August. It is a weight-inclusive, non-restrictive, non-diet book focused on how the social determinants of health are experienced and how they become barriers to nourishing the body. Woven into the book are ways to build nutrition, health, and beyond to live a nourished life.
Q: That sounds so amazing. What was it like writing this book?
It was an amazing process that took two years of writing and researching. In our weight-focused world, it is hard to have a supportive relationship with food and your body. If you are someone looking for a non-diet approach who’s open to changing their relationship with food, my hope is that Live Nourished will support you in eating a balanced, non-restrictive diet.