Wednesday, June 4, 2014

A Cross Cultural View of Health Problems Associated With Weight

A Cross Cultural View of Health Problems Associated With Weight

Over the last couple of decades, the United States has seen a surge in obesity rates and other weight problems. For example, childhood obesity rates have gone up so much that on May 3rd, 2006, many of the nation's largest beverage distributors announced that they would no longer sell non-diet sodas to most public schools. (cnn.com). However, obesity rates and other weight related health problems vary from culture to culture and country to country. 

Because the United States is an industrialized nation with easy access to junk food, especially for kids, obesity is definitely one of our nations most pressing weight related health problems. The situation is not the same in other cultures. Many people living in third world countries, especially in Africa, simply don't have the resources to obtain food.

This results in widespread malnourishment. This one example simply shows that one nation, the United States, has more resources to feed its people than many of the poverty stricken countries in Africa and elsewhere. However, when you look at this issue cross culturally, its not this simple. The amount of food available in a culture certainly is a factor to consider when studying the various health issues associated with weight, but there is much more to consider. 

In our culture, many young females develop eating disorders, such as anorexia and bulimia, that cause malnourishment yet is not caused by a lack of resources; peer pressure and a cultural pressure of females being thin is the causes for the rise in rates of conditions such as anorexia and bulimia for females. These examples barely scratch the surface of this issue, yet many interesting questions arise from the preceding examples.

How can one country with vast resources and another country stricken with poverty both have many people who are malnourished? Why are they malnourished? Besides the availability of food, what other factors must be considered for the various health problems that exist in many different cultures as a result of weight? The overwhelming amount of evidence shows that the culture one lives in, genetics and food availability contribute to the various health problems plaguing the world as a result of weight. 

It is important to note that the culture one lives in defines the foods they eat, which is what results in weight and health problems. Thus, different cultures have different health problems associated with weight and if two or more cultures have a similar health associated weight problem, the causes may be different. Also, different cultures have different explanations for the various health problems they encounter, and as a result practice different forms of healing and fixing these problems.

The culture one lives in is extremely important to consider when looking at all the health problems associated with weight. A look into the health of two ethnic groups located in Queensland, Australia, who migrated from the Pacific Islands, the Samoans and Tongans, show some interesting things regarding health and weight. (Queensland Samoa). The Samoans and Tongans are an interesting group to look at because, according to the Queensland Government, "Mortality rates for those born in the Pacific Islands are higher than for other Australians.

They are one of the few ethnic groups where this is the case." Samoans and Tongans belief that one's status is higher the more one eats. This has resulted in "obesity and its associated conditions, cardiovascular disease and diabetes... Asthma is also a problem for the Samoan community" (Queensland Samoa). Now traditionally, Samoans led a very active way of life and some genetic evidence shows that Samoans are bigger, and weigh more, than people of other cultures. However, "urbanization, lack of exercise, smoking and dietary changes have taken their toll" (Queensland Samoa). Their culture believes that spirits causes illness. Because Queensland's climate and soil allow growth of plants associated with traditional medicine in Samoa, many Samoans choose traditional healers and perceive Western medicine as ineffective.

Samoans also believe prayer is extremely important in the healing process. Now, looking at a completely different ethnic group living in Queensland, Italians, we notice some interesting differences in their health and weight problems compared to Samoans/Tongans and the general Australian population. (Queensland Italy). Even thought Italians living in Queensland show low exercise patterns, many women are overweight (more than men), many men smoke (more than woman),"... both men and women have lower mortality rates than the Australian born population" (Queensland Italy). Alcohol is also used less by Italians than the general Australian population. Food is used as preventative medicine because many Italians believe high-energy intake is a kind of preventative medicine because they believe thin people get sick more often. (Queensland Italy).

The following is important comparative information regarding Italians living in Queensland, provided by the Queensland government:There were lower mean systolic and diastolic blood pressures in Italian born migrants compared with an age-matched Australian-born sample. Smoking and obesity are higher in males born in Southern Europe, but there is a low level of mortality due to heart and respiratory disease. Thalassaemia rates are higher in Italians than the general Australian population. 

Mortality rates from diabetes are higher in Italian women than other Australian women. (Queensland Italy) In addition, Italians in Queensland rarely use hospitals, but they do tend to use western medicine. Analysis of these different ethnic groups living in the same place reveals some very important information. The preceding examples shows that Samoans/Tongans, Italians, and mainland Australians living in Queensland have much different health problems associated with weight even though they live in the same place.

This shows the effect culture has on weight and health. Samoans and Tongans have higher mortality rates than both the Italians and mainland Australians living in Queensland. Italians have the lowest mortally rate between these groups. There are many reasons for this, much of it cultural and food related. First, the similarities between these groups will be shown, and than the differences that led to these different mortality rates. It seems that both Samoans and Italians have low exercise patterns. 

Thus, they burn off less energy than people of other cultures. Both groups also smoke, which is on the rise. Now the differences are startling. According to Anne Caprio Shovic, an assistant professor and the Plan V director in the Department of Food and Science and Human Nutrition at the University of Hawaii, "Samoans are known to be the most overweight population in the world. They suffer from high rates of weight-related disease such as heart disease, hypertension, and diabetes mellitus" (Shovic).

This happens to be a result of the foods they eat and is also genetic. According to NSW Health, saturated fat and, to a lesser extend, cholesterol, are the main causes for the weight of Samoans. (NSW Health). According to NSW Health, these are the main 'problem foods' Samoans eat,But although many foods - like offal (egg liver and kidney), shellfish (egg prawns) and egg yolks, for example - are naturally high in cholesterol, they're not the main problem. 

The main cause is an unhealthy fat called saturated fat found in foods such as: fatty meat, fatty mince, chicken, chicken skin, sausages, tinned corned beef, mutton flaps and turkey tails. Full fat dairy foods like milk, cheese, cream, sour cream, yogurt, ice cream fats and oils such as butter, lard, solid cooking fat from the butcher and cooking oils labeled 'vegetable oils'. (NSW Health). It's obvious that when your culture eats these types of food consistently, even though they are tasty, they contribute to all the problems Samoans have with weight.

Since these are what Samoans have been eating for many years now, they are genetically predisposed to being overweight and/or having weight related medical problems. Italians, on the other hand, are not known to be overweight. According to Rosemary Furfaro, "For the most part, meat does not play a regular part of many Italian diets with vegetables, grains and legumes taking center stage in most homes" (Furfaro). 

Furfaro goes on to say, Basically, Italian cuisine is a combination of vegetables, grains, fruits, fish, cheeses and a scattering of meats, fowl and game usually seasoned or cooked with olive oil (with the exception of the far north). The reliance upon what the country can produce has shaped a diet popular for centuries, particularly with the poorer Italian people, and is called la cucina povera.

Now we are seeing a resurgence of this "poor people's food" and the Mediterranean diet is being touted as the model around which we should restructure our eating habits. (Furfaro).Now it seems like the picture is clear. Samoans have a tradition of eating foods loaded with cholesterol and saturated fats. This leads to all sorts of problems already discussed, such as heart disease and diabetes. On the other hand, Italians are leading the way with the Mediterranean diet:The traditional Mediterranean diet delivers as much as 40% of total daily calories from fat, yet the associated incidence of cardiovascular diseases is significantly decreased.

As a monosaturated fatty acid, olive oil does not have the same cholesterol-raising effect of saturated fats. Olive oil is also a good source of antioxidants. Eating fish a few times per week benefits the Mediterranean people by increasing the amount of 'Omega-3 fatty acids'- something that the rest of the developed societies don't get enough of. 

Eating red meat sparingly seems to also increase health. There is a general consensus among health professionals that the Mediterranean Diet is healthier than the North European and American diet because more grains, such as spaghetti, fruits, vegetables, legumes, nuts, and olive oil are consumed. (Mediterranean Diet).

It seems clear now why two different ethnic groups living in the same place, Queensland, Australia, have such different health problems associated with weight. The main difference is cultural. Samoans believe the more you eat, the higher status you have. 

They also believe many illnesses are caused by spirited. Thus, many don't see a correlation between the foods they eat and the health problems they develop. It is extremely difficult to try to change their eating habits, however, an effort is being made. According to Anne Caprio Shovic of the University of Hawaii, "The Samoan exchange lists are now being distributed worldwide to health care professionals who work with Samoan clients" (Shovic). Prior dietary intervention for Samoans depended on foods not historical part of a Samoan diet. "A literature search, personal interviews, and site visits at local grocery stores and village homes were conducted to determine what foods are common to the Samoan diet. These foods and recipes were then computer-analyzed.

Foods that are high sources of vitamins A and C, sodium, and fat are also highlighted in the Samoan exchange lists" (Shovic). It's noteworthy to mention that must Samoans are rather proud of their size and weight. Because they see it as a status symbol, and because of their traditional diet, it may be difficult to change their diets to benefit them. The new Samoan exchange lists are an excellent idea. Instead of replying upon foods Samoans don't eat, nutritionists finally developed recipes using Samoan food. Hopefully, this will start to benefit these people. 

The Italians living on Queensland, who have less of a mortality rate than main land Australians, rely on the Mediterranean diet for their healthy diet. Italians don't see food as a status symbol, yet they are extremely proud of the foods they produce and eat. Many other countries have tried to even replicate the Mediterranean diet, with some success. (Furfaro). The Samoans and Italians living in Queensland share the same environment, jobs, land, social networks and more among themselves and mainland Australians. The only difference is the culture they bring to Queensland. And the culture they brought to Queensland is the biggest factor regarding the health problems they have as a result of their weight.

The preceding example is just one of many that show that culture is vital regarding dietary health. Another excellent example is the comparison of the French diet to the American diet. According to Dr. Will Clower, an American neuroscientist who spent two years in France, "Only 8% of the French people are overweight compared to almost 50% of Americans. They live longer and have less heart disease" (Weber). What is so amazing about this? The French diet goes against just about everything American doctors and scientists have been telling us. "The French diet includes full fat cheeses, bread, creamy sauces, chocolate, wine, after dinner liqueurs, in fact all the foods that Americans are told to be afraid of" (Weber). Dr. Clower gives a rather good explanation for the striking difference in American's obesity rate compared to France and the foods we eat. 

The French eat very high quality foods and avoid processed foods. They always eat olive oil with meals, which is the key to the Mediterranean diet. And most importantly, the French have small portion sizes and eat their food slowly, as well as with wine. (Weber). Americans are told to take in low carbohydrates, low fat, medium protein and many fruits and vegetables. The French, who also eat fruits and vegetables, eat the right kind of carbohydrates and fats, and limit their portion sizes. America's obesity rate is extremely high compared to the French, and only proves again that the culture you were born in is a huge factor in your weight and health problems.

There are other factors to consider regarding weight and health that are not so dependent on food. An excellent example would be Bolivia's coca chewing population. Many workers and farmers in Bolivia rely on coca leaves, which can be made into the powerful stimulant cocaine, to make it though the day. (Barker). It has been proven that coca leaves are not addictive (Barker), and the peasants rely on them to make it though the workday. 

Now this is an extremely complicated issue. On one hand, you have the United States government's "War on Drugs" which leads to the eradication of many coca plants in South America. It's true that many coca leaves are processed in cocaine and smuggled into the United States. It's also true that the 'eradication' of coca leaves has not lowered the rate of cocaine use or the amount of cocaine smuggled into the country. Instead, peasants in Bolivia might find that they are the only ones hurt with this policy. These peasants are malnourished, and have a very low life expectancy rate.

Most grow up, work the fields and die young, between the ages of 30-50. When a child reaches the age of nine, they start using coca leaves because that is the age they usually start to work. (Barker). Food availably for peasants in Bolivia is low, and many wouldn't have the energy to even earn the meager wages or food they do without coca leaves. 

And it's not the leaves that led to the low life expectancy rate; it's the lack of the availability of food for the peasants. This is a very interesting example because it shows what a culture does when food is limited yet work needs to be done to get that food. Another interesting example is some of the Jewish eating customs.

Many people of Jewish faith eat certain foods; those that are kosher, and don't eat other foods, such as pork. (Mom). Jewish religion only allows us to eat kosher food. A rabbi blesses kosher food, and the quality is thoroughly inspected. It's also more expensive. In addition, even though Jewish people can eat kosher meat, and eat kosher dairy products, you cannot mix those two together. (Mom). It becomes 'un-kosher' to do this. 

In addition, all kitchen utensils used for meat and others used for dairy products must be kept separate. In addition, pork is strictly forbidden to be eaten by Jewish people. It's considered a "very dirty animal" (mom) and is extremely unhealthy. Now what are the results of these limitations? First, because kosher food is thoroughly inspected, the quality of the food is much higher, especially for meat. Also, most people who mix meat and dairy products together get bad stomach indigestion. And most importantly, pork really is a rather dirty animal. Pigs spend much of their time laying in their own 'manure,' In addition, pork must be cooked to a crisp in order to kill all the bacteria present in the meat. Cases of ringworm and other horrible stomach ailments have results from undercooked pork. Jewish people who stay kosher eat high quality food, don't mix certain foods together, and don't eat 'dirty' animals. As a result, many Jewish people stay in shape and have a good weight. Also, because of the preceding, Jewish people who stay kosher don't get many health problems associated with weight. (Mom).

The foods a person eats, which depend on the culture (or religion) they come from, as well as one's genetics, play the most important role in weight management, which leads to a healthier culture. With enough dedication (through exercising) and knowledge, anybody can manage their weight and be healthy (assuming food is plentiful). 

Sadly, this is not the case. Many people simply don't exercise and have other bad habits, such as smoking cigarettes. Many people also don't have the knowledge to maintain good weight and health. People come from all sorts of different cultures. As shown with the Samoans and Italians living in Queensland, two (or more) cultures living in the same environment can have strikingly different diets that are based on their cultures and thus drastically different weight and health problems.

The Samoans, loaded with foods containing cholesterol and saturated fat, seem to be considered the most overweight culture in the world. The Italians, with their Mediterranean diet, are leading the way for health. Americans, with our vast resources and wealth, have a culture that loves the wrong types of food. As a result, we have a very high obesity rate. 

Also, Americans have placed a great burden on young females, who malnourish themselves to look 'thin and sexy'- as the media likes to portray. This is how a rich American woman and a poor South American farmer can both be malnourished. In essence, the culture one is apart of plays a significant role in the foods one eats, how much they weigh, and ultimately, their health. Different cultures have different norms for the words 'fat' and 'skinny'. No culture is right or wrong with their terms for fat and skinny. However, the statistics and evidence clearly shows that some cultures are simply better handled to deal with health issues associated with weight than other cultures are.

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