Ebook PDF Nutrition Counseling and Education Skill Development 4th Edition

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vi Contents
3 Additional Resources 72
References 72
Communication Essentials 46
3.1 Nutrition Counseling Goals 47 4
3.2 Stages of Skill Development 47
Meeting Your Client:
3.3 Model of Communication 48
The Counseling Interview 74
3.4 Cultural Influence on Communication 48
3.5 Guidelines for Enhancing Counseling 4.1 Nutrition Counseling Models 75
Communication Effectiveness 48 4.2 Nutrition Counseling
Use Focuses and Intents When Motivational Algorithm 75
Formulating Responses 51 4.3 Assessing Readiness 77
Use Effective Nonverbal Behavior 52 4.4 Nutrition Counseling Protocols:
Harmonize Verbal and Nonverbal Analysis and Flow of a Counseling
Behaviors53 Interview and Counseling Session 79
Analyze Nonverbal Behavior of Your Client 54 4.5 Involving Phase 80
Communication Roadblocks 54 Greeting80
3.6 Empathy 55 Establish Comfort 80
3.7 Basic Counseling Responses 56 Small Talk 80
Attending (Active Listening) 57 Opening—First Session 80
Reflection (Empathizing) 58 Opening—Subsequent Sessions 81
Steps in Reflecting 59 Identifying Client’s Long-Term Behavior
Change Objectives (General Goals) 81
Legitimation (Normalization) 61
Explain Program and Counseling
Affirmation (Respect) 61
Process—First Session 81
Personal Support 61
Discuss Weight Monitoring, if
Partnership 62 Appropriate—First Session 82
Mirroring (Parroting, Echoing) 62 Setting the Agenda—First Session 82
Paraphrasing (Summarizing) 62 Setting the Agenda—Subsequent
Giving Feedback (Immediacy) 63 Sessions82
Questioning 63 Transitioning to the Next Phase 82
Useful Questions 64 4.6 Exploration–Education Phase 82
Problematic Questions 64 Educational Activities 83
Clarifying (Probing, Prompting) 64 Assessment—First Session 83
Noting a Discrepancy (Confrontation, Assessments—Subsequent Sessions 83
Challenging)65 Giving Nonjudgmental Feedback 84
Directing (Instructions) 65 Eliciting Client Thoughts About the
Advice 66 Comparison of the Assessment to
Allowing Silence 66 the Standard 85
Self-Referent (Self-Disclosing and Determining What’s Next 85
Self-Involving)67 Assessing Readiness to Make a Change 85
case study Communication Analysis 4.7 Resolving Phase 85
of John’s Interactions 68 4.8 Level 1: Not Ready to Change
Key Terms 71 (Precontemplative) 86
Review Questions 71 Raise Awareness of the Health Problem
Assignment—Observation and Analysis of a and Diet Options 87
Television Interview 71 Personalize Benefits 87
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Contents vii
Ask Key Open-Ended Questions to 5.2 Design a Plan of Action 100

Explore Importance of Change and Investigate the Physical Environment 100
Promote Change Talk 87
Examine Social Support 100
Summarize87
Review the Cognitive Environment 100
Offer Professional Advice, if Appropriate 88
Explain Positive Coping Talk, if Necessary 100
Express Support 88
Modify Goal, if Necessary 100
4.9 Level 2: Unsure, Low Confidence 88
Select a Tracking Technique 101
Raise Awareness of the Benefits of
Verbalize the Goal 101
Changing and Diet Options 88
Write Down the Goal 101
Ask Key Open-Ended Questions to
Explore Confidence and Promote 5.3 Dietary Assessment 102
Change Talk 88 Step 1: Food Intake Data Collection 102
Explore Ambivalence by Examining Usual Intake Form 105
the Pros and Cons 89 Diet History Interview 105
Imagine the Future 90 Step 2: Data Analysis 107
Explore Past Successes and Provide Step 3: Interpretation of Analysis 109
Feedback About Positive Behaviors
and Abilities 90 5.4 Energy Determinations 111
Encourage Support Networks 90 Step 1: Determine Resting Energy
Expenditure (REE) 111
Summarize Ambivalence 90
Step 2: Select a Physical Activity (PA)
Choose a Goal, if Appropriate 90
Factor111
4.10 Level 3—Motivated, Confident,
Step 3: Determine TEE 111
Ready 90
Step 4: Adjust for Weight Loss 112
Affirm Positive Behaviors 90
Closing Phase 90 5.5 Physical Assessments and Healthy
Weight Standards 112
4.11 FRAMES for Brief Interventions 91
Body Mass Index 112
4.12 Considerations for Acute Care 91
Waist Circumference 113
Nancy: Intervention at
case study
Three Levels of Motivation 92 5.6 Documentation and Charting 115
Key Terms 94 SOAP Format 115
Review Questions 94 case study Nancy: Documentation
Assignment—Case Study Analysis 95 at Three Levels of Motivation 117
Additional Resources 95 Adime Format 118
References 95 5.7 Nutrition Care Process 118
Standardized Language 120
Step 1: Nutrition Assessment 120
5 case study Nancy: ADIME
Documentation–Assessment121
Developing a Nutrition Care Plan:
Step 2: Nutrition Diagnosis 121
Putting It All Together 96
Self-Evaluation of PES Statements 123
5.1 Goal Setting 97 Step 3: Intervention 123
Explain Goal Setting Basics 97 case study Nancy: ADIME
Explore Change Options 97 Documentation–Diagnosis With
Identify a Specific Goal From a Broadly PES Statement 124
Stated Goal 98 Planning the Nutrition Intervention 124
Define Goals 99 Implementation of the Intervention 124
viii Contents
5.8 Step 4: Monitoring and Evaluation Terminology149

(M & E) 124 Individualization of Therapy 149
Nancy: ADIME
case study Length and Frequency of Counseling
Documentation–Intervention125 Sessions149
NCP Documentation and Charting 125 Perception of Quality of Care 150
Nancy: ADIME
case study Nonadherence Counselor Issues 150
Documentation–Monitoring Mary: Busy Overweight
case study
and Evaluation 126 College Student and Mother 151
Key Terms 126 Key Terms 151
Review Questions 126 Review Questions 152
Assignment—Nutritional Assessment 126 Assignment—Food Management
Additional Resources 129 Tool Usage 152
References 129 Additional Resources 153
References 154
6
Promoting Change to Facilitate 7
Self-Management 130 Making Behavior Change Last 156
6.1 Strategies To Promote Change 131 7.1 Social Network 157
6.2 Food Management Tools 131 Social Support 157
Meal Replacements 132 Social Disclosure 159
Detailed Menus and Meal Plans 132 Social Pressures 159
Food Lists for Weight Management 132 7.2 Stress Management 160
MyPlate or Dash Food Plan 132 Stress Management Counseling 162
Goal Setting 133 7.3 Sleep Counseling 164
6.3 Tracking 133 7.4 Mindful Eating 166
Journaling133 7.5 Relapse Prevention 167
Journaling Alternatives 134 Immediate Determinants 167
6.4 Behavior Change Strategies 135 Covert Antecedents 169
Behavior Chain 135 Relapse Prevention Counseling 169
Cue Management (Stimulus Control) 136 7.6 Ending the Counseling Relationship 171
Countering136 Preparation for a Conclusion 171
Reinforcement: Rewards 138 Final Session 171
Contracting139 Handling Abrupt Endings 172
Encouragement140 7.7 Counseling Evaluation 172
Goal Setting 140 Evaluation of Client Progress 172
Modeling140 Goal Attainment Scale 173
Problem Solving 140 Final Client Evaluation 173
6.5 Cognitive Restructuring 141 7.8 Evaluation of Counseling
6.6 Education During Counseling 145 Effectiveness and Skills 173
Effective Education Strategies 145 Client Evaluation of Counselor 173
Effective Education Language 148 Assessing Client’s Nonverbal Behavior 173
Positive or Negative Approach 148 Checking173
6.7 Supporting Self-Management 149 Counseling Checklists (Interview Guides)173
Contents ix
Charting174 8.10 Issues Pertinent to Physical

Video, Audiotape, or Observation Activity Goal Setting and Action
Evaluations174 Plan Development 196
case study Amanda: The Busy Sales
Walking Basics 197
Representative174 case study Officer Bill 197
Key Terms 175 Key Terms 198
Review Questions 175 Review Questions 198
Assignment—Identifying Stress 175 Assignment—Physical Activity
Additional Resources 175 Assessment and Counseling 198
References 176 Additional Resources 200
References 201
8
Physical Activity 178 9
Communication with Diverse
8.1 Physical Activity Initiatives 179
Population Groups 203
8.2 Role of Nutrition Counselor in
Physical Activity Guidance 179 9.1 Need for Cultural Competence 204
8.3 Physical Activity and Fitness 181 9.2 Demographics—Population Trends 204
Benefits of Regular Physical Activity 181 9.3 Increased Use of Traditional Therapies 204
Injury Risks Associated with Exercise 182 Health Disparities 205
Exercise Myths 183 Underrepresentation of Culturally
8.4 Physical Activity Goals 183 and Linguistically Diverse Health
Care Providers 208
8.5 Levels of Aerobic Physical Activity 184
Legislative, Regulatory, and
Moderate Physical Activity 184
Accreditation Requirements 208
Vigorous Physical Activity 184
9.4 Cultural Competence Models 208
Methods to Determine Level of
Cultural Competence Continuum 209
Exertion185
Campinha-Bacote Model of Cultural
Muscular Strength 185
Competence in the Delivery of Health
Flexibility186 Care Services 209
8.6 Barriers to Becoming Physically Development of Cultural Self-Awareness 209
Active 187
Development of Cultural Knowledge 210
8.7 Physical Activity Counseling
Development of Cultural Skills 211
Protocols 187
9.5 Guidelines for Delivering Cross
8.8 Assessments of Physical Activity 187
Cultural Interviews and Interventions 214
Physical Activity Status 187
The LEARN Guideline 214
Current Exercise Status 187
The 4 Cs of Culture Guideline 215
Physical Activity Readiness 187
9.6 Cross-Cultural Nutrition Counseling
Stages of Readiness to Change 189 Algorithm 215
Assessment Feedback 189 9.7 Working with Interpreters 215
8.9 Resolving Phase Protocols 190 9.8 Life Span Communication
Level 1—Not Ready to Change 190 and Intervention Essentials 218
Level 2—Unsure About Changing 192 Preschool-Aged Children (2 to 5 Years) 218
Level 3—Ready to Change 193 Intervention Strategies 218
Level 4—Physically Active 194 Middle Childhood (6 to 12 Years) 219
x Contents
Intervention Strategies 219 Group Process 252

Adolescence (13 to 19 Years) 220 Open Groups 252
Intervention Strategies 220 Closed Groups 253
Older Adults 221 Ending258
Intervention Strategies 222 Practical Considerations for Successful
9.9 LGBTQ (Gay, Lesbian, Bisexual, Groups259
Transgender, Queer) Population 224 10.5 Evaluation of Group Interactions 260
Terminology225 Group Facilitation at a
case study
LGBTQ in the United States 225 Diabetes Camp for Adolescent Girls 261
LGBTQ Health Disparities 226 Key Terms 262
Culturally Sensitive Health Care Review Questions 262
for LGBTQ People 226 Assignment—Practice Group Counseling 262
9.10 Eating Disorders 227 Additional Resources 264
9.11 Weight Bias 227 References 264
Intervention Essentials 228
9.12 Individuals with Disabilities 229
Mobility Impairment 229
11
Visual Impairment 229
Keys to Successful Nutrition
Deaf or Hard of Hearing 229 Education Interventions 265
Speech Disabilities 233 11.1 Nutrition Education Settings 266
Invisible Disabilities 233 11.2 Keys to Nutrition Education 267
case studyCounseling in a 11.3 Keys to Success 1—Know Your Audience,
WIC Program 234 Conduct a Thorough Needs Assessment 267
case study Activities 234 Needs Assessment Categories 267
Key Terms 235 11.4 Data Collection Methods 268
Review Questions 235 Nutrition Education
case study
Assignment—Conducting an Interview Intervention for a Congregate

Across Cultures 236 Meal Program 270
Additional Resources 238 11.5 Keys to Success 2—Determine Your
Educational Approach 271
References 239
case study Keys to Success 2—
Determine Your Educational Approach 272
10 11.6 Keys to Success 3—Design Theory-
Group Facilitation and Counseling 244 Based Interventions 272
Keys to Success 3—Design
case study
10.1 Communication Styles 245
Theory-Based Interventions 274
10.2 Using Questions in a Group 245
11.7 Community Level and Planning
Types of Questions 245 Models: Social Marketing 274
10.3 Facilitating Groups 247 Definition of Social Marketing 274
Preparation247 Basic Principles of Social Marketing 274
Organizational Strategies 248 Application of Social Marketing 276
Group Management 249 11.8 Keys to Success 4—Establish Goals
10.4 Group Counseling 251 and Objectives 276
Advantages of Group Counseling 251 Goals276
Disadvantages of Group Counseling 252 Objectives277
Contents xi
Verbs277 Review Questions 309

Types of Objectives 277 Assignment—Develop a TV Public
Cognitive Domain 278 Service Announcement 310
Affective Domain 279 Additional Resources 311
Psychomotor Domain 279 References 312
11.9 Generalizations 281
Keys to Success 4—
case study 13
Establish Goals and Objectives 282 Professionalism and Final Issues 313
11.10 Instructional Plan 282
13.1 Professionalism 314
Key Terms 286
Practice Management and Advancement 314
Review Questions 286
13.2 Ethics 314
Assignment—Design a Nutrition
Education Intervention 286 13.3 Client Rights 319
Additional Resources 286 Confidentiality319
References 287 Procedures and Goals of Counseling 319
Qualifications and Practices of the
Counselor319
12 13.4 Boundary Between Nutrition
Educational Strategies, Technology, Counseling and Psychotherapy 319
and Evaluation 289 Referrals320
Proper Dress Attire 320
12.1 Keys to Success 5—Provide Instruction
Planning and Incorporate Learning 13.5 Starting a Private Practice 322
Strategies 290 Define a Focus 323
Presentation290 Professional Credentials and
Discussion295 Achievements323
Demonstration295 Learn and Connect 323
Visual Aids 295 Create a Business Roadmap 324
Action-Oriented Techniques 297 Professional Support Systems 324
Technology-Based Techniques 297 Business Basics 324
Learning Domains and Strategies 298 13.6 Marketing Basics 324
12.2 Keys to Success 6—Develop Marketing Plan 325
Appealing and Informative Mass Internet Presence and Usage in
Media Materials 300 the United States 325
Developing Audio and Audiovisual Social Media Marketing 325
Messages301 13.7 Telehealth and Telenutrition 327
Developing Print Materials 301 13.8 Self-Care 327
Application of Emotion-Based Approach 304 Occupational Burnout 327
12.3 Keys to Success 7—Conduct case study Interactive Personal
Evaluations 308 Case Study 328
Planning for an Evaluation 308 Key Terms 329
Formative Evaluations 309 Review Questions 329
Summative Evaluations 309 Assignment—Evaluate Your Counseling
Presentation to Working
case study Effectiveness 329
Adults309 Additional Considerations of Videotape
Key Terms 309 Observations 330
xii Contents
Additional Resources 330 Preparation for Session 1 334

References 330 Session 1 335
Session 2 336
14 Session 3 336
Guided Counseling Experience 332 Session 4 336
Key Terms 353
14.1 Developing a Counseling Style 333
Appendix A DASH Food Plan 355
14.2 Finding Volunteer Clients 333
Appendix B Body Mass Index 358
14.3 Goals of the Guided Counseling
Experience 333 Appendix C Lifestyle Management Forms 359
Skill Goals 333 Appendix D Dietary Reference Intakes
(DRI) 399
Attitude Goals 334
Index 403
14.4 The Four Counseling Sessions 334
Preface
Welcome to the Fourth Edition for documenting their own reflections. Instructors
can assign journal entries and collect them for eval-
The fourth edition of this book continues to provide a uation. Reading journal entries allows instructors
step-by-step approach guiding entry-level practitioners to gain understanding of how students are grasping
through the basic components of changing food behav- concepts. Each chapter has a culminating assign-
ior and improving nutritional status. Behavior change is ment and a case study that integrates all or most of
a complex process, and there is an array of strategies to the major topics covered throughout the chapter.
influence client knowledge, skills, and attitudes. To be ef- ●● Evidence-based: Science-based approaches,
fective change agents, nutrition professionals need a solid grounded in behavior change models and theories,
foundation of counseling and education principles, op- found to be effective for educational and counsel-
portunities to practice new skills, and knowledge of eval- ing interventions, are analyzed and integrated into
uation methodologies. This book meets all of these needs skill development exercises.
in an organized, accessible, and engaging approach. ●● Nutrition Counseling Motivational Algorithm: To
guide the process of integrating counseling theo-
Intended Audience ries and approaches, a motivational algorithm
is presented leaning heavily on Client-Centered
This book was developed to meet the needs of health Counseling, Motivational Interviewing, and the
professionals who have little or no previous counsel- Transtheoretical Model. The algorithm provides
ing or education experiences, but who do have a solid a framework for nutrition counseling students to
knowledge of the disciplines of food and nutrition. Al- visualize implementation of a counseling session.
though the book addresses the requirements of nutrition
professionals seeking to become registered dietitians, the
●● Cultural sensitivity: The population of the United
approach focuses on skill development useful to all pro- States is increasingly heterogeneous, moving toward a
fessionals who need to develop nutrition counseling and plurality of ethnic, religious, and regional groups. To
education skills. The goal of the book is to enable entry- have effective interventions, nutrition counselors and
level practitioners to learn and use fundamental skills educators need to appreciate the influence of how
universal to counseling and education as a springboard membership in these diverse groups greatly influences
on which to build and modify individual styles. our health beliefs, behaviors, and food practices.
Although a chapter is devoted to exploring diverse
Distinguishing Features cultural groups, cultural influences regarding behavior
and attitudes are integrated throughout the book.
●● Practical examples: Concrete examples, case stud- ●● Putting it all together—a four-week guided nutri-
ies, and first-person accounts are presented repre- tion counseling program: The text includes a step-
senting a variety of wellness, private practice, and by-step guide for students working with volunteer
institutional settings. adult clients during four sessions. The objective of
this section is to demonstrate how the theoretical
●● Action based: Exercises are integrated into the text
discussions, practice activities, and nutrition tools
to give students ample opportunity and encour-
can be integrated for an effective intervention.
agement to interact with the concepts covered in
each chapter. Instructors can choose to assign the ●● The Nutrition Care Process (NCP): The NCP was de-
activities to be implemented individually at home veloped by the Academy of Nutrition and Dietetics
or used as classroom activities. Students are encour- to provide a framework for nutrition interventions.
aged to journal their responses to the exercises as a This framework is integrated throughout the text
basis for classroom discussions, distance learning, or and highlighted in relevant areas.
xiii
Acknowlegments
New Edition Highlights

All chapters of the new edition have been updated to incorporate the latest professional standards, government guide-
lines, and research findings. In particular, resources and references were updated throughout the entire book.
Selected Chapter-by-Chapter Updates

The sequential flow of the chapters follows the needs of students to develop knowledge and skills during each
step of the counseling and education process.
Chapter 1 Preparing to Meet Your Clients

●● Recent studies regarding factors affecting food behavior were integrated throughout the chapter.
Chapter 2 Frameworks for Understanding and Attaining Behavior Change

●● iscussion of the Transtheoretical Model has been expanded and coverage of Motivational Interviewing
D
has also been expanded and updated to reflect Miller and Rollnick’s most recent four-process model.
Chapter 5 Developing a Nutrition Care Plan: Putting It All Together

●● he most recent Nutrition Care Process guidelines were incorporated into this chapter. Discussion of
T
healthy eating guides was expanded including Harvard University’s Healthy Eating Plate.
Chapter 7 Making Behavior Change Last

●● Incorporating sleep hygiene in nutrition counseling has been added.
Chapter 8 Physical Activity

●● This chapter was updated to include the 2018 Physical Activity Guidelines for Americans.
●● The physical activity protocol for health practitioners (Exercise Is Medicine) developed by the
American College of Sports Medicine and the American Medical Association was incorporated
throughout the chapter.
●● A discussion of the U.S. Olympic Athlete’s Plate graphic was added to this chapter.
●● The section on the benefits of physical activity was updated and expanded.
Chapter 9 Communication with Diverse Population Groups

●● The discussion of population trends was updated and expanded.
●● Culturally sensitive approaches for working with LGBTQ individuals were added.
●● The cross-cultural intervention guideline, the 4 Cs of Culture, was added.
Chapter 11 Keys to Successful Nutrition Education Interventions

●● A new lesson plan was added using constructs from the Social Cognitive Theory.
xiv
About the Authors
Chapter 12 Educational Strategies, Technology, and Evaluation

●● Smartphone and web-based tracking apps were added.
Chapter 13 Professionalism and Final Issues

●● A review of telehealth and telenutrition was added.
●● The importance of self-care and ways in which to reduce the risk of occupational burnout was addressed.
●● The framework of the dietetics profession as established by the Academy of Nutrition and Dietetics
was updated.
●● The review of social media sites was updated.
xv
Acknowledgments
Thank you to all the reviewers and the individuals who for Health and Nutrition, and Courtney Heilman, Prod-
shared their expertise and assisted in the development uct Manager, Health & Nutrition. In addition, we want
of the manuscript. Your insights and comments were to acknowledge the valuable research and editing assis-
invaluable to the fourth edition. We greatly appreciate tance of Lauren Kulik, Montclair State University gradu-
the staff at Cengage Learning for their encouragement ate assistant. We would also like to thank the following
and tireless work shepherding us through the process. A reviewers for their valuable comments as we revised
special thanks to Samantha Rundle, Content Manager this edition.
Reviewers
Kaitlan Beretich Celesta Lyman
Baylor University Southern Utah University
Kathryn Coakley Kellie McLean

University of New Mexico La Guardia Community College
Cinda J. Catchings Rebecca Miller

Alcorn State University Montclair State University
xvi
About the Authors
Kathleen D. Bauer, PhD, RDN , is the founder Doreen Liou, EdD, RDN , was director of the
and has been the director of the Nutrition Counseling Didactic Program in Dietetics at Montclair State Univer-
Clinic at Montclair State University for more than fif- sity for fourteen years and spearheaded the program into
teen years. She teaches both undergraduate and gradu- its initial accreditation. She teaches both undergraduate
ate nutrition counseling courses. Publications include and graduate courses in nutrition education and social
book chapters and articles on cultural diversity and eval- marketing. Her research interests encompass qualitative
uation of nutrition counseling education methods. Her and quantitative methods in addressing chronic disease
applied individual and group nutrition counseling ex- risk and the applications of social psychological theories
periences extend to faith-based and wellness programs, in minority population groups. Her nutrition education
fitness centers, hospitals, nursing homes, and private experiences extend to a variety of academic, community,
practice. and clinical settings.
xvii
1 Preparing to Meet
Your Clients
Learning Objectives
1.1 Define nutrition counseling and nutrition
education.
1.2 Identify and explain factors influencing
food choices.
1.3 Describe characteristics of an effective
counselor.
1.4 Identify factors affecting clients in a
counseling relationship.
1.5 Evaluate oneself for strengths and
weaknesses in building a counseling
fizkes/Shutterstock.com
relationship.
1.6 Identify novice counselor issues.
Not only is there an art in knowing something but also a certain art in teaching it.
—CiCero
2 Chapter 1 Preparing to Meet Your Clients
Nutrition counselors and educators provide guidance for

Exercise 1.1 OVE Activity: Broadening Our
D
helping individuals develop food practices consistent
Perspective (Awareness)
with the nutritional needs of their bodies. For clients,
this may mean altering comfortable food patterns and D—defer judgment
longstanding beliefs and attitudes about food. Nutrition O—offbeat
professionals work to increase knowledge, influence mo- V—vast
tivations, and guide development of skills required for E—expand on other ideas
dietary behavior change. This can be a challenging task. Divide into groups of three. Your instructor will select
To be an effective change agent, nutrition counselors an object, such as a cup, and give you one minute to
and educators need a solid understanding of the mul- record all of the possible uses of the object. Draw a line
titude of factors affecting food behaviors. We will begin under your list. Take about three minutes to share each
this chapter by addressing these factors in order to other’s ideas, and write the new ideas below the line.
enhance understanding of the forces influencing our cli- Discuss other possibilities for using the object with your
ents. Then, we will explore the helping relationship and group and record these in your journal. Use the DOVE
examine counselor and client concerns. Part of this ex- technique to guide your thinking and behavior during
amination will include cultural components. Nutrition this activity. Do not pass judgment on thoughts that
professionals always need to be sensitive to the cultural cross your mind or on the suggestions of others. Allow
context of their interventions from both their own cul- your mind to think of a vast number of possibilities that
tural perspectives as well as their clients’ perspectives. may even be offbeat. How many more ideas occurred
Some of the activities in this chapter will provide oppor- with sharing? Did you see possibilities from another
tunities for you to explore the cultural lenses that influ- perspective? One of the goals of counseling is to help
ence your view of the world. clients see things using different lenses. What does
this mean? How does this activity relate to a counseling
experience? Write your thoughts in your journal and
1.1 Foundation of Nutrition Counseling share them with your colleagues.
and Education
Source: Dairy, Food, and Nutrition Council, Facilitating Food Choices:
Nutrition education has been defined as the following: Leaders Manual (Cedar Knolls, NJ: 1984).
“Nutrition education is any combination of educational
strategies, accompanied by environmental supports, de-
signed to facilitate voluntary adoption of food choices 1.2 Fundamentals
and other food- and nutrition-related behaviors condu-
cive to health and well-being.”1 The needs of a target
of Food Behavior
community are the focus of the nutrition education pro- The heart of nutrition education and counseling is pro-
cess. Nutrition counselors have similar goals, but inter- viding support and guidance for individuals to make
ventions are guided by the needs of individual clients. appropriate food choices for their needs. Therefore, un-
According to the Academy of Nutrition and Dietetics, derstanding the myriad influences affecting food choices
nutrition counseling has been defined as “a support- is fundamental to designing an intervention. Influenc-
ive process, characterized by a collaborative counselor– ing factors are often intertwined and may compete with
patient/client relationship to establish food, nutrition and each other, leaving individuals feeling frustrated and
physical activity priorities, goals, and individualized ac- overwhelmed when change is needed. Before we jour-
tion plans that acknowledge and foster responsibility for ney through methodologies for making change feel
the process of guiding a client toward a healthy nutritional achievable, we will explore aspects of environmental,
lifestyle by meeting nutritional needs and solving prob- psychological, social, and physical factors affecting food
lems that are barriers to change.”2 Haney and Leibsohn3 choices, as depicted in Figure 1.1.
designed a model of counseling to enable guidance to be ●● Sensory Appeal: Taste is generally accepted as the
effective and provided the following definition:
most important determinant of food choices.4
counseling can be defined as an interaction in Biological taste preferences evolve from childhood
which the counselor focuses on client experience, based on availability and societal norms, but
client feeling, client thought, and client behavior research shows that preferences can be altered by
with intentional responses to acknowledge, to experiences and age.5 Generally, young children
explore, or to challenge. (p. 5) favor sweeter and saltier tastes than adults, and
1.2 Fundamentals of Food Behavior 3
Nutrition Knowledge: Traditionally, educators and

●●
Children nutrition counselors perceived their roles as

Cost
disseminating information. After research indicated
that many clients were not responsive to simple
Convenience Taste
didactic approaches, their roles expanded to include
Food Physiology/ a variety of behavior change strategies. However,
choice metabolism the value of increasing knowledge should not be
Self- devalued. Those who have higher levels of knowl-
Variety
expression edge are more likely to have better quality diets and
Health to lose more weight in weight loss programs.10,11
Well-being outcomes ●● Convenience and Time: Our fast-food culture has
Adults
created a demand for easy-to-prepare and tasty
food. In a research survey, about half of the women
Figure 1.1 The Consumer Food Choice Model surveyed expressed that they spend less than five
Source: Adapted from A. Drewnowski, Taste, Genetics, and Food
minutes for breakfast and lunch preparation and
Choice. In Food Selection: From Genes to Culture, H. Anderson, J.
Blundell, and M. Chiva, Eds. (Levallois–Perret, France: Danone less than twenty minutes for dinner preparation.12
Institute), 30. Copyright 2002. Takeout, value-added (precut, prewashed), and
ready-made foods have become a cultural standard.
These time-saving choices are frequently more ex-
relocating to a new environment will often change pensive and likely to be higher in calories, fat, and
eating patterns and even favorite foods. The fact 6 sodium than home-prepared foods.13 Nutritional
that taste preferences can be modified should be advice needs to take all these factors into consid-
reassuring for those who want to make dietary eration. Quick, easy-to-prepare, and healthful food
changes. Illness may also modify food preference.
7 options should be stressed.
Individuals going through chemotherapy may find ●● Culture and Religion: Food is an integral part of
some of their favorite foods do not taste the same, societal rituals influencing group identity. Ritual
and they lose the desire to eat them.8 meals solidify group membership and reaffirm our
●● Habit: Research indicates that consumers who use relationships to others. For example, all-day eating
cues such as time of day/habit as a trigger to eat are at weekly family gatherings on Sundays or daily
more likely to seek healthful food choices as com- coffee breaks with sweet rolls are rituals that do
pared to individuals who choose to eat “whatever much more than satisfy the appetite. If clients need
is there” and stop eating because the food is gone. to change participation in these rituals because of
This indicates that nutrition counselors and educa- dietary restrictions, it is likely to create stress for cli-
tors could help their clients who eat food simply ents, friends, and relatives. Culture also defines what
because it is there to use preplanned cues to is acceptable for consumption such as sweet red
develop healthful habits.4,9 ants, scorpions, silk worms, or a glass
●● Health Concerns: Health can be Anecdote of cow’s milk. Culture also defines food
a driving force for food choice as A young man in his early twenties com- patterns, and in the United States,
illustrated by public campaigns menting about his food habits stated, snacking is common.14 In addition, re-
to increase intake of fruits, veg- “My friends do not say ‘let’s eat a salad ligions advocate food rituals, and may
etables, and whole grains. In together.’ If you are a guy, it is a wussy also define food taboos such as restric-
a 2018 national survey, nearly thing to do. It is kind of looked down tions against pork for Muslims, beef
half of the participants indi- upon if you are a guy—weak. Eat the for Hindus, and shellfish for Orthodox
cated they have eliminated soft steak, eat the greasy stuff, be a man.”* Jews. Since the 1970s the United States
drinks and candy to reduce sugar has been moving toward a cultural plu-
intake. Consumers are more likely to respond to
4 rality, where no single racial or ethnic
healthful food messages if the advice stresses the group is a majority. Minority groups are expected to
good taste of wholesome foods and convenient climb to 56 percent of the total population by the
ways to include them in the diet. Health status of
an individual, such as having loss of teeth or diges-
*First-person accounts from dietetic students or nutrition
tive disorders, can also affect the amount of food counselors working in the field are included throughout
consumed and food choice. this book.
year 2060.15 As a result, an array of ethnic foods is options spend a greater share of their food budgets
available in restaurants and grocery stores and at convenience, dollar, and drugstores compared
has influenced the national palate. For example, in with households with easier access.25
the past, ketchup was considered a household ●● Availability and Variety: Individuals with increased
staple; however, recent national sales of salsa now numbers of food encounters, larger portion sizes,
compete with ketchup and at times have surpassed and variety of available choices tend to increase
ketchup sales. food intake.26,27 Variety of food intake is important
●● Social Influences: Food is often an integral part of in meeting nutritional needs, but when the assort-
social experiences. Sharing a meal with friends after ment is excessive, such as making food selections
a football game or going out for ice cream to cel- from a buffet, overconsumption is probable. How-
ebrate an academic achievement helps make special ever, this finding can be useful for those trying to
experiences festive. However, foods associated with increase fruit and vegetable intake. A dinner plate
sociability are often not the most nutritious. Social containing broccoli, carrots, and snap peas was
eating frequently encourages increased consump- shown to increase intake of vegetables more than
tion of less-nutritious foods and overconsump- if the plate contained only one of the items.28
tion. 16,17
Eating with friends increases energy intake ● ● Psychological: Food behavior in response to stress
by 18 percent.18 However, even though regular varies among individuals. Some people increase
family meals have been shown to consumption, whereas others claim
be correlated with positive health Anecdote they are feeling too stressed to eat.
outcomes, an analysis of societal A female college student stated: Certain foods have been associated
trends indicates that family meal “The whole society does not empha- with depression and mood altera-
frequency has declined for middle size eating healthy. When you are tion. Depressed individuals eat
school students, Asians, and eating, you have to think hard about lower amounts of antioxidants,
adolescents. 19 what are the healthy foods to eat.” fruits, and vegetables and consume
●● Media and Physical higher amounts of chocolate (up to
Environment: North Americans are surrounded by 55 percent) than others.29,30
media messages, and most of them are encouraging
An understanding of how all these factors influence
consumption of high-calorie foods that are
our food behaviors is essential for nutrition educators
nutritionally challenged. Food distributors and
and counselors. Since we are advocating lifestyle change
manufacturers spend billions of dollars each year on
of comfortable food patterns, we need to understand
advertising to persuade consumers.20 Commercials
the discomfort that our clients are likely to feel as they
can have powerful influences on the quantity
anticipate and attempt dietary alterations. Our role is to
and quality of food consumed.21 Not only do we
acknowledge the challenge for our clients and to find
encounter food messages repeatedly throughout
and establish new achievable patterns for a healthier
the day, but we also have access to a continuous
lifestyle.
supply of unhealthy food and large portion sizes.
Almost anywhere you go—drug stores, gas stations,
hardware stores, schools, for example—there are Understanding an Effective 1.3
opportunities to purchase unhealthy food. Even
laboratory animals put in this type of environment
Counseling Relationship
are likely to overeat the calorie-dense food and gain No matter what theory or behavior change model is pro-
excessive weight.22 viding the greatest influence, the relationship between
●● Economics: An individual’s residence and counselor and client is the guiding force for change.
socioeconomic status can influence myriad factors,
including accessibility to transportation, cooking
facilities, refrigeration, grocery store options, and Exercise 1.2 Explore Influences of Food Behavior
availability of healthful food choices. For those
Interview three people and ask them to recall the last
who are economically disadvantaged, meeting
meal they consumed. Inquire about the factors that
nutritional guidelines is a challenge.23 Low-income
influenced them to make their selections. Record your
households purchase significantly less fruits and
findings in your journal. Compare your findings to the
vegetables than high-income households.24 Low-
discussion of influences on food choices in this chapter.
income households with limited transportation
1.3 Understanding an Effective Counseling Relationship 5
want to be a counselor and helps them avoid using

Exercise 1.3 Helper Assessment
the helping relationship to fulfill their own needs.
Think of a time someone helped you, such as a friend, ●● They have ethical integrity. Effective counselors
family member, teacher, or counselor. In your journal, value the dignity and worth of all people. Such
write down the behaviors or characteristics the person clinicians work toward eliminating ways of think-
possessed that made the interaction so effective. After ing, speaking, and acting that reflect racism,
reading over the characteristics of effective counselors, sexism, ableism, ageism, homophobia, religious
compare their qualities to those identified by the leading discrimination, and other negative ideologies.
authorities. Do they differ? Share your thoughts with Ethical integrity entails many facets that are ad-
your colleagues. dressed in the Academy of Nutrition and Dietetics’
Code of Ethics (a discussion of this topic can be
found in Chapter 13).33
The effect of this relationship is most often cited as the ●● They have congruence. This means the counselor is
reason for success or failure of a counseling interaction. unified. There are no contradictions between who
Helm and Klawitter31 report that successful clients iden- the counselor is and what the counselor says, and
tify their personal interaction with their therapist as the there is consistency in verbal and nonverbal behav-
single most important part of treatment. To set the stage iors as well. (For example, if a client shared some
for understanding the basics of an effective counseling unusual behavior, such as eating a whole cake cov-
relationship, you will investigate the characteristics of ered with French dressing, the counselor’s behavior
effective nutrition counselors, explore your own person- would not be congruent if the nonverbal behavior
ality and culture, examine the special needs and issues indicated surprise but the verbal response did not.)
of a person seeking nutrition counseling, and review ●● They are honest and genuine. Such counselors ap-
two phases of a helping relationship in the following pear authentic and sincere. They act human and do
sections. not live by pretenses, hiding behind phony masks,
defenses, and sterile roles. Such counselors are
Characteristics of Effective Nutrition honest and show spontaneity, congruence, open-
Counselors ness, and willingness to disclose information about
themselves when appropriate. Honest counselors
After thoroughly reviewing the literature in counsel-
are able to give effective feedback to their clients.
ing, Okun 32 identified seven qualities of counselors
They do not avoid difficult issues related to the cli-
considered to be the most influential in affecting the
ent’s problems and handle them tactfully.
behaviors, attitudes, and feelings of clients: knowledge,
●● They can communicate clearly. Clinicians must be
self-awareness, ethical integrity, congruence, honesty,
able to communicate factual information and appear
ability to communicate, and gender and culture aware-
to have a sincere regard for their clients. Effective
ness. The following list describes these characteristics as
nutrition counselors are able to make sensitive com-
well as those thought to be effective by nutrition coun-
ments and communicate an understanding about
seling authorities:
fears concerning food and weight.
●● They have a solid foundation of knowledge. ●● They have a sense of gender and cultural aware-
Nutrition counselors need to be knowledgeable in ness. This requires that counselors be aware of how
a vast array of subjects in the biological and social their own gender and culture influence them.
sciences as well as have an ability to apply principles Effective counselors have a respect for a diversity of
in the culinary arts. Because the science and art values that arise from their clients’ cultural, social,
of nutrition is a dynamic field, the foundation of and economic orientations.
knowledge requires continuous updating. Clients ●● They have a sense of humor. Helping clients see
particularly appreciate nutrition counselors who are the irony of their situation and laugh about their
experienced with the problems they face. problems enriches counseling relationships. In ad-
●● Effective nutrition counselors are self-aware. They dition, humor helps prevent clients from taking
are aware of their own beliefs, respond from an themselves and their problems too seriously.
internal set of values, and as a result have a clear ●● They are flexible. This means not being a perfec-
sense of priorities. However, they are not afraid to tionist. Such counselors do not have unrealistic
reexamine their values and goals. This awareness expectations and are willing to work at a pace their
aids counselors with being honest as to why they clients can handle.
●● They are optimistic and hopeful. Clients want to ●● They can accurately understand what people
believe that lifestyle changes are possible, and feel from their frame of reference (empathy). It is
they appreciate reassurance that solutions will be important for counselors to be aware of their own
found. struggles and pain to have a frame of reference for
●● They respect, value, care, and trust others. This identifying with others.
enables counselors to show warmth and caring
authentically through nonjudgmental verbal and This list can appear daunting, leading one to won-
nonverbal behavior, listening attentively, and der if becoming an ideal counselor is achievable. How-
behaving responsibly, such as returning phone calls ever, Egan and Reese34 emphasize that there is no right
and showing up on time. This behavior conveys the way of mixing and matching the characteristics to meet
message that clients are valued and respected. client needs. They are a list of characteristics to work
Exercise 1.4 People Skills Inventory

❏❏ Do you expect the best from people? Do you assume that others will be conscientious, trustworthy, friendly, and easy
to work with until they prove you wrong?
❏❏ Are you appreciative of other people’s physical, mental, and emotional attributes—and do you point them
out frequently?
❏❏ Are you approachable? Do you make an effort to be outgoing? Do you usually wear a pleasant expression on
your face?
❏❏ Do you make the effort to remember people’s names?
❏❏ Are you interested in other people—all kinds of people? Do you spend far less time talking about yourself than
encouraging others to talk about themselves?
❏❏ Do you readily communicate to others your interest in their life stories?
❏❏ When someone is talking, do you give him or her 100 percent of your attention—without daydreaming, interrupting,
or planning what you are going to say next?
❏❏ Are you accepting and nonjudgmental of others’ choices, decisions, and behavior?
❏❏ Do you wholeheartedly rejoice in other people’s good fortune as easily as you sympathize with their troubles?
❏❏ Do you refuse to become childish, temperamental, moody, inconsistent, hostile, condescending, or aggressive in your
dealings with other people—even if they do?
❏❏ Are you humble? Not to be confused with false modesty, being humble is the opposite of being arrogant and
egotistical.
❏❏ Do you make it a rule never to resort to put-downs, sexist or ethnic jokes, sexual innuendoes, or ridicule for the sake
of a laugh?
❏❏ Are you dependable? If you make commitments, do you keep them—no matter what? If you are entrusted with a
secret, do you keep it confidential—no matter what?
❏❏ Are you open-minded? Are you willing to listen to opposing points of view without becoming angry, impatient, or
defensive?
❏❏ Are you able to hold onto the people and things in your life that cause you joy and let go of the people and things in
your life that cause you sadness, anger, and resentment?
❏❏ Can you handle a reasonable amount of pressure and stress without losing control or falling apart?
❏❏ Are you reflective? Are you able to analyze your own feelings? If you make a mistake, are you willing to acknowledge
and correct it without excuses or blaming others?
❏❏ Do you like and approve of yourself most of the time?
Affirmative answers indicate skills you possess that enhance your ability to relate to others.
Source: Adapted from Scott N, “Success Often Lies in Relating to Other People,” Dallas Morning News, April 20, 1995, p. 14C.
toward that can be enhanced by engaging in profes-

Exercise 1.5 How Do You Rate?
sional self-improvement.
Ask a close friend or family member who you supported
It is one of the most beautiful compensations of this at one time to describe what it was about your behavior
life that no man can sincerely tr y to help another that was helpful. Write these reactions down in your
without helping himself. journal. Review the desirable characteristics for an
—Ralph Waldo Emerson effective counselor described in the previous section.
Complete the personality inventory in Exercise 1.4,
and then identify what characteristics you possess
Understanding Yourself—Personality
that will make you a good helper. What behaviors need
and Culture improvement?
Our personalities are one of the principal tools of the Write in your journal specific ways that you need to
helping process. By taking an inventory of your per- change to improve your helping skills.
sonality characteristics, you can have a better under-
standing of the ones you wish to modify. Intertwined
with a personality evaluation is self-examination of
why you want to be a counselor. What you expect out conscious and unconscious influences. An understand-
of a counseling relationship, the way you view your- ing of this concept becomes clearer when we explore
self, and the personal attitudes and values you possess assumptions regarding supernatural forces, individual
can affect the direction of the counseling process. You and nature, science and technology, and materialism. (See
should be aware that as a helper, your self-image is Table 1.1.) Kittler and Sucher36 relate this unique outlook
strengthened from the awareness that “I must be OK to its special meaning in the health community:
if I can help others in need.” Also, because you are put
. . . expectations about personal and public con-
into the perceptual world of others, you remove your-
duct, assumptions regarding social interaction,
self from your own issues, diminishing concern for your
and assessments of individual behavior are deter-
own problems.
mined by this cultural outlook, or worldview. This
Sometimes counselors seek to fulfill their own needs
perspective influences perceptions about health
through the counseling relationship. Practitioners who
and illness as well as the role of each within the
have a need to express power and influence over oth-
structure of society. (p. 35)
ers tend to be dictatorial and are less likely to be open
to listening to their clients. This type of counselor ex- Majority American values, which are shared by
pects clients to obey suggestions without questions. most whites and to some extent other racial and ethnic
A counselor who is particularly needy for approval and groups, emphasize individuality, self-help, and control
acceptance will fear rejection. Belkin 35 over fate. One study found 82 percent of
warns that sometimes counselors try
Anecdote American consumers believe they are di-
My aunt died of high blood rectly responsible for their own health.37
too hard to communicate the message
pressure. Her religious belief
“I want you to like me,” rather than a Throughout the world there are many who
was that her illness was
more effective “I am here to help you.” believe the primary influence on health
God’s will and should not
As a result, such counselors may be anx- and wellness are supernatural forces such
be interfered with by taking
ious to please their clients by trying to as the will of God, astrological agents, or
medicine or changing her diet.
do everything for them, perhaps even cosmic karma.
doing favors. The tendency will be to gloss over and Your worldview is determined by your culture and
hide difficult issues because the focus is on eliciting life experiences. Culture is shared history, consisting of
only positive feelings from their clients. Consequently, “the thoughts, communication, actions, customs, be-
clients will not learn new management skills, and liefs, values, and institutions of racial, ethnic, religious
dietary changes will not take place. or societal groups.”38 Possible societal groups include
Another important component to understanding gender, age, sexual orientation, physical or mental abil-
yourself so as to become a culturally competent nutri- ity, health, occupation, and socioeconomic status. Any
tion counselor and educator is to know what consti- individual will belong to several societal groups and ac-
tutes your worldview (cultural outlook). Each culture quire cultural characteristics and beliefs from each based
has a unique outlook on life, what people believe and on education and life experiences within those groups.
value within their group. Our worldview provides basic Because each experience is unique, no two people ac-
assumptions about the nature of reality and has both quire exactly the same cultural attributes. In addition,
Table 1.1 Worldview Assumptions
Category Assumption
Supernatural Supernatural assumptions include beliefs regarding God, malevolent spirits, ancestors, fate, or
Assumptions luck being the cause of illness. The concept of soul loss causing depression or listlessness is
prevalent in many societies. In order to alleviate supernatural problems, societies have devised
ceremonies or rituals.
Individual and Nature Not all societies make a clear distinction between human life and nature as in the United States.
Some societies believe that we are subjugated by nature and need to show respect for natural
forces and attempt to live in harmony with nature. The dominant culture in the United States
sees human beings as having higher value than nature with a need to exploit or protect it.
Technology The citizens of the United States put great fate in technology and the scientific method.
Diseases are viewed as correctable mechanistic errors that can be fixed by manipulation.
Americans tend to think science can help humanity—a view not as highly held in Europe.
Materialism Many people around the world believe that materialism dominates the worldview of Americans,
that is, the need to acquire the latest and best possessions. This may have contributed to the
popularity of “supersize food portions.”
Source: Jandt F. An Introduction to Intercultural Communication: Identities in a Global Community. 6th ed. Thousand Oaks, CA: Sage Publications,
Inc.; 2009.
we are likely to migrate to and away from various cultures

Table 1.2 Functions of Cultural Values
throughout our lives. For example, a change of job, reli-
gion, residence, or health status can alter cultural attri- ●● Provide a set of rules by which to govern lives.
butes. However, there are attributes that prevail and will ●● Serve as a basis for attitudes, beliefs, and behaviors.
affect the way we perceive ourselves and others.
We share a commonality with those who are most ●● Guide actions and decisions.
like us. For example, many North Americans appreciate a ●● Give direction to lives and help solve common
friendly, open health care professional. People from other problems.
cultures, however, may feel uncomfortable interacting
with a professional on such terms and may even view ●● Influence how to perceive and react to others.
this behavior as a sign of incompetence. Your food hab- ●● Help determine basic attitudes regarding personal,
its can also be an important component of your culture. social, and philosophical issues.
For example, Hindus find eating beef to be abhorrent—
●● Reflect a person’s identity and provide a basis for
much the way many Westerners feel about Asians con-
self-evaluation.
suming dog meat.
Understanding the role of cultural values in your Source: Adapted from Joan Luckmann, Transcultural Communication in
life as well as in the lives of clients from cultures other Nursing. Belmont, CA: Delmar Cengage Learning, 1999.
than your own provides a foundation for developing
cultural sensitivity. Our cultural values are the “prin-
independence, privacy, biomedical medicine, and physi-
ciples or standards that members of a cultural group
cal appearance. Cultural values are the grounding forces
share in common.”39 For example, in the United States,
that provide meaning, structure, and organization in our
great value is placed on money, freedom, individualism,
lives. (See Table 1.2.) Individuals may hold onto their val-
ues despite numerous obstacles or severe consequences.
Exercise 1.6 Why Do You Want to Be a Helper? For example, Jung Chang describes in her family portrait,
Wild Swans: Three Daughters of China, how her father
Describe in your journal what it means to be a helper
actively supported Mao’s Communist takeover of China
and why you want to be a helper. How does it feel
and rose to be a prominent official in the party. His devo-
when you help someone? Is it possible that you have
tion to the party never wavered, even during the Cultural
issues related to dominance or neediness that could
Revolution when he was denounced, publicly humiliated
overshadow interactions with your clients?
with a dunce hat, and sent to a rehabilitation camp.40
Exercise 1.7 What Is Your Worldview?

Indicate on the continuum the degree to which you share the following white North American cultural values; 1 indicates
not at all, and 5 represents very much.
Not Very
at All Much
1 2 3 4 5 Personal responsibility and self-help for preventing illness.
1 2 3 4 5 Promptness, schedules, and rapid response-time dominates.
1 2 3 4 5 Future-oriented—willing to make sacrifices to obtain future goals.
1 2 3 4 5 Task-oriented—desire direct participation in your own health care.
1 2 3 4 5 Direct, honest, open dialogue is essential to effective communication.
1 2 3 4 5 Informal communication is a sign of friendliness.
1 2 3 4 5 Technology is of foremost importance in conquering illness.

1 2 3 4 5 Body and soul are separate entities.
1 2 3 4 5 Client confidentiality is of utmost importance; health care is for individuals, not families.
1 2 3 4 5 All patients deserve equal access to health care.
1 2 3 4 5 Desire to be youthful, thin, and fit.
1 2 3 4 5 Competition and independence.
1 2 3 4 5 Materialism.
Can you think of a time when your values and beliefs were in conflict with a person you were trying to associate with?
What were the circumstances and results of that conflict? Write your response in your journal, and share your stories
with your colleagues.
Source: Adapted from Kittler P and Sucher K, Food and Culture in America, 2d ed. (Belmont, CA: West/Wadsworth; 1998); and Keenan, Debra P.
In the face of diversity: Modifying nutrition education delivery to meet the needs of an increasingly multicultural consumer base, J Nutr Ed.
1996;28:86–91.
As nutrition counselors and educators advocate

Exercise 1.8 Explore Your Biases
for change, there needs to be an appreciation of the
high degree of importance placed on certain beliefs, You can explore possible biases that you have by going
values, and cultural practices. You can then empathize to the Harvard Project Implicit website.
with individuals from non-Western cultures who are ❏❏ Go to a quiet environment that will allow you to com-
experiencing confusion and problems as they try to pete an implicit bias evaluation.
participate in the North American health care system. ❏❏ Go to the following website: https://implicit.harvard.
Also, awareness can help prevent your personal biases, edu/implicit/takeatest.html.
values, or problems from interfering with your ability to ❏❏ Select a category for evaluation.
work with clients who are culturally different from you. ❏❏ Take the quiz for the category you selected and
Conscious and unconscious prejudices unrelated to answer the following questions in your journal:
cultural issues that a counselor may possess could also 1. How did the evaluation compare to your beliefs
interfere with emotional objectivity in a counseling about the category you chose?
situation. Individuals could have exaggerated dislikes 2. Our biases are often unconscious. Considering the
of personal characteristics such as being obese, bald, evaluation you just completed, comment on this
aggressive, or poorly dressed. Awareness of these pre-
statement.
judices can help build tolerances and a commitment not
3. Do you agree with the bias evaluation you
to let them interfere with the counseling process through
received Explain?
facial expressions and other nonverbal behavior.
movies, and cultural encounters in markets, fairs, and

Exercise 1.9 What Are Your Food Habits?
restaurants. Learning your clients’ beliefs about illness
Record answers to the following questions in your journal; and the various functions and meanings of food are par-
share them with your colleagues. ticularly important. While exploring cultural groups,
❏❏ Who purchases and prepares most of the food con- you should remember that the characteristics of a group
sumed in your household? are simply generalities. You want to avoid stereotyping.
Do not fall into the trap of believing that each charac-
❏❏ What is your ethnic background and religious
teristic applies to all people who appear to represent a
affiliation?
particular group. Remember that the thoughts and be-
❏❏ Are there foods you avoid eating for religious
haviors of each individual develop over a lifetime and
reasons?
are shaped by membership in several cultural groups. For
❏❏ List two foods you believe are high-status items. example, a homosexual male who grew up with a learn-
❏❏ What major holidays do you celebrate with your ing disability in Alabama with first-generation parents
family? from Italy and lives in Chicago as an adult would have a
❏❏ List two rules you follow when eating a meal (for number of social groups and life experiences influencing
example, “Don’t sing at the table”). his communication style, view of the world, and expec-
❏❏ Are there food habits that you find morally or ethically tations. People totally, partially, or not at all embrace the
repugnant? standards of a culture they appear to represent.
The circumstances that bring clients to counseling
❏❏ Are you aware of any of your own food habits that
can have a major impact on their readiness for nutrition
others would consider repugnant?
counseling. Those who have been recently diagnosed
Source: Adapted from Kittler P and Sucher K, Food and Culture, with a serious illness may be experiencing shock or a
4th ed. (Belmont, CA: Wadsworth/Thomson; 2004), pp. 24–25.
great deal of physical discomfort to deal effectively with
complex dietary guidelines—or any guidelines at all.
They may display a tendency toward rebelliousness, a
Understanding your Client denial of the existence of the problems, anxiety, anger,
Just like counselors, clients come into nutrition coun- or depression. When counseling an individual with a
seling with unique personalities, cultural orientations, life-threatening illness, nutrition counselors need to take
health care problems, and issues related to the coun- into account a client’s position on the continuum of
seling process. Each person’s personality should be treatment and recovery.
recognized and appreciated. Clients have their own set An attitudinal investigation of young and well-
of needs, expectations, concerns, and prejudices that educated patients with diabetes suggests a desire for a
will have an impact on the counseling relationship. In collaborative relationship with their health care pro-
the rushed atmosphere of some institutional settings, viders helping them to explore options rather than
health care workers can lose sight of simply being told what to do.41 On
the need to show respect, especially the other hand, this same study
Anecdote
if clients have lost some of their identified a significant number of
My client, a robust man in his youth, was a
physiological or mental functions World War II veteran who took part in the in- the elderly with diabetes who did not
due to illness. vasion of Normandy. But at age seventy-five, desire an independent self-care role.
From a cultural perspective, cli- he suffered a stroke and went into a veter- Promoting self-sufficiency is often
ents are diverse in many ways, be- ans’ hospital for treatment. During his hos- a stated goal of nutrition coun-
long to a number of societal groups, pital stay, he asked a health care worker to seling; 42 however, for some cli-
and have a set of unique life expe- help him get into bed because he wanted to ents, that goal may need to be
riences contributing to a distinctive go to sleep. The worker told him he would be modified. This issue has also been
worldview. Getting a fresh perspec- able to go to sleep after he finished his lunch. addressed by the expert panel
tive from a counselor is one of the My client became very angry and threw his for the National Institutes of Health
advantages of counseling. However, lunch tray at the health care worker. report, Identification, Evaluation, and
the further away counselors are Treatment of Overweight and Obesity
from their clients’ cultural orientation, the more dif- in Adults,43 which states that a weight maintenance pro-
ficult it is to understand their worldview. If this is the gram consisting of diet therapy, behavior therapy, and
case, then you will need to explore your clients’ culture physical activity may need to be continued indefinitely
through books, newspapers, magazines, workshops, for some individuals.
Exercise 1.10 Exploring Food Habits of Others Exercise 1.11 Starting a Relationship
Interview someone from a culture different than your Lilly is forty-two years old, has three children, and is about
own. Ask that person the questions in Exercise 1.7, and twenty pounds overweight. She sought the help of a
record his or her answers in your journal. What did you fitness and nutrition counselor, Joe, because she wants
learn from this activity? How can you personally avoid to increase her energy level and endurance. She tires
ethnocentric judgments regarding food habits? quickly and feels that exercise will help her stamina.
Joe Hello, Lilly. It’s great you came a little early.
Let’s get you right on the scale. OK, at
Some clients may regard the counseling process it- 163 pounds, it looks to me as if you need
self as an issue. The act of seeking and receiving help can to shed about 20 pounds. You have a
create feelings of vulnerability and incompetence. Dur-
ways to go but worry not—we will get it
ing counseling there is a presumed goal of doing some-
off you. Everything will be fine.
thing for the clients or changing them in some way.
Lilly I really…
This implication of superiority can raise hostile feelings
Joe I am not kidding, Lilly—don’t worry. We
in the client because the act presumes that the helper
will start slowly. What you want to do is
is wiser, more competent, and more powerful than the
get your BMI down, your muscle tissue
client. This is illustrated in Helen Keller’s account of her
up, as well as get rid of the fat. If you fol-
dreams about her teacher and lifelong friend, Annie Sul-
livan, who provided constant help for almost all aspects low me, I’ll introduce you to everyone,
of Helen’s existence: sign you up for an aerobics class, and
start you on your routine.
[T]here are some unaccountable contradictions Lilly Well, you see I only want…
in my dreams. For instance, although I have the Joe Hey, Rick, this is Lilly. She is a newcomer.
strongest, deepest affection for my teacher, yet
Rick Welcome, Lilly. Don’t forget to take home
when she appears to me in my sleep, we quarrel
some of our power bars—they are great
and fling the wildest reproaches at each other.
for beginners who may not know how to
She seizes me by the hand and drags me by
eat right.
main force towards I can never decide what—an
Joe Yeah, and be sure to bring a sports drink
abyss, a perilous mountain pass or a rushing
in with you; you will get mighty thirsty.
torrent, whatever in my terror I may imagine.44
No pain, no gain!
(pp. 165–166)
In groups of three, brainstorm the concerns in this
To help alleviate the negative impact of such issues
scenario. Why is this helping relationship off to a bad
on the counseling process, the motive for help and the
start? What questions or comments could Joe have
nature of the helping task as perceived by the counselor
made that may have been more helpful?
should be made clear to the receiver.
Relationship Between Helper and Client successful Diabetes Control and Complications Trial, cli-
The helping relationship is often divided into two ents could better communicate their capabilities when
phases: building a relationship and facilitating positive health professionals articulated what problems could
action. Building a relationship requires the development develop in attempting to improve blood glucose con-
of rapport, an ability to show empathy, and the forma- trol. They found honesty more likely to occur in an
tion of a trusting relationship.45 The goals of this phase environment in which clients do not feel they will be
are to learn about the nature of the problems from the criticized when difficulties occur, but rather believe the
client’s viewpoint, explore strengths, and promote caregivers will show understanding and work toward
self-exploration. preparing for similar future circumstances. Nonjudg-
The focus of the second phase of the counseling mental feedback was also an important component of
process is to help clients identify specific behaviors to the successful DASH (Dietary Approaches to Stop Hy-
alter and to design realistic behavior change strategies pertension) dietary trial for reducing hypertension.47
to facilitate positive action. 45 This means clients need Counselors must communicate their willingness to dis-
to be open and honest about what they are willing cover their clients’ concerns and help them prioritize
and not willing to do. Lorenz et al.46 state that in the in a realistic manner.
In summary, it would be futile to start designing Another issue for novice nutrition counselors is as-
behavior change strategies when an effective relation- suming the role of expert or empathizer. Combining
ship has not developed and you do not yet have a clear the two roles can contribute to an effective interven-
understanding of your clients’ problems or an appre- tion, but a single approach is likely to hamper progress.
ciation of their strengths. According to Laquatra and An authority figure is impressive and appears to have
Danish:45 all the answers. Clients blindly accept the direction of
the “guru,” but little work is done to determine how to
Attending to the second part of the counseling
make the lifestyle changes work for them. As a result,
process without the strong foundation afforded by
clients revert to old eating patterns. On the other hand,
the first part results in dealing with the problem
the empathizer puts so much effort into focusing on cli-
as being separate from the client, or worse yet, pro-
ent problems that the client receives little direction or
viding solutions to the wrong problems. Behavior-
information. With experience and determination, the
change strategies designed under these circum-
two roles can be effectively combined.
stances are not likely to succeed. (p. 352)
The scenario in Exercise 1.11 illustrates a common

mistake helpers make—indicating that everything will Key Terms
be fine. Because it has no basis for reality, the comment
Cultural Groups: nonexclusive groups that have a set of
belittles the client’s feelings. If the client actually feels
values in common; an individual may be part of several
reassured by the comment, the benefit is temporary
cultural groups at the same time.
because no solution to the problem has been sought.
Patronizing a client is self-defeating. It indicates supe- Culture: learned patterns of thinking, feeling, and
riority and can automatically create negative feelings. behaving that are shared by a group of people.
Effective counselors provide reassurance through clari- Cultural Values: principles or standards of a cultural
fying their roles in the counseling process, identifying group.
possible solutions, and explaining the counseling Models: generalized descriptions used to analyze or
program. explain something.
Nutrition Counseling: a supportive process guiding a
Novice Counselor Issues client toward nutritional well-being.
New counselors typically have concerns about their
Nutrition Education: learning experiences aimed to
competency. A counselor who feels inadequate may be
promote voluntary adoption of health-promoting
reluctant to handle controversial nutrition issues, some-
dietary behaviors.
times giving only partial answers and ignoring critical
Worldview: perception of the world that is biased by
questions. Confidence in your ability will increase with
culture and personal experience.
experience.
Client: Are high-protein diets a good way to lose

weight? REVIEW QUESTIONS
Counselor: Some people say they lose weight 1. Define nutrition counseling and nutrition
using them. education.
In this example, the counselor is talking like a 2. What is generally considered the most important
politician—not taking a stand, trying not to offend any- determinant of food choices?
one. If you are not clear about an issue, you can tell your 3. Name and explain the seven qualities of counselors
client that it is a topic you have not thoroughly investi- considered to be the most influential by leading
gated and that you will review the matter. If after investi- authorities as identified by Okun.
gating the issue, you still do not have a clear answer, you
4. Explain how taking on the role of helper improves
should provide your client with what you have found
the self-image of the helpee.
out regarding the positives and negatives of the topic.
The Academy of Nutrition and Dietetics Code of Ethics33 5. Identify and explain how seeking to fulfill two basic
states, “The dietetics practitioner presents reliable and needs of counselors through a counseling relation-
substantiated information and interprets controversial ship can be detrimental to the relationship.
information without personal bias, recognizing that 6. Why is it important for counselors to understand
legitimate differences of opinion exist.” their worldviews to achieve cultural sensitivity?
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2
Frameworks for
15
Understanding and
Attaining Behavior Change
Learning Objectives
2.1 xplain the importance of behavior
E
change models and theories for a
nutrition practitioner.
2.2 Describe and apply major concepts of
selected behavior change theories and
models.
2.3 Describe major components of selected
theoretical approaches to counseling.
© iStock.com/majaiva
2.4 Differentiate counseling approaches for
various durations of brief interventions.
Change and growth take place when a person has risked himself and dares
to become involved with experimenting with his own life.
—HERBERT OTTO
15
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DANCE ON STILTS AT THE GIRLS’ UNYAGO, NIUCHI
Newala, too, suffers from the distance of its water-supply—at least

the Newala of to-day does; there was once another Newala in a lovely
valley at the foot of the plateau. I visited it and found scarcely a trace
of houses, only a Christian cemetery, with the graves of several
missionaries and their converts, remaining as a monument of its
former glories. But the surroundings are wonderfully beautiful. A
thick grove of splendid mango-trees closes in the weather-worn
crosses and headstones; behind them, combining the useful and the
agreeable, is a whole plantation of lemon-trees covered with ripe
fruit; not the small African kind, but a much larger and also juicier
imported variety, which drops into the hands of the passing traveller,
without calling for any exertion on his part. Old Newala is now under
the jurisdiction of the native pastor, Daudi, at Chingulungulu, who,
as I am on very friendly terms with him, allows me, as a matter of
course, the use of this lemon-grove during my stay at Newala.
FEET MUTILATED BY THE RAVAGES OF THE “JIGGER”
(Sarcopsylla penetrans)
The water-supply of New Newala is in the bottom of the valley,

some 1,600 feet lower down. The way is not only long and fatiguing,
but the water, when we get it, is thoroughly bad. We are suffering not
only from this, but from the fact that the arrangements at Newala are
nothing short of luxurious. We have a separate kitchen—a hut built
against the boma palisade on the right of the baraza, the interior of
which is not visible from our usual position. Our two cooks were not
long in finding this out, and they consequently do—or rather neglect
to do—what they please. In any case they do not seem to be very
particular about the boiling of our drinking-water—at least I can
attribute to no other cause certain attacks of a dysenteric nature,
from which both Knudsen and I have suffered for some time. If a
man like Omari has to be left unwatched for a moment, he is capable
of anything. Besides this complaint, we are inconvenienced by the
state of our nails, which have become as hard as glass, and crack on
the slightest provocation, and I have the additional infliction of
pimples all over me. As if all this were not enough, we have also, for
the last week been waging war against the jigger, who has found his
Eldorado in the hot sand of the Makonde plateau. Our men are seen
all day long—whenever their chronic colds and the dysentery likewise
raging among them permit—occupied in removing this scourge of
Africa from their feet and trying to prevent the disastrous
consequences of its presence. It is quite common to see natives of
this place with one or two toes missing; many have lost all their toes,
or even the whole front part of the foot, so that a well-formed leg
ends in a shapeless stump. These ravages are caused by the female of
Sarcopsylla penetrans, which bores its way under the skin and there
develops an egg-sac the size of a pea. In all books on the subject, it is
stated that one’s attention is called to the presence of this parasite by
an intolerable itching. This agrees very well with my experience, so
far as the softer parts of the sole, the spaces between and under the
toes, and the side of the foot are concerned, but if the creature
penetrates through the harder parts of the heel or ball of the foot, it
may escape even the most careful search till it has reached maturity.
Then there is no time to be lost, if the horrible ulceration, of which
we see cases by the dozen every day, is to be prevented. It is much
easier, by the way, to discover the insect on the white skin of a
European than on that of a native, on which the dark speck scarcely
shows. The four or five jiggers which, in spite of the fact that I
constantly wore high laced boots, chose my feet to settle in, were
taken out for me by the all-accomplished Knudsen, after which I
thought it advisable to wash out the cavities with corrosive
sublimate. The natives have a different sort of disinfectant—they fill
the hole with scraped roots. In a tiny Makua village on the slope of
the plateau south of Newala, we saw an old woman who had filled all
the spaces under her toe-nails with powdered roots by way of
prophylactic treatment. What will be the result, if any, who can say?
The rest of the many trifling ills which trouble our existence are
really more comic than serious. In the absence of anything else to
smoke, Knudsen and I at last opened a box of cigars procured from
the Indian store-keeper at Lindi, and tried them, with the most
distressing results. Whether they contain opium or some other
narcotic, neither of us can say, but after the tenth puff we were both
“off,” three-quarters stupefied and unspeakably wretched. Slowly we
recovered—and what happened next? Half-an-hour later we were
once more smoking these poisonous concoctions—so insatiable is the
craving for tobacco in the tropics.
Even my present attacks of fever scarcely deserve to be taken
seriously. I have had no less than three here at Newala, all of which
have run their course in an incredibly short time. In the early
afternoon, I am busy with my old natives, asking questions and
making notes. The strong midday coffee has stimulated my spirits to
an extraordinary degree, the brain is active and vigorous, and work
progresses rapidly, while a pleasant warmth pervades the whole
body. Suddenly this gives place to a violent chill, forcing me to put on
my overcoat, though it is only half-past three and the afternoon sun
is at its hottest. Now the brain no longer works with such acuteness
and logical precision; more especially does it fail me in trying to
establish the syntax of the difficult Makua language on which I have
ventured, as if I had not enough to do without it. Under the
circumstances it seems advisable to take my temperature, and I do
so, to save trouble, without leaving my seat, and while going on with
my work. On examination, I find it to be 101·48°. My tutors are
abruptly dismissed and my bed set up in the baraza; a few minutes
later I am in it and treating myself internally with hot water and
lemon-juice.
Three hours later, the thermometer marks nearly 104°, and I make
them carry me back into the tent, bed and all, as I am now perspiring
heavily, and exposure to the cold wind just beginning to blow might
mean a fatal chill. I lie still for a little while, and then find, to my
great relief, that the temperature is not rising, but rather falling. This
is about 7.30 p.m. At 8 p.m. I find, to my unbounded astonishment,
that it has fallen below 98·6°, and I feel perfectly well. I read for an
hour or two, and could very well enjoy a smoke, if I had the
wherewithal—Indian cigars being out of the question.
Having no medical training, I am at a loss to account for this state
of things. It is impossible that these transitory attacks of high fever
should be malarial; it seems more probable that they are due to a
kind of sunstroke. On consulting my note-book, I become more and
more inclined to think this is the case, for these attacks regularly
follow extreme fatigue and long exposure to strong sunshine. They at
least have the advantage of being only short interruptions to my
work, as on the following morning I am always quite fresh and fit.
My treasure of a cook is suffering from an enormous hydrocele which
makes it difficult for him to get up, and Moritz is obliged to keep in
the dark on account of his inflamed eyes. Knudsen’s cook, a raw boy
from somewhere in the bush, knows still less of cooking than Omari;
consequently Nils Knudsen himself has been promoted to the vacant
post. Finding that we had come to the end of our supplies, he began
by sending to Chingulungulu for the four sucking-pigs which we had
bought from Matola and temporarily left in his charge; and when
they came up, neatly packed in a large crate, he callously slaughtered
the biggest of them. The first joint we were thoughtless enough to
entrust for roasting to Knudsen’s mshenzi cook, and it was
consequently uneatable; but we made the rest of the animal into a
jelly which we ate with great relish after weeks of underfeeding,
consuming incredible helpings of it at both midday and evening
meals. The only drawback is a certain want of variety in the tinned
vegetables. Dr. Jäger, to whom the Geographical Commission
entrusted the provisioning of the expeditions—mine as well as his
own—because he had more time on his hands than the rest of us,
seems to have laid in a huge stock of Teltow turnips,[46] an article of
food which is all very well for occasional use, but which quickly palls
when set before one every day; and we seem to have no other tins
left. There is no help for it—we must put up with the turnips; but I
am certain that, once I am home again, I shall not touch them for ten
years to come.
Amid all these minor evils, which, after all, go to make up the
genuine flavour of Africa, there is at least one cheering touch:
Knudsen has, with the dexterity of a skilled mechanic, repaired my 9
× 12 cm. camera, at least so far that I can use it with a little care.
How, in the absence of finger-nails, he was able to accomplish such a
ticklish piece of work, having no tool but a clumsy screw-driver for
taking to pieces and putting together again the complicated
mechanism of the instantaneous shutter, is still a mystery to me; but
he did it successfully. The loss of his finger-nails shows him in a light
contrasting curiously enough with the intelligence evinced by the
above operation; though, after all, it is scarcely surprising after his
ten years’ residence in the bush. One day, at Lindi, he had occasion
to wash a dog, which must have been in need of very thorough
cleansing, for the bottle handed to our friend for the purpose had an
extremely strong smell. Having performed his task in the most
conscientious manner, he perceived with some surprise that the dog
did not appear much the better for it, and was further surprised by
finding his own nails ulcerating away in the course of the next few
days. “How was I to know that carbolic acid has to be diluted?” he
mutters indignantly, from time to time, with a troubled gaze at his
mutilated finger-tips.
Since we came to Newala we have been making excursions in all
directions through the surrounding country, in accordance with old
habit, and also because the akida Sefu did not get together the tribal
elders from whom I wanted information so speedily as he had
promised. There is, however, no harm done, as, even if seen only
from the outside, the country and people are interesting enough.
The Makonde plateau is like a large rectangular table rounded off
at the corners. Measured from the Indian Ocean to Newala, it is
about seventy-five miles long, and between the Rovuma and the
Lukuledi it averages fifty miles in breadth, so that its superficial area
is about two-thirds of that of the kingdom of Saxony. The surface,
however, is not level, but uniformly inclined from its south-western
edge to the ocean. From the upper edge, on which Newala lies, the
eye ranges for many miles east and north-east, without encountering
any obstacle, over the Makonde bush. It is a green sea, from which
here and there thick clouds of smoke rise, to show that it, too, is
inhabited by men who carry on their tillage like so many other
primitive peoples, by cutting down and burning the bush, and
manuring with the ashes. Even in the radiant light of a tropical day
such a fire is a grand sight.
Much less effective is the impression produced just now by the
great western plain as seen from the edge of the plateau. As often as
time permits, I stroll along this edge, sometimes in one direction,
sometimes in another, in the hope of finding the air clear enough to
let me enjoy the view; but I have always been disappointed.
Wherever one looks, clouds of smoke rise from the burning bush,
and the air is full of smoke and vapour. It is a pity, for under more
favourable circumstances the panorama of the whole country up to
the distant Majeje hills must be truly magnificent. It is of little use
taking photographs now, and an outline sketch gives a very poor idea
of the scenery. In one of these excursions I went out of my way to
make a personal attempt on the Makonde bush. The present edge of
the plateau is the result of a far-reaching process of destruction
through erosion and denudation. The Makonde strata are
everywhere cut into by ravines, which, though short, are hundreds of
yards in depth. In consequence of the loose stratification of these
beds, not only are the walls of these ravines nearly vertical, but their
upper end is closed by an equally steep escarpment, so that the
western edge of the Makonde plateau is hemmed in by a series of
deep, basin-like valleys. In order to get from one side of such a ravine
to the other, I cut my way through the bush with a dozen of my men.
It was a very open part, with more grass than scrub, but even so the
short stretch of less than two hundred yards was very hard work; at
the end of it the men’s calicoes were in rags and they themselves
bleeding from hundreds of scratches, while even our strong khaki
suits had not escaped scatheless.
NATIVE PATH THROUGH THE MAKONDE BUSH, NEAR

MAHUTA
I see increasing reason to believe that the view formed some time
back as to the origin of the Makonde bush is the correct one. I have
no doubt that it is not a natural product, but the result of human
occupation. Those parts of the high country where man—as a very
slight amount of practice enables the eye to perceive at once—has not
yet penetrated with axe and hoe, are still occupied by a splendid
timber forest quite able to sustain a comparison with our mixed
forests in Germany. But wherever man has once built his hut or tilled
his field, this horrible bush springs up. Every phase of this process
may be seen in the course of a couple of hours’ walk along the main
road. From the bush to right or left, one hears the sound of the axe—
not from one spot only, but from several directions at once. A few
steps further on, we can see what is taking place. The brush has been
cut down and piled up in heaps to the height of a yard or more,
between which the trunks of the large trees stand up like the last
pillars of a magnificent ruined building. These, too, present a
melancholy spectacle: the destructive Makonde have ringed them—
cut a broad strip of bark all round to ensure their dying off—and also
piled up pyramids of brush round them. Father and son, mother and
son-in-law, are chopping away perseveringly in the background—too
busy, almost, to look round at the white stranger, who usually excites
so much interest. If you pass by the same place a week later, the piles
of brushwood have disappeared and a thick layer of ashes has taken
the place of the green forest. The large trees stretch their
smouldering trunks and branches in dumb accusation to heaven—if
they have not already fallen and been more or less reduced to ashes,
perhaps only showing as a white stripe on the dark ground.
This work of destruction is carried out by the Makonde alike on the
virgin forest and on the bush which has sprung up on sites already
cultivated and deserted. In the second case they are saved the trouble
of burning the large trees, these being entirely absent in the
secondary bush.
After burning this piece of forest ground and loosening it with the
hoe, the native sows his corn and plants his vegetables. All over the
country, he goes in for bed-culture, which requires, and, in fact,
receives, the most careful attention. Weeds are nowhere tolerated in
the south of German East Africa. The crops may fail on the plains,
where droughts are frequent, but never on the plateau with its
abundant rains and heavy dews. Its fortunate inhabitants even have
the satisfaction of seeing the proud Wayao and Wamakua working
for them as labourers, driven by hunger to serve where they were
accustomed to rule.
But the light, sandy soil is soon exhausted, and would yield no
harvest the second year if cultivated twice running. This fact has
been familiar to the native for ages; consequently he provides in
time, and, while his crop is growing, prepares the next plot with axe
and firebrand. Next year he plants this with his various crops and
lets the first piece lie fallow. For a short time it remains waste and
desolate; then nature steps in to repair the destruction wrought by
man; a thousand new growths spring out of the exhausted soil, and
even the old stumps put forth fresh shoots. Next year the new growth
is up to one’s knees, and in a few years more it is that terrible,
impenetrable bush, which maintains its position till the black
occupier of the land has made the round of all the available sites and
come back to his starting point.
The Makonde are, body and soul, so to speak, one with this bush.
According to my Yao informants, indeed, their name means nothing
else but “bush people.” Their own tradition says that they have been
settled up here for a very long time, but to my surprise they laid great
stress on an original immigration. Their old homes were in the
south-east, near Mikindani and the mouth of the Rovuma, whence
their peaceful forefathers were driven by the continual raids of the
Sakalavas from Madagascar and the warlike Shirazis[47] of the coast,
to take refuge on the almost inaccessible plateau. I have studied
African ethnology for twenty years, but the fact that changes of
population in this apparently quiet and peaceable corner of the earth
could have been occasioned by outside enterprises taking place on
the high seas, was completely new to me. It is, no doubt, however,
correct.
The charming tribal legend of the Makonde—besides informing us
of other interesting matters—explains why they have to live in the
thickest of the bush and a long way from the edge of the plateau,
instead of making their permanent homes beside the purling brooks
and springs of the low country.
“The place where the tribe originated is Mahuta, on the southern
side of the plateau towards the Rovuma, where of old time there was
nothing but thick bush. Out of this bush came a man who never
washed himself or shaved his head, and who ate and drank but little.
He went out and made a human figure from the wood of a tree
growing in the open country, which he took home to his abode in the
bush and there set it upright. In the night this image came to life and
was a woman. The man and woman went down together to the
Rovuma to wash themselves. Here the woman gave birth to a still-
born child. They left that place and passed over the high land into the
valley of the Mbemkuru, where the woman had another child, which
was also born dead. Then they returned to the high bush country of
Mahuta, where the third child was born, which lived and grew up. In
course of time, the couple had many more children, and called
themselves Wamatanda. These were the ancestral stock of the
Makonde, also called Wamakonde,[48] i.e., aborigines. Their
forefather, the man from the bush, gave his children the command to
bury their dead upright, in memory of the mother of their race who
was cut out of wood and awoke to life when standing upright. He also
warned them against settling in the valleys and near large streams,
for sickness and death dwelt there. They were to make it a rule to
have their huts at least an hour’s walk from the nearest watering-
place; then their children would thrive and escape illness.”
The explanation of the name Makonde given by my informants is
somewhat different from that contained in the above legend, which I
extract from a little book (small, but packed with information), by
Pater Adams, entitled Lindi und sein Hinterland. Otherwise, my
results agree exactly with the statements of the legend. Washing?
Hapana—there is no such thing. Why should they do so? As it is, the
supply of water scarcely suffices for cooking and drinking; other
people do not wash, so why should the Makonde distinguish himself
by such needless eccentricity? As for shaving the head, the short,
woolly crop scarcely needs it,[49] so the second ancestral precept is
likewise easy enough to follow. Beyond this, however, there is
nothing ridiculous in the ancestor’s advice. I have obtained from
various local artists a fairly large number of figures carved in wood,
ranging from fifteen to twenty-three inches in height, and
representing women belonging to the great group of the Mavia,
Makonde, and Matambwe tribes. The carving is remarkably well
done and renders the female type with great accuracy, especially the
keloid ornamentation, to be described later on. As to the object and
meaning of their works the sculptors either could or (more probably)
would tell me nothing, and I was forced to content myself with the
scanty information vouchsafed by one man, who said that the figures
were merely intended to represent the nembo—the artificial
deformations of pelele, ear-discs, and keloids. The legend recorded
by Pater Adams places these figures in a new light. They must surely
be more than mere dolls; and we may even venture to assume that
they are—though the majority of present-day Makonde are probably
unaware of the fact—representations of the tribal ancestress.
The references in the legend to the descent from Mahuta to the
Rovuma, and to a journey across the highlands into the Mbekuru
valley, undoubtedly indicate the previous history of the tribe, the
travels of the ancestral pair typifying the migrations of their
descendants. The descent to the neighbouring Rovuma valley, with
its extraordinary fertility and great abundance of game, is intelligible
at a glance—but the crossing of the Lukuledi depression, the ascent
to the Rondo Plateau and the descent to the Mbemkuru, also lie
within the bounds of probability, for all these districts have exactly
the same character as the extreme south. Now, however, comes a
point of especial interest for our bacteriological age. The primitive
Makonde did not enjoy their lives in the marshy river-valleys.
Disease raged among them, and many died. It was only after they
had returned to their original home near Mahuta, that the health
conditions of these people improved. We are very apt to think of the
African as a stupid person whose ignorance of nature is only equalled
by his fear of it, and who looks on all mishaps as caused by evil
spirits and malignant natural powers. It is much more correct to
assume in this case that the people very early learnt to distinguish
districts infested with malaria from those where it is absent.
This knowledge is crystallized in the
ancestral warning against settling in the
valleys and near the great waters, the
dwelling-places of disease and death. At the
same time, for security against the hostile
Mavia south of the Rovuma, it was enacted
that every settlement must be not less than a
certain distance from the southern edge of the
plateau. Such in fact is their mode of life at the
present day. It is not such a bad one, and
certainly they are both safer and more
comfortable than the Makua, the recent
intruders from the south, who have made USUAL METHOD OF
good their footing on the western edge of the CLOSING HUT-DOOR
plateau, extending over a fairly wide belt of
country. Neither Makua nor Makonde show in their dwellings
anything of the size and comeliness of the Yao houses in the plain,
especially at Masasi, Chingulungulu and Zuza’s. Jumbe Chauro, a
Makonde hamlet not far from Newala, on the road to Mahuta, is the
most important settlement of the tribe I have yet seen, and has fairly
spacious huts. But how slovenly is their construction compared with
the palatial residences of the elephant-hunters living in the plain.
The roofs are still more untidy than in the general run of huts during
the dry season, the walls show here and there the scanty beginnings
or the lamentable remains of the mud plastering, and the interior is a
veritable dog-kennel; dirt, dust and disorder everywhere. A few huts
only show any attempt at division into rooms, and this consists
merely of very roughly-made bamboo partitions. In one point alone
have I noticed any indication of progress—in the method of fastening
the door. Houses all over the south are secured in a simple but
ingenious manner. The door consists of a set of stout pieces of wood
or bamboo, tied with bark-string to two cross-pieces, and moving in
two grooves round one of the door-posts, so as to open inwards. If
the owner wishes to leave home, he takes two logs as thick as a man’s
upper arm and about a yard long. One of these is placed obliquely
against the middle of the door from the inside, so as to form an angle
of from 60° to 75° with the ground. He then places the second piece
horizontally across the first, pressing it downward with all his might.
It is kept in place by two strong posts planted in the ground a few
inches inside the door. This fastening is absolutely safe, but of course
cannot be applied to both doors at once, otherwise how could the
owner leave or enter his house? I have not yet succeeded in finding
out how the back door is fastened.
MAKONDE LOCK AND KEY AT JUMBE CHAURO

This is the general way of closing a house. The Makonde at Jumbe
Chauro, however, have a much more complicated, solid and original
one. Here, too, the door is as already described, except that there is
only one post on the inside, standing by itself about six inches from
one side of the doorway. Opposite this post is a hole in the wall just
large enough to admit a man’s arm. The door is closed inside by a
large wooden bolt passing through a hole in this post and pressing
with its free end against the door. The other end has three holes into
which fit three pegs running in vertical grooves inside the post. The
door is opened with a wooden key about a foot long, somewhat
curved and sloped off at the butt; the other end has three pegs
corresponding to the holes, in the bolt, so that, when it is thrust
through the hole in the wall and inserted into the rectangular
opening in the post, the pegs can be lifted and the bolt drawn out.[50]
MODE OF INSERTING THE KEY
With no small pride first one householder and then a second

showed me on the spot the action of this greatest invention of the
Makonde Highlands. To both with an admiring exclamation of
“Vizuri sana!” (“Very fine!”). I expressed the wish to take back these
marvels with me to Ulaya, to show the Wazungu what clever fellows
the Makonde are. Scarcely five minutes after my return to camp at
Newala, the two men came up sweating under the weight of two
heavy logs which they laid down at my feet, handing over at the same
time the keys of the fallen fortress. Arguing, logically enough, that if
the key was wanted, the lock would be wanted with it, they had taken
their axes and chopped down the posts—as it never occurred to them
to dig them out of the ground and so bring them intact. Thus I have
two badly damaged specimens, and the owners, instead of praise,
come in for a blowing-up.
The Makua huts in the environs of Newala are especially
miserable; their more than slovenly construction reminds one of the
temporary erections of the Makua at Hatia’s, though the people here
have not been concerned in a war. It must therefore be due to
congenital idleness, or else to the absence of a powerful chief. Even
the baraza at Mlipa’s, a short hour’s walk south-east of Newala,
shares in this general neglect. While public buildings in this country
are usually looked after more or less carefully, this is in evident
danger of being blown over by the first strong easterly gale. The only
attractive object in this whole district is the grave of the late chief
Mlipa. I visited it in the morning, while the sun was still trying with
partial success to break through the rolling mists, and the circular
grove of tall euphorbias, which, with a broken pot, is all that marks
the old king’s resting-place, impressed one with a touch of pathos.
Even my very materially-minded carriers seemed to feel something
of the sort, for instead of their usual ribald songs, they chanted
solemnly, as we marched on through the dense green of the Makonde
bush:—
“We shall arrive with the great master; we stand in a row and have
no fear about getting our food and our money from the Serkali (the
Government). We are not afraid; we are going along with the great
master, the lion; we are going down to the coast and back.”
With regard to the characteristic features of the various tribes here
on the western edge of the plateau, I can arrive at no other
conclusion than the one already come to in the plain, viz., that it is
impossible for anyone but a trained anthropologist to assign any
given individual at once to his proper tribe. In fact, I think that even
an anthropological specialist, after the most careful examination,
might find it a difficult task to decide. The whole congeries of peoples
collected in the region bounded on the west by the great Central
African rift, Tanganyika and Nyasa, and on the east by the Indian
Ocean, are closely related to each other—some of their languages are
only distinguished from one another as dialects of the same speech,
and no doubt all the tribes present the same shape of skull and
structure of skeleton. Thus, surely, there can be no very striking
differences in outward appearance.
Even did such exist, I should have no time
to concern myself with them, for day after day,
I have to see or hear, as the case may be—in
any case to grasp and record—an
extraordinary number of ethnographic
phenomena. I am almost disposed to think it
fortunate that some departments of inquiry, at
least, are barred by external circumstances.
Chief among these is the subject of iron-
working. We are apt to think of Africa as a
country where iron ore is everywhere, so to
speak, to be picked up by the roadside, and
where it would be quite surprising if the
inhabitants had not learnt to smelt the
material ready to their hand. In fact, the
knowledge of this art ranges all over the
continent, from the Kabyles in the north to the
Kafirs in the south. Here between the Rovuma
and the Lukuledi the conditions are not so
favourable. According to the statements of the
Makonde, neither ironstone nor any other
form of iron ore is known to them. They have
not therefore advanced to the art of smelting
the metal, but have hitherto bought all their
THE ANCESTRESS OF
THE MAKONDE
iron implements from neighbouring tribes.
Even in the plain the inhabitants are not much
better off. Only one man now living is said to
understand the art of smelting iron. This old fundi lives close to
Huwe, that isolated, steep-sided block of granite which rises out of
the green solitude between Masasi and Chingulungulu, and whose
jagged and splintered top meets the traveller’s eye everywhere. While
still at Masasi I wished to see this man at work, but was told that,
frightened by the rising, he had retired across the Rovuma, though
he would soon return. All subsequent inquiries as to whether the
fundi had come back met with the genuine African answer, “Bado”
(“Not yet”).
BRAZIER
Some consolation was afforded me by a brassfounder, whom I

came across in the bush near Akundonde’s. This man is the favourite
of women, and therefore no doubt of the gods; he welds the glittering
brass rods purchased at the coast into those massive, heavy rings
which, on the wrists and ankles of the local fair ones, continually give
me fresh food for admiration. Like every decent master-craftsman he
had all his tools with him, consisting of a pair of bellows, three
crucibles and a hammer—nothing more, apparently. He was quite
willing to show his skill, and in a twinkling had fixed his bellows on
the ground. They are simply two goat-skins, taken off whole, the four
legs being closed by knots, while the upper opening, intended to
admit the air, is kept stretched by two pieces of wood. At the lower
end of the skin a smaller opening is left into which a wooden tube is
stuck. The fundi has quickly borrowed a heap of wood-embers from
the nearest hut; he then fixes the free ends of the two tubes into an
earthen pipe, and clamps them to the ground by means of a bent
piece of wood. Now he fills one of his small clay crucibles, the dross
on which shows that they have been long in use, with the yellow
material, places it in the midst of the embers, which, at present are
only faintly glimmering, and begins his work. In quick alternation
the smith’s two hands move up and down with the open ends of the
bellows; as he raises his hand he holds the slit wide open, so as to let
the air enter the skin bag unhindered. In pressing it down he closes
the bag, and the air puffs through the bamboo tube and clay pipe into
the fire, which quickly burns up. The smith, however, does not keep
on with this work, but beckons to another man, who relieves him at
the bellows, while he takes some more tools out of a large skin pouch
carried on his back. I look on in wonder as, with a smooth round
stick about the thickness of a finger, he bores a few vertical holes into
the clean sand of the soil. This should not be difficult, yet the man
seems to be taking great pains over it. Then he fastens down to the
ground, with a couple of wooden clamps, a neat little trough made by
splitting a joint of bamboo in half, so that the ends are closed by the
two knots. At last the yellow metal has attained the right consistency,
and the fundi lifts the crucible from the fire by means of two sticks
split at the end to serve as tongs. A short swift turn to the left—a
tilting of the crucible—and the molten brass, hissing and giving forth
clouds of smoke, flows first into the bamboo mould and then into the
holes in the ground.
The technique of this backwoods craftsman may not be very far
advanced, but it cannot be denied that he knows how to obtain an
adequate result by the simplest means. The ladies of highest rank in
this country—that is to say, those who can afford it, wear two kinds
of these massive brass rings, one cylindrical, the other semicircular
in section. The latter are cast in the most ingenious way in the
bamboo mould, the former in the circular hole in the sand. It is quite
a simple matter for the fundi to fit these bars to the limbs of his fair
customers; with a few light strokes of his hammer he bends the
pliable brass round arm or ankle without further inconvenience to
the wearer.
SHAPING THE POT
SMOOTHING WITH MAIZE-COB
CUTTING THE EDGE

FINISHING THE BOTTOM
LAST SMOOTHING BEFORE

BURNING
FIRING THE BRUSH-PILE

LIGHTING THE FARTHER SIDE OF
THE PILE
TURNING THE RED-HOT VESSEL
NYASA WOMAN MAKING POTS AT MASASI

Pottery is an art which must always and everywhere excite the
interest of the student, just because it is so intimately connected with
the development of human culture, and because its relics are one of
the principal factors in the reconstruction of our own condition in
prehistoric times. I shall always remember with pleasure the two or
three afternoons at Masasi when Salim Matola’s mother, a slightly-
built, graceful, pleasant-looking woman, explained to me with
touching patience, by means of concrete illustrations, the ceramic art
of her people. The only implements for this primitive process were a
lump of clay in her left hand, and in the right a calabash containing
the following valuables: the fragment of a maize-cob stripped of all
its grains, a smooth, oval pebble, about the size of a pigeon’s egg, a
few chips of gourd-shell, a bamboo splinter about the length of one’s
hand, a small shell, and a bunch of some herb resembling spinach.
Nothing more. The woman scraped with the
shell a round, shallow hole in the soft, fine
sand of the soil, and, when an active young
girl had filled the calabash with water for her,
she began to knead the clay. As if by magic it
gradually assumed the shape of a rough but
already well-shaped vessel, which only wanted
a little touching up with the instruments
before mentioned. I looked out with the
MAKUA WOMAN closest attention for any indication of the use
MAKING A POT. of the potter’s wheel, in however rudimentary
SHOWS THE a form, but no—hapana (there is none). The
BEGINNINGS OF THE embryo pot stood firmly in its little
POTTER’S WHEEL
depression, and the woman walked round it in
a stooping posture, whether she was removing
small stones or similar foreign bodies with the maize-cob, smoothing
the inner or outer surface with the splinter of bamboo, or later, after
letting it dry for a day, pricking in the ornamentation with a pointed
bit of gourd-shell, or working out the bottom, or cutting the edge
with a sharp bamboo knife, or giving the last touches to the finished
vessel. This occupation of the women is infinitely toilsome, but it is
without doubt an accurate reproduction of the process in use among
our ancestors of the Neolithic and Bronze ages.
There is no doubt that the invention of pottery, an item in human
progress whose importance cannot be over-estimated, is due to
women. Rough, coarse and unfeeling, the men of the horde range
over the countryside. When the united cunning of the hunters has
succeeded in killing the game; not one of them thinks of carrying
home the spoil. A bright fire, kindled by a vigorous wielding of the
drill, is crackling beside them; the animal has been cleaned and cut
up secundum artem, and, after a slight singeing, will soon disappear
under their sharp teeth; no one all this time giving a single thought
to wife or child.
To what shifts, on the other hand, the primitive wife, and still more
the primitive mother, was put! Not even prehistoric stomachs could
endure an unvarying diet of raw food. Something or other suggested
the beneficial effect of hot water on the majority of approved but
indigestible dishes. Perhaps a neighbour had tried holding the hard
roots or tubers over the fire in a calabash filled with water—or maybe
an ostrich-egg-shell, or a hastily improvised vessel of bark. They
became much softer and more palatable than they had previously
been; but, unfortunately, the vessel could not stand the fire and got
charred on the outside. That can be remedied, thought our
ancestress, and plastered a layer of wet clay round a similar vessel.
This is an improvement; the cooking utensil remains uninjured, but
the heat of the fire has shrunk it, so that it is loose in its shell. The
next step is to detach it, so, with a firm grip and a jerk, shell and
kernel are separated, and pottery is invented. Perhaps, however, the
discovery which led to an intelligent use of the burnt-clay shell, was
made in a slightly different way. Ostrich-eggs and calabashes are not
to be found in every part of the world, but everywhere mankind has
arrived at the art of making baskets out of pliant materials, such as
bark, bast, strips of palm-leaf, supple twigs, etc. Our inventor has no
water-tight vessel provided by nature. “Never mind, let us line the
basket with clay.” This answers the purpose, but alas! the basket gets
burnt over the blazing fire, the woman watches the process of
cooking with increasing uneasiness, fearing a leak, but no leak
appears. The food, done to a turn, is eaten with peculiar relish; and
the cooking-vessel is examined, half in curiosity, half in satisfaction
at the result. The plastic clay is now hard as stone, and at the same
time looks exceedingly well, for the neat plaiting of the burnt basket
is traced all over it in a pretty pattern. Thus, simultaneously with
pottery, its ornamentation was invented.
Primitive woman has another claim to respect. It was the man,
roving abroad, who invented the art of producing fire at will, but the
woman, unable to imitate him in this, has been a Vestal from the
earliest times. Nothing gives so much trouble as the keeping alight of
the smouldering brand, and, above all, when all the men are absent
from the camp. Heavy rain-clouds gather, already the first large
drops are falling, the first gusts of the storm rage over the plain. The
little flame, a greater anxiety to the woman than her own children,
flickers unsteadily in the blast. What is to be done? A sudden thought
occurs to her, and in an instant she has constructed a primitive hut
out of strips of bark, to protect the flame against rain and wind.
This, or something very like it, was the way in which the principle
of the house was discovered; and even the most hardened misogynist
cannot fairly refuse a woman the credit of it. The protection of the
hearth-fire from the weather is the germ from which the human
dwelling was evolved. Men had little, if any share, in this forward
step, and that only at a late stage. Even at the present day, the
plastering of the housewall with clay and the manufacture of pottery
are exclusively the women’s business. These are two very significant
survivals. Our European kitchen-garden, too, is originally a woman’s
invention, and the hoe, the primitive instrument of agriculture, is,
characteristically enough, still used in this department. But the
noblest achievement which we owe to the other sex is unquestionably
the art of cookery. Roasting alone—the oldest process—is one for
which men took the hint (a very obvious one) from nature. It must
have been suggested by the scorched carcase of some animal
overtaken by the destructive forest-fires. But boiling—the process of
improving organic substances by the help of water heated to boiling-
point—is a much later discovery. It is so recent that it has not even
yet penetrated to all parts of the world. The Polynesians understand
how to steam food, that is, to cook it, neatly wrapped in leaves, in a
hole in the earth between hot stones, the air being excluded, and
(sometimes) a few drops of water sprinkled on the stones; but they
do not understand boiling.
To come back from this digression, we find that the slender Nyasa
woman has, after once more carefully examining the finished pot,
put it aside in the shade to dry. On the following day she sends me
word by her son, Salim Matola, who is always on hand, that she is
going to do the burning, and, on coming out of my house, I find her
already hard at work. She has spread on the ground a layer of very
dry sticks, about as thick as one’s thumb, has laid the pot (now of a
yellowish-grey colour) on them, and is piling brushwood round it.
My faithful Pesa mbili, the mnyampara, who has been standing by,
most obligingly, with a lighted stick, now hands it to her. Both of
them, blowing steadily, light the pile on the lee side, and, when the
flame begins to catch, on the weather side also. Soon the whole is in a
blaze, but the dry fuel is quickly consumed and the fire dies down, so
that we see the red-hot vessel rising from the ashes. The woman
turns it continually with a long stick, sometimes one way and
sometimes another, so that it may be evenly heated all over. In
twenty minutes she rolls it out of the ash-heap, takes up the bundle
of spinach, which has been lying for two days in a jar of water, and
sprinkles the red-hot clay with it. The places where the drops fall are
marked by black spots on the uniform reddish-brown surface. With a
sigh of relief, and with visible satisfaction, the woman rises to an
erect position; she is standing just in a line between me and the fire,
from which a cloud of smoke is just rising: I press the ball of my
camera, the shutter clicks—the apotheosis is achieved! Like a
priestess, representative of her inventive sex, the graceful woman
stands: at her feet the hearth-fire she has given us beside her the
invention she has devised for us, in the background the home she has
built for us.
At Newala, also, I have had the manufacture of pottery carried on
in my presence. Technically the process is better than that already
described, for here we find the beginnings of the potter’s wheel,
which does not seem to exist in the plains; at least I have seen
nothing of the sort. The artist, a frightfully stupid Makua woman, did
not make a depression in the ground to receive the pot she was about
to shape, but used instead a large potsherd. Otherwise, she went to
work in much the same way as Salim’s mother, except that she saved
herself the trouble of walking round and round her work by squatting
at her ease and letting the pot and potsherd rotate round her; this is
surely the first step towards a machine. But it does not follow that
the pot was improved by the process. It is true that it was beautifully
rounded and presented a very creditable appearance when finished,
but the numerous large and small vessels which I have seen, and, in
part, collected, in the “less advanced” districts, are no less so. We
moderns imagine that instruments of precision are necessary to
produce excellent results. Go to the prehistoric collections of our
museums and look at the pots, urns and bowls of our ancestors in the
dim ages of the past, and you will at once perceive your error.
MAKING LONGITUDINAL CUT IN
BARK
DRAWING THE BARK OFF THE LOG
REMOVING THE OUTER BARK

BEATING THE BARK
WORKING THE BARK-CLOTH AFTER BEATING, TO MAKE IT

SOFT
MANUFACTURE OF BARK-CLOTH AT NEWALA

To-day, nearly the whole population of German East Africa is
clothed in imported calico. This was not always the case; even now in
some parts of the north dressed skins are still the prevailing wear,
and in the north-western districts—east and north of Lake
Tanganyika—lies a zone where bark-cloth has not yet been
superseded. Probably not many generations have passed since such
bark fabrics and kilts of skins were the only clothing even in the
south. Even to-day, large quantities of this bright-red or drab
material are still to be found; but if we wish to see it, we must look in
the granaries and on the drying stages inside the native huts, where
it serves less ambitious uses as wrappings for those seeds and fruits
which require to be packed with special care. The salt produced at
Masasi, too, is packed for transport to a distance in large sheets of
bark-cloth. Wherever I found it in any degree possible, I studied the
process of making this cloth. The native requisitioned for the
purpose arrived, carrying a log between two and three yards long and
as thick as his thigh, and nothing else except a curiously-shaped
mallet and the usual long, sharp and pointed knife which all men and
boys wear in a belt at their backs without a sheath—horribile dictu!
[51]
Silently he squats down before me, and with two rapid cuts has
drawn a couple of circles round the log some two yards apart, and
slits the bark lengthwise between them with the point of his knife.
With evident care, he then scrapes off the outer rind all round the
log, so that in a quarter of an hour the inner red layer of the bark
shows up brightly-coloured between the two untouched ends. With
some trouble and much caution, he now loosens the bark at one end,
and opens the cylinder. He then stands up, takes hold of the free
edge with both hands, and turning it inside out, slowly but steadily
pulls it off in one piece. Now comes the troublesome work of
scraping all superfluous particles of outer bark from the outside of
the long, narrow piece of material, while the inner side is carefully
scrutinised for defective spots. At last it is ready for beating. Having
signalled to a friend, who immediately places a bowl of water beside
him, the artificer damps his sheet of bark all over, seizes his mallet,
lays one end of the stuff on the smoothest spot of the log, and
hammers away slowly but continuously. “Very simple!” I think to
myself. “Why, I could do that, too!”—but I am forced to change my
opinions a little later on; for the beating is quite an art, if the fabric is
not to be beaten to pieces. To prevent the breaking of the fibres, the
stuff is several times folded across, so as to interpose several
thicknesses between the mallet and the block. At last the required
state is reached, and the fundi seizes the sheet, still folded, by both
ends, and wrings it out, or calls an assistant to take one end while he
holds the other. The cloth produced in this way is not nearly so fine
and uniform in texture as the famous Uganda bark-cloth, but it is
quite soft, and, above all, cheap.
Now, too, I examine the mallet. My craftsman has been using the
simpler but better form of this implement, a conical block of some
hard wood, its base—the striking surface—being scored across and
across with more or less deeply-cut grooves, and the handle stuck
into a hole in the middle. The other and earlier form of mallet is
shaped in the same way, but the head is fastened by an ingenious
network of bark strips into the split bamboo serving as a handle. The
observation so often made, that ancient customs persist longest in
connection with religious ceremonies and in the life of children, here
finds confirmation. As we shall soon see, bark-cloth is still worn
during the unyago,[52] having been prepared with special solemn
ceremonies; and many a mother, if she has no other garment handy,
will still put her little one into a kilt of bark-cloth, which, after all,
looks better, besides being more in keeping with its African
surroundings, than the ridiculous bit of print from Ulaya.
MAKUA WOMEN

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(eBook PDF) Nutrition Counseling and

Education Skill Development 4th

Ask Key Open-Ended Questions to 5.2 Design a Plan of Action 100

5.8 Step 4: Monitoring and Evaluation Terminology149

Charting174 8.10 Issues Pertinent to Physical

Intervention Strategies 219 Group Process 252

Assignment—Conducting an Interview Intervention for a Congregate

Verbs277 Review Questions 309

Additional Resources 330 Preparation for Session 1 334

New Edition Highlights

Selected Chapter-by-Chapter Updates

Chapter 1 Preparing to Meet Your Clients

Chapter 2 Frameworks for Understanding and Attaining Behavior Change

Chapter 5 Developing a Nutrition Care Plan: Putting It All Together

Chapter 7 Making Behavior Change Last

Chapter 8 Physical Activity

Chapter 9 Communication with Diverse Population Groups

Chapter 11 Keys to Successful Nutrition Education Interventions

Chapter 12 Educational Strategies, Technology, and Evaluation

Chapter 13 Professionalism and Final Issues

Kathryn Coakley Kellie McLean

Cinda J. Catchings Rebecca Miller

Nutrition counselors and educators provide guidance for

Nutrition Knowledge: Traditionally, educators and

Children nutrition counselors perceived their roles as

want to be a counselor and helps them avoid using

Exercise 1.4 People Skills Inventory

toward that can be enhanced by engaging in profes-

Table 1.1 Worldview Assumptions

we are likely to migrate to and away from various cultures

Exercise 1.7 What Is Your Worldview?

1 2 3 4 5 Technology is of foremost importance in conquering illness.

As nutrition counselors and educators advocate

movies, and cultural encounters in markets, fairs, and

The scenario in Exercise 1.11 illustrates a common

Client: Are high-protein diets a good way to lose

relationship. education intervention for women with breast cancer: Effect

and composition of the U.S. population: 2014 to 2060,

Newala, too, suffers from the distance of its water-supply—at least

The water-supply of New Newala is in the bottom of the valley,

NATIVE PATH THROUGH THE MAKONDE BUSH, NEAR

MAKONDE LOCK AND KEY AT JUMBE CHAURO

MODE OF INSERTING THE KEY

With no small pride first one householder and then a second

Some consolation was afforded me by a brassfounder, whom I

SMOOTHING WITH MAIZE-COB

CUTTING THE EDGE

LAST SMOOTHING BEFORE

FIRING THE BRUSH-PILE

TURNING THE RED-HOT VESSEL

NYASA WOMAN MAKING POTS AT MASASI

DRAWING THE BARK OFF THE LOG

REMOVING THE OUTER BARK

WORKING THE BARK-CLOTH AFTER BEATING, TO MAKE IT

MANUFACTURE OF BARK-CLOTH AT NEWALA

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Ask Key Open-Ended Questions to 5.2 Design a Plan of Action 100

5.8 Step 4: Monitoring and Evaluation Terminology149

Charting174 8.10 Issues Pertinent to Physical

Intervention Strategies 219 Group Process 252

Verbs277 Review Questions 309

Additional Resources 330 Preparation for Session 1 334