title: "All of those things we don't eat": a culture-centered approach to dietary health meanings for Asian Indians living in the United States.
abstract: This article applies a culture-centered approach to analyze the dietary health meanings for Asian Indians living in the United States. The data were collected as part of a health promotion program evaluation designed to help Asian Indians reduce their risk of chronic disease. Community members who used two aspects of the program participated in two focus groups to learn about their health care experiences and to engage them in dialogue about how culture impacts their overall health. Using constructionist grounded theory, we demonstrate that one aspect of culture, the discourses around routine dietary choice, is an important, but underrecognized, aspect of culture that influences community members' experiences with health care. We theorize community members' dietary health meanings operate discursively through a dialectic tension between homogeneity and heterogeneity, situated amid culture, structure, and agency. Participants enacted discursive homogeneity when they affirmed dietary health meanings around diet as an important means through which members of the community maintain a sense of continuity of their identity while differentiating them from others. Participants enacted discursive heterogeneity when they voiced dietary health meanings that differentiated community members from one another due to unique life-course trajectories and other membership affiliations. Through this dialectic, community members manage unique Asian Indian identities and create meanings of health and illness in and through their discourses around routine dietary choice. Through making these discursive health meanings audible, we foreground how community members' agency is discursively enacted and to make understandable how discourses of dietary practice influence the therapeutic alliance between primary care providers and members of a minority community.
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA 94121, USA. christopher.koenig@ucsf.edu
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Koenig
authors.forename: Mohan J
authors.initials: MJ
authors.lastname: Dutta
authors.forename: Namratha
authors.initials: N
authors.lastname: Kandula
authors.forename: Latha
authors.initials: L
authors.lastname: Palaniappan
mesh_terms: D000328:Adult; D001213:Asian / Q000523:psychology*; D003469:Culture; D004032:Diet / Q000208:ethnology* / Q000523:psychology; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male