| | |
---
Food, Culture, and Diabetes in the United States
Food, Culture, and Diabetes in the United States -- Posted by Gumbo on 11-19-04 05:19
Food, Culture, and Diabetes in the United States
Originally Published:20041001.
What do people in the United States eat? Is it meat and potatoes?
Things have changed in the United States as the population has grown to
include many different ethnic and cultural groups, and this has resulted in
diverse food preferences and eating habits. Asian Indians are one of the
fastest growing immigrant groups in the United States. African Americans are
numerically the largest minority group, although the Latino population is
expected to be larger than the African-American population by the middle of
the next century.1
Culture is defined as the knowledge, beliefs, customs, and habits a group of
people share. These are not inherited behaviors, but learned. Culture is
passed on from generation to generation.1 Each ethnic group has its own
culturally based foods and food habits. These traditions have been
influenced and adapted through contact with the mainstream culture.
Conversely, the foods of mainstream culture have been influenced by the
presence of these ethnic cultures. Fast-food restaurants and other take-out
restaurants now offer such wide-ranging selections as pizza, tacos, falafel,
tandoori, egg rolls, and hamburgers.1
Thus, the American diet is a combination of many cultures and cuisines. To
understand it, one must not only study the traditional foods and food habits
of the many minority groups, but also the interaction between the majority
culture and the cultures of these smaller groups.
Seventeen million people in the United States have diabetes. Key to the
increasing prevalence of diabetes is the rapid growth of the disease in
high-risk populations such as African Americans, Native Americans, Latinos,
and Asian Americans. The growth in obesity, as well as an aging population,
have also contributed to this increase.2,3
This article examines the ethnic and regional food practices of three
largest segments of the U.S. population: African Americans, Asian Indians,
and Mexican Americans, all groups with a high incidence of type 2. diabetes.
The incidence of type 2 diabetes is also high and increasing among Chinese
Americans and Native Americans, who also have unique food preferences,
habits, and issues. However, discussion of these groups is beyond the scope
of this article.
Nutrition Considerations for African Americans
The rate of type 2 diabetes among African Americans is 1.6 times higher than
that of the total U.S. population. This may be related to higher obesity
rates among African-American women.4 Diabetes educators should be aware of
the increased incidence of type 2 diabetes, hypertension, and obesity in
African Americans.4 All of these conditions require nutrition intervention
and skill in the cultural aspects of working with these clients.
The African-American diet is based in part on certain health beliefs that
have been passed down through generations and are still observed today.
Socioeconomic status and education level are important in the meal planning
and nutrition education of African-American patients. Financial and physical
constraints, available cooking facilities, and family support also should be
taken into consideration. Health literacy is also key, especially when
educators are communicating with patients about food choices and their
likely impact on health.5
Traditional African-American fare, sometimes referred to as "soul food," is
based in part on food practices and customs listed below. Many of these
customs and practices are shared by white Americans in the southern United
States, particularly those of lower socioeconomic level or living in rural
areas.
* A variety of green leafy vegetables, such as collard, mustard, turnip, and
dandelion greens; kale; spinach; and pokeweed are known collectively as
"greens" and are a staple of soul food.
* Corn is a mainstay food item.
* "Vegetable plates," which traditionally consist of vegetables and starches
and are served with cornbread or yeast rolls and "spring onions" (scallions)
or sliced raw or cooked yellow onions.
* Starchy vegetables, including dried beans (pinto, navy, lima, butter,
kidney); fresh or dried peas (black-eyed, field, green, crowder, butter);
beans with pork; corn; and sweet or white potatoes are quite popular. These
foods have a high protein content, especially when combined with grains.
Popular combinations include "hoppin John" (rice with black-eyed peas), red
kidney beans and rice, and succotash (corn with lima beans).
* Grains such as rice, grits, cornbread, biscuits, muffins, dry and cooked
cereals, and macaroni are also basic.5
* Meats are often breaded and fried. A variety of beef and pork cuts,
poultry, and fish are consumed, as well as oxtail, tripe, and tongue. Frying
has traditionally been a preferred method of meat preparation because of the
short cooking time, a feature that is practical during the heat of summer.
* Whole milk, commonly referred to as "sweet milk," and buttermilk are
popular choices. Buttermilk is a common ingredient in biscuits, cornbread,
and batter for fried chicken. Two percent and nonfat milk and powdered milk
are also becoming more popular because of the increasing awareness of the
need to reduce total fat, cholesterol, and saturated fat in the diet.5
For many African Americans, decreasing the cholesterol, fat, and sodium
content of the diet and focusing on weight management are significant goals
to help reduce the risk of diabetes complications. Toward that end, it is
helpful that African-American fare emphasizes vegetables and complex
carbohydrates.
Helping patients modify recipes for foods they typically eat is valuable in
achieving and maintaining adherence to recommended dietary changes. A study
at the diabetes clinic of Grady Memorial Hospital in Atlanta, Ga., found
that the primary reason for patients not following food recommendations was
that the recommended diet was not familiar to them and contained unfamiliar
food choices.6
A reproducible handout offering nutrition information for African-American
and southern traditional clients can be found on p. 193. Table 1 provides an
example of typical and modified meals for an African-American patient.
Nutrition Considerations for Asian Indians
Health issues facing the Asian-Indian immigrant population include diabetes,
hypertension, cardiovascular disease, and the associated complications from
these conditions.7
The Asian-Indian community is very diverse based on the region of origin
within India and the form of religion practiced. Hinduism is the predominant
religion among Indians, followed by Islam, Buddhism, Jainism, Sikhism,
Zoroastrianism, Christianity, and Judaism. The followers of these different
religions observe different dietary laws and codes for fasting and feasting
that influence their eating patterns.
A survey of food consumption practices among 73 Asian-Indian adults in the
New York City and Washington, D.C., areas showed that acculturation of this
population in the United States has led to more frequent selection of
American or other ethnic foods for main meals and replacement of traditional
sweets with cookies, doughnuts, and other Western pastries. Length of stay
in the United States had an effect on the choice of fats used in cooking;
those who had lived here more than 5 years appeared to have decreased their
consumption of butter and ghee (clarified butter) and used margarine as an
alternative. These individuals continued to consume rice, chappati (flat
bread), yogurt, dhal (a spiced lentil dish), and curried vegetables. This
group reported an increase in intake of whole grain breads, fish, poultry,
meat, potato chips, cakes, cheese, fruit, and alcoholic and nonalcoholic
beverages (other than water) after immigration to the United States.8
Thus, the diet of Asian Indians in the United States has changed from one
featuring low-fat, high-fiber foods to one characterized by higher-fat
animal protein, low fiber, and high levels of saturated fat. There is an
increased tendency among Asian Indians in America to consume fast foods and
convenience foods.
Other factors that may increase the risk for chronic disease in this group
include sedentary and stressful lifestyles. Insulin resistance in Asian
Indians is associated with a number of metabolic abnormalities that are
demonstrated risk factors for coronary heart disease. These include elevated
glucose, insulin, and triglycEride levels.8
Table 2 provides an example of a typical and modified meal for an Asian
Indian patient.
Nutrition Considerations for Mexican Americans
Food is a big part of Mexican-American life. Unfortunately, so is a high
incidence of type 2 diabetes. Prevention and treatment programs for diabetes
targeting this population must include foods commonly found in the
traditional diet.
When working with Mexican-American patients, health care teams should assess
the level of acculturation to mainstream American dietary practices. In
addition, diabetes education providers much determine the primary language
spoken at the patients' home and the degree to which patients rely on folk
remedies for health issues. For those using folk remedies, providers must
inquire about which foods are considered "cold" or "hot" for healing
purposes and determine which conditions are treated by each.9
Nutrition educators should emphasize positive food practices related to
traditional health beliefs and dietary customs. For example, the traditional
Mexican diet is low in fat and high in fiber. Therefore, maintaining or
returning to traditional diets may be beneficial. Educators should encourage
the consumption of a variety of healthy foods, particularly those that are
familiar and culturally acceptable (i.e., corn, tortillas, rice, and beans).
Misconceptions and myths about dietary recommendations should be dispelled.9
A reproducible handout offering basic nutrition information for Mexican
American clients can be found on p. 194. Table 3 provides an example of
typical and modified meals for a Mexican American patient.
Summary
This brief review of nutrition-related cultural variations among three
ethnic populations demonstrates the crucial importance of asking patients
about their specific food habits in order to have any hope of providing
culturally appropriate advice for modifying traditional eating patterns to
prevent and treat type 2 diabetes. Appropriate help in this regard will
almost always require consultation with a registered dietitian. Involving
family members in nutrition counseling sessions is also effective in
promoting interest in following the recommendations.
Related
Discussion:
obesity often indicates lack of discipline (2 posts)
by tigerlilly@privacy.net.org.com - Last post on: 07-19-05 01:08
Becoming a Sumo wrestler
Sumo wrestling is not an occupation – it’s a way of life. It can take up to ten
years to become a professional fighter, and requires a lifetime’s dedication.
Sumo wrestlers usually begin as teenagers. They join schools which teach the
basics of Sumo, history, and te... (Read More)
Chinese Energetic Method and Homeopathy for Arthritis & Rheumatism (1 posts)
by Accem - Last post on: 06-30-04 16:14
Arthritis & Rheumatism
compiled by Accem Scott, ND
In Chinese Medicine Arthritis & Rheumatism are called Bi conditions or
syndromes
Most joint related conditions even injury related can be grouped into
the category of Bi syndromes. A good way to visualize what all Bi
conditions have in comm... (Read More)
Gastroparesis - A Case Of Unexplained Lows (1 posts)
by Gumbo - Last post on: 11-03-04 18:08
This is a multi-part message in MIME format.
------=_NextPart_000_001F_01C4C1E9.3B33D590
Content-Type: text/plain;
charset="iso-8859-1"
Content-Transfer-Encoding: quoted-printable
Gastroparesis
A Case Of Unexplained Lows
By Deborah Thomas-Dobersen, RD, MS, CDE, and Terri Ryan-Turek, RD, ... (Read More)
In ICU with septic blood infection (1 posts)
by Liz-TX - Last post on: 03-07-05 21:49
It has been years since I have posted.. Things have been going fine for the
most part. I have been on Remicade, Methetrexate, 10 mg. Predisone for my
Rheumatoid Arthritis.
For the past 6 weeks I was having cold sweats. I mentioned it to my
doctor/s who suggested reducing my thyroid med, goi... (Read More)
Top
Discussions From Our Archives
Weight Loss Surgery Can Cure Diabetes
"To Your Health"
Bunion Surgery and arthritis
Gout Diagnosis and Immediate Relief
Ayurvedic Herbal medicines are better safe, but not heavy metals
Turmeric
Other
Discussion Categories
Diabetes Symptoms
Health Care Policy
Health Care Providers HMO
|
|
