South Asia: India and Pakistan
Anna Johnson, Dani Meyers, Stephanie Ensign, and Morgan Garlock
Historical Perspectives
Location
Southeast Asia 540,403 square miles What kind of
influences may there be due to the geographic region? Fresh fish Agricultural society Very poor
1600’s British arrived in India for the East
India trade Pakistan was part of India In 1947 Pakistan and India became
independent nations Pakistan has four provinces Most speak the official language: English National language is Hindi
British Influence
Predominantly practice Hinduism and Muslim Others: Islam, Buddhism, Jainism, Sikhism,
Zorastrainism, Christianity (introduced by Portuguese), and Judaism.
Ramadan-- sunrise to sunset fasting for one month
Religion
Health Practices/Beliefs
Health
Practices/Beliefs Religion has a HUGE
influence on health beliefs and food choices. Hindu: Do not eat beef
or pork. Islam
Avoid all pork. Other forbidden foods
are alcohol, the flesh of clawed animals, and the meat of an animal that isn’t slaughtered humanely.
Orthodox Jains
Vegetarians, avoid eating root vegetables because insects might be killed when the tubers are harvested.
No blood-colored foods. Beliefs advocate moderation even
when eating healthful foods. Obesity is discouraged. The laws of food consumption dictate
that solid food should fill half the stomach, liquid ¼, and the remainder left for the process of digestion.
Health Practices/Beliefs
Food for medicinal purposes.
Believe that the body consists of five humors (phlegm, wind, bile, hot, and cold) which when kept in balance through a regulated lifestyle (including diet) can prevent illness.
Hot/Cold classification for foods. Cold: rice, leafy vegetables, fruits, dairy products, honey,
sugar, pickles, condiments Hot: wheat, spices and seasonings, chicken, oils
Health Practices/Beliefs
Health
Practices/Beliefs Food taboos during
pregnancy: Hot foods such as
spices, mangoes, and papayas are avoided.
Vegetables that cause flatulence and cold foods are restricted for lactating women.
Diabetes
Believe that diabetes is caused by divine power and is inevitable.
Bitter gourd is commonly used for its hypoglycemic effect. Individuals taking an oral diabetes agent or insulin could have hypoglycemia if they also consume bitter gourd.
Cancer Plant based diet Heavily pickled foods may have
correlation to stomach cancer
Health Practices/Beliefs
Ayurveda
The code of life and longevity Based on the belief that humors in the body and in foods can
interact to preserve a homeostatic harmony or cause imbalance.
Yoga Good for the body and mind
Health Practices/Belief
Sattvic foods: milk, milk products, rice, wheat, ghee,
most legumes, and some other vegetables. They are believed to help make a person serene,
enlightened, healthy, and long-lived. Rajasic foods: meats, eggs, and foods that are bitter,
spicy, sour, salty, and rich. They are believed to contribute to aggression, passion,
and desire for power. Tamasic foods: garlic and pickled, preserved, stale, or
rotten foods and alcohol and drugs used for pleasure and in excess. They are believed to contribute to lust, malice, confusion,
slothfulness, and dullness.
Health Practices/Beliefs
Traditional Foods
Grains with vegetables Legumes with vegetables Milk products with vegetables or fruits Grains combined with meat, poultry or seafood Bread Dessert Most diets are high in fat Common spices: ginger, turmeric, cumin, coriander, mustard, fenugreek, curry
Traditional Foods
Curry: any spicy stir-fry vegetable dish or
gravy dishes with meat or vegetables Rice: the most commonly and widely
consumed food in India Few foods are eaten throughout all of India
Traditional Foods
Coastal India
Seafood dishes including curried shrimp, crab, and clam
Southern India: Fried rice dishes, semolina wheat, spiced vegetable
curries, yogurt-based dishes, and deep-fried salty food Northern India:
Rice served as pilaf; seasoned chicken, lamb, or beef; korma, masala, and bread
Traditional Foods
Professional Interaction in a
Healthcare Setting
Important information to know about your
client Religious affiliation Degree of adherence to medical regimens Length of residency in the US Degree of acculturation Vegetarian or non-vegetarian food preferences Use of supplements, herbs and complementary
medicine
Professional Interaction
Small talk is significant, rushing is considered
rude A direct “no” is considered impolite Agreement may be indicated by shaking their
head back and forth, the way we indicate negative
The left hand is never used in social purposes It is impolite to show the sole of one’s shoe Touching a person’s head is offensive
Professional Interaction
English is spoken, written and understood, but
use of regional languages is preferred Loudness is considered rude Self-control in demeanor and expression are
followed Expectation of privileges, such as getting
immediate appointments or service, may not be unusual
Women are the primary gatekeepers of food and are responsible for food handling
Professional Interaction
Don’t understand the connection between body
weight and diabetes Fasting and feasting practices can be problematic
with diabetes Those of Indian and Pakistani decent have a higher
rates of diabetes, obesity and heart disease Important counseling objectives include
carbohydrate counting, portion sizes, modification of recipes to be high in fiber and lower in fats (particularly saturated) Traditional foods may need to be adjusted
Professional Interaction
Questions?