General Diet/Summary   •   Nutrition Facts   •   Possible Deficiencies   •   Common Foods   •   Meal Patterns   •  Transition Foods   •  Recipes   •  Resources

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Ethiopia

General Diet/Summary:

In Ethiopia the most common foods in the diet include millet (including a unique variety called teff), sorghum, and plantains. Enset (a plantain-like plant) is a staple in the mountainous regions of Ethiopia. Some animal proteins are available, but a large number of Muslims and people following the Ethiopian Eastern Orthodox religion have introduced dietary restrictions (no pork) and the development of vegetarian fare. Wat is the national dish of Ethiopia. It is a spicy thick stew made with legumes and some kind of meat or fish. A spongy bread called injera is served with most meals and is used in place of utensils to scoop up food. Many of the traditional Ethiopian dishes are very spicy! Foods are often flavored with a hot spice mixture called berbere. Honey* is especially well-liked, and baklava (a drier version of the Greek pastry) is a favorite dessert. Coffee is the number one export and is commonly consumed. Access to safe water can be a problem.

*Do not give honey to children under 1 year of age.

Pica, the practice of eating non-nutritive substances such as clay and chalk, is most often practiced by black women during pregnancy and the postpartum period but can also occur in children. Pica may occur due to a number of reasons that are not clearly defined. In Africa, clay may be eaten to alleviate hunger, to sooth irritation of intestinal parasites, for spiritual purposes, and for medical reasons.

Nutrition Facts:

Overall, the Ethiopian diet can provide many essential nutrients. The traditional Ethiopian diet is:

• High in fiber – Complex carbohydrates are found in fruits, vegetables, nuts, seeds, and grains. These foods contain fiber, which is important for digestive health.

• Low in dairy products – Lactase is the enzyme that breaks down lactose sugar in milk and other dairy products. Lactose intolerance is the inability to digest lactose due to a lactase deficiency. Many African people are lactose intolerant and eat only small amounts of dairy. Teff and the green, leafy vegetables common in the Ethiopian diet are alternative sources of calcium.

• Low fat – Fat is essential to any child’s diet. The Ethiopian diet is low in saturated and trans fats (the less healthy fats) and provides foods rich in the mono- and poly-unsaturated fats (think vegetable oils, nuts, and seeds).

Possible deficiencies

• Calcium – Calcium is needed to build strong bones and teeth. It also plays a role in blood clotting, muscle contraction, and nerve-cell communication. In the long term, dietary intakes well below the recommended levels may impact bone development. Bones increase in size and mass during childhood and adolescence, therefore adequate calcium and vitamin D should be consumed throughout childhood into early adulthood.

• Iodine – Iodine is needed for production of thyroid hormone. Deficiency of iodine can lead to development of an enlarged thyroid called a goiter, hypothyroidism, and mental retardation in children whose mothers were iodine deficient during pregnancy.

• Iron – Iron is necessary for oxygen delivery to cells and regulation of cell growth. Iron deficiency develops gradually and is commonly seen in women of childbearing age and children. A lack of iron results in an insufficient supply of oxygen to cells eventually causing anemia, fatigue, poor work performance, slow cognitive and social development in children, and decreased immunity.

• Vitamin A – Vitamin A plays a critical role in healthy vision, growth and development, and immune function. Vitamin A deficiency is common in developing countries, and is often accompanied by zinc deficiency. Symptoms of deficiency include blindness, diminished ability to fight infections, decreased growth rate, and slow bone development.

• Vitamin D – Vitamin D is needed for calcium absorption and maintenance of calcium levels to enable normal development of bones and prevent muscular spasms caused by low levels of calcium in the blood. A poor diet and lack of exposure to sunlight can result in vitamin D deficiency. A deficiency in childhood can result in development of the disease Rickets in which bones become soft.

• Zinc – Zinc is involved in many important processes in the body. Symptoms of zinc deficiency include delayed growth, loss of appetite, impaired immune function, hair loss, diarrhea, delayed sexual maturation, eye and skin lesions, delayed wound healing, taste abnormalities, and mental fatigue.

» See more about common nutrient deficiencies here.

Meal Patterns:

Ethiopians usually eat one or two meals a day and snacks in between. Meals may be limited when food is in short supply. Food is usually offered on a communal plate and each person uses bread to scoop up what is served. Sharing food is an important social activity, and meals are often joyous and noisy. Only the right hand is used for eating. Before the meal, hands are washed under water poured from a pitcher into a basin. A prayer is said and an appetizer of curds and whey may be served. At the start of the meal, injera is layed directly on the table. Different kinds of stews are arranged on top. If you find yourself a guest in an Ethiopian home, don’t be surprised if the host hand feeds you a piece of food as a sign of respect!

Transition Foods:

The transition diet is one you develop to help bridge the gap between your child’s native diet and what eventually will become his or her regular diet at home. The transition diet often includes recipes and foods from the native diet. A good way to start the transition process is to ask exactly what foods your child ate in the orphanage or foster home, using that as a base for your cooking at home. As one parent put it, “I would encourage all parents to adapt the foods they present to mimic what the child had at the orphanage during the first months home. It is an easy adaptation that parents can make to create a more familiar environment during what can be a hard transition.” It may also be helpful to watch the caregivers feed your child at least one meal before returning home. Simple things such as the temperature or texture of foods may be important to your child. One mother wrote, “Our daughter was on formula at the orphanage but they gave it to her very, very hot. It took us a while to realize she wanted everything HOT and would cry hysterically if it wasn’t hot.” Even if you don’t know exactly what your child ate previously, incorporating native foods into his or her diet is a great way to help your child transition to a new culture, as well as preserve traditions from his or her first culture.

Native Ethiopian foods that are commonly served in the orphanages are injera (a spongy bread made from teff flour) and different types of stews, including doro wat, (a spicy chicken stew) misir wat and kik wat (lentil stews), and shiro wat (chick pea flour stew). Beans, especially lentils and chick peas, are very common, as are tropical fruits such as bananas and mangos. Other foods commonly served in Ethiopian orphanages are scrambled eggs, rice, collard greens, and pasta.

Once home, every child’s food preferences will be different, and it will likely take some trial and error to discover what your child will eat and enjoy. The following food ideas may help your Ethiopian child transition into a new culture:

• Ethiopian stews tend to be fairly spicy, so your child might enjoy some added heat. Many parents found that their newly adopted child readily ate Mexican food such as huevos rancheros and other similar foods. For huevos rancheros, simply scramble eggs and top them with cheese and a spicy salsa.

• Red sauces are also a common favorite among Ethiopian children. Try making pasta with spaghetti sauce, or incorporating spicy red salsas into more of your dishes.

• Pancakes are similar to injera, the staple food in Ethiopian diets, so your child might feel comfortable eating these. Try making them both savory and sweet if your child enjoys them.

• Other excellent transition foods include fruits, potatoes, beans, rice, breads, and any type of stew.

• It is always a good idea to learn how to make native Ethiopian dishes. Your child might remember and enjoy these foods, and as one adoptive parent put it, “these kids have so many losses (language, culture, family, country) that we should attempt to let them keep as many of their native foods as possible, especially during the transition.”

Resources:

• Kittler PG, Sucher KP (2008). Food and culture, Fifth Edition. Belmont, CA: Thomson Wadworth.

• http://www.foodbycountry.com/Algeria-to-France/Ethiopia.html

• Berhe N, Halvorsen BL, Gundersen TE, et al. Reduced serum concentrations of retinol and alpha tocopherol and high concentrations of hydroperoxides are associated with community levles ofs. mansoni infection and schistosomal periportal fibrosis in Ethiopian school children. Am J Trop Med Hyg 2007;76(5):943-949.

• Hall A, Tuffrey V, Kassa T, et al. Case control analysis of the health and nutrition of orphan schoolchildren in Ethiopia. Trop Med Int Health 2010;15(3):287-295.

• Kassu A, Tomoki Y, Mulu A, et al. Serum zinc, copper, selenium, calcium, and magnesium levels in pregnant and non-pregnant women in Gondar, northwest Ethiopia. Biol Trace Elem Res 2008;122:97-106.

• Mengesha B, Ergete W. Staple Ethiopian diet and cancer of the oesophagus. East African Medical Journal 2005;82:353-356.

• Stoecker BJ, Abebe Y, Hubbs-Tait L, et al. Zinc status and cognitive function of pregnant women in southern Ethiopia. Eur J Clin Nutr 2009;63:916-918.

• Umeta M, West CE, Verhoef H, et al. Factors associated with stunting in infants aged 5-11 months in the Dodota-Sire District, rural Ethiopia. J Nutr 2003;133:1064-1069.