CHAPTER 10 Mexican American Food Practices


The extended family might accompany the person during health care visits and decisions might be made as a group. For many Mexican Americans, family roles and responsibilities come before all other responsibilities. Family members’ support and understand- ing are critical for helping to maintain necessary lifestyle changes.


The mother or primary female caretaker typically decides when an illness is beyond her ability to treat with folk remedies and when to seek additional help. At this point, the family may become more involved in the decision-making process. Remind Mexican American mothers of the importance of their own self-care.49


As appropriate, involve promotoras de salud (lay Hispanic or Latino community health-outreach education workers) on your health care team to follow up with family members. Promotoras receive specialized training to provide basic health education. For example, intervention studies using promotoras reported positive changes in family members’ knowledge, attitudes, behaviors, and beliefs relative to diabetes prevention and control.50


Nutrition Counseling Consult culturally specific nutrition counseling strategies, including advice that is consistent with the Mexican Dietary Guidelines51 (also refer to Resources on pages 211 and 212), the US Dietary Guidelines for Americans, and Spanish MiPlato (MyPlate in Spanish).


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Assess literacy and determine whether a person prefers to read in English or Spanish. Those who are less acculturated may seek health information in Spanish, while highly acculturated Mexican Americans may prefer English.45


Bilingual materials help ensure


that other members of the person’s support system can read the materials. Culturally appropriate nutrition education materials with colorful graphics are generally well-accepted, with or without text, depending on the person’s language and literacy level.


Use food models, graphics, or pictures with Mexican foods com- monly consumed at breakfast, lunch, and dinner to determine what traditional foods are preferred and consumed frequently. Food models can be helpful when discussing portions.


Ask specifically about soft drinks, agua frescas, fruit juices, and energy drinks. Instead of sugar-sweetened drinks, encourage con- sumption of water and aguas frescas without added sugar (made by blending fruit with water or by infusing fruits, seeds or grains, or flower petals with water).


Encourage consumption of healthy, traditional foods, including those that are high in vegetable protein, such as corn and beans (legumes), and those that are good to excellent sources of fiber, certain vitamins and minerals, and phytonutrients such as nopales.


Suggest using whole-grain (integral or entero) foods such as corn tortillas, oats, amaranth, brown rice, and whole-wheat bread and pastas, as well as legumes such as beans, lentils, and fava beans for more fiber.


Inquire about cooking methods such as the use of frying, includ- ing what types of fat or oil used, and how often fried foods are consumed. Suggest stews and grilled or roasted foods with little or no oil. Offer healthy alternatives to prepare foods with substitutions (e.g., heart-healthy oils in place of lard) or other ways of cooking (e.g., stir-frying in place of deep-frying).


Address ways to reduce sodium, including cutting back on and finding substitutes for processed meats and sausages, snacks, instant soups, and canned foods. Suggest lower-calorie, salt-free flavor substitutions (herbs and spices) in traditional dishes and family recipes. Talk about the flavor ingredients they may use such as garlic, onion, cilantro, lime, oregano, yerba buena (spearmint), epazote, and hojas de laurel (bay leaves), among others.


Probe to learn about foods that the person and their family currently consume. For example, if they eat tortillas, find out how many, what kind (corn or wheat flour), and what size tortillas they eat at each meal. Also ask whether the tortillas are homemade or store-bought, perhaps at a Hispanic market (la tienda); home- made tortillas are more likely to be larger in diameter and thicker.


Consider cultural customs when advising changes in a person’s food choices. For example, ask if they are open to eating fewer tortillas rather than simply telling them to eat only one or two torti- llas per meal. If not, consider negotiating a suggestion or another option as appropriate.


Encourage appropriate amounts of fruits and vegetables in every meal, including those common to their regional heritage, perhaps beans (dried and boiled, not fried), cantaloupe, guayabas, jicama, mangos, oranges (e.g., mandarin), nopales, onions, papayas, peaches, peppers and chilies, salad greens, tomatillos, tomato, watermelon, and others. Be aware, however, that some may be costly or unavailable.


Reinforce and build on other positive healthy eating practices. For example, café con leche is made with a significant amount of calcium-rich milk; encourage lower-fat milk and cut back on sweet foods such as sweet bread, cookies, and pastries if they are consumed regularly.


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