Ch 13 People of the Balkans

Regional Variations: Middle East

-3 areas: (Greek/Turkish; Iranian; Arabic) -Similarity is striking -Greek/Turkey feature more meat, fish/seafood, cheese, butter and olive oil (Spankopita, caviar dip, salads) -Arab fare: grains, legumes, veggies (Kibbeh, Ful medames, Pacha) -Iranian: wide variety of fruits and vegetables, rice, tea, eggplants called Persian cuisine, based on Persian royalty -Israel's food and culture most varied- blends Middle Easstern with Jewish immigrant groups

Meal Comp: Daily Balkan Patterns

-3 meals/day -Light breakfast, main meal at midday -Snacking prevalent -Mezze: small dishes of various items widely available from street vendors

Family (Middle Eastern)

-Arab families: strong patriarchal family whose honor must be maintained -Demand conformity/subordination -Extended family members live in single home/family compound -(Egyptians traditionally live in nuclear family groups) -Men & women equal but with different roles/responsibilities -Children valued -Men are providers, women are socializers -Marriage contracts arranged; many marry cousins -Egyptians/Arab Christians do not -Egyptians are more westernized

Romanian Fare

-Between West and East -Turkish/Hungarian overtones -Many are Eastern Orthodox

Meal Comp: Middle East

-Coffee/Tea served early 7 or 8, then light meal bread, cheese, beans, eggs olives -Lunch: main meal, early afternoon -Dinner may be leftovers from lunch -Served all at once, except Jordan, Lebanon, Syria

Regional Variations: Balkans

-Combine Europe, Middle Eastern elements -Northern: more influenced by Europe (ex. Romania) -Southern: more influenced by Middle East (Greek considered Turkish, includes Albania) -Fruits are cooler weather -Desserts: dumplings, strudels, compotes

Religions of Middle Easterners

-Early immigrants were Christian (E.Orthodox) -Egyptian Coptic Church: oldest Christian following in the world -Recent immigrants: Islam (Sunni Muslims) -Friday Sabbath moved to Sunday in Iran -Bahai faith: offshoot that renounced ties to Islam -Turkish Americans: Sunni Muslim -Israeli Americans: typically Jewish

Hospitality and Generosity

-Essential for social status -Extravagance in serving guests, sharing food when eating in front of others -People are expected to share food with those who may be watching them eat -People w/ diabetes advised to take with them extra portions of food

Fatalism vs. Free Will

-Fatalism: all events are predetermined in advance for all time and human beings are powerless to change them -Weaknesses/downfalls are attributed to God's will -Fatalism causes lack of motivation, clients are unmotivated to change lifestyle behaviors that put them at risk

Form vs. Content

-Form of speech is emphasized at expense of its content and meaning -Positive response does not impose obligation to action -Client may state intentions that they may not actually carry out -Recommended to apply plan of action and discuss perceived barriers

Therapeutic Uses of Food- Balkans

-Fresh foods considered best (canned/frozen may be avoided) -Amount of food special concern (food deprivation causes illness) -Iran: hot-cold shift in food can cause illness (Temperature, not spiciness causes shift; digestive system must have time to adjust to one extreme) -Incompatible foods may be damaging to health -Egyptians: no fish with dairy -Some avoid eating sour foods with milk -Iran: no melon with yogurt (wind in stomach) -Many special foods associated w/ childbirth -Division b/t food and medicine is blurred

Olives/ Olive Oil

-Generally eaten cold in meals -World's oldest fruit -Extra virgin: first pressing

Special Occasions

-Greek Easter: Red eggs, Easter bread, roast lamb -Croatians: Christmas eve cod, stuffed cabbage, sauerkraut -Serbians: Patron Saint's Day, St. Nick's / St. Martin's Feast

Religions of the Balkans

-Greek/Greek American: Greek E. Orthodox Church -Serbs: Serbian Orthodox Autonomous Church -Croatians/Slovenians: Roman Catholic; some Slovenians are protestants -Windish: In the US, associated with Lutherans

Worldview: Family (Balkans)

-Greeks, Croatians, Serbs: strongly patriarchal

Fatness vs. Thinness

-Health and weight in Arabic language used interchangeably -Fatness is associated w/ good health, strength, wealth, prestige -People may not be willing to lose weight

Health Beliefs/Practices: Middle Easterners

-Iranians: traditional humoral medicine (HOT AND COLD ONLY; people born with a physiological temperament) -Women are colder than men -Younger people are hotter than older -Iranians are concerned about blood content -Narahati: physical/emotional discomfort -Narahati qalb: heart distress; from strong expression of anger/sadness -Tradition of home health -Fold remedies common, herbal remedies prevalent -Wasm (cauterization): heated rod places symbolic burn marks on a patient in the location of ailment -Cupping: leg pain, paralysis -Mental illness: possession by devil -Health is in God's hands; illness may be seen as punishment

History of Balkans in US

-Late 1800s early 1900s after WWII -Early immigrants came for economic opportunities -Bosnian refugees came in early 1900s seeking refuge from ethnic cleansing -NYC: largest concentration of Greek Americans (unemployment low, families living below poverty is below avg) -Midwest: Croatians/Serbs -Ohio: Slovenians

Staples (Food Habits)

-Loaves and flatbreads (pita, lavash) -Wheat doughs for pies/turnovers (phyllo) -Bulgur: cracked whole wheat steamed/crushed for tabouli -Rice pilaf -Falafel w/ lentils -Fava beans in pita bread w/ raw veggies, may help blood pressure -Eggplant is most popular -MOUSSAKA: minced lamb, eggplant, onions, tomato sauce -Fruits preferred fresh -Fruits added to savory dishes -SLATKO: fruit simmered in thick syrup -Dairy fermented into yogurt/cheese -Camel's milk: high in vitamin C; Kefir is fermented camel's milk; lower in fat and lactose, higher in potassium, iron, vitamin C -Most meat and seafood consumed -Lamb most popular, pork also popular -SOUVLAKI: thin slices of lamb layered onto rotisserie, may be made into GYROS -Numerous spices/herbs from former spice trade -VERJUICE: from unripe lemons, gives sour taste to dishes

Nutritional Status: Intake

-Mediterranean: low saturated fat, high monounsaturated fats, high omega 3 fatty acids -Lower risk of CVD, cancer -Diet becoming more westernized -Alcohol consumption not fully understood -Obesity: Greece (50% women, 75% men) -High prevalence of undiagnosed problems (Type 2 diabetes, hypertension, insulin resistance) -Turkey: CVD most common cause of death -Breastfeeding rates high (strong support network) -Turkish moms nurse sons longer b/c breast milk believed to increase strength -Iran: celiac disease is primary source of diarrhea

Conformity vs. Rebellion

-Middle Easterners value conformity, uniformity, homogeneity -Conformity leads to social prestige and honor, failure to conform brings shame

Ramadan

-Month Muslims fast sunrise-sunset -Break fast with iftar: dine with relatives and neighbors, meal is light, avoid salt -Eid al-Fitr: Follows end of Ramadan, cross between Thanksgiving/Christmas -Eid al-adha: Feast of Sacrifice held with annual pilgrimage to Mecca -Ramadan fasting has no significant changes in body weight; increases in uric acid blood level -Pregnant women can fast safely

Health Beliefs/Practices: Balkans

-Most care provided by mothers/grandmothers -Herbal pharmacy for therapeutic teas -Cupping w/ bloodletting to release toxins -Severe conditions: midwives/bonesetters -EVIL EYE : FROM ENVY; causes accidents/illness -Wear garlic and blue amulets with eye in the center -Receive a compliment: spit to keep harm away -Wind/air cause illness -Lebanese Muslims: women vulnerable to wind after childbirth

Iran

-Most significant holiday is Muharram: martyrdom of Mohammed's grandson (mourning, penitence for Shiites) -Nau Roz: Spring festival w/ special meal, ceremonial table setting, 7 foods start w/ S

Israelian Families

-Nuclear families -Kibbutzim: rural settlement where families live and work communally -Children raised by age-level -Community meals -Home typically patriarchal, women well-eduated and many employed

Moroccan Cooking

-Part of Maghreb, region of North Africa -Cooking is Berber in origin -Exquisite seasonings -Couscous is a staple: crushed semolina -Food eaten w/ first 3 fingers of right hand

Northern Balkans

-Pork/veal w/ German style sausage -Pljeskavica -Potatoes, cabbage, cucumbers, mushrooms

Albanian Fare

-Regional discord, shifting boundaries -Influence of Greece, Turkey, Italy, Armenia, Russia -Vegetables pickled as side dishes -Fruits only eaten fresh, desserts/preserves -ALWAYS prepared separately

Cultural Perspective

-Retain strong ethnic identity in the US -Temperate in climate, suited to agriculture but some mountainous regions -Very diverse in religious affiliation

Turkey

-Seker Bayram is Eid al-Fitr known as Sugar Festival, gifts exchanged -10th day of first lunar month: martyrdom of Mohammed's grandson -Kurban Bayram: remembrance for Abraham almost sacrificed his son

Shame vs. Guilt

-Shame: external judgment -Guilt: internalized self punishment -Shaming is used for controlling/modifying behavior -Diabetes and male impotence; evokes a psychosocial feeling of shame -Client may avoid any behavior in public that is shamed, would reveal his/her illness -Suggest way for clients to adhere to recommendations without disclosing his/her illness

Sheep's Milk vs. Goat's Milk

-Sheep's milk is rich -Goat's milk is leaner, less calories but more sodium

History of Middle East in US

-Statistics inexact -Until 1900s: all Egyptians -Later termed Syrians/Turks from Asia -Early Arab immigrants: economic opportunity -One of the fastest growing ethnic groups in America -Most are now Muslim; prefer to be called ARAB -Israeli immigration: 1950, after independence of the nation -Iranian/Turkish Americans do well with income & education

Israel

-Traditional holidays of the Jewish calendar -Sabbath: sunset Friday to sunset Saturday (businesses close, work is prohibited) -Friday Meal: white linen, traditional cup of wine -Saturday's food must be prepared Friday -Independence Day celebrated with barbecues

Middle East

-Turkey: Meals vary slightly, served on large tray -Israel: breakfast light but Sabbath breakfast heartier; midday meal largest -Hospitality is a duty; family's status measured by how guests are treated -Invited guests bring a gift which will be served -What food and its order expresses recipients status (sex, age, family, social rank) -Guests entertained in separate room before meal -Always wash hands before eating -Muslim areas: Allah is thanked before and after meal -3 fingers of right hand if forks/spoons not offered -Women never eat food eaten by a Muslim man who is not immediate family

Vertical vs. Horizontal Relations

-Vertical: patriarchal family, society hierarchy -Communication pattern is as follows, expected to comply -Health care provider is viewed as a judgmental authority figure; it is recommended to start out w/ vertical relationship and gradually introduce horizontal

Traditional Food Habits: Balkans

-Wheat, olives, dates -Sheep -Rice, chickpeas, lemons -Christian areas in Greece: lamb preferred -Alcohol banned for Muslims; widely consumed in Turkey b/c proximity to Russia

7 Species

1) Wheat 2) Barley 3) Fig 4) Pomegranate 5) Olive 6) Grapes 7) Date honey

Cold Food

Beef, Cucumber, Tomatoes, Eggplant, Grape leaves, Lemons

Hot Foods

Lamb, Eggs, Onions, Garlic, Carrots, Peppers, Apples

Collectivity vs. Individuality

People in society behave as committed members of a primary group rather than independent individuals. -Client's relationship with primary group may need to be addressed in relation to compliance