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Clinical Pearl: Report on Somali Diet

Author(s): Aliya S. Haq, MS, RD, CD, WIC

Between 1999 and 2002 a dietitian at the WIC clinic at Harborview Medical Center in Seattle collected information about the diet of Somali immigrants during more than 70 nutrition education groups with more than 400 Somali patients. The information was compiled into a report and reviewed by Harborview's Somali Caseworker Cultural Mediator. See REPORT ON SOMALI DIET, for the full article including information about religious proscriptions; commonly consumed foods and methods of cooking; foods high in fat, protein, carbohydrates and fiber; common dietary beliefs; common nutrition/diet related health problems; general recommendations for providers; and group education intervention. The following passages are excerpts from the article.

Among Somalis, family meal is the norm. Frying is the most common method of cooking. Lamb or goat meat is considered the best meat to eat. Tea is the most common drink with lots of sugar. Drinking 4-6 cups of sweet tea a day is common. Homemade cakes are often eaten as snacks.

Religion influences Somali dietary practices in a number of ways. Almost all Somalis are Sunni Muslims. For many people (including Somalis) who practice Islam, religion has a much more comprehensive role in life than is often typical in the Americas or Europe. "Halal" foods are foods that one is allowed to eat. Halal foods include all foods of plant origin and some of animal origin only if they conform to the religious method of slaughtering. "Haram" are forbidden foods or drinks, including pork, blood and animals not slaughtered in the proper way, alcohol and drugs, and foods containing ingredients obtained from other haram foods. Fasting is a common religious expression and is also a common dietary factor for Somalis. All adult Muslim Somali people must fast, meaning to abstain from eating, drinking and smoking, from dawn to sunset everyday of Ramadan, the ninth month of the Islamic (lunar) calendar. There are some exceptions to the fasting for sick persons, travelers, and pregnant and breastfeeding women.

Westernization appears to have already influenced some aspects of the dietary practices of Somalis in Seattle. A common concern of most Somali parents is that while they like to cook and eat Somali foods, their kids are moving more towards a diet of fast foods. French fries and the like are readily becoming popular in Somali homes in the USA, and so also the consumption of soda pop and high-fat snacks. Cheese is now being included among foods regularly eaten by Somalis in Washington State. Pepsi and the sweetened red drink "Vimto" are common drinks in addition to sweet tea. Excessive fruit juice consumption by kids, a westernized habit, is an emerging concern. The practice is observed as contributing to feeding disorders in kids. Pediasure, a pediatric nutritional supplement, is a very popular drink among Somalis, used to promote weight gain. It often replaces meals. Refined flours are commonly being used as a substitute for, or in combination with, the whole grain ingredients that were used back in Somalia. This change includes making anjera (a bread staple) with pancake mix or all-purpose flour instead of corn, teff and other ingredients of traditional anjera.

Nutrition/diet related health problems of concern for Somali immigrants and their health care providers include anemia, constipation, poor dental health, allergies, lipid abnormalities, diabetes, childhood and postpartum obesity, failure to thrive (FIT), feeding disorders/feeding mismanagement, daycare feeding concerns, and eating disorders (among Somali teens, this is a fairly new and upcoming concern).