Ulam,Malunggay, andMyPlate:CreatingaCulturallyTailoredHealthEducatorGuideforFilipinoAmericans

JamieMichelleL.Prudencio,DanielleCo,andEdithChen

Source:CaliforniaHealthInterviewSurvey,2011-2016*Chronicdiseaseprevalencerateswereallcalculatedforalladults,exceptfor heartdiseasewhichwerecalculatedfor agegroups45-85.**Overweight/ObesityforAsiansweredefinedaccordingtotheWorldHealthOrganizationrecommendedBMIcutoffpointsforAsians.

IntroductionFilipinoAmericanshaveoneofthehighestprevalenceratesfordiabetes,obesityandcardiovasculardisease.

FoodandHealth• Researchhassuggestedthatthesechronicdiseaseratesareoftenlinkedtodiet(Kimet.al,2013).• TheUnitedStatesDepartmentofAgriculture(orUSDA)hasasetofeatingguidelinescalledMyPlateinordertofacilitateandpromotehealthyeatingbehaviorsforAmericans.

• MyPlatefacilitatesnutritionbydividingone’smealsintofivemajorfoodgroupswhichfollowtheserecommendations:

Source:USDA,CenterforNutritionPolicyandPromotion,January2016

MyPlate

ResearchQuestions:

• CantheMyPlatehealthyeatingguidelinesbeappliedtotheFilipinoAmericanpopulation?

• TowhatextentaretheeatinghabitsanddietarybehaviorsofFilipinoAmericanscapturedinMyPlate?

Objectives• ToworkwithAsianPacificIslanderForwardMovementandtheLosAngelesCountyDepartmentofPublicHealthtounderstandtheeatingbehaviorsof6AsianAmericansubgroupsinLosAngelesCounty• ToculturallytailortheSupplementalNutritionAssistanceProgram(SNAP)-EducationImplementationGuideandcurriculumforAsianAmericanpopulations

Methodology• AboutFocusGroup:TheFilipinoAmericanfocusgroupwastakenplaceonJuly13,2018atthePilipinoWorkersCenterinLosAngeles,CA.• Eligibilitycriteria:Participantsmustbe18+,haveorbeeligibleforCalFresh,andidentifyasFilipinodecent.• CalFresh:programforlowincomefamilies/individualstoprovideheathyandnutritiousfood

Methodology• Descriptionofthesample:consistedof6participants:5middleaged,olderfemalesand1youngadultmale.

• Analysis:FilipinoAmericanfocusgrouptranscriptionswerebothanalyzedindependentlyandtogetherasaresearchteam.AnalysisincludedmembersoftheFilipinoAmericancommunity(insiders)aswellasnon-members(outsiders).

MyPlate TypicalFilipinotablesetting

Ulam:ü- ləm (n.)onepotmeal,maindish• ExplainsthatthereisalackofpremeasuredportionsinFilipinoAmericaneating• Ratherthaneatingonwhatisonlyontheplate,habitsaretoeatuntilfull

Sources:FolksyFoxy,PanlasangPinoy

“...sometimeswehavemoregrainsthanvegetables,orsometimeswedohaveproteinbuttheamountofgrainsthatwedotake,likerice,isjusttoomuch…”

--Filipinoimmigrantfocusgroupparticipant

Kanin:kuh n-in(n.)rice

• EssentialpartofFilipinoAmericandiet,andtraditionallypartofbreakfast,lunch,anddinner.• Customarytohavemorericeavailablethanneeded,asulam andsidedishesareofteneatentogetherwithrice• Isnotpre-measuredassuggestedinMyPlate,whereoneservingofriceshouldbe½acup

“Becausesometimes,whenwearegettingrice,wesortofgettoomuch.Then,whenwegetourmaindish,whenthere'snotenoughrice,westilladdmorericebecausewestillhavesomeofthemaindishleft.”

--Filipinoimmigrantparticipant

• FilipinoAmericanshavethelowestfruitandvegetableconsumption(18.7%)comparedtoallracial/ethnicgroups.• “IthinkeveryFilipinoknowstheimportanceoffruitsandvegetablesbutsometimesitgetsreallyunproportionatethatitaffectstheirhealth.”• Manydonotknowiftheyareeatingenoughvegetablesduetothecommunaleatingandstyleofulam.

AreFilipinoAmericansgettingenoughvegetables,asrecommendedbyMyPlate?

Mulunggay:malün-gahy (n.)moringa• TherearemanyfruitsandvegetablesintheUnitedStates,buttherearemoreculturallyrelevantfruitsandvegetablesforFilipinoAmericanstoachieverecommendeddailyintake:• E.g.:calamansi,mango,mulunggay,okra,eggplant,sitaw,calabasa andbittermelon.

Limitations

• Samplebias• Smallandmaynotbegeneralizabletoalargerpopulation• ManylivedinHistoricFilipinotown,afooddesert• ParticipantsmaybemorehealthconsciousasmanyhadparticipatedintheHealthyEating,ActiveLiving(HEAL)Workshops• Selfreportedhealtheatingbehaviors• Underestimatingtheirconsumptions• Exaggeratinghealthinessduetofocusgroupdynamics

SummaryandFurtherConsiderations

• MyPlatemaynotbehelpfulinguidingFilipinoAmericanstowardhealthyeatingduetotheircommunalwayofeatingandonepotmeals.• UnderstandingtheuniquedietarybehaviorsofFilipinoAmericansisimportantincreatingaculturallytailoredeatingguide.• Aculturallytailoredeatingguidecouldhelpadapthealthiereatinghabitsandpreventthegrowingratesofchronicdiseases(i.e.,diabetes,obesityandcardiovasculardisease) intheFilipinoAmericanpopulation.• IndesigningahealthyeatingguideforFilipinoAmericanpopulations,itshouldincludefamiliarculturalfoods,Filipinowaysofeatingandcooking,whilehighlightingtheirbeneficialhealthpropertiestoreinforcehealthyeatinghabits.

AcknowledgementsThis project was funded through a grant from the National Institutes of Health (NIH)Building Infrastructure Leading to Diversity (BUILD) # 5RL5MD009603 and NationalInstitute of Minority Health and Health Disparities, NIH R15 Academic ResearchEnhancement Award, Grant Number: 1R15MD011666-01. This research is supported by apartnership of California State University Northridge as part of the BUILD project. This wasa multi-disciplinary, multi-lingual community research collaboration led by APIFM.Additionally, faculty engaged from various disciplines and universities were consultedincluding sociologist and Asian American Studies from CSUN, Nutritional Science fromPepperdine, and Community Health Sciences from UCLA.

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