Culture and Health on nutrition part 1 & 2

Culture

overrides flavour in determining what is offensive or unacceptable e.g. rattle snake.

African American Traditional food

"Soul food" which is high in fat cholesterol and sodium.

Dietary Acculturation

1. Acculturation is the process that occurs as people who move to a different cultural area adopt the belief, values, attitudes, and behaviors of the dominant culture; not limited to immigrants but affects anyone who moves from one community to another. 2. Dietary Acculturation Occurs when eating patterns of immigrants change to resemble those of the host country. 3. In United States acculturation is linked to increased risk of chronic disease and obesity.

Chinese American Health beliefs

1. Belief that health and illness are related to the balance between yin and yang forces in the body. 2. Yin represents female, cold, and, and darkness; yang represents male, hot, and light. 3. Disease caused by yin forces are treated with yang food, and disease caused by yang forces are treated with Yin food. 4. Pregnancy is considered Yang or hot therefore eats Yin food like fruits and vegetable, seaweed, cold drinks, juices, and rice water. 5. Yang food includes chicken, meat, pig's feet, meat broth, nuts, fried food, coffee, and spices.

Chinese Americans.

1. Chinese Americans use variety of vegetables, sea vegetables, fish, nuts, seeds, beans, soy foods, vegetables and nut oils, herbs and spices, tea, wine, and beer. 2. The Asian American has the lowest risk of obesity and diabetes when compared to other cultures like African Americans and Mexican Americans 3. Use few daily products lactose intolerance is common. 4. Calcium is provided by tofu, small fish (bones are eaten), and soups made with bones that have been partially dissolved by vinegar. Sodium intake is generally high e.g. soy sauce. 5. Most Asian cultures consume a lot of soup with their meals; soups are low in fat than any other Asian diet.

Cultural values

1. Cultural values define desirable and undesirable and undesirable personal and public behaviour and social interaction. 2. Understanding the client's cultural values and their impact on health and food choices facilitates cross- cultural nutrition care. Food customs originate in one's culture and are based on one's religion and nationality 3. During illness patient will do much better with food familiar to them or from their own cultures, so as nurses you should always inquire and include the patient's favorite foods when planning a diet. And also respecting patient's cultures and values.

Health Beliefs

1. Each culture has a unique point of view on life, health, and illness, and the meaning of each society. 2. Almost all cultures define certain foods that promote wellness, cure disease, or impart medicinal properties. 3. For instance, hot oregano tea season with salt is used to treat an upset stomach in Vietnamese culture. 4. Culture also shapes body image. In US "you can never be too thin," and thinness, particularly in women, is equated in beauty and status. 5. Overweight and obesity may be viewed as a character flaw. 6. Conversely, thinness has historically been a risk factor for poor health or associated with poverty. While in other cultures like African, Mexican, American Indians, and Caribbean Islanders overweight is a sign of health, beauty, and prosperity.

Points to Consider Regarding Dietary Acculturation

1. Generally, with acculturation, the intake of sweets and fat increases, neither of which has a positive effect on health. 2. Because dietary acculturation is most likely to change food choices for breakfast and lunch rather than dinner, focus on promoting healthy "American" food choices for those meals. 3. Portion control is a better option than advising someone to eliminate an important native food from their diet. Lower fat or lower sodium options, when available, may also be an acceptable option for the client. 4. It is also essential to determine how often the food is consumed in order to determine the potential impact of that food. For instance, lard is unimportant in the context of the total diet if it is used in cooking only on special occasions 5. Don't assume the client knows what American foods are considered healthy. 6. Suggest fruits and vegetables that are similar in texture to those that are familiar but unavailable to the client.

African American Nutrition -Related Health problems

1. Have high intake n fat than whites 2. Have high prevalence of obesity 3. Have high rate of death from heart disease, stroke compared to whites (per national health disparity report)

HISPANICS IN MINNESOTA

1. Hispanic, refers to the Spanish language, not place of origin 2. Social Structure - Spending time with family and friends are vital parts of life 3. Diet - tends to be low in fruits and vegetables and high in flour tortillas, white rice, and processed foods 4. Religion - Roman Catholic Christians, 5. Medical Care - diabetes 6. Family includes people of mixed ancestry who share historical backgrounds, cultural traditions, and the Spanish language. 7. Diabetes is twice as prevalent in the Hispanic/Latino population as in the white population 8. Some lactose intolerance 9. Establish a relationship with the family before care begins and Acknowledge male family members who are present

HMONG in MINNESOTA

1. Hmong (the H is silent) 2. Originally lived in the mountains of South China 3. Social Structure - Hmong are organized into 18 clans determined by ancestral lineage. 4. Diet - rice, noodles, fish, meat, and green vegetables with hot chili sauces 5. Religion shaman is a religious leader who makes all decisions related to spiritual healing and conducts religious ceremonies. 6. Medical Care - chronic obstructive pulmonary disease, diabetes, congestive heart failure, and hypertension. 7. With older Hmong avoid direct eye contact - is considered to be rude. 8. Hmong people originally lived in the mountains of South China, Laos, Vietnam, Burma, and Thailand. 9. They have large, extended families and practice traditional ceremonies to remember their ancestors. Clan leaders are the key decision makers 10. Hmong tend to eat the same types of food at each meal, with very little fruit or dairy products. 11. Hmong people often prefer hot dishes and drink hot or warm water. Traditionally, a sick person must eat hot food with certain vegetables. 12. The adoption of a Western diet and sedentary lifestyle has led to a dramatic increase in the prevalence of diabetes. 13. Refugees 30 years of age or older may have long-term effects from malnutrition and exposure to yellow rain and other war zone chemicals. Many refugees have intestinal parasites, tuberculosis, anemia, depression, and post-traumatic stress syndrome.

Mexican American Nutrition -Related Health problems

1. Mexican Americans use a lot of fruits and vegetable intake when compared with other ethnic cultures. 2. However, Mexican born American residents have decreased of fiber, and fruits intake and increases in fast-food, and salty snacks. 3. Based on statistic for 2007-2010, the prevalence of obesity is 36% among Mexican males and 44% among Mexican females 4. Higher prevalence of type 2 diabetes.

Ethiopians in Minnesota

1. Minnesota has the largest Ethiopian refugee population in the world 2. Socially - speak softly and politely - modesty is important - match the genders of the interpreter and patient 3. Religion - half of the population in Ethiopia is Muslim, and half Christian 4. Medical Care - long-term effects of malnutrition, physical and psychological trauma from war, and infectious diseases, including sexually transmitted infections 5. Family members usually attend to the needs of the sick. They can overindulge the patient—rather than encouraging self-care and attempts at recovery

Some cultures in Minnesota, Russian

1. Minnesota has the largest Russian community in the Midwest 2. Social Structure - the strongest personality is usually the head of the family 3. Diet - high in fat, carbohydrates, and sodium 4. Religion - Judaism or Eastern Orthodox Christianity 5. Medical Care - diabetes, hypertension, coronary disease, gastrointestinal problems, tuberculosis, mental illness, and alcohol and substance abuse 6. Compared with other major immigrant populations in Minnesota, Russian Americans are generally older (83 percent are age 50 or older), have fewer children, and are more educated (95 percent have at least a high school diploma). 7. Diet high in fat, carbohydrates, and sodium, contributing to health problems that include diabetes, hypertension, and coronary and gastrointestinal diseases. 8. Some Russians believe that disability or illness is caused by something the individual did not do right, such as not eating well or not dressing warmly enough 9. Bad health news is not given to a person who is ill or disabled. The family does not want the person to become anxious. It is commonly believed that the individual needs to be at peace so physical and emotional conditions do not worsen

Somalis in Minnesota

1. Minnesota has the largest Somali population in the U.S. 2. Social Structure - family and clans 3. Diet - rice, bananas, and the meat of sheep, goats, and cattle, with little fresh fruit or vegetables 4. Religion - Sunni Muslims 5. Medical Care - recent immigrants to the US are malnutrition, iron deficiency anemia, Vitamin A deficiency, and scurvy 6. Death and Dying - is considered uncaring for a health care provider to tell the dying person s/he is dying. 7. Families traditionally live in multi-generational households 8. Under Islamic law, a man may have as many as four wives if he can support them equally, and under law, he is bound to support his children 9. the father is the decision-maker and wage earner for the family, 10. Coffee and teas are preferred Somali drinks. 11. Somali men and women eat separately in gathering like mosque otherwise, families can eat together 12. Ramadan is observed as the most important Islamic holiday, a month long holiday during which people refrain from taking medications, and eating and drinking during daylight hours, with the exception of pregnant women, the very ill and young children.

Chinese American Nutrition -Related Health problems

1. The traditional Chinese diet is low in fat and dairy products and high in complex carbohydrates and sodium (Kittler et, al., 2012). 2. Due to acculturation the diet becomes higher in fat, protein, sugar, and cholesterol 3. Prevalence of obesity is low at 11.6% 4. Have same rate of diabetes as whites 5. Cancer is the leading cause of death among Asian American e.g. prostate cancer, stomach cancer and breast cancer.

Mexican Americans

1. Traditional Mexican diets are influenced by Spanish and Native American cultures 2. Generally are low -fat, high fiber diet rich in complex carbohydrates, and vegetable proteins, with emphasis on corn, corn products, beans, and rice. 3. Tortilla-based dishes. Milk is not widely used lactose intolerance is common. 4. Salsa is consumed a lot in Mexican culture or included. Salsa predominantly contains tomatoes, onions, and peppers, all which are low in fat. 5. Health Beliefs: illness is inevitable and to be endured. Certain foods may be considered "cold" or "hot" for healing purposes. 6. Prayer is appropriate for all illness, and lighting of candles on behalf of a sick person is common

When and how food is eaten

A. All cultures eat at least once a day B. Some may eat five or more meals each day C. Time of meals time differ from cultures to cultures and also per geographical region.

Symbolic use of foods

A. Each culture has food customs and bestows symbolism on certain foods. B. Customs determines what foods are served as meals versus snacks and what foods are considered feminine versus masculine. C. Culture also determines which foods are used in celebration and which provide comfort. D. People who move to other cultures may retain their own cultural comfort foods a link with the past.

The role of certain foods in the Diet

A. Every culture has a ranking for its foods that is influenced by cost and availability. B. Core food provides a significant source of calories and is regularly included in the diet. C. In much of the world, high fat diets have replaced traditional diets high in complex carbohydrates.

Cambodians (Khmer) in Minnesota

A. Social - They speak Khmer, Chinese, Vietnamese, and French. B. Communicate indirectly C. Diet - Food is deemed either hot, cold, or neutral D. Religion - Buddhists E. Medical Care - endure pain stoically F. Throughout history, their culture has been heavily influenced by Thailand, Laos, China, and IndiaG. be respectful, polite, and speak softly H. raise large families I. Spokesperson for the family may be the father, or the eldest son or eldest daughter. J. Theravada Buddhists. Food is deemed hot, cold, or neutral. For example, chicken is hot, vegetables are cold, and rice is neutral L. Khmer people who eat a traditional Cambodian diet eat rice at all three meals and prefer warm tea or water to drink. Most Khmer do not use ice and rarely consume dairy products. Many are lactose intolerant.M. May fear surgery and giving blood due to the belief that these procedures will result in heat loss.

Culture has a profound and unconscious effect on food choices. Yet within all cultures, individuals may behave differently from the socially standardized food way due to:

Age, Gender, State of health, Household structure, Socioeconomic status

Culture:

Encompasses the total way of life a particular population or community at a given time.

African Americans

Majority can trace their ancestors to West Africa, although some have emigrated from Caribbean, Central Africa and East African countries

Think about food and religion. What do you know about this Islam (Halal)?

Proper or legitimate, Ritually acceptable; most often used in the context of the slaughter of animals for meat; also refers generally to Muslim dietary regulations the food permitted in compliance with Islamic Law

Dietary Acculturation

Think of how one's cultural influences nutritional practices. Look back into your family linkage trees

To be labelled

a food item must be readily available, safe, and nutritious enough to support reproduction, However, cultures do not define as edible all sources of nutrients that meet those criteria. For instance, in US. Horsemeat, insects, and dog meat are not considered food, even though they meet the food criteria.

How food is prepared

a) Traditional method of preparation varies between and within cultural groups. For instance, vegetables often are stir-fried in Asia cultures but boiled in Hispanic cultures b) Choice of seasonings varies among geographic regions and between seasons, based on availability. c) Within home-prepared meals, seasonings are adjusted to suit the family's preferences. d) Many religious groups have specific dietary laws that they must be followed.

Religion, culture and beliefs

are all component of cultural assessment.

Race, ethnicity, and geographic region

are often inaccurately assumed to be synonymous with culture. The misconception may lead to stereotyping a group. For instance, some of stereotypic such as "Jews adhere to orthodox food laws or that all Southerners eat sausage, biscuits, and gravy.

Culture

determines what is edible and what is inedible.

some religions, such as Judaism and Islam,

have specific laws regarding food. It is important for you to assess the extent to which Jewish or Muslim patients adhere to Kosher or Halal (Islamic) dietary practices, so that appropriate meals are served when patients are cared for in the home or the hospital. Orthodox Jewish beliefs adhere to kosher dietary laws. In this religion, the dairy-meat combination is unacceptable. Only fish that have scales and fins are allowed; meats that are allowed include animals that are vegetable eaters, cloven-hooved, and ritually slaughtered. It is also important just don't assume that someone is Jewish and follows Kosher, or someone has an Arab name and is assumed he/she is a Muslim. There are Arabs who are Christians. So do your homework be culturally competent.

Think about food and religion. What do you know about this Christianity Ash wednesday or Friday lent

holy day of prayer, fasting, and repentance. Abstain from meat

Food customs originate

in one's culture and are based on one's religion and nationality. This applies to most cultures.

Think about food and religion. What do you know about this Judaism (Kosher)?

kosher dietary laws. In this religion, the dairy-meat combination is unacceptable. Only fish that have scales and fins are allowed; meats that are allowed include animals that are vegetable eaters, cloven-hooved, and ritually slaughtered.

Acculturation

the extent to which immigrants adopt attributes of a new culture, can also influence dietary practices, so don't stereotype, don't assume

The nurse must first identify

the needs during cultural assessment and report them so that the plan of care can be changed to meet those needs. Therefore, assessing those cultural needs is very essential.

In Cultural competency care,

the nurse must have the ability to adapt practiced skills to fit the cultural context of the client.

Always inquire and include

the patient's favorite foods when planning a diet.