Approximately 30% of the Asian population in the UK are Hindu, most from the Gujarat region of India. Hinduism has at its core the idea that the soul is eternal and a belief in reincarnation. Hindus do not eat beef as the cow is considered sacred and usually do not eat pork. Some will eat other meats and fish although many are vegetarian and the more orthodox (women particularly) may not eat eggs. Hindus rely on pulses and dairy products for their proteins and wheat is their main staple in the form of chapattis, puris, and parathas. Ghee and oil are used in cooking. Possible nutritional deficiencies are similar to those outlined for vegetarians.
Jainism is an offshoot of Hinduism with similar beliefs and ideas. Most Jains, particularly women, are strict vegetarians and may refuse food which has been cooked in a utensil previously used for cooking meat. Many Jains also avoid what are described as ‘hot’ foods (lentils, carrots, onions, aubergines, chilli, ginger, dates, eggs, tea, honey, and brown sugar).
Moslems make up about 30% of the Asian population and follow the dietary laws laid down in the Koran. They are forbidden to eat pork or any product of the pig, or to eat the blood of any animal. Animals must be slaughtered according to the regulations and a short prayer said to render the meat ‘halal’. Foods containing non-halal meats are forbidden. Only fish with fins or scales may be eaten. Alcohol is forbidden. Wheat, in the form of chapattis is the usual staple for Moslems from Pakistan and rice for those from Bangladesh.
Sikhs make up the other large group of the Asian population in the UK and have the fewest dietary restrictions. Most will not eat pork or beef but will eat lamb, poultry, eggs, and dairy produce. Some Sikhs are lacto-ovo-vegetarian. Wheat and rice are the main staples in the diet. Alcohol is not permitted.
Fasting plays a role in the religious life of all groups; however, young children and pregnant women are not normally expected to fast. Young children are strongly influenced by family food habits and there is a danger of weight loss if the child follows the adult pattern of fasting. It is important to remind parents that their children need to eat during these periods.
The lacto-vegetarian diet common to many Asians is potentially rachitogenic in Britain and in the 1970s some Asian children were noted to have florid or sub-clinical rickets. This is probably the combination of several factors, including low maternal vitamin D intake, low levels of vitamin D in breast milk as a consequence, a low intake of dietary vitamin D, and possibly a high intake of phytate-containing foods which inhibit the absorption of calcium and vitamin D. Late weaning onto a diet low in vitamin D may cause deficiency in later childhood. In the homelands this deficiency is compensated by the synthesis of vitamin D in the skin under the action of ultraviolet light of the sun. The relative lack of sunlight in Britain and the skin pigmentation of Asian children is probably the main limiting factor. Additionally there is tendency to late weaning and prolonged breast-feeding which may limit vitamin D intake. Vitamin D supplementation for Asian children is recommended from one month of age until five years of age. With more widespread vitamin D supplementation the incidence of rickets in this population has now greatly declined. The practice of supplementation with vitamin D should continue.
Weaning should be encouraged between the ages of 4-6 months using adapted family foods to avoid the problem of proprietary baby foods containing non-halal meat products. There is a tendency for Asian Moslem babies to be kept on milk-based food for too long and this may result in iron deficiency and can be aggravated by the use of cows’ milk before one year of age. This practice is partly traditional and partly a result of anxieties about the religious acceptability of proprietary baby foods. Certain weaning foods are suitable and parents should be encouraged to seek them out and use them. They are supplemented with iron and should be encouraged in addition to other acceptable iron containing foods, for example egg yolk, halal beef or lamb (pureed if necessary), and green vegetables. It is also important to encourage foods which aid iron absorption i.e. those which are high in vitamin C.
Progression onto the normal family diet by approximately one year is desirable. Much support and advice may be necessary and the language gap may compound the difficulties of getting acceptance of these different feeding practices.