Food and eating practices in multigenerational, Pakistani, Muslim families living in Edinburgh; a qualitative study
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Non-communicable diseases (NCDs), including type 2 diabetes mellitus and cardiovascular diseases pose a grave challenge to the health of populations. A fourto six-fold increase in risk of NCDs has been documented among South Asians living in the UK, and lifestyle factors, including an unhealthy diet have been implicated. Pakistanis are the largest ethnic minority in Scotland, many of whom still prefer to live together as multigenerational families. The older generation mostly came from Punjab, Pakistan, while subsequent generations were born in Scotland. Research on food and eating practices among Pakistanis living in the UK has tended to focus on individual practices and preferences, has mostly been disease oriented and quantitative in nature, and has lacked the cultural insight needed to inform effective health promotion interventions. This qualitative study aims to fill a gap in the literature by exploring food and eating in multigenerational Pakistani, Muslim families. This study used qualitative interviews informed by the case study approach and an ethnographic perspective. Two or more adult family members of different genders and generations were recruited from eight multigenerational Pakistani families living in Edinburgh. Twenty-three interviews were conducted in total. The data were analysed thematically using the method of constant comparison. The analysis identified distinctive features and commonalities within each generation as well as the ways in which the preferences and tastes of one generation could influence the food eating by family members belonging to other generations. The older generation exhibited a need to maintain their ethnic identity through eating traditional foods such as salan and roti, and adhered to cultural and religious values and traditions. Their experiences, both before and after migration, influenced their present everyday food and eating. Almost all families had one person from the older generation who had a chronic illness, but the impact of this illness on that person’s diet and the diet of other family members varied. Within the second generation, differences were apparent according to gender and place of birth. Women juggled multiple roles as wives, daughters-in-law and mothers, and were responsible for most of the food-related chores. Preferring traditional meals and prioritising taste over health, Pakistan-born women were more likely to adhere to cultural values in relation to food-related issues than their British-born counterparts. Second-generation women accommodated the wishes of all family members, including husbands, in-laws and children, which constrained food-related decisions and their role as gatekeepers of food. Second-generation men preferred fried meaty dishes over roti and many opted out of family meals by eating food from outside the home. Children were looked after and fed by many members of the family. They often ate five meals daily, along with a variety of snacks. Feeding was seen by women, especially older generation, as a function of nurture, and well fed children as a sign of affluence. This study highlights the issues which influence and inform food and eating practices in multigenerational, Pakistani, Muslim families. It is the first of its kind not only to look at what members of different generations eat, but also how and why they eat it. It offers an insight into how continuities and change in eating practices can co-exist, leading to multiple menus and how individuals are influenced by others when making decisions about everyday foods. A range of factors, including historical experiences, cultural and religious values, familial hierarchy, identity maintenance and attitudes towards health and disease are shown to affect the diet of these individuals, which vary according to gender and generation. It is shown that the gatekeeping function is not solely restricted to second generation women, even though they are primarily responsible for food-related tasks, and multiple gatekeepers exist with varying roles. Generally, the link between food and health was not recognised by participants in this study, although some individuals had made dietary changes for health reasons. It is recommended that health promotion interventions should take into account the way members of the family influence the diet of other family members, rather than restricting the focus to the person with or at risk of a NCD or the cook.