Hilary Creed-Kanashiro

Traditional food diversity predicts dietary quality for the Awajún in the Peruvian Amazon.

OBJECTIVE Our goal was to assess the potential for evaluating strengths of the Awajún traditional food system using dietary assessment, a traditional food diversity score and ranking of local foods. DESIGN The method was used for dietary data obtained from mothers and children in the Awajún culture of the Peruvian Amazon where >90% of the dietary energy is derived from local, traditional food. Traditional food diversity scores were calculated from repeat 24-hour recalls. Group mean intakes of energy, fat, protein, iron, vitamin A and vitamin C from each food item were used to rank foods by nutrient contribution. SETTING The study took place in six remote communities along the lower Cenepa River in the Amazonas District of Peru, South America. SUBJECTS Dietary data were collected from 49 Awajún mothers and 34 children aged 3-6 years, representative of the six communities. RESULTS Higher traditional food diversity was associated with greater protein, fibre, vitamin and mineral intakes when controlling for energy (partial correlations = 0.37 to 0.64). Unique sources for iron, total vitamin A and vitamin C were found in the Awajún traditional food system. CONCLUSIONS A traditional food diversity score was a useful tool for predicting nutrient adequacy for the Awajún. Promotion of the Awajún traditional food system should focus on dietary diversity and unique nutrient-dense local foods.

Infant and young child feeding in the Peruvian Amazon: the need to promote exclusive breastfeeding and nutrient-dense traditional complementary foods.

The study objective was to understand the role of traditional Awajún foods in dietary quality and the potential impacts on growth of Awajún infants and young children 0-23 months of age. Research took place in April and May of 2004, along the Cenepa River in six Awajún communities. Anthropometry estimated nutritional status for 32 infants (0-23 months). Repeat dietary recalls and infant feeding histories were completed with 32 mothers. Adequacy of the complementary foods was compared with World Health Organization guidelines. Anthropometry indicated a high prevalence of stunting (39.4% of infants and young children), with nutritional status declining with age. Half of the Awajún mothers practised exclusive breastfeeding. Dietary recalls and infant food histories suggested that many of the infants were getting adequate nutrition from complementary foods and breastfeeding; however, there was variation in breastfeeding and complementary feeding practices among the mothers. Complementary feeding for young children 12-23 months generally met nutrient recommendations, but mean intakes for iron, zinc, calcium and vitamin A were inadequate in infants 6-11 months. Traditional foods provided 85% of energy and were more nutrient dense than market foods. Appropriate infant and complementary feeding was found among some women; however, given the range of feeding practices and introduction of market foods, health promotion targeting infant and young child feeding is warranted.

Determinants of household food access among small farmers in the Andes: Examining the path

OBJECTIVE Household food access remains a concern among primarily agricultural households in lower- and middle-income countries. We examined the associations among domains representing livelihood assets (human capital, social capital, natural capital, physical capital and financial capital) and household food access. DESIGN Cross-sectional survey (two questionnaires) on livelihood assets. SETTING Metropolitan Pillaro, Ecuador; Cochabamba, Bolivia; and Huancayo, Peru. SUBJECTS Households (n = 570) involved in small-scale agricultural production in 2008. RESULTS Food access, defined as the number of months of adequate food provisioning in the previous year, was relatively good; 41 % of the respondents indicated to have had no difficulty in obtaining food for their household in the past year. Using bivariate analysis, key livelihood assets indicators associated with better household food access were identified as: age of household survey respondent (P = 0.05), participation in agricultural associations (P = 0.09), church membership (P = 0.08), area of irrigated land (P = 0.08), housing material (P = 0.06), space within the household residence (P = 0.02) and satisfaction with health status (P = 0.02). In path models both direct and indirect effects were observed, underscoring the complexity of the relationships between livelihood assets and household food access. Paths significantly associated with better household food access included: better housing conditions (P = 0.01), more space within the household residence (P = 0.001) and greater satisfaction with health status (P = 0.001). CONCLUSIONS Multiple factors were associated with household food access in these peri-urban agricultural households. Food security intervention programmes focusing on food access need to deal with both agricultural factors and determinants of health to bolster household food security in challenging lower- and middle-income country contexts.