Page 254 - Nutrition Essentials for Nursing Practice

242 U N I T 2 Nutrition in Health Promotion

Interrelated changes in food choices that occur as part of acculturation are as follows:

■ New foods are added to the diet. Status, economics, information, taste, and exposure are
some of the reasons why new foods are added to the diet. Eating “American” food may
symbolize status and make people feel more connected to their new culture. Frequently,
new foods are added because they are relatively inexpensive and widely available.

■ Some traditional foods are replaced by new foods. This often occurs because traditional
foods may be difficult to find, are too expensive, or have lengthy preparation times. For
many ethnic groups who move to the United States, breakfast and lunch are most likely
to be composed of convenient American foods, whereas traditional foods are retained for
the major dinner meal, which has greater emotional significance.

■ Some traditional foods are rejected. To become more like their peers, children and adoles-
cents are more likely than older adults to reject traditional foods. Traditional foods may
also be rejected because of an increased awareness of the role of nutrition in the develop-
ment of chronic diseases. For instance, one reason why Indians who have resided in the
United States for a relatively long period tend to eat significantly less ghee (clarified but-
ter served with rice or spread on Indian breads) may be that they are trying to decrease
their intake of saturated fat.

Understanding Acculturation

It is important to understand acculturation so that interventions to promote healthy food
choices can be tailored to be culturally and individually appropriate. Ideally, clients will
retain healthy traditional food practices, adopt healthy new food behaviors, and avoid form-
ing less healthy American dietary habits. While first-generation citizens usually need help
choosing American replacements for their native foods, second-generation citizens may
need help selecting healthy American foods.

To be effective in encouraging clients to make healthier food choices, health-care pro-
fessionals must possess specific knowledge about food habits, preferences, and practices
among the cultural and ethnic groups they see in their practice (Goody and Drago, 2009).
Questions that may aid in the understanding of food habits include the following:

■ What traditional foods do you eat daily?
■ What are your favorite foods?
■ What foods do you eat on holidays or special occasions?
■ What traditional foods do you no longer eat?
■ What new foods do you eat? Remember that new immigrants may not know the name of

American foods.
■ What prompted you to eat these new foods?
■ Do you regularly eat new foods?
■ What foods do you eat to keep you healthy?
■ What natural herbs or home remedies do you use?
■ What foods do you avoid to prevent illness?
■ Do you balance some foods with other foods?
■ Are there foods you will not eat? Is it because of personal preference, cultural norms, or

religious mandate?
■ Do you have enough food to eat each day?
■ For hospitalized clients: Are there any special customs or religious practices you want

performed before or after a meal?

Suggestions for conducting effective cross-cultural nutrition counseling are listed in
Box 10.6.