SomaliaSomalia

By: Leyla Mumin and Leana By: Leyla Mumin and Leana SchererScherer

History of Somalia (1)(2)History of Somalia (1)(2)

• Colonized by Italy until 1960Colonized by Italy until 1960• Civil war from 1991Civil war from 1991• Tribal- sub clanTribal- sub clan• Same language, religion and cultureSame language, religion and culture• Located on the horn of AfricaLocated on the horn of AfricaReported by Mumin interview:Reported by Mumin interview:• Black hawk down Black hawk down • Left Somali at 5 years oldLeft Somali at 5 years old• My grandfatherMy grandfather

Family value (1,4)Family value (1,4)

• Elders watch children while parents workElders watch children while parents work• Send money back home to familySend money back home to family• Adult children are expected to take care of Adult children are expected to take care of

elderly parents in their homeselderly parents in their homes• Highly patriarchal- women are expected to Highly patriarchal- women are expected to

cater to men.cater to men.• Arrange marriage very popularArrange marriage very popular• Marry young- between the ages of 14-16Marry young- between the ages of 14-16• Men are sole provider for the family.Men are sole provider for the family.

Religion and Religious Belief Religion and Religious Belief (2,3)(2,3)

• Islam is practiced in SomaliaIslam is practiced in Somalia

• Women wear hijab when outside and with Women wear hijab when outside and with menmen

• Can’t consume improperly slaughtered Can’t consume improperly slaughtered animalsanimals

• Can eat meat slaughtered by Jew or Can eat meat slaughtered by Jew or ChristianChristian

• Animals that catch prey with their mouths Animals that catch prey with their mouths are not allowedare not allowed

Religious belief cont.(2,3)Religious belief cont.(2,3)

• Can’t consume alcohol Can’t consume alcohol

• Can’t eat pork productsCan’t eat pork products

• Self-indulgence is not permittedSelf-indulgence is not permitted

• Not everyone practices these Not everyone practices these prohibitionsprohibitions

AnjeraAnjera

• 4 cups sorghum 4 cups sorghum flourflour

• ½ cup sugar½ cup sugar

• 4 ¼ cups water4 ¼ cups water

• ½ teaspoon salt½ teaspoon salt

• 1 tsp instant dry 1 tsp instant dry yeastyeast

Sorghum (5,6) Sorghum (5,6) • Key staple in many parts Key staple in many parts

of the developing world, of the developing world, especially in the drier and especially in the drier and marginal areas of the marginal areas of the semi-arid tropics.semi-arid tropics.

• Versatile- almost taste Versatile- almost taste and scent free; naturally and scent free; naturally white in colorwhite in color

• Strong resistance to harsh Strong resistance to harsh environmentsenvironments

• Gluten-free Gluten-free

Modified versionModified version

• 4 cups whole 4 cups whole wheat flourwheat flour

• ¼ cup applesauce¼ cup applesauce

• 4 ¼ cups of water4 ¼ cups of water

• ½ tsp salt½ tsp salt

• 1 tsp instant dry 1 tsp instant dry yeastyeast

Nutrient Profiles- Nutrient Profiles- MacronutrientsMacronutrientsORIGINAL ANJERA

MODIFIED ANJERA

Nutrient Profiles- MicronutrientsNutrient Profiles- Micronutrients

RDA % RDA RDA % RDA %%

Vitamin AVitamin A 0 %0 % MagnesiuMagnesiumm

19 %19 %

Vitamin EVitamin E 1 %1 % ManganesManganesee

34 %34 %

Vitamin Vitamin B6B6

13%13% NiacinNiacin 19 %19 %

Vitamin Vitamin B12B12

0 %0 % Pant. AcidPant. Acid 1 %1 %

Vitamin CVitamin C 0 %0 % PhosphorPhosphorusus

21 %21 %

Vitamin DVitamin D 0 %0 % PotassiumPotassium 3 %3 %

CalciumCalcium 1 %1 % RiboflavinRiboflavin 4 %4 %

ZincZinc 9 %9 % SeleniumSelenium 11 % 11 %

CopperCopper 13 %13 % Iron Iron 9 %9 %

SodiumSodium 16%16%

ThiaminThiamin 13 %13 %

RDA % RDA %RDA % RDA %

Vitamin AVitamin A 0 %0 % MagnesiuMagnesiumm

22 %22 %

Vitamin EVitamin E 3 %3 % ManganesManganesee

102%102%

Vitamin B6Vitamin B6 13%13% NiacinNiacin 23 %23 %

Vitamin Vitamin B12B12

0 %0 % Pant. AcidPant. Acid 11 %11 %

Vitamin CVitamin C 2%2% PhosphoruPhosphoruss

25 %25 %

Vitamin DVitamin D 0 %0 % PotassiumPotassium 4 %4 %

CalciumCalcium 2 %2 % RiboflavinRiboflavin 12 %12 %

ZincZinc 18 %18 % SeleniumSelenium 62 % 62 %

CopperCopper 22%22% Iron Iron 11 %11 %

SodiumSodium 16%16%

ThiaminThiamin 20 %20 %

Original Anjera Modified Anjera

Notable Differences Between Original Notable Differences Between Original and Modified Recipeand Modified RecipeOriginalOriginal

-Gluten-free-Gluten-free

-higher Kcals: 214.7-higher Kcals: 214.7

-higher CHO: 47.8 g-higher CHO: 47.8 g

-higher Fat: 1.6 g-higher Fat: 1.6 g

-lower Protein: 4 g-lower Protein: 4 g

-higher sugar: 11.5 g-higher sugar: 11.5 g

ModifiedModified

-Contains Gluten-Contains Gluten

-lower Kcals: 166.8 -lower Kcals: 166.8

-lower CHO: 35.7 g-lower CHO: 35.7 g

-lower fat: .92 g-lower fat: .92 g

-higher Protein: 6.7 g-higher Protein: 6.7 g

-lower sugar: 0.6 g-lower sugar: 0.6 g

-higher Vitamin E, -higher Vitamin E, vitamin C, calcium, vitamin C, calcium, zinc, copper, thiamin, zinc, copper, thiamin, entire second row of entire second row of micronutrientsmicronutrients

Traditional Food Habits (7) Traditional Food Habits (7) • Cuisine depends heavily Cuisine depends heavily

on meat. on meat.

• Sheep and goat meat are Sheep and goat meat are popularpopular

• Camel meat is considered Camel meat is considered the best. the best.

• Camels are also important Camels are also important sources of fat and milksources of fat and milk

- drank and used to make - drank and used to make butter and a yogurt called butter and a yogurt called jinow. jinow.

• Pasta was widely eaten Pasta was widely eaten during the Italian during the Italian colonial period and is colonial period and is still popular; rice, still popular; rice, sorghum and cornmeal sorghum and cornmeal are typical grains.are typical grains.

• Popular drinks include Popular drinks include fruit juices and spiced fruit juices and spiced teatea

• Eat only with right Eat only with right hand hand

Sample Somali menuSample Somali menuBreakfast: Breakfast: Anjera with liver stew, a cup of Anjera with liver stew, a cup of Somali tea Somali tea

Lunch: Lunch: Rice with lambRice with lamb

Dinner: Dinner: Beans with riceBeans with rice

Traditional Food Habits Traditional Food Habits Continued…Continued…

•Fingers or rolled leafs are used for scooping foodFingers or rolled leafs are used for scooping food•Women serve men first, and then eat with Women serve men first, and then eat with children when men finishchildren when men finish•Among nomads and farmers cooking is done Among nomads and farmers cooking is done over wood or charcoal fires outdoorsover wood or charcoal fires outdoors

Diet Changes Associated Diet Changes Associated with Acculturation (8)with Acculturation (8)

• Study by Mary Benbenek et al (8): Study by Mary Benbenek et al (8): Enablers and Enablers and barriers to dietary practices contributing to bone barriers to dietary practices contributing to bone health among early adolescent Somali girls living in health among early adolescent Somali girls living in MinnesotaMinnesota

Findings: Findings:

-Traditional Somali food is often eaten at home (Not -Traditional Somali food is often eaten at home (Not high in calcium).high in calcium).

-When asked about intake of calc/vit D rich foods: -When asked about intake of calc/vit D rich foods: juice is drank regularly, tuna consumed juice is drank regularly, tuna consumed OCCASIONALLY, and milk is available but not OCCASIONALLY, and milk is available but not preferred. preferred.

Diet Changes Associated Diet Changes Associated with Acculturation (8)with Acculturation (8)Findings Continued…Findings Continued…

-Milk and calcium-containing foods like cheese and -Milk and calcium-containing foods like cheese and pizza were mostly consumed at schoolpizza were mostly consumed at school

-No clear consensus on which foods contained pork, so -No clear consensus on which foods contained pork, so some calcium-containing foods were avoided during some calcium-containing foods were avoided during RamadanRamadan

-Family meals were infrequent except during Ramadan-Family meals were infrequent except during Ramadan

-All girls in the study expressed willingness and -All girls in the study expressed willingness and openness towards dietary changeopenness towards dietary change

-Favorite restaurants: McDonald’s and Subway -Favorite restaurants: McDonald’s and Subway

Enablers and Barriers to increased Enablers and Barriers to increased intake of calcium and vitamin D intake of calcium and vitamin D (8)(8)EnablersEnablers

-School, -School, milk and milk and cheesecheese

-Acculturation -Acculturation calcium/vitamin calcium/vitamin D rich foodsD rich foods

BarriersBarriers

-Eating traditional foods -Eating traditional foods at homeat home

-Lack of family meals -Lack of family meals convenience foodsconvenience foods

-misconceptions/ lack of -misconceptions/ lack of knowledge about knowledge about which foods contained which foods contained porkpork

-taste preferences-taste preferences

-Acculturation: -Acculturation: convenience foodconvenience food

Healthcare Disparities Healthcare Disparities Amongst Somali Immigrants Amongst Somali Immigrants (9)(9)• Study by Mark Wieland et al (9): Study by Mark Wieland et al (9): Diabetes Care Diabetes Care Among Somali Immigrants and Refugees Among Somali Immigrants and Refugees

Results: Results:

-Somali patients less likely to meet criteria for -Somali patients less likely to meet criteria for optimal glycemic control optimal glycemic control

-Trend towards lower rates of lipid control-Trend towards lower rates of lipid control

-No significant difference in optimal blood -No significant difference in optimal blood pressures. pressures.

-Increased years in U.S. corresponded with -Increased years in U.S. corresponded with increased risk of diabetes and obesity. increased risk of diabetes and obesity.

Counseling tips (3)

•Don’t mention weight while counseling

• In-dept interview is preferred

•Be mindful of religious practices

•Use of community resource can provide additional support for nutritional change

ReferencesReferences1.1. Boyle, Elizabeth Heger and Ali Ahmed. Boyle, Elizabeth Heger and Ali Ahmed. Culture, Structure, and the Refugee Experience in Somali Culture, Structure, and the Refugee Experience in Somali

Immigrant Family Transformation. Immigrant Family Transformation. International Migration. Vol. 48 (1) 2010. International Migration. Vol. 48 (1) 2010.

2.2. Langellier, Kristin M. Langellier, Kristin M. Performing Somali Identity in the Diaspora. Performing Somali Identity in the Diaspora. Cultural Studies. Vol. 24, No.1, pp. Cultural Studies. Vol. 24, No.1, pp. 66-9466-94

3.3. Kittler, Pamela Goyan. (Eds.) (2008). Kittler, Pamela Goyan. (Eds.) (2008). Food and CultureFood and Culture. (6th ed.) Belmont, CA.: Wadsworth, Cengage . (6th ed.) Belmont, CA.: Wadsworth, Cengage Learning Learning

4.4. Hawa Ibrahim A. Koshen (2007): Strengths in Somali Families, Marriage & Family Review, 41:1-2, 71-Hawa Ibrahim A. Koshen (2007): Strengths in Somali Families, Marriage & Family Review, 41:1-2, 71-9999 http://dx.doi.org/10.1300/J002v41n01_05

5.5. Elkhalifa AEO. Sudanese women and traditional uses of fermented sorghum. The Ahfad Journal. Elkhalifa AEO. Sudanese women and traditional uses of fermented sorghum. The Ahfad Journal. 2005; 22: 77-92. Available at: 2005; 22: 77-92. Available at: http://0-web.ebscohost.com.skyline.ucdenver.edu/ehost/pdfviewer/pdfviewer?sid=e64036a7-7ade-http://0-web.ebscohost.com.skyline.ucdenver.edu/ehost/pdfviewer/pdfviewer?sid=e64036a7-7ade-468e-8fb4-f83e1ac66baa%40sessionmgr13&vid=4&hid=21. Accessed October 16, 2012.468e-8fb4-f83e1ac66baa%40sessionmgr13&vid=4&hid=21. Accessed October 16, 2012.

6.6. U.S. Grains council. Sorghum Handbook: All About White Sorghum.U.S. Grains council. Sorghum Handbook: All About White Sorghum.

7.7. Aliprandini M. Our World: Somalia. Great Neck Publlishing; 2011Aliprandini M. Our World: Somalia. Great Neck Publlishing; 2011

8.8. Benbenek MM, Garwick AW. Enablers and barriers to dietary practices contributing to bone health Benbenek MM, Garwick AW. Enablers and barriers to dietary practices contributing to bone health among early adolescent Somali girls living in Minnesota. among early adolescent Somali girls living in Minnesota. Journal for Specialists in Pediatric NursingJournal for Specialists in Pediatric Nursing. . 2012; 17: 205-214. Available at:http://tb4cz3en3e.search.serialssolutions.com/?2012; 17: 205-214. Available at:http://tb4cz3en3e.search.serialssolutions.com/?V=1.0&pmid=22734874. Accessed October 1, 2012. V=1.0&pmid=22734874. Accessed October 1, 2012.

9.9. Wieland ML, Morrison TB, Cha SS, Rahman AS, Chaudhry R. Diabetes Care Among Somali Immigrants Wieland ML, Morrison TB, Cha SS, Rahman AS, Chaudhry R. Diabetes Care Among Somali Immigrants and Refugees. and Refugees. J Community HealthJ Community Health. 2012; 37: 680-684. Available at: . 2012; 37: 680-684. Available at: http://tb4cz3en3e.search.serialssolutions.com/?V=1.0&pmid=220758511. Accessed October 1, http://tb4cz3en3e.search.serialssolutions.com/?V=1.0&pmid=220758511. Accessed October 1, 2012.2012.