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Cultural and Religious
Influences on Food and Nutrition
Chapter 10
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Cultural, Ethnic, and Religious
Influences on Food and Nutrition
• Nutritional requirements among people of similar age and
gender are essentially the same throughout the world
• How a person chooses to satisfy nutritional requirements
is influenced by many variables including:
– Culture
– Socioeconomic status
– Personal factors
– Religion
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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
U.S. by immigrants such as:
– Early settlers
– Native Americans
– West African slaves
– Mexican immigrants
– Chinese and Italian immigrants
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American Cuisine (cont’d)
• Cross-cultural food creations
• “Typical American diet” is difficult to define
• Driven by expediency and ease, convenience
foods and restaurant-sourced meals (either
eat-in or take-out) are a driving force in
current food trends
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American Cuisine (cont’d)
• Convenience foods
– On a typical night in 2007, 89% of meal
preparers made dinner at home
o 57% of those made dinner from scratch
o 24% made their “home-cooked” meals
with prepackaged foods that require some
preparation
o 8% used only frozen or heat-and-serve
prepackaged foods
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American Cuisine (cont’d)
• Convenience foods (cont’d)
– What is important in defining “convenience food”
o Helps me maintain a healthy diet is the top answer
– Convenience products range from convenient
ingredients used to make home-cooked meals to
complete, ready-to-heat meals
– The more convenient the meal is, the greater the
impact all around on time, budget, and nutritional
value
– On the downside, these products tend to be high in
sodium
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American Cuisine (cont’d)
• Restaurant-sourced meals
– In 2006, the average American ate out
approximately 5 times/week
– Compared to 3 years ago, Americans say they
are less willing to pay more for healthy dishes
– Americans go for value/combo meals because
they are easy, convenient, and inexpensive
– Meals ordered out
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Question
• What is true of the typical American diet?
a. Is high in calcium and selenium
b. The majority of foods served are made from
“scratch”
c. Does not include foods from other cultures
d. Is difficult to define
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Answer
d. Is difficult to define
Rationale: A “typical American diet” is difficult
to define.
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The Impact of Culture
• Culture has a profound and unconscious effect
on food choices
• Race, ethnicity, and geographic region are often
inaccurately assumed to be synonymous with
culture
– Leads to stereotypic grouping
• Subgroups within a culture display a unique
range of cultural characteristics that affect food
intake and nutritional status
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The Impact of Culture (cont’d)
• Defined by culture
– What is edible
– Role of food
– How food is prepared
– Symbolic use of food
– When and how food is eaten
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The Impact of Culture (cont’d)
• Culture defines what is edible
– 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
– Culture overrides flavor in determining what is
offensive or unacceptable
– Disliking the idea of the food rather than the
actual food itself
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The Impact of Culture (cont’d)
• The role of certain foods in the diet
– Every culture has a ranking for its foods
– Major food categories include core foods,
secondary foods, and occasional foods
– Core foods
o Provide a significant source of calories and
are regularly included in the diet, usually
on a daily basis
o Core foods are typically complex
carbohydrates
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The Impact of Culture (cont’d)
• The role of certain foods in the diet (cont’d)
– Secondary foods
o Foods widely consumed but not on a daily
basis
o Vary with availability
– Peripheral foods
o Eaten sporadically
o Typically based on an individual’s
preferences, not cultural norms
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The Impact of Culture (cont’d)
• How food is prepared
– Traditional methods of preparation vary between
and within cultural groups
– Traditional seasonings also vary among cultures
• Symbolic use of foods
– Each culture has food customs and bestows
symbolism on certain foods
– Culture also determines which foods are used in
celebration and which provide comfort
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The Impact of Culture (cont’d)
• Symbolic use of foods (cont’d)
– To express love
– To reward or punish
– To display piety
– To express moral sentiments
– To demonstrate belongingness to a group
– To proclaim the separateness of a group
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The Impact of Culture (cont’d)
• When and how food is eaten
– All cultures eat at least once a day
– Mealtimes vary according to culture
– In the United States, bad manners in eating
may be associated with animal behavior
• Cultural values
– Define desirable and undesirable personal and
public behavior and social interaction
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The Impact of Culture (cont’d)
• Health beliefs
– Each culture has a unique point of view on
life, health, and illness and the meaning of
each in society
– Some cultures define foods that create
equilibrium within the body and soul
– Culture also shapes body image
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The Impact of Culture (cont’d)
• Dietary acculturation
– Occurs when eating patterns of people who move
change to resemble those of the host country
– In the U.S., acculturation is linked to increased
risk of chronic disease and obesity
o Studies show that it increases the prevalence
of unhealthy eating practices
– Generally food habits are one of the last
behaviors people change through acculturation
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The Impact of Culture (cont’d)
• Dietary acculturation (cont’d)
– Usually, first-generation Americans adhere
more closely to cultural food patterns
– Second-generation Americans do not have
the direct native connection and may follow
cultural patterns only on holidays and at
family gatherings
– Children tend to adopt new ways quickly
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The Impact of Culture (cont’d)
• Dietary acculturation (cont’d)
– Interrelated changes in food choices that
occur as part of acculturation:
o New foods are added to the diet
o Some traditional foods are replaced by
new foods
o Some traditional foods are rejected
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The Impact of Culture (cont’d)
• Understanding acculturation
– Interventions to promote healthy food
choices can be tailored to be culturally and
individually appropriate
– The art of asking the right questions, rather
than making general assumptions, is key to
understanding the client’s level of
acculturation
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The Impact of Culture (cont’d)
• Understanding acculturation (cont’d)
– Questions to ask:
o What native foods do you eat daily?
o What native foods do you no longer eat?
o What new foods do you eat?
 New immigrants may not know the
names of American foods
o What foods do you eat to keep you healthy?
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The Impact of Culture (cont’d)
• Understanding acculturation (cont’d)
– Questions to ask (cont’d)
o What foods do you avoid to prevent illness?
o Do you balance some foods with other
foods?
o Are there foods you will not eat? Is it
because of personal preference, cultural
norms, or religious mandate?
o For hospitalized clients, ask if there are any
special customs or religious practices they
want performed before or after a meal
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Question
• Which occurs first in dietary acculturation?
a. Some traditional foods are rejected.
b. New foods are added to the diet.
c. The children in the family become
acculturated.
d. Some traditional foods are replaced by new
foods.
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Answer
b. New foods are added to the diet.
Rationale: Interrelated changes in food choices
that occur as part of acculturation include
adding new foods to the diet.
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Traditional Diets of Selected Cultural
Subgroups in the United States
• The U.S. Census Bureau projects that by the
year 2060, less than 50% of the U.S. population
will be white
• The nutritional implication of this shift in cultural
predominance is that cultural sensitivity will
become increasingly important to nursing care
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• Cultural awareness facilitates nutrition care
consistent with the individual’s needs, desires,
and lifestyle
• Actual food choices vary greatly within a
subgroup based on national, regional, ethnic,
and individual differences
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• African Americans
– Majority of African Americans can trace their
ancestry to West Africa
o Some have immigrated from the Caribbean,
Central America, and East African countries
– Much of their native heritage has been
assimilated, lost, or modified
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• African Americans (cont’d)
– Traditional food practices
o “Soul food”
 Tend to be high in fat, cholesterol, and
sodium
 Corn and corn products (grits, cornmeal)
are the primary grain
 Meats are often breaded and fried
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• African Americans (cont’d)
– Traditional food practices
o “Soul food” (cont’d)
 Become a symbol of African American identity
and African heritage
 Today African Americans’ food habits usually
reflect their current socioeconomic status,
geographic location, and work schedule
 Soul food may be reserved for special
occasions and holidays
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• African Americans (cont’d)
– Health beliefs
o Health beliefs and practices are a blend of
traditional African concepts as well as those
encountered through early contact with both
Native Americans and whites
o Home remedies and natural therapies may be
frequently used
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• African Americans (cont’d)
– Nutrition-related health problems
o African Americans score just slightly below
the national population
o A greater proportion of African Americans
are considered to have “poor” diets when
compared to the general population
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• Mexican Americans
– Hispanics or Latinos are described as people
of Cuban, Mexican, Puerto Rican, South or
Central American, or other Spanish culture or
origin regardless of race
– Have become the largest ethnic minority in
the U.S.
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• Mexican Americans (cont’d)
– Traditional food practices
o Traditional Mexican diet is generally a lowfat, high-fiber diet rich in complex
carbohydrates and vegetable proteins
o Pork, goat, and poultry are the most used
animal proteins
o Lactose intolerance is common
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• Mexican Americans (cont’d)
– Health beliefs
o Traditional health beliefs are a blend of European
folk medicine introduced from Spain and Indian
rituals
o Health is viewed as a gift from God
o Illness is inevitable
o Certain foods may be considered “cold” or “hot”
for healing purposes
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• Mexican Americans (cont’d)
– Nutrition-related health problems
o Mexican Americans have the highest Healthy
Eating Index (HEI) scores of all ethnic groups
o Acculturation generally decreases the quality of
the diet
 A high prevalence of overweight and obesity
 A high prevalence of type 2 diabetes
 Cavities and gingivitis are common
 High alcohol use
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• Chinese Americans
– “Asian Americans” encompass a diverse population
originating from at least 25 countries
– 2 dietary commonalities exist between these diverse
cultures:
1. Emphasis on rice and vegetables with relatively
little meat
2. Cooking techniques that include meticulous
attention to preparing ingredients before cooking
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• Chinese Americans (cont’d)
– Traditional food practices
o Foundation of the traditional diet are grains:
rice and wheat
o Most Chinese food is cooked
o Lactose intolerance is common
o Sodium intake is generally assumed to be high
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• Chinese Americans (cont’d)
– Health beliefs
o Believe that health and illness are related to the
balance between yin and yang forces in the body
o Diseases caused by yin forces are treated with
yang foods, and diseases caused by yang forces
are treated with yin foods
o The hot–cold theory of foods and illness also exists
in Puerto Rico and Mexico
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Traditional Diets of Selected Cultural
Subgroups in the United States (cont’d)
• Chinese Americans (cont’d)
– Nutrition-related health problems
o Asian American women have the highest life
expectancy
o Prevalence of overweight and obesity are low
o Asians are 60% to 74% more likely to
develop diabetes
o The leading cause of death among Asian
Americans is cancer
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Question
• Which traditional diet is generally a low-fat,
high-fiber diet rich in complex carbohydrates
and vegetable proteins?
a. American
b. African American
c. Mexican
d. Asian
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Answer
c. Mexican
Rationale: The traditional Mexican diet,
influenced by Spanish and Native American
cultures, is generally a low-fat, high-fiber diet
rich in complex carbohydrates and vegetable
proteins, with an emphasis on corn, corn
products, beans, rice, and breads.
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Food and Religion
• Religion tends to have a greater impact on food
habits than nationality or culture
• Religious food practices vary significantly
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Food and Religion (cont’d)
• Christianity
– 3 primary branches of Christianity are Roman
Catholicism, Eastern Orthodox Christianity, and
Protestantism
– Dietary practices vary from none to explicit
o Roman Catholics
 Do not eat meat on Ash Wednesday or Fridays
in Lent
 Avoid food and beverages 1 hour before
communion
 Several fast days during the year
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Food and Religion (cont’d)
• Christianity (cont’d)
– Eastern Orthodox Christians
o Observe numerous feast and fast days
throughout the year
– Only denominations in the Protestant faith with
dietary laws
o Mormons (Latter Day Saints)
o Seventh-Day Adventists
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Food and Religion (cont’d)
• Christianity (cont’d)
– Mormons
o Do not use coffee, tea, alcohol, or tobacco
o Limit meats; eat mostly grains
o Some fast 1 day per month
– Most Seventh-Day Adventists
o Lacto-ovo vegetarians
o Overeating is avoided
o Coffee, tea, and alcohol are prohibited
o 5 to 6 hours between meals without snacking
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Food and Religion (cont’d)
• Judaism
– 3 main Jewish denominations: Orthodox,
Conservative, and Reform
– Differ in their interpretation of the precepts of
Judaism
– Orthodox Jews believe that the laws are the direct
commandments of God so they adhere strictly to
dietary laws
– Reform Jews follow the moral law but may selectively
follow other laws
– Conservative Jews fall between the other two groups
in their beliefs and adherence to the laws
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Food and Religion (cont’d)
• Judaism
– Orthodox Jews keep “kosher,” a word commonly
used to identify Jewish dietary laws that define:
o “Clean” foods
o “Unclean” foods
o How food animals must be slaughtered
o How foods must be prepared
o When foods may be consumed (e.g., the
timing between eating milk products and meat
products)
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Food and Religion (cont’d)
• Islam
– Muslims eat as a matter of faith and for good
health
– Health and food are considered acts of
worship for which Allah must be thanked
– Halal: Islamic dietary laws
– Haram: foods that are prohibited
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Food and Religion (cont’d)
• Hinduism
– A number of health beliefs and dietary
practices stem from the idea of living in
harmony with nature
– Ahimsa: nonviolence as applied to foods
– Another influential concept is that of purity
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Food and Religion (cont’d)
• Buddhism
– Life revolves around nature with its 2 opposing
energy systems of yin and yang
– Illnesses may result from an imbalance of yin
and yang
– Most Buddhists subscribe to the concept of
ahimsa, so many are lacto-ovo vegetarians
– Dietary practices vary widely depending on the
sect and country
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Question
• Why do Muslims eat?
a. To keep ahimsa
b. As a matter of faith
c. To live in harmony with nature
d. To keep kosher
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Answer
b. As a matter of faith
Rationale: Muslims eat as a matter of faith and
for good health.
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