Nutrition and Health — Ethiopian-Israeli Community

Injera — fermented teff flatbread — is a cornerstone of Ethiopian culture and also happens to be nutritionally superior to many common breads. Teff is a highly nutritious grain: it contains elevated levels of dietary fiber, iron, calcium, and antioxidants. Due to the fermentation process, injera has a low glycemic index — meaning it raises blood sugar more slowly than white bread, which is especially beneficial for people with or at risk for diabetes.

Research shows that in the period following immigration to Israel, community members who continued eating injera and traditional foods were at lower risk of developing diabetes than those who rapidly transitioned to a Western diet high in refined carbohydrates. The decline in injera consumption after immigration is partly linked to rising diabetes rates.

The message: do not give up injera. If you are raising children, introduce them to traditional foods. Injera is available at Ethiopian stores in Israel's major cities. Maintaining healthy traditional foods like injera, lentils, and vegetables is an important part of any long-term health strategy.

Ethiopian cuisine is rich in legumes and lentils — misir (red lentils), shiro (processed lentil paste), berbere preparations, and more. These are first-class sources of plant protein, and are rich in dietary fiber, iron, folate, and potassium. Large studies show that regular legume consumption reduces the risk of heart disease, type 2 diabetes, and bowel disease.

The advantage of Ethiopian legumes is twofold: they are nutritious and relatively affordable in Israel. They provide an excellent alternative to processed meats and saturated fats, and form balanced meals that suit Orthodox fasting days and a healthy lifestyle in general.

Message for the community: as you adapt to everyday Israeli life, preserve traditional legume cooking. Misir, shiro, and kisra are not just part of heritage — they are a foundational part of a healthy, disease-preventive diet. A referral to a clinical dietitian (available through a family doctor) can help integrate these foods optimally within a balanced meal plan.

One of the most concerning findings in Ethiopian-Israeli community health is the direct link between dietary change after immigration and diabetes rates. At the time of immigration, the community's diabetes rate stood at just 0.4%. After 10-16 years of living in Israel, this rate surged to 17.7%. A central factor driving this increase is the shift from traditional whole foods to an Israeli/Western diet high in processed foods.

Processed foods include: white bread, burekas, croissants, sugary drinks (cola, commercial juices), salty snacks, and processed deli meats. The problem: these foods are rich in fast sugars, trans fats, and salt, causing sharp post-meal blood sugar spikes. Over time, this leads to insulin resistance and diabetes.

Practical steps: reduce white bread — substitute rye bread, whole grain, or injera. Limit sugary drinks to occasional consumption. Prepare homemade snacks — nuts, fruits, cut vegetables. Read food labels — if the first ingredient is sugar or white flour, choose a different product. Small, consistent changes are better than extreme diets that cannot be maintained long-term.

Ethiopian Orthodox fasting requires approximately 180 days per year of abstaining from animal products. For most people, fasting is healthy and spiritually enriching. However, people taking ongoing medications — for diabetes, blood pressure, epilepsy, mental health, and HIV — may face significant medical risks if they continue fasting without adjusting their treatment.

What can happen: diabetes medications taken without food (especially insulin and metformin) can cause hypoglycemia — dangerously low blood sugar that causes fainting and distress. Blood pressure medications taken during prolonged fasting can cause pressure drops. HIV medications that need to be taken with food can cause severe side effects when taken while fasting.

The solution is simple and does not require giving up fasting: speak with your family doctor before the Great Fast (approximately April-May) and before any extended fasting period. The doctor can adjust dosages, change timing of doses, and recommend a safe-fasting protocol. In Israel, doctors are familiar with Ethiopian fasting — do not hesitate to ask.

Moving to a new society often involves abrupt dietary change. For Ethiopian Israelis, this transition can be dramatic — from traditional whole foods (injera, legumes, vegetables, olive oil) to fast, processed Israeli food. The data speak for themselves: a 44-fold increase in diabetes rates over the years of absorption.

The recommended approach is gradual: do not try to change everything at once. Preserve elements of the Ethiopian kitchen you enjoy — injera, tibs, misir, shiro — and gradually integrate healthy Israeli foods (root vegetables, hummus, whole-grain breads). Plan at least one meal per week that is a traditional Ethiopian meal.

Practical tips for maintaining health within the new culture: at the market, choose fresh vegetables and fruits over packaged products. Bake bread at home when possible — the injera fermentation process is simple and rewarding. Limit fast food to two or three times per week at most. Drink water, not sugary beverages. And for any nutritional questions — a clinical dietitian is the right address.