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Transcript
Chapter 31
Transcultural and Social
Aspects of Nutrition
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Ethnic Influences on Food Choices
• Culture affects the way a person thinks, feels, and
behaves, as well as eating habits.
• Ethnic and religious factors may play an important part in
food acceptance, especially during illness.
• To provide optimal care, understand the transcultural
aspects of food and eating, and work within a person’s
cultural context to promote optimal nutrition.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Acculturation
• Acculturation
– The process that occurs as individuals adopt the
beliefs, values, attitudes, and behaviors of the
dominant culture.
– Dietary practices are changing rapidly among
younger people.
• Often, individuals are more influenced by the region in
which they live and the availability of food products in
that region than by their own specific ethnic or cultural
background.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices of Ethnic Groups
• Anglo-American
– Excess amounts of simple sugars, fried foods, and
calories
– Obesity, hypertension, and diabetes
• African Americans
– Diet may be high in fat (fatty meats, fried foods),
sodium (salted meats), and sugar
– Hypertension, heart disease, and obesity
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices of Ethnic Groups (cont’d)
• Latino Americans
– Foods are believed to be either “hot” or “cold,” and this
theory may affect food choices during illness.
• Mexican Americans
– Food traditionally considered to be hot or cold should
be balanced.
– Fried foods and limited amounts of milk and milk
products, are common.
– Obesity and diabetes
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices of Ethnic Groups (Cont’d)
• Caribbean
– Eating patterns reflect those of the country from which
a person originated.
• Cuban
– Fried foods, especially fish, poultry, eggs, and rice are
served, as are many varieties of beans.
– Use limited amounts of milk; therefore, calcium levels
may be deficient.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices of Ethnic Groups (cont’d)
• Puerto Rican
– Limited use of meats, most food is cooked for long
periods or fried, malt beer may be given to children
– Diet may be low in calcium.
• Asian Americans
– Lactose intolerance is common; extensive use of soy
sauce and other high-sodium seasonings
– Cardiac diseases, hypertension, diabetes, cancer, and
obesity risk
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices of Ethnic Groups (cont’d)
• Chinese
– Observe the yin–yang balance, especially during
illness
– High in fiber, starch, and many nutrients
– Low in fat, may be low in protein, and often high in
sodium
– Stir-frying and steaming are common cooking
methods
– Liver problems, hepatitis, and lung cancer
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices of Ethnic Groups (cont’d)
• Japanese
– Use little meat and animal fat, many vegetables, raw
fish (sashimi) and sushi are common
– Milk is rarely used by adults.
– Broiling, steaming, boiling, and stir-frying
• Korean
– Rice is served at every meal; seafood accounts for
most of the animal protein; beef; Korean ginseng for
healing and maintaining health
– High sodium levels in diet can lead to hypertension.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices of Ethnic Groups (cont’d)
• Filipino Americans
– Traditionally considered nutritionally complete
because their basic staples are vegetables, fruits, and
fish.
– Rice is believed to give a person energy; garlic and
onions are believed to lower blood pressure.
– High sodium levels in the diet can lead to
hypertension.
– “Hot-and-cold” food principle
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices of Ethnic Groups (Cont’d)
• Southeast Asian
– Rice, fish, soybean products, a wide variety of fruits
and vegetables; soft drinks and sweets are eaten at
every meal. Milk is rarely used by adults.
– Cooking styles differ
• Native Americans
– Lactose intolerance; food has great religious and social
significance; diets may be deficient in calcium,
riboflavin, and vitamins A and C
– Obesity and diabetes
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices of Ethnic Groups (cont’d)
• Asian Indian
– Based on the region of origin and the form of religion
practiced
– Hindus rarely eat beef and may refrain from eating
gelatin-based products; fasting is a common practice
– Deficient in protein, iron, and vitamin A
– Diabetes, hypertension, cardiovascular disease,
cancer, osteoporosis for women, respiratory
infections, intestinal infections, anemia, proteinenergy malnutrition, and the associated complications
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices of Ethnic Groups (cont’d)
• Middle Eastern Americans
– Vegetables and legumes are often the entree; all
forms of pork are customarily forbidden; large
quantities of fat added to food
– Women may eat only after the men and children are
fed.
– Calcium and protein intake may be inadequate.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Is the following statement true or false?
The use of home-based or herbal remedies by any culture
may be contraindicated with Western-style
pharmaceuticals.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
True
Holistic herbs, hot–cold remedies, or over-the-counter
treatments may be contraindicated with Western-style
pharmaceuticals.
For example, dark green leafy vegetables, such as collards
or kale, are contraindicated with products such as aspirin
(salicylates) or ibuprofen, and they can interfere with the
effectiveness of blood-thinning medications such as
warfarin (Coumadin).
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices Related to Islam
• Dietary laws are similar to Jewish kosher laws.
• Alcoholic beverages are not allowed.
• They fast for a month each year, avoiding food from
dawn until after dark.
• Honey, dates, milk, meat, seafood, and olive oil
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices Related to Judaism
• Kosher eating demands
– Separate dishes, pans, and silverware are used to
prepare and to serve meat and dairy foods.
– Meat and dairy may not be eaten at the same meal.
Pork products, rabbit, shellfish, and scavenger fish
are not allowed.
– Meats must be slaughtered by a ritual method and
only the front quarter of the animal may be eaten.
– Food must be prepared ahead of time for the
Sabbath; certain days of fasting are observed.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices Related to Mormon
• Do not use alcoholic beverages or stimulants (coffee,
tea, or caffeine-containing carbonated beverages)
• Observe “fast offerings,”—giving up two meals on the
first Sunday of each month.
• Live by a health code and the Word of Wisdom; they
are to preserve their bodies and maintain the best
possible health.
• Meat is eaten sparingly and “in season” (winter).
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dietary Practices Related to Roman
Catholicism
• Dietary and fasting regulations are mostly voluntary.
• Some abstain from eating meat on Fridays.
• Most must fast and abstain from meat on Fridays during
Lent.
• Ash Wednesday and Good Friday are observed as days
of fast and abstinence.
• Do not eat or drink (except water) for 1 hour before
taking Holy Communion.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Vegetarian Choice
• Vegans
– Strict vegetarians; exclude all animal products from
their diet.
• Lacto-vegetarians
– Eat plant foods and dairy products (no eggs).
• Ovo-vegetarians
– Eat plant foods and eggs (no dairy products).
• Lacto-ovo vegetarians
– Eat plant foods, dairy products, and eggs.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Vegetarian Diet
• Vegetarians have lower rates of coronary artery disease,
hypertension, non–insulin-dependent diabetes, and
obesity, and lower mortality rates from colon cancer.
• Plant sources of protein provide sufficient amounts of
essential and nonessential amino acids.
• Likely to consume an adequate amount of each nutrient,
as long as they meet their calorie needs.
• Specific dietary recommendations for vegetarians are
available in the Dietary Guidelines for Americans.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
A vegan diet would include which of the following?
a. Only vegetables
b. Vegetables and fish
c. Vegetables and eggs
d. Vegetables and dairy products
e. Vegetables, eggs, and dairy products
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
a. Only vegetables
A vegan diet consists of only vegetables all animal products
are excluded from their diet.
Lacto-vegetarians eat plant foods and dairy products (no
eggs).
Ovo-vegetarians eat plant foods and eggs (no dairy
products).
Lacto-ovo vegetarians eat plant foods, dairy products, and
eggs.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Food Choice and Economic Conditions
• Food is relatively inexpensive in the United States.
• More affluent people tend to eat at restaurants more
often and may eat more fat due to a higher intake of
cheese, meat, fish, and poultry.
• When income rises, people tend to eat fewer eggs, rice,
and beans.
• People with lower incomes may skip meals.
• The homeless or “street people” may beg or look through
trash for food.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Food Choice and Emotional State
• Emotional factors may affect the eating patterns of the
client in a healthcare facility.
– Food may become a reward. Purees of certain foods
may be considered “for babies.”
• Clients who are sad, lonely, or depressed may overeat or
refuse to eat.
• Snacking leads to poor nutrition and can be a sign of
eating for emotional comfort.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Food Choice and Social Factors
• Some guidelines to provide a sense of social involvement
for clients during meals include:
– Visit the client for a few minutes.
– Allow two clients to eat together.
– In a double room, open the curtain.
– Let clients meet in a common lounge for meals.
– Encourage family members to visit at mealtime.
– Turn on the television or radio.
– Place flowers nearby.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Food Choice and Physical Factors
• Clients experiencing illness may not be well enough to
eat, and the nurse must take time to feed them.
• When nutritional needs are increased, obtaining an
adequate amount of nutrients to treat acute illness takes
precedence over following a low-fat or low-calorie diet
for chronic disease prevention.
• Malnutrition is common among those with AIDS;
therefore, increased calorie and protein intake is
required to replenish losses.
• Other diet modifications may be necessary to alleviate
symptoms or complications.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Food Fads and Fallacies
• Quick weight-loss schemes and food fads are big
business in the United States.
• Direct toxicity and failure to seek legitimate healthcare
are other possible outcomes that can significantly affect
health.
• Clients with specific concerns about food fads or who
may be at risk for health problems because of them
should be directed to a dietitian.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
What criteria of a fad diet should one look for before
following the latest diet?
a. It forbids any type of snacking.
b. It does not recommend exercise.
c. It recommends the use of pills or potions.
d. It is a collection of rigid menus.
e. It uses food from each of the major food groups.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
e. It uses food from each of the major food groups, not
eliminating any as “bad,” unhealthy, or dangerous.
A diet plan should use food from each of the major food
groups, not eliminating any as “bad,” unhealthy, or
dangerous.
The number of servings recommended from each food
group compares with the suggestions in the MyPlate
framework of 2011.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
End of Presentation
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins