Both sets of parents in the Hispanic-American and African-American families were overweight, which they did not see as a problem for them: they said that their parents also had 'meat on their bones.' I connected this with the attitudes of my own grandparents. While not overweight, they were inclined to see chubbiness in children as cute, particularly given the poverty and hunger in which they had grown up. This belief was echoed in the Southeast Asian family I interviewed. Health protection and health restoration were less suspiciously viewed than I anticipated: in my preliminary research I read that African-Americans who had experienced racism in the medical system were often mistrustful of doctors and nurses (African-American parents more likely to report distrust of medical research, 2009, JAMA and Archives Journals). My personal interviews indicated that health protection and restoration was of great priority, and overall all of the parents trusted their family physicians. Health promotion through diet was less clearly understood in terms of how it was prioritized and there may have been a failure on the part of family physicians to communicate how to treat obesity in a 'medical' fashion that was meaningful and realistic in the context of the patient's lifestyles and belief patterns.

Personal traditions and practices

Although the families I interviewed were middle-class, some of the poverty that older generations had experienced clearly affected their own perceptions and thinking, particularly the idea that higher calorie, higher sugar 'comfort' foods were signs of love. Although my own culture does not have the same comfort foods, the attitudes of the Latino and African-American families echoed what I had observed in some aspects of my own culture. Some members of my family, particularly family members that had switched to a very Westernized diet in the United States, had trouble balancing the need for satisfying their children's desires and the abundance of high-caloric, highly-palatable food in America.

Nursing: Professional culture

My professional culture of nursing counsels me on...

However, as a nurse I also realize the importance of communicating with a patient to make the advice meaningful: understanding how to make diet and exercise work with the patient's lifestyle is just as important as conveying the importance of maintaining a healthy weight.
Conclusion

Amongst individuals of all cultures, there is often a disconnect between perceptions of obesity in their child and 'reality' (Doolan 2009). But past, cultural memories of food insecurity, even if not directly experienced by the parents can impact how children's and adult's health is perceived, particularly if elders have an important role in the household rearing of children and health beliefs and practices, as in the case of African-Americans and Latinos, as well as Southeast Asian households like my own. Nurses must not assume that the patient 'knows' he or she is at risk for certain health complications before it is too late, and contextualize the presentation of medical information in light of the patient's cultural heritage.