Category Archives: food and health

Review: The Way We Eat Now

The Way We Eat Now

Bee Wilson The Way We Eat Now: How the Food Revolution has Transformed our Lives, Our Bodies, and Our World.  Basic Books. New York. 2019. ISBN 978046509377

Richard Zimmer (Sonoma State University)

Bee Wilson’s central message in The Way We Eat Now is that since most of the industrialized world now has enough food to eat, it can change its eating and cooking patterns to prevent health risks, particularly diabetes and obesity. She offers a comprehensive solution: eat more tasty vegetables, more complex starches, less meat, snack less food, eat less food overall and on smaller plates and drink alcohol in smaller glasses. And eat with other people as much as possible. A food historian and writer based in England, Wilson discusses these “modest proposals” in a lively and readable fashion for the average reader. She uses research drawn from experts in various fields, supplemented by interviews with other people and recollections from her past. Her analyses are multi-faceted, comprehensive, and provocative enough to encourage more discussion and research among anthropologists and other social scientists interested in all aspects of food.

We are in the fifth stage of food, Wilson argues, one where the average person has not only enough food but an overwhelming array of foods from which to choose. She notes that mega- supermarkets may contain up to fifty thousand items (p.201.) So many overwhelming choices that competing less-choice alternatives such as Trader Joe’s still offer four thousand items (p.210.) Moreover, many of the choices that the shopper confronts in the supermarket, Wilson argues, are filled with sugar and carbohydrates, dangerous nutrients that promote weight related issues in children and adults: “…billions of people across the globe are simultaneously overfed and undernourished: rich in calories but poor in nutrients [sic.](p.5.)” As she notes and as others have noted, there is an increasing risk of Type II diabetes because of these eating patterns (see, for example, https://diabetes.diabetesjournals.org/content/66/6/1432

This all happened in the period since the end of WWII, in part inspired by Norman Borlaug’s “miracle wheat” (Wilson’s term) and “modern farm methods”, which allowed more people world-wide to be fed (p.3.) More food was more available–but at a nutrient and taste price. As with other food writers, Wilson also notes that as people became more “modern,” more attuned to international trendy food consumption patterns, they became more obese and more malnourished (see her comments on South Africa as one example: (pp.13-15.)        Furthermore, major international corporations used this opportunity to promote more sugary, starchy, and salty foods. Children are socialized to begin their consumption of these foods, often starting with cartoon characters on the cereal boxes. Chile, as Wilson notes, banned the use of cartoons in 2016 so as to stop what they saw as a slide to obesity (p.269.)

Wilson contends that many changes in food choices and in how we consume those food choices promote obesity and Type II diabetes. Many people snack more (p. 143, et seq),   and the snacks they eat are often salty high calorie and without much nutrient value. Parade Magazine, a color Sunday supplement available in American newspapers, ran the recipes for three “Slam Dunk Snacks” served in National Basketball Arenas in the country: Cheetos popcorn, Chicharonnes [Fried Pork Belly or Rinds] Nachos. and Crab Fries with Cheese Sauce, (Ashton 2019:14.) The article also featured a website for more “game-day snacks. (ibid.)”

Furthermore, many people have replaced regular meals with snacks (p.143 et seq.) They eat high calorie energy and/or granola bars. And they no longer sit down to a regular meal with family or friends, In Chapter 4, “Out of Time,” Wilson laments the loss of family and group meals and notes how many people squeeze in eating. Within two generations in this new world, people have gone from families eating the same foods to each person eating on her or his own schedule whatever she or he wants. The eating patterns and rituals that served to promote social solidarity have disappeared.

One snack example is instant noodles (ramen.) Wilson notes that despite their variety, they basically have the same ingredients –wheat, salt, and vegetable oil (pp.81-2.) As Han has noted, people in South Korea, especially children, often just eat the dry spices of the noodle packages and eat them alone, and they get them in convenience stores ( 2018:102.)

Of particular interest are some of the points Wilson makes about obesity. India has a diabetic epidemic. People there have experienced a speedup of time to becoming undernourished–within a single generation. Best put it in her words: “…[the thin-fat] babies grew inside their malnourished mothers with phenotypes for hunger but–thanks to the huge changes in India’s food supply between the 1970’s and the 1990s-found themselves eating an unexpectedly plentiful diet (p.57.)”

Similarly, people consume beverages that are filled with calories, often with no other food value. They may be alcoholic or non-alcoholic. They may be milkshakes or huge cafe lattes. Unlike food, these beverages do not satisfy any hunger. Wilson notes that in some countries, such as Mexico, bottled drinks are necessary because of the uncertain water supply. But “[w]ith certain exceptions, our bodies simply do not register the calories from liquids in the same way that we do with solid food (p.64.)”

As noted in the beginning, Wilson does offer both hope and concrete solutions to the problems of obesity and malnourishment. We should eat less meat, more vegetables, less or no sugar, drink more water, and eat more foods from a “traditional” past when possible. We should use smaller plates and glasses. We should eat more communally and snack less. And we should take the time to enjoy our foods. Her final chapter: Epilogue: New Food on Old Plates, sums it up best: “Try to relish a range of tastes that go beyond sweetness…Come to your senses (p.306.)”

This book is useful for undergraduates who would benefit from a comprehensive view of changes in world eating patterns. It is particularly useful for graduate students in anthropology, sociology, economics, nutrition studies, and public health, for the same reasons and for ideas for future research in all aspects of food and nutrition.

 

 

BIBLIOGRAPHY

 

2019

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068646/ Accessed Nov. 5, 2019

2019

https://clindiabetesendo.biomedcentral.com/articles/10.1186/s40842-016-0039-3 Accessed Nov. 5, 2019

 2019

Alison Ashton. What America Eats: Slam Dunk Snacks. Parade Magazine. Oct. 20.:14.

2018

Kyung-Koo Han. Noodle Odyssey–East Asia and Beyond. in Kwang Ok Kim, ed. Reorienting Cuisine: East Asian Foodways in the Twenty-First Century. Berghahn Books. New York. 91-107.

 

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Review: Reconstructing Obesity

Reconstructing Obesity: The Meaning of Measures and the Measure of Meanings

Megan B. McCullough and Jessica A. Hardin, eds. Reconstructing obesity: the meaning of Measures and the Measure of Meanings. Berghahn. New York, 2015. ISBN: 978-1-78533-028-5. 245 pp.

Richard Zimmer (Sonoma State University)

Megan McCullough and Jessica Hardin have compiled an excellent series of essays as to how different societies and professional groups define and evaluate obesity. Briefly, the writers of these essays, including the two editors themselves, make several points. First, measures of obesity are not standardized, nor are they reliably accurate. Second, people from different societies, for historical and contemporary reasons, do not define obesity as do many Western health professionals. Third, the implications of the aforementioned mis-measurement and varying definitions of obesity affect how people do or do not receive services and how they may come to think and feel about themselves regarding weight. Consequently, “erroneous measurement” and “stigmatization” may affect the health of individuals and groups of individuals. Lastly, an important strength of the book is that the literature on this subject is well-reviewed and ample.

McCullough and Hardin set the stage in their introduction, showing how cultural assumptions about health and obesity distort weight understanding and services provided. As with the other contributors, they deconstruct the cultural assumptions behind the characterization of obesity: “The underlying message from popular media and health studies argues that there are direct, easily identifiable links between obesity and ill health. (p.7.)” They conclude that “…[a]pproaches to obesity should expand the scope of health intervention, promotion, and intervention beyond the individual to engage deeply with culture to account for gendered dynamics, models of embodiment, histories, globalization, and a host of other factors. (p.17.)”

Part I concerns itself with the measurement of obesity.

Anne E. Becker details different “fatness” and “obesity” measures. These measures, she contends, are culture-bound to Western ideas of agency.. Weight loss programs, however, focus on what the person “should be.” Most important, and this is a recurrent theme throughout the book, health care professionals expect the “overweight” person to accept an overweight characterization and to address by herself prescribed “necessary” remedies to lose weight—often, despite cultural pressures to the contrary. (pp.31-2.) I specifically use “herself” here because more pressure is put on women than on men. As Becker and the other authors suggest, this way of proceeding generally causes failure to lose weight, with serious other consequences, both medical and psychological.

Emily Yates-Doerr reviews and critiques in detail the measures used by health professionals to characterize obesity. One example she offers is the use of the BMI. Yates-Doerr relates how public health professionals in Guatemala would subtract the weight of the outer garments the women wore from their measured weight. But they would vary in terms of how much they estimated those garments weighed (p. 52.) Consequently, the BMI measures can be seriously misleading. She concludes: “How are risk of morbidity and mortality determined; what remains unspoken and what concerns are not attended to by using weight as a key determinant of health? (p. 67.)”

Darlene McNaughton focuses on the relationship in terms of health programs between diabetes and obesity. She terms this focus “diabesity.” Drawing on feminist theory and other perspectives, she says: “Overweight and obese people are imagined either as diabetic or becoming diabetic. (p. 77)” McNaughton couples these perceptions with a generalized fat prejudice, particularly in countries like Australia—because “fat” is visible (pp.78-82.) “Fat” people thus are stigmatized and experience the consequences of that judgmental stigmatization.

Part 2 focuses on Histories of “Fat”

Hannah Garth looks at the history of food scarcity in Cuba after the Revolution . She cites a previous study by J. Alvarez from 2004: the Cuban government instituted a system of food rationing “…because of an increase in the need for food due to increased purchasing power and decreases in domestic food production resulting from the shift towards state ownership of farmland and food production enterprises (p. 90.)”   The collapse of the Soviet Union brought in the “Special Period,” where there was even less food than before. Many people remember when there was very little or no food. In the present, they feel insecure about the availability of food. Thus, any program that addresses dieting and obesity runs into difficulties because people resist changes to their food consumption and eating habits. As Garth notes about several of her informants, people eat when they find food available (p.98.)

Jessica Hardin explores obesity and disease in Western Samoa, analyzing how culture and cultural/religious contradictions affect obesity determination and health programs in the area. Western Samoa is often thought of as one of the most obese areas in the world.   In the past and in the present, many Samoans feasted at important family occasions, consuming large amounts of food. Moreover, higher status Samoans tended to eat more, and their size was a measure of their importance (p.110, et seq.) In addition, they tend to eat processed and fast food and other nutritionally deficient food. Trying to introduce dieting runs counter to this value and practice. Since many Samoans are Christians, many fast as part of their religious practice. They do so, however, in church, which contradicts family social practices and weakens family ties. Furthermore, fasting by itself is not necessarily healthy. Hardin concludes by saying that programs that focus only on a metric basis for health must be replaced by a more sophisticated understanding of the “…intersections of health and religious belief [are] critical domains for use in health interventions, but they may provide new ways for thinking about the multiple meanings o f health and alternative modes of measuring health. (p.125.)”

Part 3 Focuses on How Different Cultures Address “Fat”

Rochelle Rosen draws important lessons about caring for diabetes and obesity in American Samoa. To best address the two conditions, she contends that health practitioners must incorporate each society’s often multiple cultural understandings of both conditions. Otherwise, the focus is on the person or client’s individual agency and individual responsibility to change. In particular, she notes: “Where health is communal, interventions predicated on individual self-care may fail to help. (p.142.)” Anthropologists and behavioral scientists, she contends, should continue to elicit these behaviors from the “…emic perspective of the people who engage in them …(p.142.)” to be effective.

Sarah Trainer examines the ways in which modern women in the United Arab Emirates (UAE) think about the categories of “fat” and “thin”, nutrition, their concerns about them, and how to address these concerns. Emirati women, she says, are concerned about being ” thin, but not skinny” , using a variety of weight loss aids and exercise (pp.152-156.)   But the focus is not always maintained and consistent. In one of her studies, she notes “…sedentary patterns…coupled with nutritionally poor diets among the participants (p.156.)” Continuing with the critique of using standardized measurements, such as BMI and body fat percentage data, she says that “…none of these possible threats to health, nor the verbally expressed stress of many young women, would be obvious…[from the aforementioned data.] (p.156.)” As a result, public health, she contends, is not getting better (p.162,), despite increased governmental surveillance–because women want to be thin, regardless of many of the consequences of doing so (p.162.)

Tracey Galloway and Tina Moffat explore the efficacy of school-based childhood obesity preventions in Canada. Many of these programs originated in the United States. They are largely behaviorist based, and often very strict. Children’s self-reports included the following: not being allowed to get up when eating, having to eat at one’s desk, and having food inspected and “unacceptable” items removed, to be returned at the end of the day (p.174.) Furthermore, girls and boys differed both in their perceptions of foods and the restrictions placed upon themselves.   Girls saw more restrictions on what they should and should not eat, while boys saw more restrictions on where they could move within the classroom (pp.174-5.) Galloway and Moffat go further: “…very few of the rules, restrictions, and rewards around food and beverage consumption in schools are related to nutrition or health…But it is surprising that these [positive] messages about food [issued by the Ontario Ministry of Education] are largely absent from the children’s perceptions of the rules and regulations governing their lunch and snack times (p. 178.”) They also note that children are rarely consulted in the design of programs. In addition, children’s privacy itself is invaded in the program process. Following the above genderization of food programs, they cite a previous study which shows that “…teachers socialize girls early into the idea that boys should be fed to satiety while girls should exercise restraint (p.183.)” Nevertheless, according to relatively recent research on school diets in Canadian schools, children are eating more healthy foods (https://www.cambridge.org/core/journals/public-health-nutrition/article/examining-differences-in-school-hour-and-school-day-dietary-quality-among-canadian-children-between-2004-and-2015/EE852354AB74B07F23B88313348084AE/core-reader

Lisa Rubin and Jessica Joseph examine what it means to be “fat” or “thin” in the United States, among girls and women, and especially among African American women. Starting with the statistics on being overweight and obese, they note the result—a “war” on obesity (p.200.) The programs that have developed to address these issues focus on individual action and on “…biomedical intervention or surgery” (p.201.) This focus persists despite the evidence they cite from earlier researchers that suggests “…poverty, stress, and discrimination contribute significantly to the onset and maintenance of conditions often associated with obesity (p.201.)” Reviewing the literature on African American women, they note that these women saw that attempts to redress their weight and obesity issues were “…’part of an effort to diminish black [sic] womanhood.’ (p.209.)” They conclude that “…[m]ore research is needed to examine concerns about eating disorders, overweight, and obesity among Black women from their own perspective. Rather than one imposed by a dominant medical, or eating disorder establishment P. 211.)”

Megan McCullough starts off her essay this way: “I am a fat anthropologist and not an anthropologist who is fat. (p. 215.)” She then stated that if someone had seen her, that person would have decided that she was fat or obese (p.215.)   McCullough put out this preface because she will then take us through her experience with her pregnancy as she encountered the medical establishment’s treatment of her. She felt stigmatized, judged, misjudged, and shamed by medical personnel throughout. She quotes a nurse who said to her: “’I don’t have any extra large robes in here so you will have to make do with this and a sheet…’ (p.213.)” As a result of these experiences, and acknowledging that there are dangers in terms of obesity, McCullough raises larger questions: “ What kinds of care are obese African-American or Hispanic women receiving?   What about obese lesbian mothers? P.230.)”

Stephen McGarvey, in his Afterword, restates the central concern of these essays—mismeasurement, stigmatization, medicalization, focus on individual agency, and a failure to address historical and cultural circumstances. What he proposes is that attention must be paid to the effects all of these have on research, program, and treatment (pp.235-237.) The Afterword’s and the whole book’s focus on individual agency is itself of particular importance because ” A survey of more than three hundred international policy makers found that 90 percent of them still believe that personal motivation-a.k.a.–willpower–was a very strong cause of obesity. (Wilson 2019:21.)” McGarvey intends to have the issues he delineates addressed in a more sensitive and successful fashion.

As I have noted, the book is an important contribution to addressing what is a significant concern in the understanding of weight issues. I would like to address the issues raised from a somewhat different angle, hoping to add to future research, program, and treatment. In terms of my background, I am an anthropologist. I am also a psychologist. One of my specialties is that I assess clients who are going to get gastric bypass, laparoscopy, gastric band and gastric sleeve surgeries. The stated purpose of these surgeries is to enable a person who has had significant difficulties in losing weight to lose weight. These clients have tried diets, often to no avail. They are at risk for Type II diabetes and other medical problems, including heart conditions, etc. The purpose of the assessment is to make sure that the client has no underlying psychopathology or substance abuse that would prevent her or him from understanding the nature of the surgery and following the doctor’s post-operative orders.

My role is to assess, not say whether the surgery itself is indicated. Generally, the population I see for gastric bypass surgery is severely [ the preferred term] obese, even considering the issues of mismeasurement raised by many of the essay writers. The laparoscopy and other surgeries population is severely overweight, but not necessarily severely obese. Laparoscopy and the other mentioned surgeries is a less invasive surgical procedure, which is why it is used for this condition. All the patients I have seen have had difficulties with different diets. Approximately 70% have Type II diabetes. About 60% have either been molested or raped, equally across categories of their gender, sexual identity, or sexual preference.

The surgeries for severe obesity are often successful for reducing the presence and risk of Type II diabetes (see, for example, https://care.diabetesjournals.org/content/34/Supplement_2/S361. The site offers a useful description of the measures used to determine severe obesity and the different types of surgeries considered.) The surgeries do entail risks, including rupture of the surgery area. The person must be careful in following all the post-operative instructions, including changing long-term eating patterns. Those receiving gastric bypass surgery can no longer drink carbonated beverages and must eat very small portions of food.

The physicians for whom I do the surgery assessments run support groups for their patients. Many of their patients have talked to family and friends who have had the surgery and they get ample visual and written material as well. As noted above, my “sample of clients” shows a high level of being sexually abused. Rarely have they gotten therapy for that abuse. I do recommend that they see a therapist. Depending on the circumstances, I may set this as a precondition of the surgery. My statistics may be slightly higher than other studies, as, for example:” Obesity rates were not different across groups in childhood or adolescence. By young adulthood (ages 20–27), abused female subjects were significantly more likely to be obese (42.25%) than were comparison female subjects (28.40%). Hierarchical linear modeling growth-trajectory analyses indicated that abused female subjects, on average, acquired body mass at a significantly steeper rate from childhood through young adulthood than did comparison female subjects after controlling for minority status and parity. (https://pediatrics.aappublications.org/content/120/1/e61?download=true.)” Other researchers have also seen the link between being sexually abused as a child and obesity, as, for example: https://www.obesityaction.org/community/article-library/sexual-abuse-and-obesity-whats-the-link/

There may be other co-occurring [the preferred term] conditions that may require stronger interventions than dieting and/or exercise. I also treat clients from Workers Compensation or with disabilities from non-work-related accidents. Many of them can no longer move easily and are often depressed as well. They often gain large amounts of weight, some moving into the category of severely obese. One client was hurt on the job so that he could not walk or move easily. Before the accident, ironically, he had the gastric bypass surgery, because he weighed 350 pounds. After the accident, he could barely move. Furthermore, his weight climbed to 450 pounds. He did not want to take medications and he did not want to come to therapy, either—even after the risks were explained to him. I offer details about these cases because I think the book should help further address how to best address populations with these kinds of issues.

Some of the essays specifically concern how weight issues affect African American women.      The American Psychological Association issued a report on ideas and changes that should be made concerning this population: https://www.apa.org/pi/women/resources/reports/obesity.pdf

As the book recommends, more research should be done and greater sensitivity should be shown to this population and to similar ones as well (2014: 14.) Often, however, external factors, such as no place to exercise, family dysfunction for some, lack of money—cannot easily be addressed in programs.

In sum, this is an excellent, well-written book that is useful for anthropologists, public health and policy makers, and practitioners working in the field of obesity. It would also be useful for graduate students in these same areas.

 

BIBLIOGRAPHY

2019. Bee Wilson. The Way We Eat Now. Basic Books: New York.

https://www.apa.org/pi/women/resources/reports/obesity.pdf 2014 (Accessed August 26, 2019.)

https://www.cambridge.org/core/journals/public-health-nutrition/article/examining-differences-in-school-hour-and-school-day-dietary-quality-among-canadian-children-between-2004-and-2015/EE852354AB74B07F23B88313348084AE/core-reader 2019 (Accessed August 27, 2019)

https://care.diabetesjournals.org/content/34/Supplement_2/S361 2011(Accessed August 26, 2019

https://www.obesityaction.org/community/article-library/sexual-abuse-and-obesity-whats-the-link/ 2019 (Accessed August 27, 2019)

https://pediatrics.aappublications.org/content/120/1/e61?download=true 2007(Accessed August 26, 2019)

 

 

 

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Review: Organic Food, Farming and Culture

Chrzan, Janet and Jacqueline A. Ricotta, eds. Organic Food, Farming and Culture. An Introduction. Bloomsbury Academic. 2019. 332 pp. ISBN 1350027839, 9781350027831

Organic Food, Farming and Culture

Ellen Messer, Ph.D. (Friedman School of Nutrition Science and Policy, Tufts University, and Boston University Program in Gastronomy)

On a recent walk through the Portland (Maine) lower port area, I happened upon a burger joint announcing its 100 percent organic grass-fed beef, ground and shaped into a patty that was broiled and served with any other number of “value added” ingredients. The place was relatively empty on this not yet high tourist season day and pre-dinner hour, so I initiated a conversation with the young man taking the orders. “What’s the simplest burger you have?” I asked. The answer was that the default option was with cheese and one sauce + relishes. If I wanted just a plain burger, I would have to specify “no cheese”.

“What about the sauces and toppings—are they all organic?” I asked. He honestly didn’t know. Were the buns organic? Someone else would have to check. From the consumer’s value-driven perspective, such limitations on the boundaries of organic foodstuffs are confusing, not to say, troubling, as concerned, values/ideology-driven eaters try to negotiate dietary intakes that are healthy, respectful of the environment, and caring regarding biological food sources; kind and committed to labor and justice issues, and also wary of contributing to local or larger world food and hunger problems. Local food and sustainable farming advocates, additionally, emphasize the dangers of transferring one’s nutritional loyalties and food dollars to non-local, transnational food corporations that access their ingredients or processed foods wherever they are cheapest and for whatever reasons, never mind injustice to labor or damages to the environment, so long as they don’t enter into the profit-accounting assessment.

These are the conundrums and issues that Organic Food, Farming and Culture. An Introduction. edited by Janet Chrzan (and anthropologist) and Jacqueline A. Ricotta (a professor of horticulture) seek to clarify. The reasonably well-organized volume deliberately begins with some history of organics and ends with an essay contrasting GMOs and organics. Sandwiched in between are short profile pieces by organic farmers, chefs, and consumers, juxtaposed with scholarly essays by academics, policy-makers, industry leaders, cooks or chefs, and other users.

Part One provides multiple “History” entries that succinctly explore the origins of organic food science and technology practices and the organic food movement in the US, Europe, and other places. Gene Anderson’s lyrical chapter on traditional foods as organic foods, with special attention to Chinese and Mexican food systems that are his main areas of ethnographic research, will serve admirably as a classroom basis for understanding the particulars of these histories, and could also be used to encourage students to write their own comparative chapters, based on other world places Anderson has not treated.

Part Two examines “Organics in Practice,” with separate chapters considering agronomics, markets and evolving monitoring standards all along the supply chain. The two-part “Consumers, Citizens, and the Participatory Processes on Organic Food: Two Case Studies from Denmark” compare and contrast bottom-up municipal organic food efforts with top-down Copenhagen government organic efforts and are well worth reading in any course dealing with comparative food-policy (or other policy), government-community relationships, and networking.

Part Three considers “Organic Food Values, Sustainability and Social Movements” reviews and updates evidence on the “Farming for Food or Farming for Profits” controversy. Simply stated: how can and do organic farmers manage to make a living, which starts with gaining access to land and then matching production to effective demand. Syntheses of the demonstrably incomplete and variably framed scientific evidence tying organic foods to (as yet unproven) superior nutrition and health benefits, or the additional controversy surrounding whether organic food-production has the capacity to feed the world, allow readers to access the evidence and draw their own conclusions. Particularly the organic food and “food security” issues suggest good research or exam questions on whether the evidence supports the “yes” or “no it can’t” point of view, and also what additional studies are necessary to move this debate forward.

The final section Four continues the examination of user understandings when choosing organic over non-organic or unmarked foods and “organic food culture,” that encourages eaters to associate with others who favor eating organic as a cultural identity. Here, chefs and academics together raise the usually contentious question— “Is there Really a Difference Between Conventional, Organic, and GMO?”. Here the authors agree in principle and practice with Food Politics blogger Marion Nestle, who advises: Much depends on which foods, which measurements, and which values make a difference. In their concluding chapter, authors Anderson, Chrzan, and Ricotta summarize the plethora of values and challenges facing food producers, processors, purveyors, and consumers in their multiple value-laden choices to eat healthy, environmentally sustainable, socially just, affordable, palatable, and culturally appropriate food. Take-aways, not surprisingly, are that people do not always act on their stated values; also, that chefs and consumers probably care more about the trusted relationship with the farmer who assures them that the produce they buy is farmed organically, and less about official (USDA) certification. Overall, it “takes a community” and reliable partners all along the food value chain to keep organic production viable and attract new entrants. From beginning to end, this book provides numerous examples of such growing relationships (multiple entendres intended), and encourages readers to seek and share more profiles and vignettes from their personal experiences. Unfortunately, readers like me will likely complete the historical, operational, social-organizing, and concluding chapters with no clearer answer to the question whether organic food can feed the world? I have never been convinced by conventional and GMO proponents that it could not, but most pro-organic examples, including those here, lead or leave me to wonder about the limits to livelihoods, dedicated labor and enterprise for most organic practitioners, however passionate.

Such ambiguities and ambivalence aside, students will probably enjoy the design and organization of the book, which includes brief profiles, personal stories, and inter-personal intersections among them. The wide-ranging subject matter, which touches on everything from minute technologies of soil regeneration to alleged spiritual values of eating or growing organic food, will appeal in places to particular readers, who can pick and choose to read what interests them. I agree with the glowing, collegial endorsements printed on the back cover that the volume’s “strength .. is the explicit connection of abstract food studies with the hands-in-the-dirt [or cooking pot] practices of living farmers, chefs, and purveyors” (Ken Albala, Food Studies historian). Also, that this book provides an “accessible source of information on the agronomic, nutritional, political, and economic dimensions of organic food and agriculture” (Lisa Markowitz, Anthropology, Culture & Agriculture), to which I would add social and cultural dimensions throughout.

Students will likely also relate very well to the repeated profiles, which show how a young organic farmer became engaged in this livelihood, who helped (him) along the way, energetic and continually evolving partnerships with chefs who value the rare and wonderful products he nurtures, and learn to appreciate how conservation initiatives are connecting new entry to retiring farmers, and helping young entrepreneurial farmers gain access to farmland while giving the older generation peace of mind that the farmland will be cared for in perpetuity. Anecdotes describing some of the difficulties, such as removing the organic slugs that also enjoy the pricey organic produce or figuring out ways to use abundant organic root and tuber crop deliveries from CSAs, some of which go to community operations that feed the hungry, add humanity to the mix, and put a human face on the numbers of hungry that organic food can potentially feed. The human faces of the profiled individuals, and partnerships between farmers and chefs, gardeners and their food products, are also presented in numerous photographs, which are not always in sharp focus, and in some cases, present multiple views of the farm, produce, or producer-chef relationship that could have been reduced to one.

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Thesis Review and Interview: Deorukhe Women’s Agency in the Making of Bodies, Cuisine, and Culture in Maharashtra, India

DSCN1379

Photograph: Gauri A. Pitale – Waterlogged rice fields of rural Konkan, Maharashtra

Please note: As Associate Editor, I am soliciting reviews of recent dissertations in the Anthropology of Food. So if you have written a recent thesis or would like to review one, you can contact me directly: Katharina Graf (kg38@soas.ac.uk).

Anna He Purnabramha: Deorukhe Women’s Agency in the Making of Bodies, Cuisine, and Culture in Maharashtra, India. Gauri Anilkumar Pitale. Ph.D. Thesis in Anthropology, Southern Illinois University, Carbondale. 2017.

Elizabeth Finnis (University of Guelph, Canada)

Gauri A. Pitale’s doctoral work takes a biocultural approach to understanding potential health implications of dietary changes in the context of liberalization, globalization, and national change in India. Pitale worked with 66 pairs of Deorukhe Brahmin mothers and daughters living in rural and urban Maharashtra; mothers were all born and raised in a pre-liberalization India, with daughters born and raised in the post-liberalization era. Drawing on qualitative and anthropometric data, Pitale looks at intergenerational differences, asking how changing dietary practices are implicated in notions of the self and identity. In doing so, she considers Chronic Non-Communicable Diseases (CNCDs), including obesity, hypertension and diabetes, testing a range of hypotheses, and exploring foodscapes in terms of the lived experiences of her participants and issues of purity, perceptions of health, and the body. What particularly stands out in her ethnographic approach is the placing of anthropometric measurements within larger contexts of notions of identity and caste purity. Her anthropometric results and discussions are bracketed by chapters that draw on her qualitative data and her fieldwork reflections, including considerations of changing perceptions of food/cooking and implications for relationships and exchange, and the ways that processes of urbanization can affect food habits and preferences.

There is much to think about in Pitale’s work, including reflections on the expected and unexpected in fieldwork, urbanization and the presence of CNCDs, and changes in food habits that have both dietary and moral implications for participants. Pitale’s dissertation allows readers to reflect on questions that are of importance both in contemporary India and that also address broader issues of identity, belonging, food, and place. These include: How do notions of purity and kinship intersect with cooking rules, not just in terms of food eaten, but also with regards to how the space of a traditional hearth is used, and what it symbolizes? How does convenience get complicated by notions of authenticity and taste? What do kitchen implements and home-grown or home-prepared spices mean in terms of family history and tradition? How do space and place affect the types of food that daughters want to cook, and their relative cooking skills? How are community ties reinforced through shared cooking activities? And, How are anxieties around maintaining caste identities and/or engaging with cosmopolitan identities, intersecting with food?

These questions are considered through different cultural and data lenses. For example, Pitale provides a discussion of cooking and kitchens, including the symbolic, sacred value of the traditional chul (a u-shaped clay stove, coated with a double-layer of plaster made from cow dung and water, and red earth) and its associated rules for use, versus the comparatively rule-free and convenient gas stove. Through her discussion, Pitale demonstrates some of everyday complexities of balancing multiple factors in food preparation and consumption.

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Photograph: Gauri A. Pitale – Chul in a rural Deorukhe kitchen

Another example includes considerations of some of the differences when it comes to cooking skills among rural and urban daughters. While young rural women are expected to develop cooking skills and learn how to manage a kitchen at a young age, in part related to the need for an alternative cook when mothers are practicing menstrual seclusion, urban daughters are less likely to have significant skills in the kitchen. When urban daughters do cook, it is more likely non-traditional recipes, or “fun” foods like pizza and cakes. This also connects to the chul, with urban daughters preferring to use gas stoves, and in some cases, being unable to effectively cook on a chul at all.

With her anthropometric data, Pitale also considers how nutritional transitions are implicated in CNCDs; she hypothesises clear differences between her rural and urban participants, with a generational effect. Her findings indicate that, for example, based on weight circumference, almost all mothers (rural and urban) would be considered obese (86.4%), but rural daughters were more likely to be underweight than urban daughters. One of Pitale’s surprising findings was in terms of blood pressure; contrary to expectations, rural mothers had higher blood pressure than urban mothers. This finding questions underlying assumptions that traditional diets and activity levels can help to minimise high blood pressure, while urbanized diets and lifestyles can increase it.

Overall, this is a rich dissertation that uses a range of data collection methods to create a complicated picture of the ways that food intersects with notions of the self, and health. Who should read this dissertation? This work is of interest to anyone who is thinking about how food practices shape and are shaped by everyday rural or urban life, and the implications that this has for how people think about their identities and health, and to those looking for an example of the complexities of economic liberalization, rural-urban differences, and caste in contemporary India. The thesis will also be of interest to researchers thinking about how to approach biocultural research projects, and how to integrate anthropometric and qualitative data within ethnography. As I read the dissertation, a number of questions emerged for me around some of the public elements of Pitale’s work, her findings, and her fieldwork experiences, and my review concludes with an interview addressing some of these questions.

Elizabeth Finnis (EF): Hi, Gauri! I enjoyed reading your doctoral work, and thank you for letting the SAFN blog host this review and an interview with you about your work and research experiences. My first question is something that I often ask people during (or immediately after!) a defense: Who would you hope would read your work, outside of anthropological audiences?

Gauri A. Pitale (GAP): I would love for everyone to read my dissertation because I certainly find it rather riveting a topic! Jokes apart, I think my study would be illuminating for those governmental agencies that are working on addressing problems related to the double-burden of overnutrition and undernutrition that India is facing. As a country, we [Indians] are leading in the numbers of deaths that are connected to CNCDs. The increasing encroachment of multi-national corporations that sell fast foods and ones that may result in the disappearance of small kirana (grocery) shops is concerning. India is in a precarious position. The coming two to three decades will vitally change the food consumption and the food distribution system of the entire country. Yes, certainly we should address the biological causes that make Indians susceptible to CNCDs. But if the government does not increase awareness among people, there is high likelihood that India will face the same challenges that western nations like the United States of America faced starting the 1970s and 1980s. On the one hand, we notice that an increasing number of urban Indians are becoming more and more conscious of how to maintain their health by going to dieticians and/or the gym. On the other hand, large swathes of Indians are turning to Ayurveda and traditional remedies to counter these same problems. It is my hope that this dissertation highlights how variable the answers can be within one country. Other than government agencies, I would also love for my research to be read by the Deorukhe community. I hope they find it useful. I have already given them a copy of my dissertation and am currently waiting to hear back from them.

EF: So, then what do you hope a non-anthropologist will really understand about your research?

GAP: When I explained my dissertation research focus to my Indian friends and family, their responses were rather interesting. Some found the research topic to be rather bland, while others thought that the information I was gathering was so commonplace that they couldn’t comprehend why it needed to be researched at all. Non-Indian friends and family also found the subject pale in comparison to studying the more “exotic” aspects of Indian culture and society. I soon realized that people take food for granted. While Indians have a medicinal system entrenched in food, westerners are usually more focused on the nutritional aspects of food. That said, food and eating has been and will always remain a social as well as an emotional experience. Though the relationship between food consumption and health seems like a straightforward one, my study demonstrates that making any sort of policy decisions to control or even address the rising appearance of Chronic Non-Communicable Disorders (CNCDs) will remain hopelessly abstruse if we disregard the historical, ecological, political, as well as the economic aspects of why people eat the way they do. Certainly, there are a multitude of factors involved but a deep understanding of the issue on both a local and global level is valid and necessary. To actually affect change, we need to start making lay people aware of this simple fact: food and the body are not things that can be studied bereft of their social surroundings.

EF: Your answer makes me think a bit about how the participants in your research thought about blood pressure and mental/emotional stress. You argue that for your participants, particularly the rural ones, high blood pressure is considered related to mental and emotional stress, and is therefore seen as a temporary condition. Are there bigger implications of this understanding of high blood pressure?

GAP: This is one of the aspects of my study that surprised me immensely. I hypothesized that high blood pressure would be more common among urban participants in comparison to rural participants. This is in line with published research doing a comparative analysis between urban and rural populations. Therefore, the results of my data collection coupled with my experiences in the field were atypical and confusing. My rural interlocutors did view high blood pressure to be the result of a temporary condition. These people were also going to rural medical practitioners. I wish I had the time to visit these doctors to ascertain whether they had actually told the interlocutors that this was a temporary condition. The main thing that concerned me was, if hypertension was being viewed as a temporary health issue occurring as a result of stress, then treating it accordingly might result in more health complications in the long run.

More importantly, the implications of this perspective are two-fold. One, if and when a complication does occur in the future when these women are older, the problem would be treated as something to be expected because high blood pressure is seen as a chronic health condition that plagues old people. Two, most studies expect hypertension to be a condition that is commonly noted among urban people; rural people suffering from the same condition might not even be considered to be at risk. This could mean that they will never be tested or treated until a complication arises. A large part of rural India bears the burden of undernutrition. The Deorukhes are comparatively well-off thanks to their caste status. Therefore, we must also acknowledge this occurrence of hypertension among this rural population might not be something that applies to people of all castes in rural India. For all of these reasons, it is highly likely that these conditions will not be noticed anytime soon. This concerns and worries me, especially in connection to their long-term health and their quality of life.

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Photograph: Gauri A. Pitale – Roadside fruit seller, Mumbai

EF: I found it interesting to read your brief discussion of the guilt felt by some mothers if they don’t – or can’t – cook for their children. Do you think similar feelings can play out in different kinds of households, both within and outside of India? What makes it different (or not) for your participants?

GAP: What a fantastic question! I am happy you asked me this. The guilt felt by mothers is certainly not unique to Indian culture. There are many cultures in which I assume women experience guilt that corresponds with the diet and health of their family members. I assume because having grown up in India, I experience this guilt and deal with it on a day-to-day basis. I believe the difference lies in how my participants experience this within the social dynamics of Indian society. I am certain women in other cultures also have certain expectations that are thrust upon them. In the case of my interlocutors however, there is the added layer of caste-related food prescriptions. The expectation that Deorukhe Brahmin women in general have to safeguard household purity is a larger part of this guilt. Women have to learn to prepare traditional foods so that they can pass on traditions to daughters and daughters-in-law. And while every culture has a family recipe that can be learned from elders in the family, how integral these recipes are to one’s communal identity changes from one culture to another.

I can give you an example of something that occurred in my own family. I happened to visit the family of a friend who was of a lower caste. They invited me for dinner one evening. I remember that her mom had made some type of shellfish that I had never tried before. I found it to be rather delicious. Upon returning home my grandmother promptly asked me what had been served for dinner. I told her about this unheard-of shellfish and asked my mother why she never cooked this fish at home. My grandmother immediately replied, “We don’t buy that kind of fish. Those are eaten by lower caste people.” Until that moment, I had no idea that my friend belonged to a different caste group at all. But my grandmother deemed it necessary to educate me about the differences in upper and lower caste fish consumption at the age of 10, lest I make any such demands again. These conversations are ubiquitous in rural and urban Indian households. The guilt felt at crossing these boundaries is an additional aspect of the guilt felt by my interlocutors. It may not be unique to India because I am sure this kind of gate-keeping also occurs in other world cultures. The difference may be in the amount of social consequences that result from women’s failure to control the food that enters their households in general and into the bodies of their family members in particular.

EF: I also appreciated the methodological and positionality reflections that you incorporate into your dissertation. For example, you write about how, when collecting data, you were positioned as the ‘expert’, but that when you entered kitchens, you became understood as lacking in experience and basic knowledge. What did this kind of ‘flip’ in perceptions of expertise teach you about doing ethnographic research?

GAP: The first lesson that I learned when I went into the field was that people tell you what they think you want to hear. This is a lesson we all learn as anthropologists, and that’s why we spend so much time getting comfortable with our interlocutors and participating in their lives as we observe them. My fieldwork was incredibly fruitful. Despite that, my appearance as an Indian woman who lived in America and had come back to India to study the Deorukhes put me in an interesting position. In one part of the introduction chapter of my dissertation, I discuss my position and the social capital that I had which resulted in the Deorukhes allowing me into their homes. However, my familiarity, while at times a disadvantage, was also an advantage in this case. I want to be clear that I’m not implying that non-native anthropologists may not have used this strategy to make their interlocutors comfortable. But the fact remains that the conversations about food and food habits that I had with Deorukhe mothers lacked the depth that I found satisfying. I also realized that talking in their living rooms about food often resulted in the whole family, and in some case entire neighborhoods, monitoring the interaction. The resultant conversation was stunted and awkward, something I noticed as I started transcribing my field recordings. I was spending more time asking questions and directing conversations rather than getting answers.

The request to enter their kitchens to watch them cook was put forth for two main reasons. One, not everyone is allowed entry into each other’s household kitchens. The audience had to leave or wait outside in the living room, allowing me and the woman to be alone or at least have fewer people around. This was something I noticed in one household during my first visit. I went into the kitchen to return a cup of coffee to the lady of the house. She told me where to place the dirty cup in the kitchen and promptly started amending some of her answers. Her husband and some men in the village were sitting outside in the living room hearing us talk. In the kitchen, she started complaining about how difficult it is to manage the food habits of her husband. It became obvious that the kitchen was her domain and the one place she felt safe to voice her opinions without being overheard, especially by the men since they rarely ventured into this space. The second reason was to reduce the awkwardness of sitting and talking without having anything to do. Most of my interlocutors were happy to show off their kitchens to me. No matter how small or large, how fancy or simple, these were their spaces, arranged to their liking, and spaces that they controlled. Also, if they kept busy, I assumed our discussions would be more fruitful. The dynamic shift was an unexpected discovery. As soon as I noticed it, I immediately began to ponder on the manner in which their assumption of my inexperience in matters related to running a household relaxed them and made them want to impart knowledge to me.

Present day anthropology has come a long way from what we thought about our interlocutors to how we perceive them today. They are the experts from whom we learn. I went into the field with that point of view. And while I fully intended to carry out semi-structured interviews, I also had a long list of questions prepared so that I could collect data on food acquisition patterns. I still have this data. I have piles of data about how much rice, flour, lentils, masalas, etc. each household buys. I also have data about the money each household spends on food and other food acquisition pattern information. While I meticulously collected this data in the field, I also realized that for me, the deep ethnographic data that started to shine and capture my attention was what I encountered in the kitchens as I watched women cook. These discussions and interactions were far more rewarding and indicative of what they wanted to tell me. I chose to focus on their voices rather than only focus on my initial study objectives. What this taught me is that it is important to go into the field with specific objectives. However, it is equally important to allow our interlocutors to tell us what they deem to be important for us to know. In between these two points is where the actual fun and research lies!

EF: In focusing on the health of women, did you ever get participants wondering why you weren’t also considering the health of men? If yes, in what kinds of ways did you respond to these queries?

GAP: The Deorukhe community did initially assume that my research was about the entire household. I would have very much liked to have focused on entire households because the data gathered would have been richer, especially ethnographically speaking. There were, however, several restrictions. For one, my study was self-funded, which meant I could only spend a certain amount of time in the field. For statistical reasons, I needed to recruit at least 35 families from both rural and urban settings. I also needed to visit each family at least three times to note seasonal changes in their diet as well as their anthropometric measurements. All of this really restricted my ability to spend more time with each family. The more people I needed to meet, the more difficult it was to find time to meet with them. The men of the household, especially rural men, often controlled my access to their wives and daughters in the initial stages of my study. Though I was requesting the women to be a part of my study, in many rural families the men closely monitored the initial conversations. In one household in particular, the women and her daughters never uttered a single word in reply until the husband said, “Alright, go ahead and add us to your list of participants.”

Restricting the study to women and girls was something that I had already discussed with my advisors and committee members. This is because ease of access to my interlocutors and the ability to hold conversations in both public and private was important to me. There is a high amount of gender segregation in India. As a woman, it was easier for me to get access to and speak with young girls and women. Conversations with men were not impossible but these took place more in urban settings rather than rural settings. As for your question about whether participants wondered about why my research did not consider men, they did not. That is because I told them when I was recruiting that I was focusing on women because they were the gastronomic gate-keepers and the ones in charge of managing the household’s food consumption patterns. This made sense to my interlocutors. From their perspective, I was not only measuring their and their daughters’ bodies, but at the same time I was discussing with them the health of their entire family. My interlocutors often told me how they managed to ensure their sons, husbands, or fathers-in-law stayed healthy. This was vital to their discussions about the various challenges that they face when trying to keep their families healthy, a responsibility not to be taken lightly.

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Photograph: Gauri A. Pitale – Food court of a mall, Mumbai

EF: Your picture of changing food habits among your participant households is both rich, and, as you indicate yourself, patchy in some ways. What’s next for you, in terms of research?

GAP: This is a wonderful question! I loved every minute of my fieldwork and found interacting with the Deorukhe community in general to be a very rewarding experience. As a doctoral candidate who went into the field for her first long-term fieldwork, I experienced a lot of anxiety when things did not go as planned. The lack of both time and money was on the forefront of my mind. This meant that as much as possible, I collected every piece of information that I could. Along the way, I also collected large swathes of data about factors that I had not even considered to be influential to my research results. This is a large reason for why my research results are rich and at the same time provide a patchy picture. I think that is the strength of ethnographic fieldwork. I struggled to make sense of the enormous amount of information that I gathered during my fieldwork after I returned to America. After much contemplation and several discussions with my advisors and doctoral committee members, it became clear that the only way I could write this dissertation, for me, was by focusing on things that my interlocutors spoke about the most. Those are the things I have written about. I am happy with the way my dissertation has turned out, but it honestly only speaks about 30% of the information that I have gathered during my fieldwork.

Going forward I will publish chapters of my dissertation. Someday soon, I would also like to return to the field with funding so that I can fill in the gaps that currently exist, while also noting the changes that have taken place since 2014. And while I want to continue working with the Deorukhe community, I would also like to add another caste group, preferably people who are meat-eaters. This might allow for a richer and better comparative analysis. In an India that is experiencing large-scale dietary changes, I would like to see how the idea of purity and caste identities continues to play out. That would enable us, as food anthropologists, to really study the communal tension that underlies the study of food and culture in modern day India.

EF: Thank you, Gauri, for your responses, and for your contributions to the SAFN blog!

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Filed under anthropology, book reviews, cooking, cuisine, culture, diabetes, food and health, gender, India, nutrition, obesity

Healthy Eating Research Grants

The Robert Wood Johnson Foundation sponsors a program called Healthy Eating Research through which they support research on healthy eating among children. The program recently released a call for proposals for rather substantial grants, which we quote below. This seems like a great opportunity for anthropologists who do research in related areas. Note that they will hold a webinar for interested applicants to describe the program and the grant application process on June 6, which is next week. If anyone from SAFN gets a grant, we would like to read about it here!

From the CFP web site:

Healthy Eating Research has released its 2018 Call for Proposals (CFP). This CFP is for two types of awards aimed at providing advocates, decision-makers, and policymakers with evidence to promote the health and well-being of children through nutritious foods and beverages.

The two types of funding opportunities included in this CFP are:

  • Round 11 small-scale grants (up to $200,000 and 18 months)
  • Round 11 large-scale grants (up to $500,000 and 24 months)

The Robert Wood Johnson Foundation (RWJF) is focused on policy, systems, and environmental change (PSE) strategies that support parents’ and caregivers’ ability to provide environments that nurture and foster children’s physical, socioemotional, and cognitive health and well-being. In the area of food and nutrition, RWJF is particularly interested in PSE strategies that impact families, early care environments, schools, and communities at a population-level. Research studies must focus on PSE approaches with strong potential to improve children’s physical, socioemotional, and/or cognitive health and well-being through nutritious foods and beverages. Proposals will need to make clear connections between the study’s PSE strategies of interest and specific indicators of child health and well-being.

All studies must have the potential to impact groups at highest risk for poor health and well-being, and nutrition and weight-related health disparities. We are especially interested in studies focused on black or African American, Latino(a) or Hispanic, American Indian or Alaskan Native, Asian American, and native Hawaiian or Pacific Islander populations; and children living in lower-income rural and urban communities, with the aim of promoting equity. Target age groups are infants, children, and adolescents (ages 0 to 18) and their families.

Click here to download the CFP for more information on eligibility and selection criteria and descriptions of the types of studies that could be funded.

HEALTHY EATING RESEARCH ROUND 11 GRANTS

Approximately $2.6 million will be awarded through HER Round 11 grants. The anticipated allocation of funds is as follows:

  • Approximately $1.6 million will be awarded as small-scale grants, resulting in the funding of up to 8 small research grants through this solicitation. Each grant will award up to $200,000 for up to 18 months.
  • Approximately $1 million will be awarded as large-scale grants, resulting in the funding of 2 large-scale grants through this solicitation. Each grant will award up to $500,000 for up to 24 months.

How to Apply

All applications for this solicitation must be submitted via the RWJF online system. Visit www.rwjf.org/cfp/her11 and use the “Apply Online” link.

There are two phases in the application process:
Stage 1: Concept Paper
Stage 2: Full Proposal (for invited applicants only)

Applicant Webinar

A webinar for interested applicants will be held on Wednesday, June 6, 2018, from 3:00-4:00 p.m. ET. The purpose of the applicant webinar is to describe the Healthy Eating Research program, explain the scope of the CFP, review the application and review processes, and give you a chance to ask questions about this funding opportunity.

Registration is required to participate in this webinar. Please register at: https://cc.readytalk.com/r/pikqk3gpn57y&eom

Key Dates and Deadlines

June 6, 2018 (3 p.m. ET): Optional applicant webinar.
Registration is required: https://cc.readytalk.com/r/pikqk3gpn57y&eom

July 18, 2018 (3 p.m. ET): Concept papers for small- and large-scale grants are due in the online system. Concept papers submitted after July 18, 2018 (3 p.m. ET) will not be reviewed.

Frequently Asked Questions

Download answers to Frequently Asked Questions for this CFP. If you have additional questions about this funding opportunity, please contact the HER national program office at healthyeating@duke.edu or 1-800-578-8636.

 

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Filed under anthropology, CFP, food and health, grants, nutrition

Food Insecurity and Chronic Malnutrition in Rural Indigenous Guatemala

SAFN GUATEIMG_1

With the title, “Latinx Foodways in North America,” we aim to put the series in a more international perspective, inclusive of the United States, Caribbean, Mexico, Central America, and Canada. Here we introduce Dr. Meghan Farley Webb’s informative piece on fieldwork methods and nutrition with indigenous communities in rural Guatemala. Her work illustrates the global framework of this series. Enjoy!

Food Insecurity and Chronic Malnutrition in Rural Indigenous Guatemala

Wuqu’ Kawoq | Maya Health Alliance is an NGO providing high-quality, evidence-based health care in indigenous communities in Guatemala. Guatemala is especially affected by chronic malnutrition, or stunting, with some Maya communities experiencing stunting rates of seventy-five percent.1 As part of our Complete Child program, we have undertaken several mixed-methods studies to explore why stunting remains a problem in Maya communities.2-3 Food insecurity, common in rural indigenous communities, contributes to the persistence of stunting in Maya communities. In some communities where we work, all households experience moderate to severe food insecurity, as measured by the FANTA Food Access and Insecurity Scale. The FANTA scale provides a quick (only nine questions) and cross-culturally reliable means of assessing household food insecurity. The scale pays special attention to the issue of reliable access to healthy food.

Poor Feeding Indicators & Food Availability

Twenty-four hour food recalls are an important tool in nutritional assessment, but they have been shown to underestimate caloric and dietary diversity in Guatemala.4 Our investigations show similar problems, in part because most rural communities have a once weekly market where diverse fruits and vegetables can be purchased. Little access to refrigeration means that nutritionally diverse foods are often not available during the week. While seven-day food frequency questionnaires report higher quantities of fruits and vegetables, children’s diets remain deficient in dairy, flesh foods, eggs, and vitamin-A rich foods. Use of these questionnaires—which query the frequency of consumption of culturally relevant food items, divided into WHO food groups—is imperfect, as it may over- or underestimate consumption of some items; however, we find they provide an accurate general assessment of dietary diversity.

In contrast to the limited availability of fresh fruits and vegetables, pre-packaged junk food is readily available in tienditas (small corner stores). Focus groups and ethnographic interviews reveal that the ease of preparation of pre-packaged foods as well as children’s requests for junk foods and their relative low cost were additional drivers for the consumption of low-quality, processed foods. The proliferation of junk foods—sometimes referred to as “coca-colonization”5—means that Guatemala must simultaneously work to combat both stunting and obesity.

Poverty & Food Expenditures

In addition to this limited access to high-quality, nutritionally diverse foods, our research shows how endemic poverty contributes to food insecurity. We use the Quick Poverty Score to assess poverty in the communities we serve. The tool uses locally relevant “poverty indicators” to assess the likelihood that a household member is at or below $2 USD or $1USD/day. It is unsurprising that many households in rural indigenous Guatemala experience high levels of poverty. On average food expenditures are low, often so low that it would be impossible to meet caloric and micronutrient needs. Our research shows that underemployment and agricultural cycles result in high variability in income, and therefore, limit money available to spend on food.

Non-Traditional Agricultural Exports

Stunting rates remain high even in agricultural communities for two reasons. First, many households do not own enough land to sustain domestic production. Second, many rural agricultural communities have shifted from milpa (corn and beans) production to production for export. In the Guatemalan highlands, broccoli, snow peas, green beans, and blackberries have replaced traditionally grown and locally eaten crops. The shift to non-traditional agricultural exports negatively impacts dietary diversity not only because of a loss of subsistence crops, but also because growing these non-traditional exports often requires taking on significant debts for seeds and other agricultural inputs. Non-traditional agricultural exports have further worsened the conditions of food insecurity as the majority of rural Maya farmers do not report economic benefits to growing these crops. This is due in large part to the practice of selling crops to middlemen, rather than directly to exporters.

Programmatic Implications & Additional Research

Our research has shown how economic and environmental factors contribute to food insecurity and chronic malnutrition in rural indigenous Guatemala. Programs aimed at improving nutritional outcomes in indigenous children must also address cultural factors. For example, focus groups and numerous clinical interactions have demonstrated the importance of secondary caregivers, especially paternal grandmothers. Multi-generational family compounds mean that mothers, at whom most nutritional programming is aimed, may not be fully in control of food purchasing and/or preparation decision making. Home-based nutritional counseling offers one way to address barriers to improving nutritional outcomes in infants and young children. Internal evaluation of our nutritional programming and a recent clinical trial demonstrate the effectiveness of such intensive, home-based nutritional counseling to improve dietary diversity, minimum acceptable diet, and height/length-for-age. More information about our research, including copies of our published work and training materials, can be found here.

Meghan Farley Webb is a Staff Anthropologist with Wuqu’ Kawoq|Maya Health Alliance.

 

1 Black, R. E., C. G. Victora, S. P. Walker, Z. A. Bhutta, P. Christian, and M. Onis. 2013. “Maternal and child undernutrition and overweight in low-income and middle-income countries.”  Lancet 382. doi: 10.1016/s0140-6736(13)60937-x.

2 Ministerio de Salud Pública y Asistencia Social, Instituto Nacional de Estadística, and Secretaría de Planificación y Programación de la Presidencia. 2015. Encuesta Nacional de Salud Materno Infantil 2014-2015: Innforme de Indicadores Básicos. Guatemala City: Ministerio de Salud Pública y Asistencia Social (MSPAS).

3 Chary, Anita, Sarah Messmer, E. Sorenson, Nicole Henretty, Shom Dasgupta, and Peter Rohloff. 2013. “The Normalization of Childhood Disease: An Ethnographic Study of Child Malnutrition in Rural Guatemala.”  Human Organization 72 (2):87-97.

4 Rodriguez, M. M., H. Mendez, B. Torun, D. Schroeder, and A. D. Stein. 2002. “Validation of a semi-quantitative food-frequency questionnaire for use among adults in Guatemala.”  Public Health Nutrition 5. doi: 10.1079/phn2002333.

5 Leatherman, T.L. and A Goodman. 2005. “Coca-colonization of Diets in the Yucatán.” Social Science and Medicine 61(4):833-846. doi:10.1016/j.socscimed.2004.08.047

Photo provided by the author and Wuqu’ Kawoq:

Image 1: A vendor sells fresh produce in the market. Most rural indigenous communities in Guatemala have only one market day a week.

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Filed under anthropology, anthropology of food, food and health, food security, indigenous people

Review: Metabolic Living

 Metabolic Living: Food, Fat, and The Absorption of Illness in India. Harris Solomon. Duke University Press, 2016

Gauri Anilkumar Pitale
Southern Illinois University

          This original ethnographic work studies the meanings and practices surrounding metabolic functions in the everyday life and diet of contemporary urban Indians. Set in the city of Mumbai, the author challenges the reader to question the notion of “globesity”. Such terms loom important in the epidemiological considerations about the sudden increase in obesity and type 2 diabetes in India in the past few decades. Solomon provides the readers with detailed ethnographic vignettes that render his interlocutors as real people with problems and issues connected to city living, the same problems that affect their bodies in turn. Using the concept of ‘absorption of illness’ as the central theme of the book, the author states, “I consider how people make connections between food and urban life to explain that absorption is taking hold as the ground for experiencing and making sense of chronic illness” (Pg. 5).

            The book begins with a discussion of the ‘thin-fat’ Indian phenotype, used by scientists to comprehend the current rates of obesity and diabetes in India. Trying to attack the concept of metabolic syndrome from many perspectives, the author generates an ethnography that takes into consideration the problem of obesity and diabetes from several different directions. He carefully begins this book by discussing the Indian thin-fat phenotype. This phenotype, typical of Indians, results in the Indian people having a high amount of central adiposity (abdominal fat). A phenotype resulting from the environment of the womb (connected to the thrifty phenotype theory), this theory suggests that Indians are more susceptible to metabolic disorders. Diabetes and obesity are therefore developmental in origin. Giving us an account of his visit to Dr. Yajnik’s clinic (Dr. Yajnik is one of the two authors who proposed the theory of the thin-fat Indian phenotype), he reports Yajnik’s opinion that there is a need to address the underlying susceptibility of Indian bodies to being afflicted by metabolic disorders, rather than focusing purely on the treatment and prevention of the diseases themselves.  Talking to householders and the other people that he encountered throughout his fieldwork, Solomon plots the changing perspectives in relation to food and the body. He considers the conception of both the food and the body from the viewpoint of doctors, epidemiologists, scientists, nutritionists, housewives, street food servers, and manufacturers of processed food products.

            Tracing the historical perception of the problem of diabetes in India, Solomon brings forth the idea of “tenshun”. “Tenshun”, that mental stress which his interlocutors claim, afflicts the mind and predisposes people to obesity and diabetes, is at the heart of the epidemic that plagues contemporary Indians. Hinting at the ever-shifting discussions about bodies, he brings to light the many terms that people use to refer to overweight and obese bodies. This is important because people in India are showing signs of obesity. The words used range from mota (Hindi for fat) to the usage of the English word “healthy” to allude to overweight or chubby bodies. Diseases too are referred to with specific names. Diabetes could be referred to simply as sugar and cardiovascular disease as blockage. Solomon’s aim in discussing these terms is to imply that metabolic disorders have become common enough to form a part of the daily conversations of Mumbaikars. The threat of being afflicted with diabetes or obesity is real and looms large in their minds. This brings us back to the idea of “tenshun”. Through the course of this book, Solomon brings to light his interlocutors’ claims that merely living in Mumbai makes one’s body absorb the stresses of living, in turn creating diseased bodies that suffer from metabolic problems. Every discussion about obesity and diabetes gave way to deliberations pertaining to stress. His participants assert that the stresses of city living affected their diets, the development of their illness, and their body’s responses to such health conditions.

            Solomon weaves the chapters of his book together using interludes. These interludes, tangentially connected to the general theme of illness absorption that is so central to this book, are heavily fleshed out ethnographic vignettes about the city of Mumbai. These detailed descriptions talk about the mango madness that endangers the carefully prescribed diets given by exasperated nutritionists. They tell us of the struggles of Manuli (Manuli is that suburb of Mumbai where Solomon carried out household research) locals in attempting to have the governmental authorities take note of their troubles over accessing their share of food owed to them through the state’s ration card. These vignettes transpose the reader to the site of the study. They render Mumbai as a city of multiple communities and provides the reader with a multi-faceted understanding of Solomon’s field site.

            The strength of this ethnographic work lies in its multi-pronged approach. Not only does he interact with housewives, so well known as the domestic gatekeepers of Indian households, he also studies and interviews food corporation researchers and marketing heads, whose aim is to float “functional foods” that these very housewives will allow into their homes. By considering the struggle between the concerns about adulteration (milawat) which his respondents focus on intensely, the author discusses the newest fad of “functional foods” which are becoming popular in Indian households. Functional foods are foods created by food companies to render everyday staples healthier. Functional foods promise “extra benefits” because they are enriched with vitamins and minerals. They espouse to function categorically by aiding in the prevention of metabolic disorders. Fast gaining popularity in India, functional foods claim to assure buyers that they will alleviate their health problems. In such a manner, everyday staples such as wheat, rice, flour, and milk become functional foods. In the face of fears about adulteration and metabolic problems, the author demonstrates why and how functional foods are gaining traction in India.

            Solomon pushes the envelope on the famous concept of ‘gastropolitics’ put forth by Appadurai and studied by many food scholars since. Using the example of the famous Mumbai vada-paav, he connects street food to the very identity of urban spaces. Focusing on the vada-paav, referred to as the “lifeline of Mumbai” by some of his interlocutors, he pushes forward the concept of gastropolitics to demonstrate to the reader that street food can be reflective of politics, power, and class dynamics within a city. Attempting to trace the origin of the vada-paav, its usage, and its attempted standardization by both political parties and food corporations, the author states, “By moving beyond the confines of street food as a bounded entity, it is possible to map the reaches of gastropolitics into livelihoods, community injuries, dreams of urban renewal, and transnational enterprise” (Pg. 75).

            In the latter half of the book, Solomon focuses on the clinical therapies and gastric bypass surgeries taking place in Indian hospitals as the site to study the discussions pertaining to metabolism. While early on in the book he deliberates on the ever-blurry food-drug boundary, in the latter half of the book he acknowledges the necessity of looking at diets as therapy. Shadowing clinical dietary therapists and nutritionists, he demonstrates the daily struggles of both the clinicians and the afflicted when it comes to nutritional therapy.  In a clinician’s office where metabolism is being treated as a site of problem, multiple medical epistemologies collide. As Harris states, “These counseling visits illustrate the power of diets to coordinate the uncertainties of the metabolism” (Pg. 160). In these clinics, the onus is not only on the patient’s metabolism but also on their compliance. Dieticians insisted that patients’ compliance or non-compliance was what affected the result of dietary therapy. The dietician’s office was also a place where functional foods were prescribed to ailing patients. Such clinical therapies involved first measuring the patients’ bodies, both outwardly and internally. Weighing and measuring bodies went hand in hand with blood sugar, cholesterol, and hormonal level test. Through his ethnographic vignettes, Solomon manifests that the Ayurvedic concept of food as medicine is significantly overlapping with biomedical treatments for metabolic disorders. The result is a medical landscape that is vastly varied but one where food takes the center stage when it comes to health and disease.

            Solomon concludes the book by considering the idea that “as metabolic illness increasingly occupies global health interest and investment, what is needed is a perspective on metabolisms and their disorders different from one grounded in concerns about overconsumption” (Pg. 228). By tracing the historical food flows, the current shifting foodscape of Mumbai, the food standardization attempted by corporations, the author demonstrates to the readers that metabolic diseases are firmly entangled in social, political, gendered, and historical processes. Harris claims that through his work he approaches the concept of metabolism ethnographically. He states, “My principal concern in this book has been to develop an ethos of absorption at the interfaces between food and living” (Pg. 227).

            A wonderfully evocative ethnography, Solomon’s book makes one reflect on the very nature of metabolic syndrome. How does one address the solutions to a health problem that is so closely connected to food? The very food and eating which are sacred, political, social, and emotional.  Metabolic syndrome renders food as a focal point. Food can be addictive, rendering one’s body diseased, or it can be therapeutic, cleansing one’s body from the inside. Through this book, Solomon relays and reflects on this problematic relation, challenging medical experts to consider a multi-layered approach to solving the issues of obesity and diabetes that plague contemporary India.

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Filed under anthropology of food, food and health, India