Ethnic Nutrition. Dr Danielle Gallegos Ms Pernilla Ellies

Transcription

1 Ethnic Nutrition Dr Danielle Gallegos Ms Pernilla Ellies

2 Anaemia information (in Swedish)! Vad är järnbristanemi? Brist på järn i kroppen kan leda till blodbrist, anemi. Hemoglobin (Hb) är ett ämne som finns i de röda blodkropparna och som fångar upp och transporterar syre från lungorna ut till kroppens celler. Blodbrist är när mängden hemoglobin eller antalet röda blodkroppar, eller båda, sjunker under det normala. Då får kroppen mindre syre och man blir trött, blek och andfådd. Ibland kan man även få yrsel, hjärtklappning, huvudvärk och öronsus. Kroppen behöver järn för att bilda hemoglobin. Men järn är också viktigt för andra processer i kroppen, exempelvis för bildning av arvsmassa (DNA) och i många enzymreaktioner. Om man har blodbrist som beror på järnbrist, järnbristanemi, har kroppens järnförråd minskat så mycket att det bildas färre röda blodkroppar i benmärgen än normalt. Läs mer om allmän blodbrist och blodbrist på grund av B12-brist i Infomedica. Länkar finns i kapitlet Fördjupning och länkar.

3

4 Objectives! What ethnic and CALD mean! What diversity means! The importance of using an interpreter! What the main nutritional issues are for CALD groups

5 What does ethnic mean?! Ethnic derives from the Greek word ethnikos and was originally applied to cultural heathens, strangers or outsiders and always excluded the dominant group! Culturally and Linguistically Diverse (CALD)! Terms are very fluid and dependent on an individual s self view as well as a government view

6 Who does CALD include?! The term CALD is inclusive! For the purposes of this lecture it does not include: indigenous Australians, migrants from predominantly Angloceltic backgrounds e.g NZ, USA, UK, SA! Includes migrants and refugees! Can include first generation and subsequent generations even if they are born in Australia

7 CALD Groups in WA! In 2001 in Western Australia " 27% were born overseas " of these 11% do not speak English at home " 200 different countries represented " Over 170 different languages spoken " Over 100 different faiths practised

8 Diversity within Diversity! Education! Religion! Ethnicity! Background: rural or urban! Refugee/migration experience! Age Everybody is an individual

9 Three levels of uniqueness in Human Behaviour Specific to group or category Specific to individual Personality Culture Inherited & learned Learned Universal Human Nature Inherited

10 Language Using Interpreters! Who to use?! Always use an accredited interpreter - do not use family members! Ascertaining if the client is happy with the interpreter - political, historical reasons, confidentiality! Interpreters for some languages are not accessible! Make sure you know how to work with interpreters effectively

11 What are the nutritional issues for CALD groups! Iron deficiency anaemia! Vitamin D deficiency! Obesity! Type 2 diabetes! Poor dentition! Breastfeeding

12 Iron deficiency anaemia Risk factors in the general population Risk factors in refugees Long periods without access to nourishing foods Parasitic diseases, incl. malaria Pregnancies close together Long periods of time breastfeeding Tuberculosis Iron deficiency anaemia: see for definitions

13 Nutritional Management of Anaemia! Increase consumption of iron rich foods " haem sources (animal foods) " non-haem sources (wholemeal cereals, beans, greens, milo)! Increase consumption of vitamin C rich foods (orange, berries, kiwi fruit, capsicum, tomatoes)! Decrease consumption of tannins (tea), phytates (unprocessed bran), coffee, antacids and aspirin

14 Vitamin D deficiency! Risk factors " Dark skin " Veiling " Infants of dark skinned and veiled women " Older persons living in residential care

15 Recommended dietary intakes of vitamin D! The NHMRC recommends " pregnant women & young children reasonable summer sunlight exposure " housebound or not exposed to direct sunlight for at least 1-2 hours per week, oral vitamin D supplement " elderly Food sources of vitamin D should be included in the diet (fortified margarine, butter, oily fish)! Recent recommendation " Oral vit D supplementation may be needed in women with dark skin pigmentation or dress codes which prevent adequate sun exposure

16 Obesity! Risk factors " Inadequate physical activity " High energy intake! Treatment " Increased physical activity " Reduced energy intake

17 Type II Diabetes Risk Factors! Ethnicity! Age! Weight! Physical activity! Family history! History of gestational diabetes! High consumption of saturated fat

18 Poor Dentition! Poor access to public health in home countries " no fluoride in the water supply " no access to dental checks! Torture! High current intake of sugary drinks and sweets

19 Breastfeeding! There are no reliable data on rates of breastfeeding amongst CALD women in Australia! Rates are potentially lower for CALD women due to: " Anecdotally Australians not seen as being breast feeding friendly - where are all the breastfeeding women? " Lack of peer and family support " Economic having to go back to work or study! Ramifications are: " Higher rates of illness " Inappropriate alternatives to breast milk " Developmental delay " Increased rates of lifestyle diseases later in life

20 Conclusion! Everybody is an individual and should be treated as such! Successful communication is the key! Cultural food patterns adds another dimension to communicating information regarding diet and health! Food has social, religious, cultural & economic meanings as well as being nutrients

21 Ethnic nutrition is not only about common nutritional conditions, it is also about, the changes to food habits people experience when they move to a new country and access to culturally relevant nutrition information.

22 References Burns C, Webster K, Crotty P, Ballinger M, Vincenzo R, Rozman M. Easing the transition: food and nutrition issues of new arrivals. Hlth Prom J Aust 2000;10(3): Sellen DW, Tedstone AE, Frize J. Food insecuirty smong refugee families in East London: results of a pilot assessment. Public Health Nutrition 2002;5(5): Diamond TH, Levy S, Smith A, Day P. High bone turnover in Muslim women with vitamin D deficiency. MJA 2002;177: Allotey P, Manderson L, Reidpath D. Addressing cultural diversity in Australian Health Services. Health Promotion Journal of Australia 2002;13(2): Australian Iron Status Advisory Panel. Centrelink, Working with interpreters. Multicultural Services Customer Segment, Haymarket, NSW. Mason S, Diamond, TH. Editorial: Vitamin D deficiency and multicultural Australia. MJA 2001;175: Diamond TH, Levy S, Smith A, Day P. High bone turnover in Muslim women with vitamin D deficiency. MJA 2002;177: Hassan K, Sullivan KM, Yip R, Woodruff BA. Factors associated with anaemia in refugee children. J. Nutr. 1997;127: