Capstone Final Version

EFFECTS OF IMMIGRATION ON DIETARY HABITS AND PHYSICAL ACTIVITY PATTERNS IN TURKISH FAMILIES

A Capstone Project Submitted in Partial Fulfillment of theRequirements of the Renée Crown University Honors Program at

Syracuse University

Kaan Karahan

Candidate for Bachelor of Scienceand Renée Crown University Honors

May 2016

Honors Capstone Project in Nutrition Science

Capstone Project Advisor: _______________________ Sudha Raj, Associate Professor

Capstone Project Reader: _______________________ Matthew Mulvaney, Associate Professor

Honors Director: _______________________ Stephen Kuusisto, Director

Abstract

The purpose of this research is to analyze the consequences of immigration and the extent

to which the dietary habits as well as the physical activity patterns of immigrant families are

influenced by the countries they immigrate into. The research focuses on Turkey as a country of

origin and examines the experiences of Turkish families who have immigrated to Switzerland

and the United States, representing two different cultural environments. Analytical methods

consist of a desk research on general dietary and physical activity habits of Turkish immigrants

to these three countries and a qualitative research among six Turkish families, two living in

Turkey and two having immigrated into Switzerland and the United States each. Results of this

study show that families who relocate to new countries go through some stages of adaptation

from trying to maintain the same routine as in their home countries to finally embracing parts of

the new culture they favor, eventually developing a hybrid model.

i

Executive Summary

This Capstone Project analyses how migration impacts people’s dietary habits and their

physical activity patterns. It aims to provide a perspective on the extent to which immigrants

adopt the nutrition and health, well-being culture that exists in their new environment. The

project provides this perspective through the experiences of Turkish families, first studying

dietary habits along with physical activity patterns of families living in Turkey, then looking at

how they are altered after immigrating to different countries through the lenses of Turkish

families who have immigrated to the United States and Switzerland. These two countries are

selected to represent two sufficiently different environments in terms of the nutrition and

physical activity patterns typically observed among their citizens.

The method of the study is based on an ethnographic approach revolving around six

Turkish families, two currently living in Turkey, in Switzerland and in the United States. Each

ethnographic session with them was conducted in three phases: a) a qualitative in-depth

interview where dietary habits and physical activity patterns were described by the participants

along with detailed perspective on their general life-style, b) an in house kitchen tour and pantry

check where the food stocks of the participants were observed, and c) store visits with

participants where they typically do their grocery shopping to gain insights on the selection

process of the types of products preferred and purchased.

Apart from this ethnographic study, a general research on dietary habits and overall

health and well-being approaches of the people of these three countries have been conducted as

an additional aid to better understand and interpret the new environments of the immigrant

families.

ii

The results suggest that immigrating families have gone through significant adjustment

periods in their dietary habits which may be classified into three stages:

1) The comparison stage: As they settle in a new country, they try to continue with their

routines. They look for food products and ingredients to be able to cook the same type of

food that they previously used. They try similar products and compare them to what they

were originally cooking. They can be frustrated if same taste or experiences are not

obtained.

2) The discovery stage: With trial of new products and recommendations of new friends

come new experiences and new tastes. Gradually a liking is developed towards the new

substitutes. The positive aspects and/or the good tastes of the new environment are

discovered.

3) The adoption stage: Having developed a good understanding of the new culture, the life-

style and the products available, immigrants make choices and establish their new

routines.

The Turkish families living in Turkey generally believe they have a healthy diet. They

believe the food products they find in stores and bazaars are of good quality in terms of nutritive

values. They intend to be active with busy city life but lack of infrastructure that enables outdoor

activity limits them. Their children are relatively more active through school and sports teams.

Overall they eat a lot of vegetables but this is coupled with a high calorie diet through high

intake of carbohydrates and sugar. Most of the entertainment activities and special events revolve

around feasting.

Those who immigrate to new countries try to stay true to their roots in terms of preferring

traditional dishes and the traditional cooking habits however they also go through some

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voluntary and involuntary changes as described above, when they can’t find the same products or

they get to try the new products.

The families in Switzerland experienced a culture where there is high level of intellectual

knowledge about healthy food and healthy living. Organic products are very visibly marketed,

processed products are limited and sports are a part of life among all age groups. These result in

observations among immigrants where they notice that over-weight people are rare, elderly

people are able to lead a healthy, active life. Hence beyond developing a liking towards the new

environment, immigrants look for fast ways to adopt a similar lifestyle. Some of the adjustments

they make are, reducing the intake of carbohydrates, specifically bread, rice, while increasing

consumption of organic vegetables. They also increase their consumption of Swiss cheese and

wine, two very commonly offered products in Switzerland especially for social events. Last but

not least, they develop an interest towards sports like hiking, biking and skiing all of which are

encouraged through the immediate vicinity of suitable places and are commonly practiced within

the cities by the locals.

The families in the United States experienced a culture where the taste perception of food

bypasses the concerns over health. They experienced lots of new tastes in a diverse environment

introducing them to the best dishes from many different countries such as Mexico, Italy and

India. Apart from taste, they experienced very convenient ways of preparing meals due to high

presence of processed food and vast choices of fast food options. Hence, while they also kept

cooking some traditional dishes and Turkish style meals at home, they also increased their

purchase of processed foods and adopted a more convenient eating style. Fast food, red meat and

ethnic cuisine consumption generally increased while consumption of vegetables and fruits

decreased. The families were quick to observe and hear about the presence of chronic obesity

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among the American population and hence developed a determination not to fully adopt the

American diet and life-style. Hence they encourage their children to be active through sports

while the adults try controlling their meal portion sizes. Overall they enjoy American festive

events such as Thanksgiving and follow to some extent Christian celebration traditions around

Christmas and Easter times through their communities. In summary, we may conclude that,

immigrant families try to adopt the best of both worlds, the one they came from and the one they

came into.

This project is important to understand the effects of immigration on nutrition, health and

well-being. The objective was to ultimately shed light on how changes occur in people’s dietary

habits, physical activity patterns, how they adjust to the new culture and environment, what

choices they make and why. Similar studies have been carried out in the past however, most of

these studies have been conducted via quantitative methods. This study which is conducted

through a qualitative method, could potentially point to a more in-depth understanding of the

“why” and “how”.

Readers need to bear in mind that some limitations exist in conducting this research

project. Method of sampling the qualitative nature of the main research and the length of time

respondents were observed are some of those limitations.

v

Table of Contents

1) Abstract...........................................................................................................i

2) Executive Summary......................................................................................ii

3) Acknowledgements....................................................................................viii

4) Introduction...................................................................................................1

5) Turkey’s Food Production, Imports and Exports......................................3

a. Exports.................................................................................................8

i. Animal Products.......................................................................8

ii. Vegetable Products...................................................................9

iii. Animal and Vegetable By-Products........................................9

iv. Food Stuff................................................................................10

b. Imports...............................................................................................10

i. Animal Products.....................................................................11

ii. Vegetable Products.................................................................11

iii. Animal and Vegetable By-Products......................................12

6) The Turkish Diet.........................................................................................12

7) Dietary Habits and Lifestyle in Switzerland.............................................16

8) Dietary Habits and Lifestyle in the United States....................................19

9) Literature Review........................................................................................21

10) Methods........................................................................................................28

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11) Results..........................................................................................................31

a. Families in Turkey............................................................................31

i. B. Family..................................................................................31

ii. Y. Family.................................................................................36

b. Families in Switzerland....................................................................44

i. K. Family.................................................................................44

ii. G. Family.................................................................................52

c. Families in the United States...........................................................61

i. E. Family.................................................................................61

ii. A. Family.................................................................................68

12) Discussion and Conclusions........................................................................75

13) Limitations...................................................................................................84

14) Works Cited.................................................................................................86

15) Appendices...................................................................................................94

vii

Acknowledgements

I would like to take this opportunity to express my gratitude to everyone who supported

me throughout the course of this senior year Capstone as my final honors requirement at

Syracuse University. I feel very fortunate and thankful for their hospitality, aspiring guidance,

constructive criticism and friendly advice for the duration of this project.

I express my warm thanks to all the families and participants that allowed me into their

homes and their lives. Without their help this project would not have been possible. I am

sincerely grateful to them for sharing a glimpse of their lives with me.

I would also like to thank my Capstone advisor, Dr. Sudha Raj and my Capstone reader,

Dr. Matthew Mulvaney, for their insight and support throughout the entirety of the project.

viii

Introduction

Immigration is the movement of people from one place in the world to another for the

purpose of taking up permanent or semi-permanent residence, usually across political boundaries

(National Geographic, 2005). Immigration has both positive and negative impacts on the people

going through this process. Some positive consequences of immigration for immigrants may

involve higher chances of job security, sustainable economic growth, safety and cultural freedom

(Embrace, 2012). On the other hand immigrants may also suffer from negative consequences

such as an increase in the cost of living, problems with facing a language barrier or racial

tensions they may experience in the host country (BBC, 2014). Immigrants who immigrate to

different countries may become acculturated or assimilated to a new culture depending on the

length of their residence in the new environment that is unfamiliar to them; they may acquire or

give up certain eating habits, hobbies and other life ways, which is why immigration brings

along with it cultural changes. Immigration has direct consequences on dietary habits and

physical activity as well, which is the purpose of the research concerning this paper. The

following capstone paper will highlight Turkey as a country of focus and analyze how Turkish

families who emigrated from Turkey to other countries have adapted their routines for dietary

needs as well as physical activity. The paper will first provide a background on Turkey’s

agricultural products as a base for understanding the traditional Turkish diet and give brief

descriptions of Swiss and American dietary and physical activity habits. The paper will present a

qualitative analysis on impacts of immigration and end with the results and conclusion.

The goal of this research is to understand how immigration from the home country to a

foreign one may cause changes in lifestyle with a focus on nutrition as well as health and well-

1

being. For the purpose of this research project, six Turkish families have been recruited as

follows in Table 1:

Table 1: Families by country of origin and residence

# of families 2 2 2

Country of origin Turkey Turkey Turkey

Country of residence Turkey Switzerland United States

Families living in Turkey represent the control group who have provided a good basis for

understanding current Turkish routines while families living in Switzerland and the United

States, represent the families who have immigrated and hence have been through a cultural

adaptation process. Considering this is qualitative research, hence limited in representation of

the true universe, some criteria have been applied in sample selection to eliminate some of the

external factors which may hamper with the goal of the research. For example all families have

been selected from the same socio-economic classes in order to eliminate income bias on choice

of food products and types of physical activities they may be able to engage with. Socio-

economic status has been determined by a criteria similar to the one recommended by Turkey’s

Researchers’ Association, i.e. the education/occupation of the head of household and some

consideration for their residential unit (rental value of the unit occupied relative to the average

rental value in city of residence). Respondents of this research have been selected so that they all

belong to upper-middle socio-economic class (Turkish Researchers’ Association, 2012):

- Head of household has at least 4 year university education

2

- Head of household either works in a managerial position or has retired from such a

position

- Family lives in an area with above average rental value relative to city average

My own experience as an immigrant has been a powerful motivational factor for this

study. As the researcher of this project who is also originally from Turkey but has lived in the

United States and in Switzerland for many years, certain behavior changes have been witnessed

based on firsthand experience; such as social and cultural adjustment by experiencing the

traditions and lifestyle in the new location. This research paper is written with the hopes of

studying and sharing how immigrants generally adapt to their new locations with a focus on

behavioral changes in their dietary habits and physical activity which are directly related to the

topic of Nutrition Science.

Turkey’s Food Production, Imports and Exports

Turkey can be considered as a natural bridge that forms between Asia and Europe. The

country which has soil on both continents is divided between Europe and Asia by the Bosphorus

and Dardenelles straits. Turkey also has shores to the Mediterranean Sea, the Aegean Sea and the

Black sea. Turkey is known to the world to be a significant supplier of a large range of fruits and

vegetables due to its favorable geographical conditions and climate. Majority of Turkey’s food

production can be summed up in five different categories. Production statistics for main fruits,

beverages and spice crops, vegetables, cereals and grain, livestock and fishery (Turkish

Statistical Institute, 2014), are shown below.

3

Grape Apple Orange Olive Tea Hazel Nut0

50000010000001500000200000025000003000000350000040000004500000

Figure 1: Production of Main Fruits, Beverage and Spice Crops (Unit: Tons)

(Turkish Statistical Institute, 2014)

Turkey is among the world leaders in grape and apple production. Turkey’s grape and apple

production quantity ranks 6th and 3rd in the world respectively (Maps of World, 2013). Wine

making in Anatolia dates back 6000 years however today, only 5% of grapes produced in Turkey

are processed for wine-making. The rest is used for fresh or dried consumption (Geerts, 2010).

While produced in relatively lower quantities, it is noteworthy that Turkey is the world’s largest

hazelnut producing country, representing about 75% of the world’s production. The second

largest producer Italy, produces only about a quarter of Turkey’s amount (FAOSTAT, 2012).

Roasted hazelnut is a popular snack in Turkey and its use in the food industry for baking cakes,

biscuits, etc. is widespread (Hazelnut Demo Group, 2012).

.

4

http://www.mapsofworld.com/world-top-ten/world-top-ten-grape-producing-countries-map.html

Tomatoes Potatoes Cucumbers Melon Water melon

Onion (dry)

2 000 000

4 000 000

6 000 000

8 000 000

10 000 000

12 000 000

14 000 000

Figure 2: Vegetable Production (Unit: Tons)


Turkey is the world’s 4th largest tomato producer after China, U.S.A. and India

(FAOSTAT, 2012). Tomato is also the most consumed food product in Turkey. A person in

Turkey consumes about 106 kg or 233 lbs. of tomatoes per year followed by potato consumption

at about 52 kg or 114 lbs. (Ekotrent, 2012). This is not surprising considering that tomato is

utilized in a variety of ways in the Turkish diet mostly in the form of tomato paste as an additive

for color and taste.

Wheat Barley Maize Sunflower Cotton Sugar Beets0

2000000400000060000008000000

100000001200000014000000160000001800000020000000

Figure 3: Cereal and Grain Production (Unit: Tons)

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Wheat is the most produced cereal grain in Turkey. Latest data indicate that in 2015, the

production of wheat had a record year following a year of drought. It is interesting that despite

high production quantity, wheat is also the highest imported food product in Turkey (see section

on imports on page 10). The reason for this dilemma is the poor quality of seeds used in local

production according to the Agriculturalists’ Association of Turkey. It is claimed that only about

50-60% of local wheat production is made with certified, high quality seeds (Cosan, 2015).

Turkey therefore needs to import wheat in order to produce flour both for local consumption and

for export.

Sugar beet is another key product in Turkey. Due to its geographic location, Turkey

produces most of its sugar from beet similar to most European countries while 80% of the

world’s sugar production comes from cane which is globally preferred due to lower production

costs. Turkey ranks 15th in the world for sugar production quantity however from a consumption

point of view, it ranks much higher with 25 kg (55 lbs.) per person per year following top sugar

producers in the world like Brazil, Russia and U.S.A. with consumption at 57 kg (125 lbs.), 39

kg (86 lbs.) and 31 kg (68 lbs.) per person respectively (Agricultural Engineers Organization,

2014).

6

Meat Milk Poultry Meat Honey0

2000000400000060000008000000

100000001200000014000000160000001800000020000000

Figure 4: Livestock Production (Unit: Tons)


Turkey ranks 9th in the world for milk production (Chartsbin, 2011) and 10th in poultry

meat (Khan, 2014). While there is relatively high milk production, consumption per person is

quite low at about 140 kg (309 lbs.) per year while for example in Switzerland, which is among

the global leaders in production, consumption per person is over 300 kg (661 lbs.) per year.

Again, low quality production with poor hygiene standards is cited as the reason for low

consumption by one of the top dairy products producers in Turkey (Hurriyet, 2007).

Sea Products Aquaculture Products Freshwater Products0

50000

100000

150000

200000

250000

300000

Figure 5: Fishery Production (Unit: Tons)

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Turkey’s fishery production is not well developed although it is surrounded by the 3 seas

(Mediterranean, Aegean and Black Sea). It is however a sector estimated to be growing at about

10% per year as claimed by the University of Canakkale (18 Mart Universitesi). This sector is

relatively young with about 40 years of history only. Investments are being made to increase fish

farming (Guder, 2014).

Exports

Turkey exports food in four categories: “animal products, vegetables/fruits/cereals,

animal and vegetable by-products and food stuff”. Main animal product exports are poultry and

eggs, given Turkey is among the top 10 poultry producers in the world. Top exports within

vegetables category are nuts (mainly hazelnuts) and citrus products. Wheat flour produced from

imported wheat is also among the sizeable export products. Below charts show the details of all

exports and their shares in each category (National Statistical Institute, 2014).

Figure 6: Animal Products

31.0%

21.0%

12.0%

9.2%

7.4%

4.1% 3.4%

PoultryEggsNon-fillet Fresh FishFish FilletsCheeseNon-Fillet Frozen FishFermented Milk Products

8


Figure 7: Vegetable Products

18.0%

14.0%

12.0%

10.0%

6.4%

4.8%

3.5%3.4%2.3%

NutsCitrus ProductsWheat FloursGrapesTomatoesDried FruitsTropical FruitsPitted FruitsDried Legumes


Figure 8: Animal and Vegetable By-Products

35.0%

23.0%

20.0%

13.0%

8.0%

Seed OilsOther vegetable oilsPure Olive OilMargarineOther


9

Figure 9: Food Stuff

12.0%

12.0%

6.9%6.4%6.4

%

5.5%

3.4%

3.2%

3.0%

3.0% 2.8%1.9% Processed Fruits and Nuts Baked Goods

Chocolate PastaConfectionary Sugar Other Edible PreparationsFruit Juice Pickled FoodsOther Processed Veg-etables

Yeast

Processed Tomatoes Jams


Imports

Turkey’s food imports are also categorized in a similar fashion. Turkey’s main imported

products are meat, wheat, soybean as well as seed and palm oils used in the production of

processed food. Below charts show the detailed list and shares of all imported products in each

category (Turkish Statistical Institute, 2013).

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Figure 10: Animal Products

28.0%

11.0%11.0%

9.8%

5.5%

5.3%

3.6%3.2% 2.2% 2.1%

BovinePoultry MeatButterNon-Fillet Frozen FishCheeseNon-Fillet Fresh FishFish FilletsEggsPoultryMollusks


Figure 11: Vegetable Products

23.0%

13.0%

9.7%

7.9%

7.6%

5.2%

4.9%

3.8%3.3% 2.2%

WheatSoybeansCornSunflower SeedsDried LegumesOther NutsOther Oily SeedsBananasRice Coffee


11

Figure 12: Animal and Vegetable By-Products

44.0%

27.0%

6.1%

5.8%

3.8%3.5% 2.6%

Seed OilsPalm OilStearic AcidCoconut OilFish OilOther Pure Vegetable OilsOther Vegetable Oils


In summary, Turkey is among the world leaders in production of some fruits,

vegetables and animal products. Main products ranking high in production quantity globally are

grapes, apples, hazelnuts, tomatoes, milk and poultry. While wheat production is also high, there

are quality issues, hence Turkey is also a key importer of wheat which is then processed to form

flour and exported. Turkey’s other important exports are hazelnuts, citrus products and poultry.

Bovine is Turkey’s key imported product. Importing of bovine is encouraged in order to help

reduce meat prices in the market (Yildirim, 2014). Wheat and palm oils are also among Turkey’s

top imports in order to supply the local food industry.

The Turkish Diet

The traditional Turkish diet consists of three meals a day: breakfast, lunch and dinner.

Breakfast is often the most important meal of the day and is prepared to be very rich in terms of

quantity. Some common food products consumed for breakfast include cheese (specifically feta

and kasseri), butter, olives, eggs, tomatoes, cucumbers, jam, honey and kaymak (similar to

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clotted cream). Sucuk, a spicy Turkish sausage often is used with eggs since it goes very well

together. Other products which would be common for breakfast would include pastirma (a form

of air dried, cured beef) along with simit (Turkish soft pretzel covered with sesame seeds) or

regular bread (Warren, 2012).

For lunch and dinner, a typical meal starts off with soup followed by a casserole dish

made with vegetables or legumes boiled in water. Minced meat is often used to complement the

vegetables as well as rice or bulgur. Carbohydrate consumption tends to be high among the

general public where in certain cases carbohydrate products such as rice, bulgur and pasta may

even be consumed during the same occasion. Food may also be served with a side of salad or

cacik as well (a cold liquid like yogurt dish made with cucumbers, salt and garlic) (Business with

Turkey, 2004). Other sides may include dolma (grape leaves stuffed with rice which is prepared

with olive oil) or meze (cold starters) which are especially common when eating fish or kebabs.

Certain mezes may include mussels, glasswort, baba ghanoush, hummus or raw meatballs. Many

key ingredients used for dinner and lunch in Turkey would include lamb, beef, chicken,

eggplants, green peppers, onions, garlic, lentils, beans, tomatoes, nuts (specifically pine-nuts,

walnuts and hazelnuts). Kebabs, doner (meat rotating against a charcoal fire) and kofte

(meatballs) made from various meat types such as lamb or beef are also very popular.

For snacking, dried fruits and nuts are also consumed by many Turks especially during

social gatherings or festivities (Tezcan, 2016). However generally speaking, snacking is not a

wide-spread practice among adults. It is more common for children to snack on chips, biscuits

and candies.

Bread is a very important item in the Turkish diet since it is consumed during all three

meals of the day in large quantities. Casserole dishes almost always have to be eaten with bread

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in order to help consume the sauces and juices of those dishes. It is customary for families to buy

a loaf of bread every day. Most bread consumption is with the basic, white, plain bread. Bread

left over from the day before is considered stale and may be kept refrigerated to use later on in

cooking (stale bread is a main ingredient for meatballs). Tea and coffee are consumed in large

quantities, mainly tea with breakfast or in the afternoon with snacks (Welter-Cayli, 2015), while

coffee is preferred after meals (Irez, 2013).

Spices are very important ingredients since most Turks prefer spices to add flavor to the

dishes. Some spices and herbs that are often used consist of oregano, hot red pepper flakes, mint,

allspice, cinnamon, parsley, cumin, sumac, paprika, mint, black pepper and thyme (Taviloglu,

2014).

In terms of preferred methods of food preparation, Turkish people often prefer to prepare

food from fresh raw materials as well. Vegetables and fruits are usually bought from a bazaar or

a market for fresh goods. Processed food such as frozen vegetables, precooked/premade foods

are not as common. They are considered to be expensive and not tasty. Most dishes in Turkish

cuisine require high levels of fats and oils. Frying, boiling and grilling are key methods of

cooking (Bellwoar, 2016).

It was mentioned earlier that milk consumption in Turkey is relatively low. However

yogurt and feta-cheese are more common dairy products compared to milk. Yogurt is offered

both, for lunch and dinner. It is eaten separately or used in mezes (cold starters) or mixed with

cucumbers to make “cacik”. “Ayran”, which is a liquid yogurt drink, is also consumed in large

quantities in place of water or soft carbonated drinks along with meals (Turkey’s For Life, 2011).

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In terms of overall health and well-being, the Turkish diet is somewhat healthy but is

weak in terms of balancing adequate consumption. Due to the fact that general population is not

physically very active, they have a tendency to gain weight. Losing weight is not seen as a

priority and being slightly overweight is seen as a benefit by most adults due to the concern of

their children potentially being under nourished at a young age. For this reason if children are not

chubby, they are not considered as being healthy. It may be fair to say that, in Turkey,

understanding of the concept of nutrition is mainly related to quantities of food consumed. An

important point that the Turkish Association for the Study of Obesity mentions is that counting

calories, or knowledge regarding calories per day is something that most Turkish people do not

understand or consider as important. Physical activity, eating and well-being is not a very high

priority for most Turkish citizens and education on attempts to increase these aspects of life is

lacking (Hurriyet, 2012). Rates of obesity have increased in Turkey over the past 20 years.

Currently it is at 36% on average and is more prevalent in females (% obese females versus

males: 44% vs 27%) (Erem, 2015).

Overall, the Turkish diet is rich in vegetables, carbohydrates and meat however

somewhat poor in dairy products. Meals tend to be served with many dishes called mezes, hence

there is a habit of eating a high variety of food products in each meal which also translates into

oversized portions. Due to methods of cooking, the Turkish diet also leads to the high

consumption of fats and oils. A relatively less active lifestyle coupled with these eating habits,

can cause obesity problems and limit life expectancy which is the age of 75 in Turkey and below

the European averages at over 80 years (World Health Organization, 2015).

In the next section of this thesis, dietary and physical activity habits in Switzerland and

the United States will be summarized as the main focus of the research is, studying the changes

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in Turkish families’ dietary habits as well as their health and well-being routine after they have

immigrated to Switzerland and the United States.

Dietary Habits and Lifestyle in Switzerland

In Switzerland, there are different linguistic regions and for this reason eating habits tend

to be somewhat different depending on the region that one is in. These regions consist of Swiss

German, French, Italian and Romansch. The Swiss aim to eat at least four meals a day that

consist of breakfast, lunch, snack and dinner. Certain families also snack between breakfast and

lunch as well. Shops close around 7:30 p.m. during a week day except on Thursdays which is

considered as the “shopping day” of the week and that day most shops close at 9:30 p.m. On

Saturdays, shops close at 5:30-6:00 p.m. Most stores are closed on Sundays except for a small

number of restaurants. All this is to indicate that, Swiss people do not wish to be a “high

consuming” nation. In fact, Swiss are often asked to go to ballot boxes to vote about store

opening hours and so far, with a great majority, extension of shopping hours have been voted

against (Siegenthaler, 2012). Consequently, Swiss shoppers prefer not to do bulk shopping, i.e.

they don’t keep large stocks in their homes. Their refrigerators are relatively small versus those

that can be seen in Turkey and particularly, in the United States. They prefer to buy fresh and in

small quantities (Atma Global, 2013).

An important aspect of the Swiss diet which also further explains why people do not

carry large food stocks is that, Switzerland has been able to limit the utilization of processed,

artificial foods. Most food sold in supermarkets and bakeries is made with fresh ingredients such

as fresh milk/cream, fresh fruits and real fats, hence does not last very long (Lennon, 2013).

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For breakfast, freshly baked bread, sandwiches and croissants are popular. Bread in

bakeries come in many different varieties with many different types of ingredients. Bakeries

producing these special types of bread and other tasty pastries are referred to as “artisanale”

meaning “made by artists”. Another popular breakfast food is “Birchermuesli”. This is a type of

cereal dish which was first introduced in Switzerland back in the 1900’s by Swiss doctor

Maximillian Oscar Bircher-Brenner. It contains oat flakes, lemon juice, milk, grated apples or

berries, hazelnuts and almonds (My Switzerland, 2016).

Popular food items for lunch, dinner and snacking in Switzerland include cheese,

sausages, chocolate and wine. The Swiss really enjoy cheese and they have a large number of

their own creations, such as Gruyere, Emmental (known as Swiss cheese in the States), Fribourg

and Tilsit. Brie and Mozarella are also quite popular since these cheese are from neighboring

countries of France and Italy. Cheese is so popular in Switzerland that it can be served as the

main course for fondue (eaten by dipping pieces of bread in a pot of molten cheese), raclette

(melted cheese eaten with boiled potatoes), tartiflette (potatoes, cheese, bacon and onions cooked

in a saucepan). Occasionally cheese may also be eaten as a savory replacement for dessert as

well. Sausages are especially common in the Swiss German regions and they are served either

cooked or cold (such as bradwurst, a popular sausage made from veal or pork). Steak and fries

are also quite popular in French regions. Both fresh and salt water fish are consumed in

Switzerland, however, since the nation has no shores to sea, all saltwater fish products are

imported (My Switzerland, 2016).

Swiss wine is accompanied by Swiss food which goes well with cheese, sausages and

other dishes (Atma Global, 2013). In fact, Switzerland is among the highest alcohol consuming

countries in the world as measured by per capita consumption. It is about 10 liters (2.64 gallons)

17

per person versus 8 liters (2.11 gallons) in the United States (OECD Stat, 2013). Majority of the

alcohol consumption is with wine. According to a study conducted among women drinking wine

with the objective to understand how wine consumption changes eating habits, it was found that

those who drank wine had higher intakes of cheese, potatoes and processed meat in their diet

which is the case in Switzerland (Kesse et al., 2001)

Exercising and sports are very popular in Switzerland. It is part of the daily routine. The

mountainous area of the nation provides great opportunities for Alpine and Nordic skiing along

with snowboarding during the winter. During the summers, mountain hiking/climbing/biking are

also quite popular. There are bike lanes present in every city and bicycles are utilized as a basic

method of transportation. Due to the layout of the cities and infrastructure of roads and traffic

most people consider bicycles and public transportation to be more convenient than private cars.

It is common to see many people commuting to their school or work by bicycle (Christiani and

Ver Berkmoes, 2012). This culture of being physically active has kept Swiss obesity rates at a

low level of 9% of the total population which is considerably low when compared to most

countries (Sassi et al., 2014).

In summary, Swiss families are eating a diet that combines influences from Germany,

France and Northern Italy (My Switzerland, 2016). They consume less processed food and more

fresh products mainly being locally produced. Their diet is rich in calories as it contains a lot of

cheese, potatoes and wine however the active lifestyle compensates for the high calorie intake

hence overall, Switzerland has one of the lowest obesity rates in the world and highest life

expectancy at 83 years (OECD Stats, 2013).

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Dietary Habits and Lifestyle in the United States

Cultural and ethnic diversity fueled by the immigrants, have enriched America’s culinary

experience over the years. In a country as large and diverse as the United States, there is no

single type of diet but there are certain food choice patterns. Overall, it can be said that, whatever

the choice is, majority of Americans have been increasingly consuming more calories than they

need and their physical activity has not been increasing to spend the excess calories. So today,

the United States is among the countries with the highest obesity rates in the world.

Approximately 36% of adults are considered as obese (National Institute of Diabetes, 2012) and

it is estimated that by 2030, half the population will be classified as obese. This is mainly a result

of “convenience seeking” culture which has fueled the fast food offerings which are rich in

added fat, sugar and sodium. Since 1970, the number of fast food restaurants have more than

doubled (President’s Council on Fitness, Sports & Nutrition, 2014) and interestingly, about 20%

of all meals consumed in the US are eaten in a car (Do Something, 2014).

In addition to fast food consumption, convenience seeking culture causes Americans to

choose ready to eat meals, canned goods and frozen foods for lack of time to prepare food from

scratch at home. Also high prices for healthier foods such as fresh fruits and vegetables is why so

many Americans choose to consume a less healthy diet (Parker-Pope, 2007). Last but not least,

the food culture has come to a certain point where companies within the food industry have

increased portion sizes over time in order to remain competitive causing the calorie intakes to

rise (Woolston, 2016). In view of all these facts, it is estimated that only about 1% of Americans

are eating a healthy diet as defined by the American Heart Association’s “Ideal Healthy Diet”

(Mozaffarian et al., 2014).

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In recent years due to increasing obesity concerns, there have been some improvements

in reducing the calorie intakes. Calories consumed by an average adult, have gone down from

2220 in 2003 to 2134 in 2010 (Corrs, 2015). Consumption of fruits and vegetables has increased.

However these improvements are still not enough to significantly impact the concerns over the

American diet.

Most American diets fall into the categories of “Western” and “Prudent” diets (Woolston,

2016). The prudent diet consists of eating large amounts of fish, poultry, cruciferous vegetables

such as broccoli and cabbage, tomatoes, legumes, fresh fruits and whole grains. At the same

time, calorie rich foods are also consumed such as red meat, eggs, high-fat dairy products,

French fries, pizza and candy. The Western diet on the other hand is quite different. Red meat

and other high fatty foods are more in the frontlines while fruits, vegetables and whole grains are

pushed to the sidelines. The Western diet is also high in salt, sugar and cholesterol. Abundant

fiber is not present and there is not enough nutrients and phytochemicals (Woolston, 2016). Most

Americans likely do not strictly follow one or the other diet. Majority would have mixed

adherence to both (Shakersain et al., 2016). However considering only about 12% of calories

consumed in the United States are plant based (Central Ohio Bariatrics, 2013), we can assume

that there is a high preference towards the Western diet. Further, the Western diet typically

impacts 50-65% of population towards having chronic diseases (Cordain, 2005).

In summary, the typical American diet leads to significantly higher levels of calorie

intakes versus recommended healthy levels (3750 kilocalories in the United States daily energy

intake average per capita versus average minimum daily requirement of 1800 kilocalories) (FAO

Food Consumption Nutrients, 2008). Consumption of solid fats, added sugars, refined grains and

sodium is particularly high. Over 60% of calories consumed comes from processed foods. Eating

20

on-the-go, snacking, and preference for fast food dominate American dietary habits. Lack of

physical activity adds to the issues caused by poor nutrition intake. Hence obesity is a huge

concern and recently emerging preference towards eating more plant based food is good news

but more radical changes in both calorie intake and lifestyle are required.

Literature Review

It is estimated that today there are about 120,000 Turks living in Switzerland, mostly in

the cities of Zurich, Basel and Lausanne. Large numbers of Turks began migration to Europe

after World War II as labor migrants. Migration to Europe from Turkey occurs to this day with

Turks immigrating in hopes of finding jobs. In a study conducted within Switzerland, the relative

risk of low fruit and vegetable consumption for six migrant groups were observed (one group

being of Turkish origin). Volken et al., conducted a cross sectional survey which included 14,637

subjects of Portuguese, German, Italian, Turkish, Serbian, Kosovan and Swiss permanent

residents. The results of each ethnic group were later compared to the average results of the

national Swiss population. The total population of the sample was between the ages of 17-64.

The length of stay of the migrants were noted by the researchers but it was stated in the article

that length of time spent in Switzerland had no statistically significant association with fruit and

vegetable intake among migrants (Volken et al., 2012). Fruit and vegetable intake were

calculated by the participants themselves using portion sizes where one serving of fruit or

vegetables was considered the size of a participant’s fist and potatoes and sweet corn were

excluded from their calculations (Volken et al., 2012). The results of the experiment concluded

that the groups of migrants at greatest risk of having a low fruit and vegetable intake when

compared to the Swiss nationals were the Turkish and Kosovan migrants. On the other hand, it

was noted that migrants from Portugal, Serbia, Germany and Italy had similar levels of intake of

21

fruits and vegetables when compared with the Swiss nationals. The researchers also came to the

conclusion that education (having a secondary education or college education) along with being

economically active (job security) increased the rates of fruit and vegetable intake (Volken et al.,

2012).

In another study conducted by Kleiser et al., the food intake of young people with a

migration background who were living in Germany was observed. This study only focused on

adolescents between 0 and 17 years of age (age range taken directly from the article) living in

Germany. Food frequency data of 7186 boys and 6919 girls aged 3 to 17 years were collected

and analyzed separately for Turkish, Russian Germans (a single group) and other migrants

(Kleiser et al., 2009). The daily food intake of the participants was calculated via a healthy diet

score being assigned to each participant so the diet could be interpreted. It was noted that

Turkish participants consumed significantly more soft drink, fried potatoes, chocolate cream and

snacks when compared to other migrants and non-migrants. It was also revealed that Turkish

participants consumed more poultry, fish and pasta/rice however less sausage/bacon and cooked

vegetables when compared to Russian Germans and non-migrants. Russian Germans on the other

hand demonstrated that they consumed less cooked vegetables than non-migrants and other

migrants. Overall it was revealed that both the Turkish and Russian German participants showed

a less favorable diet where more unhealthy foods such as fast food and calorie dense foods were

being consumed when compared to non-migrants. It was also noted that the non-migrants had a

better mean score for a healthy diet assigned to them based on their dietary intakes when

compared to all the other groups of the study (Kleiser et al., 2009). A correlation was made with

having a less favorable score for a healthy diet for individuals who were older, male or a migrant

with low or middle class economic status that were living in rural or provincial areas. Lifestyle

22

and nutrition habits are influenced by many factors such as the degree of integration, length of

stay in the migrant country, generation of migration and language abilities. In Kleiser et al.’s

study, the researchers established that migrant children, especially Turkish and Russian Germans

were not more likely to eat according to the national recommendation when compared to non-

migrants. It is noted that the migrant children seem to have adapted the less preferable aspects of

the Western food culture which is evidenced by the high prevalence of their consumption of soft

drinks, fast food and sweets (Kleiser et al., 2009).

In a study conducted by Wandel et al., changes in food habits among South Asians were

observed who had migrated to Oslo. 629 migrants who relocated to Norway from Sri Lanka and

Pakistan, aged 30-60 had their dietary patterns altered due to cultural change. The participants of

the survey had been living in Norway between 1 and 34 years whereas Sri Lankans had been

living in Norway for an average of 13 years whereas Pakistanis had been living on average for

20 years. Traditionally the Pakistani and Sri Lankan dietary patterns consisted of consuming

three hot meals a day that revolved around rice, unleavened bread (chapatti, roti) which is also

served with lentils or a meat based stew. After migration however, the dietary habits of both

groups were altered into a bi-cultural eating pattern with a heavy reliance on traditional dishes

for dinner. It was revealed that a majority of Sri Lankans reported an increase in consumption of

products such as meat, milk, butter, margarine and potatoes. Almost half of the migrants from

Pakistan reported an increased consumption of oil, meat, fish and potatoes (which are common

food items consumed by Norwegians). It was also observed that there was a decrease in bean and

lentil consumption among both groups after migration (Wandel et al., 2008). In conclusion, a

number of socio-cultural factors such as length of stay, level of education and command of

Norwegian language were found to modify the changes in food habits after migration. This

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transition brought upon by migration, which entailed moving from a less economically

developed country to a more economically developed country had direct results on the lifestyles

of the migrants. Both the Pakistani and the Sri Lankan ethnic groups had changed their meal

patterns when compared to their traditional meal patterns within their countries of origin. Total

number of hot meals were cut down from 3 per day to an average of 1.5 (Pakistanis) and 1.6 (Sri

Lankans) per day. Also it was gathered from the questionnaires that the decline of hot meals per

day was a result of the change in daily work schedules along with the adaptation to the climate

and lifestyle of Norway for the migrant families. The change in lifestyle also entailed less

outdoor activity and less physical activity when compared to the migrants’ country of origin

(Wandel et al., 2008).

In another study conducted by Renzaho and Burns, post migration food habits of sub-

Saharan Africans who relocated to Victoria, Australia were analyzed. This study also used a

cross sectional survey along with a snowball method for recruitment. A total of 139 households

participated in the study and it was noted that changes in food habits among sub-Saharan African

migrants had occurred. Most notably, changes had been reported “in terms of food procurement,

introduction of commercially prepared foods at the expense of home cooked meals, preparation

methods and meal pattern” (Renzaho et al., 2006). Traditional food items used by sub-Saharan

Africans had been replaced with alternative Australian foods. Most important Australian food

items which had been adopted by the sub-Saharan Africans consisted of pizza, breakfast cereals,

fast foods at places such as McDonalds/KFC, pasta and a variety of newer types of vegetables

(broccoli, sprouts, salad) (Renzaho et al., 2006). New types of food items were used as additional

food products for nourishment and old recipes that were used by sub-Saharan Africans had been

modified. Traditional food items for the migrants consisted of products such as African

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vegetables (sweet potato leaves, cassava leaves, pumpkin leaves, bean leaves, tarot leaves and

amaranth), black eye beans, maize flour, camel milk and meat, cocoyam and yam products,

sorghum, fresh water fish, cassava, plantain banana, basso, goat meat, palm nut, snail and

traditional yogurt. However, it was noted that these food products were either not available in

Australia or were in inadequate supply. Certain products such as cassava roots, cocoyam, millet

flour, sugar cane, passion fruit, white bait and amaranth which were available in Australia, were

not consumed by the sub-Saharan Africans due to taste differences than what they were

accustomed to in their original homes. Also, certain food items such as snow peas, cabbage,

asparagus and figs were tested by the migrants as new foods but rejected due to taste. Further,

sub-Saharan Africans used a coping mechanism where they would substitute certain ingredients

that were absent with readily available Australian ingredients in order to stay close to their

traditional recipes. For instance, lamb would occasionally be substituted for camel meat

(Renzaho et al., 2006). It was also noted that the migrants had succeeded in retaining some of

their traditional foods such as injera/chapatti (flat bread), semolina, rice, pasta, black eye beans,

certain vegetables (spinach, cabbage, onion), ghari and ambuulo. The author also stated the

importance of understanding these changes, since the more familiar the Australian government

becomes with sub-Saharan African culture and the migration process the easier it will be for

them to allow effective health promotion and community development programs to be utilized in

the future (Renzaho et al., 2006).

In a study focusing on Turkish immigrant couples in Canada, Ataca and Berry examined

the acculturation and adaptation of 200 married Turkish immigrants via self-report

questionnaires who moved to Toronto (Ataca et al., 2002). Their goal was; first, to introduce

marital adaptation of married immigrant couples and to distinguish among psychological,

25

sociocultural and marital adaptation; second, to examine the three facets of adaptation

separately for males and females; and third, to examine the similarities and differences in

acculturation and adaptation in relation to socioeconomic status and gender. The findings

supported the notation that adaptation is multifaceted. Regarding the facet of psychological

adaptation, other than stress and coping models, personality variable of hardiness, social support,

acculturation attitudes and discrimination were the main problems faced by the immigrants. For

sociocultural adaptation, social learning perspectives were mainly related to variables in

acquiring social skills among the new culture, language proficiency and contact with members of

the dominant group (Canadians). Regarding marital adaptation, associations were made with

marital stressors and marital support. There were also findings regarding gender differences and

socioeconomic status, where different genders responded to adaptation at different levels. From

the findings it was understood that the Turkish immigrants did not acculturate uniformly.

Working class and professional Turkish immigrants were distinguished in terms of acculturation

and adaptation experiences. Gender differences were also found to be more apparent in low

socioeconomic class immigrants. Women were found to be psychologically more vulnerable

when compared to men and the risk factor for women increased as socioeconomic status also

decreased. Overall, Turkish immigrant couples strongly endorsed separation but immigrants of

higher socioeconomic status preferred integration and assimilation to a higher extent while

preferring separation to a lesser extent when compared to immigrants of lower socioeconomic

status (Ataca et al., 2002).

In an international review conducted by Berry regarding immigration, acculturation and

adaptation, he investigated the key reason behind what happens to individuals who have grown

in one cultural context and tried to reestablish themselves in a new cultural environment. Berry

26

found consistent and applicable data from the researches he analyzed focusing on psychological

consequences of immigration. An important finding was that psychological acculturation was

influenced by numerous factors in the society of origin along with the society of settlement

(Berry, 1997). A key factor was the reason of immigration in the first place, i.e. whether it is

voluntary or forced. Other factors included national immigration and acculturation policies,

ideologies and attitudes of the dominant society and social support. Berry states that in societies

which have suitable assimilation policies, there was evidence that immigrants often prefer

integration and when they do, they adapt better to the new culture. In his review, Berry states that

there are three possible outcomes of the acculturation process. These are, acquiring essential

social skills (behavioral shifts), coping with stressors to avoid acculturative stress and

succumbing to problems to a degree that results in mental disorders (Berry, 1997). If enough

behavioral shifts are demanded by the new environment but do not occur, stressors may start to

appear in the daily intercultural encounters that may require coping to prevent acculturative

stress. If these difficulties prove to be unbearable, it can lead all the way to psychopathologies.

Overall Berry’s conclusion states that most accultured individuals make positive adaptations to

their new environments (psychopathology has not been widespread so far), however he also

notes that the transition and process of acculturation is not an easy one.

In conclusion, most of these studies that have been analyzed consist of themes revolving

around the topics of migration and changes in dietary habits. In all the studies observed it is seen

that dietary habits of migrants had been altered after their immigration to foreign countries. In

the study conducted by Kleiser et al., Turkish and Russian German migrant children had

developed a more negative pattern of eating habits where they started consuming more calorie

dense foods and sweets. In another study conducted in Switzerland it was noted that the levels of

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fruit and vegetable consumption among migrants had a direct correlation to job security and

education and these are only some of the changes assimilation brings upon migrants. Although

the degree to which changes in diet may occur depending on the individual and distance between

the host country and origin country, however, change is inevitable after immigrating to a foreign

country. This is because the culture is different which forces people to assimilate. Although most

of the studies in this review focus on large sample sizes, large surveys and cross sectional studies

without participant observation, the themes of the research articles are similar to the current

study. Since the methods of the current study consist of utilizing an ethnographic research

method, analyzing the diets of a small sample size via qualitative interviews has been the main

course of action.

Methods

Ethnography can be defined as a branch of anthropology that focuses on “social

interactions, behaviors and perceptions that occur within groups, teams and communities”

(Reeves Scott, 2008). Ethnographical studies aim to provide an insight into people’s views and

behavior along with the nature of the location they inhabit. This is done with the help of detailed

observations and interviews (Reeves Scott, 2008). This type of qualitative research was chosen

for the current study and data collection. Qualitative interviews were conducted focusing on a

small sample size of six families since a small sample size allowed for an opportunity for richer

data collection that would provide more depth and detail to the current study. Detailed form of

participant observation methodology was used in the form of a pantry check where the

participants gave a tour of their home kitchen while showing the products they had at home and

that they would use for their food preparation. Another form of participant observation method

used was to conduct trips to the local grocery store with the participants where the participants

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were observed buying food products. The same manner of research would be very difficult to

conduct with a large sample size of participants; therefore, the current methodology was used.

The current project consisted of interviewing and conducting qualitative research with two

Turkish primary householders within Turkey, Switzerland and the United States. In order to find

participants for the research, a convenience sampling methodology was used to recruit the

participants. For the recruitment process, individuals known to the researcher were selected.

Recruited individuals consisted of U.B., A.Y., from Turkey, C.K. and Y.G. from Switzerland and

finally A.A. and S.E. from the United States as the participants. Equal time was spent with each

participant in order to keep the results as consistent as possible. During each session with the

participants a qualitative interview took place in two stages. Stage one consisted of an in home

interview where a discussion guide was followed while recording all of the discussions with the

participants on film. The topics of discussion included the following:

1) Who makes up the household? Members of the household, their ages, education, occupation. Length of time in marriage.

2) Daily life of the family Description of a typical day in their life as a family.

3) Shopping habits of the primary household shopper Shopping habits for a typical main grocery shopping trip: where the shop is, how they

travel to the store, how often, key items purchased and their quantities, how much money spent.

4) Cooking habits Types of dishes made and what cooking methods are mostly utilized?

5) Eating habits of the family Meals served/cooked in a typical week (focusing on the last 3 days and separate for

breakfast/lunch/dinner). Meals served/cooked for a special gathering at home (Breakfast, lunch and dinner).

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Whether eat outside, how often, types of restaurants chosen, for which occasions (e.g. family outing, group parties, business dinner, etc.).

Most favorite dishes of the family to eat at home or outside. Dishes considered as traditional favorites.

6) Food storing habits of the family Results gathered from in house pantry check.

7) Special days Differences in food items eaten during key cultural days/holidays (e.g. Christmas,

Thanksgiving, Ramadan, Eid, etc.).

8) Health and well-being Whether involved in any sports, how often, which sports, duration. If injured ask about

lifestyle prior to injury. Age when started each sport activity they are practicing. Description of health and well-being, how they determine whether a person/child is

healthy. Where they obtained their first knowledge on health and well-being. Where they obtain information about health and well-being today. Whether they have experienced any health problems. Also for other family members. What do you do to stay healthy? Also for other family members. Whether they have ever smoked, if they quit: when and what influenced them to quit.

Also for other family members.

For immigrant families: Length of time living in the United States/Switzerland. Changes occurred in lifestyle after relocating. Changes occurred in eating/shopping/cooking/physical activity habits and practices. Which cultural routines they still follow/which new cultural routines adopted (for

example: thanksgiving, escalade).

Source: (Aykan, 2015)

The interviews were followed up by an in house pantry check where the participants were filmed

as they gave a tour of their kitchen and other parts of their home where they stored food,

beverages and kitchen supplies. Stage 2 of the research consisted of visiting the local grocery

store (in some cases stores) with the primary household shoppers where the researcher tried to

understand the reasons for their purchase behavior and observe what key items were purchased.

30

RESULTS

Families in Turkey

B. Family, interviewed on 8/7/2015:

1) Who makes up the household: Four people live in this household. O.B. is 37 years old,

her husband M.B. is 38, A.B. their new born son is 3.5 months old and M.H., is 45. O.B. works

for a private, fast moving consumer goods company as a manager in marketing. M.B. works as a

salesman for a company that sells and produces various technological devices. M.H., lives with

the family but she is technically not part of the family, she is the family’s maid whose main

responsibility is to look after the baby when O.B. and M.B. are at work, and do other house

chores. O.B. and M.B. are from a small city called Kirsehir, they moved to Istanbul for

university and stayed afterwards. O.B. possesses a masters degree in sociology from Galatasaray

University while M.B. has an MBA from Sabanci University. This is an upper middle class

family who live in an 1100 meter square feet apartment in Kadikoy, Istanbul.

2) Daily life: O.B. and M.B. wake up between 6:30 and 7 a.m. during weekdays and have

breakfast around 7:30 a.m. Both wife and husband leave to work around 8 a.m. and have lunch

while at work around noon. During work days the family eats dinner together around 7-8 p.m.

Before having their baby, O.B. and M.B. were going to bed around midnight, however after their

baby was born, they try to sleep early since the baby wakes them up during the night. During the

weekends the family wakes up later than usual, at around 9 a.m. and eats breakfast at 10 a.m.

Lunch is also eaten a little later than usual, at around 1-2 p.m. Dinner time does not change.

While O.B. and M.B. are at work, M.H. cooks their dinner.

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3) Shopping habits of O.B.: O.B. is the main shopper of the household as most women are

in most Turkish families. She has two stores of choice. These are Demtas, a local grocery store

and a mini market called Aras Market. Aras Market provides home delivery service meaning,

they receive orders by phone and deliver products to their home. This helps O.B. save time. She

prefers Demtas due to the fact that it’s very close to her home and also Aras because of the

convenience. She often visits Demtas when returning from work. Certain key items she buys

from these markets are tea, milk, meat, fruits, vegetables, bread, dry fruit, walnuts, nuts. She also

mentioned that she prefers to buy packaged bread rather than the traditional oven baked bread.

This is because, they don’t like to consume a lot of bread for weight gain concerns and she

doesn’t like to throw away the left-over either. So she prefers the long lasting, processed bread.

(Note that, wasting bread in Turkey is not considered a good practice from religious point of

view).

4) Cooking habits: Even though M.H. does the cooking for this household, O.B. and M.B.

get to decide what to eat. The family often tries to have a balance between meats and vegetables

during meals. They try to avoid chicken, they do not think it is healthy because of the use of

antibiotics which they learned from the news in the newspapers. They prefer meat instead of

chicken and they have their meals along with soup or salad. Her soup choices are: yayla soup

(rice, yogurt and mint soup), yogurt soup, lentil soup and tarhana (a soup made from a fermented

mixture of grains and yogurt, mixed with onions, tomatoes, green peppers and water). Salads

consist of a seasonal mixed green salad or an arugula salad with olive oil and pomegranate sauce

which is a common salad dressing in Turkey. Meat is sautéed, braised or stir fried. For the baby,

she has been breast-feeding A.B. and also giving him processed baby food for vegetable and

fiber intake.

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5) Eating habits of the family: For breakfast the family (except for A.B.) consumes two-

three types of cheeses such as feta, kasar (a pale yellow cheese made from sheep milk) or string

cheese. They also consume cucumbers and tomatoes (if in season) with black and green olives on

the side. There would be a wide variety of jams present such as strawberry, rose, apricot, cherry

and these are often homemade by O.B.’s parents. There would also be pekmez (molasses, a thick

syrup of grape juice). The family also consumes boiled eggs with tea and occasionally has simit

(sesame covered Turkish version of a bagel). For lunch and dinner the family has meat with rice

(bulgur preferred but with guests they would do white rice). Their preferred drink is water. Juices

and soft drinks would be rarely consumed by them due to high sugar or harmful ingredients like

aspartame, however they would still buy them to offer soft drinks to their guests in case asked

for. Also a dessert would be common at least once a day such as ice cream or a type of Turkish

milk dessert if eating outside. These may include kazandibi (white pudding with a blackened

surface) or sutlac (a rice pudding). The family eats out 2-3 times a week, usually during

weekends. If they do, they attempt to eat fish since it is something that they don’t cook at home

often due to the odor it causes when cooking. O.B. mentioned that she and her husband prefers

fish such as sea bass, gilthead and red mullet (mullet is made fried while the others are grilled).

A family favorite dish is manti (Turkish ravioli filled with minced meat). O.B. mentioned that

her mother often makes manti and she keeps a stock of it in her freezer in Istanbul. O.B. and

M.B. also like to drink beer from time to time. Since O.B. had her baby recently she hasn’t been

able to drink for a very long time and she still avoids alcohol due to lactation. Rose wine is

among the alcoholic beverages they consume.

6) Food storing habits: O.B. has two refrigerators in her kitchen. In her first fridge she

stores items such as packed bread, wine, jams, yogurt, tomato paste, green olives, lettuce, lemon,

33

pomegranate sauce, dill, string cheese, ayran (a diluted salted yogurt drink), kefir, yogurt, eggs,

canned tuna and beer. In her freezer she had manti, pastries such as yufka (phyllo pastry), grape

leaves to make dolma (grape leaves stuffed with rice). In her secondary refrigerator, she keeps

mostly fruits such as water melon, apples, peaches, apricots and pears. She also has a stock of

yarma (coarsely ground wheat used for making soup), potatoes, onions, walnuts and dried

grapes. In her pantry she keeps wheat, rice, beans, lentils, instant coffee, sunflower seeds (she

likes it with beer), tea (mint, sage, she makes the tea from leaves versus using teabags due to

concerns she has about bleached white teabags, again heard of adverse effects from the papers),

Turkish coffee, pekmez (a very sweet syrup made with grapes). Water is kept in a special, large

container which has a capacity of about 19 liters or 5 gallons (very common in Turkey, almost

every house has it because tap water is not drinkable but can be used for cooking and cleaning).

The water is delivered by Aras Market. She keeps dates as a snack. Spices and herbs such as

cumin, red pepper flakes, black pepper, cinnamon, salt and sumac were the herbs she stored.

There were two types of olive oils, one is refined, used for cooking and the other is extra virgin

olive oil, used as a salad dressing.

7) Special days: The family celebrates three major holidays throughout the year. These are

the two religious feasts: Eid, following Ramadan, the Holiday of Sacrifice, as well as New

Year’s Eve. For Eid the family makes an exception to eat baklava (flaky pastry with layers that

often have pistachios or walnuts, covered in sugary syrup) which is something very common to

eat during Eid among Turkish people. She often prepares the baklava herself with yufka that she

brings from Kirsehir. Often Eid is about dessert. For Eid and the Holiday of Sacrifice, the family

often eats at home and visits other family members, there won’t be any major changes to their

diet other than increasing intake of sweets. More meat than usual is consumed during the

34

Holiday of Sacrifice. For New Year’s, if they are having guests over or if they themselves are

guests at another place, they often go “a little crazy with junk food”. They have food and

beverages such as coke, beer, chips. The family basically consumes party food. There would also

be a good source of protein for the main course such as beef or turkey, served with rice and salad

as a side and Turkish desserts that would follow. They also consume raki (a Turkish alcoholic

beverage) and have meze such as hummus or topik (a dish made from chickpeas, cumin, tahini

and onion currant).

8) Health and Well-Being: O.B. and M.B. try to be physically active throughout the week.

O.B. used to go swimming 2-3 times a week for 45 minutes sessions. She also used to do Zumba

and Greek dancing before having her baby. She had started swimming in 2009 due to neck pain.

At the moment she is still trying to lose her pregnancy weight and for that, she is trying to

exercise by walking. M.B. on the other hand, has a gym membership but does not use it that

often. He may be going to the gym a few times a month, irregularly. He used to be more active

but after 2012, he switched jobs and now has to dedicate more time to his work. M.B. used to be

more active during his university years. To O.B., health and well-being means “feeling light, not

heavy, having energy to do whatever you want to do. Exercising, drinking lots of water, trying to

consume more vegetables rather than meat and carbohydrates”. O.B. and M.B. are also

concerned about the health and well-being of their baby. They experience some pressure from

their families to ensure the baby stays healthy and according to traditional view, a healthy baby

has a rather full body, is little overweight. O.B. does not agree with this. She started paying

attention to health and well-being back in 2003 when she started doing sports. Around 2001 she

started putting on weight as her activity level dropped after she started working. She gets most of

her knowledge about health and well-being and nutrition from the internet. She also asks

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questions to her doctor if she is visiting for a health reason. M.B. has health issues which he links

to stress. These issues are pain around his neck and back. O.B. does not smoke, M.B. used to

smoke until university but he stopped afterwards due to a cousin passing away from cancer. O.B.

reads a lot of books, she wants to learn an instrument and she is also going encourage her baby,

A.B., to participate in sports when he is old enough.

SUMMARY: This family is following the typical rich Turkish diet most of the time. They don’t

have special dietary requirements. While they try to watch for their weight and have some

pounds to lose, they are not making a special effort other than trying to reduce intake of bread,

however they don’t limit consumption of other types of carbohydrates. They don’t count calories

and their calorie intakes seem to be high due to consumption of sugar-rich food products. Their

activity levels are relatively low and have been adversely affected after having the baby. They

wish to lead a healthy life and for that, they are restricting consumption of carbonated drinks,

alcoholic beverages, poultry and they don’t smoke; they eat fresh, homemade meals.

Y. Family, interviewed on 8/4/2015:

1) Who makes up the household: There are two people that live in this household. A.Y.

who is 56 years old and her son C.Y. who is 17. A.Y. is retired from a previously self-employed

textile business. A.Y. lost her husband T.Y. in 2006. She has been a widow since and currently

being retired in the present. A.Y. lives in an upper middle class neighborhood on the outskirts of

Istanbul called Kemer Country. C.Y. is a scholarship student at ITU, which is one of the

commonly known high schools of Istanbul.

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2) Daily life: C.Y. wakes up around 6 a.m. every morning and boards his bus at 6:30 a.m. to

get to school during the week. The family lives on the outskirts of Istanbul which is why C.Y.

has to wake up very early to get to school on time. A.Y. also wakes up early but since she is

retired she does not wake up during the same time as C.Y. Often she wakes up around 7-8 a.m.

A.Y. lives a very calm life. She does not go out often, she spends most of her time at her home,

more specifically in her kitchen and her garden. She is responsible for taking care of the house.

She does most of the chores around the household such as preparing food, washing clothes and

dishes, looking after her plants in her garden etc. C.Y. eats breakfast and lunch at school around

9 a.m. and 12 p.m. respectively. C.Y. arrives from school at around 4:30 p.m. The two family

members have dinner together around 5 p.m. During the weekends C.Y. tends to sleep in, waking

up around 9-10 a.m. A.Y.’s schedule is unaltered. The family has two large meals on the

weekends, brunch when both members are up and then dinner at 5 p.m. A.Y. goes to bed

between 11 p.m and 12 a.m. C.Y. however, has to go to bed earlier at around 10 p.m. in order to

wake up on time for school.

3) Shopping habits of A.Y.: A.Y. is the family member who does the main shopping for

the family. She prefers three specific grocery stores for most of her shopping habits. These are

“Koyum Gida” (a local grocery store, translates to “my farm nutrition”), “Onur Market” (another

local market) and Carrefour (a French super market chain). She also has a habit of going to a

local bazaar which is only available on Thursdays and she prefers to buy meat products from a

local butcher in the same district as the other stores. When shopping, A.Y. pays most attention to

quality and price. Since she is not working, she has time to search and explore different prices in

different stores in her neighborhood. A.Y. often buys her fruit and vegetable products from the

bazaar. She believes these products are fresher at the bazaar than in supermarkets. She mentioned

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that the local farmers are the ones who grow and sell these products which is why she believes

they are healthier, in other words she stated that they were “organic” although none of the

products were actually labeled as organic. From the bazaar she brings in products such as

tomatoes, cucumbers, lemons, peaches, grapes, watermelons, melons, green and red bell peppers,

parsley, mint, purslane and garbanzo beans. During our grocery shopping A.Y. also made note of

not buying fruits and veggies from markets since she believes that they are not well taken care of

and are often left to rot on display. However she prefers to buy cheese and olives from the

markets since they are sold in closed containers, while at the bazaar, they are sold in bulk by the

kilo and in the open. She believes buying these products at the supermarkets is the safer option

for these two specific products (cheese and olives) since they are shielded from dust and

contamination. She specifically visits Koyum Gida to buy one product in particular, which is

olives. From her visit to Carrefour she purchased Feta cheese, Turkish coffee, Danone regular

yogurt (she made note that she is only able to find this brand in Carrefour), organic whole,

Nutella, Lipton Ice Tea peach, Turkish lemon soda (Frutti brand). Finally from Onur Market, she

purchased organic eggs, hazelnuts, extra virgin olive oil and red lentils. An important note about

A.Y. is that she adjusts her shopping and foods habits around her son C.Y. where she prepares

and makes dishes mostly to his liking.

4) Cooking habits: A.Y. utilizes very simple cooking habits during her daily life. For

personal consumption of the family she often tries to provide a protein component along with

starch and vegetables for C.Y. but for herself she prepares food that require minimal effort in

terms of preparation. When preparing foods A.Y. often uses frying methods for eggs and meat

which is very common in Turkey. For vegetable dishes, unless she is making a salad or

consuming a dish that is supposed to be consumed raw she often boils them in water or uses her

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oven and accompanies most of her vegetable dishes with olive oil. Some examples of these are

boiled purslane accompanied with yogurt and olive or a simple salad made with seasonal

vegetables, always accompanied by olive oil. A.Y. chooses to make most of her own meals from

scratch. She buys the raw ingredients from the market but prepares most dishes in her own style.

For instance, for meatballs she buys ground meat from the butcher, but prepare her own

meatballs with onions and spices. If making an eggplant stuffing or lentil dish she is also using

homemade tomato paste. A.Y. indicates that she does not like to consume a lot of processed

foods, believing them to be unhealthy but being unable to specify in what ways.

5) Eating habits of the family: A.Y. is a lacto-ovo vegetarian and pescatarian who

consumes fish, eggs but no other types of meat. C.Y. however does not have any restrictions

although he is trying to be careful with his weight since he is an active teenager. For breakfast

the family members often eat close to a traditional Turkish meal. Eggs, cooked differently

depending on mood but commonly fried or menemen style (menemen is an egg dish that is

scrambled and cooked with tomatoes and green peppers), black and green olives, feta cheese,

tomatoes and cucumber. Organic whole wheat bread is used as the main starch component and

for beverages A.Y. prefers tea whereas C.Y. settles for milk. For their dinner which happens

around 4-5 p.m., A.Y. prepares a protein dish along with a starchy component, such as steak and

pasta, purslane with yogurt or meatballs with a salad for C.Y. During this meal A.Y. always

drinks water whereas C.Y. switches between water, ice tea, or kefir. Some favorite food dishes of

A.Y. consist of seasonal salads with olive oil, fish, specifically, anchovies, salmon, red mullet

and sea bass (all preferred grilled), feta cheese paired with tomatoes and seasonal salads with

olive oil. In terms of more traditional choices, A.Y. stated that she loves okra with olive oil and

she likes drinking Turkish coffee (stating that she drinks up to 10 cups a day) she says:

39

“Nowhere else in the world is there something that tastes as good”. She drinks her tea and coffee

without sugar or cream. C.Y. on the other hand prefers pizza and Turkish cuisine more heavy on

meat dishes, food items such as kebabs, meatballs, manti, borek (flaky pastry filled with thin

layers of food such as cheese or cooked ground beef), karniyarik (whole eggplants fried and

stuffed with seasoned minced meat in the middle), eggplant dolma (consists of artichoke rice and

minced meat and onions stuffed in an eggplant). On a different scenario however, if she were to

be expecting guests over for a meal she would make certain food items differently. For breakfast

she would opt for the more traditional Turkish breakfast type of meal where she would have

tomatoes, cucumbers, feta cheese, variety of olives, clotted cream with honey (these two are

often accompanied together), pastirma, sucuk, eggs, borek, variety of jams, fruit juices and

whole fruits. She also stated: “Breakfast when prepared by Turks for guests becomes bigger and

keeps expanding (in terms of size)”. For lunch she mentioned that different types of dishes

featuring olive oil would be common in her household such as kidney beans prepared with olive

oil, a seasonal salad, a meat dish such as beef or sautéed chicken along with white rice prepared

with butter. She would also utilize fruits or a classical Turkish dish, like kadayif (shredded pastry

with pistachio filing in thick syrup) as a dessert. Rice is something that the family does not

consume a whole lot on their own but since white rice is very commonly used in the Turkish diet

she would prepare a rice dish when expecting guests. For a dinner situation depending on the

weather, she might decide to use the garden where she could prepare a barbeque meal if the

weather is fitting. She listed the same food items as lunch with the addition of a wheat salad and

artichokes that she cooks in a pot along with olive oil and oranges which is a unique Turkish

dish. Artichoke hearts are sold by street vendors or at bazaars in Turkey that are ready to eat and

have their shells removed. This is not a common practice in Europe or in the States where

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commonly artichokes are sold either in cans or as a whole. The family eats out very rarely,

usually once a month and this is due to their financial situation. Another factor contributing to

this is also because C.Y. and A.Y. usually like to eat different things. C.Y. prefers meals like

pizza, or other Turkish meat heavy foods such as kebabs. A.Y. described to me going out with

her son as: “C.Y. eats, I wait. C.Y. does not like the Mediterranean cuisine. Our common

favorite dishes however consist of fish but there is nowhere near where we live that serves fresh

fish. You need to go to the city for good fish and that seems very out of our way most times.

Instead I sometimes order a pizza home for C.Y.” A.Y. also on rare occasion goes out with

friends as a social event but she doesn’t do this quite often since she is usually busy at home or

with her son and his school work.

6) Food storing habits: A.Y. also has two refrigerators and a freezer as a means of food

storage. She keeps sirloin steak (individually packaged into plastic bags by herself) and borek in

her freezers. In her fridge she has a large variety of products. During observations, food items

present included mercimek koftesi (red lentil patties), meatballs (homemade), wheat (she

mentioned that she boils it and puts yogurt on top to make cold ayran soup), Turkish delight

(from Afyon, a city in Turkey), kadayif (homemade), peaches, green grapes, tomatoes,

cucumbers, lemons and oranges (for making orange juice or lemonade or to be used in other

dishes like salads). She also keeps her feta cheese and black/green olives in her fridge in a bowl

of water. She stated that this way some excess salt is disposed of and it makes her feel like she is

consuming something that is more “light”. There was also a stock of eggs in the fridge along

with regular yogurt, purslane, kefir, ayran, whole wheat pre sliced bread (she mentioned that she

doesn’t buy traditional bakery bread because it is less healthy and goes bad quickly). She also

keeps a small quantity of chocolate (two regular sized bars) and some alcohol made up of beer,

41

wine (red, rose and white) and raki. She stated that she enjoys alcohol on rare occasions for

dinner and when in the company of friends or if eating fish. In her dry pantry, she keeps a large

stock of spices, most notably flaked red pepper, cumin, cinnamon, salt and pepper. In terms of

dry grains and other dry storage products she keeps bulgur, red/green lentils, packaged pasta

(bowtie and vermicelli), sugar, homemade tomato paste and white rice. She also purchases

drinking water in a butt (19 liter container) of water.

7) Special days: A.Y. is a Muslim, however her husband was a Christian which is also why

C.Y. is a Christian like his father. Therefore the family has special occasions on both Muslim

and Christian holidays. For New Year’s, Ramadan and the Holiday of Sacrifice they usually

consume a classic Turkish meal with braised lamb, dolma (made with grape leaves and olive oil)

and white rice or borek with baklava as a dessert either at a family members house or at their

own place. For Christian holidays, the family most notably, celebrates Christmas and Easter. She

stated that “I used to prepare extensively and we would have a table full of delicious food with

fish, nice desserts, baklava, kadayif, sutlac (rice pudding), salads or we would go out to a nice

restaurant but ever since I lost my husband, I had no motivation to these things”.

8) Health and Well-Being: In terms of physical activity, A.Y. is not involved in many

sports at the moment. Even though she used to do 20-30 minute walks in the past (seventeen

years ago), after she became pregnant with C.Y., she has stopped in frequency since she has

developed a problem with her knees and hip. Her condition progressed throughout the early

years of C.Y. For that reason, she has been doing physical therapy at home every night for 15

minutes for her legs. C.Y. on the other hand goes to fitness three times a week and plays

basketball for a local club and they have their training sessions five times a week. Basketball is

his main sport since he has been doing it since the age of five. On occasion he also plays soccer

42

on astro turf with his classmates. Often for each of these activities he commits two hours a

session for basketball and depending on how tired he is 1 to 2 hours for fitness. Since the

interview took place during the summer, the basketball season was over but was supposed to

start again in mid-August. According to A.Y. to be classified as healthy and well, she stated that:

“being healthy and well starts with the family being together. When the family is missing it’s not

the same. I used to have more fun when cooking and spending time in the kitchen”. When asked

where she would obtain information about health and well-being she stated that the number one

option would be the internet with a doctor being a secondary option. She also mentioned that

C.Y. used to be overweight and as he transitioned into young adulthood he started to learn more

about health and eating well through school and team mates in basketball which is why in recent

years he has been consuming less rice, desserts and chocolate along with eating before bedtime.

When asked if the family ever received help from a dietitian she said: “Some of my friends went

to dietitians, got to the weight they wanted and then 3-5 months later they were right back where

they started”. A.Y. is also a smoker although her friends and son are strongly against it. She

stated that she becomes tense and angry when she tries to cut off her addiction.

SUMMARY: This family eats a traditional Turkish diet most of the time. Focus is on making

sure the child eats well and gets all the calories and nutrition he needs while the female head of

household claims to pay less attention to her own diet. The explanation of their dietary habits by

the female head of household sounds like they are being very careful to eat healthy and rather

low calorie diet, however, in reality, looking at their pantry as well as the listing of the types of

food they eat, it is apparent that the diet of the teenage child particularly is rather high calories

and contains carbohydrates and sugars. There is a lot of emphasis on making sure the food is

43

from a healthy source and is organic however, there is a lack of knowledge on what organic food

production is. Anything produced by local farmers is understood as “organic”. Physical activity

of the adult is very low while the teenage child is more active through some sports. The adult

also has a smoking habit.

Families in Switzerland

K. Family, interviewed on 6/15/2015:

1) Who makes up the household: The K. family has been living in Geneva, Switzerland

for five years (moved during 2010) and they consist of four members. C.K. and I.K. are the

adults of the household. They have been married for 23 years and they have two daughters, B.K.

and Y.K. C.K. who is 45 years old is a housewife and the main shopper of the family. I.K. is 52

and works for a global company as a supply chain director. B.K. and Y.K. are students who are

respectively 19 and 16 years old. B.K. is currently attending university in the United States

whereas Y.K. is attending an international high school in Geneva. For education regarding the

adults of the family, I.K. has a masters in Industrial engineering from Bogazici University

whereas C.K. has an economics degree from the Marmara University both which are in Istanbul.

C.K. is from Adana, which is in the southern part of Turkey whereas I.K. is from Istanbul. The

family is also a Jewish Turkish family. I.K. and C.K. spent 2-3 years in Eastern Europe at the

start of I.K.’s career, then moved back to Turkey before finally moving to Switzerland.

2) Daily life: I.K. and Y.K. wake up around 6:30 a.m. and leave to go to work and school

around 7:30 a.m. For C.K. the time she wakes up varies, since she doesn’t have to go to work or

has no regular morning activity. Depending on the day and her daily activities she usually wakes

up around 7-8 a.m. I.K. and Y.K. have breakfast before they leave around 7 a.m. C.K. has

44

breakfast once she gets up. All family members usually eat lunch around 12 p.m. and dinner

around 7 p.m. On the weekends dinner is still around the same time but breakfast and lunch are

consumed around 9-10 a.m. and 1-2 p.m. respectively.

3) Shopping habits of C.K.: There are two main grocery stores C.K. uses for shopping.

Switzerland is known for being an expensive country where almost all goods and services are

sold at a higher price when compared to countries like the United States or Turkey. C.K. also

finds Switzerland very expensive as she compares prices to Turkey. Therefore, she prefers to

drive across the French border (Geneva is on the western end of Switzerland located very close

to the French border) and shops from two stores in France. One of the two shops is Carrefour,

where she buys most of her food items such as vegetables, fruits, fresh fish and meat. C.K. was

observed while buying a variety of products from Carrefour which included French chocolate

croissants and daily baked bread from the bakery section. For meat, she bought scald fish and red

meat along with quail eggs (BIO, meaning organic in Switzerland) and regular eggs (BIO). Black

olives (canned), black berries, raspberries and blueberries were her fruits of choice. For

vegetables she preferred grass onion, tomatoes, green beans, baby peas, mushrooms, pickles,

broccoli, potatoes and lettuce. She also bought Swiss cheese, apple juice (BIO), orange juice

(BIO) and seltzer water. She mentioned that she started buying BIO products after their move to

Geneva since food production and quality is regulated more strictly and they became more aware

of the potential harms of processed foods than they originally were in Turkey. Seeing a large

selection of BIO products triggered her curiosity to learn about them. The second store she visits

is a Lebanese market that is very near the location of Carrefour. From here, she buys certain

items that are commonly used by individuals living in the Middle East but are less common in

general stores in Europe. She prefers this store as she finds the food she is used to buying in

45

Turkey such as certain cheeses (Feta), olives (fresh, non-canned) and meat. During the visit to

the Lebanese store she also bought mint, parsley and lemon.

4) Cooking habits: C.K. cooks daily and is responsible of all the cooking in the household.

She tries to be careful when serving her family and herself food items that are not too “heavy on

sugar” and that tend to be “light”. She values vegetables as very healthy and important. In their

diet, “there are always a minimum of two types of vegetable dishes (per meal) when eating

together as a family”. For vegetables she chooses to serve them raw or boiled/grilled. The most

common techniques she uses are boiling, baking and grilling. When she cooks red meat, chicken

or fish she prefers to grill or bake. She does fry food but not very often. She considers it to be an

unhealthy technique. When it comes to eggs, boiling is also a common method used by the

family. She likes to save food, storing them as leftovers for the next day. Also she showed a

raclette (a type of Swiss cheese often eaten by melting) and a fondue (a dish consisting of melted

cheese or melted chocolate in which people can dip bread or pieces of fruit) set which she

acquired after moving to Switzerland and she occasionally cooks food Swiss style.

5) Eating habits of the family: B.K. is the only vegetarian of the household which is why

C.K. always prepares something unique for her if the family is having meat as the main meal of

the day when she comes back from college to visit her family. Some examples include: “fresh

quinoa salad or bulgur style salad”. B.K.’s favorite thing to eat is beet roots according to C.K.

The rest of the family members don’t have any restrictions although I.K. (the father of the

household) is trying to be careful with his cholesterol intake. For breakfast I.K. and Y.K. often

have muesli since it is fast and easy to prepare. C.K. on the other hand prefers to have a variety

of food items for breakfast and prefers something closer to the traditional Turkish breakfast such

as “feta cheese, tomatoes, olives and two slices of whole wheat bread and coffee”. To these she

46

adds avocados as she developed a liking to avocados after moving to Switzerland. In Turkey,

avocado is not a commonly found fruit, while in Switzerland, it is shelved regularly in the

supermarkets next to other fruits so it is more available and visible. For lunch, I.K. goes to the

cafeteria at work where he eats either a hot meal or a sandwich with cold cuts. For Y.K. it is

similar since her school also has a cafeteria which rotates food items on a daily basis. For dinner

the family eats together. Usually they consume meat, chicken or fish along with vegetables.

From an example she gave, the family had: “chicken schnitzel, grilled eggplants and a salad

along with cacik”. On the weekends the family has all three meals of the day together and have a

much larger breakfast with eggs, freshly baked bread or croissants. Different types of cheese

such as Swiss cheese, feta, goat cheese, mozzarella and gruyere. There are raspberries and

blueberries along with cold cut meats such as salami and horse meat similar to pastirma. Other

than these, cucumbers and tomatoes are also consumed on the weekends for breakfast. For lunch

and dinner on the weekends, C.K. either prepares a meal from scratch or the family consumes

leftovers from the day before. Another example she gave here were to either cook borek with a

specific filling such as cheese or meat or have lentils (red/green) with white rice. She also likes

to add a bit of flavor to her rice by adding vegetables to it such as peas and carrots. Bulgur is also

an alternative to rice and sometimes a meat dish is served with bulgur. The family tries to not go

too heavy on meat consumption trying to keep themselves in balance. C.K. also made a note that

the family tries to avoid junk foods, no soft drinks for instance. Artificial drinks or even juices

which have sugar are avoided. Water or seltzer water is the preferred beverages most of the time.

If the family has guests, C.K. stated that she asks and tries to prepare dishes that the guests prefer

eating. If she doesn’t know what they like she makes sure to have a lot of different food available

in terms of variety. For instance, if a group of foreigners were to come (8-10 people) who have a

47

desire to see some original Turkish dishes then she would prepare a total of “10-12 dishes in

order to accommodate for everyone”. The food would consist of meze’s as appetizers such as

dolma (goes with yogurt), borek, icli kofte (fist sized bulgur balls filled with minced meat), a

seasonal salad and main courses and dessert. A meat dish served with tomato sauce (similar to

meat loaf) was an example she provided. For dessert she would try to make a Turkish dessert

such as sutlac or kadayif. She also made note that these 10-12 dishes may not be preferred by

every single guest but she would make a lot of food so that on average 3-4 dishes would

accommodate a single person since people may like different things. If for instance a vegetarian

were to be coming she would increase the amount of vegetarian dishes. She became more aware

of different types of diets after moving out of Turkey and making multi-national friends.

Combining this with Turkish hospitality, leads to over preparation for guests. If guests don’t

have a preference for foods she might also use BBQ methods if the weather is nice. Weather

permitting, the family likes to eat outside once a week. The household members’ favorite cuisine

for eating out is Italian. They like risotto, pasta and pizza. Chinese, Indian and Swiss style

restaurants are also occasionally visited. Eating out is seen as an opportunity for a family get

together.

6) Food storing habits:

In her pantry, C.K. keeps products from different countries such as Mexican tortillas, French

crepes, thai spring roll, pancakes, Turkish red lentils, bulgur, American cranberries (dried),

quinoa, corn flakes, different types of nuts. A variety of spices including masala, curry,

rosemary, lemongrass, za’atar (a mix of sumac, thyme, hyssop and oregano), mint, red pepper

flakes, basil, cumin, cinnamon, curcuma, black pepper and salt plus a small selection of canned

goods such as peas, corn and mushrooms. C.K. has two refrigerators with freezers in her kitchen

48

and an extra freezer in her basement. In all these, she stocks a very large variety of food

products. Here’s a list of what was observed in them: tomato paste, BIO milk, coconut oil,

yogurt, black and green olives, olive paste, nectarines, oranges, avocado, tomatoes, mascarpone,

mozzarella, feta (from Carrefour), salakis (a Greek brand of Feta cheese), parmesan, grana

Padano, horse meat, gruyere, Swiss cheese, Halloumi cheese, Smoked salmon, ham cold cuts,

butter (no margarine in household because of trans fats), American steak sauce, pesto, jalapeno

sauce, homemade mustard, asparagus, artichoke hearts, grape leaves, vegetables like lettuce

(BIO), eggplants, carrots (BIO), lemon, zucchini, quail eggs, cherries, chicken. It is noteworthy

that her freezer was full of meat, frozen vegetables, fruit and bread. Meat such as fish and

chicken along with frozen raspberries, cherries, potatoes and some green mix (peas, carrots,

potatoes), homemade vegetable mix consisting of leek, carrot and potato for soup preparation.

Frozen ginger, chickpeas, mushrooms were also found to be present. She had homemade borek

(with spinach and cheese, she had five large plates ready to go, which she prepared in advance in

case the family has visitors unexpectedly. She also makes and freezes her own chicken stock.

She does not like using the premade processed stocks. Overall C.K. has a very large supply of

food stock at her home and food from a variety of cultures around the world including, Asian,

Turkish, Indian, American, Swiss and Mexican. For this reason she keeps certain food items in

her kitchen to prepare dishes from different cultures which she would not have, if she were living

in Turkey.

7) Special days: The family does not follow any cultural holidays in Switzerland, however

they do follow certain religious holidays. Since the family is a Turkish Jewish family, they

follow traditions during Rosh Hashanah and Passover. For Rosh Hashanah C.K. stated: “family

comes together, specific food combinations have to be on the table. Lamb, certain vegetables

49

such as steamed carrots and potatoes, a dessert with fruit, honey and apple are traditional”. She

also mentioned that they do not mix dairy and milk during these meals. The family does not

practice kosher but during religious holidays they avoid mixing meat and dairy. For Passover,

she stated: “you’re not allowed to eat anything containing bread (flour) or yeast. We usually

consume eggs, lamb, fish and vegetables. We also don’t eat rice during this time, instead we

have potatoes and for dessert “I like to make different types of jams which we eat with

unleavened bread”.

8) Health and Well-Being: In terms of physical activity most of the family members are

regularly active. I.K. plays tennis twice a week for 2 hour sessions and has been doing this sport

since he was twelve years old. C.K. likes to be active outdoors, she walks almost every day or

rides a bicycle for half an hour, if the weather is nice. B.K. is not involved in sports but her

younger sister Y.K. plays basketball at a local club for 1.5 hours a day, three times a week.

Before moving to Switzerland from Turkey Y.K. used to participate in competitive swimming,

however the Swiss curriculum for competitive swimming requires practicing two hours a day, 4-

5 times a week and that was too much for her. Y.K.’s education started to get adversely affected

which is why she switched to basketball. C.K. also mentioned certain health conditions affecting

the family. I.K. has cholesterol problems which can potentially lead to a heart attack one day,

this is due to his family genes and for this reason he tries to stay active and be careful with his

cholesterol consumption. For instance, when I.K. eats a meat dish at home it has to be less in

total amount of fat (lean meat) if possible. Also coconut oil is used by C.K. when preparing

certain dishes for I.K. since it has no cholesterol in it. C.K. has a back pain problem but it is not

too severe at this time. She might need to do physical therapy in the future if it gets worse. B.K.

is also a smoker and the only smoker in the family. When asked about whether or not C.K. was

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trying to stop B.K., she stated “no, because then she would want to do it even more”. When

asked about how she determines if someone is healthy and well, she states that the life-style, the

activities, foods consumed and whether there is a smoking habit or not, indicate how healthy one

may be. For her family, by buying and cooking healthy foods, she is claiming to be doing her

part well. It is noteworthy that, she was doing the same in Turkey too, however she adds that, in

Turkey, the environment is polluted; she is not sure about the adverse effects of that pollution.

From a health and well-being perspective, she is happier in Switzerland as she has more

confidence about the quality and cleanliness of the products sold, availability of BIO foods are

abundant and importantly, doing sports is easier due to well-designed bike lanes on the roads,

lots of parks and trails to walk. She is very intrigued about the elderly people she sees around in

their 70’s and 80’s, being very active, still engaged in sports. She aspires for her family to be like

them when they grow older. She indicates that, before coming to Switzerland, she thought eating

well was more important to stay healthy but now she realizes that the activity levels are also

important. C.K. also stated that after she got married and had children she started to care a lot

more about health and eating well and that health became more of a priority in her eyes. When

asked about where she obtains information regarding health and well-being she stated that the

number one option was the internet with doctors coming in second. When asked about any other

observations that she thought changed about their lifestyle after their move to Geneva she stated:

“our life was more stressful in Turkey, I feel like it’s more peaceful here, less traffic. I have

never biked outdoors until I came here. In Turkey, we socialized more, we had friends and

family. However it was not suitable for outdoor sports”. Another point made was that, every

family member has purchased a bike after their move and that the family goes on a ski holiday

twice a year which is something they did not do regularly while living in Turkey.

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SUMMARY: This family has redefined the meaning of health and well-being after they moved

from Turkey to Switzerland. Their observation on how local Swiss people live their lives, the

range of products available in the stores as well as the diversity of new friends they made from

different nationalities, all have been important in the changes they introduced to their lives.

Overall they became more active and switched to more organic food products. Their diet became

more diverse as they tried to maintain a Turkish diet but added elements of Swiss and other

international cuisines which are easily accessible in Geneva given it is a cosmopolitan city with

more than half of its population being non-Swiss (due to the presence of United Nations and

other major multi-national firms’ headquarters). Overall they appear to be happy with the

changes in their lives and they feel more optimistic as well as more in-control for leading

healthier lives than when they were in Turkey.

G. Family, interviewed on 6/17/2015:

1) Who makes up the household: There are four members that make up G. family

household. The mother Y.G. who is a 43 year old pharmacist working for a global company in

Geneva Switzerland, the father E.G. is a 52 year old retired architect and their son and daughter

C.G. and N.G. who are students at the International School of Geneva and are 17 and 14 years

old respectively. Both parents hold university degrees from the Marmara University in Istanbul.

The family has been living in Geneva, Switzerland for five years, they moved in 2010.

2) Daily life for the family: A typical day for the family during the week starts early in the

morning. Y.G. wakes up at around 6:00-6:15 a.m. and the kids get up around 6:30 a.m. Since

E.G. is retired he sleeps in. Y.G. and the kids have breakfast around 6:45 a.m. and then leave at

7:30 a.m. to go school and place of work. Y.G. has lunch at the company cafeteria around 12:00-

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1:00 p.m. and the same goes for C.G. and N.G. The father, E.G. has a brunch type of breakfast

around 10 a.m. and skips lunch. N.G. and C.G. usually arrives from school around 5 p.m. if they

don’t have any sports activities after school and they also have a snack once they get home. The

mother, Y.G. arrives around 7 p.m. and the family then has dinner at 8 p.m. It gets quiet in the

house after 10:30 p.m. and everyone is asleep by midnight at the latest. On the weekends the

household sleeps in and brunch happens at around 11 a.m. Lunch is rare on the weekends and

dinner is eaten a little earlier too at around 6 or 7 p.m.

3) Shopping habits of Y.G.: This family visits a variety of places but they do most of their

shopping also in France similarly for cost reasons. While E.G is the main shopper of the house,

on the weekends, he and Y.G. go together across the French border to shop at a bazaar that sets

up every Sunday in a small border city called Douvaine, where they buy most of their vegetable

and fruit needs from Turkish-French farmers. There are many Turkish farmers and workers

living in France and both Y.G. and E.G. have developed connections with them. They believe,

these farmers give them good/fresh products. They are also happy to be shopping in Turkish

style, i.e. having conversations. From the bazaar they purchase cucumbers, zucchini (white),

chives, potatoes, green beans, parsley, apricots, strawberries and cherries. White zucchini is

usually not available in Swiss markets while that is the type more common in Turkey, hence they

are happy to find this product in the bazaar. There is also a chance for the farmers to bring

certain products from Turkey if the household requests it. Y.G. gave an example of plums that

would fit into this category which are hard to find in Switzerland and not very popular. During

the week when the bazaar is closed the family also shops at Swiss grocery stores as well. Coop is

the name of the grocery store they visit the most often in Switzerland and this is because it is

closest to their home. During observations they bought ground meat, regular yogurt, seltzer

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water, coca cola, bread, chocolate, skimmed milk and bananas. A final major grocery store that

the family visits is a Turkish store which is located in Annemasse (also across the French border

but takes 30 minutes to drive to). The family visits this store once every two or three months

where they buy products such as sucuk and olives. The family is not very picky with olives

however, also buying them from Coop when needed.

4) Cooking habits: Y.G. is the main cook of the family and tries to cook dinner daily.

When making vegetable dishes like zucchini, peas or lentils she often boils them with a mixture

of seasoning, minced meat, tomato paste and onions. For salads she uses dressings such as

balsamic, olive oil, nar eksisi (pomegranate syrup) or lemon juice. Olive oil is used in a lot of

dishes in the household and meat is often pan fried. Certain traditional dishes especially when

using eggplants are cooked in the oven. Barbequing is also used by the family during the summer

time. Using the barbeque was not something that they brought with them from Turkey but is

something they picked up from their neighbors who happen to be American. Leftovers are also

used throughout the week; trashing food is perceived as a sin.

5) Eating habits of the family: The family has no eating restrictions although the members

are trying to be careful with their weight gain. For breakfast during the week Y.G. and her kids

try to have something “quick” which is easy to prepare. The members usually either have cereal,

toast with cheese or a muffin that Y.G. bakes along with skimmed milk or tea. Skimmed milk is

preferred compared to regular milk in order to cut off excess fat from the diet. Tomatoes and

cucumbers are also consumed and some fruit (seasonal, she mentioned watermelon), no eggs are

consumed during the week (eggs are more commonly eaten during the weekend when the family

has more time to prepare). For lunch Y.G. eats at her work cafeteria. Depending on what is

available, she usually goes for a cold starter such as a salad and chicken or lentils as an entrée.

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N.G. the younger daughter eats lunch at the school cafeteria but the older son, C.G. has the

liberty of eating off campus since he is older. His choices are a little different where he goes for

pizza, sushi or McDonalds most of the time. C.G. has been open to different types of cuisine and

has developed a liking to Asian cuisine which is not very popular in Turkey but has a strong

presence in Switzerland. At around five p.m. when the children get home from school a fruit

snack is common consisting of cherries, apricots and apples (depends on the season). For dinner

Y.G. mentioned that they recently had chicken with cream and mushroom sauce, some borek

with potato and cheese filling and zucchini with olive oil. As a dessert she named baklava but

this was due to her recent travel to Turkey and she brought some with her. Normally baklava is

not very commonly eaten except for special occasions. Since E.G. is retired, the types of meals

eaten by him are more similar to what the family also eats during the weekends. For brunch, eggs

are cooked depending on the mood (sunny side up is a popular method for them), with different

cheeses such as feta, tete de moine (a type of thinly shaven Swiss cheese, has a strong smell),

bread, olives, cucumbers, tomatoes, different types of jams (strawberry, orange, grape) and

sausages (also sucuk if they have are at home). N.D. also prefers Nutella to jams. They usually

eat food that is similar to what they normally eat during the week for dinner. The family

regularly cooks pasta and has chicken for their evenings since it is one of their favorite

combinations. When asked about their favorite dishes Y.G. stated that chicken is a family

favorite we eat it very regularly. Y.G. is also a fan of okra and artichokes, however she buys okra

rarely now and artichoke purchases is almost nil. She stated: “okra is harder to find and for

artichokes you need to buy them full or canned, you can’t buy them the same way you can in

Turkey, weeded out and ready to go”. Interestingly, she stated that when they first arrived in

Switzerland, due to difficulty of finding some of the vegetables they consumed while in Turkey,

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they kept cooking the same few meals until they found replacements or discovered others they

liked. Other traditional favorites of the family consist of borek (with various fillings such as meat

or cheese), imam bayildi (eggplant cooked in olive oil with onions, garlic and tomatoes) and

karniyarik (whole slitted eggplants with minced meat filling and seasoning). Manti (dumplings

with minced meat covered in yogurt and garlic sauce) is also another family favorite from

Turkey. Y.G. also mentioned that yogurt consumption of the family decreased after their move to

Geneva since the yogurt in Switzerland is very watery for them. The closest alternative is Greek

yogurt but C.G. and N.G. finds it to be more solid like to what they were used to in Turkey so

less yogurt is consumed in the household. Fish is also a meat dish the adults of the family love,

however they are not able to find the same types of fish in Switzerland as they had in Turkey.

Y.G. and E.G. mentioned “bluefish, anchovies and turbot” as some types of fish that they miss

from Turkey and are hard to find in Switzerland. For this reason they have changed their fish

eating habits by adapting to salmon which their children and Y.G. enjoy but the father not so

much. Other changes to their eating habits consisted of adapting various American elements to

their diet. The family lives next doors to an American family which is why they actually started

eating hamburgers because of their influence. Also E.G. made a note that to make hamburgers

properly, if the weather is nice they use their barbeque grill. Peanut butter and jelly on bread and

mac and cheese was also other examples that the family learned from their neighbors. The family

has also taken a liking to Italian cuisine in Switzerland as well. When the family likes to go out

(which occurs usually once every weekend), an Italian restaurant is usually preferred and the

reason behind it is that “Italian cuisines is everywhere in Geneva, not like in Turkey”. For Italian

cooking Y.G. stated “usually we prefer pasta dishes or pizza, the pizza here is very thin and

different. Also the desserts are really nice, panna cotta is one of my favorites”. Swiss cuisine is

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also liked by the family with fondue, raclette, filet de perche (a Geneva dish, made with lake

perch that has been breaded and oven baked with a white wine sauce added on top) and rosti

(potatoes made in a style of a fritter) being their favorite types of Swiss food. Sushi is rarely

consumed as a family since E.G. is not a big fan of raw fish but N.G. and C.G. seem to enjoy it

very much. The parents also stated that from time to time Y.G. and E.G. visit a delicatessen for

wine and cheese which is another popular thing to do in Switzerland. Another note made was

that the family struggled in terms of eating outside when they moved initially since Swiss

restaurants are open for lunch during 12-2 p.m. and then close until dinner time, “In Turkey you

don’t have a problem like this, restaurants are open the entire day in Istanbul, eager for

customers” stated Y.G. When asked what they would serve guests, Y.G. and E.G. both agreed

that they’d serve Turkish food. Y.G. started off by saying “there would be a lot of food, mezes,

starters, like a salad with nar eksisi (pomegranate syrup, gives a slight sour taste), dolma, maybe

a cacik (diced cucumber garlic and mint in yogurt), humus salad or a cheese platter with

proscuito are some starter options then eggplant roast (imam bayildi or karniyarik were previous

examples) with meatballs or sucuk as the main course”. For holidays, in particular for New

Year’s, Y.G. and E.G. mentioned that there would be turkey for sure as the main course with a

special rice dish on the side with chestnuts and butter. Tapas and cold appetizers, “dolma for

sure, eggplant salad, bulgur, tabbouleh salad, Turkish garlic yogurt with walnuts and carrots,

haydari (thick strained yogurt with herbs) and dessert, preferably baklava or kadayif”. Y.G. and

E.G. also listed certain dietary habits that changed since their move to Switzerland. Most notably

bread consumption has decreased. This was interesting because usually Turkish people consume

bread for every meal, however E.G. stated “bread used to come home by delivery every morning

in Turkey, there is no such service like that here so we eat less also”.

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6) Food storing habits: Y.G. keeps the entire house’s food supply in her kitchen. She has

one fridge, a freezer and a dry pantry. In her fridge there was a supply of olive oil, watermelon

(pre sliced, in Turkey they are sold as whole), green plums (also brought from Turkey),

hamburger buns, helva (a sweet Turkish dessert made with clarified butter, sugar and semolina

flour), leftover zucchini from dinner (made with boiling zucchini with tomato paste, onion and

minced mea), carrots, cucumbers, tomatoes (baby sized and large), feta, Swiss cheese, brie

cheese, parmesan, sucuk, apple/grapefruit juice, American barbeque sauce and Greek yogurt. In

her freezer, there was phyllo pastry (for making borek), grape leaves, manti and simit (which she

brought from Turkey). In her dry pantry area, there were olives (also brought from Turkey),

peanut butter, Swiss muesli, tahini (sesame seed paste, popular in Turkey), quinoa,

marshmellows, graham crackers (another influence from their neighbors, Mexican tortillas (she

makes wraps with cold cuts such as ham or salami, or uses it to make toast with cheese), Turkish

delight, a wide variety of teas (green tea, black tea, flavored teas), chocolate and seltzer water

(she also stated that her consumption of seltzer water increased since it is available in larger

bottles, in Turkey they are commonly sold in 200 ml bottles which is equivalent to 6.7 oz). In her

kitchen there was also a small wine rack with red and rose types of wines. When asked about

alcohol, Y.G. stated that even though they love raki, they drink it less in Switzerland when

compared to Turkey and have made a slow switch to wine and beer for alcohol consumption

after their move. E.G. has also expressed an interest in learning more about wine and champagne

since these drinks are more popular in Switzerland. The family also sees themselves to be more

knowledgeable regarding wine compared to when they lived in Turkey. An interesting fact was

that, this family’s Turkish coffee consumption had decreased and changed their coffee needs

with espresso. An espresso machine was present with many coffee capsules. Also, tea is more

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commonly brewed in Turkey, but the family here has been using more tea bags for simplicity

ever since their move to Geneva.

7) Special days: The family does not particularly celebrate their usual customs as they used

to in Turkey. Even though the family members are Muslim, Ramadan and the Holiday of

Sacrifice are not followed. To them those holidays give them an opportunity to visit their friends

and family and have feasts with them but since they are away from their relatives while in

Geneva, nothing special occurs. Therefore the only major holiday followed by them is New

Year’s.

8) Health and Well-Being: When asked about whether or not the family was physically

active, Y.G. stated “myself and E.G. are not but the kids are very active”. Y.G. and E.G. have not

been very physically active throughout their lives but their children are very active. C.G. has

been playing rugby for the past three years, which is a new sport for him since it is not played in

Turkey. C.G. plays for the school team where they practice twice a week for 1.5 hour sessions.

C.G. also likes to run but does not compete in this area. C.G. runs for 30 minute sessions three

times a week. N.G. on the other hand also does two sports activities which are dancing and track

and field. Both sports are practiced twice a week for 1.5 hour sessions and take place during after

school. Although the adults are not very physically active Y.G. also stated “so many people here

are doing sports, there are so many chances and opportunities which push us also”. Y.G. had a

gym membership last year and went once a week, stating “even that was a lot for me”. The adults

occasionally take walks on the weekend. All family members also have bikes but the adults don’t

use them very often. C.G. is the member that bikes the most, using his bike to go to friends’

houses. “If we had lived in Turkey, I would never let him bike around the same way we let him

here” said Y.G. concerning her son. E.G. also mentioned that skiing is popular for the family,

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they ski usually for a week every year with C.G., N.G. and E.G. being the main skiers. The

family has been skiing since 2007 so all the members of the family know how to ski but Y.G.

prefers not to since she is afraid of accidents. When asked about what health and well-being

means to them Y.G. responded “eating healthy and having a peaceful mind”. In terms of

smoking, E.G. was the only smoker in the family, however he quit 15 years ago for his family.

He knew the risks smoking could bring and wanted to take care of himself better, saying “I quit

first for my family, second for myself”. For the family, internet is the main source of knowledge

regarding nutrition with doctors coming in second. When asked about any health related

problems within the family, Y.G. stated that nothing was wrong at the moment, everybody is

healthy with no problems. She also stated that the family uses vitamin supplements and vitamin

C is given to the children, especially during the fall season to prepare them for the winter season.

Finally after being asked whether they feel healthier in Switzerland or in Turkey Y.G. stated: “In

Geneva I feel healthier, there are less GMO’s, the weather is cleaner, there is law here and is

being implemented, in Turkey they pump hormones to so many foods and get away with it”.

SUMMARY: Similar to the K. family, this family also claims to have become more aware of

healthier living conditions in Switzerland. They try to maintain a Turkish diet as much as

possible by visiting bazaars and shopping for food products they were eating in Turkey but with

the influence of their environment and limitations in accessibility to some products previously

consumed, they have introduced some changes to their diet. They made some substitutions for

products they liked to consume but cannot easily find where they shop (e.g. Turkish coffee

replaced with Espresso). Their activity levels have increased compared to when in Turkey. Kids

became significantly more active while the adults acquired bicycles to use only occasionally and

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they all started skiing. Overall, they are very pleased with the changes they introduced to their

lives and are not particularly missing anything. They are appreciating better quality products

they believe they find in Switzerland in terms of containing less additives and being more

organic.

Families in the U.S.A.

E. Family, interviewed on 11/20/2015

1) Who makes up the household: The E. family consists of four members. S.E. is the

mother who is 48 years old and is married to H.E., the 58 year old father of the household. The

couple have been married for 25 years. S.E., a graduate from Ege University in Izmir is a

pharmacist and H.E. is a mechanical engineer from the Middle East Technical University from

Ankara. H.E. also has a PhD in the subject of mechanical engineering from Carnegie Mellon

University. The couple moved to the United Sates in 1990 so H.E. could attend university in PA.

Two years later the family moved to Cincinnati in 1992 where H.E. got a job in a global

company. The couple also have two children, M.E. and O.E. who are 23 and 20 years old

respectively and are both attending the Ohio State University in Columbus. M.E. is a senior

whereas O.E. is a sophomore. Due to the M.E. and O.E. attending college, the house is occupied

solely by the parents throughout most of the year, while the children visit during holidays.

2) Daily life of the family: Since S.E. is a pharmacist, her daily schedule changes from

week to week depending on what shift she has been assigned to (sometimes during the night as

well). Sometimes she is working in the morning and sometimes in the afternoons, her schedule is

irregular. Occasionally she also works during the weekends and has certain weekdays off as well.

H.E. has a regular schedule where he wakes up at 7 a.m. to be at work on time and finishes up in

the office at 5 p.m. H.E. has regular lunch breaks at his work place whereas S.E. does not. In the

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mornings they usually have breakfast right after they wake up but during their days off they have

a late brunch. The family also has dinner at around 7 p.m. both on work days and off days. The

children’s schedule are different from semester to semester due to classes.

3) Shopping habits of S.E.: The main grocery store that S.E. uses is Kroger. It gives her a

wide variety and is close to her house. Every time she visits Kroger she always wants to make

sure she has her basic needs. These consist of milk, eggs, yogurt, fruits (bananas, oranges and

apples), certain vegetables (most notably lettuce, tomatoes and cucumber), juice and water. She

travels by car and makes trips at least once a week and twice a week at most. Occasionally she

also visits a store called Jungle Jim’s once every two months which has a wide stock of more

ethnic food products from different countries. During our visit to Kroger I was able to observe

some of the products she bought. These consisted of bananas, cranberries (for making compote),

whole grain bread, ground sirloin, Special K original cereal, Ritz crackers (with a hint of salt,

low sodium), Italian green beans, cage free eggs (vegetarian fed hens, she mentioned that some

hens are fed fish which she finds absurd), Danone nonfat Greek yogurt, 2% milk (tastes better

than skim milk). At this point she made a note that the family is not “totally diet crazy (meaning

that they don’t buy everything fat free)”. She also purchased orange juice (with pulp, noting that

she likes the mouthfeel of pulp), frozen fruit mixture (blueberries and strawberries), sausage beef

franks, string cheese (2% milk and 50% less fat). She also noted that they don’t buy soft drinks

such as Coca cola or Sprite but they drink these when they go out. She continued to shop by

purchasing some canned artichokes (precooked), canned sweet peas and carrots, Perrier soda

(with 0g sodium), Snapple strawberry kiwi (stating that “always drinking water becomes

boring”). Other products she purchased included V8 low sodium juice, small water bottles (24

pack, she also drinks tap water with a purifier at home but these bottles are easier to carry

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around). She also bought bananas and talked a little about potassium “potassium is good for the

heart and potassium levels increase as goods are less processed”.

4) Cooking habits: A major change in the way S.E. prepares food was made obvious that

she spends less time in the kitchen preparing food from scratch and relies on convenience more

with ready to eat or food that requires minimal preparation. She still cooks certain food items the

way most Turkish people do but to a lesser extent since she does not have enough time during

the day. For instance she had a large bowl of fresh green beans boiled with tomato paste, onions

and minced meat in her fridge. Convenience still does play an important role in the family’s

daily life cycle however. Olive oil is still used for a variety of dishes especially for salads and

vegetables. Meat is pan fried or baked in the oven.

5) Eating habits of the family: Regarding S.E. and H.E.’s eating habits, both members

have continental style breakfast at home during the week with bread, butter, olives, some fruit

and cheese/yogurt or just cereal. S.E. also mentioned that sometimes she would be eating some

saltine crackers with a glass of milk for breakfast or not having breakfast and getting a breakfast

biscuit to go from McDonalds every once a week. When asked about why the breakfast was so

simple she said that “theoretically I would like to have eggs and a rich type of Turkish breakfast

with many different dishes but I just shy away from it because of the effort of preparation”. They

don’t consume meat for breakfast. For lunch, both members pack lunch at home and because

S.E. does not get an official lunch break she snacks throughout the day when she is not busy with

patients. She mentioned that she packs sandwiches with cold cuts or snacks, some yogurt with

fruits like bananas. H.E. also packs his lunch at home and he often takes string cheese, yogurt,

fruit such as apples, bananas and a croissant if any are available at home with him. For dinner

they usually eat a type of protein such as chicken, beef or fish and a salad for instance with bread

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and butter. Other types of dinner foods include boiled vegetable dishes such as lentils, green

bean and peas. During the weekends, H.E. and S.E. have brunch where they have a larger variety

of food available for breakfast such as eggs, spreading (butter and jams), cheese, honey,

tomatoes, bread, bagels, muffins, cucumber, and different types of cheeses, most notably string

cheese, feta and lor cheese (similar to cottage cheese) with tea or coffee. Weekend lunch is not

common but they snack on fruit or nuts. Dinner is similar to what they eat during the week. O.E.

and M.E. have a different schedule at college. It is very rare that they cook. For breakfast they

choose between breakfast cereal bars or actual cereal in most cases. Lunch almost every day is

eaten outside, such options include Jimmy Johns, McDonalds and Chinese food. For dinner,

there is ready to eat or easily prepared meals at home. During the weekends M.E. and O.E.’s

breakfast is richer where they utilize eggs, bacon and have bread with spreading. Lunch and

dinner habits are similar. S.E. cooks two times per week and the couple eats three to four times a

week outside at restaurants for lunch or dinner. Some of the restaurants that the family likes to

visit include Skyline Chili which is a fast food restaurant unique to Cincinnati. They usually eat

Skyline once a week, pizza is also a favorite of the family, Panera bread for soup and salad and

Chinese food pick up is also common. S.E. at this point stated that the family likes fast food but

tries to not eat too much. They find it convenient due to time restrictions. S.E. also made note of

a Turkish restaurant that the family went to the day before the interview took place where they

had lahmacun (very thin Turkish pizza with minced meat and onions), pide (Turkish flat bread

with melted cheese on top) and fresh chicken soup. Regarding portion sizes S.E. mentioned that

the sizes of meals are very big in America compared to Turkey and she is not able to finish most

dishes that she orders but she always brings home the leftovers. The favorite dishes of the family

consist of chicken, hamburgers, hot dogs, chicken parmesan, spaghetti and rice. Meatballs, lentil

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soup and white beans are their traditional favorites. Also S.E. mentioned that in 1990 when she

first came to America she started to eat donuts where she liked them to the extent that she would

be eating two a day, which later led to a weight gain of ten pounds and ultimately canceling

donuts out of her diet. Meat consumption overall for the family has increased since their move to

the States. Meat is eaten at least two times a week. If the family were to have guests over for a

meal, they would attempt to prepare a simple Turkish meal. For breakfast, they would try to have

the basics such as eggs, cheese (feta, lor), cucumbers, tomatoes, bread, butter, jam and tea. For

lunch or dinner they would try to make something like beef or meatballs with salad and green

beans on the side. Borek with feta and spinach would also be an option. She would also attempt

to make baklava as a dessert (she learned how to make baklava from phyllo dough and syrup

because she struggles with finding it).

6) Food Storing Habits: S.E. keeps all of her food supply in her kitchen. She has a fridge, a

freezer, and a pantry area. In her fridge she had left over green beans in a large bowl, orange

juice, apple juice and vegetables such as tomatoes, carrots, lettuce, parsley, bell peppers, potatoes

and eggplants. There were green and black olives, goat cheese, lor cheese, feta, barbeque sauce,

ketchup, mayonnaise, phyllo pastry, peanuts, walnuts and vinegar for salad. Her freezer included

an organic berry mix (blueberry, strawberry and pomegranate), broccoli, corn and pita bread. In

her dry pantry she keep products like dry beans, red lentils, cracked wheat, pancake mix, Lipton

tea (in tea bags), Turkish coffee, instant coffee, peanut butter, dried figs, mint (for soups) and

Turkish tea (not in tea bags). She also has a spice rack with cinnamon, ginger, dill, seasoned salt,

red pepper flakes (brought from Turkey), oregano, basil and garlic powder. Besides these areas

there is a fruit platter in the middle of the kitchen with bananas, a mango, kiwis and oranges. She

also has a wine rack with mostly red wine.

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7) Special days: The family celebrates few of the American holidays. Most notably

Thanksgiving, Christmas/New Year’s and the 4th of July. For Thanksgiving, they make the

regular traditional turkey with all the American sides such as stuffing, yams, cranberry sauce,

gravy and pumpkin pie. This is one of S.E.’s favorite holidays. For Christmas and New Year’s

they would either go out to a restaurant or have turkey at home with a rice side. They would not

do the traditional ham. July 4th is a time where they normally do a barbeque and make hot dogs,

hamburgers and corn on the cob. The family members are Muslim but they do not fast. For

Ramadan and the Holiday of Sacrifice they won’t do anything extraordinary, they usually go out

to an American or Turkish restaurant.

8) Health and Well-Being: For sports and physical activity, M.E. is the most active

member of the family. M.E. has been doing fitness since he started college on a regular basis

where he goes to the gym four to five days a week for hour long sessions. O.E. and H.E. do not

do a particular sport. S.E. walks for physical activity two to three times a week. She has a Fitbit

bracelet that counts steps taken within a day. Her goal is to reach 7000 steps during the days she

goes out for a walk. S.E. also has a sports bike in her basement which she uses twice a week for

15-20 minute sessions. When asked about their past, S.E. revealed that she used to play

volleyball during college but she stopped afterwards. For extracurricular activities M.E. and O.E.

both are capable of playing instruments, trumpet and trombone respectively and they were part

of their school band during middle school, high school and college. Regarding medical problems,

S.E. had foot surgery in 2005 due to an injury which left her disabled for 6-8 weeks but she made

a full recovery. Other than that there are no major accidents that the family was not able to

recover from. Both S.E. and H.E. have hypertension which is why they have to be careful with

their sodium intake. They check labels before buying food products. Both members were also

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smokers but they quit 25 years ago because they knew it was unhealthy for them. S.E. also has

acid reflex, sometimes when she eats vegetables it upsets her stomach and she finds that meat

makes her feel better. No vitamin supplements are used. To S.E. for someone to be healthy and

well “you need to be mentally and physically well I believe, so if you are in a good condition

mentally, you can be healthy physically, have a balance in life with needs and food”. She also

stated “sometimes you need to eat to be happy”; she said that when she first moved to the States

for the first time she felt homesick for two weeks which is why she started to indulge on donuts.

When asked about any changes that come to mind regarding their life in Turkey and America she

said “a long time ago we didn’t have access to McDonalds breakfast, hamburgers got into our

lives too much as well”. This is one of the reasons the eating habits of the family got simpler,

relying on convenience has become a major factor. The family does less exercise, relies on cars

more and have to arrange walking times. When asked about what she does to learn about health

and well-being she noted that she has to attend mandatory training sessions and fulfill 60 hours

of training every three years to legally practice pharmacy where she learns about food addiction

and other diseases. She developed an interest in the field when her mom was diagnosed with

diabetes when she was very young.

SUMMARY: When looking at the dietary patterns of the E. family, there are many differences

when compared to the families living in Europe and Turkey. The E. family has changed their

dietary habits in a way to favor convenience on top of traditional methods of cooking at home.

Even though some Turkish dietary elements have been conserved, eating outside and increasing

consumption of fast food and canned food is apparent. Another important factor to note is that

the E. family has more knowledge regarding nutrition facts where S.E. picks ingredient at the

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grocery stores always after looking at their labels. The children have both been participating in

music and sports but overall activity levels have decreased since cars are relied on heavily as a

main transportation method. American traditions and holidays have also been embraced.

A. Family, interviewed on 11/23/2015

1) Who makes up the household: Four members make up the A. family. A.A., born in

Ordu, Turkey and aged 49, is the mother of the household and is married to L.A., from Adana

Turkey of age 53. They have two children D.A. 23 and M.A., 21. A.A. and L.A. met in Istanbul

when they both moved to the city to attend college. A.A. attended Istanbul University whereas

L.A. went to Yildiz Technical University. They moved to Cincinnati, Ohio in 1992 because

A.A.’s brother was also living in Cincinnati and L.A. wanted to pursue further education at

Xavier University. A.A. currently works at a local hotel as the manager of housekeeping and

L.A. is a car salesman. It is noteworthy that A.A. started to work about 10 years after they moved

to the United States. For many years, she stayed as a housewife to look after the children. D.A.

graduated from Denison University two years ago and is currently working for a digital

advertising company in Columbus, Ohio. M.A. is currently attending Boston University as a

senior.

2) Daily life of the family: A.A. works the morning and afternoon shifts during the week,

therefore she has to wake up at 5 a.m. She leaves her house at 5:30 a.m. so she can arrive at work

at 6 a.m. She usually packs breakfast with her and has her meal at work before she starts. She

eats lunch at the hotel and finishes work around 2:30 p.m. She has lunch in the evenings around

6 p.m. L.A. works from 10 a.m. to midnight. He has breakfast at home but lunch and dinner

while at work. During the weekends the members wake up late at around 10 a.m. They have

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brunch instead of breakfast and have dinner in the evening. M.A.’s schedule changes every

semester because of college classes. D.A. lives with roommates from his college in Columbus.

Both members occasionally cook simple food at home or go out with friends.

3) Shopping habits of A.A.: A.A. has two main preferences for grocery stores. A grocery

store called Fresh Market where she buys products such as meat, fish and bread and a smaller

grocery store called Pipkins where she has more access to organic fruits and vegetables. A.A.

stated that Fresh Market is very pricey when vegetables and fruit are concerned which is why she

goes to two different stores to buy all of her food needs. She also mentioned an international

market called Jungle Jim’s but it is located further away from her house which is why she only

goes there once a month for some Turkish products like feta cheese, olives, phyllo pastry, sucuk,

pastirma (cured spiced beef), tomato paste and pepper paste. During our visit to Pipkins she

purchased tomatoes, organic grapes, parsley, garlic cloves, small cucumbers (she doesn’t like the

larger ones due to too many seeds), whole carrots, strawberry preserves (reminds her of Turkish

jam). There were also a few items she didn’t buy because she had some at home but normally

she would also buy green lettuce, bulgur wheat (to make kisir which is a type of salad with

lemon juice, parsley and tomato paste), whole grain corn flour (to make corn bread), lentils for

soup, lima beans, eggplants, walnuts, certain fruit items to eat for breakfast like strawberries,

blueberries and raspberries. From the Fresh Market trip, observations were made while she

purchased products such as dried mint, green beans, mushrooms, zucchini, ground beef, jasmine

rice, spaghetti squash, rack of lamb, French batard bread, ground sirloin, Chobani yogurt and

frozen artichokes.

4) Cooking habits: Even though A.A. has been living in the U.S.A. for a very long time she

does a good job at keeping up with traditional cooking habits. She uses olive oil almost every

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time she cooks at home, especially when cooking meats and vegetables. For green beans and

mushrooms, she likes to boil them in water and mix them with tomato paste, onions, minced

meat and cook with olive oil. The family does not eat ham of any kind but rather cooks other

types of protein such as fish, lamb or beef. Rice is made at home with olive oil and butter rather

than just using butter like most Turkish families. She has also adapted to making more Italian

dishes at home as well, such as pasta because her children like Italian food. She makes her own

meatballs from ground beef which she mixes with mint and onions. For cooking meat, she likes

to pan fry most meat while also using her oven sometimes. When it comes to eggs she either

boils them or scrambles them. A.A. also prepares tea and coffee in the regular Turkish way

without a coffee machine or tea bags, she brews her hot drinks.

5) Eating habits of the family: During the week A.A. and L.A. have breakfast at different

times. A.A. packs her breakfast to take to work in most cases where she eats olives and feta

cheese with some bread. L.A. eats at home and has a bigger breakfast where he makes eggs

menemen style (scrambled eggs with tomatoes, onions and green pepper). For lunch she eats at

the hotel. She consumes something simple such as a salad or a vegetable dish if available. For

dinner A.A. has a bigger meal, where she has a soup (such as lentil soup or vermicelli noodles

with chicken stock) or a salad consisting of lettuce, tomatoes, onions, olive oil and lemon juice.

Main entrée is meat with vegetables, for example karniyarik (eggplant with seasoned minced

meat filling), imam bayildi (eggplant cooked with olive oil with onions, garlic and tomatoes)

with rice. L.A. usually gets a sandwich or Chinese food as take away from a store near his work

place. During the weekends the couple have brunch where they sit together and have tomatoes,

feta cheese, olives, honey, strawberry jelly, green peppers, cucumbers and scrambled egg or

mihlama (feta cheese melted into scrambled eggs). Dinner is similar to what is made during the

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week with lunch not being an actual meal by itself during the weekends. When having guests

over, A.A. tries to prepare a little bit of everything. For breakfast she gave the examples of

making pancakes, boiling/scrambling eggs, hot dogs, crepes, olives, strawberry/grape jellies,

butter, pogaca (palm sized buns with feta and parsley filling),maybe make some borek with

minced meat. If guests were to arrive for lunch she said they wouldn’t eat that heavy, just soup or

salad maybe some borek. A vegetable dish with rice might also be utilized. Dinner however,

would be heavier with a soup starter and either green beans/white beans/cauliflower served with

fried eggplant and fried peppers with tomato sauce. Borek may also be used again as well. Other

options would be to make meatballs and rice if she wants to keep it simple. The family doesn’t

eat out very often because they already eat outside during work many times which is why A.A.

prefers to cook at home. When they do go out however, the family prefers Indian or Chinese

restaurants. These cuisines offer the family a rich variety of vegetable choices. A.A. also

mentioned that they like the exotic spices used in the Indian restaurants and going to Chinese

also gives them wide access to seafood. For A.A. and L.A., their favorite dishes consist of

karniyarik and manti. She only makes manti for very important days though because it takes a lot

of effort to make. She does it in a traditional style by making dough from scratch, enclosing the

dough with minced meat and also preparing homemade tomato sauce and liquid yogurt to go on

top. D.A. and M.A. are a little different. M.A. likes what her parents favor in terms of food such

as karniyarik, imam bayildi etc. but D.A. prefers dishes like meatballs and rice. D.A. enjoys

Turkish food but eats more American food while living by himself.

6) Food Storing Habits: A.A. keeps all of her food products in her kitchen. She has a very

large dry pantry area and one fridge with a freezer. In her refrigerator, products such as Chobani

Greek yogurt, two types of feta cheese (French feta and a Turkish brand of Feta), tomatoes,

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pepper paste, green peppers, bell peppers, banana peppers, lettuce, scallions, cauliflower, green

olives, white beans, phyllo dough, eggs, cooked spaghetti, Penna pasta (packaged, ready to

cook), risotto (packaged), milk and Hershey’s chocolate sauce were observed. In her freezer food

items consisted of meat on the bone (Halal meat from the international store), ground beef (for

making meatballs), dolma, spinach, Turkey (to prepare for thanksgiving). Her dry pantry had a

wide variety of products consisting of green lentils, white beans, dried peppers, Jimmy Johns

chips, hummus (canned), peaches (canned), green beans (canned), spaghetti Bolognese sauce,

olive oil, canola oil, Ahmad tea (an English brand of tea which she uses to brew). She had some

fruit on a platter at the center table of her kitchen which contained lemons, tomatoes, oranges and

mandarins. She also has a stock of soft drinks which consist of Coca Cola and Sprite. Next to the

soft drinks there were also some breakfast products such as Cinnamon Toast Crunch cereal,

honey granola cereal (which they don’t consume in the morning but they eat as a snack or

dessert) and pancake mix. Other products present consisted of Chips Ahoy cookies, jasmine rice

potatoes, black olives, V8 vegetable juice, pineapples, sugar, onions and Turkish coffee (which

she makes using a cezve (a type of pot specifically designed to make Turkish coffee). She also

had a spice rack that contained cumin, oregano and mint.

7) Special days: The family celebrates Thanksgiving as their only American holiday.

Turkey is the main course baked in the oven. However, the side dishes during Thanksgiving

consist of Turkish side dishes rather than the traditional American sides. For sides, A.A. would

prepare green beans, dolma, hummus, borek and rice with butter. During Ramadan, the family

does not fast, however, they do make and eat baklava. A.A. knows how to make baklava and she

makes her own if she has time, if not she buys some from a local Turkish restaurant. For the

Holiday of Sacrifice, A.A. likes to make kavurma (braised lamb cubes, browned in fat). A.A.

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also stated that she follows other important days in Turkey on TV such as the 29th of October

which is the Republic Day or the 23rd of April which is the National Sovereignty and Children’s

Day in Turkey but does not cook or do anything special.

8) Health and Well-Being: The adults of the family are not involved in any types of sports.

The children, on the contrary are very active. D.A. does cross country and practices yoga

whereas M.A. does kickboxing and yoga. Both children were also involved in taekwondo since

the age of five but they stopped after they went to college. M.A. goes to kickboxing three times a

week for one hour sessions and does yoga three times a week for 45 minute sessions. D.A. does

yoga in a similar manner but he practices cross country on his leisure, he tries to run at least three

times a week between 30 and 60 minutes. The family has had no major injuries/illnesses in the

past with the exception of a kidney stone surgery that L.A. underwent. In terms of body health,

the adults have some issues. A.A. is overweight and has excess lipids, her doctor told her she

should lose some weight. She claimed that her continuously gained weight year on year over the

past 10-12 years. She is trying to reduce the amount of carbohydrates she is consuming but it is

hard for her to make significant habit changes at this stage. L.A. is also overweight and has more

issues with his health. L.A. is pre-disposed to insulin resistance, so he has to be careful with

glucose consumption. He also has high cholesterol. For this reason he is trying to be careful with

his meat intake. To A.A. health and well-being means to take care of yourself, “it is a matter of

fact of how you live your lifestyle, how you eat, how much you sleep, what you enjoy”. Sports,

she does not find to be very crucial in lifestyle as much as eating healthy, stating “eat healthy, be

happy”. For supplementation she takes vitamin D, especially over the winter when there is less

sun but other members of the family don’t. When asked about what resources she would use to

learn about health and related issues she mentioned the internet would be their primary source

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and a doctor’s opinion would be their secondary. A.A. is also the only member of the family that

smokes. She smokes one to two cigarettes a day and does so secretly from her children. She had

quit smoking after marriage but when her daughter M.E. left the house to go to college she

picked up this habit again. When asked about any changes that occurred in her life style when

she moved to the States, she mentioned that “a big change was my social life, I had difficulties,

finding friends takes a lot of time. Also in Turkey, you can’t dream of a car back in our day, here

we were able to get a car, we go wherever we want”. She also made a note that she does not miss

Turkish food a lot, because she can make most of the dishes she likes, however she still misses

her mom’s food.

SUMMARY: The A. family remains more loyal to the traditional Turkish diet when compared

to the E. family. Even though the amount of time spent in the U.S. is similar with both families,

A.A. still tries and cooks meals from scratch in a similar manner as they do in Turkey. The fact

that she didn’t work for many years seems to have contributed to conservation of Turkish habits.

She had more time hence didn’t adopt convenience seeking behavior. They also consume more

meat and foods high in Omega-6 fatty acids. This results in a calorie rich diet, which is also the

cause of the health problems of the adults. Certain American cultural habits have also been

embraced, consumption of more ethnic foods such as Indian, Chinese and American food items

has increased. In terms of physical activity, D.A. and M.A. are heavily involved in sports while

the adults are lacking in this area. Overall, the combination of Turkish and American dietary

habits is not helping their health and well-being.

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Discussion and Conclusions

Immigration is a very significant change in people’s lives impacting not only their dietary

habits and physical activity patterns but also their overall lifestyle and emotional states as they

try to deal with complexities of adjusting to a new environment, culture, rules and regulations.

Among the changes they have to manage, ensuring continuity of their nutritional needs and

dietary requirements, particularly those of their children, is a priority. In establishing these, they

go through three stages of adaptation.

The first stage is the “comparison stage” and occurs during the initial exposure of the

immigrants to their new country of residence. During this stage, the families go through a major

learning experience in all aspects of their lives, hence for cooking and preparing meals, they

wish to continue with their routine. They look for familiar ingredients and products they used to

eat and cook with. If they can’t find the same products or the same tastes they try similar

products and compare ingredients if taste is not fully satisfying to them. They may get frustrated

if what they prepare isn’t looking or tasting the same. They may limit their menus to a few dishes

that are easier to prepare.

The second stage is the “discovery stage” which takes place after the initial exposure of

the families to their new environments. During this stage, the families further learn about their

new environments through recommendations from new friends on matters such as new stores

selling their type of ethnic food, markets where certain vegetables may be found or products that

may be best substitutes to what they are looking for. These discoveries help them feel more

comfortable and help diversify their menus. This is also the stage when they start thinking about

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physical activities and make discoveries about sports facilities and other activity options

available.

The third and final stage is the “adoption stage” and this is when the families have

finally adapted to their new environment. During this stage immigrants are fully aware of the

new type of culture being offered to them by their new environment and understand clearly the

products and lifestyle changes that are offered to them. At this stage the immigrants change

certain ways about their lifestyle in order to make new routines while retaining certain elements

of their old lifestyle the same, since the new environment may not force a change regarding all

aspects of their lifestyle.

A common theme the families followed in Switzerland and the United States was,

substituting when possible or consuming less of the products in the new countries which did not

taste the same as in Turkey or those which were not easily available. Similarly, in the study by

Renzaho et al., sub-Saharan Africans who immigrated to Australia used coping mechanisms of

substituting regular ingredients from their diet with other ingredients more readily available to

them in Australia (i.e. camel meat substituted with lamb meat). Other food items like cocoyam,

millet flour and passion fruit that were available in Australia were not consumed due to taste

differences to those that were available in Africa (Renzaho et al., 2006). This is a similar theme

throughout the current study where some products like yogurt or artichokes were consumed less

due to taste differences experienced in Switzerland.

The research by Ataca and Berry was indicating that adaptation is multi-faceted and we

need to consider psychological, marital, sociocultural, socioeconomic status and gender of

immigrants to understand how and to what extent they may adapt to a new society. Their

research suggested that immigrants with higher socioeconomic status prefer integration and

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assimilation to a greater extent than those with lower socioeconomic status (Ataca et al., 2002).

The finding among immigrants with high socioeconomic status is parallel to those found in the

current study. The immigrants studied in this study were already married when they immigrated,

belonged to relatively high socioeconomic status and immigrated willingly for higher education

or to take on higher level managerial jobs through transferring within their companies. They

faced no language barriers which is why they could understand and communicate well in their

new environments. They showed the capability to adopt new social skills fairly easily while

having no economic limitations. Hence the participants in the current study were found to be

well adjusted to the new cultures and they made educated, informed choices for their nutrition

needs, health and well-being. They were able to find substitutes or develop compensating

behavior for what they missed or couldn’t find in their new environments.

Last but not least, the international review by Berry had suggested that the adaptation

process is not at all easy, however if immigration originated through voluntary means, the

outcome would be more positive (Berry, 1997). In the current study, the three stages of

adaptation described above is similar to the challenges mentioned by Berry, and the voluntary

nature of immigration of the respondents led to a positive acculturation, again in line with

Berry’s findings.

Consequently the consumption of key products and the dietary habits of Turkish families

changed without major disruption upon immigration to Switzerland and to the United States.

Table 2, provides a comparative summary.

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Table 2: Consumption of food products in Turkey and how it changes among immigrant

families

Switzerland Turkey United States

1 Less Cereal, grains More

2 More Vegetables, fruits Less

3 Same Animal products (meat, poultry) More

4 Less Fishery Less

5 More Dairy More

6 More Alcoholic beverages Same

7 Less Processed food More

Conclusions below explain these changes in more detail:

1. Among Turkish families, processed products from cereals and grains in the form of

bread, pasta and borek was consumed in all meals. Given that particularly bread is such a critical

product, it was purchased fresh almost every day and even delivered to homes through markets

and/or doorkeepers of apartments. It has been observed that, in Switzerland, families lost the

habit of eating bread with every meal. One key reason was cited as lack of convenience in

getting fresh bread every day and second due to concerns around weight gain causing families to

reduce intake of carbohydrates. On the other hand families in the United States, increased their

consumption of this food category with the addition of fast food in the form of sandwiches and

pizzas as well as the increased consumption of breakfast cereals for convenience reasons.

2. Among Turkish families, vegetables, were the basis for many meze dishes and eating

casserole dishes with vegetables and meat as the main course was very common, at least once a

day. Consumption of fruits was also high but usually after being processed into jam, dessert or

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being dried. In Switzerland, consumption of vegetables and fruits increased among immigrant

families as they reduced consumption of carbohydrates. They also appeared to have developed

an awareness to eat more vegetables and fruits encouraged as a result of the high presence of

organic products. In the United States, cooking vegetables was associated with longer

preparation and cooking times which suggested some inconvenience. Vegetables were common

as side dishes along with salads, however the most consumed vegetable as a side dish was

potatoes rather than green vegetables.

In the study concerning immigration to Switzerland by Volken et al., immigrant workers

from Turkey had low rates of fruit and vegetable consumption however these levels appeared to

be increasing as education levels of respondents increased (Volken et al., 2012). When

comparing these past results to the current study, similarities are observed regarding the

increased consumption of vegetables and fruits in Switzerland among the highly educated

immigrants.

3. Consumption of meat and poultry products among families in Turkey was high. This is

due to the popular Turkish dishes such as meatballs and kebabs. It was common to find “meat

restaurants” as popular places for people to socialize and dine out. In Switzerland, consumption

of animal products stayed at a relatively similar level to the consumption in Turkey. Even though

animal meat products were sold at higher prices in Switzerland, the families still bought the

regular amounts as they did in Turkey since meat was considered as an irreplaceable source of

rich protein, beneficial for the development of children. In the United States though, there was an

overall increase in meat consumption. This can be explained by lower prices for meat products in

the United States and also the heavy presence of meat that revolves around fast food and eating

out.

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4. Fish consumption among Turkish families was very common and at high levels due to the

country being surrounded by three different seas. Also the surrounding seas gave the Turkish

families a wide variety of fish products that are not very common in other countries. Fresh fish is

also sold at fish markets which are widespread in residential areas next to supermarkets in

Turkey. In Switzerland, fish consumption among Turkish families decreased. Even though fish

was still consumed by these families, it was bought less due to inaccessibility to specific fish

types but also due to fish being more commonly sold in grocery stores in packages, i.e. not fresh.

The Turkish families also considered freshwater fish that is more commonly found in

Switzerland to be less tasty compared to the saltwater fish in Turkey. This was similar in the

United States where packaged fish was more common and fish markets were not widely

available.

5. Turkey is a country where dairy consumption is very low. Dairy products commonly

consumed by the families living in Turkey were cheese and yogurt. In Switzerland, while dairy

consumption among the immigrant families seemed to rise due to a wider variety of and

accessibility to cheese, milk was also more commonly used in homes because there was an

increase in cereal and muesli consumption. However, yogurt consumption appeared to decrease

due to inaccessibility to yogurt with the same texture as in Turkey. In the United States dairy

consumption also increased due to a very high consumption of cereal. Another reason is that in

the United States, milk is sold in jugs that come in larger sizes than the package sizes available in

Europe. Buying larger containers of milk correlated to larger consumption of milk within the

household versus buying smaller containers of milk.

6. Among the Turkish families alcohol consumption was at a moderate level, taking place

mostly during special occasions and social events (e.g. Raki is a traditional drink consumed

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commonly with mezes, fish and meat in restaurants as well as at home). In Switzerland, alcohol

consumption seemed to rise due to the wine culture being very popular in Switzerland and also in

the neighboring country, France. The immigrant families in this country held a wide selection of

wines in their homes. In the United States, wine and beer were also consumed but they were at a

similar level as to what families had been consuming in Turkey. In the United States, the

consumption of soft drinks increased rather than that of alcoholic beverages. Specifically

consumption of soda drinks and fruit juices sold in bottles were widely available at homes.

7. Even though in Turkey most food items were sought to be bought as fresh from the

market or grocery stores, processed food consumption was common in the form of processed

grains and snacks such as cookies. Families who moved to Switzerland developed a higher sense

of awareness and knowledge regarding the adverse effects and potential harms of processed

foods. This knowledge came from a limited array of available processed food products in

markets as well as emphasis made on the matter in schools and workplaces. Along with greater

access to BIO (organic) foods in the grocery stores, the families shifted their dietary habits to

favor more unprocessed foods. In the United States, processed food consumption had increased

due to convenience culture strongly affecting dietary habits. Market shelves are stocked with

processed, packaged, frozen food items which also normalize their consumption in consumers’

minds. In the study by Kleiser et al., Turkish immigrant children below the age of 17 had started

to consume more of the less preferable aspects of Western food culture after their move to

Germany. Their new diet consisted of a higher consumption of soft drinks, fast food and sweets

when compared to their diets in Turkey. This is also relevant to the current study where the

families that had immigrated to America indulged in different types of processed foods.

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This suggests that an increase in consumption of food and beverage products based on

popularity and availability in the new location of immigrants parallels the observation by

Margareta Wandel et al., where her team observed an increase in consumption of popular

Norwegian food products and meals after families relocated from Pakistan and Sri Lanka to

Norway (Wandel et al., 2008).

Immigration also impacts physical activity patterns. This is summarized in Table 3 below

based on the responses of participants interviewed in all of the three countries:

Table 3: Physical activity levels in Turkey and how they change among immigrant families

Switzerland Turkey USA

Adults Moderate activity Sedentary or light activity Sedentary

Children Vigorous activity Moderate activity Vigorous activity

After analysis of the data collected, it is clear that immigration leads to significant

changes in the physical activity patterns of the people. They compare themselves to the rest of

the population in their new environment and start imitating their lifestyles.

The adults in Turkey were classified as sedentary to performing light activities (e.g.

walking, casual swimming in summer), while children were moderately active through school

teams if they participated in one. Activity was claimed to be higher among younger children and

intensity of participation in sports decreased as they reached later teenage years due to the

necessity of attending weekend education courses to prepare for high school and university

entrance exams. Among adults, most socialization opportunities surrounded eating occasions

compared to outdoor sports activities.

Families who moved to Switzerland observed that their new environment had very

convenient public transportation and availability of bike lanes that are heavily used by the local

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people. So they bought bikes, bus passes and started using these transportation means. (It is

interesting that the use of public transportation in Turkey is associated with low income while in

Switzerland, all social and demographic groups use public transportation). Other activities adults

started in Switzerland were hiking and skiing. All children got involved in winter sports as well

as in sports related teams via their schools or municipality clubs. Another observation made by

immigrants in Switzerland was that, elderly people were all quite healthy, active and at good

ideal weight. They became an inspiration for immigrant families who became intrigued about

how they managed to age in a healthy way. These observations and search for knowledge also

encouraged higher physical activity among adults.

Those who moved to the United States increased their utilization of cars. Some shopping

trips which may be done by foot in Turkey, became impossible in the United States as

supermarkets were far from residential housing and shopping was done more in bulk due to this

distance as well as due to the size of supermarkets, variety of offered products and the sizes of

pantries at homes. An interesting observation made by the researcher was on the size of shopping

carts in supermarkets. The carts were larger in the United States than those that can be found in

Turkey and in Switzerland. Increased driving and time spent in cars, led to a decrease in their

activity levels. While most of the adults seemed to be sedentary, which was also caused by not

having sidewalks in suburban Ohio on the level compared to that in Istanbul, the children were

quite active with sports. In the United States sports are highly encouraged by the schools and

when children start to participate in sports at an early age through schools, they develop the habit

of being active. Residential homes with gardens compared to apartment living in Turkey may

had also helped children to be more active. However, it is estimated that the lack of highly active

grown-up role models and the necessity to drive cars may be causing the United States residents

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to have decreased their activity levels in the later stages of their lives. Immigrant families also

found the United States festive events around Christmas, Easter, Thanksgiving, Halloween, 4th of

July, to be quite entertaining to participate in. Hence they participated in all the feasting that

came with them.

In summary, families developed a hybrid eating pattern by mixing elements of their

routines in Turkey and those that they found and favored in their new locations. Families

relocating to Switzerland were estimated to lower their calorie intakes slightly, replacing foods

high in carbohydrates with relatively lower ones while they increased their physical activity

levels. Families relocating to the United States tended to increase their calorie intakes as they

continued consuming foods high in carbohydrates and they introduced more fast food, processed

food choices as well as potentially increasing portion sizes when eating out. The adults’ activity

levels decreased while that of children increased.

Limitations

In terms of limitations, the study was conducted using a convenience sampling method

using a small number of families. This resulted in a limited representation of the population,

therefore the results observed are limited to a specific social class and few families which cannot

be generalized to the entire population. This study also did not take into account regional

differences among participants. There are different dietary habits based on different regions in

Turkey and since not all participants share the same city of origin, cultural habits may have

inconsistently changed across all participants. Other limitations include the length of time spent

in observing and studying the families. Due to limited time to complete the project and limited

time the respondents could be available for this project, a longitudinal analysis could not be

conducted. The participants’ responses are self-reported; the reality of their experiences can only

84

be speculated and could perhaps provide a rationale for a more detailed study in the future. A

richer data could have been generated had it been possible to live with the respondents over

extended periods of time to experience the full spectrum of habit changes and behaviors

portrayed around different events. Last but not the least, the researcher himself is a Turkish

citizen who has been an immigrant in both Switzerland and the United States, hence may have

had some biases based on personal experiences.

85

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Appendices

Terminology used for foreign food/beverage items, tools and cooking methods:

1) Artisanal: Made by artists.

2) Ayran: Diluted, salted yogurt drink.

3) Baklava: Flaky pastry with layers that often have pistachios or walnuts, covered in sugary

syrup.

4) Birchermuesli: A Swiss breakfast dish that contains oat flakes, served with fruits, nuts

and milk.

5) Bradwurst: Sausage made from veal or pork.

6) Borek: Flaky pastry filled with thin layers of food such as cheese or cooked ground beef.

7) Cacik: Cold liquid like yogurt dish made with cucumbers, salt and garlic.

8) Cezve: Coffee pot used to make Turkish coffee.

9) Dolma: Grape leaves stuffed with rice.

10) Doner: Meat skewed on a spit, grilled against vertical charcoal fire.

11) Emmental: Swiss cheese.

12) Filet de perche: A Geneva dish, made with lake perch that has been breaded and oven

baked with a white wine sauce added on top.

13) Fondue: A sauce like Swiss dish made with melted cheese and seasoned with dry white

wine and flavored with kirsch. Served as a hot dip for bread. Can also be used as a dessert

dish with melted chocolate and pieces of fruits replacing cheese and bread respectively.

14) Fribourg: A semi-soft Swiss cheese made with raw cow’s milk.

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15) Gruyere: A hard yellow cheese, named after the town of Gruyeres in Switzerland.

16) Haydari: Thick strained yogurt with herbs.

17) Helva: A dessert made with clarified butter, sugar and semolina flour.

18) Icli kofte: Fist sized bulgur balls filled with minced meat.

19) Imam bayildi: Eggplant cooked in olive oil with onions, garlic and tomatoes.

20) Kadayif: Shredded pastry with pistachio filing in thick syrup.

21) Karniyarik: Whole eggplants fried and stuffed with seasoned minced meat in the middle.

22) Kasar: A pale yellow cheese made from sheep milk.

23) Kavurma: Braised lamb cubes, browned in fat.

24) Kaymak: Clotted cream.

25) Kazandibi: White pudding with a blackened surface.

26) Kisir: A type of salad made with bulgur wheat, lemon juice, parsley and tomato paste.

27) Kofte: Meatballs.

28) Lahmacun: Very thin Turkish pizza with minced meat and onions.

29) Lor cheese: Cottage cheese.

30) Manti: Turkish ravioli filled with minced meat.

31) Menemen: An egg dish that is scrambled and cooked with tomatoes and green peppers.

32) Mercimek koftesi: Red lentil patties.

33) Meze: A term used for cold starters in Turkey.

34) Mihlama: Feta cheese melted into scrambled eggs.

35) Mozzarella: A southern Italian type of cheese traditionally made from buffalo milk.

36) Nar eksisi: Pomegranate syrup.

37) Pastirma: Cured, spiced beef.

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38) Pekmez: Molasses, a thick syrup of grape juice.

39) Pide: Turkish flat bread with melted cheese on top.

40) Pogaca: Palm sized buns with feta and parsley filling.

41) Raclette: A Swiss dish that consists of melted cheese eaten with potatoes.

42) Raki: An unsweetened, anise flavored alcoholic beverage.

43) Rosti: Potatoes made in a style of a fritter.

44) Simit: A soft pretzel covered with sesame seeds.

45) Sucuk: A spicy sausage flavored with garlic.

46) Sutlac: Rice pudding.

47) Tarhana soup: A soup made from a fermented mixture of grains and yogurt, mixed with

onions, tomatoes, green peppers and water.

48) Tartiflette: Potatoes, cheese, bacon and onions cooked in a saucepan.

49) Tete de moine: A thinly shaven Swiss cheese with a strong smell.

50) Tilsit: A semi-hard, smear-ripened type of Swiss cheese.

51) Topik: A dish made from chickpeas, cumin, tahini and onion currant.

52) Yarma: Coarsely ground wheat.

53) Yayla soup: Rice, yogurt and mint soup.

54) Yufka: Phyllo pastry.

55) Za’atar: A mix of sumac, thyme, hyssop and oregano.

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