Cultural and Religious Influences on Food and Nutrition
Cultural and Religious Influences on Food and Nutrition
Unfolding Case
Phouvong Chanthavong
Phouvong is a 61-year-old man who immigrated with his wife and two daughters to the United States from Laos at the age of 35 years. He does not speak English, but his daughters are bilingual. He has just been admitted to the hospital for pneumonia where it was discovered he also has type 2 diabetes.
Check Your Knowledge
True
False
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1
Religion tends to have a greater impact on food choices than culture does.
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2
Race and ethnicity are synonymous with culture.
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3
Core foods tend to be complex carbohydrates, such as cereal grains, starchy tubers, and starchy vegetables.
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4
Both Hinduism and Buddhism promote vegetarianism.
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5
The hot-cold theory of health and diet refers to the temperature of the food eaten.
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6
First-generation Americans tend to adhere more closely to their cultural food patterns than subsequent generations.
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7
For many ethnic groups who move to the United States, breakfast and lunch are more likely than dinner to be composed of new “American” foods.
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8
Food prepared away from home tends to increase a person’s intake of calories, sodium, added sugar, and saturated and solid fat.
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9
Dietary acculturation always produces unhealthy changes in eating.
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10
Like restaurant food, the portion sizes listed on convenience meals are much larger than they should be.
Learning Objectives
Upon completion of this chapter, you will be able to
1 Debate the value of using convenience foods to prepare home-cooked meals.
2 Select the healthiest choices from a restaurant menu.
3 Give examples of how culture influences food choices.
4 Explain the general ways in which people’s food choices change as they become acculturated to a new area.
5 Contrast American cultural values with those of traditional cultures.
6 Give examples of questions that may aid in the understanding of a person’s cultural food pattern.
7 Summarize dietary laws followed by major world religions.
Based on Maslow’s hierarchy of needs, food and nutrition rank on the same level as air in the basic necessities of life. Obviously, death eventually occurs without food. But unlike air, food does so much more than simply sustain life. Food is loaded with personal, social, and cultural meanings that define our food values, beliefs, and customs. That food nourishes the mind as well as the body broadens nutrition to an art as well as a science. Nutrition is not simply a matter of food or no food but rather a question of what kind, how much, how often, and why. Merging want with need and pleasure with health are keys to nourishing body, mind, and soul.
This chapter discusses what America eats and the impact of culture on food choices. Traditional food practices of major cultural subgroups in the United States are presented, as are religious food practices.
Culture encompasses the total way of life of a particular population or community at a given time.
AMERICAN CUISINE
American cuisine is a rich and complex melting pot of foods and cooking methods that have been adapted and adopted from cuisines brought to the United States by immigrants. Early settlers from northern and southern Europe came with their own established foodway that changed in response to what was available in the New World. Native Americans made significant contributions to American cuisine by introducing items such as corn, squash, beans, cranberries, and maple syrup. Later, West African slaves brought okra, watermelon, black-eyed peas, and taro and influenced the regional cuisine in the Southeastern United States with fried, boiled, and roasted dishes made with pork and pork fat. Likewise, American Southwest cuisine was shaped by flavors and ingredients brought across the border by Mexican Indians and Spanish settlers.
In the early 1850s, the first wave of Chinese immigrants came to the United States to join the gold rush. They brought stir-fry, a novel cooking method, and new foods such as egg rolls, fried rice, and spare ribs. The first wave of Italian immigrants arrived around 1880, and although they were unable to replicate their native foods, they utilized the available ingredients to create Americanized versions of lasagna, manicotti, veal parmigiana, and meatballs. Today, Italian food is mainstream American fare.
The influx of immigrants continued, and cuisines from around the globe melded. Today, it is difficult to determine which foods are truly American and which are an adaptation from other cultures. Swiss steak, Russian dressing, and chili con carne are American inventions. And although ethnic restaurants and ethnic foods sections in grocery stores offer distinct fare, cross-cultural food creations, such as Tex-Mex wontons and tofu lasagna, reaffirm the ongoing melting pot nature of American cuisine.
Although a “typical American diet” is difficult to define, Box 10.1 offers a snapshot view of what and how America eats. Driven by expediency and ease, convenience foods and restaurant-sourced meals (either dine in or takeout) are a driving force in current food trends.
Foodway an all-encompassing term that refers to all aspects of food including what is edible, the role of certain foods in the diet, how food is prepared, the use of foods, the number and timing of daily meals, how food is eaten, and health beliefs related to food.
BOX 10.1 Snapshot View of What and How America Eats
More than 80% of our meals are prepared at home.
Bananas are the most purchased fresh fruit, followed by apples, grapes, strawberries, and oranges.
Tomatoes are the most purchased vegetable, followed by potatoes, onions, carrots, bell peppers, and broccoli.
The average number of in-between meal snacks eaten daily per person is 2.6.
41% of adults eat three or more snacks daily.
79% of all restaurant meals are from fast-food outlets.
Pizza is the most popular fast-food item ordered for dinner.
42% of women take calorie counts on the menu into account when ordering at a restaurant; 29% of men do.
Sources:Parade. (2014). What American eats: Our exclusive survey on the nation’s changing tastes. Available at http://parade.com/334779/parade/what-america-eats-our-exclusive-survey-on-the-nations-changing-tastes/. Accessed on 4/1/16; and Sloan, A. (2016). What, when, and where America eats. Food Technology, 70, 23-35.
Food Prepared at Home
During an average week, American consumers eat dinner at home 5.7 times (Sloan, 2016). Generally, food prepared at home is healthier than food obtained away from home (Virudachalam, Long, Harhay, Polsky, & Feudtner, 2014). Lower household wealth and education attainment are associated with a higher likelihood of either always or never cooking dinner at home; wealthier, more educated households were more likely to sometimes cook dinner at home (Virudachalam et al., 2014).
Fifty-eight percent of the main dishes made at home are made from scratch or made with fresh ingredients (Parade, 2014). Most people who prepare meals at home either very often or occasionally incorporate convenience items, such as pre-prepared and/or frozen ingredients to make from scratch cooking easier and quicker. Generally, the more convenient the meal is, the greater the impact all around on time, budget, and nutritional value. Frozen complete or nearly complete meals or boxed “helper” type entrées earn their designation as “convenient” but cost more than “from-scratch” items, lack that “homemade” taste, tend to be high in sodium, and the 1- to 2-cup portion sizes listed on the label may leave many people hungry. See Box 10.2 for tips on balancing convenience with nutrition.
A relatively new and growing option for preparing food at home is to use a meal kit delivery service. Consumers choose from a list of available meals online and receive the recipe and all the ingredients in the proper portions delivered to their door. Salt, pepper, and oil may be the only additional ingredients needed. These services are attractive to people who do not have the time for or interest in meal planning and food selection and they enable people to try new cuisines without investing in exotic ingredients such as a bottle of a spice when only a fraction of a teaspoon is needed. Meal kits tend to get favorable reviews for taste, variety, freshness, and convenience and eliminate waste from leftovers. On the downside, they are more expensive than traditionally prepared meals, the sodium content tends to be high, and not all delivery services provide nutrition information on their recipe cards.
Quick Bite
Examples of convenience items with a positive impact on nutrition
Fresh fruits and vegetables from the salad bar
Frozen juice concentrate
Washed spinach
Prewashed and cut vegetables
Complete salad kits
Plain frozen vegetables
Fresh sushi
Whole-grain rolls from the bakery section
Jarred spaghetti sauce
Prepared hummus
Rotisserie chickens
Lean delicatessen meats
Food Cooked Away from Home
Data from 2012 show that 43.1% of food spending was on food away from home (FAFH), which has risen steadily from 25.9% in 1970 (U.S. Department of Agriculture [USDA], Economic Research Service [ERS], 2014). Although eating out may be easy and quick, diet quality suffers. Meals and snacks based on food prepared away from home contain more calories per eating occasion than home-prepared food (USDA, ERS, 2014). A study by Todd, Mancino, and Lin (2010) found that for the average adult, eating one meal of FAFH increases daily calorie intake by 134 calories. In addition, FAFH decreases the number of servings of fruit, vegetables, whole grains, and dairy per 1000 calories consumed; and fiber, calcium, and iron intakes decline. Conversely, FAFH increases sodium per 1000 calories and the percentage of calories from saturated fat, solid fat, alcohol, and added sugar. Because eating out has evolved from a special treat to a regular event, planning and menu savvy are needed to ensure that eating out is consistent with, not contradictory to, eating healthy. Tips for eating healthy while eating out appear in Box 10.3. “Best bet” choices from various ethnic restaurants are listed in Box 10.4.
BOX 10.2 Tips for Balancing Convenience with Nutrition
Read the label to comparison shop. Calories, fat, saturated fat, and sodium can vary greatly among different brands of similar items. A rule-of-thumb guideline is to limit sodium to less than 800 mg and fat to no more than 10 to 13 g in a meal that provides 300 to 400 calories.
Look for “healthy” on the label. The government allows “healthy” on the label of meals or entrées that limit sodium to 140 mg/100 g of food. And “healthy” foods must also provide 3 g or less of total fat or 1 g of saturated fat per 100 g of food. They are a better choice than the products not labeled “healthy” yet may still lack adequate fiber.
Add additional ingredients to “stretch” the meal. For instance, adding a bag of frozen vegetables, a can of tomatoes, or a can of garbanzo or black beans provides nutrients and increases volume.
Add healthy side dishes. A convenience “meal” that provides 300 to 400 calories may leave many people hungry. Adding quick and easy side dishes, such as bagged salad mixes, raw vegetables, whole-grain rolls, an instant cup of soup, or piece of fresh fruit, can greatly increase nutritional and satiety values.
Adjust the seasoning when possible. Some frozen meal solutions contain a separate seasoning packet; using half satisfies taste while cutting sodium.
Another category of food cooked away from home is prepared meals from the grocery store. Prepared food is a $29-billion-a-year business and is growing twice as fast as overall grocery store sales (Hobson, 2016). The trend in buying prepared items began with the desire for convenience; its growth is fueled by consumers’ perception that prepared food is fresher and healthier than take out dinners or convenience foods from the frozen food aisle. However, the “fresh” food may not actually be made on premises, sodium content is often high, serving sizes are not suggested so it is easy to over buy and overeat, and items are generally much more expensive than making the item at home.
BOX 10.3 Tips for Eating Healthy While Eating Out
Plan Ahead
Choose the restaurant carefully so you know there are reasonable choices available.
Check online or call ahead to inquire about menu selections. This is an especially important strategy when the location is not a matter of choice but, rather, a requirement such as for business luncheons or conferences. It may be possible to make a special request ahead of time.
Don’t Arrive Starving
People become much less discriminating in their food choices when they are hungry.
Eating a small, high-fiber snack an hour or so before going out to dinner, such as whole wheat crackers with peanut butter or a piece of fresh fruit with milk, can take the edge off hunger without bankrupting healthy eating.
Balance the Rest of the Day
When eating out is an occasion, such as for a birthday or anniversary celebration, make healthier choices the rest of the day to compensate for a planned indulgence.
Practice Portion Control
Order the smallest size meat available.
Create a doggie bag before eating; if you wait until the end of the meal, there may not be any left.
Order regular size, not biggie size or super size.
Order a la carte. Is a value meal a “better value” if it undermines your attempt to eat healthily?
Order a half portion when available.
Order two (carefully chosen) appetizers in place of an entrée, or order an appetizer and split an entrée with a companion.
Know the Terminology
Calorie-laden words to watch out for include:
Buttered
Battered
Breaded
Deep fried
Au gratin
Creamy
Crispy
Alfredo
Bisque
Hollandaise
Parmigiana
Béarnaise
En croute
Escalloped
French fried
Pan fried
Rich
Sautéed
With gravy, with mayonnaise, with cheese
Less fatty terms are baked, braised, broiled, cooked in its own juice, grilled, lightly sautéed, poached, roasted, and steamed.
Beware of Hidden Fats, Such as
High-fat meats
Nuts
Cream and full-fat milk
Full-fat salad dressings and mayonnaise
Sauces and gravies
Make Special Requests
Order sauces and gravies “on the side.”
Ask that lower fat items be substituted for high-fat items (e.g., a baked potato instead of French fries).
Substitute brown rice for white rice.
Request an alternate cooking method (e.g., broiled instead of fried).
BOX 10.4 Best Bet Choices from Fast-Food and Ethnic Restaurants
Fast Foods
English muffins or bagels with spreads on the side
Butter, margarine, or syrups on the side—not added to food
Baked potato—plain or with reduced-fat or fat-free dressings or salsa
Pretzels or baked chips
Regular, small, or junior sizes
Ketchup, mustard, relish, BBQ sauce, and fresh vegetables as toppings
Grilled chicken sandwiches without “special sauce”
Veggie burger
Small roast beef on roll
Fruit’n yogurt parfait
Lean, 6-in subs on whole-grain rolls
Side salads with reduced-fat or fat-free dressings
Lean meats: Canadian bacon, ham, grilled chicken, shrimp, crab meat
Half-cheese pizza
Salad as a side dish
Buffet
Survey the buffet before beginning.
Use a small plate.
Pile food no thicker than a deck of cards.
Practice the “plate method”: one-quarter meat, three-quarters plants.
Mexican
Sauces: salsa, mole, picante, enchilada, pico de gallo
Guacamole and sour cream on the side
Black bean soup, gazpacho
Soft, nonfried tortillas as in bean burritos or enchiladas
Refried beans (without lard)
Arroz con pollo (chicken with rice)
Grilled meat, fish, or chicken
Steamed vegetables
Soft-shell chicken or veggie tacos
A la carte or half entrée
Fajitas: chicken, seafood, vegetable, beef
Flan (usually a small portion)
Chinese
Hot-and-sour soup, wonton soup
Chicken chow mein
Chicken or beef chop suey
Szechuan dishes
Shrimp with garlic sauce
Stir-fried and teriyaki dishes
Noodles: lo mein, chow fun, Singapore noodles
Steamed rice instead of fried
Steamed spring rolls
Tofu
Steamed dumplings and other dim sum instead of egg rolls
Fortune cookies
Use chopsticks
No monosodium glutamate (MSG)
Italian
Minestrone
Garden salad; vinegar and oil dressing
Breadsticks, bruschetta, Italian bread
Sauces: red clam, marinara, wine, cacciatore, fra diavolo, marsala
Shrimp, veal, chicken without breading
Choose vegetables for a side dish instead of pasta or potatoes
Limit “unlimited” bread or breadsticks
Italian ice or fruit
Indian
Raw vegetable salads, Mulligatawny soup (lentil soup)
Tandoori meats
Condiments: fruits and vegetable chutneys, raita (cucumber and yogurt sauce)
Lentil and chickpea curries
Chicken and vegetables
Chicken rice pilaf
Basmati rice
Naan (bread baked in tandoori oven)
Dal
Japanese
Boiled green soybeans, miso soup, bean soups
Sushi—cooked varieties include imitation crab, cooked shrimp, scrambled egg
Most combinations of grilled meats or seafood
Teriyaki chicken or seafood
Steamed rice, rice noodles
Green tea
Greek
Lentil soup
Greek salad, tabouli
Chicken, lamb, pork souvlaki salad or sandwich
Shish kebabs
Pita bread
Make a meal of appetizers: baba ghanoush (smoked eggplant), hummus (mashed chickpeas), dolma (stuffed grape leaves), and tabouli (cracked wheat salad). Olive oil is often poured on the baba ghanoush, hummus, and other foods, so ask for it on the side.
Convenience Food broadly defined as any product that saves time in food preparation, ranging from bagged fresh salad mixes to frozen packaged complete meals.
THE EFFECT OF CULTURE
Quick Bite
Culture
Has an inherent value system that defines what is “normal”
Is learned, not instinctive
Is passed from generation to generation
Has an unconscious influence on its members
Resists change but is not static
Culture has a profound and unconscious effect on food choices. Yet, within all cultures, individuals or groups of individuals may behave differently from the socially standardized foodway because of age, gender, state of health, household structure, or socioeconomic status. Race, ethnicity, and geographic region are often inaccurately assumed to be synonymous with culture. This misconception leads to stereotypic grouping, such as assuming that all Jews adhere to orthodox food laws or that all Southerners eat sausage, biscuits, and gravy. Subgroups within a culture display a unique range of cultural characteristics that affect food intake and nutritional status. What is edible, the role of food, how food is prepared, the symbolic use of food, and when and how food is eaten are among the many characteristics defined by culture.
Subgroups unique cultural groups that exists within a dominant culture.
Culture Defines What Is Edible
Culture determines what is edible and what is inedible. To be labeled a food, an 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 the United States, horsemeat, insects, and dog meat are not considered food, even though they meet the food criteria. Culture overrides flavor in determining what is offensive or unacceptable. For example, you may like a food (e.g., rattlesnake) until you know what it is; this reflects disliking the idea of the food rather than the actual food itself. An unconscious food selection decision process appears in Figure 10.1.
Edible foods that are part of an individual’s diet.
Inedible foods that are usually poisonous or taboo.
The Role of Certain Foods in the Diet
Every culture has a ranking for its foods that is influenced by cost and availability. Major food categories include core foods, secondary foods, and peripheral, or occasional, foods.
Core Foods
Core foods provide a significant source of calories and are regularly included in the diet, usually on a daily basis. Core foods are typically complex carbohydrates, such as cereal grains (rice, wheat, millet, corn), starchy tubers (potatoes, yams, taro, cassava), and starchy vegetables (plantain or green bananas). In much of the world, highfat, energy-dense diets have replaced traditional diets high in complex carbohydrates (Caprio et al., 2008).
Core Foods the important and consistently eaten foods that form the foundation of the diet; they are the dietary staples.
Unfolding Case
Consider Phouvong. A core food in his eating pattern is sticky rice, a type of rice referred to as glutinous because it is glue-like or sticky, not because it contains gluten. Through an interpreter, the nurse learns Phouvong eats a traditional Laotian eating pattern and will not eat American food. The only food he eats that is not prepared by his wife is food prepared by other Laotians in his tightly knit community. What information would be important to obtain in order to meet his nutritional needs in a culturally appropriate manner?
Figure 10.1 ▶ Food selection and decision making.
Secondary Foods
Foods widely consumed, but not on a daily basis, are considered secondary foods, such as vegetables, legumes, nuts, fish, eggs, and meats. Secondary foods used by a culture vary with availability. For instance, the types of legumes used in Chinese culture include mung beans and soybeans, whereas those used in Latin American culture include black beans and pinto beans.
Secondary Foods foods that are widespread in the diet but not eaten consistently.
Peripheral Foods
Peripheral, or occasional, foods, eaten sporadically, are typically based on an individual’s preferences, not cultural norms. They may be foods that are reserved for special occasions, not readily available, or not generally well tolerated, as is the case with milk among Asian Americans.
Peripheral, or Occasional, Foods foods that are infrequently consumed.
How Food Is Prepared
Traditional methods of preparation vary between and within cultural groups. For instance, vegetables often are stir-fried in Asian cultures but boiled in Hispanic cultures. What is deemed a healthy cooking method in the United States, such as baking and grilling, may be seen by other groups as causing an undesirable change in the nature of the food (Carr, 2012). Traditional seasonings also vary among cultures and may be the distinguishing feature between one culture’s foods and another’s (Table 10.1). The choice of seasonings varies among geographic regions and between seasons, based on availability. With home-prepared meals, seasonings are adjusted to suit the family’s preferences.
Table 10.1 Examples of Seasonings Used by Various Cultures
Cultural Group
Distinguishing Flavors
Asian Indian
Garam masala (curry blend of coriander, cumin, fenugreek, turmeric, black pepper, cayenne, cloves, cardamom, and chili peppers), mint, saffron, mustard, fennel, cinnamon
Brazilian (Bahia)
Chili peppers, dried shrimp, ginger root, palm oil
Chinese
Soy sauce, rice wine, ginger root
French
Butter, cream, wine, bouquet garni (tarragon, thyme, bay leaf)
German
Sour cream, vinegar, dill, mustard, black pepper
Greek
Lemon, onions, garlic, oregano, olive oil
Italian
Tomato, garlic, basil, oregano, olive oil
Japanese
Soy sauce, sugar, rice wine vinegar
Korean
Soy sauce, garlic, ginger root, black pepper, scallions, chili peppers, sesame seeds or oil
Mexican
Tomatoes, onions, chili peppers, cumin
Puerto Rican
Sofrito (seasoning sauce of tomatoes, onions, garlic, bell peppers, cilantro, capers, pimento, annatto seeds, and lard)
Thai
Fermented fish sauce, coconut milk, chili peppers, garlic, ginger root, lemon grass, tamarind