Food plays an important role in defining a culture. Foods can elicit great emotion, provide comfort, and, often, represent beliefs. For good health, foods should provide essential nutrients. Unfortunately, cultures do not always adopt dietary habits for optimal health. Not so long ago, refined bread and polished rice were foods for the upper classes, whereas the lower classes were relegated to eating whole-grain breads and brown rice. Whole grains' superior nutrient content was unknown to most people. In this issue, the recent dietary trend of decreased consumption of dairy foods is discussed with regard to cultural sensitivities.

In her article entitled "Dairy foods: are they politically correct," Barbara Moore points out that healthcare professionals, in their attempt to be sensitive to those with lactose intolerance, which more often occurs in nonwhite races, are reticent to recommend dairy product consumption. The assumption that minorities should not be advised to consume dairy products is largely a myth. In her article entitled "Can Chinese children drink milk?" Heather Greenfield provides evidence from her own intervention, consisting of 300 mL of milk per day and school milk programs in Asia, that illustrates Asian children can tolerate milk consumption. We have similar data for African American adolescent girls who were classified as having lactose maldigestion based on a breath hydrogen analysis. These girls, who participated in a metabolic study and consumed 1200 mg calcium/day through dairy products, primarily milk, that contained 33 g lactose, had negligible gastrointestinal symptoms.1

The advantages of incorporating dairy products into the diet to reduce the risk of chronic diseases, including osteoporosis, hypertension, and cancer, are summarized in Barbara Moore's article. The evidence strongly supports a positive relationship between dairy product consumption and health. What is yet to be determined is if there are racial differences in the amount of dairy products or dairy constituents, such as calcium, to achieve optimal health. African Americans have greater bone mineral density and lower fracture incidence than either Caucasians or Asians. Their more efficient use of calcium, which optimizes calcium retention and bone accretion, may reduce their calcium intake. Asians may absorb calcium more efficiently than Caucasians.2 The effect of race and ethnicity on the relationship between calcium intake and calcium retention and disease incidence must be more rigorously studied. Nevertheless, it is likely that no subpopulation, on average, is consuming sufficient calcium intakes for optimal health.

In my opinion, it is culturally insensitive to be remiss in promoting consumption of a food group that supports health and reduces chronic disease incidence. A growing proportion of our population is racially and ethnically diverse. In 1980, the US population was 72% white, but that number fell to 66.5% in the 2000 census. During the same period, the black population increased from 26.8% to 30.4%, and Asians now comprise 4.2% of the total population. Of the 11.9 million people who identified themselves as Asians in the 2000 census, 20% were Chinese; Filipinos and Asian Indians were the next largest Asian groups. Thirteen percent classified themselves as having a Hispanic origin. If we worry about cultural sensitivities more than we worry about giving sound nutritional advice, we put one third of our population at risk.

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