|Culture, Environment, and Food to Prevent Vitamin A Deficiency (International Nutrition Foundation for Developing Countries - INFDC, 1997, 208 pages)|
|Part IV. Understanding Vitamin A deficieny in the community|
|9. The contexts of culture, environment, and food|
In this section we discuss food selection and consumption of pregnant and lactating women, and infants and young children. Information on consumption patterns was obtained from the food frequency and 24-hour recall modules, key-informant interviews, and the modules on food categories, attributes, and concepts.
The general food pattern of families is a necessary first step in order to understand food patterns of vulnerable individuals. In Doumen village, China and Sheriguda, village, India, and in Filingué, Niger, families eat three meals a day. The first meal of the day often consists of the leftovers from the previous night. In Filingué meals are built around a grain with a sauce, that often contains greens and pumpkin, providing good potential for vitamin A. In Sheriguda, evening meals occasionally contain meat.
For the Aetas, meals usually consist of rice and a sauce of greens; fat and animal protein is limited in the family meal pattern.
There is little evidence from any of the sites that consumption patterns change during pregnancy. In Peru and Niger, pregnant women deliberately avoid eating too much because they do not want to gain too much weight, leading to a difficult delivery. While some food items are noted in each area as being good for pregnancy, there is no general pattern with respect to their vitamin A content.
A change in diet during the postpartum period is characteristic in all areas. In Doumen village, many hen's eggs are given to women, who are also encouraged to eat dark-colored foods (such as black rice, red jujube) to regain their strength. In both sites in Peru most women interviewed reported that special foods, selected for their qualities with respect to the humoral medicine system, are consumed. In Sheriguda, three stages of postpartum diet are recognized: in the first three days, only rice with spices is eaten; from day four to twenty-one the diet is semi-restricted, with few animal and plant foods; a regular diet is resumed after twenty-one days.
During lactation, women's dietary patterns may also be different from the rest of the family. In all areas, more liquids are taken, often as cereal gruels. In Niger women actively try to gain weight to recover their strength, and they seek more meat, liver, and richer sauces. While eggs are encouraged on a daily basis in Doumen village, they are rejected during lactation in Filingué, and are recognized as lactogenic foods in Sheriguda village.
Breastfeeding is practiced in all areas, but for varying durations. Cessation of breastfeeding varies widely, from an average of six to thirty months. Rural areas (Chamis, Peru, and Filingué, Niger) have longer average periods of breastfeeding than urban areas. In Filingué and Doumen the first colostrum is discarded. Water with sugar is often given to newborns. Breastfeeding is supplemented with various foods, some of which have potential for providing vitamin A. For example, mashed vegetables and eggs are the first foods in Doumen village. Soups and purees are given in the Peruvian settings. In Peru herbal infusions are given to infants, but sweet potato, eggs, and greens are thought to be too strong for children under one year of age.
Young children's eating patterns gradually assimilate to that of the family. Eggs are considered an ideal food for young children in Doumen village. In most areas, young children are reported to eat more snacks, including fruits and vegetables. In Sheriguda village, for example, carrots are regarded as a food only for children's snacking and are eaten raw.
As the foregoing summaries suggest, the application of the procedures produced descriptive summaries of the dietary patterns of vulnerable groups. The modules on food beliefs provided information about the cultural factors associated with these patterns.