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EgyptEgyptPopulation: 83,688, 164

Major Cities: Cairo (Capitol) Alexandria

Ethnic Groups: Egyptian – 99.6% Other – 0.4%

Religions: Muslim(Sunni) - 90% Coptic – 9% Other Christian – 1%

Primary Language: Arabic

Obesity – 30.3% (adult prevalence)

HISTORY• Egyptian culture has been influenced by the Persians, Greeks, Romans,

British, French

• Persians conquered Egypt in 525 B.C.

• Alexander the Great conquered Egypt in 332 to 31 B.C.

• Egypt comes under Roman Rule in 31 B.C.

• Arabs conquered Egypt in 642 B.C.

• Ottoman Turkish Empire ruled Egypt in 1717 A.D.

• Napoleon Bonaparte invaded Egypt in 1798 A.D. Repelled by the British and the Turks in 1801.

• British troops take control of Egypt in 1882. Egypt becomes a British protectorate in 1914.

• Egypt gains its independence in 1922. Egypt is declared a Republic in 1953

• Tripartite Invasion of Egypt by Britain, France and Israel due to nationalization of the Suez Canal

FAMILY• Family is the most significant unit of Egyptian society

• The individual is always subordinate to the family, tribe or group

• Nepotism is viewed positively, since it is patronage of one’s family

• The family consists of both the nuclear and the extended family

• Women defer to men and younger members defer to older members

• The father controls the families’ possessions and income

• Honor is an important facet of interpersonal relationships. An individual’s honor is intricately entwined with the reputation and honor of everyone in their family.

• Having children is considered the greatest blessing of all and child care is primarily the woman’s responsibility. Many Egyptian women (both Coptic and Muslim) abide by the Koranic directive to breast-feed children for two years.

RELIGION• Religion is the single most important element in social fabric• There are 5 pillars of Islam: (1) Shahadah (the testimony of faith) (2) Salat (prayer 5x a day) (3) Zakat (alms-giving) (4) Sawm (fasting during Ramadan) (5) Hajj (pilgrimage to Mecca)

• Fasting is seen as a spiritual exercise by both Muslims and Christians

• Fasting during Ramadan is from dawn to dusk during the 9th month of the Islamic Calendar to encourage a feeling of nearness to God.

• All adults must give up food/drink/smoking/sexual activity

• During Ramadan many Muslims will try to eat a large meal called suhur just before dawn. The will break the fast with dates or water before having a proper meal.

• Eid ul-Fitr is a festivle that ends Ramadan

COMMON HEALTH ISSUES• Ranked 8th in the world for obesity (2006).

• 66% of population is overweight• 30.3% of population is obese

• Children under the age of 5 years underweight: 6.8 % of population

• Major Infectious diseases: (food or waterborne diseases) bacterial diarrhea, HepA, typhoid fever (vector borne diseases) Rift Valley fever, schistosomiasis (water contact disease)

• Diabetes rates (2007): 10.1% : 4, 357,100 (20-79 yro)• Diabetes type 1 incident (2007): 8 per 100,000 children• Male deaths attributed to diabetes (2007): 17,013 (8.4%)• Female deaths attributed to diabetes (2007): 41,136 (21.6%)• Predicted diabetes prevalence (2025): 12.2%

ACCULTURATION• Interethnic marriage is discouraged with the exception of

Egyptian men and American women. Children will be raised Muslim.

• Difficult areas of acculturation has been separation of sexes as segregation cannot be maintained in American schools or work places.

• The more acculturated a woman is, the less she is accepted by newly migrated Arab women or those who remain conventional

• Conflict is high with parents and second or third generation children. Egyptians and Syrians acculturate the most successfully.

• It is believed that the longer they are in the United States, the more “Americanized” their diets become

• It is unlikely that dietary practices related to religion change at all. This has led to increased numbers of Arab markets in the U.S.

MEAL COMPOSITION & ETIQUTTE • Host must feed their guests well. Compliment the host on their

home.

• Wait for the host or hostess to tell you where to sit

• Eat with the right hand only

• It is considered a sincere compliment to take second helpings

• If you are full DO NOT leave your plate empty. Leave a little bit of food on your plate and then push it away. If it is empty, it will be filled again.

• In Egypt and Middle East, it is considered rude to look at a fellow diner’s plate in public because it sends a signal of desire or envy but okay to do it at home

• Egyptians tend not to drink while eating but they often finish off with something sweet like a soda

• Cuisine tends to be heavy in carbohydrates emphasizing economically filling ingredients (beans, rice and pasta)

COMMON INGREDIENTSSPICES:

• Baharat : Spice mixed consisting of pimento, white/black pepper, cinnamon, cloves and nutmeg. •Coriander•Cumin

•Feteer Meshaltet: Fluffy pastry, hand stretched and folded unto itself in thin layers, brushed with ghee and then baked.

•Fava Beans

•Ghee: Clarified butter used in all cooking from breakfast to dessert

•Karkade: A hibiscus tea sought after for its medicinal properties (reduce high blood pressure)

•Nuts: Almonds, peanuts, pistachio and hazelnuts are the favorites. Used in many various dishes

COMMON MEALS• Koshari – made up of rice, lentils,

chickpeas and macaroni topped with tomato sauce and fried onion

• Ful – mashed fava beans served with olive oil, chopped parsley, onion, garlic and lemon juice

• Aish Baladi – pita like bread which is an important component of every meal. Mixture of whole meal and white flour then baked near an open flame

COMMON MEALS• Um Ali – traditional Arabic desert

served on special occasions. A sort of bread pudding and with the cinnamon nut filling of baklava

• Shai tea – almost exclusively imported from Kenya and Sri Lanka. Comes in two varieties: Koshary and Saiidi. Sweetened with can sugar, flavored with mint leaves. Adding milk is common.

BASBOUSA RECIPE

ORIGINAL MODIFIED

¾ c butter¾ c sugar1 ¼ c buttermilk2 c semolina1 ½ tsp vanilla1 tbs baking powder1 ½ tsp baking soda

Sugar Syrup:

1 c sugar1 c water½ fresh squeezed Lemon juice

1 tbs tahina (ground sesame)¼ c ghee, softened1 can fat free sweetened condensed milk1 tsp baking powder2 ½ cups fine semolina½ c low fat yogurt1 c water

Syrup (optional):

½ c sugar1 c water1 tsp lemon juice1 tbs cornstarch½ c cold water (to mix with corn starch)1 tbs rose water

NUTRITIONAL CONTENT• Original recipe:

Calories: 327.1 (per serving) Calories from Fat: 108 33% DV Total Fat: 12 g 18% Saturated Fat: 7.4 g 37% Cholesterol: 31.5 mg 10% Sodium: 377.3 mg 15% Total Carbohydrates: 51 g 17% Dietary fiber: 1 g 4% Sugars: 30.4 g 121%

Protein: 4.5 g 9%

• Modified recipe:

Calories : 181 (per serving) Cholesterol: 5 mg Protein: 4.7 g Sodium: 70 mg Carbohydrates: 33 g Fats: 3.2 g

COUNSELING

• Eye contact and close range conversations are important to interpret the meaning of the conversation.

• Interactions are highly contextual – body language and general

atmosphere are as important to communicate as the words

• Middle Easterners may expect health care providers to make decisions for them and be responsible for the consequences

• Are hesitant to ask questions when confused and may give answers they feel will make the provider happy.

• Proper posture is a sign of respect. Crossing legs and pointing with the foot or showing the soul of the foot is considered impolite

• Older male relatives will join and participate in the conversation. Their presence should be valued and their opinions fully solicited. A female may ask for her husband/father to sign any medical documents

REFERENCES• Kittler PG, Sucher KP. Food and Culture. 5th ed. Belmont, CA: Thompson Wadsworth, 2008.• Flitter, E. Egyptian Etiquette for Eating. May 22, 2008. Wall Street Journal. Available at:

http://online.wsj.com/article/SB121001458628368321.html. Accessed on November 11, 2012.

• Egypt: Language, Culture, Customs and Etiquette. Kwintessential. Available at: http://www.kwintessential.co.uk/resources/global-etiquette/egypt-country-profile.html. Accessed on November 1, 2012

• Egypt. Available at: http://www.everyculture.com/Cr-Ga/Egypt.html. Accessed on October 27, 2012.

• Egyptian Cuisine: Key Ingredients. Available at: http://www.sbs.com.au/food/cuisine/Key_Ingredients/424/13 . Accessed on November 5, 2012

• The World Fact book: Egypt. Central Intelligence Agency. Available at: https://www.cia.gov/library/publications/the-world-factbook/geos/eg.html. Accessed on October 9, 2012

• International Diabetes Association. Diabetes Atlas: Egypt. Available at: http://da3.diabetesatlas.org/atlasff5d.html?id=4. Accessed on 27 October 2012.

• Religions. Sawm: Fasting. BBC. Available at: http://www.bbc.co.uk/religion/religions/islam/practices/sawm.shtml. Accessed on 01 November 2012.

• Egypt: Family and Kinship. Library of Congress. Available at : http://lcweb2.loc.gov/cgi-bin/query/r?frd/cstdy:@field(DOCID+eg0073). Accessed on: October 12, 2012

• Egypt Profile: A chronology of Key Events. BBC. November 5, 2012. Available at : http://www.bbc.co.uk/news/world-africa-13315719. Accessed on 5 November 2012.

• Basbousa. Food.com. Available at: http://www.food.com/recipe/basbousa-1576-1587-1576-1608-1587-1577-12957. Accessed on 05 November 2012.

• Nestle. Low Fat Basbousa with yogurt. Available at: http://www.nestle-family.com/recipes/english/by-product-sweetened-condensed-milk_Low-Fat-Basbousa-with-Yogurt_43039.aspx. Accessed on 05 November 2012.