Confronting Colonialism in Canadian Dietetics Curricula

Despite commitments by many Canadian universities to enact reconciliation on their campuses, some Indigenous scholars suggest that institutional change efforts have been largely selective and symbolic, rather than structural and substantive [19, 23–26]. These critiques note that interrupting and redressing settler colonialism in higher education and health care are not about simply including more Indigenous Peoples and knowledges into existing institutions [27]. It also requires asking how those institutions can interrupt colonial patterns and better serve Indigenous communities, including by addressing institutional complicity in Indigenous genocide and the theft of Indigenous lands and livelihoods (including Indigenous food sources). This is why some suggest that more decolonial or anti-colonial approaches to institutional change are necessary [19]. These critiques also point to the need to ensure that efforts to confront settler colonialism and support the resurgence of Indigenous health and food knowledges avoid the common colonial pitfalls of settler paternalism, tokenism, depoliticisation, and ahistoricism.

In relation to the increased inclusion of Indigenous-related content in course curricula, as well as the increased number of courses dedicated exclusively to Indigenous-related content, Indigenous scholars have raised a number of relevant concerns. These include concerns that processes of Indigenisation and decolonisation can actually be undermined if curricular changes are poorly implemented, and that a narrow focus on curricular changes could displace possibilities for deeper transformations of the colonial distribution of power, land, and resources in higher education and beyond [19]. Others note a concern that many curricular shifts prioritise non-Indigenous students’ learning over that of Indigenous students [28], centre the feelings and fragilities of non-Indigenous students, and are premised on the notion that it is primarily the responsibility of Indigenous staff, faculty, and students to shoulder the labour of institutional change. These concerns warrant serious consideration by settlers and suggest that curricular changes must be done in intellectually rigorous and relationally accountable ways that interrupt implicit colonial norms, and colonial patterns of relationship, labour, and resource distribution. At the same time, this does not negate the imperative to transform existing course curricula. The need to engage these transformations is evidenced below in our analyses of the current lack of engagement with issues related to both colonisation and Indigenous Peoples in existing dietetics curricula.

As Liboiron [27] notes, in order to identify and interrupt colonialism in higher education, “we must first learn about the ways our disciplines have specifically aligned with and benefited from colonialism so that everyone can see those legacies with enough clarity to address them.” In the case of dietetics, it is important to highlight that food and nutrition have been used to control Indigenous Peoples in Canada, beginning from the arrival of European settlers in the 1500s. This has included the intentional starvation of Indigenous Peoples by the Canadian government as a political weapon, nutrition-related experimentation in residential schools, the provision of rancid rations, and the continued use of Eurocentric nutrition guidelines [29]. Five centuries of colonial efforts to dispossess and settle Indigenous lands, destroy Indigenous food sources, and assimilate Indigenous People into Canadian society have seriously endangered and in some cases eradicated Indigenous knowledges, including knowledge of Indigenous cultures, traditional food practices, and food systems [29].

It is important to emphasise that the fields of nutrition and dietetics were not only complicit in colonisation and genocide, but also that much of their foundational knowledge is derived from colonial research. For instance, during the 1940s and 50s, settler nutrition researchers like Frederick Tisdall, co-inventor of Pablum, and Lionel Pett, the inaugural leader of the Nutrition Services Division and lead author of the precursor to Canada’s Food Guide, conducted biomedical experiments among Indigenous communities and Indigenous children in residential schools experiencing hunger and malnutrition [30]. Rather than providing immediate food relief, offering medical treatment, or addressing the underlying causes of hunger and malnutrition, these researchers treated Indigenous Peoples as “experimental materials”, and Indigenous communities and residential schools as “laboratories” to test out general theories of nutrition and produce knowledge that would enable more efficient “management” of Indigenous Peoples by the settler state. According to Mosby, “The nature of the experiments that [Pett] conducted in residential schools was determined based on a whole series of internal debates among nutrition professionals and bureaucrats about Canada’s Food Guide and about what a healthy and nutritionally adequate diet looked like…You can draw a direct line between the types of experiments that were being done in residential schools and these larger debates about how they should structure the food guide” [31]. Dietetics programmes in Canada have a responsibility to grapple with the implications of the fact that their field and its foundational knowledges emerged, at least in part, from these deeply colonial contexts.

The negative effects of settler colonialism on Indigenous Peoples’ nutrition, health, and well-being are intergenerational and ongoing. This is not a “thing of the past”—Indigenous Peoples’ access to food is still heavily controlled by colonial institutions, and Indigenous Peoples’ displacement from their ancestral territories significantly affects their ability to access traditional foods [32, 33]. For example, Indigenous heritage has been noted as a demographic household characteristic associated with greater likelihood of food insecurity [29]. At the same time, it is important not to conflate Indigeneity with risk. It is not being Indigenous that makes Indigenous Peoples vulnerable to food insecurity and poorer health outcomes; it is settler colonial policies and practices that create these risks. In response, as Robin, Dennis, and Hart emphasise [29], Indigenous Peoples have fought to sustain, reclaim, and restore their food systems and achieve food sovereignty in ways that “strengthen cultural ties and connections to land and spirituality”.

Indigenous Peoples are increasingly leading their own efforts to improve and ensure culturally safe and relevant health care for their communities [29]. At the same time, there remains an essential role for settler clinicians to work towards transforming the provision of healthcare services in Canada by interrupting colonial practices and policies and taking on more of the labour of institutional change. We emphasise the education of settler dietetics students here because settler clinicians make up the overwhelming majority of registered dietitians (RDs). However, we also recognise that this recentres the learning of settlers, and thus, we highlight the need for dietetics programmes to engage in the parallel work of making clear and substantive commitments to support Indigenous dietetics students in culturally relevant ways, especially given the extremely low numbers of Indigenous clinicians.

As future healthcare providers, settler dietetics students have a responsibility to learn how these historical and ongoing colonial systems have shaped their field, to consider what this means for their own practice, and to advocate for institutional and social change in order to help ensure that Indigenous patients have access to culturally safe healthcare and that Indigenous communities can exercise self-determination in their health care. However, many dietetics programmes continue to emphasise Eurocentric nutrition knowledge and food service management at the expense of attention to social and political issues, including the politics of whose food knowledges “count” [34]. As a result, future settler dietitians may unknowingly perpetuate colonialism and anti-Indigenous racism, alongside other forms of systemic marginalisation, in the healthcare system. They will also be unprepared to advocate for the systemic changes that are needed in order to interrupt colonial patterns in healthcare practice.

Conversations about colonisation, decolonisation, and Indigenisation are relatively new to the field of dietetics education [35]. Huycke, Ingribelli, and Rysdale note, “few dietetics programs offer required courses in cultural competency and dietetics students have generally felt academically underprepared to counsel clients from other cultures” [35]. A focus on interrupting settler colonialism and serving Indigenous communities is especially rare [35], and these discussions are more likely to take place outside of dietetics programmes. Fraser and Brady [34] also found that accredited English dietetics programmes in Canada did not provide adequate knowledge and skills related to social justice advocacy. In a recent survey of Canadian dietitians, the majority of respondents agreed that social justice and advocacy were inadequately incorporated into their dietetic education and training, and more than half felt that they were inadequately prepared with the knowledge or confidence to engage in social justice advocacy [36]. Respondents noted several reasons why social justice should be included in dietetic education, including client-centred care, reflexive practice, advocating for change in the social and structural determinants of health, preventing dietitian burnout, and future growth and relevance of the profession [36].

There is still very little published scholarly literature around decolonising or Indigenising the core curriculum in dietetics, and a lack of literature examining colonial structures and settler complicity within dietetics education programmes. Wilson et al. [37] however did address Indigenous knowledges and epistemologies, Indigenous self-determination, critical reflexivity, and colonisation within a core dietetics curriculum that they developed through an environmental scan, stakeholder input, and teaching development. For instance, they included a learning outcome of “recognise and explain how the colonisation of Australia impacted and continues to impact Indigenous health”. The dearth of literature in the field of dietetics education on Indigenisation and colonisation is indicative of the larger need to confront colonialism and anti-Indigenous racism in dietetics educational programmes and practice.

The current dietetics curriculum in Canada is severely lacking in Indigenous-related topics as well as coverage of the impacts of colonisation. The field needs to address these issues to ensure that dietetics education curricula equip students with the necessary skills and knowledge for entry into ethical practice in dietetics. This includes ensuring that students have confronted the colonial dynamics that continue to shape their fields and places of work and study and negatively affect Indigenous patients.

We note that the recent changes to the ICDEP competencies can be mobilised by dietetics programmes to further advocate for and engage curricular change and other efforts to identify, interrupt, and redress colonialism in the study and practice of dietetics. At the same time, we recognise that these revised competencies are in themselves limited and only represent the first step in a long-term process.

On the one hand, the ICDEP’s inclusion of three competencies related to “awareness” of Indigenous values and ways of knowing related to food, Indigenous traditional foods, and the impact of colonialism on Indigenous Peoples can offer important initial steps on the pathway to transforming curricula and practice. On the other hand, the language of “competencies” may encourage a superficial “checklist” approach to change [26]. Many Indigenous and other decolonial scholars have pointed out that confronting colonialism in the context of education and other social institutions is not a one-time event but a long-term relational process of learning and unlearning that has no clear end point.

Furthermore, simply cultivating settlers’ “awareness” of food-related issues that negatively affect Indigenous Peoples does not necessarily lead settler dietitians to accept responsibility to interrupt ongoing harm. These competencies also do not require students to gain awareness of how settler colonialism has shaped Canadian society, higher education, and food systems, or to gain awareness of their complicity in colonialism and anti-Indigenous racism if they are settlers. In other words, the competencies do not require students to confront colonialism in dietetics or in Canada more generally, or in their own practice as future dietitians. In addition to competencies, RD employment opportunities generally do not prioritise these issues, treating them at best as optional “add-ons”.

As many critical Indigenous scholars have pointed out, the Indigenisation of higher education is not merely a matter of increased representation of Indigenous People and Indigenous knowledges. It also requires that Indigenous Peoples and knowledges be treated with dignity, respect, and reciprocity; otherwise, there is a risk of reproducing colonial patterns of engagement [19, 23, 26]. This means that Indigenous scholars, elders, and knowledge keepers should be consulted and fairly compensated as experts in Indigenous food and health knowledges, not settler scholars. Research related to Indigenous Peoples and knowledges in dietetics should also be led by and/or conducted alongside Indigenous Peoples and communities and, when appropriate, should be informed by Indigenous research methodologies, so as not to reproduce patterns of settler paternalism in healthcare [38]. Engagements with Indigenous-related material should also be accompanied by explicitly inviting non-Indigenous students to confront the complicity of their field in systemic colonial harm on both individual and institutional levels and to incorporate this knowledge into their practice, especially when interfacing with Indigenous patients and communities. The role of settler practitioners and colonial healthcare systems in producing negative health outcomes and experiences for Indigenous Peoples must be clearly presented; otherwise, this could lead students to pathologise and blame Indigenous Peoples, rather than identifying the root causes in the colonial healthcare system and settler colonial system more generally. As well, while it is important to highlight the harm produced by settler health and food systems, it is also important to avoid damage-centred narratives that depict Indigenous Peoples as passive victims [39] and erase the strength of their deep, holistic relationships with their foods and food systems, and their efforts to revitalise these [29]. Finally, it is crucial that these efforts be grounded in consideration of the many complexities involved. This includes the complexities that arise from the fact that Indigenous communities, like all communities, are heterogeneous and diverse and thus do not speak with a “single voice”, as settlers often expect them to.

With all of this in mind, the inclusion of Indigenous-related material in dietetics curricula must be done in thoughtful, accountable ways that do not tokenise these issues, present them as mere add-ons, or treat colonialism in metaphorical ways. Ideally, this should be done in collaboration with, and following the guidance of, Indigenous Peoples, who should be fairly compensated for their time and expertise. At the same time, settler instructors must accept responsibility to “do their own homework” and minimise the labour that they ask of Indigenous colleagues and collaborators. Dietetics curricula should emphasise the importance of ensuring Indigenous Peoples’ access to their ancestral, traditional food sources. In turn, this requires emphasising that Indigenous Peoples cannot access these food sources if they cannot safely access their lands and if they are not safe from various forms of colonial violence, including the gendered violence faced by Indigenous women, girls, and Two Spirit people [6].

Material related to Indigeneity and to how settler colonialism and anti-Indigenous racism continues to shape the dietetics field should be incorporated throughout curricula as opposed to merely in a single course or module [40]. This can also address supposed barriers to implementation such as “already full programs” [36]. Brady [36] suggests that distinct social justice courses “would reinforce knowledge silos” and that dietetics education as a whole should be planned through a social justice and, we argue, decolonial lens. Although dedicating specific courses to these topics is not mutually exclusive with weaving it throughout all courses, limiting the integration of material to a small number of courses within a programme lets other instructors “off-the-hook” with respect to revising their own courses and mentorship towards anti-oppressive and anti-colonial practices. Changes should also extend to practical application, in accordance with the value placed on clinical knowledge and skills [41].