UConn NUSC 1167 Chea Exam 3 Final

Blue zones

-areas where there are higher rates of individuals living over 100 years old

-ex: higher life expectancy in Okinawa, Japan

Why is Japan a blue zone?

-they are plant based

-wake up with a purpose everyday

-positive attitudes "igikai"

-social support

-physical activity (gardening, yoga)

-genetics

Traditional Health Beliefs and Practices of Japan

-Shinto concepts of purity and pollution

-Health maintenance achieved by cleanliness, avoiding contaminated substances (blood, skin infections, corpses), and usage of botanical remedies

Medications from China

Kanpo: herbs initially available to the wealthy

-now available to everyone

-reimbursed under health insurance

Kanpo-i

Herbal practitioners in Japan

-examine symptoms carefully and in detail to determine the best therapy combinations

-natural medications are used to enhance the immune system

-western bio medicine in Japan was introduced by the Portuguese during the 16th century

Health concerns in Japan

-stress induced illness and work related fatigue

-can lead to suicides (koroshi)

-herbs, teas, and spas are utilized by the Japanese to relieve stress

Traditional Food Habits in Japan

PROTEIN FOODS:

-fresh fish and shellfish usually consumed raw

-beef, pork poultry

-kobe beef ; derived from a cattle fed beer and massaged to relieve stress

-expensive

FRUITS AND VEGETABLES IN SEASON

-taro

-daikon (white radish)

-edamame (soybean pods)

-seaweed and algae ; nori (paper thin sheet of algae used for sushi

Meal Composition and Cycle in Japan

-three meals a day plus a snack (oyatsu)

-breakfast ; salty sour plum

-rice w/ nori and egg on the side

-lunch

dinner ; soups w/ 3 sides

Etiquette in Japan

-chopsticks are the main utensil

-sit at low tables

Special occasions in Japan

NEW YEARS

-food is prepared ahead of time prior to the seven day event

-cleaning the house completely

-taking care of debt

-consumption of mochi

-Ozoni ; soup with mochi, vegetables, fish cakes, chicken or eggs

-some birthdays are considered bad luck (women turning 33, men turning 42

)

Nutrition and health status in Japan

JAPANESE/AMERICAN DIET

-high in carbs, low in fat and cholesterol

JAPANESE AMERICAN DIET

-more westernized

-cancer risk ; colon, breast, prostate

-increased progression of atherosclerosis

JAPANESE AMERICAN ELDERS

-osteoporosis

HIGH PREVALENCE OF LACTOSE INTOLERANCE

-the body has limited amount of lactase, the enzyme that breaks down milk sugar

Counseling in Japan

JAPANESE AMERICAN VALUES AND HEALTH

-placing family before individual

-preserving harmony with society

-respecting and caring for elders

CONVERSATION

-being formal and polite

-avoiding confrontation

-preferring to sit further apart from another person

-greeting with a bow

Population of Koreans in the US

POPULATION: 1.7 million

-over half of the population immigrating since 1980

-a majority of this population immigrated from North Korea to South Korea

Reasons for immigration in Korea

-economic opportunities

-avoiding political conflict

Socioeconomic status of Koreans

-due to language difficulties or licensing restrictions, some Koreans work in temporary or permanent nonprofessional employment

-operation of small businesses

Middle Class:

-high achievement in education and professionalism

-individuals learning English quickly

-willing to give up Korean traditions

Religion in Korea

South Korea

major religions include:

-Buddhism

-confuscianism

-christianity

-shamanism

-belief in natural and ancestral spirits

-Chundo Kyo - national Korean Religion

Family in Korean

-confuscianism influenced family structure regardless of religion

-highly valued

-loyalty to family is more important than the individual wants or needs

-Male ; head of household (or eldest son)

-oldest male children ; more privileges (education)

-birthday celebrations ; age 1, and age 60 (5 repeats or 12 year cycles)

Traditional health beliefs and practices in Korea

Health is related to:

-happiness, the ability to live a full life

-the body functioning without impairment

-not burdening one's children

-good appetite

-balance of um (yin) and yang

-folk illnesses ; psychological distress, excess emotion (sadness, anger, scared)

Examples of Korean Folk Illnesses

Hwabyung

-anger, victimization, stress

-associated with poor appetite, stomach pain, chest pain, weight gain, shortness of breath, and high blood pressure

-affects mostly women

Han

-causes a painful lump in the throat

-person suffers disappointments and regrets

Shinggyongshaeyak

-caused by stress (lack of positive or happy interactions with individuals)

-results in insomnia, weight loss, and nervous collapse

-reliance on a shaman or spiritual mediator

Hanyak

-traditional approach to natural cures in Korea

-Hanui ; person that practices hanyak

-medical history and makes observations of the patient

-listens to the quality of the voice

-takes the patient's pulse

-mix of integrative and biomedicine for treatments

Traditional Foods of Korea

Staples:

-rice

-noodles (wheat, buckwheat, mung beans, sweet potatoes

Vegetables

-chinese cabbage (bok choy, nappa cabbage)

-kimchi (pickled, fermented vegetables) ; seasoned with garlic, onions, chili peppers

-fish and shellfish

-fire pot (similar to Mongolian Hot Pot)

Traditional foods:

-kochujang

-bulgogi (flavored with onions, soy sauce, sesame oil, and garlic

Meal composition and etiquette in Korea

-three meals/day

-chopsticks and soup spoons

-elders are served first, children served last

-food passed with right hand

Birthday celebrations in Korea

1st Birthday

-the child is dressed in traditional clothing

-placed among stacks of objects (rice cakes, cookies, fruits)

-the child chooses an object that represents professions ; used to predict the future (pen ; writing

coin ; finance)

Therapeutic Uses of Food in Korea

Um and Yang

-Um ; cold foods (fruits, vegetables)

-Yang ; warm foods (meats, chiles, spices)

Health promoting foods

-kimchi

-broiled seaweed

Healthcare and Counseling in Korea

-uninsured

-cultural beliefs and attitudes

-conversation ; quiet approach

-family members are actively involved in making healthcare decisions

Africa Facts

-second largest continent in the world

-population ; over 1 billion as of 2013

-Languages ; between 800 - 1700 spoken (ethnic and tribal groups)

History of Africans in the US

Enslavement

-in 1916, Dutch traders sold 20 West Africans to colonists in Jamestown, VA

-identified themselves with their tribal groups, rather than their native country or Africa as a whole (Ashanti, Yoruba)

-development of a black Creole native-born culture ; combination of white and West African influences

Emancipation

-began during the American revolution

-civil war (confederates supported slavery , union opposed slavery)

-emancipation proclamation ; signed by President Lincoln in 1862

-1865 ; Union victory over Confederates, all blacks given freedom in the U.S.

History of Africans in the US post-emancipation and the civil rights movement

-slave owners exploited African American labor through tenant farming and sharecropping

-experienced racial persecution by white supremacist groups

-by the 10th century, African Americans migrated to the Northeast for Industrial Opportunities

-racial segregation and the civil rights movement (Martin Luther King Jr, Rosa Parks, Brown vs. Board of Ed)

African Demographics

-approx 1.6 million American immigrants were of African descent

-West Africa ; Nigeria and Ghana

-East Africa ; Kenya, Somalia, Ethiopia

-more than one half of African Americans reside in the southern US, primarily in the suburbs

-the remainder live in the northeast and midwestern urban areas

African immigrants

-west africa (nigeria or ghana) ; 29% of african immigrants

-east africa (kenya, tanzania, and uganda) ; 17% of african immigrants

-eritrea (27,000) and Sudan (83,000) ; due to ethnic and civil conflicts

-less than 1% from the caribbean or central america

African religions

-the first black church (Baptist) was founded during the 1770s in South Carolina

-largest denomination ; national baptist convention of the USA

Other religions followed:

-methodist episcopal churches

-pentecostal denominations (ex: church of god in christ)

-islam

Religions followed by African immigrants:

-islam, christianity, eastern orthodox

African Family

-kinship defined the form of African societies

African American homes

-large and extended family structure

-multigeneral homes

-in 2012, 50% of African American families were headed by single women

Family Structure in Africa

-patriarchal

-arranged marriages

-families immigrating to the US ; conflict between children and parents may occur

Origins of food in Jamaica

-Arawaks (Amerindians, Tainos - Puerto Rico)

-Xaymaca

-Transferred agricultural practices, enslaved by those they taught

Jamaican Geography

-3rd largest caribbean island

-mountainous

-prone to hurricanes

Jamaican Consumption

Arawak foods

-maize

-manioc (cassava, yuca, could eat leaves)

-sweet potato

-game and fish

African foods

-plantains

-bananas

-watermelon

-tamarind

-kola nut ; water potable

weakness of manioc

-mostly carbohydrate

-monotonous part of diet

-low dietary diversity

-high calorie needs for slave labor

single crop plantations

-not foods for consumption

burden

-demands of slavery

-self sustaining food production

-people who were enslaved grew food

Jamaican cultivation

Three distinct ways of cultivation:

-individual plots

-provision grounds

-yards surrounding homes

-"negro plantations"

release owners from providing food

-salted, rotten fish

-67 hours/week

-1 year of work was 52 + 37 weeks

-crop demand competition

grew

-millet

-sorghum

-rice (hand milled, labor intensive, less prepared)

-black eyed peas

-hibiscus

-yam

-pigeon pea

-banana

-plantain

-rice

-taro

-okra

-starch/carb forward

-little protein (plant based, salted fish)

Ackee and Saltfish

A modern food of Jamaica

-national dish

-ackee (africa) and saltfish (salt dried cod)

-vegetable base ; tomato, bell peppers, onions, scallions, garlic

Ackee

-canned in brine

-saturated fat

-lower in carbs

-fiber

-some sugar and protein

-poisonous

-prepared by sauteeing

Green banana

a modern food of jamaica

-fiber

-resistant starch

-vitamins (C, B6, Provitamin A)

-minerals (zinc, magnesium, phosphorus

-prepared by boiling

-eaten as a dish ; mackerel and green banana ; veggie base ; boiled dumplings

Callaloo

-a modern food of Jamaica

-Jamaican spinach (fiber, iron, calcium, potassium)

-eaten with yams, green bananas, dumblings

-prepared by sauteeing, boiling, and with sauce

Plantains

-a modern food of Jamaica

-carbohydrate rich

-vitamin c

-minerals ; (folate, magnesium, potassium)

-prepared by roasting, frying, boiling

Saltfish

-a modern food of Jamaica

-protein, salt, little fat

-prepared by cooking boiling, soaking,

-made in the dish ackee and saltfish

-made into fritters

Jamaican special diet

Rasta and Ital

-Ital ; using things in their natural state

-Livity ; socially committed lifestyles, self-reliance, cooperative living, peaceful existence

Ital deit

- a special jamaican diet

-vegetarian or vegan

-eat plant based foods from the earth

-avoid alcohol

-most drugs

-herbal remedies

-semi organic

Jamaican public health priorities

Ministry of health and wellness

-8 priorities ; improve the health of the population with an emphasis on reducing mortality, morbidity and disability related to NCDs and their risk factors

Public Health changes

-25-30% # in morbidity and mortality due to diabetes and cardiovascular disease

Nutrition Transition

-from under nutrition to over nutrition

-home cooked to fast food

-NCD (obesity)

Jamaican migration in US

obesity changes

-national survey of American Life

-African Americans ; 36.1 %

-Afro-caribbeans ; 24%

-less access to traditional foods

-adapting traditional dishes with available foods

Food availability

-Hartford, CT

-9% Jamaican ancestry or nativity

-Traditional foods available

Obesity

-39.8% all adults

-Black men ; 36.9%

-black women ; 54.8%

Africa General Facts

Language; english

dialect ; patois

capital; kingston

population ; 2,952,824

national bird ; doctor bird

national fruit ; ackee

music ; reggae

1 usd = 140 jmd

Jamaican Breakfast

Ackee and saltfish

Callaloo (may include saltfish)

Porridge (peanut, banana, cornmeal, oatmeal)

jamaican fried dumpling

stew liver/kidney

Jamaican Lunch

-jerk chicken (grilled)

-rice and pease (kidney beans or gungo peas)

-Jamaican patty (beef, chicken, soy, veggie, cheese)

-brown stew chicken

-soup

-escovitch fish

Jamaican dinner

-Curry mutton (goat) with white rice, oxtail, and rice and peas

Combination of:

-boiled food or rice

-animal protein

-vegetables

Soup

-typically cooked in large portion to feed the family

Spices and Herbs

-scotch bonnet pepper

-ginger

-thyme

-cinnamon leaves

-peppermint

-cerasee

-fever grass

More traditional Jamaican items

-festival

-suga bun

-coconut/peanut drops

-tamarind balls

-coco bread

-mannish wata (goat soup)

-bammy

-sorrel drink

-mackerel rundown

Traditional Jamaican fruits

ackee

pineapple

mango

sweetsop

bradfruit

passionfruit

jackfruit

starfruit

avocado

otaheite apple

naseberry

passionfruit

coconut

tamarind

pear

papaya

sugar cane

june plum

star apple

Jamaican Health concerns

-high prevalence of iron deficiency

-increasing level of obesity, fat/oil intake, and salt intake

-increase in levels of hypertension, diabetes, cardiovascular disease, and stroke

Jamaica's health infrastructure challenges

-lack of adequate lab equipment in hospitals

-deterioration of buildings

-overoccupied

The future of Jamaican healthcare

-new buildings required

-infrastructure expansion required

-other facilities requiring refurbishing and support services

Traditional African Health beliefs and practices

-health maintained through harmony with environment

-causes for adverse events and illnesses: supernatural, natural, and social forces

-evil eye ; an evil gaze from one individual to another is thought to cause illness and misfortune

-african healer

Role of the African healer

-diagnose illness

-determine cause of illness

-remove evil and take measures to prevent reoccurrence

Foods of West Africa

-COASTAL ; corn, millet, rice

-SOUTHERN ; yams, cassava, plantains

-fruits ;ackee apples

-veggies ; okra

-common prep methods ;

boiling of starchy vegetables (ex: fufu from potatoes, in nigeria)

Food of east africa

(ethiopia, eritrea, somalia, sudan)

-staple foods; millet, sorghum, plantains

Ethiopia ;

-Muslim influence ; halal dietary practices

-Injera ; traditional flatbread, prepared from fermented dough

-wat ; spicy stew ; national dish of ethiopia

-berbere; hot spices

National dish of Ethiopia

Doro Wat ; a spicy stew

South Africa

-temperate climates are favorable for growing and harvesting fruits and vegetables; cucumbers, carrots, apricots, tangerines

-cuisines influenced by the dutch, british, and french settlers

meat dishes

-mutton in stews

-grape-stuffed chicken

-spicy fruit or vegetable relishes

-chutney

-dried fruit

African Special Occasions

Sunday dinners ; large family meal influenced by "the slave diet"

-fried chicken, spare ribs, black eyed peas, corn, greens, potato salad, rice

-sweet potato pie

-homemade fruit wines

Christmas

-turkey with cornbread stuffing

-baked ham

-desserts: fruit cakes, cream pies, cobblers, coconut cake

Kwanzaa (dec 26-Jan 1)

-created in southern california in 1966

-a candle is lit each day to symbolize 1 of 7 principles (unity, self determination, collective work and responsibility) (cooperative economics, purpose, creativity, faith)

-dishes from Africa, the caribbean, and the southern US are prepared

Child naming ceremonies in nigeria

-performed by the grandmother, who offers symbolic foods to the infant

African Therapeutic uses of food

-maintenance of healthy by eating three hearty meals, which includes a hot breakfast

high blood

-african belief

-thought to be caused by excess blood moving to one part of the body, usually the head, and consuming an excess amount of rich foods, sweet food, or red colored food (red wine, red meat, beets)

low blood

-african belief

-associated with anemia

-caused by eating too much astringent (tea) and acidic foods or beverages (vinegar, lemon juice) and not enough red meat

Pica

-practice of eating nonnutritive substances (clay, chalk, laundry starch)

-research has indicated that pica is most often practiced among black women during pregnancy and postpartum period

regional differences

-rural ; clay

-urban ; laundry starch

possible causes

-need for minerals, hunger or nausea, need for special treatment, cultural treatment

Native American overview

-comprise the largest number of ethnic groups of any minority populations in the US (400 american indian and alaska native nations)

-population ; 5 million

-tradiitonal foods that influenced US diet ; corn, squash, beans, cranberries, maple syrup

Native American Migration and Settlement patterns

-arrive in north america approx 20,000-50,000 years ago crossing bering strait

-known for not documenting written info about their history

-white settlers provided written documentation and commentaries

-decline in population due to european diseases, conflicts/massacre of nations, and white settlement westward

Bureau of Indian Affairs

BIA

-oversee federal indian reservations

-attempted to establish a program of cultural assimilation (unsuccessful)

-BIA employment program ; out migration of Native Americans from reservations to major cities (LA, NYC)

Native Food Circle

fruit, protein, vegetables, and carbs are all 1/4

dairy is not found in the native food circle

Adobe ovens

-used by native americans for food preparation

-southwestern native americans

-used for preparation of cornmeal bread

Southwestern US NAtive american food

green chili stew, fry bread, feast day cookies

Northeastern US Native American Food

iroquois soup or duck with wild rice

bannocks

indian pudding or maple popcorn balls

strawberry juice

Diabetes in native americans

native american adults have more diabetes than any other race or ethnicity

Kidney failure in native americans

kidney failure from diabetes in native americans has dropped more than any other race or ethnicity

why?

the following have improved:

diabetes clinical teams

diabetes patient registries

nutrition services for adults

access to registered dieticians

access to physical activity specialists

access to culturally tailored diabetes education materials

Where is Cambodia

southeast asia

Neighboring countries of cambodia

Thailand

Laos

Vietnam

Capital of Cambodia

Phnom Penh

Cambodia Facts

population - 15,205,539

Language ; khmer

religion; buddhism

Cambodia History

Angkor Empire

-peak from the 10th and 13th centuries

-declined due to attacks by Thai and Cham (now Vietnam)

Late 1800s

Cambodia under french rule until 1953

Khmer Rouge (1975-1979)

Communist party, led by Pol POt, gained Cambodian rule in 1975

Consequences : evacuation of Phnom Penh, major cities

agricultural society and elimination of social classes

citizens were deprived of their basic rights, many died of starvation, exhaustion, diseases or execution

Cambodian Family Structure

-large, extended family

-father ; authoritative figure

-valuing elders

-good behavior by the children

Cambodian Tradition and Holidays

Khmer New Year (chaul chhnam Thmey) - mid April

-people go to the temple and pray

-celebration with food, drink, games

Thanksgiving - september or october

-the deceased family members are honored in prayer, food is prepared for the deceased spirits

Traditional Cambodian foods

-Nom Ban Chok (khmer noodles)

-Lok Lak (stir fry beef w vegetables)

-Bo Bor (rice porridge) ; consumed plain or with vegetables and animal protein, breakfast food or used for treating illnesses

-Pra Hok (fermented fish paste)

Cambodian Nutritional status

Cambodian Americans in the US

-poor mental health status

-high rates of chronic disease

-food insecurity

-previous food deprivation may be associated with : dietary behaviors (eating chicken with skin) , classified as overwight or obese

The Mediterranean Diet

-promotes intake of grains, legumes, vegetables, fruit, and wine

nutrients : complex carbohydrates and phytochemicals

-low intake of meat and dairy, also fat

-most of fat consumed is from olive oil

Cities Dr. Chea visited

Madrid

Barcelona

Granada

Malaga

Traditional Foods of Cambodia

Tortilla Espanola ; potato omelet and thought to be the national dishof Spain

- appetizer, snack, or filling for bocadillos (sandwiches comprised of a baguette, protein, and vegetables - see Barcelona and Granada slide)

Patatas bravas ; potatoes topped with a spicy sauce

Gazpacho ; tomato soup served cold

Paella ; popular in coastal regions

-saffron-seasoned rice topped with chicken, mussels, shrimp, sausage, tomatoes, and peas

Tapas

small appetizer dishes

Piononos

Custard like dessert local to Granada, Spain