Cath Lab Digest

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Ostomy Wound Management presents this extended version of Nutrition 411 to help readers address transcultural nutrition concerns. We are grateful to the authors for their timely insights.

     According to US Census Bureau data, as of July 2006 approximately one in three US residents (about 100 million people) was a minority. Hispanics are the largest minority group (44.3 million, 14.8% of the population), followed by black Americans (40.2 million or roughly 13.5% of the population) and Asians (14.9 million).1 Census statistics project that racial and ethnic diversity will continue to increase into the middle of the century. By 2050, the minority population is forecasted to reach approximately 235.7 million or 54% of the US population.2 The Hispanic population is expected to triple, and the Asian population is expected to more than double. The number of American Indians and Alaskan natives also is projected to increase from 4.9 million to 8.6 million (or from 1.6% to 2% of the total population), and the number of native Hawaiians and other Pacific Islanders is expected to more than double, from 1.1 million to 2.6 million.

     Tremendous variations in language, culture, religious beliefs, education, food habits, and socioeconomic status exist within each minority group. Patients with different cultural and religious backgrounds often bring their own sets of beliefs and practices that can affect medical treatment, including wound healing. Healthcare professionals cannot assume that each group, neatly categorized by the US Census Bureau, is heterogeneous. However, a basic understanding of religious and cultural norms as they relate to food habits can help registered dietitians (RDs) and other members of the healthcare team. The nutrition care plan goal for patients with wounds is to meet nutrient needs within the context of customary food habits.

     This article addresses the food habits of our nation’s largest ethnic, racial, and religious groups and discusses how these diets affect nutrient intake as it relates to wound healing. The general nutrient guidelines for wound healing are outlined in Table 1. Individual treatment plans, including decisions about vitamin and mineral supplementation, must adapt these guidelines to meet the needs and medical conditions of each specific patient.

Hispanic Food Patterns

     The US Census Bureau defines the Hispanic/Latino profile as Cubans, Mexicans, Puerto Ricans, and South and Central Americans. The Mexican-American population makes up the majority of the Hispanic population. The typical Mexican diet is rich in complex carbohydrates in the form of corn, corn products, beans, and rice. Enough protein to meet most needs is provided by eggs, fish, beans, and most types of meat and poultry.3 Mexican diets often are high in fat because many of the foods are deep-fried. The nutrients most likely lacking are calcium, iron, vitamin A, folacin, and vitamin C,3 many of which are essential to wound healing.

     If nutrient needs are increased because of wounds, a diet with meat, poultry, beans, and low-fat cheese can provide additional protein. Liberal use of tomatoes and fruits, common ingredients in Mexican foods, can increase vitamin C intake. Clinicians also should encourage a diet that includes dark-green leafy and deep-yellow vegetables, even though some of the Hispanic population is not familiar with these foods.

Asian Food Patterns

     The US Census Bureau classification of Asians includes persons from a wide variety of countries, including Vietnam, China, India, Pakistan, and Japan. Their corresponding cultures have diverse food habits.