Cultural Factors as Important as Cost in Diet Choices Among Poor

Diet is a well-established factor in cancer prevention. According to two Baylor College of Medicine researchers, cultural factors play a more powerful role than cost in determining the food choices of people with low incomes. Speaking at the 1997 Biennial Symposium on Minorities, the Medically Underserved, and Cancer, the researchers said that blacks and Hispanics typically eat a less healthy diet than whites, but not because of cost.

Healthy Food Only Slightly More Expensive
A diet that meets cancer prevention guidelines actually costs little more than the far less healthy one that many low-income individuals eat, reported Walker S. Carlos Poston II, PhD, assistant professor in the Department of Medicine and Behavioral Medicine Research Center of the Baylor College of Medicine.

At a middle-income level, buying a varied diet, including five daily servings of fruits and vegetables, a high level of fiber, no more than 30% of calories from fat, and a moderate amount of protein, would, in fact, reduce a family’s average weekly food bill by $1.37 and increase a low-income family’s weekly food budget by only $.22.

“Junk food is not cheap,” Poston said, adding that blacks and Hispanics typically eat more fried foods and less fruit than whites.

Food preferences and cooking methods play a crucial role, he noted. Coca-Cola, beans, tortillas, and meat are the four leading calorie sources in the diet of a typical resident of a poor county in Texas, reported Poston’s copresenter, John P. Foreyt, PhD, professor of medicine and director of Baylor's Behavioral Medicine Research Center.

In addition to being 97% Mexican-American, he said, the county’s population is almost 50% diabetic. In addition to cultural differences with regard to food choices, he added, cultures also differ in their attitude toward body weight. Hispanic and African-American cultures, for example, appear to be more accepting of overweight, especially in women.

Cultural Sensitivity Needed
Programs aimed at persuading members of ethnic minorities to adopt more healthy diets must be based on behavioral analyses specific to the particular culture, Foreyt observed. Unfortunately, few good studies now exist, he added. Family networks, which are very important in a number of minority cultures, must be involved if real change in eating habits is to take place, Poston noted.

Attitudes of health workers must also change, he added, particularly with regard to people who do not adhere to the suggested dietary regimen. Contrary to the impression given by many attempting to influence people to change their diets, he said, nonadherence is not a personality defect, nor is it uncommon. Relatively few Americans meet the guidelines, and most Americans live in a “toxic” environment full of unhealthy foods. Intervention programs that do not take account of these facts will not succeed, he said.