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Mexicans and Central Americans Chapter 9 Introduction Latinos are the largest nonEuropean ethnic group in the US Not a single ethnic group Rich cultural heritage Reflected in foods ◦ European and native Indian Mexico Northernmost Latin American country Part of North America Varied geography Climate from arid desert to tropical lowlands Most Mexicans of mixed Indian and Spanish ancestry Official language is Spanish History in the US Chicanos ◦ Born in the US or those who immigrated and are US citizens Braceros ◦ Work here legally but remain Mexican citizens Unauthorized migrants ◦ Those who enter the country illegally Terms may vary regionally Current Demographics 32 million Chicanos and Braceros ◦ ◦ ◦ ◦ 11.5 million born in Mexico Accounts for 59% of the Latino population Primarily live in California and Texas Since 1990 has become more nationwide 11 – 12 million unauthorized migrants ◦ Majority from Mexico Latino neighborhoods: Barrios Socioeconomic Status Live in Latino neighborhoods Maintain ethnic identify ◦ La Raza Some become completely assimilated Others become bicultural Worldview Proudly maintain their ethnic identity 75% of Mexican descent are are Roman Catholic ◦ Nearly all practice religion If not Catholic will be Protestant ◦ Virgen de Guadalupe Strong faith Believe they have no control over their own fate The Chicano Family Most important social unit Well-being of the family comes before the needs of the individual Male is head of the household ◦ Machismo: Pride and self-worth a man feels when fulfilling his obligations and duties to his family and community Wife is homemaker Children are cherished ◦ Taught to share and work together Often live with extended family Traditional Health Beliefs and Practices Elements of Indian supernatural rituals European folk medicine Many use traditional cures Health is a gift from God ◦ Illness due to outside forces ◦ Might be being punished by God Prayer always appropriate ◦ Interventions of the saints ◦ Virgin Mary or St. Francis ◦ May make pilgrimages to their shrines Traditional Health Beliefs and Practices: Hierarchy of Healers Senora or abuela ◦ Family health experts ◦ Home remedies ◦ OTC Yerbero ◦ Herbalist Sobador ◦ Massage therapist Partera ◦ Midwife who may also treat young children May purchase traditional herbal remedies, homeopathic cures and amulets at botánicas ◦ May also purchase therapeutic items at religious fiestas Traditional Health Beliefs and Practices: Hierarchy of Healers Curandero or Curandera Lay healer who intervenes in multiple dimensions, e.g., physical and spiritual Powers may be God-given at birth, learned or received Broad range of complaints including the supernatural Faith is crucial - prayer is primary treatment May counteract spells/hexes from a brujo ◦ Someone who works on behalf of the devil ◦ Use milagros or exvotos An effigy of the afflicted body part Traditional Health Beliefs and Practices Illness believed to be due to ◦ ◦ ◦ ◦ ◦ Excessive emotion Dislocation of organs Magic Imbalance in hot or cold Anglo disease Pneumonia or appendicitis Treatment is based on the cause Traditional Health Beliefs and Practices: Susto Due to excessive emotion Physical, physiological, psychological Espanto ◦ Type of susto due to being frightened by a ghost ◦ Soul leaves the body Susto is serious and may be treated by a curandero Nervios is caused by susto ◦ ◦ ◦ ◦ Seen in adult women Cannot be cured by traditional healer Crying, sleep problems, headache, etc. Chronic condition related to health behaviors Traditional Health Beliefs and Practices: Bilis From too much rage Excess bile spills into the blood Envidia ◦ Caused by envy ◦ May affect a person’s success Traditional Health Beliefs and Practices: Caida de la mollera Fallen fontanel in infants From a fall, yanking the nipple out of a baby’s mouth too quickly or holding the baby vertical at too young an age Believed the palate drops preventing the infant from feeding Wear tight caps to prevent Salt poultices or olive oil followed by a dip in water to treat May hold baby upside down and gently shake, pull the hair, suck the fontanel, press palate to reposition the fontanel Traditional Health Beliefs and Practices: Mal de ojo Evil eye Supernatural origins Children especially vulnerable Caused when someone casts a strong, admiring look on another person Believed to result in death if not treated quickly Cleansing ritual used including sweeping an egg over the ill individual Traditional Health Beliefs and Practices Mal aire ◦ Bad air or wind ◦ May cause headaches and colds Mal puesto ◦ Witchcraft ◦ Swelling, trembling, paralytic twitching Traditional Health Beliefs and Practices: Empacho Digestive ailment Nausea, gas, weakness Eating too many hot or cold foots or hot-cold imbalance A ball or wad of food adhered to the stomach Herbal teas Curandero may pray, pinch the spine and massage the stomach Traditional Food Habits Influences Indian (mostly Aztec) Spanish Some French and Viennese Islamic culinary traditions via Spain Traditional Food Habits: Ingredients and Common Foods Chile peppers Beans Cocoa Corn Tomatoes Traditional Food Habits: Aztec Foods Corn the staple grain Legumes, fruits, vegetables Turkeys and dogs for meat ◦ Some game No consistent source of fat or oil Average Indian ate mostly vegetarian diet of corn and beans Traditional Food Habits: Spanish Contributions Cinnamon Garlic Onions Rice Sugar cane Wheat Distillation ◦ Alcoholic beverages ◦ Mescal, tequila Hogs ◦ Added needed protein and lard ◦ With indigenous ingredients produce the classic flavors and foods of Mexico Corn tortillas with pork filling, etc Traditional Food Habits: Staples Typical Mexican diet ◦ ◦ ◦ ◦ Corn Squash Beans Varied fruits, vegetables, meats ◦ Chile peppers ◦ Very little variety Traditional Food Habits: Staples Breads ◦ Tortillas Traditional flat bread of Mexico Corn is heated in lime Pulverized Made into flour Masa harina Then into dough Cooked on griddle with a little lard Why the lack of pellagra in a corn based diet? Pellagra ◦ Niacin deficiency disease ◦ Prevalent in areas with corn based diet When corn kernels are prepared for masa harina, the alkaline lime solution used to soften them releases the niacin that was bound to a protein Traditional Food Habits: Staples One-dish meals are typical ◦ Caldos (soups) ◦ Sopas-secas (casseroles) ◦ Gordos (similar to dumplings) Meats ◦ Grilled or fried Carne asada ◦ Stewing or braising helps tenderize tough cuts of meat ◦ Use all parts of the animals Chorizo Traditional Food Habits: Staples Famous for stuffed foods ◦ Flautas, tacos, enchiladas, tamales, quesadillas, and burritos Fill tortillas with anything ◦ Vegetables Part of main dish Substantial garnish Potatoes, greens, tomatoes, onions Chile peppers Traditional Food Habits: Staples Sweets ◦ ◦ ◦ ◦ Sugar cane Dried or candied fruits and vegetables Sugared fruit or nut pastes Flan Coffee is most common beverage ◦ Milk consumed infrequently Beer is most important alcoholic beverage ◦ Tequila, mescal, whiskey Traditional Food Habits: Regional Variations: Mexican Plains Northern and Central part of Mexico Natives were seminomadic Corn, beans, squash, greens Tuna (Cactus fruit) Nopales (Young cactus leaves) Piñons (pine nuts) Pozoles (Hominy based stews) Traditional Food Habits: Regional Variations Mexican plains (Northern) Spanish introduced ◦ Longhorn cattle ◦ Dairy cows ◦ Wheat Beef and wheat frequently consumed Raise goat and sheep Barbacoa ◦ Cow/kid/lamb heads and/or cheeks prepared this way Traditional Food Habits: Regional Variations Baja Peninsula ◦ Fish Cheese ◦ Queso Fundido Wheat/wheat tortillas Buñuelos ◦ Popular dessert ◦ Serve with café con leche Aguamiel ◦ Honey water ◦ From Maguey cactus ◦ Distill fermented aquamiel to make pulque ◦ Distill pulque to make mescal ◦ Distill mescal to make tequila Traditional Food Habits: Regional Variations: Tropical Mexico Hot lowlands, tropical forests Seafood and freshwater fish Tomatillos, chayote squash, onions, jicama Bananas and starchy plantains Carambola (Star fruit), cherimoya (custard apple) Soursop, guava, zapote Avacados, guacamole Mamey (plum) Yucca (cassava or manioc) Traditional Food Habits: Regional Variations Chile Peppers ◦ Over 90 types Smaller the chile the hotter it is Develops more heat as it ripens Heat intensifies when it is dried Contain capsaicin Traditional Food Habits: Regional Variations: Yucatan Isolated region Many Mayans Dense mountainous jungles Use banana leaves to wrap and steam foods ◦ Called píbil Salbutes ◦ Similar to a tostada ◦ If stuffed, called a Panucho Traditional Food Habits: Regional Variations Citrus Fruits ◦ Juices used for marinade ◦ Pickling ◦ Orange and lime Achiote ◦ Recado colorado ◦ Paste to coat foods ◦ Called annatto in the US Seafood and eggs are common Traditional Food Habits: Regional Variations: Southern Mexico Similar to Yucatan as more tropical and Indian-influenced Poultry, goat, pork Chapulines ◦ Grasshopper found in the corn fields ◦ Pan-fried with chiles, garlic, salt, lemon juice Beverages are hot chocolate, coffee, Atole: thin cornmeal and milk gruel Ice cream, ices, flan, popular desserts Traditional Food Habits: Regional Variations: Southern Mexico Cacao trees ◦ Use lots of chocolate in sweet and savory dishes Moles ◦ From Aztec word “molli” meaning “sauce with chiles” ◦ Use unsweetened chocolate ◦ Are rich, complex sauces used as a base for stews or poured on top of food ◦ Chiles, tomatoes, nuts, raisins, sesame seeds, avocado leaves also common ingredients Meal Composition and Cycle: Daily Patterns 4 – 5 daily meals Most meals eaten at home or family style Breakfast: pastries, fruit, café con leche Late morning: brunch of tortillas, eggs, meat, beans, wheat rolls, sweet bread, fruit, coffee, hot chocolate Lunch: soup, rice, beans, salad, dessert Afternoon snack: sweets w/ coffee or hot chocolate, siesta afterwards Dinner: light supper often leftovers Snacking Frequent from morning to midnight Antojitos – “little whims” ◦ Tostadas Food vendors Pastelerías ◦ Coffee, pastries, chocolates Open air markets Cantinas ◦ Serve botanas Cocktail foods or appetizers Special Occasions Sundays Family celebrations ◦ Weddings ◦ Baptisms ◦ Quinciñeras Girls 15th birthday Holidays Festive foods include: ◦ ◦ ◦ ◦ ◦ Tamales Moles Turkey Arroz con leche Pastel de tres leches Special Occasions: Dia de los Santos Reyes Three Kings Day January 6th Common gifts are new shoes. Celebrated with the Rosca de Reyes. ◦ Raisin studded, ring shaped loaf of bread Ceramic doll baked inside represents Baby Jesus. Person getting Baby Jesus must give a party on Candelaria Day Feb 2nd Special Occasions Lent Capirotada ◦ A holiday bread pudding Días de los Muertos: Days of the Dead November 1 and 2 Large feast honoring the deceased Pan de muerto ◦ Bread decorated with skull and crossbones Mold skulls and skeletons from sugar paste Altars set up for the dead with food, alcohol, etc. Special Occasions: Christmas Posadas Christmas festivities Piñatas Buñuelos Salad of fruits, nuts and beets served on Christmas Eve Role of Food and Etiquette in Mexican Society Meal planning done by wife, served by wife or servants Eat everything served, ok to leave some on plate Share food Do not reject anything offered Host begins meal with “¡Buen provecho!” Fork remains in left hand, knife in right Keep hands above table Pass dishes to left Do not leave table early Therapeutic Uses of Food Hot/Cold Theory ◦ Disease is caused by an imbalance between hot and cold ◦ From Arab system brought to Mexico by the Spanish Applied only to ◦ Foods ◦ Prevention ◦ Treatment Does NOT encompass moral or social beliefs Therapeutic Uses of Food Based on the concept that the world’s resources are limited and must remain in balance People must stay in harmony with the environment Hot is strength Cold is weakness Therapeutic Uses of Food When applied to food: ◦ Proximity to the sun ◦ Method of preparation ◦ How the food is thought to affect the body Meals balanced between hot and cold foods are thought to be health promoting ◦ Rice (hot) ◦ Soup (made with hot and cold) ◦ Beans (cold) Unbalanced meals may cause illness Therapeutic Uses of Food Hot foods Alcohol Aromatic beverages Beef Chiles Corn husks Oils Onions Pork Radishes Tamales Cold foods Citrus fruits Dairy products Most fresh vegetables Goat Tropical fruits Hot or cold depending on prep Beans Corn/rice products Sugary foods Wheat products Therapeutic Uses of Food Illnesses treated with a diet rich in foods of the opposite classification Hot illnesses ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Treat with a “cold” substance (food/drink) Pregnancy Hypertension Diabetes Acid indigestion Susto Ojo Bilis Therapeutic Uses of Food “Cold” illnesses Treat with a “hot” substance Hot illnesses Pneumonia Empacho Colic Sour foods thought to thin the blood ◦ Avoided by menstruating women Thought to increase blood flow Acidic foods ◦ May cause menstrual cramps Therapeutic Uses of Food Latinos more likely than white to consider certain foods herbal medicines Home remedies are common Chamomile ◦ Colic, menstrual cramps, anxiety Mint and anise tea ◦ Nausea, gas, diarrhea, colid Garlic ◦ Yeast infections of the mouth, toothache Therapeutic Uses of Food Hypertension ◦ Garlic, passion flower, or linden flowers ◦ Sapodilla tree leaves in teas Act as a sedative Diabetes ◦ ◦ ◦ ◦ Sage Trumpet flower Prodigiosa leaves and flowers Indian plantains, papayas, bitter gourds, aloe vera juice, prickly pear cactus ◦ May have potent diuretic or hypoglycemic properties Contemporary Food Habits in the United States: 4 Regional Variations Texas Modified Mexican food into US dishes – Tex Mex ◦ Tamale pie, nachos ◦ Combo plates ◦ Drunken pudding – whiskey sauce for BBQ kebabs Some foods retained Mexican heritage ◦ Chili con carne Anchos, jalapeños Cumin Ground beef instead of shredded 4 Regional Variations, continued New Mexico New Mexico chile ◦ Mildly pungent ◦ Red or green Simple sauces ◦ Only ground red chili pepper, water, garlic, oregano, and salt to taste ◦ Use pork instead of lamb, goat or beef 4 Regional Variations, continued Sonora Mexican state of Sonora and Arizona Prefer mild ◦ Often drop “chile” such as in carne verde Beef and a traditional dried beef jerky, machaca ◦ Stuffed foods Large wheat tortillas May be the original home of burritos ◦ Deep-fried version, chimichangas 4 Regional Variations, continued California border Neither side can claim Mixture of products ◦ Hamburgers with jalapenos on the side ◦ Burritos filled with refried beans, carne asada and French fries Market for Latino foods is increasing Appreciation of authentic regional fare is increasing Adaptations of Food Habits: Ingredients and Common Foods Recent immigrants, those who live near the border and migrant workers continue traditional foods Source of fat varies ◦ Less acculturated Whole milk and fat added during food prep ◦ More acculturated Fast food, snacks, added fat Less acculturated ◦ More fruit, beans, rice ◦ Less sugar and sugar sweetened beverages Generational changes between those born in Mexico and those born in US Greatest dietary changes occurred between the 1st generation born in Mexico and the 2nd generation, born in the United States Between 2nd and 3rd generation less significant. ◦ Exception was consumption of corn tortillas (decreased 69% between first and second generations, an additional 30% drop between 2nd and 3rd generations Generational changes between those born in Mexico and those born in US Reduced consumption of legumes, most vegetables, rice, and pasta More breads, cereals, margarine, mayo, butter, potato chips and French fries Whole milk preferred among Mexican born ◦ Low-fat among US born Generational changes between those born in Mexico and those born in US Soda intake high in all generations ◦ US born prefer diet Alcohol intake increases ◦ Especially beer consumption in males Sweet and carbonated beverage intake increases in US Baked goods are generally purchased Extra income spent on meat Meal Composition and Cycle: Daily Patterns Traditional foods preferred for most meals Vegetables are served in soups or stews Fruits are a snack or dessert Chicanos adopt American meal pattern (3 meals/day) Milk a superfood for children ◦ Adults may not consume at all ◦ About 50% of adults are lactose intolerant Meal Composition and Cycle: Daily Patterns – Recent Immigrants May continue to grill and fry outdoors ◦ May not understand how to use the oven May avoid canned or frozen foods ◦ Unsure of how to use them Cooking at home is still popular Spend more money on flour and dry beans Shop at small ethnic stores or convenience stores with fewer healthy options Eat out more frequently than any other ethnic group in the US Special Occasions Sundays ◦ Still have tamales, enchiladas ◦ Labor intensive foods served Easter ◦ No preference Christmas ◦ Tamales Thanksgiving ◦ Turkey and mashed potatoes Special Occasions Mexican Independence Day ◦ Foods that are red, white, and green ◦ Mariachis, traditional clothing Cinco de Mayo ◦ Meaning has been lost ◦ Very popular in US Mexica Aztec New Year’s Day ◦ Beginning of the Aztec solar year ◦ Emphasizes indigenous Indian identity Nutritional Status: Intake Health statistics difficult to determine Life expectancy for Mexican Americans similar to that of whites ◦ Misreporting may be an issue LBW infants and infant mortality lower for Mexican Americans than for the total population ◦ See Cultural Controversy 95% breastfeed their infants in the first week of life ◦ May be given formula, water, sweetened herbal teas early Iron deficiency anemia a problem Baby bottle tooth decay (BBTD) a problem Nutritional Status: Intake Highest component scores on the USDA Healthy Eating Index (HEI) ◦ Good compliance with MyPyramid recs ◦ Those born in Mexico have slightly higher scores ◦ Appears to decrease with acculturation Low protein consumption combined with lower intake of iron and vitamin C may result in low hemoglobin levels in young children and pregnant women Nutritional Implications Traditional diet contains sources of: ◦ Vitamin A ◦ Vitamin C ◦ Thiamin ◦ Niacin ◦ B-6 ◦ Folate ◦ Phosphorus ◦ Zinc ◦ Fiber Mexican Americans consume less of these Inadequate income or lack of traditional ingredients may limit consumption of these nutrients Nutritional Implications High prevalence of obesity ◦ 36% of men ◦ 45% of women ◦ Also in children Low socioeconomic status Leisure-time physical inactivity Cultural ideal weight is higher ◦ Latina women believe weight gain after marriage is normal ◦ Extra weight associated with health and wellbeing Nutritional Implications Diabetes rate 2x higher ◦ ◦ ◦ ◦ May have greater insulin resistance Complications are more prevalent Death rates from diabetes 64% higher Comorbidities of heart disease, angina, hypertension, arthritis, etc., are high ◦ High rates of metabolic syndrome Leads to type 2 diabetes and heart disease Nutritional Implications CVD number one cause of death Lower rates of ◦ Hypertension ◦ Dyslipidemia Higher rates of ◦ ◦ ◦ ◦ ◦ Ischemic stroke Intracerebral hemorrhages Gall Bladder disease Dental caries Alcohol intake in men Counseling Access to biomedical care may be limited Income may restrict doctor visits 35% do no have health insurance Not comfortable speaking English Feel God or fate determines health ◦ Unwilling to take preventive measures Counseling High context Non-confrontational Warm, dignified relationship is most effective Touching with a handshake Maintain eye contact Have less personal space than Americans Present-oriented Polychronistic ◦ Appointment times may be problematic Counseling Men may not acknowledge illness May continue working Modesty and privacy valued Many use home remedies Most health beliefs and practices do not interfere with treatments Counseling: Exceptions Diabetes and hypertension treatment with botanicals Empacho treated with lead or mercury based meds Caída de la mollera has been associated with severe diarrhea and dehydration ◦ Failure to thrive may be a concern Tea made of wormwood for diarrhea ◦ Toxic ingredient in absinthe Dried rattlesnake powder ◦ Source of botulism and salmonella Home remedy for infants made from honey ◦ Botulism Counseling Family participates in health care Consult members in decision making Gaining family support is beneficial Nutrition intervention and advice may be perceived as an accusation of inadequacy to the women Children may speak English well and translate in the market In-depth interviews are crucial Familiarity with Spanish needed Belize, Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, and Panama CENTRAL AMERICANS History of Central Americans in the US No data prior to 1960’s First group ◦ ◦ ◦ ◦ Often listed with South Americans Well-educated professional men Women coming for temporary domestic jobs Largely urban residents Second group ◦ Refugees from El Salvador, Guatemala, Nicaragua ◦ Known as “foot people” as they walked to the US ◦ Younger, poorer, less educated Current Demographics Exact number unknown due to illegal immigration Most in California, Texas, Florida Largest groups: El Salvadorans, Guatemalans, Hondurans, Nicaraguans Few from Costa Rica, Belize and Panama Identity may be more of race than country of origin ◦ Ladino: Mixed Spanish and Indian heritage ◦ Indian Campesinos: Peasants Socioeconomic Status Data limited as combined with South American data First wave immigrants now a middle class population with above average income and education ◦ Graduate from high school in numbers higher than that of whites More recent immigrants typically fall below poverty level and with lower education levels ◦ Belize, Costa Rica have better levels ◦ Panama have the best numbers Worldview Latino communities will have areas specific to one ethnic group Guatemalans ◦ May prefer to be called Chapines Mayan communities very likely to keep traditional beliefs and practices Nicaraguans adapt more to pan-Latino community Garifuna – black Caribs from Belize and Honduras Worldview: Religion Most are Roman Catholic ◦ Guatemalans observe Catholic practices but may maintain Mayan beliefs ◦ Participation in the US declines as Mayans are dependent on sacred locations Pentecostal Church Churches that offer traditional Central American social activities plus worship are successful Worldview: Family Highly value family and extended kinship Father is head of household and provider Children are carefully controlled ◦ Especially girls Roles of men and women change in the US ◦ Women may be more easily employed Disintegration of the family unit has been a problem Traditional Health Beliefs and Practices Good health preserved by ◦ Good diet with consumption of fruits and vegetables ◦ Fresh air ◦ Regular hours ◦ Guatemalans and Panamanians ◦ Exercise ◦ Don’t get too thin A balance between the spiritual and social world Health is a gift of God Prayer used to restore harmony Traditional Health Beliefs and Practices Nicaraguans believe in witchcraft ◦ Brujos or brujas Can assume shape of animals Have power to cure illness Guatemalans ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Illness caused by outside forces Satan sends disease to punish unbelievers Sickness due to witchcraft Curanderos, sobadores Jeberos (herbalists) Espiritistas (treat witchcraft with prayer) Naturalist doctors or naturopaths May call in priests Traditional Health Beliefs and Practices Balance of hot and cold Disrupted by sudden exposure to extremes in temperature or strong emotions Folk conditions ◦ Bilis and Cólera Anger, general distress, leads to stroke ◦ Mal de ojo ◦ Susto and Cólera lead to high blood pressure ◦ High blood pressure From living at too high an altitude Having too much blood Traditional Health Beliefs and Practices Nicaraguans extensively use herbal remedies Guatemalans believe strength maintained through quantity and quality of person’s blood ◦ Emergence of foot items that are “strong” or “health-promoting” ◦ OTC drugs are used but considered weak ◦ Medications and herbs often brought by others to new immigrants Traditional Food Habits: Ingredients and Common Foods Native Indian dishes ◦ Highland regions Spanish influence ◦ Lowland region Eastern coast ◦ Caribbean Islander Northern nations ◦ Similar to Mexico Southern area ◦ Europe and Africa Traditional Food Habits: Staples Mayan foundation was corn and beans Supplemented with ◦ ◦ ◦ ◦ ◦ ◦ Squash Tomatoes Chiles Tropical fruit Cocoa Some game Rice now a staple Traditional Food Habits: Beans Beans consumed daily Black beans in Guatemala Red beans elsewhere Simmered w/ spices Pureed Fried With rice Gallo pinto in Nicaragua ◦ Red beans and rice fried with onion Traditional Food Habits Corn eaten as tortillas Enchiladas are like tostadas ◦ Mixtas in Guatemala Pupusas in El Salvador ◦ Stuffed tortillas ◦ Fried and served with pickled cabbage Tamales ◦ Nactamal in Nicaragua ◦ Black tamales in Guatemala on special occasions Empanadas ◦ Small turnovers Traditional Food Habits: Starch French bread is popular Coconut bread ◦ A specialty on the Caribbean seacoast Rice ◦ Fried before boiling ◦ Cooked with coconut milk ◦ Served as pancakes in Costa Rica Traditional Food Habits Soups and stews ◦ May include fruit or fruit juices Fruits and vegetables numerous Coffee and Hot chocolate Tiste ◦ Nicaraguan favorite made with roasted corn, cocoa powder, sugar, cod water and cracked ice Beer Boj, Venado ◦ Fermented sugar cane Traditional Food Habits: Regional Variations Belize and Honduras use coconut milk El Salvador often fries food Guatemala uses achiote ◦ Known as annatto in the US ◦ Mild seasoning Nicaragua uses sour orange, sweet peppers, mint Costa Rica uses lots of seasonings Panamanian fare very international Meal Composition and Cycle Beans and corn eaten at every meal Rice is common Queso Blanco or meat Wealthier areas include soup, meat, fish or poultry, tortillas or bread, substantial garnishes, maybe appetizers and dessert Iguana is popular Special Occasions Focused on Catholic religious days ◦ ◦ ◦ ◦ Christmas Easter Lent Saints’ days Including All Saint’s Day Sundays Ceremonial occasions Etiquette Similar to Mexico Eat when host says “¡Buen provecho!” Most eat with fork in left hand and knife in right ◦ Nicaraguans may eat American style ◦ Fork in right hand, knife in left and switch Hands above the table, wrists on the edge Bread or tortillas placed on side of plate May use tortilla to scoop up small bits of food Dishes passed to left Leave nothing on your plate Take small portions and ask for seconds Therapeutic Uses of Foods Hot-cold theory May also balance wet-dry Guatemalan Americans believe diarrhea is caused by hot weather ◦ Alleviated by cold drinks ◦ Will avoid ice cubes in hot weather Panamanians may avoid cold foods when sick Both will avoid fatty foods and highly spiced dishes when sick Therapeutic Uses of Foods Herbal remedies and teas popular ◦ Manzanilla (chamomile) improves circulation, cramps, flu ◦ Banana leaf and mint Digestion and regularity ◦ Rosa de Jamaica (hibiscus) Respiratory illness, diarrhea, UTI ◦ Papaya leaf Gastritis, laxative Therapeutic Uses of Foods Lime, fig leaf, grapefruit Anxiety and relief of stress Avocado, garlic, ginseng, and valleriana ◦ Remedies for hypertension and diabetes among Panamanians. Coca leaves ◦ Source of cocaine ◦ Used medicinally in some areas Contemporary Food Habits in the US: Adaptations of Food Habits Low rates of assimilation Traditional foods readily available Few new foods added Some report diet has declined since coming to US Guatemalan refugees ◦ If a food is tasty and does not cause stomach discomfort, it must be good to eat. ◦ High intake of candy, soft drinks, and chips noted Milk may be avoided Some foods discarded due to taste and/or texture Nutritional Status: Nutritional Intake Data is limited May arrive with deficiency diseases if in refugee camp ◦ Especially children under age 5 Infectious illnesses common ◦ Tuberculosis ◦ Parasites Endemic infections ◦ Chagas’ heart disease from a parasite ◦ Cyclosporiasis is an infection from a protozoa ◦ Sickle Cell Anemia Nutritional Status: Nutritional Intake Infant mortality rates are below average for whites No excessive low birth weight Breastfeeding considered healthy but impractical ◦ Used as supplement to formula for first 2 – 3 years Overweight in children double Pesticide or herbicide poisoning ◦ Problem with farm workers ◦ When labor codes are not enforced ◦ Mishandling of dangerous products Counseling Access to biomedical care may be difficult Many uninsured Polychronistic Present oriented View health from day to day with little control Concept of scheduled appointments unfamiliar ◦ Little interest in arriving on time Counseling Touching used to communicate feelings Direct eye contact when speaking, downcast when listening Don’t point with fingers or feet Have less personal space than most Americans High context ◦ Calm, measured voice and emotional restraint Respectful, warm, caring speaking style best Counseling: Cultural based descriptions of symptoms Weak heart ◦ Palpitations or dizziness; Weak stomach ◦ Indigestion Weak nervous system ◦ Headaches or insomnia Anemia associated with weak blood, cured by “eating iron” Counseling: Cultural based descriptions of symptoms: Guatemalans Identify susto and nervios as illnesses ◦ If not treated, thought to cause diabetes Believe injections are most effective treatment ◦ more potent than pills Some fear the “chemicals” used in biomedicine. Treatment is successful if symptoms are alleviated Counseling Most important emotional support from family Post-Traumatic Stress Disorder among refugees As assimilation into other Latino communities is common, practitioner needs to be aware of cross-cultural exchanges of health beliefs and practices In-depth interview is crucial May need to obtain information from family and community experts
