Caribbean Islanders and South Americans

Caribbean Islanders and South Americans
Chapter 10

Caribbean Islanders Bahamas Greater Antilles Lesser Antilles
Jamaica Cuba Largest Island Hispaniola Puerto Rico US territory Lesser Antilles Aruba Bonaire Curacao US Virgin Islands Martinique Antigua/Barbuda Barbados Dominica Dominican Republic Grenada Haiti St. Christopher /Nevis St. Lucia St. Vincent /Grenadines Trinidad Tobago

Caribbean Islanders

Introduction Homelands vary greatly geographically
Ethnic backgrounds very different Variety of regional fares with few national cuisines Native dishes with food introduced from Europe, Africa, Asia Strong, spicy flavors

History of Caribbean Islanders in the US: Immigration Patterns
About 20% of the Latino population Puerto Rico, then Cuba, then the Dominican Republic Smaller numbers from Jamaica and Haiti

Puerto Ricans Not immigrants
Over half the population of Puerto Rico lives in the US NYC Puerto Rican population is larger than the largest city in Puerto Rico Largest numbers came to the US after WWII A very fluid population

Cubans Majority came to US in 1959 after Fidel Castro gained control
Most were of the upper socioeconomic class fleeing communism More Cubans came to the US in the 60’s and 70’s with the airlifts Recent arrivals from the Mariel boatlift are poor, less skilled Called marielitos

Dominicans Information is limited on immigration 4 Groups
: Political dissidents came to escape the Trujillo regime Post-Trujillo era and improvements slowed immigration Flotilla group in the 1980’s Those who have left after the early 80’s Often better educated Seeking employment opportunities

Current Demographics:
Puerto Ricans Largest group in NYC Cubans Miami Dominicans NY, NJ, MA, FL Others NE and South

Socioeconomic Status Economic and education levels vary greatly
Puerto Ricans have highest unemployment, Cubans the lowest 25% of Puerto Ricans live in poverty 2nd generation Puerto Ricans income is higher Cubans have highest income among Latinos, but still below national average Dominicans have lowest median family income and highest rates of poverty among Latinos

Education Rates Puerto Ricans and Cubans graduate from high school at below general population for 1st generation Lower for those born in Puerto Rico or Cuba Cubans graduate from college at about rate of the general population Double those of Puerto Ricans Over half attend private schools Half of Dominican Americans have graduated high school, slightly lower for those foreign born 62% of foreign born Haitian adults have graduated high school

Factors Influencing Socioeconomic Status
Frequent changes in residence Low education levels and undeveloped job skills translate into unemployment and low-level employment Racial bias Cubans immigrated out of necessity and brought with them upper class values Importance of education and financial success

Worldview: Religion Majority are Roman Catholic
95% of Dominicans Majority of Jamaicans are Protestant Church of God 7th Day Adventists Judaism

Worldview: Folk Religions
Voodoo Combo of W African tribal rituals and Catholic beliefs, local customs Catholic rites practiced with ancestor worship, drums, African dancing Worship is family based No central leadership/organization of activities Ceremonies conducted for Christmas, harvest, funerals Originated in Haiti

Worldview: Folk Religions
Santeria found in Cuba and Puerto Rico Afro-Catholic cult similar to Voodoo Rastafari Jamaica Natural, simple lifestyle Sacramental use of marijuana Considered a political movement Both Afro-Caribbean religions

Worldview: Family Puerto Rico Compadrazgo – co-parenting
Men are head of household Women maintain the home Men are aggressive, women reserved Elders are honored Children well behaved Traditional Cuban families are similar and extend to include relatives

Worldview: Family Families change in the US
Women work in greater numbers than men May make higher income Have greater authority Children gain greater autonomy Dominicans and Jamaicans have high levels of divorce and abandonment

Worldview: Family Common-law marriage common in rural Haiti
Man may maintain several households as long as he supports each wife and children Similar to West African polygamous societies Gender roles inflexible Have maintained more traditional families while living in the US

Traditional Health Beliefs and Practices
Beliefs similar to other Latin American cultures Puerto Ricans, Cubans, Dominicans, Haitians Illness is punishment from God or sent by devil Fate determines life/death Prayer, lighting candles to saints Laying on of hands Dominicans employ the promesa Guardian angel to protect from evil Illness caused by evil spirits or the devil Dominicans and Haitians

Puerto Ricans Nervios Experienced trauma as child may be nervous for life Ser nervioso Crying bouts, headaches, stomach maladies, tendency toward violence in men Padecer de los nervios Mental illness associated with depression Psychologists or psychiatrists

Puerto Ricans, continued
Ataques de nervios, or ataques A hysterical reaction to stressful events Acute breathing difficulties, frenzy, sudden onset of illness Nervios Found in more women than men Associated with a weak character Helped by prayer, massage, sedatives, and herbal teas Physicians and mental health specialists also help

Puerto Ricans, continued
Pasmo Type of paralysis from imbalance of hot and cold Cured through folk remedies Fatique Acute breathing difficulties Responds to emergency care provided by a physician

Traditional Health Beliefs and Practices: Haitians
Concerned with flow of blood Hot, cold, weak, thin, thick, dirty, yellow Febles Insufficient blood or anemia due to poor diet Gaz (gas) pain settles anywhere – from eating leftovers Nursing mother’s milk may thicken or spoil Move san is more serious After a fright mother’s milk spoils with resulting failure to thrive, diarrhea for infant Evil eye mal dyok

Closely related to African beliefs Mild conditions treated by older women Entire family is consulted Conditions due to supernatural Priests, priestesses, healers consulted Santeros specialize in soul possession and mental disorders Ancestors provide instructions regarding health behaviors through dreams Brujos (witches) and curenderos (healers)

Good hygiene Daily bathing Good diet Regular sleep Various other practices Teas and OTC preparations used by all Home remedies Bodegas, Botanicas have remedies to purchase

Traditional Food Habits: Indigenous Foods – Fresh fruits and vegetables
Cassava Manioc and Yucca Acerola Avocados Bananas Plantains Beans Calabaza Pumpkin Cashew apples Cocoa Coconuts Corn Guavas Malanga Cocoyam Mammee apples Papayas Pawpaws Pineapple Sapodilla Naseberry Soursop Squash Sweet potatoes Tomatoes Fish and Small game

Traditional Food Habits: Indigenous Foods
Chile peppers Extremely hot varieties favored Pepper sauces Allspice Recao Long cilantro Annatto Achiote Cooking techniques underdeveloped

Traditional Food Habits: Indigenous Foods - Cassava
Staple starch is Cassava Also called Yucca or Manioc Tapioca comes from cassava Bitter and sweet Baked into bread made from pressed, dried, grated cassava that was fried in a flat loaf Must be cooked as it contains hydrocyanic acid which is toxic in large amounts

Traditional Food Habits: Foreign Influence
Spanish brought cattle, goats, hogs, sheep Introduced rice Breadfruit, coffee, limes, mangoes, oranges Spices like ginger, nutmeg, mace African slaves cultivated Akee Can cause fatal hypoglycemia Most akee products are banned in the US Yams, okra, taro Asians introduced soybean, greens, lentils

Traditional Food Habits: Staples
Legumes Rice and peas Rice with red beans Puerto Rico Black beans with rice Moors y Cristianos Cuba Black-eyed peas with rice Haiti Pigeon peas Lentils Chickpeas Garbanzo beans Bodi beans Chinese long beans

Cassava bread Chili sauces Pepper pot Meat stew w/ cassava Tamales Pasteles Dough packets w/ savory fillings Kerry or Colombo Curried dishes Callaloo Taro greens w/ okra Bacalaitas Dried salt cod fritters Stamp and go, arcat de marue, many different names Foofoo Okra and plantain Coocoo Cornmeal-okra bread

Coffee Most popular beverage Jamaica produces some of the most expensive coffee in the world Rum Fermented molasses Originated in Barbados in early 1600’s Byproduct of sugarcane industry Juices from tropical fruits Spiced with ginger, coconut milk may be added

Traditional Food Habits: Regional Variations
Butter preferred in French-influenced countries Roux used to thicken sauces and stews Lard in Spanish-influenced nations Use more tomatoes, onions, annatto, sweet bell peppers Coconut oil common in Jamaica British-influenced countries use scallions, parsley, cilantro, thyme

Traditional Food Habits: Regional Variations: Puerto Rico
Puerto Rico known for distinctive flavorings Alcaparrado, sofrito, adobo Starchy foods Side dish or in soups and stews Called Viandas Pork is a favorite meat or beef or goat Black beans common Many finger foods for snacks

Traditional Food Habits: Regional Variations: Cuba
Black beans very popular Viandas Foofoo Cassava balls Tostones Fried plantains Meats and viandas served with mojito Sauce of olive oil, juice from limes or sour oranges, onions, and garlic Many foods with Spanish origins

Traditional Food Habits: Regional Variations: Dominican Republic
Stews a specialty Mondongo (tripe soup) Sancocho (soup with several meats) Locrio Origins from paella but uses only a single item (protein) Salads, avocados, hearts of palm Common side or dessert is Habichuelas con dulce Red beans, coconut milk, evaporated milk, whole milk, sugar, and butter Desserts of flan, fruit compotes, puddings

Traditional Food Habits: Regional Variations: Jamaica
Akee Salt cod Curried goat Bammies Type of cassava bread Mackerel rundown Cooked in coconut milk with vegetables “Jerk” foods Wet spice used in BBQ

Traditional Food Habits: Regional Variations: Haiti
Banana-stuffed chicken Poulet roti a la creole BBQ goat with chile peppers Kabrit boukannen akbon piman Griot Pork marinated in seasoned sour orange juice, boiled, fried Patties Curried meat turnover Side dishes of Cornmeal mush Black rice (riz noir) Rice cooked in mushroom broth

Traditional Food Habits: Regional Variations: Others
Curaçao An orange-flavored liqueur Dominica Crapaud or “mountain chicken” A large, tasty frog Barbados Unusual seafood dishes Flying fish Green turtles Sea urchins

Meal Composition and Cycle
Emphasis on starchy vegetables Some leafy vegetables Some meat, poultry or fish Fried or grilled May be cooked first with sugar to caramelize Served with rice and beans Breads of all sorts Soups and stews are popular Fruits maybe for snack or dessert

Ethnic heritage and social class determine which dishes are served Poor native Indian Cassava, tomatoes, chiles with some salted fish Asian Indian Adapt to Caribbean ingredients Curry dish with coconut, fried plantains, pineapple Most have muticultural mix

Meal Composition and Cycle: Daily Patterns
3 meals a day Haiti may have only 2 Traditionally has been larger breakfast and lunch Often toast and coffee for breakfast Changing somewhat to heavier evening meal Jamaicans may have fish at breakfast Lighter, leisurely dinner Rice, beans, squash Desserts daily Coffee, snacks

Meal Composition and Cycle: Daily Patterns: Special Occasions
Emphasis on Christian (Catholic) holidays Christmas Pasteles commonly served Similar to tamales Noche buena (Christmas Eve) Mass followed by a feast Carnival Day-long birthday open house in Curaçao Thanksgiving in Puerto Rico Sunday meals emphasize fresh meat and/or picnics

Meal Composition and Cycle: Daily Patterns: Etiquette
Knives and forks held European-style Pass dishes to the left Keep hands visible Wait until host starts the meal In Cuba, do not consume fruits and vegetables with the hands In Puerto Rico don’t waste food Don’t take more than you can eat

Therapeutic Uses of Food
Hot-cold classification system of diet and health Puerto Ricans add cool Balance hot-cold elements in meals Puerto Ricans, Dominicans, Haitians most likely to follow Haitians believe women are warmer than men and people cool as they age Heavy or light foods in addition to hot/cold/cool Consume heavy foods (starches) during the day Light foods (soup) in the evening

Puerto Ricans follow hot/cold carefully during pregnancy (hot condition) Infants are particularly watched High calorie tonics to stimulate appetite, provide strength, energy Especially for pregnant women, children, post-partum women

Dominican Americans use hot/cold for numerous ailments Nutritional practices during lactation may be problematic Haitians apply hot/cold/heavy/light to many factors influencing health Life cycle, reproductive cycle, climate, etc. Heavy focus on mother’s milk and illnesses it may cause

Non-Hispanics may believe cassava helps prevent heart disease and cancer Plantains used to decrease risk of heart disease, HTN, ulcers, constipations Teas for numerous ailments Many herbals Rum and marijuana to treat several problems

Contemporary Food Habits in the US: Adaptations of Food Habits
Traditional food habits easily maintained Study of Puerto Rican women: Nonmigrants and return migrants ate more starchy vegetables, sugar, and sweetened foods Forward migrants ate a greater variety of foods Quickly reverted to their traditional food habits when they returned to the island Study of Afro-Caribbean immigrants Ate traditional foods frequently Few Western foods were popular

Ingredients and Common Foods
Data is limited Rice, beans, starchy vegetables, sofrito, and bacalao remain basis of diet for Puerto Ricans Poultry used when possible Cubans increase intake of meat Poorer Cuban immigrants have diet similar to subsistence Puerto Rican diet Some Western foods accepted Convenience foods, frozen and dehydrated foods Low intake of leafy vegs, consume local fruits

Dominicans report more varied and abundant diet in US Rice main contributor to energy for MA Latinos Bread main contributor for non-Hispanics Hispanics who have lived in the US >20 years have similar profiles to non-Hispanics Increased consumption of simple sugars

Nutritional Status: Intake
Limited information Lower rates of preventative care and insurance coverage Higher rates of risk factors Puerto Ricans have worst health indicators Diabetes prevalent LBW infants, preterm delivery, infant mortality high in US, higher in Puerto Rico Cubans have the best

Light breakfasts of bread and coffee Light lunch Often sandwich and beverage Heavier dinner More traditional foods More high calorie snacks between meals Grocery shopping a social occasion for many women More trips to store, less advance planning Prefer frying, then boiling, baking and far last grilling

Special Occasions Foods remain the same
More special occasions in the US West Indian Carnival in NYC Puerto Rican Day in June Dominican Day parade in August in NYC Reggae festivals throughout on Feb 6 Bob Marley’s birthday

Nutritional Status: Nutritional Intake
Lower rates of preventative care Inoculations and screenings Lower rates of health care insurance coverage Hispanics have highest rate of uninsured in the US Higher rates of risk factors Puerto Ricans have the worst health indicators Cubans have the best Puerto Ricans living on the mainland experience more physical illness, have less access to health care Low socioeconomic, education levels associated with some disparities.

Nutritional Status: Elders with disabilities and diabetes more prevalent in Puerto Ricans than whites in same neighborhoods Physiological responses to life stress may be affected by nutritional status Intake of B vitamins and antioxidants Younger men die in disproportionately high numbers Often from preventable causes Puerto Ricans born in Puerto Rico have lower mortality rates than those born on mainland

Nutritional Status: Puerto Ricans
High infant mortality rate Preterm LBW 40% higher than whites Risk factors Poverty Young maternal age Low educational attainment Inadequate prenatal care

Nutritional Status Infant mortality, LBW, preterm delivery rates even higher in Puerto Rico High rates (8.2%) of LBW infants in the Haitian American community Hypertension and preeclampsia Infant mortality rate of Cuban American babies well below the national average.

Nutritional Status Data on breastfeeding is conflicting
Overweight Hispanic women in NY less like to initiate and more likely to discontinue BF than lower-weight women Many switch to bottle feeding in 2 – 4 weeks Whole milk, condensed milk, evaporated milk and juices frequently fed to infants Solid food started early

Nutritional Status Caribbean diet limited due to low income
Emphasis on carbohydrates and vegetable protein, with a low consumption of leafy vegetables and often fruit Results in inadequate intake of calories, vitamins A and C, iron, and calcium Puerto Rican and Dominican elders with B12 deficiency due to inadequate intake

Nutritional Status Low iron intake among African- Caribbean Islanders
Anthropometric measurements and physical observation 20 percent of children under fifteen showed signs of malnutrition 37 percent of the men and 17 percent of the women had adipose tissue measurements consistent with adult marasmus 12 percent of immigrants suffered from anemia

Nutritional Status Native Puerto Ricans Parasitic diseases Dysentery
Malaria Hookworm Filariasis Schistosomiasis High blood lead levels

Nutritional Status Overweight /obesity higher than national or state averages Women and children Associated with a traditional diet of rice, beans, poultry, oil Larger portion size Low levels of physical activity Cultural norms Well-being associated with “a little fat”

Obesity Rates in Hispanics

Nutritional Status: Heritability may be involved in metabolic syndrome
Obesity/waist circumference Insulin resistance Hypertension Dyslipidemia At increased risk for Type 2 diabetes, CVD Impaired glucose tolerance after gestational diabetes Death and renal failure rates higher

Nutritional Status: Hypertension rates lower than that of whites
Mortality from HTN, CVD, stroke varies Puerto Ricans have highest Cubans have lowest rates Deaths higher for men Noncompliance rates are high

Nutritional Status: CVD rates are lower than national average
Heart disease is leading cause of death Chronic liver disease and cirrhosis 7th most common cause of death Men drink more heavily than women Dental health problematic Lactose intolerance may be a problem

Counseling Language issues Health beliefs
Access to health care limited God or fate determines outcome interfering with seeking health care Seeking preventive measures lower than average Ex: Puerto Ricans not seeking vaccinations Illness a sign of personal weakness Ex: Haitians Highest uninsured rates in the US

Counseling Expressive conversational style
Respect/politeness practiced, not rude to interrupt Shaking hands upon greeting and leaving customary Touching is common Direct eye contact is the norm Haitians will divert eyes with authority figures Cubans see looking away as disrespectful or dishonest

Counseling: Puerto Ricans
Open about physical and emotional complaints May not ask questions Give adequate time and consideration of symptoms Very modest – health providers of same gender best Present oriented Flexible appointments helpful Some hot/cold practices may be harmful Pregnancy Be clear with terms involving blood May believe that ulcers lead to cancer

Counseling: Haitians Expect quick diagnosis with a stethoscope
Men are doctors, women are nurses Expect a prescriptions Dominicans Traditional healers used to complete treatment May not understand prescription drugs are for a specific condition May use briefly and then resort to home remedies All share prescriptions

Counseling Physicians, then television source of health care information High context communicators Participation greater if men in family are supportive and if respected community members are supportive Place significant emphasis on socioeconomic status In depth interview should be conducted

South Americans

Introduction Widely varied geography
Extremes in terrain and climate limit agriculture Spanish were first to arrive Portuguese, Italians, Germans Forced labor from West Africa Japanese immigration in recent years

Countries in South America
Argentina Brazil Bolivia Chile Colombia Ecuador Guyana Paraguay Peru Suriname Uruguay Venezuela France has French Guyana Great Britain has the Falkland Islands

Immigration Patterns First South Americans in US from Chile
Came to CA for the Gold Rush Counted as “Other Hispanics” prior to in census Most South American immigration occurred in the past twenty years Periods of land reform, economic hardship, or political repression Came for jobs and educational opportunities Significant numbers of political exiles from Argentina and Chile.

Current Demographics South Americans account for only 5% of Latinos
Many South American populations have almost doubled since 2000. Colombia, Ecuador, Peru with highest numbers Settle in the Northeast, especially NY and NJ Proud of their ethnic identity Differentiate themselves from other Latinos

Socioeconomic Status Recent immigrants well-educated professionals
Advanced degrees Columbia, Ecuador, Brazil have higher rates of poverty Peru, Guyana, Argentineans, Bolivians, and Chileans have lower rates of poverty

Worldview: Religion Predominately Roman Catholic
Influence seen in many South American institutions Blended belief systems Incan gods included in Catholic rites Venezuelan Cult of Maria Lionza mixes indigenous, Catholic and African practices

Worldview: Religion Brazil Spiritism Umbanda Candomblé
Christian precepts with scientific principals Communicate with dead through mediums Umbanda Afro-Brazilian faiths plus Christian charity and spiritism Candomblé Afro Brazilian faith founded by blacks in the Bahia region African beliefs regarding health/wealth with Catholic beliefs Yoruba (African) deities called orixás venerated with animal sacrifice, feasting, and dancing Orixás correlate with a Catholic entity

Worldview: Religion Protestant missionaries during 20th century
Guyanese Episcopal church Ecuador has about 40% Protestant Brazil has Baptist, Pentecostal, 7th Day Adventist, Universalist Chilean Protestants are Pentecostal of 7th Day Adventists Germans follow Lutheran or Baptist Small numbers of Jews and Buddhists Come to US and are very active in their churches

Worldview: Family Family life important in all South American societies Argentina has Spanish and Italian influence Extended families gather weekly Grandparents involved in family decisions Children stay home until marriage Brazil has extended family living close Relatives mentor children through rites of passage

Worldview: Family Chilean fathers are head of household but mother makes all decisions Colombian fathers hold all authority and children obey their parents Ecuadoran families Spanish influenced ruled by father who provides financial support Indian influenced father and mother share more power and household responsibilities

Worldview: Family Peruvian families include extended families and godparents. Families patriarchal in Spanish speaking Less so in poor, rural Indian homes Venezuelan family changed rapidly Urban Declined in size Extended family less common

Worldview: Family Less acceptable for women to work outside the home
Indian women often work on farm Urban areas of Venezuela women have outside jobs but retain responsible for household chores Chilean women involved in local social and political issues

Worldview: Family Immigrate as family groups if possible
Suffer from stresses of American informality and freedom Men lose some authority over wives and children Women find it difficult to adjust to working outside the home Women may not be able to have paid help and have to work and run the home

Self-diagnosis Health advice from mothers or friends Visit pharmacy Can buy meds by the pill

Brazilians may attribute bad health to liver problems or hot/cold imbalance Faith with health Catholics will believe in fate Seek intervention from patron saints when ill Spiritists use homeopathy, exorcism, past-lives therapy, acupuncture, yoga therapy, chromotherapy

Candomlé followers believe must have balance between earthly and spiritual spheres Ecuadoran healers treats many illness Peruvian urban dwellers typically obtain biomedical care Rural regions use home remedies and ritual magic

Herbal teas Soursop treats diabetes Seeds of the guarana relieve fatigue/help with weight loss Retained urine treated w/ avocado leaves Papaya leaves for intestinal worms Rue for uterine pain Black nightshade for coughs Pau d’arco (tree bark) to treat rheumatism, diabetes, VD, yeast infections, enlarged prostate and several cancers

Traditional Food Habits: Ingredients and Common Foods
Similar to other LAC regions Combines native ingredients, preparation techniques with foods of colonial Europeans Corn based w/ chile pepper as spice Tomatoes Cassava or yucca Pumpkin, bananas, plantains Beef, rice, onions, olive oil Introduced by Spanish and Portuguese and eaten regularly Tropical fruits

Potatoes First cultivated by Incas and popular in Peru and Ecuador Sweet potatoes Called yams in the US Sweet potatoes colored similar to potatoes yams are darker and more reddish colored True yam is drier and starchier

Tubers or roots Apio or arracacha Oca Yacón Aahipa (jicama)
White root similar to a mild carrot Found in Colombia, Peru, and Venezuela Oca Like a potato in appearance, leaves like clover Yacón Taste and texture of a sweet turnip Commonly eaten raw and cooked in Bolivia, Brazil, Colombia, Ecuador, and Peru Aahipa (jicama) Native to the Amazon River basin.

Beans are common but not eaten at every meal Peanuts and cashew used often Grilling popular for meats Indigenous meats Llama, Deer, Rabbit, Wild pig, Capybara, Tapir, Cuy (guinea pigs) Fish in coastal areas Iguana and alligator

Grilling favored way to prepare meats Asado: Sides of beef, whole lambs, hogs, and kids hung over smoldering wood to slowly cook for hours A grill is used today Steaks, organ meats and marinated kebobs favorites Pachamanca Steam foods in a pit oven (Peru) Young pig or goat with guinea pigs, chickens, tamales, potatoes and corn tucked around layers of hot stones and aromatic leaves and herbs Curanto is closer to an elaborate coastal clambake (Chile) Shellfish, suckling pig, sausages, potato patties, peas, and beans layered with seaweed.

Stuffed Foods Empanadas in Argentina Fried or baked Numerous fillings Empadinhas in Brazil Spicy shrimp mixture Abalone in Chile Salteñas in Bolivia Filled with cheese Tamale like steamed packets Champanas in Peru Made with cassava dough Bollos in Ecuador Chicken with plantain dough Pamonhas in Brazil Corn kernal dough with cassava and coconut Hallacas in Venezuela Ground corn meal dough with tomatoes and annato Humitas in Argentina, Bolivia, Brazil, Chile and Ecuador

Regional Variations: Peru and Ecuador
Highland fare of the Andes Lowland dishes of the tropical coast Mountain cuisine preserves many ingredients and dishes of the Incas Potatoes eaten at almost every meal and for snacks Boiled, dried, or made into potato starch Corn in the mountains Bananas and plantains Chips and made into flour

Regional Variations: Peru and Ecuador
Picante and lots of chile peppers Salsa de aji Condiment at most meals (chiles, onion, salt) Charqui Dried llama Anticuchos Marinated beef heart skewered and grilled Rabbit or Seafood Chucula Thick plantain and milk beverage w/ cinnamon Pisco Grape brandy

Regional Variations: Argentina, Chile, Bolivia, Uruguay, Paraguay
Hearty foods with emphasis on beef Eats more beef per capita than any country worldwide Influence from immigrant populations Matambre: national dish Flank steak dish with eggs and spinach Means “to kill hunger” Pasta popular on Sundays in Argentina Coffee popular but most popular is maté

Regional Variations: Chile, Bolivia, Paraguay, Uruguay
Robust soups and stews Sopa Paraguay, fish soups and stews in Chile Uruguay Eat beef like in Argentina, but also mutton and lamb Chilean wine Lots of beans in Chile Frog legs in Bolivia Chicha Corn liquor popular in Bolivia Maté is popular From a holly family plant native to Paraguay Dried, powdered leaves called yerba

Regional Variations: Colombia and Venezuela
Colonial Spanish in character w/ typical Spanish flavors Guascas/Huascas- Flavor of boiled peanuts in soups/stews Naranjillos used for their tart juice Colombia: Bogata chicken stew (chicken, 2 types potatoes, cream) Sancocho (boiled dinner w/ beef brisket, starchy vegs Venezuela Ropa vieja: Shredded flank steak served in a sauce Pabellon caraqueno: Flank steak, rice w/black beans Arepa: Staple cornmeal bread formed into patties and cooked on a griddle, sometimes stuffed

Regional Variations: Guyana
Influenced by the Caribbean Pepper pot, coocoo, black cake (dense fruitcake) African Foofoo Asian influence Chinese noodles Indian curries, roti National specialty: Portuguese garlic pork Famous for demerara sugar Source of demerara rum

Regional Variations: Brazil
Portuguese and African influence Dried salt cod and very sweet desserts from Portugal Dendê oil, okra, and spicy foods from Africa Malagueta - a small, mouth-searing chile pepper popular with Africans in Brazil Afro-Brazilian fare cozinha baiana from state of Bahia Fritters made from dried shrimp, dried salt cod, yams, black-eyed peas, mashed beans, peanuts, and ripe plantains fried in dende oil Vatapa is a paste made with smoked dried shrimp, peanuts, cashews, coconut milk, and malagueta chiles

Regional Variations: Brazil
National dish is feijoda completa Black beans w/smoked meats, sausages, served w/rice, sliced oranges, boiled greens, and hot sauce mixed w/lemon or lime juice South influenced by Argentina, Germany Grilled meats and chimichurri sauces popular Churrascaria rodizio – an outdoor bbq Coffee, rum, beer, maté popular Guaraná is a soft drink from Guaraná fruit Cachaça distilled from sugar cane Used to make batidas or caipirinhas

Meal Composition and Cycle: Daily Pattern
3 meals w/ afternoon snack Poor areas, early breakfast, large dinner about 6 Light breakfast of bread or roll w/ jam, coffee Lunch is main meal and consumed leisurely Appetizers, meat/seafood dish, side dish, salads, dessert Nap Lighter dinner about 9 of cold cuts, seafood salad, soup, or stew Beer, wine, fruit juice and soft drinks

Meal Composition and Cycle: Daily Pattern
Afternoon break typically throughout South America Coffee consumed in Colombia, Ecuador, Brazil Tea in Chile and Uruguay Maté in Argentina, Paraguay, Uruguay, Brazil Snacks of fruit, sandwiches, pastry Street vendors are common Poor may skip lunch and snacks and have dinner of soup/stew with starchy side dish

Special Occasions Catholic traditions influence holidays
Rich Christmas Eve Dinner Epiphany Easter and Carnaval Animals associated with water are allowed on fast days St. John’s Day in Brazil and Ecuador All Soul’s Day Independence Days of their country in the US

Etiquette Women prepare meals, serve to men. Women eat last
European-style fork in left hand, knife in right Bread at side of plate without butter Only food eaten with hands All other items require cutlery Fold salad, do not cut Even sandwiches Pass left, keep hands above table Wait for host to begin meal Don’t pour wine with your left hand or hold bottle at base when pouring

Therapeutic Use of Foods
Candomblé orixás associated with certain foods and followers honor their deity by eating those items Use hot/cold system of medicine and adapted by their healers Hot conditions treated with hot orixás Cold conditions treated with cold orixás Classification system is inconsistent

Therapeutic Use of Foods
Hot/cold classifications not associated with candomblé Food hot in temperature or irritating to the stomach to be avoided during fevers Menstruation, pregnancy, lactation require specific foods Eat specific foods at specific times of the day Fruit is good in the morning, harmful in the evening Avoid some combinations of foods Acidic fruits with milk

Adaptation of Food Habits in the US
Very little data Continue eating favorites from home with adapted ingredients Adaptation to schedules difficult Late dinners, early American work schedule Short lunch No leisure time after lunch Poorer Chileans diets may improve in US

Parasitic infection, iron-deficiency anemia, protein calorie malnutrition Common in many rural areas of South America Chronic Chagas’ disease endemic in some regions Can affect the esophagus and colon Risk factor in CVD

Overweight and obesity prevalent Ecuadoran elders deficient in B12, D, folate, iron, zinc despite being overweight Metabolic syndrome present Central body fat present Hypertension common in many populations

Counseling Access to health care may be limited
Preventive practices uncommon May seek help only in emergency situations Many without health insurance Unauthorized persons will avoid contact with any government agency Many do not speak English well

Counseling More formal in their interaction
Conversations reserved, little emotional expression Venezualans are very direct Brazilians typically restrained with strangers Less personal space than Americans Direct eye contact Except Columbia – not with authority figures or embarrassing situations Present oriented and polychronic Immediate interventions valued, not preventative In Argentina will protect patient from negative diagnosis

Counseling May seek homeopathic or OTC remedies
Brazilian women with diabetes reported Dietary restrictions burdensome Sadness when following diet Cravings for sweets Loss of autonomy Had no symptoms therefore restrictions unnecessary In depth interview is needed

Caribbean Islanders and South Americans

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