American Diet Rubs Some Immigrants Wrong Way

By Jennipher Shaver, Contributing Writer

The world's vision of the health of Americans is anything but flattering.

America's emphasis on quantity, inactivity and convenience foods leaves other cultures dismayed, repulsed or, at the least, confused. In a country of excess, mainstream culture values the most food you can get for your money and the quickest way to prepare a meal.

Immigrants coming to the United States to find a better way to live or to learn about American culture aren't finding one thing: the healthiest of lifestyles.

Conversations about immigration are typically about how immigrants change the American landscape. But a question more and more people are asking is: How does America affect them? What does picking up and moving to the United States do to their diet, activity levels and overall health? And, really, what does this say about American culture?

More than 1.5 million people come to the United States each year, whether they come as immigrants or international students. Most say they come here to be with their families, to work, or to experience the American way of life.

Faced with new challenges and a new environment, immigrants adapt to America through a process of acculturation. Everyone acculturates differently and at varying speeds, but picking up some of America's customs is almost always inevitable. The beginnings of acculturation typically start with a new job, but can also be learned from watching and modeling television, friends or family.

For immigrants, diet usually changes because traditional foods may not be available or easily accessible. Some immigrants may also purposely change their diet to get the full American experience or "fit in." This is usually more common in children and adolescents but also happens in adults.

Food's Cultural Role

Food and culture are intrinsically linked. Dr. Mary Darling said that if you define culture as what is transferred from one generation to the next through teaching, practicing, imitating and modeling, then culture plays a 100 percent role in diet.

"We all live in our culture now, and whatever our current selection is, from fast food to gourmet items, it shows the role that our current culture plays in our diet," said Darling, a registered dietician and retired nutrition professor at the University of Minnesota.

Basically, our culture defines what food is available, and that ultimately decides what we can choose to eat. What may be more important in culture's role with diet are emotional feelings and associations with food.

Dr. Marci Campbell, an associate professor of nutrition and public health at the University of North Carolina, has created programs that aim to reduce the risk of cancer in minority populations. In the Wellness for African Americans Through Churches (WATCH) project, Campbell was aware of cultural issues that come into play with diet and health.

"People grow up with a certain association with food, and people have an emotional attachment to food and enjoy it," Campbell said. She said many people eat what they grew up eating or simply what's available.

And many times, availability is an issue. While immigrants and international students may wish to eat what they grew up eating, in America, that may not be possible because sometimes those foods aren't available or their costs are too high. This can make for an especially stressful time.

Acculturation Process

Despite the endless variety in American supermarkets, newly landed immigrants may feel overwhelmed with the overall culture and new diet choices. A trip to the local grocery store could prove to be confusing, and quite literally foreign, even if immigrants can find their local delicacies.

New immigrants can do one of two things with their diet when first in America: stick to their original diet or try the American way.

University of Missouri graduate student Chunxiao Li moved to Columbia, Mo., two years ago from China and has tried to keep her diet as traditional as possible. She feels that Americans eat very unhealthfully, and although her diet hasn't really changed that much, she feels like she eats less healthfully than before she moved.

"It's not too easy to eat a Chinese diet [in America]," Li said. "But I cook for myself, so it's better."

At home, Li cooks meals of with a lot of vegetables and rice. She said she drinks mainly tea.

Xinning Huang, Li's friend and a graduate student at the University of Missouri, also said that cooking at home is the key to staying healthy and eating well. Huang frequents the two Chinese markets in Columbia, but has also incorporated American foods.

"We get Chinese vegetables, which are very important for my health, I think," Huang said. "I've also learned to eat cheese and milk."

According to numerous studies about dietary acculturation, or the process of immigrants gradually adopting an American diet, most international students and immigrants change their diet at least somewhat after living in the United States. Like Huang, adding in dairy products is common for immigrants whose original diet didn't contain them.

Dr. Jessie Satia Abouta, the lead author of several journal articles on dietary acculturation and Chinese-American women's health, said that it seems that the more acculturated the woman is, the more typical American food she eats.

One study, published in the Journal of the American Dietetic Association, included interviews with 244 less-acculturated Chinese-American women in Seattle. Satia, an assistant professor of nutrition at the University of North Carolina, found that most of the women in the study ate milk, cheese and Western fast food. How often or how much they consumed depended on the women's level of overall acculturation into American society.

"Women more acculturated ate more American food," Satia said. "The women that worked outside the home with younger kids were more likely to be acculturated. Their diet usually changes for the worse."

The study also found that breakfast was the first meal to be Westernized.

"If you don't have time to make breakfast, you get a big bowl of cornflakes and give it to the kids because you have to go to work," Satia said.

According to Satia, these results can not be generalized to other cities without further research since cultural practices and diet vary due to the availability of traditional foods and the cost of living. Satia did say, though, that the process of acculturation was similar across ethnicities.

A handful of other studies have been conducted on diet and acculturation. Although small, all of them have similar results.

In a cross-sectional mailing survey of 348 Korean-Americans in the United States, those who were more acculturated ate more American food and less traditional Korean food. Bicultural people typically had the most variety, eating both American and Korean foods. Common American foods included oranges, low-fat milk, bagels, tomatoes and bread. It's important to note in this case that even though their diet changed, the quality of their diet didn't.

Another study of 63 people voluntarily surveyed from the College of Health Sciences at Florida International University showed that Asian students do change their eating patterns after living in the United States. Unlike Li and Huang, whose diets didn't change that drastically, researchers found that students start eating more sweet and salty snacks, fruit and dairy, and reduced their intake of vegetables and meat.

Anette Riihelä said that was the case for her. For a year, Riihelä lived in the United States as a high-school exchange student. She lived with a host family in Liberty, Mo., to experience a typical American life.

In her homeland of Finland, Riihelä would eat a lot of fresh fruits and vegetables, rye bread, salad, oatmeal, dairy, fish and boiled potatoes. She said her diet changed when she came to the United States because, well, the diet is just "different." With a great cook for a host mom, Riihelä loved eating french toast, pancakes and burritos.

"In the U.S., I ate more snacks like candy bars. People seem to do that there," she reflected of her stay last year in Missouri. "And I also ate more over there. It was too easy to grab a Coke or a burger, and sometimes there were no other options."

She said that in Finland, many of her peers think of Americans as fat and as "eating junk food all the time." After her experience in the United States, Riihelä said she still believes that's pretty accurate.

"I would connect hamburgers and Coke to the American culture -- like many people in Europe do, too," she said.

Health Implications

Adopting a traditional American diet of burgers and fries isn't doing much for immigrants' health. When most immigrants move, they not only are prevented from eating their traditional diet, but their physical activity often drops as well.

"Chronic disease and obesity are strongly related to a diet high in fat and sugar," Satia said. "We're talking about type 2 diabetes, cancer and heart disease. This trend in acculturation puts many at risk for disease."

This comes at a time when already 59 million adults, or one-third of the total U.S. population, are obese -- a rate that has doubled in the last 20 years, according to the Centers for Disease and Control and Prevention. Second to only tobacco, poor diet and physical activity are blamed for 300,000 deaths each year. The obesity epidemic is now costing the United States about $117 billion a year.

With rising numbers and expanding waistlines, it's easy to see why health professionals and researchers such as Darling, Campbell and Satia are looking into how other cultures pick up our unhealthy habits. It turns out, we can learn a lot from them.

"We learn that other cultures eat a lot better," Satia said. "They eat less food, walk around more, and have a diet based on whole grains, vegetables and lean cooking."

In many of Satia's interviews with Chinese-American women, she recalls them not wanting to eat in Chinese restaurants because of the excess of oil, fat and meat. "The restaurants were just catering to American palettes," she said.

But not all of America's food is bad, and some immigrants benefit from the change in diet. Many Hispanics eat less saturated fat when they move to United States. Many Asians start eating more fruit and dairy, which provides a good source of calcium. Satia said making healthy choices is key.

Lessons For Americans

As a culture that is overweight, Americans are fascinated by other cultures' ability to stay trim and fit. Some diets even seem to ward off disease entirely.

For a time, researchers were pondering the Mediterranean diet, which promised lower heart disease and death rates. The diet focuses on fruits, vegetables, bread, cereals, potatoes, beans and nuts. The benefits of olive oil and wine were stressed, while red meat, eggs and dairy were eaten in small amounts. While the diet supplies a relatively large number of calories from fat, according to the American Heart Association, saturated fat consumption is well within dietary guidelines.

Then there was the Okinawa Centenarian Study, where a low-calorie diet of fruits, vegetables, fish, soy and unrefined carbohydrates allowed Okinawans to live to be more than 100 years old. Okinawa is a group of 161 islands between the Japanese main islands and Taiwan, and the residents there have the lowest levels of coronary heart disease, stroke and cancer in the world.

However, before you jump on the Mediterranean and Okinawa bandwagons, these diets haven't been proven to directly help your heart or give you age-old longevity. A lot of other cultural factors come into play that America's culture may just not support. Both diets include high levels of physical activity and extended social support. And for the Okinawans, diet is much more than just food -- it's a spiritual way of life.

In American culture, food is seen as just what it is -- food. Most people don't talk about their chi, or life energy; they just grab a bite and run.

For most health professionals, moderation is the key. We should enjoy our traditional American foods in blissful moderation and start eating more like our neighbors -- including foods like fruits and veggies, whole grains and lean meats.

And how do you keep immigrants' diets from becoming so, well, American? Intervention studies now urge dieticians and health professionals to be aware of cultural differences and eating patterns. The American Dietetic Association recommends blending traditional foods with healthy American ones.

That's a bit of advice we could all put into practice -- immigrants or not.

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