Culture is a Road to Improved Nutrition

Discovering the Mayan ways

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Edward (Ted) Fischer is Professor of Anthropology and Director of the Center for Latin American Studies and the Institute for Coffee Studies at Vanderbilt University. Prof Fischer is also the founder of Maní+, a social enterprise in Guatemala that develops and produces locally-sourced complementary foods to fight malnutrition, and serves as an advisor to the World Health Organization on Wellbeing and the Cultural Contexts of Health.

Prof Fischer posits that food is about much more than macro- and micronutrients, arguing that it is instead intimately linked to identity and social relations in his article, ‘Beyond Nutrition: Eating, Innovation, and Cultures of Possibility’ published in the Sight and Life magazine. In his opinion, food is an integral part of our identity, and any attempts to change diets need to take this into account. The composition also explains why culture should not be seen as an obstacle to health, but as a source of potential. In addition, he says that public health and nutritional interventions should work with, rather than against, this dynamism, and beneficiaries should be treated as clients, customers, and collaborators, and as sources of inspiration and innovation, as well as mouths to feed.

Here at Sight and Life we had an opportunity to talk with Prof Fischer and discuss his continual fascination with the Maya way of life. During our interview, he shared how it led to a realization that, far from being a hindrance, culture is an aid to improving nutrition.

Sight and Life (SAL): What inspired your passion for the topic of eating, innovation, and the cultures of possibility?

Prof Edward Fischer (EF): As a cultural anthropologist, I have spent the better part of my life and career (the last 25 years) working with the Maya people of highland Guatemala. I have cumulatively lived and worked there for several years, I visit several times a year, and I have deep personal as well as professional ties. Maya culture and traditions are endlessly fascinating to me, and I have spent countless hours in the fields of maize, beans, and squash and around the hearth watching women make tortillas and slow-cook black beans. Maya families tend to have a close sense of kinship and community; while most Maya are very poor in material and economic terms, they have a richness of social ties that we have lost.

The beauty of Maya culture is in contrast to their history of colonization, marginalization, and violence. Half the population of Guatemala is Maya, and yet they are largely excluded from national economic and political life. There is also still the palpable legacy of the violence of the 1970s and 1980s, when Maya communities were intentionally targeted for extermination by the US-backed military.

 

SAL: How do you explore this through your research?

EF: My work looks at these paradoxes: How the Maya adapt and co-opt the globalized economy for their own ends (by growing broccoli for export to the US, for example), and how we can understand wellbeing in the context of material poverty.

When I was in graduate school, we learned that the Maya were especially short because of some local evolutionary adaptation or a genetic bottleneck. If you have ever been to Guatemala, you will have noted the heights: Maya men average just 1.59 meters (5.21 feet) and Maya women 1.47 meters (4.82 feet). They were thought to be the ‘pygmies of Central America.’ However, research by anthropologist Barry Bogin has shown that this is not genetic; the difference in height is virtually all nutritional and environmental.

I saw in development programs a lot of distribution of imported malnutrition products, which struck me as odd and counterproductive in a predominately agricultural country, with a majority of those suffering from malnutrition being rural farmers. For that reason, I started looking into malnutrition, and how to develop something locally that would support farmers.

SAL: Were there any unexpected findings?

EF: We discovered a number of surprising things. First, there is an epidemic of early childhood malnutrition, but also of adolescent and adult obesity: This is the dual burden of malnutrition. Thus, it is very important that interventions be targeted at specific at-risk children within families.

Second, I was surprised to see, behind the scenes of the malnutrition world, that well-intentioned humanitarian workers often saw Maya culture as a problem, not something to be celebrated and nourished. Many want to “overcome” traditional beliefs to get people to eat well in specific ways (such as a certain number of calories, the amount of protein, and so on).

In view of that, I wrote this article largely as a response — to show how culture can be used to improve nutrition, and that it is more than an obstacle. Also, to underline the important subjective, affective, and emotional aspects to food that are real and important (even if they are not measured in neat numbers of grams or RDA), and that we who are fighting malnutrition need to engage, rather than fight.

SAL: Did your work present any unexpected challenges?

EF: Fieldwork in difficult places always presents an endless string of challenges, logistical, cultural, and intellectual. This is even more so when doing interventions. As we were developing the Mani+ project in Guatemala, we encountered one obstacle after another, not least in the food science of developing a new product. The peanut oils interact with plastics in ways I could not anticipate. Packaging solids and liquids is straightforward, but getting pastes into little sachets is almost impossible because of the consistency. Therefore, when students ask what being a successful social entrepreneur requires, I tell them that it takes naïve optimism. I saw a problem with malnutrition in Guatemala, and what I thought was a relatively simple solution. Had I known all of the reasons my ‘relatively simple’ solution was not so simple, all of the reasons that it should not work, I probably would not have started. However, I was naively optimistic. Hence, when the problems started coming, I dealt with them one by one as they arose, thinking each one would be the last one to solve and then we would end up with our product. However, had I know at the start the string of obstacles we would face, I would not have begun.

In addition, taking culture seriously means working in local languages and local communities. In Guatemala alone, there are 23 Mayan languages spoken. The easy fix is to do all programming in Spanish, the country’s official language. That works fine in urban areas, but in the rural villages, where malnutrition is most prevalent, many do not speak Spanish well and women are the least likely to speak Spanish in Maya communities. Therefore, we have had to go through the hard work of translating materials, and training native speakers to do educational sessions with our program. It is not easy, but it makes all the difference.

Here is a photo gallery of typical Mayan meals captured during Ted Fischer’s time in Guatemala:

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Why Ethnographic Research?

Insight behind gathering research data from a cultural perspective

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Dr Eva C Monterrosa is the senior scientific manager at Sight and Life and the co-author, with Prof Gretel H Pelto, graduate professor at Cornell University, Ithaca, of “The Mother-Child Food Relationship in the Study of Infant and Young Child Feeding Practices”, published in the ‘Focus on Food Culture’ edition of Sight and Life magazine. This article shines a light on how biology and culture come together at the level of the diet by reviewing infant and young child feeding (IYCF) practices. Far from ‘story-telling’, Dr Monterrosa says research that incorporates a cultural perspective achieves two objectives: First, to generate explanatory frameworks that help us understand and generate hypotheses about health behaviors; and, second, to design programs to improve behaviors.

When we spoke with Dr Monterrosa about how she came to this topic of research, she had some stimulating answers:

Sight and Life magazine (SAL): Why did you choose this topic – what inspired it?

Eva Monterrosa (EM): In my opinion, public health nutrition research design is focused on getting the results we want – often at the expense of understanding ‘how’ results were achieved. But it is precisely the ‘how’ (or the ‘black box’) that can help us design programs that achieve our goals. A successful outcome in one setting might not lead to success when it is replicated in a different context. By context, I don’t just mean a different country. Even replication in the the same type of institution, such as a hospital or clinic, can be a challenge. In essence, we must understand the context to know what factors are driving our results, and how to adapt interventions to fit our context. Ethnographic research gives us the tools to do this.

Guatemala research
Dr Monterrosa and colleague researcher watching mothers in Guatemala make pap food for their young children. Photo credit Eva Monterrosa

 

SAL: What challenges do you face when doing this type of research?

EM: I think my greatest challenge is people telling me, often not in a nice way, that my research is ‘story telling’, or worse yet saying that what I do is ‘not research’. This however, speaks to another predisposition in nutrition science: That research is only valid if it uses a randomized trial design , or uses complex statistical procedures. Don’t get me wrong – I can hold my weight when it comes to running a complex analysis of longitudinal data, but I understand this work’s limitations. Moreover, when you deal with food and eating habits, these are complex social phenomena that cannot be reducible simply to numbers.

In the research Prof Pelto and I share in the article, we use ethnographic methods, such as observations, interviews, and other cognitive elicitation techniques, including free listing, and card-sorting exercises. The selection of the methods is always guided by a research question. One must skillfully apply interviewing techniques, including careful wording of questions and precise ordering to reduce reporting bias. Lastly, a rigorous analysis of the text data is necessary to elicit solid insights based on the data.

SAL: What has been the most surprising result or outcome from your research?

EM: When study participants ask clarifying questions – their questions lead to all sorts of wonderful discoveries. I recall from my Mexico work that I asked one of my first participants: ‘What meals do you prepare at home?’ And she asked, ‘Meals for whom? My family or my children?’ and this was an unexpected answer that led to a wonderful discovery of child-appropriate meals, which added another dimension to our data analysis. We went from just describing complementary feeding practices to understanding how mothers and children inhabit the same ‘eating space’. It was fascinating!

SAL: Why is applied ethnographic research for nutrition science important?

EM: Two pieces are featured in this issue of Sight and Life magazine, because I want our readers to understand the explanatory power of ethnographic methods, and how this work can help their scientific inquiries or programs. It is not about the biological perspective versus the cultural perspective. That is counterproductive. We need a holistic view of nutrition science.

SAL: Do you think people will listen?

EM: I hope so! Prof Pelto developed the biocultural framework in the late 1970s as a framework to examine the different domains that in interaction determine dietary and eating practices. Today, there is a new generation of scientists seeking to address the complexity of eating practices. We are seeing a rise in training on mixed-method designs, excellent research question(s), solid training in ethnographic methods, and the analytical procedures to elucidate patterns in the data.

Guatemala
As a guest, people are always curious as to why you visit their communities. This bright, young girl didn’t leave my side the whole time we were conducting focus group discussions in her village. Photo credit Eva Monterrosa

SAL: How is your research used?

EM: Much of the work that we do is used to develop programs. A lot of the nutrition research that draws on the biological perspective has an impact on the policy sphere, for example, in helping to set recommendations of vitamin A or calcium. As for the ‘how’ to develop programs for administering vitamin A or calcium? That is a whole different research phase, but it is the space that our research inhabits.

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