Question

Locate an article on the nutritional beliefs of a culture or religion. Provide a summary of the article and include a link to the article. What interventions should be implemented to ensure cultural competence?

Answer 1

Food habits are one of the most complex aspects of human behavior, being determined by multiple motives and directed and controlled by multiple stimuli. Food acceptance is a complex reaction influenced by biochemical, physiological, psychological, social and educational factors. Metabolic conditions play an important role. Age, sex and mental state are factors of importance. People differ greatly in their sensory response to foods. The likes and dislikes of the individual with respect to food move in a framework of race, tradition, economic status and environmental conditions

For most people food is cultural, not nutritional. A plant or animal may be considered edible in one society and inedible in another. Probably one of the most important things to remember in connection with the cultural factors involved in food habits is that there are many combination of food which will give same nutritional results.

Culture consist of values, attitudes, habits and customs, acquired by learning which starts with the earliest experiences of childhood, much of which is not deliberately taught by anyone and which so thoroughly internalized that it is unconscious but ‘goes deep’. Food habits are among the oldest and most deeply entrenched aspects of many cultures and cannot, therefore, be easily changed, or if forcibly changed, can produce a series of unexpected and unwelcome reactions. Food and food habits as a basic part of culture serve as a focus of emotional association, a channel of love, discrimination and disapproval and usually have symbolic references. The sharing of food symbolizes a high degree of social intimacy and acceptance.

In many cultures food has a social or ceremonial role. Certain foods are highly prized; others are reserved for special holidays or religious feasts; still others are a mark of social position. There are cultural classifications of food such as ‘inedible’, ‘edible by animals’, ‘edible by human beings but not by one’s own kind of human being’, ‘edible by human being such as self’, ‘edible by self’. In different cultures, certain foods are considered ‘heavy’, some are ‘light’ some as ‘foods for strength’; some as ‘luxury’, etc.

The challenge to health care provider is to be culturally adaptable, to display cross-cultural communication skills, to remain aware of nonverbal cues that are culturally motives, and to move toward a trusting interpersonal relationship as quickly as possible.

John Cassel (1957) had illustrated in his review, that it is possible to derive some guiding principles indicating the significance of social and cultural factors to health programs in general. Health workers should have an intimate detailed knowledge of the people’s beliefs, attitudes, knowledge and behavior before attempting to introduce any innovation into an area.

The second principle, which is usually more difficult to apply, is that the psychologic and social functions of these practices, beliefs, and attitudes need to be evaluated. As stated by Benjamin Paul“It is relatively easy to perceive that others have different customs and beliefs, especially if they are ‘odd’ or ‘curious’. It is generally more difficult to perceive the pattern or system into which these customs or beliefs fit.” It is in this area of determining the pattern or system into which these customs or beliefs fit those social scientists can probably make their greatest contribution to health programs. This is the knowledge that will help to determine why certain practices exist, how difficult it will be to change them, and give indications of the techniques that can be expected to be most helpful.

A third principle that should be emphasized was unfortunately not well illustrated in the example but is of fundamental importance. The sub cultural groups must be carefully defined, as programs based on premises, true for one group, will not necessarily be successful in a neighboring group. This also is an area in which we as health workers can receive invaluable assistance from social scientists.

Anne Burgess (1961) stated that health assistants with some training in the principles of anthropology and education are indeed an innovation and it appears an effective one. Where nutrition education has proved disappointing in the past, could it be that ‘retention of customs’ has been as ‘turbulent a thing’ as that of the villagers.

Nelson Freimer et al (1983)Cultural variation may play an important role in human nutrition and must be considered in either clinical or public health intervention particularly in areas with large immigrant populations. Acculturative and environmental change influences the food habits and health of transitional groups. Nutritional assessment may be complicated by cultural variation. The relationship between ethnicity and nutrition may be of evolutionary significance. Food beliefs may have beneficial or detrimental effects on health status. The study of acculturating populations may elucidate the pathogenesis of nutrition-related chronic diseases. Appreciation of the interaction of culture and nutrition may be of benefit to physicians and nutritionists in clinical practice and to those concerned with the prevention of nutrition related chronic diseases.

Christine M. Olson (1989) had stated that childhood nutrition education is imperative in health promotion and disease prevention. The Report concludes ‘that overconsumption of certain dietary components is now a major concern for Americans’. While many food factors are involved, chief among them is the disproportionate consumption of foods high in fat, often at the expense of foods high in complex carbohydrates and fiber that may be more conducive to health.

Two widely recommended strategies for incorporating nutrition education directed toward children and youth into health promotion and disease prevention efforts are school-based nutrition education and the integration of nutritional care into health care. School based nutrition education programs targeted toward very specific eating behaviors are showing very promising results in regard to behavior and attitude change of children and adolescents. Substantial changes in health care providers’ attitudes and practices and in the funding and financing of health care will be needed if nutrition education is to be delivered in the context of routine health care.

Puline M Adair, Cynthia M Pine et al (2004) had conducted a study on familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economically diverse groups. Factor analysis identified those attitudes, towards tooth brushing, sugar snacking and childhood caries. Attitudes were significantly different in families from deprived and non-deprived backgrounds and in families of children with and without caries. Parents’ perception of their ability to control their children’s tooth brushing and sugar snacking habits were the most significant predictors of whether or not favorable habits were reported. Some differences were found by site and ethnic group. This study supports the hypothesis that parental attitudes significantly has an impact on the establishment of habits favorable to oral health. An appreciation of the impact of cultural and ethnic diversity is important in understanding how parental attitudes to oral health vary. Further research should examine in a prospective intervention whether enhancing parenting skills is an effective route to preventing childhood caries.