Multicultural Handbook of Food, Nutrition and Dietetics

Edited by Aruna Thaker BSc PGDip RD Retired Chief Dietitian Arlene Barton MPhil BSc (Hons) RD Lecturer in Clinical Nutrition and Dietetics HPC Registered Dietitian, UK University of Nottingham

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Library of Congress Cataloging-in-Publication Data Food, nutrition, and dietetics : a multicultural handbook / edited by Aruna Thaker, Arlene Barton p. ; cm. Includes bibliographical references and index. ISBN 978-1-4051-7358-2 (pbk. : alk. paper) I. Thaker, Aruna II. Barton, Arlene [DNLM: 1. Diet–ethnology. 2. Food. 3. Cultural Characteristics. 4. Dietetics. 5. Nutritional Physiological Phenomena–ethnology. QT 235] 613.2–dc23 2011035251

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[1 2012] Contents

Contributors vii Acknowledgements ix Foreword xi Introduction xiii

Chapter 1 South Asian Sub-continent 1 1.1 Gujarati Diet 1 1.2 Punjabi Diet 28 1.3 Pakistani Diet 41 1.4 Bangladeshi Diet 72 1.5 Sri Lankan Diet 85 Chapter 2 West Indies 113 Chapter 3 East Asia 135 3.1 Chinese Diet 135 3.2 Vietnamese Diet 168 3.3 Japanese Diet 178 Chapter 4 Israel 197 Chapter 5 Eastern Mediterranean Region 212 5.1 Arabic Diet 212 5.2 Somalian Diet 236 Chapter 6 West Africa 248 6.1 Nigerian Diet 248 6.2 Ghanaian Diet 266 Chapter 7 East and South-East Europe 277 7.1 Polish Diet 277 7.2 Greek Diet 296 7.3 Turkish Diet 306 vi Contents

Chapter 8 Maternal and Child Nutrition 317 8.1 Introduction 317 8.2 Preconception 317 8.3 Pregnancy and lactation 319 8.4 Childhood nutrition 326 8.5 Breastfeeding 327 8.6 Bottle feeding 331 8.7 Weaning 337 8.8 Preterm infant nutrition 345 8.9 Food allergy and intolerance 346 8.10 Oral health 347 Chapter 9 Nutritional Management of Disease 354 9.1 Cancer in the different BME groups 354 9.2 Metabolic Syndrome and Polycystic Ovary Syndrome (PCOS) in BME groups 363 9.3 Vitamin D deficiency in BME groups 366

Index 379 Contributors

Editors Wynnie Yuan Yee Chan BSc PhD RPH, Freelance Nutritionist and Health Writer, Hong Kong Aruna Thaker BSc PGDip RD, Retired Chief Mary Foong Fong Chong BSc(Hons) PhD, Dietitian, Purley, Surrey. Formerly at Community Singapore Institute of Clinical Sciences, Brenner Services Wandsworth, Nutrition and Dietetic Centre for Molecular Medicine, Singapore Service, London Thushara Dassanayake BSc PGDip RD, Specialist Arlene Barton BSc(Hons) MPhil RD, Lecturer in Renal Dietitian, Imperial College Healthcare Clinical Nutrition and Dietetics, The University NHS Trust, London of Nottingham, Sutton Bonington, Loughborough, Zelalem Debebe BSc RD, Adult and Lead Paediatric Leicestershire Dietitian, Hounslow & Richmond Community Health Care, West Middlesex University Hospital, Isleworth, Middlesex Maclinh Duong BSc(Hons) RD, Primary Care Contributors Nutrition Care Dietitian, Community Services Wandsworth, St John’s Therapy Centre, London Zenab Ahmad BSc RD, Dietitian, King George Mandy Fraser BSc(Hons) RD, Public Health and Hospital, Goodmayes, Ilford, Essex Sports Nutrition Post Graduate Certificate Lorraine Bailey BSc RD MSc, Nutrition Specialist, Specialist, Paediatric HEF Dietitian, Central Nestlé Research Centre, Lausanne, Switzerland London, Community Healthcare NHS Trust Dr Suzanne Barr BSc(Hons), MSc, PhD, RD, Westminster, Woodfield Road Medical Centre, Division of Diabetes & Nutritional Sciences London School of Medicine King’s College, London Fumi Fukuda BSC RD Community Dietitian, Heidi Chan BSc(Hons) RD, Senior Specialist British Forces, Germany Medical Centre, Metabolic Dietitian National Hospital for Hammersmith Barracks, Herford Neurology and Neurosurgery, London Eulalee Green BSc MSc RD Dietitian, Health Keynes Chan BSc (Hons) RD, Macmillan Oncology Development Manager, Maternal & Child Dietitian, South London Healthcare Trust, The Nutrition, Ealing, London Princess Royal University Hospital, Orpington, Kalpana Hussain BSc RD, Paediatric Dietitian, Kent Porters Avenue Health Centre, Romford, Essex viii Multicultural Handbook of Food, Nutrition and Dietetics

Rose Jackson BSc(Hons) RD MSc, Diabetes Stavroulla Petrides BSc(Hons) PGDip RD, Specialist Specialist Dietitian, Queen Mary’s Hospital, Dietitian in Chronic Disease, Enfield Primary Roehampton Care Trust, Enfield Bushra Jafri BSc RD, Renal Dietitian, Lister Rupindar Sahota BSc RD, Diabetes Specialist Hospital, Stevenage, Hertfordshire Dietitian, Hounslow & Richmond Community Susanna Johnson BSc RD, Senior Dietitian, Health Care, West Middlesex University Hounslow & Richmond Community Health Care, Hospital, Isleworth, Middlesex West Middlesex University Hospital, Isleworth, Tahira Sarwar, Specialist BSc(Hons) ADDP RD, Middx Diabetes Dietitian, Community Nutrition and Ruth Kander BSc(Hons) RD, Specialist Renal Dietetics Department, Nottingham Dietitian, Imperial College Healthcare NHS Vanitha Subbu BSc PgDip RD, Community Trust, Hammersmith Hospital, London Specialist Dietitian, Northwick Park Hospital, Maureen Lee, Health Visitor, Kensington and Harrow, Middlesex Chelsea Primary Care Trust, London Natalie Sutherland BSc RD, Dietitian for Stroke, Renuka McArthur BSc MSc RD DDPHN DHA South London Healthcare NHS Trust, London PGCE, Consultant Dietitian and Health Educator, Elzbieta Szymula MSc PGDip RD, Specialist Diabetes Specialist Centre, Gulf State, Dubai Cardiovascular Disease Dietitian, Central Christina Merrifield BSc (Hons) RD, Lead Dietitian, London Community Healthcare, Lisson Grove Cromwell Hospital, London Health Centre, London Kashena Mohadawoo BSc (Hons) RD, Community Ravita Taheem BSc PGDip RD, Community Dietitian, Community Services Wandsworth, St Development Dietitian, Southampton University John’s Therapy Centre, London Hospitals Trust, Southampton, Hants Afsha Mugha BSc (Hons) RD, Paediatric Dietitian, Angela Telle BSc RD, Nutrition Consultan, Illumina The London NHS Trust, King George’s Hospital, Lifestyle Consulting, Hornchurch, Essex Goodmayes Redbridge, London Aruna Thaker BSc PgDip RD, Retired Chief Rabia Nabi BSc RD Intermediate Care Dietitian, Dietitian, Wandsworth PCT, London Hainault Health Centre, Hainault, Essex Deborah Thompson BSc RD, Dietitian, The Princess Lindy Parfrey BSc RD, Dietitian, South Australia Royal University Hospital, Orpington, Kent Damyanti Patel SRN, National Diversity Sunita Wallia MSc RD PGDip ADP, Specialist Coordinator, Macmillan Cancer Support, London Community Dietitian, NHS Greater Glasgow Ruple Patel BSc(Hons) RD, Specialist Renal and Clyde, Glasgow Dietitian and Master NLP Practitioner, St Helier Ghazala Yousuf BSc MSc RD, Specialist Paediatric Hospital, Carshalton, Surrey Dietitian The Portland Hospital, London Shamaela Perwiz BSc (Hons) RD MSc, Community Rita Žemaitis BSc RD, Dietitian, Westminster Dietitian, London Primary Care Trust, London Acknowledgements

The editors are grateful to following people for their assistance with coordinating the contents of the multipart chapters.

Arit Ana MSc BSc PGDip RD, Freelance Consultant Thomina Mirza BSc RD, Children Centres Dietitian, in Public Health Nutrition, Trainer and Writer, St Bartholomew’s Hospital and the London NHS Luton, Beds Trust, London Auline Cudjoe BSc(Hons) RD Primary Care Tahira Sarwar, Specialist BSc ADDP RD, Diabetes Prescribing Lead Dietitian, Community Services Dietitian, Community Nutrition and Dietetics Wandsworth, St John’s Therapy Centre, London Department, Nottingham Shahzadi Uzma Devje BSc PGDip MSc RD, Jevanjot Kaur Sihra BSc RD, Food Development Mississauga Diabetes Centre, Mississauga, Dietitian, Sandwell Primary Care Trust, West Ontario, Canada Midlands Eulalee Green BSc RD MSc, Dietitian, Health Sarah Toule BSc(Hons) MSc, Project Manager Development Manager, Maternal & Child African Caribbean Communities, Prostate Nutrition, Ealing Cancer Organization, London Dr Yvonne Jeanes BSc PhD RD, Senior Emma Tsoi BSc MSc PGDip RD, Specialist Dietitian Lecturer,Clinical Nutrition Health Sciences for Continuing Care, Central London Community Research Centre, Department of Life Sciences, Healthcare, Soho Centre for Health & Care, London Roehampton University, London Tahira Sarwar, Specialist BSc(Hons) ADDP RD, Sema Jethma BSc RD, Nutrition Consultant, Diabetes Dietitian, Community Nutrition and Hainault, Essex Dietetics Department, Nottingham Deepa Kariyawasam BSc(Hons) RD, Senior Renal Eulalee Green BSc MSc RD Dietitian, Health Dietitian, King’s College Hospital, Denmark Development Manager, Maternal & Child Hill, London Nutrition, Ealing, London x Multicultural Handbook of Food, Nutrition and Dietetics

The editors and contributors gratefully acknowledge the following for reading and usefully commenting on their sections in this volume:

Karishma Desai BSc, London Rabbi David Meyer MBA NPQH, London Rathika Howarth BSc MA DDPHN, Research and Dr Gita Patel PhD, Senior Clinical Research Community Development Consultant, London Associate, London Mrs Jagpoonia BA PGDip, Ethnic Dimension, London Shehlata Patel BCom, Devon Naomi Joseph BSc(Hons) RD, London Dr Pushpa Ranjan MD, Wijesinghe Ministry of Nicholas S Kempton BA(Hons), Hartshill, Warwickshire Health Care and Nutrition, Colombo, Sri Lanka Sajeda Malek BSc(Hons), Surrey Christopher Reynolds, Editor, London Foreword

It is a pleasure to write the Foreword to this Asian origin communities has been the most Multicultural Handbook of Food, Nutrition and neglected aspect of the considerable work now Dietetics. As the editors say in their Introduction, available, summarised elegantly in Chapter 1. In they and their several contributors from many dif- some settings, notably for African-origin people ferent backgrounds ‘had a vision that culturally across the western hemisphere, the mortality on appropriate dietary information was needed..’. transport ships and conditions under slavery Some 30 years ago, there was virtually no system- meant little direct connection with original western atic nor clear realisation in Britain or other African roots could persist. Traditional foods faded European countries of what ‘culturally appropri- for African-Americans, lost historically via forced ate’ meant, and certainly little practical dietary transit only through the Caribbean, and with dif- information for specific peoples of any background. ferent climates for growing such crops. However, So this text brings together, probably for the first yams, sweet potato, edoes, occasionally cassava, time, comprehensive portraits of regional and local and then green bananas and especially for ethnic and geographic food patterns and what is Jamaicans, breadfruit still form a main focus of known of their relationship to the emergence of many Caribbean-origin households at home and ‘chronic disease’ in respective populations. Having abroad. While household soups remain strong fea- authors from many of those backgrounds write tures, dietary patterns are generally quite distinct their relevant chapters adds key value, where out- from most directly west African peoples’ diets. siders would have been less able to grasp subtleties Hence the term ‘African-Caribbean’ is confusing needed to understand food choice and dietary – and should not include people of direct West behaviour. African, and of Caribbean origin of African, descent The editors should be congratulated on choos- under one heading. Chapter 6 outlining data from ing appropriate authors, as should be the authors Ghana and Nigeria redresses that balance. on delivering their effective texts. Each chapter Throughout, the text is ‘flavoured’ intriguingly begins with a brief historical outline, of how migra- with historical vignettes, as in Chapter 2 on the tion developed to Britain and more globally, who West Indies, that shows that the word ‘barbeque’ migrated, and where possible a sketch of how ties may have originated from the conquered Arawak with original countries were maintained, helping or Taino Indians when the Caribbean islands were reinforce trading to allow continued traditional first colonised by Europeans. Chapter 3 on east Asia, diets to persist. Dietary variation within South and notably Chinese migration, both historically xii Multicultural Handbook of Food, Nutrition and Dietetics and now short-term, is of great relevance with so from among large UK groups of people from many current Chinese government-funded projects Polish, Greek and Turkish backgrounds and these globally, not least as dietary patterns change original countries, plugs an important gap, at least rapidly and for concerns over the traditionally in my reading. The final chapters set all this work high salt intakes both from popular Chinese into their maternal and child health & more clinical cooking, and also in Japan. In both these dynamic context. nations and their migrants, high stroke rates from The scientific basis generally remains wanting to elevated blood pressure may be related to excess link reliably particular food patterns, respective salt intakes, and rising smoking habits, which nutrient intakes, and their biochemical translation change dietary preferences but have often been with most chronic ‘disease’ outcomes. In part, this minimised by religious restrictions elsewhere. is because the phenotypes of, for example, (high) There are also major opportunities in China itself blood pressure, almost as variable as food patterns to test whether formal trials, and/or local and in its measurement, and type 2 diabetes lack preci- regional government and tax initiatives, can cut sion, except as related to excess body fat and less that high salt content, and the over-consumption muscle mass. While basic and clinical science of both food and drink that goes with it. The grapple with those issues, this book offers both authors bring out important results from Hong general and more specialist readers insights into Kong, showing that short sleeping hours in a large improving the measurement and understanding of survey was associated with higher BMI and pre- diet among many of the world’s major populations sumably over-eating. Then a particularly welcome who migrated to Europe and beyond. It will be a Chapter 5 contains important data on people of very useful reference for any modern, properly Eastern Mediterranean mainly of Arab origin, informed health practitioner. including Yemenis and Somalis, long-neglected but growing groups often but not just originally Kennedy Cruickshank refugees, following the ravages of war and civil King’s College & King’s Health Partners, London disruption. The fascinating account in Chapter 7 December 2011 Introduction

The UK is now a multicultural society and so dieti- resources to consult to ensure that any dietetic tians and other health and food providers need to treatment takes into account their religious or cul- be aware not only of the medical aspects of a patient’s tural needs and habitual food choices. condition but also their cultural requirements in The editors and contributors had a vision that terms of religion and traditional food choices. culturally appropriate dietary information was In the 20th century, young men from different needed. And it was as a result of discussions with ethnic groups arrived in the United Kingdom from colleagues and students wishing to expand their the former British colonies. These men arrived for knowledge that this vision was realized in this work and had varying skill levels from unskilled handbook. to professional workers. Many of these men subse- The aim of this multi-contributor volume is to quently settled permanently with their families in take this vision a step forward and provide in- this country. Research has shown that the tradi- depth dietary information on well-established as tional diets of their country of birth can, in most well as recently migrated ethnic groups. cases, be relatively healthy. However, following The book is divided into nine main chapters: migration, lifestyle changes occur which can bring 1 South Asian Sub-continent detrimental effects to their health. The incidence of 2 West Indies chronic illness has been shown to dramatically 3 East Asia increase in these minority groups, especially 4 Israel among the first generation of migrant workers. 5 Eastern Mediterranean Region In the western world there are increasing levels 6 West Africa of obesity, cardiovascular disease and diabetes 7 East and South East Europe affecting all ethnic groups. It is important when 8 Maternal and Child Nutrition developing strategies to address these issues and 9 Nutritional Management of Disease also when seeing individual clients to ensure that the messages are culturally acceptable. In each of these chapters there are sections that Many registered and student dietitians have relate to particular cultural groups from that admitted that they have limited knowledge of the region. It is envisaged that if you want information cultural requirements of the ethnic minorities they about a particular group you can go directly to the do not come into contact with regularly. When a relevant section; however, you may find links to patient or client is referred to them there are few other chapters where more detail is available. xiv Multicultural Handbook of Food, Nutrition and Dietetics

The authors of each section are experienced reg- commonly eaten in traditional diets and suitable istered dietitians, mainly from the cultural group alternatives available in the UK. It also provides they are writing about. Each contributor not only best practice information and, where possible, has expert dietetic knowledge, but also long and what support is available from well-established varied experience of the traditional diets and diets voluntary organizations. on migration of the ethnic group. This makes the It is hoped that this resource will be valuable not text highly practical. The editors have also contrib- only to dietitians and students who are presently uted from their own experience and from the working with different black and minority ethnic limited research data available for ethnic groups. groups but also to other professionals who want The editors and contributors acknowledge that deeper understanding of the needs of different there are many lacunae in the literature as often ethnic groups. different cultural groups are grouped together in Many people have played a part in the creation research studies, which makes generalization of this handbook and the editors would like to thank difficult. them all for their very valuable contribution. This book offers practical information about traditional diets, how they have changed on migra- Aruna Thaker and Arlene Barton tion and the impact this will have on migrants’ October 2011 health. It gives much needed insight into the foods 1 South Asian Sub-continent Sema Jethma, Ruple Patel, Aruna Thaker (Gujarat), Renuka McArthur, Jevanjot Sihra, Rupinder Sahota, Ravita Taheem, Sunita Wallia (Punjab), Zenab Ahmad, Bushra Jafri, Afsha Mughal, Rabia Nabi, Shamaela Perwiz, Tahira Sarmar, Ghazala Yousuf (Pakistan), Kalpana Hussain, Thomina Mirza (Bangladesh), Thushara Dassanayake, Deepa Kariyawasam, Vanitha Subhu (Sri Lanka)

The cultural groups from Gujarat, Punjab, Pakistan, information on migration, traditional diets and Bangladesh and Sri Lanka have migrated from the changes in migration, religious influences and on South Asian subcontinent to the United Kingdom dietary considerations for specific diseases, such as from different regions over last 60 years, mostly obesity, diabetes and cardiovascular disease. due to economic and political upheavals, and made the UK their home. As a result of the vast distances between the countries there were many 1.1 Gujarati Diet differences in their cultural, traditional beliefs and Sema Jethma, Ruple Patel, Aruna Thaker diets but also many similarities as well. The reasons for these changes are many, but lifestyle changes, 1.1.1 Introduction especially dietary changes, have had the greatest impact on health. The traditional diets which they The South Asian sub-continent comprises India, were following were much healthier, more in line Pakistan, Bangladesh and Sri Lanka. Four per cent with what is currently recommended, but inclu- of the total UK population is classified as ‘Asian’ sions of some of the host country’s unhealthy foods or ‘Asian British’ and this group makes up 50.2% are having detrimental effects. This is now high- of the UK minority ethnic population (UK Census, lighted in scientific research; however, much of this 2001). is generic to those of South Asian origin rather than ‘South Asian’ defines many ethnic groups, with related to specific cultural groups. In this book, for distinctive regions of origin, languages, religions the first time, an attempt has been made to provide and customs, and includes people born in India, detailed information on each of group. There is Bangladesh, Pakistan or Sri Lanka (Fox, 2004).

Multicultural Handbook of Food, Nutrition and Dietetics, First Edition. Edited by Aruna Thaker, Arlene Barton. © 2012 Blackwell Publishing Ltd. Published 2012 by Blackwell Publishing Ltd. 2 Multicultural Handbook of Food, Nutrition and Dietetics

PAKISTAN Rajasthan

Banaskantha Rann of Kuchchh

Patan Kuchchh Little Rann Mehsana of Kuchchh Sabarkantha Gandhi Nagar Kheda Ahmedabad Gulf of Kuchchh Surendranagar Panchmahal Dahod Anand Jamnagar Rajkot Madhya Vadodara Pradesh Porbandar BharuchNarmada Bhavnagar Amreli Gulf Junaghad of Khambhat Surat

Ara Diu Navsari Dangs bia n Sea Maharastra Daman Valsad

Dadra N State of Gujarat, INDIA Nagar Haveli

Figure 1.1.1 Map of Gujarat

Gujarat state is situated on the west coast of India husbandry and dairy farming also play a vital role and boasts a 1,600 km-long coastline. The Arabian in the rural economy. Dairy farming – primarily Sea sweeps the western and south-western fron- milk production – is run on a cooperative basis tiers. The state extends from Kutch in the west to and has more than a million members; it is one of Daman in the south, with Pakistan to the north- the best examples of cooperative enterprise in the west and the state of Rajasthan to the north and developing economy so that Gujarat is now the north-east. To the east is Madhya Pradesh and largest producer of milk in India. ‘Amul’ (Anand Maharashtra (Figure 1.1.1). This state celebrated Milk Union Limited), formed in 1946, is based in the 50th anniversary of its formation on 1 May 2010. Anand and is Asia’s biggest dairy. Its products are Gujarat is one of the prime developing states of well known throughout India. India and is known for its vibrancy and colourful The state is currently experiencing rapid urbani- profile. Traditionally, the population has engaged zation, with 37.67 per cent of the population living in agriculture as their principal occupation. It is the in 242 urban areas according to the 2001 census. main producer of tobacco, cotton, peanuts (ground- Over the last four decades it has become an indus- nuts) and other major food crops (rice, wheat, trial powerhouse, thereby reducing its dependence sorghum (jowar), millet (bajra), maize, red gram on agriculture. Oil, fertilizers, chemicals and tex- dal (tuvar dal) and whole pulses); crops account tiles production attract many outsiders from across for more than half of the total land area. Animal India. The South Asian Sub-continent 3

The population of Gujarat state was 50,671,017 of these countries. After independence from Britain according to the 2001 census. Some 89.1% of the in the 1960s, the majority of East African Asians population are Hindus, Muslims account for 9.1%, migrated or were expelled from these countries (in Jains 1.0% and Sikhs 0.1%. The density of popula- the 1970s from Uganda). Most moved to Britain, tion is 258 persons per km2, which is less than that India or other popular destinations like the United of other Indian states. States (USA) and Canada as they had acquired Gujarati is one of the 14 main languages of India British citizenship. and is spoken by an estimated 47 million people The first Gujaratis to come to UK were students worldwide making it the 26th most commonly in the late nineteenth century for further studies, spoken language in the world. In Gujarat 71% especially in law. Notable among them was speak Gujarati; the rest (29%) speak Hindi. Almost Mohandas Karamchand Gandhi, born in Porbandar 88% of the Muslims speak Gujarati while the other on the western coast of Saurashtra. He was the 12% speak Urdu. In addition to Gujarati, Kutchi is pre-eminent political and spiritual leader of India widely spoken in Kutch District. Almost all Jains during the independence movement, pioneering speak Gujarati and a few speak Marwardi as well. satyagraha (resistance to tyranny through mass civil Gujaratis form the second largest of the British disobedience), a philosophy firmly founded on South Asian-speaking communities, with impor- ahimsa (non-violence), which inspired civil rights tant communities in Leicester and Coventry, in the movements and demands for freedom across the northern textile towns and in Greater London. world. Prior to Indian independence in 1947 small numbers of students, sailors and emissaries Migration to the United Kingdom migrated to the imperial capital by exercising the Britain has had commercial links with Gujarat right of all colonial subjects to study, travel and since the early seventeenth century when the settle in UK. This was followed by different types British East India Company first set up a trading of migration during the postwar period of decolo- post in Surat in 1612. nization, as the British government began recruit- Migration was common from Gujarat during the ing labour from its former colonies to fill vacancies 18th century. When the winds were favourable, in its industrial sectors. people travelled in dhows (traditional Arab sailing Later the main growth of Gujarati communities vessels) to East Africa, especially Zanzibar, for in UK came when their experience in the textile cloves and other spices. and steel industries was welcomed at a time of In 1896, when Kenya, Uganda and Tanzania labour shortages. These South Asian workers typi- were part of British East Africa, migration from cally followed an arrangement known as ‘chain Gujarat and Punjab started for the construction of migration’, which involved men from villages and the railway from the Kenyan port of Mombasa to districts (generally in Gujarat, Bengal and the Kampala in Uganda to provide a modern transpor- Punjab) migrating temporarily to industrialized tation link to carry raw materials out of Uganda inner cities and sharing dormitory-style accommo- and to import manufactured British goods to East dation while searching for employment as semi- Africa. After the construction was completed many skilled labourers. When the government began to of these workers remained in East Africa and restrict entry into Britain in the 1960s, many of established substantial Indian minority communi- these men decided to stay permanently, sponsor- ties. Their numbers may have been as high as ing their immediate families and establishing their 500,000 in the 1960s. Apart from being employed lives in different parts of UK. to manage the railways, they ran businesses which were, and in some cases remain, the backbone of Current UK population the economies of these countries. These ranged from small rural grocery stores to sugar mills. In There are 300,000 Gujarati language speakers in the addition, Indian professionals – doctors, teachers, UK, including East African Gujaratis, many of them engineers and civil servants – in privileged posi- in Leicester, Coventry, Bradford and the London tions played an important role in the development boroughs of Wembley, Harrow and Newham. 4 Multicultural Handbook of Food, Nutrition and Dietetics

1.1.2 Religion ● Sattvik (nutritious) food is the most desirable. Non-irritating to the stomach and purifying to The majority of Gujaratis are Hindus. Hindu reli- the mind, it includes milk, fruit, vegetables, gion is believed to be the oldest religion in the nuts and whole grains. These foods are believed world; it is nearly 5,000 years old. It can be seen as to produce calmness and nobility, or what is a ‘way or interdependence of life’ which gave rise known as an ‘increase in one’s magnetism’. to other religions – Jainism, Buddhism and Sikhism. ● Rajasi food is believed to produce strong emo- Hindus avoid eating meat and eggs or food pre- tional qualities, passions and restlessness of the pared from animal products (e.g., cheeses that mind. This category includes meat, eggs, fish, contain rennet and gelatin). They believe that if spices, onions, garlic, hot peppers, pickles and they consume animal flesh, they will accumulate other pungent or spicy foods. karma – the spiritual load we accumulate or relieve ● Tamasi food is leftover, stale, overripe, spoiled ourselves of during our lifetime – which will then or otherwise impure food, and is believed to need to be redressed through good actions in this produce negative emotions, such as anger, jeal- life or the next. Approximately 80% of Gujaratis are ousy and greed. lacto-vegetarians (i.e., dairy products, including milk, yoghurt, butter and ghee [clarified butter], Many Hindu families have a room set aside for are included in their diet). a shrine where deities are worshipped; it is treated ● Hindus do not eat beef or beef products as cows as a holy place. Some devotees will refuse to accept are considered sacred (this is also the case with any food that is not offered first to the deities. They Zoroastrianism). The cow has been a symbol of do this is by placing freshly cooked food garnished wealth since Vedic times (1500–500 BC), possi- with few holy basil leaves (tulsi) before the deities bly because the largely pastoral Vedic people and reciting shlokas (prayers). Once the food has and subsequent generations relied heavily on been offered to God, it is eaten as prasad (blessed). dairy products and bullocks for tilling the Before starting any meal some devout Hindus fields. The milk of a cow is believed to promote will first sprinkle water around the plate as an sattvic (purifying) qualities. The ghee from act of purification. Five morsels of food are placed cow’s milk is used in ceremonies and in prepar- on the side to acknowledge the debt owed to the ing religious food. Hindus still use cow dung devta runa (divine forces) for their benign grace for various purposes; the burning of cow dung and protection. This is then given to birds and repels mosquitoes and the ash formed is used animals. as a fertilizer. There are rituals entrenched in Hindu religion ● Although many Hindus are lacto-vegetarian, which are associated with food. Food is essential proscribed animal products tend to vary from for survival so it is treated with respect from one country or region to the next. For example, the time it is cultivated, how it is cooked and dis- meat and poultry may be consumed in one geo- posed of. Wasting food is discouraged so food is graphical location, while fish may be a staple either served or placed on the table for family food for people living in the coastal areas. members to help themselves to whatever they want to eat. Women takes immense pride in pre- Foods such as onions and garlic are avoided or paring and serving food and hospitality is part of restricted as they are thought to inhibit Hindus’ the culture and tradition norms. ‘Atithi devo spiritual quest. bhava’ is a Sanskrit phrase which means ‘a guest is divine’. This is very apparent and especially when guests are treated with the same devotion, Religious dietary restrictions love and respect accorded to God. Frequently, it The Bhagavad Gita is the holy Hindu scripture and happens that people drop in unexpectedly and comprises of 18 chapters. In chapter 17, verses 2–22 stay for lunch or dinner. If there is not enough healthy eating habits are recommended. Food is food to go round, then a meal will be prepared for classified into three major categories: them. The South Asian Sub-continent 5

Fasting yoghurt, and have their meals before sunset because large amounts of bacteria grow overnight Hindus practise fasting on special occasions, such when there is no ultraviolet light from the sun to as holy days, new moon days and festivals. A fast destroy them. is different from a hunger strike: a fast is a personal act of devotion, while a hunger strike is a public act, most often used to highlight an injustice. A fast Religious festivals, celebration and is also different from anorexia nervosa: it is a ‘dis- public holidays ciplined’ diet, not total abstention from food. Gujarat is known as the land of festivals, making Hindus fast in various ways, depending on the it popular throughout India as well as the rest of individual: they may choose not to eat at all during the world for its spirit of festivity associated with the fasting period, or eat only once a day or eat special dishes. Every festival brings with it the joy only ‘pure’ foods, such as fruits, nuts and milk. of the festival and also ceremonious food that is Women and older members of the family fast more looked forward to all year long. These festivals regularly then younger family members, but on have been celebrated in the region for millennia. certain religious days the whole family may fast. People observe these festivals strictly as they Fasting is believed to help reinforce control over choose to keep to their age-old customs and tradi- one’s senses and is seen as a way of staying close tions. Dates of the festivals vary every year as to God and achieving close mental proximity to Hindus follow the lunar calendar. Gujaratis are Him, suppressing earthly desires and guiding the proud of their rich heritage and this can be seen in mind to be poised and at peace. Hindus believe the way they celebrate. that when there is a spiritual goal behind fasting, it should not make the body weak, irritable or Makar Sankranti and the kite-flying create an urge to indulge later. A change of diet festival (January) during the fasting period is considered to be very The kite-flying festival takes place in mid-January good for the digestive system and the entire body. and marks the time when the sun’s rays reach the Tropic of Capricorn after the winter solstice. It is The Jain community celebrated with folk music and dance as well as kite flying. People gather on terraces to fly kites of Gujarat is a stronghold for the Jain community. various colours to celebrate Makar Sankranti or Jainism was founded as an offshoot of Hinduism Uttrayana. The glass-reinforced threads of the in the sixth century BC. Jains preach non-violence Indian fighter kites are pitted against each other in to all living creatures and practise a unique concept the air, and the kite fighter who cuts the other’s of restricted vegetarianism. The Jains have also thread is the winner. At night, kites strung with heavily influenced the cuisine of Gujarat with the Chinese lanterns are flown. Food such as undhiyu Gujarati thali containing different lacto-vegetarian (a mixture of seasonal vegatables), sugar cane juice dishes along with rotli (flatbread) and chaas and sweets are prepared to celebrate the day. (yoghurt drink). They do not consume root vegetables such as potatoes, garlic, onions, carrots, rad- Maha Shivratri (February/March) ishes, cassava or sweet potatoes. However, they do Maha shivratri marks the birthday of Lord Shiva. consume rhizomes such as dried turmeric and Traditionally, a fast is observed from dawn to dusk, dried ginger. The reason behind this restricted diet and only pure foods (e.g., milk, fruit, nuts, yoghurt, is that vegetables grown underground Kandmul potatoes and sweet potatoes) are eaten. Some are believed to contain far more bacteria, and hence people abstain from all solid food and consume are alive than other vegetables. Most Jain recipes fluids only. substitute potatoes with plantain. Some Jains also avoid brinjal (aubergine) owing to the large number Holi (March) of seeds they contain, as a seed or bean sprout is Holi is a spring festival and is celebrated at the end taken to be a form of life. Strict Jains do not consume of winter by people throwing coloured powder food which has been left overnight, such as and coloured water at each other. 6 Multicultural Handbook of Food, Nutrition and Dietetics

Ram navmi (March/April) dance, drumming and colourful dress. The dance Ram navmi is the birthday of Lord Ram. A fast is continues all through the night with great zeal. observed or one meal a day can be taken. Today Gujaratis are proud to hear their drumbeats and see their attire on international catwalks. Mahavir Jayanti (April) This marks the birth of Lord Mahavir and is one of Sharad Purnima the biggest Jain festivals in India. This is a harvest festival celebrated on the first full moon after Navratri by having dinner with milk (doodh) and pava (rice flakes) by moonlight. Shravan (July/August) This is a holy month when devotees attend a Diwali (October/November) temple on specific days or, if possible, for the whole Diwali (the festival of light) is celebrated over four month to worship Lord Shiva. Devotees fast for the days and on each day a religious ceremony is per- whole month or on specific days, during which formed in every home. Specific dishes are prepared they consume just one meal a day. for each day. In the evening diva (oil-filled lamps to signify the triumph of good over evil) are lit and Rakshabandhan (August) placed in front of the house. This festival marks the special bond between brother and sister. On this day a sister ties a rakhee New Year (wrist band) on her brother’s wrist and in return The fourth day is celebrated as New Year. On this he buys her a gift. A festive meal is prepared and day devotees go to the temple to pray, meet and bhajiya includes snacks such as and Indian sweets greet family and friends and to see the display of or puddings. sacred Annakut, an array of hundreds of lacto- vegetarian dishes arranged in tiers before the Janmashtmi (August/September) deities. Business people also mark the end of the Janmashtami is the birthday of Lord Krishna. A fiscal year when a sacred ceremony is performed on fast is observed on this day. He was born at mid- the new account books after which the fast is broken. night so the next day his birthday is celebrated and mal puda (pancakes made from whole wheat flour, sugar and ghee) and rabadi (sweet thickened milk) 1.1.3 The traditional diet and are served with other elaborate dishes. eating pattern Gujarati lacto-vegetarian cuisine has evolved over Navratri (September/October) hundreds of years and contains dishes made from Navratri is the principal festival of Gujarat. It is cereals, pulses, vegetables (shaak), and side-dishes celebrated not only in Gujarat but in different parts such as pickles, chutney, papadoms (papad), raita of India and around the world where Gujaratis (yoghurt mixed with shredded cucumber/ have migrated. These celebrations are a part of a vegetables) or salad (kachumber) and chaas. nine-day festival before Dussehra, which celebrates Northern Gujarat, Kathiawad, Kutch and south- the nine manifestations of the Mother Goddess. ern Gujarat are the four major regions of the state During these nine days, people observe fasts and and each has its own cuisine. Many Gujarati dishes visit temples to pray to the Goddess. are distinctively sweet, salty, sour and spicy at the At night, the festive mood overtakes everybody. same time and can vary widely depending on The young and old celebrate the festival alike. The the family or region. This harmony, derived from main attraction is Dandia Ras (a dance with deco- the mix of the sweet with the salt, sour and spices, rated sticks) and Garba (a regional dance wearing is what makes the cooking of lacto-vegetarian traditional dress) performed in groups by huge dishes of this state different from the rest of the crowds in the open. People joyfully dance to drum Indian subcontinent. beats and folk songs while carrying diva (tea Meals are usually served in a thali and include candles). The festival is a true blend of devotion, flatbreadrotli , rice, whole pulses or dal, or yoghurt The South Asian Sub-continent 7 soup (kadhi) and shaak, with papad or raita. Different Indian breads accompaniments and sweet dishes are served depending on the menu and occasion. The cuisine Different types of unleavened, round, soft breads changes with the seasonal availability of vegeta- are flattened by rolling and baked in a tava (frying bles. Fresh fruits are normally eaten between meals pan). They vary in size and thickness in different or sometimes served with the meal. In summer, regions and are called by different names. when mangoes are widely available, keri no ras Plain flatbread is traditionally referred to as roti, (fresh mango pulp) is often an integral part of the but also commonly known as chapatti. If possible it meal. is served piping hot. A small piece of bread is torn There are also simple meals of rice and dal off and used to scoop up a vegetable dish or folded known as khichadi, served with kadhi or with lightly into a loose cone to scoop liquid dishes like dal that spiced chaas and shaak. form part of the meal. Cooking methods are handed down from one Rotli or phulka is made from a firm but pliable generation to the next and these cooking styles are dough. Some people add salt and/or oil. The dough followed even though sometimes the main ingre- is rolled out into circles 15–18 cm in diameter. The dients differ according to the country in which rolled rotli is then placed on a preheated tava and they are prepared. First-generation South Asians partly cooked on both sides, and then directly put are likely to follow traditional eating patterns and on a medium flame, which makes it puff up like a habits (Thomas & Bishop, 2007). People who balloon when hot air cooks the rotli rapidly from migrated from East Africa were able to maintain the inside. Finally, ghee is spread on it. their religious festivals and cultural and traditional Double pud in rotli follows the same method as diet, but they also included cassava (mogo) and above, but two small balls are loosely joined with green banana (matoke). oil and flour, rolled together and then cooked. Atta (whole wheat/whole meal flour) is the When it is slightly cold they are separated and main ingredient of most varieties of breads on the ghee is spread on it. This type of rotli is served with South Asian subcontinent. Traditionally, chakki atta, freshly squeezed mango pulp. which is creamy-brown in colour, is made by stone- Plain paratha is one of the most popular breads, grinding wheat. This process imparts a character- made from firm dough shallow-fried in a tava. istic aroma and flavour to the breads. Layered or puffed paratha are made by rolling Atta is made from wheat which has a high gluten out the dough in circles approximately 15 cm in content so dough made from this flour is strong diameter and then ghee or cooking oil and a sprin- and can be rolled out very thin. kling of flour is spread over it. It is then folded and Since nothing is removed from atta, all of the rolled again and shallow-fried over a low heat. The wheat grain is preserved. Atta available in the UK paratha can be round, square or triangular. varies in its fibre content from very low to around Spicy paratha are made following the same 12%. The high bran content of atta makes it rich in method but salt, chilli powder, turmeric and cumin dietary fibre; it also contains significant quantities are added before rolling and cooking. of starch, protein, vitamins and minerals. Sweet paratha are made following the same When South Asian communities migrated to UK method but sugar or jaggery (unrefined cane sugar) the atta they were used to was not available. In is added. 1962 Elephant Atta ‘medium flour’ was launched Stuffed paratha are usually filled with vegetables and today it is widely used by this community. such as boiled potatoes, radishes, cauliflower or However, as the fibre content of this flour is 7.1% paneer, seasoned with herbs, spices and other sea- this has resulted in a reduction in the fibre content sonings. The stuffing is made into a small ball and of their diet. placed in the middle of the dough and sealed. This Now different brands of chakki atta are widely is then rolled quite thin and shallow-fried. available in UK but people from the South Asian Bhakhari is a thicker, crisper flatbread cooked communities are reluctant to change, as over the without oil over a very low heat. years they have acquired a taste for medium atta Thepla is a shallow-fried, spiced flatbread made and also because chakki atta is more expensive. with wheat and chickpea flour dough. It usually 8 Multicultural Handbook of Food, Nutrition and Dietetics contains shredded vegetables or leftover cooked in methionine, but deficient in lysine, which is rice to which salt, chilli powder, turmeric, cumin found in pulses) the two foods complement each and sesame seeds are added. other, forming a complete protein. In Gujarati Puran puri (vedmi) is made with a sweetened cuisine a combination of three parts rice to one part tuvar dal or mung dal filling following the same dals is used in the preparation of most dishes. method as stuffed paratha but cooked at a low tem- Pulses and dals have been part of the South perature and spread with ghee. Asian diet for generations and the skills of cooking Puri: plain puri made with whole wheat flour or delicious dishes has been passed on from one gen- semolina and deep-fried. Spicy puri (tikkhi) is made eration to another and make the lacto-vegetarian with salt, chilli powder, turmeric and ajmo (carom diet unique but also nutritious. seeds). Bajri no rotlo is made from bajri atta and cooked Whole pulses without oil or ghee. Jawar no rotlo is made from jawar atta and cooked All pulses grow in a pod. Green tender pods with without oil or ghee. seeds are used as vegetables and cooked with Makai no rotlo is made from makai (maize) atta aubergine. Tender pods with seeds are sold fresh which is cooked without oil or ghee. or frozen: e.g., french beans, pink beans (valor), Khakhra is a very thin flatbread made from moth haricot beans (surti papdi). bean flour, wheat flour and oil and cooked on a hot Seeds (lilva): They are sold fresh, frozen or tinned: tava. There are several types such methi, jeera and e.g., peas, broad beans, black-eyed beans, soya different masala flavours. It is mostly eaten asa beans, chana (chickpeas), red gram (tuvar lilva). snack by the Jain community. Dried whole pulses Khichadi is a mixture of rice and tuvar dal or mung When they are fully mature, the crop is harvested dal with a little ghee. It is a very popular dish and and the seeds are sun-dried. They are cleaned and regularly cooked in most homes, typically on a sold as whole pulses which are soaked, boiled and busy day due to its ease of cooking. cooked in different ways. They are also sold in tins, Kadhi is a mixture of yoghurt, chickpea flour, which reduces the cooking time. salt, turmeric, crushed ginger, chillies and garlic simmered over a slow heat and stirred continu- ● Plain boiled pulses are eaten as a snack or ously. Vaghar of ghee, mustard seeds, cumin, fenu- cooked as a dish. greek seeds, curry leaves and asafoetida is added. ● Whole pulses are deep-fried and consumed as It is garnished with chopped coriander leaves and a snack (e.g., Bombay mix). served hot. ● They are dry-roasted in cast-iron wok in hot Rice: There are hundreds of varieties of rice but sand. Roasted Bengal gram (Chana) are a most most prized is Basmati rice. It is a staple of the diet popular snack. and plain boiled rice is eaten at least once a day. It ● They are boiled and mashed and used as snack also has a symbolic importance as it is needed for all (e.g., Bengal gram chana chor garam). the religious rites, including wedding ceremonies. Most pulses can be sprouted (e.g., sprouted Vegetable rice (pilau) is made by adding a mung or moth). Sprouting has both nutritional and mixture of different vegetables (e.g., peas, spinach practical advantages: and onions). Pulses and dals: There are many varieties of ● Germination increases the content of folic acid pulses and dals and most are available in the UK. and other B vitamins. Apart from soya beans, pulses contain 20–25% ● Tannins and phytates, which adversely protein by weight, twice the protein content of affect bioavailability, are broken down by wheat and three times that of rice. For this reason, germination. pulses are called ‘vegetarian meat’. The digestibil- ● The breakdown of phytic acids allows more ity of pulse protein is high but it is relatively poor absorption of calcium and iron and genera- in the essential amino acid methionine. However, tion of vitamin C also helps in the absorption as they are commonly consumed with grains (high of iron. The South Asian Sub-continent 9

● As they become soft, digestibility is increased ● Sweetmeats: e.g., sesame snaps (chikki). In and they can be eaten raw in salad. Gujarat chikki is prepared with nuts or oilseeds ● Cooking time is reduced as they are stir-fried. and jaggery. Split whole pulses are called dals and are eaten Vegetables with or without the skin. In the tropics, seasonal vegetables are very cheap Cooking methods and they are bought and cooked fresh for each Depending on the menu, dal can be cooked into meal. These include both green leafy vegetables different textures: liquid, semi-liquid or dry. and root vegetables. Potatoes are considered as Dals are deep-fried and used as a snack. Dals are vegetables rather then starchy food as in the UK. also made into vadi like soya chunks and cooked Methods of cooking vegetables with vegetables. ● dry vegetables (koroo shaak); Dals without skin is ground into flour. ● vegetable in sauce (rasa varoo shaak); ● deep-fried vegetables (tareloo shaak); Chickpea flour ● stuffed vegetables (bhareloo shaak); This is one of the most versatile of the pulse flours ● stir-fried vegetables (e.g., cabbage, carrots and and is used in a variety of ways: green chillies [sambharo]); ● as a thickening agent (e.g., added to yoghurt in ● vegetables cooked with dal; preparation of kadhi); ● steamed dishes made with vegetables (e.g., ● to prepare sweet or savoury dishes; patra, muthiya); ● added to wheat flour to make Indian bread; Tropical fruits are delicious and are seasonal. ● to make puda (pancakes). Fresh fruits are included in the diet (e.g., fruit Black gram flour or mung flour salad, fruit juices, milkshake). Fruits are also made Papadoms are mostly made from black gram flour into pickles. or mung flour with the addition of different spices. They are rolled very thin and dried in the sun, then Milk and dairy foods dry-roasted over low flame or deep-fried. Traditionally, throughout India (including in Gujarat) full-fat cow or buffalo milk is boiled Moth dal flour before it is consumed. As the milk cools a layer of Mathiya are prepared in the same way as papad- cream (tor/malai) forms and this is skimmed off and ams but deep-fried and prepared on special occa- reserved. When enough cream is accumulated a sions and especially for the festival of Diwali. small amount of yoghurt is added and left overnight. Next morning this mixture is churned with Dal and rice flour the addition of water and this process separates the These are used in fermented dishes, e.g., steamed fat from the cream. The fat is called ‘white butter’. – dhokra/khaman/muthiya; or baked – ondhwa. The liquid that remains is called chaas and is used in cooking. White butter is placed in a pan and Nuts and oilseeds brought to the boil at a low temperature. It is Nuts, such as almonds, cashews, pistachios and stirred until all the water has evaporated. When it walnuts, are widely used in cooking. is cool it is sieved through muslin to remove Oilseeds are rich in fat. Groundnuts (peanuts) any remaining sediments. This pure fat is called and sesame seeds are commonly used: ghee and is used in religious ceremonies and in ● Dry-roasted in a cast iron wok over a low flame cooking. (e.g., peanuts). In the UK commercial butter is used to make ● Deep-fried as snacks. ghee at home; alternatively, ready made ghee can ● Sesame seeds used to garnish dishes. be bought from groceries. ● Crushed into powder and used in cooking, Milk is used in beverages, as a milky drink, in especially stuffed vegetables, and added to milkshakes, for making milky puddings, yoghurt sweet dishes and puddings. and paneer (unsalted white cheese). 10 Multicultural Handbook of Food, Nutrition and Dietetics

Yoghurt is mostly made at home, but in the UK ● Papdi: Like papadam but made from seasoned commercially made yoghurt is widely available. It rice flour which is steamed then rolled quite is used in cooking, for making sweet dishes, kadhi thin and sun-dried. Papdi can be cooked over a and raita (see Table 1.1.1). low flame or deep-fried. ● Rice sev: Made from rice flour cooked in the Beverages same way as above but prepared by squeezing ● Masala tea (chai) is made by brewing leaves, through a special press and sun-dried. Rice sev sugar and milk with a mixture of aromatic is deep-fried. spices (e.g., dried ginger, black pepper, cloves, ● Vadi (rice flour): Like soya chunks; it is cardamom, cinnamon and nutmeg) and herbs deep-fried. (e.g., basil or mint). ● Limbu pani (sweetened and spiced lime juice). Pickles and chutney ● Fruit juice (sweetened and unsweetened). ● Mango pickles (sweet or spicy). ● Carbonated drinks (e.g., cola or Lucozade). ● Lemon pickles (sweet or spicy). ● Chaas made with natural yoghurt and water. ● Green chilli pickles. ● Mixed vegetables pickle made with mustard Accompaniments powder and lemon juice. ● Raita: Made with yoghurt, chopped fruit, auber- ● Herbs preserved in brine or vinegar. gine or grated vegetables. Added to this mixture ● Tamarind chutney (tamarind and dates). are fresh chopped green chillies, coriander leaves, ● Green chutney (coriander and mint). salt, sugar and cumin powder or mustard powder. ● Mango chutney. ● Bharatu: Made with yoghurt and roasted auber- ● Red chutney (red pepper, red chillies and gine. Added to this mixture are fresh chopped tomatoes). green chillies, coriander, salt, sugar and cumin ● Coconut chutney. powder. ● Mint and tomato chutney.

Table 1.1.1 Description of Gujarati foods

Food groups Description of foods Gujarati name

Bread, rice, potatoes, Wheat atta (flour) Ghau no lot pasta and other starchy Vermicelli Ghau ni sev foods Semolina Soji Plain flour Maido Millet Bajri Sorghum Jowar Maize Makai Rice Chokha White rice boiled/steamed Bhaat Pilau rice (cooked with vegetables) Pulav Rice pudding Kheer Rice flour Chokha no lot Rice flakes (pounded rice) Pava Puffed rice (made by heating rice in a Mumara sand-filled oven) Potato Batata Sweet potato Shakkaria Sago Sabu dana Yam Suran A mixture of rice and dal flour is used to make different snacks The South Asian Sub-continent 11

Table 1.1.1 (cont’d)

Food groups Description of foods Gujarati name

Vegetables and fruits Amaranth tender Tanjurdo Aubergine Ringun Bitter gourd Karela Bottle gourd Dudhi Black-eyed beans Chora Broad beans Fafda papdi Cluster beans Guvar Cauliflower Ful kobi Cabbage Kobi Carrot Gaajar Colocasia leaves Arvi/Salia na pan Drumstick Saragavo Green peas Vatana/Matar Fenugreek leaves Methi ni bhaji Fennel leaves Sava ni bhaji French beans Funsi Mint Fudino Okra (ladies’ fingers) Bhinda Onion Doongari Other gourds Parval,Gheloda, Kankoda Pink beans Valor Pumpkin Kollu Radish Moora Radish leaves Moora ni bhaji Ridge gourd Turia Snake gourd Gulka Spinach Bhaji Sweet corn Makai Apple Sufferjan Banana Kela Custard apple Sitaful Dates Khajoor Figs Anjeer Grapes Draksh Guava Jamfal Jackfruit Phanas Lime Limbu Mango Keri Melon Tarbooch Orange Mosumbi Pears Nashpati Pawpaw Papaya Pomegranate Daddam Pineapple Ananus Tangerine Suntra Sapodilla (Sapota) Chikku (Continued) 12 Multicultural Handbook of Food, Nutrition and Dietetics

Table 1.1.1 (cont’d)

Food groups Description of foods Gujarati name

Meat, fish, eggs, beans Meat Mass and other non-dairy Chicken Moorghi sources of protein (i.e., Eggs Inda pulses/dals, nuts and seeds) Fish Maachli Bengal gram/dal/flour Chana/Chana ni dal/lot Black gram/dal/flour Urad/urad in dal/lot Black-eyed peas/dal White chora/dal Field beans/dal Val/val in dal Green gram/dal Mung/Mung ni dal Lentil/dal Masoor/Masoor ni dal Turkish gram/dal Moth/Moth in dal Red gram/dal Tuvar/Tuvar ni dal Peas Vatana/Matar Almonds Badam Cashews Kaju Dried coconut Copru Fresh coconut Naliyer Dates Khajur Pistachios Pista Peanuts (groundnuts) Sing danna Walnuts Akhrot Milk and dairy foods Milk Doodh Milk powder Doodh no powder Yoghurt Dahi Buttermilk Chaas (Reduction of milk in an open wok until it is thickened to fudge-like consistency but not caramelized) Maavo Unsalted white cheese (can be made at home) Paneer Foods and drinks high Pre-packed tropical fruit juices in fat and/or sugar Indian sweets and puddings Ladwa, Burfi, Jallebi, gulab-jambu, kulfi, ice cream Sugar and sugary foods Sugar Sakker Jaggery Gor Fats and oils Corn oil Makai nu tel Sunflower oil Suryamukhi nu tel Peanut oil Sing nu tel Sesame seed oil Tul nu tel Rapeseed oil Canola/rapeseed oil Butter Maakhan Clarified butter Ghee The South Asian Sub-continent 13

How herbs and spices are used in cooking from northern Gujarat use dry red chilli powder, Herbs and spices are an integral part of South whereas people from southern Gujarat prefer Asian cooking and apart from flavouring the food green chillies, ginger, garlic and coriander. they also have medicinal properties. The making Gujarati Jains (and many Hindus) avoid garlic and of masala is traditionally done on grinding stones. onions. Nowadays, people use an electric blender or Traditionally, dried (whole and ground) and grinder and ready-made masala are widely avail- fresh herbs and spices are used in the Gujarati diet. able in the UK. Each person makes their masala They are an excellent way to add flavour to foods to their own recipe, hence dishes taste different when reducing the salt and/or sugar content of depending on the household. For example, people the diet (see Table 1.1.2).

Table 1.1.2 Use of herbs and spices in Gujarati diet

Ingredients Gujarati name Comments

Asafoetida Hing Used in vegetable/pulse cooking Bay leaves Tejpatta In rice dishes Coriander leaves Lila dhana/Kothmeer For garnish/in chutney Curry leaves Mitho-limbdo In yoghurt dishes Coriander seeds Dhana Used for making coriander powder Cumin seeds Jeeru As seasoning Cinnamon Taj Whole stick and powder used in cooking Cardamom Elchi In tea, whole in cooking, crushed in pudding Cloves Laving Used whole in cooking Green chillies Lila marcha In cooking, pickles, chutney Garlic Lasan In cooking, crushed Ginger Adhu In tea. In cooking, crushed or grated Dried ginger Sunth In tea Fenugreek Methi In cooking, in pickles Mint Fudino In tea, in chutney Mustard seeds Rai In cooking, pickles Nutmeg Jaifal In pudding Poppy seeds Khus khus For garnish Peppercorns Kara mari In tea, in cooking Red chillies, whole Lal mircha In vaghar Red chilli powder Mirchu In cooking, garnish Sesame seeds Tal For garnish, crushed, used in cooking, sesame snaps Saffron Kasar In pudding and sweets Turmeric powder Harder In cooking Tamarind Amli In chutney and in pulses Sesame seeds Tal For garnish, crushed used in cooking, Sesame snaps Fennel seeds Variyali In cooking Carom seeds ajmo In vaghar for cooking vegetables and pulses Cocum Kokum na phool In dal dishes 14 Multicultural Handbook of Food, Nutrition and Dietetics

Cooking methods and food preservation foods may exacerbate joint pain and arthritis Cooking is mostly done over an open flame. A (Hamid & Sarwar, 2004). pressure cooker is used initially to cook pulses or ● During pregnancy and postnatally: Women dals. It is also used for cooking vegetables and rice who have recently given birth may be given dishes. katlu, an Indian sweet made from nuts, herbs, Steaming, shallow frying, baking and dry roasting spices and jaggery, as it is thought to aid con- are common cooking methods, but most of the valescence, increase lactation and reduce dishes are deep-fried in oil. back pain. The consumption of pulses and Sun drying: This is a common way of preserving beans may be discouraged if a mother is food. breastfeeding as such foods are thought to induce colic in the baby (Hamid & Sarwar, 2004). Vaghar Vaghar is essential when spices and herbs are added one at a time to hot oil or ghee and this Paan and mukhvas tempering is either done as the first step in the Mukhvas is mostly eaten after a meal. It is made cooking process, before adding the vegetables or with dry-roasted split coriander seeds, fennel as the last, pouring the tempered oil over dal. The seeds and sesame seeds. oil extracts and retains all the sharp flavours of the Mukhvas is added to betel nut paan. mustard seeds (rai), mitho-limbdo (curry leaves), The use of chewing tobacco (paan or gutka) is cumin seeds (jeera), asafoetida (hing), etc., and common in the South Asian subcontinent. Research coats the entire dish. looking at paan and gutka use by Gujaratis living in the USA showed that the use of paan had fallen but Therapeutic use of foods the use of gutka had increased (Changrani et al., The use of ayurvedic (traditional) medicine has 2006). been shown to be more common among Indians The use of chewing tobacco is a risk factor for than in any other ethnic groups (Sproston & oral cancer, however it is a strong cultural habit for Mindell, 2006). many and the safe use of these products is being promoted (Carlisle, 2002). A patient quoted in an ● Hot and cold foods: ‘Hot’ foods, such as article by Sproston and Mindell (2006) highlights mangoes and ginger, are thought to promote an this: ‘You can take tobacco out of the pan but not increase in body temperature; conversely, ‘cold’ paan away from the community’. foods, such as potatoes, are believed to reduce temperature (Thomas & Bishop, 2007). It is Smoking believed that hot foods should be avoided in Research looking at cigarette smoking in ethnic hot conditions, such as pregnancy (Hawthorne minority groups versus the general population has et al., 1993) and cold foods avoided in cold con- shown that self-reported smoking levels for Indian ditions, such as lactation. For health profession- men is less than the general population in UK (20% als it is important to be aware of such beliefs, versus 24%) and also for women from ethnic especially if they have nutritional implications, minority groups versus women in the general pop- for example, a pregnant women suffering from ulation in UK (Sproston & Mindell, 2006). nausea and vomiting and not meeting her nutritional needs may be avoiding ginger, yet anecdotally ginger can be helpful in sickness Alcohol and may help her to increase her oral intake Drinking alcohol is forbidden and the majority of and meet her requirements. first-generation migrants avoided it. However, ● Joint pain: Sour foods, such as lemon or tama- with exposure to western culture, and as alcohol is rind, may be avoided by older people or those widely available, alcohol consumption is quite with joint problems as it is believed that these common among the younger generation.