3.4 Food Choices and How We Make Them

Clients may access food at a number of sources: supermarkets, convenience stores, farmers’ markets, sidewalk vendors, ethnic food markets, restaurants, fast food businesses, delis, commodity supplemental food program warehouses, and more. Some of these may offer ethnic foods, others will not.

Keep in mind that more than 23 million people, including 6.5 million children, live in “food deserts,” locations that lack access to stores where affordable, healthy food is readily available.¹ Smaller stores may sell produce at prohibitively high prices.

The more available a food is, the easier it is to add it to our diets.

Traditional Roles of Food

• Staple Foods
  • “Staple” foods form the foundation of a culture's diet. A staple food is typically bland, relatively inexpensive, easy to prepare, and an important source of calories. Staples are considered to be an indispensable part of a meal. Examples: cereal grains (rice, wheat, millet, and corn); starchy tubers (potatoes, yams, taro, and cassava); or starchy vegetables (plantains, green bananas, and some beans).
• Nonstaple Foods
  • Foods eaten less frequently have a weaker cultural meaning; they are based on individual preferences. Nonstaple foods are often considered:
    • Protective Foods: Generally rich in nutrients, these are used in various combinations with traditional herbs or spices. Examples: vegetables, legumes, nuts, fish, eggs, meat, poultry, and certain grains.
    • Status Foods: These are generally rare and expensive in a cultural group’s place of origin. They are not a part of the typical daily diet, are usually consumed on special occasions, and take lots of time and ingredients to prepare.

Traditional Preparation

Methods of food preparation — which may vary greatly or only a little, both within and between cultures — play a big role in influencing food choices. Examples: Central Americans often prepare beans as a paste and eat them with tortillas. People from the Caribbean frequently fix beans as a stew or with rice and sofrito (onions, bell pepper, garlic, cilantro, oregano, and salt sautéed in oil). People of Chinese origin use beans extensively in foods such as soy sauce, tofu, soy milk, and desserts.

Traditional Seasonings

The use of seasonings often distinguishes one culture’s traditional food habits from another’s. Seasonings vary from country to country and according to the weather and the time of year. Example: In the tropics, fresh hot peppers are plentiful, and foods are highly spiced. In more moderate climates, fresh, flavorful herbs are easily grown and commonly used.

Frequency of Consumption

Even when people eat the same foods, the frequency of consumption can vary based on culture. The frequency of consumption may change over time, too. Example: Yogurt is a traditional food in the Middle East; now, people of many ethnic backgrounds in the U.S. eat it.

• In the U.S., lactose intolerance occurs more frequently among individuals who are African American, Native American, Jewish, Mexican American, or Asian American.² For these people, eating lactose-containing foods such as milk products may cause cramps and diarrhea.
• Milk-drinking by youth and adults tends to be uncommon within these groups — even for those who do not have the condition. Most infants can tolerate lactose, but in some the ability to digest it fades by age 2. Most lactose-intolerant children, adolescents, and adults can avoid digestive discomfort by taking small servings spaced throughout the day.
• Cheese and yogurt are often better tolerated than milk, but for severe cases of lactose intolerance, all milk products may be omitted from the diet. Other dietary sources of calcium, such as leafy greens, should be emphasized for these individuals.

Food is often believed to promote health, cure disease, or have other medicinal qualities. Health beliefs can have a great impact on food choices.

Culture	Food	Special Preperation	Medicinal Use*
Hispanic	Raw Onions	Chopped with honey	Believed to be good for a cold or other respiratory infection
Vietnamese	Oregano tea	Served hot, with salt instead of sugar	Given for an upset stomach
Vietnamese	Rice porridge	No special preparation	Considered standard food for sick people
Taiwanese	"Tonic" herbs with chicken	Cooked slowly	Believed to increase blood circulation
Caribbean, Filipino	Chayote, papaya	No special preparation	Used as a treatment for hypertension
Caribbean, Filipino	Soup	Prepared with pig's feet and viandas	Believed to restore strength
Iranian	Liver, beets, pomegranate	No special preparation	Believed to increase blood
United States	Chicken soup	Hot	Cold remedy
Indian	Ghee, nuts	No special preparation	Considered extra-nourishing and associated with strength-giving properties
Chinese	Fresh ginger (cut into pieces)	Cooked slowly with brown sugar and water to become ginger soup	Believed to cure or prevent "cold" in winter or on rainy days

^* Encourage clients to seek medical treatment for conditions that require it rather than relying solely on folk remedies.

As we mentioned in Module 2, culturally based attitudes about food, the proper uses of food, and body weight can affect the food choices people make.

• Be sure to find out the background of the person you are speaking with before you address weight issues. People from different cultures may view weight differently. Those who have experienced poverty and insufficient food may be all too familiar with the danger of underweight in children. They may view overweight as a sign of wealth and excess weight as healthy. Mentioning underweight, especially if talking about a child, may be seen as offensive.

Foods to Celebrate

All cultures celebrate with food, and they make their food choices accordingly. There may be special foods for any number of occasions, including religious holidays, national holidays, family get-togethers, or gatherings in honor of individuals’ accomplishments. Within cultures, individual families may have their own traditions at times of celebration.

Examples: People from the Caribbean Islands often eat roasted pork for celebrations, while Central Americans often choose turkey. Among Filipinos, noodles are served at birthday parties and other functions to symbolize long life. In the southern United States, eating black-eyed peas on New Year’s Day is said to bring good luck for the year.

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Foods to Comfort

Many cultures associate the preparation of food with nurturing children and families, and specific foods with emotional comfort. In times of change, however, any traditional food can be comforting.

Sample Client Responses

“After I got older, and some of my brothers and sisters were away at college, my mother continued to get up every morning and fix me a huge breakfast.”

“Thirty years ago when I came to this country [from India], when I missed my Mom, I cooked a pot of rice. So when I get real homesick, I still do it, I cook that rice.”

Economic considerations often have a major impact on food choices. In 2015, 12.7 percent of U.S. households were food insecure at some time during the year, meaning access to adequate food was limited by a lack of money and other resources. Of those households, 5.0 percent had very low food security, and the food intake of one or more household members was reduced and their eating patterns were disrupted several times during the year due to lack of money and other resources for food.³

In the United States, economic status may vary according to level of education, ability to speak English, job skills, and employment opportunities in the community.

To better understand how economics affects your clients’ food choices, consider each family’s background and present situation. Immigrants may have different resources than they did in their homeland, for better or worse.

Affordability and availability are interdependent. Those who are new to the area may find an amazing number of foods available, but cost can greatly reduce the actual number of choices.

Besides being able to purchase food, a family must be able to prepare it. The time needed for preparation plays a big role in food choices, because so many adults work away from home for most of the day. A family must also have the space and equipment necessary for storing and preparing the foods they are used to eating.

You may need to provide families with information about affordable, nutritious foods that are compatible with their food preferences and storage capabilities, and are easy to prepare.

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Practice Pointer

Extend purchasing power: To make food purchases more economical, some community groups have formed buying clubs. Some have even evolved into co-ops. One church group arranged to bus people to a grocery discount chain to enable families to get more food for their money. To pass the time and make the 40-minute bus ride more enjoyable, nutrition education was provided to the families along the way.