CH:11 Nutrition and Culture- DUDEK

RESPONSES TO STUDENT LEARNING OBJECTIVES
  1. Suggest ways to eat healthy while eating out (FAFH)

    • Plan ahead by checking menus and select restaurants with healthy options.

    • Avoid arriving at the restaurant on an empty stomach to prevent impulsive, calorie-dense choices.

    • Practice portion control by asking for a half-portion or taking half the meal home immediately.

    • Substitute fried items with steamed, grilled, or baked alternatives and request sauces on the side.

    • Balance the day’s remaining meals by eating lighter at home to compensate for restaurant-consumed calories.

  2. Describe the characteristics of traditional food practices for different cultural groups in the United States

    • Black Americans (Soul Food): High in fat, sodium, and cholesterol; involves frying and long-cooking vegetables with fatty meats.

    • Mexican Americans: High-fiber, low-fat diet featuring corn, beans, rice, and squash with limited animal protein.

    • Asian Americans: High in complex carbohydrates and vegetables; rice or wheat staples; uses meticulous preparation and little dairy.

  3. Discuss the nutrition-related health concerns of different cultural groups in the United States

    • Black Americans: Highest rates of morbidity and mortality for hypertension, heart disease, stroke, and diabetes.

    • Hispanic/Latino Americans: High prevalence of obesity and Type 2 diabetes (twice the risk compared to White Americans).

    • Asian Americans: Risk of diabetes at lower BMI values due to visceral (abdominal) fat; high rates of COPD and tuberculosis.

  4. Explain the general ways in which people’s food choices change as they become acculturated to a new area

    • Breakfast and lunch typically change first to convenient, processed American options.

    • Intake of sweets, fats, and manufactured foods increases while fiber and vegetable intake often decreases.

    • Second-generation individuals may restrict traditional foods to holidays or family gatherings.

  5. Summarize dietary laws followed by major world religions

    • Christianity: Varies (Lent fasts for Catholics; lacto-ovo vegetarianism for Adventists; no caffeine for Mormons).

    • Judaism: Kashrut laws forbid pork, shellfish, and mixing meat and dairy; blood must be drained from meat.

    • Islam: Halal (permitted) vs. Haram (forbidden); no pork or alcohol; requires ritual slaughter.

    • Hinduism/Buddhism: Frequently vegetarian due to the principle of ahimsa (non-violence); Hindus avoid beef.

THE SIGNIFICANCE OF FOOD
  • Maslow’s Hierarchy: Food and nutrition are ranked at the same level as air as basic necessities of life. Unlike air, food provides more than physical sustenance.

  • Multidimensional Meaning: Food is loaded with personal, social, and cultural meanings that define values, beliefs, and customs.

  • Art and Science: Nutrition involves balancing wants with needs and pleasure with health to nourish the body, mind, and soul.

  • Culture Defined: The total way of life of a population at a given time. It defines:

    • How food is handled, prepared, and consumed.

    • What is considered edible and safe.

    • Relationship between food and health.

AMERICAN CUISINE AND FAFH
  • Melting Pot Nature: American cuisine melds globe-spanning cuisines (e.g., Tex-Mex wontons). Inventions like Russian dressing and chili con carne are uniquely American.

  • Food Away From Home (FAFH):

    • Accounts for over 40\% of total food spending.

    • Provides approximately \frac{1}{3} (33\%) of total calorie intake for adults over 20.

    • FAFH contains on average 200-300 more calories per meal than home-prepared equivalents.

    • Generally higher in calorie density, sodium, and fried components compared to home meals.

  • Strategies for Healthy Dining:

    • Familiarize yourself with nutritional terminology to avoid hidden fats.

    • Balanced remaining meals for the day around the FAFH meal.

    • Use portion control methods.

BODY IMAGE AND CULTURE
  • U.S. Perceptions: Thinness is equated with beauty, status, and health. Obesity is often viewed as a character flaw.

  • Cultural Variations: African, Mexican, Native American, and Pacific Islander traditions often view being overweight as a sign of health, beauty, and prosperity.

  • Historical Views: Historically, thinness was a risk factor for poor health or poverty.

DIETARY ACCULTURATION
  • Definitions:

    • Acculturation: Adopting dominant culture beliefs/behaviors.

    • Dietary Acculturation: Adopting the eating patterns of the host country.

  • Generational Progress:

    • First-Generation: Adheres closely to native patterns.

    • Second-Generation: Often limits traditional foods to special occasions/holidays.

    • Children: Adopt new habits quickly through peer influence at school.

  • Nutritional Impact: Linked to increased chronic disease risk. Breakfast and lunch change before dinner.

  • Counseling Recommendations: Focus on portion control and substituting low-sodium/low-fat versions of traditional ingredients (e.g., light soy sauce) rather than elimination.

    • Inclusion over Exclusion: Do not tell a patient to stop eating their traditional foods.

    • Modifications: Recommend brown rice instead of white, or using vegetable oil instead of lard.

CULTURAL GROUPS IN THE U.S.

BLACK OR AFRICAN AMERICANS

  • Soul Food: Staple items include corn products, biscuits, black-eyed peas, catfish, chitterlings, and ‘greens’. High in fat and sodium; low in potassium and calcium.

  • Health Beliefs:

    • Natural Illness: Caused by cold, dirt, or improper diet.

    • Unnatural Illness: Caused by witchcraft or social conflict.

  • Health Statistics: Highest morbidity/mortality from hypertension and heart disease. Adults are 66 cases per 1000 more likely to have diabetes than Whites.

HISPANIC OR LATINO AMERICANS

  • Mexican Subgroup: Traditionally low-fat, high-fiber (corn, beans, squash).

  • Acculturation impact: Shift toward flour tortillas over corn; increase in non-homemade meals and fast food.

  • Health Beliefs: Influence of Roman Catholicism; illness may be seen as ‘evil eye’ or divine punishment.

  • Health Statistics: Over 2x Type 2 diabetes risk. Life expectancy is longer than White Americans (84.1 years for women).

ASIAN AMERICANS

  • Traditional Diet: High in rice/wheat and vegetables; low dairy (common lactose intolerance); high sodium (soy sauce/preservation).

  • Health Beliefs (Chinese):

    • Yin & Yang: Balance of hot/cold energies.

    • Medicinal Foods: Eating fish eyes for vision.

  • Health Statistics: Lowest obesity prevalence. Diabetes risk occurs at lower BMI values (BMI < 25) due to visceral (abdominal) adiposity rather than peripheral fat.

FOOD AND RELIGION

CHRISTIANITY

  • Roman Catholic: Meat abstinence on Ash Wednesday/Fridays of Lent; fasting before communion.

  • Church of Latter-day Saints (Mormon): No alcohol, coffee, tea, or tobacco. Fasting once monthly.

  • Seventh-Day Adventist: Focus on lacto-ovo vegetarianism. Meals spaced 5-6 hours apart (no snacking).

JUDAISM (KASHRUT)

  • Allowed: Kosher mammals (split hoof/chews cud, e.g., cow, sheep), kosher birds, and fish with fins/scales (e.g., salmon).

  • Prohibited: Pig, carnivorous animals, shellfish, blood.

  • Mixing: Milk and meat cannot be combined or eaten together within a specific timeframe.

ISLAM (HALAL/HARAM)

  • Haram (Prohibited): Pork, alcohol, blood, decaying carcasses, carnivorous animals.

  • Halal (Permitted): Properly slaughtered animals. Food/health are viewed as acts of worship.

HINDUISM AND BUDDHISM

  • Hinduism: Aim for spiritual purity; cattle are sacred (no beef). Most are vegetarian (ahimsa).

  • Buddhism: Focus on non-harming; many are semi- or full vegetarians.

REVIEW QUESTIONS AND ANSWERS
  • Question 1: Which of the following religions does not encourage a vegetarian diet?

    • Answer: 2. Judaism (Judaism permits kosher meats; the others either mandate or strongly encourage vegetarian habits).

  • Question 2: Characteristics of a traditional Chinese diet:

    • Answer: 2, 3, 4 (Low in fat, high in sodium, extensive use of vegetables. It is specifically low in dairy).

  • Question 3: Best approach for an overweight woman from Mexico:

    • Answer: 2. Encourage more nutritious food choices (Focusing on appearance or strictly American foods is not culturally competent; emphasizing traditional fiber/grains is better).