1. Culturally Appropriate Foods Panel Christina McGeough, MPH, RDN, CDE Institute for Family Health Clinical Director of Diabetes, Nutrition & Wellness

2. From My Pyramid to My Plate

3. Nutrition Education  Nutrition Education messages to different cultural groups should not be one size fits all  Food choices vary by region even among similar racial/ethnic groups  We learn our eating behaviors from our family, culture, society, etc.  Most people often don’t think about portion size or dividing their plate  Many of us eat combination foods ( soups, stews, casseroles, lasagna, burritos); which makes teaching and demonstrating food groups and portion difficult

4. Latin America  Sub regions  North America  Central America  Caribbean  South America  Primary Languages  Spanish  Portuguese

5. Country of Origin & Food Preferences  Mexico  Corn and beans, thin cuts of meats preferred  Stews, moles and braised meat and poultry are common  Flavoring: tomato sauces and rich chili pastes Technomic Inc. “Grow in America Chain Store Guide: Top 50 Hispanic Markets Report 2005; “Targeting the Hispanic Foodservice Consumer: Keys to Future Success,” January 2006

6. Country of Origin and Food Preferences  South America  Staples: Potatoes, corn and rice  Meats are preferred roasted, grilled or fried  Flavoring: Annatto, coriander, onion, tomatoes and green peppers. Sweet dishes are preferred  Near the Ecuador, preferred foods vary by climate

7. Country of Origin and Food Preferences  Caribbean  Staples: Rice and beans  Meats are preferred roasted, grilled or fried  Flavoring: Garlic, coconut milk and adobo.  Preference for root vegetables such as yuca, malanga and yams

8. Typical Dominican Foods Bread (cornmeal/arepa dominicana) Eggs (scrambled +onions) Fruits bananas, passion fruit, papaya, mangoes, pineapples, jagua and zapote (soft edible food) Salami Ham Mangu (boiled and mashed plantains (topped with onions and deep fried salami, cheese, fried eggs and avocado) Squash (yucca or auyama or cassava) Oatmeal Mangu + eggs Ñame/yam – cooked and boiled Cheese (typically deep fried) Sausage/ longaniza Empanada/ham cheese, corn, meat, eggs, salami Beverages Morir Sonando orange juice+ milk + cane sugar+ ice + evaporated milk(sometimes) Coffee with milk Cocoa Juice: lemon, passion, tamarind, pineapple, Lunch (largest meal of the day) Rice beans (red white or black) – Sancocho --stew with rice and avocado + roots (plantains) + chicken and beef meat (beef, chicken, pork, goat) – Chicharrones de pollo or carne frita (fried meat) – Shrimp stew- camarones guisados – Turkey stew- pavo guisado Foods are from a multitude of patient reported recalls*

9. Typical Dominican Foods (cont’d) Vegetables (corn, potatoes, peas, eggplant, broccoli, avocadoes) Casabe (thin flatbread made with cassava) Empanadas water coffee sweet desserts: cakes, puddings, caramel dipped fruits and creams Dinner (light meal) small sandwich fresh fruit cheese boiled or friend plantains sausage or ham bread rice + beans  Chicken stew—pollo guisado  Liver and onions- hígado encebollado  Cod fish a la dominicana- bacalao a la criolla  Breaded deep fried chicken- pica pollo  Pork roast- puerco asado  Spicy goat meat- chivo picante  Herring stew- Arenque guisado  Eggs a la dominicana- revoltillo de huevos  Pasta  Salad (cabbage and cucumber)  Tostones ( twice fried plantains)  Platanos—sliced plantains  Mofongo (balls of mashed plantains that are salted and roasted)  Seafood

10. One Language Many Variables USAMexico Central America CaribbeanSouth America BeansFrijolesHabichuelas/ Judias Fríjoles/Habas SquashCalabazaCalabaza/ Ahuyama Ahuyama/ Zapallo Corn on the cobEloteMaiz asadoMazorca PeanutsCacahuatesManí Rice stuck to the pot Pegado de arrozConcónPega/concolón Slide by Sandra Arevalo MPH RDN CDE

11. One Language Many Variables USAMexico Central America CaribbeanSouth America Banana Platano maduro Banano OrangeNaranjaChina (PR)Naranja PapayaLechozaFruta Bomba (Cuba) Papaya Fruit smoothieAgua frescaBatidoJugo/Refresco Snack (Picar)MeriendaBocaditoEntremés/ Refrigerio Slide by Sandra Arevalo MPH RDN CDE

12. Cultural Sensitivity & Awareness  Know what participants eat  Then explain where these nutrients fit within their healthy plate and how the WIC package can help balance nutrition needs  Explain new and complex medical terms in simple ways (demonstrate which foods to include or avoid (as in the case of food sensitivities/allergies) with visual images Medical terms may be hard to understand  Diabetes  Wheat allergy  Lactose intolerance

13. Simple Popular Tools  Hand portions  Serving Spoon  Plate Method  Simple Recipes  Supermarket Tours  Food tasting  Pictures  Handouts

14. Guide Participants in Simple Ways Local Circular Sample IFH Super Market Map

15. Use Patient Friendly-Educational Materials  Simple wording  Short sentences  Picture based  Focus on key points  What patient might experience  What patient should do  No statistics, anatomy, physiology  Sensitive to culture

16. Translate Properly  Translation is more than a simple word-to-word replacement  Keep same meaning and style as source text  Source text needs to meet cultural needs of target audience  Consider translating to multiple Spanish language terms

17. Thank you! www.institute.org