Development of a culturally appropriate food guide for pregnant Caribbean immigrants in the United States.

Communities with large Caribbean immigrant populations in Boston, Mass, have alarmingly high rates of both infant mortality and low-birth-weight infants. Although the federally funded Special Supplemental Food Program for Women, Infants, and Children (WIC) has been shown to increase infant birth weight and reduce fetal mortality, observations made in this study show that pregnant Caribbean immigrants who enrolled in WIC did not receive comprehensive, culturally appropriate nutrition counseling. Public health nutritionists and other health care providers used the Basic Four food group model as the basis for their dietary recommendations. The Basic Four model, however, is culturally biased and does not accommodate the food habits of the Caribbean immigrant. Furthermore, it does not adequately address the needs of pregnant women who are either lactose malabsorbers or vegetarians. Using ethnographic and nutrition science research methods, two culturally appropriate food guides were developed to accommodate the food practices of pregnant women from Haiti and the English-speaking Caribbean. The guides group foods into three categories: growth, protection, and energy. The guides not only include cultural foods but allow for the Recommended Dietary Allowance (RDA) for calcium to be met by nondairy sources and the RDA for protein to be met by vegetable sources. This study suggests that the Basic Four system is an inadequate model for Caribbean immigrants and that it is possible and necessary to construct culturally appropriate food guides that meet the US RDAs.