Thursday, October 8, 2009

Nutrition in a developing country

I recently received a healthy lifestyle magazine in a care package from my family, and an article about antioxidant-rich foods caught my eye. In the U.S. this buzz-word, “antioxidant” is fairly well-known, but when I found myself trying to explain it to my Nicaraguan host sister over breakfast, I was met with a blank stare and a scrunched-up nose (in Nicaraguan nonverbal communication, that means confusion). “Free radicals?” She asked, “Those are in our bodies? Why do they need to be destroyed?” As I watched her eat some the typical breakfast of white sweet bread and tortilla with sugared-down coffee, I realized that this world of food that I was trying to explain was completely foreign. In Nicaragua, you eat what is available and you don’t complain. Food is a scarce resource that is subject to Mother Nature’s quirks and a person’s income level.

I realized that Nicaraguans don’t have ¨favorite foods¨ when I tried to use that as an ice-breaker introduction for a workshop I led with midwives. “State your name, the community you’re from and your favorite food” I instructed. One by one the women went off onto long tangents about how they just eat whatever is in season – beans, tortilla, etc. (of course, “only if God grants me the money to buy them or the good fortune to grow them.”) Most summed up saying that their “favorite foods” were beans and tortilla (aka what they eat every day). The concept was lost on them and I just had to smile at my mistake. I hadn’t realized before that experience what a luxury it is to even have a favorite food. The freedom of choice in what you eat is not universal and in poor countries such as Nicaragua, nutrition and health suffer.

In every rural Nicaraguan kitchen you can always find a few staples: tortillas made of maize, red beans, white rice and salty cow cheese. Sometimes there is a little bit of tomato, onion, plantain and some fruit to mix with sugar to make a sweet juice – but basically that’s about it. They don’t “count carbs” or even calories for that matter - most have never been inside a large grocery store that we would be familiar with in the U.S. A little corner store run out of someone’s house carries most of what they need: salt, sugar, beans, rice, white bread, soda pop…

As I continued reading the magazine, I saw a poll of some major personalities in the healthy-living world which asked them what they usually ate for breakfast. One nutritionist stated that he had “A medicinal smoothie that includes whey protein, a fatty-acid supplement, super greens, coconut powder, wild berry concentrate, goat milk kefir and frozen acai fruit.” My mouth literally dropped. This morning, when I went to my kitchen for breakfast there were red beans, tortilla and sweet coffee, period. If I were to read that article before joining Peace Corps, I probably would have thought – “Why didn’t I think of that smoothie?! I’m going to the store right now to stock up…” Now I realize that eating healthy is a privilege that only those in developed countries or with high incomes can afford. Before Peace Corps, even though I lived in the remote state of Alaska, I could still acquire a variety of exotic and healthy foods (however at a slightly larger price than the “lower ’48” – but still accessible). Another expert who was interviewed said that he enjoyed a Japanese breakfast; “steamed rice, miso soup, grilled salmon, pickles, cooked vegetables, sea vegetables and green tea.” Although there are some international restaurants in the capital of Managua, most people in the country only know “Nicaraguan food.” Being able to enjoy food from other countries that is easily affordable is also a benefit of living in a first-world, immigrant nation such as the United States.

I have been working lately in elementary schools giving classes on nutrition. Teaching something like the basic food groups is very useful and promoting a balanced diet. There are many varieties of fruits and vegetables here, but the habit of putting them into meals is not common. Simple carbohydrates, sugars and oil are prevalent, as well as high blood pressure, diabetes and high cholesterol. I’ve gradually been teaching kids that sugar is not a protein, and that no, coffee is not good for toddlers.

I have also been doing some workshops in the surrounding communities teaching mothers and daughters how to cook with soy. Soy beans are grown in Nicaragua and are very affordable ($0.50/pound) and from just one simple bean you can extract soy milk, soy meat, tofu, soy flour, soy pudding... The benefits of soy are numerous: there is no cholesterol, it contains omega-3 fatty acids, has twice the amount of protein of red beans, and contains vitamin B and calcium. Although this bean is readily available here and often cheaper than the widely-used red beans, many mothers – due to lack of education, end up feeding it to their animals instead of their family.

There are also many food myths that need to be debunked. I have been working with a pregnant women’s group promoting breast feeding and proper nutrition for the mothers during and after their pregnancy. Many women believe that powdered milk you can buy at the store is somehow “better” for their babies than their own breast milk. There is also a belief that after birth, new mothers should only eat tortilla, cheese and a corn meal drink called pinol. Needless to say this does not provide to the mother the proper vitamins and minerals she needs to provide nutritious milk to her newborn.

Since I am a community health volunteer here, these ideas on nutrition are not new to me, but the longer I am here the more I realize how this affects one’s health. Who do you think will be more susceptible to illness? The kefir-shake drinking health guru in the U.S. or the malnourished Nicaraguan little girl who is fed on only beans and tortilla? The answer is simple and problematic. One’s income and education level are directly related to nutrition and therefore health. The term “food security” is thrown around a lot here in Peace Corps and has to do with ensuring that people have available, accessible and sufficient food that fulfuills proper nutritional requirements, whether this means they grow or buy it. Most Peace Corps volunteers directly work in this whether they are in the business, agriculture, environment or health sector. A married couple who is in Peace Corps who live about a half an hour away from my site recently co-wrote an essay regarding food security which won recognition in a worldwide Peace Corps essay contest. You can see the essay here:

As I read that magazine, salivating at the photos of strawberries, spinach and apples, I also had to realize that I am still very thankful for the food that is put on my plate here every day. I know that people sweat out in the fields to cultivate these beans and corn. Those tomatoes and cucumbers were grown right here in Nicaragua. I am definitely eating locally this year. Although I can´t say I´m not looking forward to some good kefir when I get back to the states!

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