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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Eggciting Innovation

Eggs for Improved Maternal, Infant and Young Child Nutrition

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The statistics show the continued, and sadly in some cases growing, prevalence of malnutrition in a number of countries. The 2015 Global Nutrition Report (GNR) had as one of its key messages, “Although a great deal of progress is being made in reducing malnutrition, it is still too slow and too uneven.” And the 2016 GNR just launched this month, states that “Malnutrition and diet are by far the biggest risk factors for the global burden of disease: every country is facing a serious public health challenge from malnutrition.” Addressing nutrient (macro and micro) deficiencies amongst the most vulnerable, usually women and children is proving to be a ‘hard egg to crack’ and requires disruptive ideas and real innovation.

Eggs

Enter the humble egg

Eaten since the beginning of time; eaten almost everywhere in the world; relatively easy to obtain; adaptable to many different types of cooking techniques and; an affordable source of highly digestible protein, we believe that the time has come to re-think and innovate around the humble egg!

We are not alone in our thinking, and Iannotti et al. have written an excellent review article that eloquently positions the egg as offering real potential to improve maternal and child nutrition in developing countries. Studies promoting egg consumption for women and children as part of wider dietary improvements show that, child growth indicators are significantly improved in the intervention group compared to controls and a recent breakthrough research study shows that all nine essential amino acids were significantly lower in stunted children compared with non-stunted children. This is important because it tells us that stunted children are not receiving sufficient quality protein from their diets.

Did we put all our eggs in one basket?

Could this research point to the fact that in nutrition’s zeal, over the last four decades, to focus on ensuring that children received sufficient micronutrients (particularly vitamin A, iodine, iron, zinc, and folate), that protein fell off the agenda? It would seem that the widespread assumption that children were receiving enough protein from their basic diet was incorrect. Now is the time to realise that it is not ‘either/or’ but rather that optimal child growth and thus development, depends on addressing deficits of both protein and micronutrients. This calls for ensuring adequate micronutrient and protein in the diet especially during critical life stages – pregnancy, lactation, infancy and adolescence. We need to take a holistic approach and embrace the farm to flush approach anchored in food systems (take a look at this Sight and Life magazine focusing on food systems), so as not to neglect any of the nutrients as we look to future solutions that can be scaled up in order to have the impact that the 2016 GNR rightly puts under the spotlight.

Don’t count your chickens before they hatch

While eggs are a highly nutritious food source, both the productivity of laying hens and the nutritional content of their eggs are, to a certain extent, a function of the hen’s dietary intake. The reality is that for laying hens, an optimally micronutrient fortified diet improves egg production in numerous ways – increased egg numbers, improved egg weights, percentage lay and increased feed efficiency. Interestingly, for many micronutrients, egg content responds rapidly (within a few weeks) to dietary changes; transfer efficiency, from feed to egg, does depend on the micronutrient – high for vitamin A, selenium, iodine, and DHA; medium for vitamin D and E and; low for folic acid, niacin, and iron. This points, to a real opportunity to improve the nutritional value of eggs with only limited input in the feed and in egg eating populations requires no need for dietary behaviour change communication, which we know to be both costly and not always highly successful.

Projections from FAO suggest significant growth in egg consumption in developing countries. Even in countries considered to have largely vegetarian population, such as India, data shows that the diet of many Indian households is diversifying to include more animal source foods, a trend that has been particularly notable in rural populations. This makes the idea of tapping into the potential of eggs extremely eggciting. A ‘powdered’ micronutrient feed supplement for chickens could contribute to solutions for farmer through improved egg production and, for consumer by providing added nutritional value. An additional advantage of eggs is their environmentally friendly packaging. 

The proof of the pudding is in the eating

There is research to show the benefits of consuming fortified eggs. A 2009 study showed that feeding DHA-fortified eggs to infants and pregnant mothers improved infant visual acuity and attention and other studies have found that DHA fortified eggs were associated with increased gestational duration and infant birth size. In addition to DHA, there is literature to support the role of eggs in reducing deficiencies of iodine and vitamin A and even decreased anemia.

“Leaders don’t wait for problems to lay eggs before they attempt dealing with them.” 
– Israelmore Ayivor

A range of nutrients delivering various levels of their recommended daily allowance could relatively easily be added to eggs through the chicken feed. There are many avenues to explore, such as supplying micronutrient feed supplement directly to existing farmer networks or to women running poultry programs. Simultaneous social marketing campaigns could encourage egg consumption and an assessment over time could be undertaken to provide the evidence of impact…

Sight and Life is actively exploring these eggciting opportunities and would be interested in hearing from anyone keen to invest or partner with us, as we believe the egg just can’t be beaten.

To contact us regarding this project send an email to Kalpana.Beesabathuni@sightandlife.org

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