Dietary Culture Shock Greets Immigrants to Land of Plenty

One immigrant family stockpiled peanut butter received from a federal food supplement program because family members didn’t know how it was supposed to be eaten.

Thay Phan sidestepped the sandals and sneakers strewn on the front porch of a tiny beige clapboard house on Alabama Street in Canoga Park and rapped on the door.

Within seconds, Siv Til, a 73-year-old Cambodian refugee, stood in the open doorway, clasping his hands in front of him--a traditional greeting of welcome in his homeland--and flashing a toothless grin for his visitor. Surrounding Siv Til were most of his other 15 family members.

Phan’s visit wasn’t a social call, although he has grown friendly with the family since its members began arriving here six months ago. As a community worker with the refugee program at the Canoga Park Health Center, a facility of Los Angeles County Department of Public Health Services, Phan, a Cambodian turned U.S. citizen, was making a visit to provide nutrition instruction.

The Siv Tils are experiencing what some social-service workers describe as a kind of dietary “culture shock.” Besides coping with a new land, new home, schools, job-hunting, English classes and health-care appointments, the family is learning how to operate modern cooking appliances and how to deal with new dietary customs and food choices.

Rice, Corn in Native Diet

In the mountainous area of war-torn Cambodia where the family once lived, the native diet included mostly rice, corn, chicken and potatoes. “In Cambodia,” Phan explained, “most people don’t know about cereal or fresh milk.” In Canoga Park, the family is finding a much wider choice of foods: everything from Slurpees at the 7-Eleven to Big Macs at McDonald’s and grocery-store produce departments overflowing with exotic fruits and vegetables.

They’re not alone, as statistics show. During 1984, 218,600 immigrants settled in Los Angeles County, many of them in the San Fernando Valley, according to figures compiled by the Population Research Unit of the California Department of Finance.

Although many immigrants, especially those who lived in large cities, are somewhat Westernized, many others are not. Valley social-service workers tell of one immigrant family that did not know the purpose of an oven and used it for storage.

Another immigrant family stockpiled peanut butter received from a federal food supplement program because family members didn’t know how it was supposed to be eaten. When the larder got too large, the family tried to give away the peanut butter as gifts.

Need for Refrigeration

Immigrants unaccustomed to refrigeration often fail to preserve food properly and risk poisoning and other ill effects.

The bulk of Valley immigrants in need of nutrition education, according to social-service workers, originate from Southeast Asian countries such as Cambodia, Laos and Vietnam, or from Mexico. Of these groups, Southeast Asian immigrants generally have a more difficult time adapting to American diets, workers say, partly because of the limited availability of Southeast Asian food here.

American supermarkets are “beyond belief for some immigrants,” noted Gayle Schachne, a registered dietitian and project director of the Women, Infants and Children Program at Granada Hills Community Hospital. WIC, a federally funded food supplement program for lactating or pregnant women, infants and children, has 15 Valley clinic sites and includes many immigrants as participants. “Where else has a refugee seen such a wealth of goods? These people are introduced to everything all at once.”

Private nutrition counseling, at $35 an hour or more, is often financially out of reach for immigrants. And, even if such counseling is affordable, a language barrier often inhibits its effectiveness. As a result, health-care programs sponsored by federal agencies and county health centers squeeze nutrition education in their already packed agendas and provide help for immigrants in nutritional quandaries.

Cushion for Culture Shock

Basic nutrition instruction, such as that provided by Phan during his home visits to the Siv Til family, helps to cushion the cultural shock. The goal of workers like Phan isn’t to completely revamp the immigrants’ native diet, but rather to teach them to incorporate the best of their dietary customs into the healthiest of American practices and to take advantage of ovens, refrigerators and other modern appliances.

During earlier visits to the Siv Til home, Phan, fluent in six languages, had already demonstrated the use of the stove and oven and reminded them of the importance of covering and refrigerating perishable food. He had also informed them of the locations of both American and ethnic supermarkets in the neighborhood. During his most recent visit, Phan, who also helps immigrants get medical appointments, family planning and other services, conversed in their native language, asking if all was well, if the stove was working and if they had any questions.

The Siv Tils, like most immigrants, are willing students and quick learners, according to Phan and other Valley social-service workers. Once immigrants are shown how to use a certain food, most accept it as part of their diet. Cheese, for example, is not a staple in most Indochinese diets. “But I show them how to use it and suggest recipes,” Phan explained.

Schachne finds the same acceptance from her WIC program participants, particularly among the youngest immigrants. “Once we show immigrants new foods and let them taste them, the adults may not eat them. But the little kids will go for it.”

Known, Unknown Foods

Suggesting recipes that contain a known food and an unknown food is another easy way to help immigrants incorporate American foods into their diets, said Schachne. “We sponsor food days,” she explained. “Last year, we had a pizza day. We took French bread, a food normally eaten by Southeast Asians, and cheese, a food not normally eaten by them, and made French bread pizzas.” Besides introducing immigrants to cheese, the pizza day program helped them learn how to use an oven.

During another food day program, immigrants learned how to mix hot cereal. “We also did a peanut butter day,” Schachne said. “We showed immigrants what to do with peanut butter--how to put it on apples, vanilla wafers, celery and so on. Once they were shown what they could do with it, they were very receptive to eating it.”

Participants in the WIC program are also required to obtain individual nutrition counseling from the program dietitian at least twice every six months. Each month, as WIC participants gather to obtain food vouchers, a brief program on nutrition or a related topic is conducted.

Nutritionists and other health-care professionals at the eight county health centers in the Valley also answer immigrants’ dietary questions and gear their counseling to individual needs. Many Latino immigrants, for example, have problems with weight control, diabetes and high blood pressure, according to Betty G. Waldner, a county nutritionist for the Valley.

Obese Children

“Many of the pregnant women are also anemic,” she said. Obesity is a problem even in children, so Waldner spends lots of time dispelling the myth that a fat baby is a healthy baby.

The excessive consumption of sweets and fast food are two dietary pitfalls encountered by many immigrant groups, social-service workers agreed. “Many immigrants get caught up in the fast-food habit just like the rest of us,” Schachne observed.

Many Vietnamese immigrants who found it difficult to obtain sugar in their country tend to drink “lots of soda and punch” when they arrive here, Waldner noted.

Despite cultural differences in dietary habits, the goals of nutrition education for immigrants are essentially the same: to teach them how to adapt to new foods and to follow a diet healthy enough to prevent malnutrition and other ills. “We’re trying to save tax dollars,” Schachne said.

For social-service workers, the reward of teaching nutrition to immigrants is the hope--and sometimes the reality--that the newcomers will soon get into the mainstream themselves without abandoning their dietary heritage.

Sometimes, the workers concede, their instruction is a little too successful. “I’ve had reports from mothers saying, ‘My kids won’t eat Vietnamese foods anymore,’ ” Schachne said with a laugh.