CHAPTER 8 East Africa: Kenyan American Food Practices


Overweight and Obesity Central obesity is on the rise in East Africa and in Kenya specifically; however, prevalence is lower than African Amer- icans in the US. A 2015 World Health Organization study reported that approximately 31% of Kenyan adults fall into the overweight or obesity category, with rates for women almost double compared to men.14,15 Many Kenyan Americans and other African immigrants to the US develop overweight or obesity with longer stays in the US, often associated with lifestyle changes and physical inactivity.12


Tere is a strong preference for larger body sizes


in some African countries, including Kenya, where it may be desirable to be overweight because it is believed to reflect good health and higher social status.16


Diabetes Diabetes rates in Kenya are lower compared to the US. Te International Diabetes Federation reports a 3% adult diabe- tes prevalence for Kenyans.17


burden of type 2 diabetes in Kenya, with many persons currently undiagnosed and others not receiving adequate treatment.18,19


Many East African people living with undi-


agnosed diabetes who migrate to the US might be unaware of their status. Tere are limited data on the prevalence of diabetes in Kenyan Americans.


Other Nutrition-Related Concerns Child malnutrition is a significant concern in parts of Africa, including Kenya. Te US Agency for International Development (USAID) reports that 26% of Kenyan children suffer from stunting or low height-for-age, attributable to food insecurity, inadequate infant and young child feeding practices, and poor access to health care.20,21


Micronutrient


deficiencies, especially iron, iodine, and vitamin A, are prevalent in Kenya.9,22


It is important to recognize that


immigrants from Africa, including Kenya, may be refugees and they could be at greater risk for malnutrition; screening is recommended.23


171 However, there is an increasing


Traditional Health Beliefs and Practices Although Western medicine is more widely accepted in Kenya, the use of traditional healing practices is widespread, particularly in rural areas where access to basic health care and medical supplies are limited. Despite the use of these practices, traditional medicine carries a stigma in Kenya, and unlike many other African countries, Kenya has yet to develop a national policy and regulatory framework address- ing traditional medicine. Tere are also insufficient efforts to conserve medicinal plants, in part due to climate change but also unsustainable harvesting practices. As society in Kenya undergoes modernization, indigenous communities are being exploited, resulting in loss of indigenous knowledge. Concerns about safety, efficacy, quality control, access, and inappropriate use of herbal medicine also exist. Experts are making an effort to document and study traditional healing practices and acknowledge their potential contributions to health care. Tese efforts include integrating traditional healers into the broader health care system for a more com- prehensive approach to health care.24,25 Traditional medicine in Kenya includes herbal remedies, medicinal plants, spiritual healing, bone-setting, and the use of ritual ceremonies. A study conducted among rural and urban Kenyans reported that many participants believed only certain medical conditions can be treated in a hospital (e.g., measles, which requires traditional medicine, but not malaria); diseases can be caused by evil spirits; and caregivers might switch from allopathic medicine to traditional medi- cine when they felt that allopathic medicine was ineffective.26 Traditional healers may offer remedies and advice on ways to treat health conditions by dealing with causes of the illnesses that are outside the human body, which might include curses, violations of a cultural taboo, or angry ancestors. Some illnesses might also be attributed to eating the wrong foods. Treatment often involves ritual practices and tradi- tional medicines.27


Te use of medicinal plants is a common practice in


Kenyan traditional medicine, and different plant species are used for various ailments. Knowledge about these remedies is often passed down through generations. Box 1 on the next page lists examples of medicinal plants used in Kenya.27,28


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