arabic power point-diabetes care center
TRANSCRIPT
Arabic
Food &CultureLydia Dysart & Alyssa Fritz
Henry Ford Hospital
Dietetic Interns 2015-2016
The Arab World 21 Arab States identified by UNESCO:
Algeria, Bahrain, Comoros, Djibouti,
Egypt, Iraq, Jordan, Kuwait, Lebanon,
Libya, Malta, Mauritania, Morocco, Oman,
Qatar, Saudi Arabia, Somalia, Sudan,
Syria, Tunisia, United Arab Emirates,
Western Sahara, Yemen,
Facts About the Arab World “Arab” – referring to anyone who speaks Arabic as their first language
Over 300 million worldwide
Muslims, Christians, and Jewish Arabs
“Arab Americans” – Americans of Arab descent Lebanon, Syria, Palestine
Arrived in the late 19th century
Largest community is in the Detroit-Dearborn area:
300,000-350,000 in the Greater-Detroit area
1/3 of the city of Dearborn
Islam
Monotheistic Middle East religion
beginning the 7th century
Five Pillars
Faith, Prayer, Charity, Fasting, Hajj
1.5 Billion followers worldwide
Islamic Holidays
Al-Hijra
Islamic New Year
Ramadan
The month of fasting - fast from sunup to
sundown
Eid-ul-Fitr: Festival of Breaking the Fast
End of Ramadan – celebratory meal
Eid-ul-Adha: Festival of the Sacrifice
Ramadan
Chabbakia-Fried dough, sesame seeds,
honey
Mujadarra- lentils and rice,
yogurt
Konafah- pastry made with phyllo dough and
cheese
Paomo- bread and mutton soup Khyar Bi Laban- cucumber yogurt
saladQatayef- Arabic pancake filled
with sweet cheese and nuts
Eid-ul-Adha: Festival of the Sacrifice
Asian Muslims celebrate with
sheer korma, a sweet dish
made with milk, vermicelli and
biryani.
In Bosnia and Herzegovina
stuffed vegetables called
dolma is served.
Uighur Muslims prepare
traditional Xinjian Noodles
Ramadan – Implications for Diabetes Fasting - one meal at sunrise, one meal at sunset
Quran exempts certain groups from fasting for health reasons
Risks
Hypoglycemia – highest risk in those taking insulin or certain medications
Hyperglycemia – highest risk after overeating at night
Dehydration
Tips
Monitor blood glucose levels throughout the day – end the fast if <70mg/dl
Continue taking medications – dose/times may need to be adjusted by doctor
Dawn meal – whole grains + protein + fat
Dusk meal – limit dates to 1-2 per evening, drink lots of water, be cautious of
overeating
T2DM in Arabic-Speaking Countries Dramatic increase in prevalence past 30
years
Wealth
Urbanization
Decreased physical activity
Changes in nutrition
280,000 diabetes-related deaths per
year
Risk Factors Obesity
78.5% of people with diabetes are overweight
45.7% are obese
Modernization
Urbanization
25.5% have diabetes in urban areas vs. 19.5% in rural areas
Highest rates in wealthiest countries
Education
Marriage
Physical Inactivity
Risk Factors Food Consumption:
Dates, milk, fresh fruits and vegetables,
whole wheat bread, fish high saturated
fat, refined carbohydrates, low dietary
fiber
1990-2007: Average energy
consumption per person is 2780kcal/day
Prevalence Among Arab Americans in Dearborn, Michigan
Sample size: 542 subjects in Dearborn, randomly selected
95% immigrants, in US for 11 years (mean length)
Mean age: 38 years
Glucose tolerance assessed with two hour 75 g oral glucose tolerance test
Higher in men than women
Abnormal Glucose Tolerance:
Affects 41% of the population 20-75 years of age; >70% those >60 years of age
Higher rates than white, African American, Hispanic populations in US
High prevalence of diabetes and impaired glucose intolerance + low detection rates = prevalence expected to increase
Need for increased public awareness and regular surveillance for diabetes, need to develop culturally sensitive community-based interventions aimed at prevention and management
Diabetes in Arabic Population Responsibility
Fatalism- belief that events are controlled/predetermined by fatalism.
Social Acceptance
Status and social acceptance are highly valued in Arabic population-
Illnesses like diabetes could evoke feelings of shame
Single men and women may avoid care
Role of the RD
Motivational interviewing- find culturally appropriate ways to help the patient take their medication, carbohydrate count, or choose different foods
Educate patient– diabetes is unrelated to infertility or impotence.
Diabetes in Arabic Population Desirable Body Type
Overweight is associated with “health”– strength, prosperity, wealth prestige
Westernization changing idealistic body image but mainly in youth, not in adult
population with diabetes
Hospitality and Generosity
Maintain good social status.
Food rituals—host offers unrestricted food (in quantity and variety) and it is
customary to convince guests to eating much more than they are capable of.
The Role of the RD Understanding the cultural context of the disease
Values: conformity, associated with social honor
Patient with diabetes with this background may not be skilled in self management
Patient may perceive RD or CDE to be authority figures
Cause fear of admitting problems or asking questions– feelings that they are unqualified to participate
Providing quality care
Demonstrate a peer-type relationship with patient
Involve the patient in their care– what are their perceived barriers, what are foods that they enjoy eating, what is their plan of action?