Changing dietary patterns in the Peruvian Andes

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Changing dietary patterns in the Peruvian Andes a

William R. Leonard & R. Brooke Thomas

b

a

Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, 40536, USA b

Department of Anthropology, University of Massachusetts, Amherst, Massachussetts, 01003, USA Available online: 31 Aug 2010

To cite this article: William R. Leonard & R. Brooke Thomas (1988): Changing dietary patterns in the Peruvian Andes, Ecology of Food and Nutrition, 21:4, 245-263 To link to this article: http://dx.doi.org/10.1080/03670244.1988.9991039

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CHANGING DIETARY PATTERNS IN THE PERUVIAN ANDES

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WILLIAM R. LEONARD and R. BROOKE THOMAS Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, 40536, USA and Department of Anthropology, University of Massachusetts, Amherst, Massachussetts, 01003, USA (Received August 19, 1986; in final form November 23, 1987) This study examines the effect of seasonality and socioeconomic differentiation on food consumption and dietary change in the southern highlands of Peru. Nutritional data were collected by means of food weighing on a sample of 33 households (n=179) from the town of Nunoa. Comparisons with previously-reported data for this community indicate that the composition of the diet has changed markedly since the 1960s while the energy content has not. Seasonality in food availability is evident, as traditional stored foods and non-local products assume greater importance during the months preceding the harvest. However, such seasonal effects are mediated by dramatic socioeconomic differences in food consumption. Upper SES families have more diverse diets that are higher in energy and fat, but less seasonally variable than those of poorer families. On the other hand, the poorer households purchase fewer non-local foods and thus experience marked seasonal fluctuations in energy consumption. Hence, increased levels of commercialization of the economy, improvement of public health facilities and government services and the introduction of agrarian reform policies over the past two decades have done little to improve the nutritional status of most community members. KEY WORDS: nutritional survey, dietary change, seasonality, socioeconomic status, Peru, Andes, traditional food

INTRODUCTION Previous nutritional studies of Andean populations have demonstrated that the traditional highland diet is seasonally variable, non-diverse and marginal in terms of energy and other nutrients (cf. Baker and Mazess, 1963; Collazos et ai, 1954, 1960; Ferroni, 1980, 1982; Gursky, 1969; Mazess and Baker, 1964; PiconReategui, 1976, 1978; Thomas, 1973, 1976). For populations residing in the altiplano region (3600-5000m), the diet has traditionally been composed of a locally-grown tubers and cereals along with meat and dairy products. Over the past twenty-five years, however, Peru has undergone substantial political and economic change that has dramatically affected agricultural production, social relations and food availability in the rural sierra. This study examines the influence of some of these changes on dietary patterns and nutritional intake in the southern highland community of Nufioa (Department of Puno; altitude 4000m). Most of the significant changes in the highlands have come as the result of the agrarian reform implemented by the Valasco regime in 1968. One goal of the reform was to break up large estates {haciendas) in order to increase rural agricultural production and better integrate the rural population into the national economy as food producers (Painter, 1983, p. 37). It was hoped that this increased production would improve the rural standard of living as well as increase the domestic food supply for urban areas (Ferroni, 1980; Painter, 1983). 245

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246

WILLIAM R. LEONARD AND R. BROOKE THOMAS

Unfortunately, the agrarian reform had very limited success. Although the large haciendas were appropriated, most of the land was reorganized into two forms of state-supervised cooperative production units: The Agrarian Production Cooperative [CAP] and the Rural Association of Social Interests [SAIS] (Martinez, 1980). In the Department of Puno, 75% of the cultivable land came under the control of government cooperatives that employ only 7% of the rural population (Araburu and Ponce, 1983 p. 42). Consequently, the reform did little to even out the distribution of land in the rural highlands since control was merely shifted from the haciendas to government-controlled cooperatives. Another result of the agrarian reform and Peruvian national food policy was to increase the variety of non-traditional food products available in the highlands (Ferroni, 1980, 1982; Marquis and Kolasa, 1986; Orlove, 1987; Painter, 1983). The increased availability of market foods in the sierra was partly the result of the urban bias in national food and agricultural practices since then 1960s. It was hoped that by articulating rural production with urban consumption Peru could become self-sufficient in terms of food (Painter, 1983). Unfortunately, such efforts were largely undercut by continued reliance on cheap, imported foods rather than on traditional, domestically produced ones. The government's policy of subsidizing wheat imports is one example of how foreign products have been emphasized in Peruvian food policy. During periods of severe drought in the late 1950s, Peru began receiving surplus wheat from the US under the Food-for-Peace Bill (PL 480) of 1954. Since that time, the government has continued to subsidize wheat imports in order to make cheap flour widely available. Overall, the effects of government subsidies have been to make certain market foods widely available throughout the country as well as to provide profits for a small number of multinational corporations (Painter, 1983; Orlove, 1987). Within the district of Nufloa, these national policies have had considerable impact. The land reform instituted in 1972 produced great movement of rural families into the district's major town such that now, the population of the town of Nufioa is twice what it was in the early 1970s, accounting for almost half the population of the district (4500 of 9800 people) (Carey, 1986; Leatherman et al. 1986). This rural influx has increased the number of landless and unemployed and exacerbated socioeconomic differentiation (Leatherman et al., 1986; Luerssen and Markowitz, 1986). The town of Nufloa has also become more of a commercial center since the 1960s, partly as a result of the growing importance of its Sunday Market. Since its beginning in 1967, the market has expanded to where it is now the focal point for social and business interactions for the entire district (Escobar, 1976). Goods from the larger towns in the Department of Puno (for example, bicycles, pots, radios), as well as a variety of food products from all over the country (for example, fruits, vegetables) are now available every week in the market (Escobar, 1976, 1986; Luerssen and Markowitz, 1986). Given that anthropological research has been conducted in Nufloa since the early 1960s (Baker and Little, 1976), the present study provides an opportunity to evaluate how the social and economic changes of the past two decades have directly influenced food consumption patterns in this community. The central issues addressed in this paper are: First, how has the highland diet changed since the prereform period? Second, to what extent do environmental (i.e. seasonal) factors continue to influence dietary intake? Third, how does diet differ along socioeconomic lines?

DIET ANDES

247

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SAMPLE AND METHODS The data presented in this paper were collected between January and August of 1985 on a sample of 33 households from the town of Nufioa. The study was conducted within the framework of a larger project that examined patterns of illness within this community. During the first field season of this larger project (1983/ 84), health and production surveys were conducted on a random sample of 15% of the households in Nufloa (90 of the approximately 600 households) (Leatherman, 1987). From this initial sample 33 households representative of the lower and middle socioeconomic groups were selected for detailed study of food consumption. Primary occupation of head of household was found to be the most effective means of evaluating socioeconomic status (SES) within this community (Leonard, 1987). As such, upper SES (middle class) families are defined as those whose head of household had stable employment and thus, a regular source of income (for example a teacher or a worker in the town hall). Lower SES families are defined as those with a head of household who was not employed or involved in temporary wage-labour. Table I presents the sex and age distribution of the 179 individuals of the 33 households in the sample. This distribution is comparable to that of the total Nufioa population based on 1984 estimates (49% male and 51% female; Carey, 1986). Individuals of the present sample range in age from one to 70 years, with a median age of 13 years. Male and female age distributions are comparable (maximum age of 70 years in males and 65 years in females), with a median age of 15 years for males and 13 years for females. Most notable about the age distribution is the small number of individuals for the late teen ages (16-19 years). It is in this cohort that outmigration for educational and employment opportunities is greatest. Seven of the 33 households (21%) in the present sample are upper SES. These families account for 52 individuals, or approximately 30% of the total. Nutritional data were collected by means of individual food weighings using the protocol outlined by Weiner and Lourie (1981 pp. 352-365). Prior to cooking, each of the components of the meal, along with all of the household containers were weighed. Then, during the meal itself, all food consumed by each member of the household and the unconsumed portions were weighed. A top-loading, spring balance measuring ounces and pounds was used for all food weighings. The balance was periodically calibrated with standard weights to insure consistent measurements. TABLE I Age and sex of a sample of 33 households from Nufioa, Peru Males Age Group 1-3 4-6 7-9 10-12 13-15 16-19 20-35 36-70 Total

Females

n

Percent

n

Percent

13 7 12 7 9 5 16 18 87

7.3 3.9 6.7 3.9 5.0 2.8 8.9

19 15 9 9 1 2 18 19 92

10.6

10.1 48.6

8.4 5.0 5.0 0.6 1.1

10.1 10.6 51.4

248

WILLIAM R. LEONARD AND R. BROOKE THOMAS TABLE II Components of the Nufloan diet: 1962,1967, 1985

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Food Item A. Tubers 1. Papas (Solarium spp.) 2. Chuno/Moraya (Freeze-dried tubers) 3. Papa Lisas ( Ullucus tuberosa) 4, hanos ( Trapaeolum tuberosum) 5. Oca (Oxalis tuberosa) 6. Camote (Impomoea batatas) B. Vegetables 1. Onions 2. Red Pepper 3. Green Pepper 4. Tomato 5. Garlic 6. Carrots 7. Cabbage 8. Squash 9. Lettuce 10. Turnips

Food Items observed in each Survey (X) 19821 19672 19853 X X X X X

X X X

X X X X X X

X X

X

X X X X X X X X X X

X X X

X X

C. Fruits 1. Apples 2. Oranges 3. Pineapple 4. Tangerine 5. Banana D. Cereals 1. Quinoa (Chenopodium quinoa) 2. Cahihua (Chenopodium palUdicaule) 3. Barley 4. Wheat 5. Corn 6. Rice 7. Oats E. Animal Products 1. Meat 2. Cebo (Lard) 3. Cheese 4. Milk 5- Egg 6. Fish 7. Blood F. Other 1. Salt 2. Sugar 3. Flour 4. Bread 5. Oil 6. Coffee 7. Tea 8. Pasta 9. Jam

X X X X X X X

X X X X X X

X X X X X X X

X X

X X X

X X X X X X X

X X X X X X X

X X X X X X X X X

X X

X X

DIET ANDES 10. 11. 12. 13. 14. 15. 16. 17. 18.

Evaporated Milk Powdered Milk Candy Cookies Mazzamora Morada (Fruit desert) Vinegar Soda Pop Cholocate/Cocoa Corn Meal

Total

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249 X X X X X X X X X 18

24

51

'Mazess and Baker (1964) Gursky(1969) 'Present Study 2

A minimum of one complete day of data was obtained for each family. For 29 of the households, at least one day in each of the pre- and post-harvest seasons was collected. The pre-harvest sample includes all data collected from January through May (the time of the potato harvest). The post-harvest sample encompasses the months of June through August. Caloric and nutrient values for each food item were derived from standard nutritional tables for Andean foods (Collazos et al. 1962, 1975; Woot-Tsuen and Flores, 1961; Minesterio de Pervision Social y Salud Publica, 1979). DISCUSSION DIETARY CHANGE National political and economic change since the 1960s has resulted in increased importance of the market economy and greater reliance on wage labor in the Peruvian highlands. These changes have been translated into greater availability of and reliance on non-traditional foods in communities throughout Peru (Ferroni, 1980, 1982; Marquis and Kolasa, 1986; May and McClellan, 1974). For Nufioa, dietary change is evaluated by comparing data from the present survey to those of previous surveys of this community (Mazess and Baker, 1964; Gursky, 1969). The methodology in the Mazess and Baker study differs from Gursky's and the present study's in that household-level food weighing and dietary recall techniques were used. Consequently, the Mazess and Baker data are used only for comparisons of food usage, not of individual energy intake. All comparisons are limited to the postharvest period (June to August) since both the Gursky and Mazess and Baker studies were confined to that portion of the year. Diet composition In 1985, a total of 51 different foods were observed (excluding herbs and spices, and combing all animal parts into a single meat group; see Table II). This is more than double the number reported by Gursky (1969) for his 1967 study and roughly three times that reported by Mazess and Baker (1964). The items added to the Nufioan diet in 1985 include processed foods such as canned evaporated milk, oatmeal, pasta and chocolate as well as a wide variety of fruits and vegetables from the lowlands (eg. tangerines, bananas, sweet potatoes, summer squash). The

250

WILLIAM R. LEONARD AND R. BROOKE THOMAS TABLE HI Average daily energy contribution of 14 important food items in Nufioa, Peru: 1962, 1967, 1985 19621

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Food Item 1. Chuno (Freeze-dried potatoes) 2. Potatoes 3. Barley 4. Quinoa (C. quinoa) 5. Canihua(C. pallidicaule) 6. Meat 7. Corn 8. Wheat 9. Sugar 10. Cornmeal 11. Flour 12. Bread 13. Rice 14. Oatmeal

%

Rank

Cals

%

1569

49.5 24.7

134 11 143

8.4 1.0 8.9

238

14.9

3.9 2.5 1.7

1 2 3 4 5 6 7 8

41 94 42 82

5.9

0.5 0.0 0.0 0.0 0.0 0.0

12 12 12 12 12

782 181 162 155 124 79 54 16 0 0 0 0 0

5.7 5.1 4.9

19853

19672

Cals

9

177 352 193 82 14 0

Rank

Cals

%

Rank

6

345 295 28 22 8 58 10 6 118 0 88 134 124 56

22.2 19.0

1 2 9 10 12 7 11 13 5 14 6

13 5 2 11 7

2.6 2.6 5.0

11.1 22.1 12.1 5.0 1.0 0.0

10 8.5 4 1 3 8.5 12 14

1.8 1.4 0.5 3.7 0.6 0.4 7.6 0.0 5.6 8.6 8.0 3.6

3 4 8

'Mazess and Baker (1964) (1969) Present study

2 Gursky 3

expanded range of food items observed in 1985 no doubt reflects the increased importance of Nufioa's Sunday Market. While it is clear that total food variety is substantially greater in the present study, a simple item count does not assess the importance of these new foods (for example, how frequently or rarely they are consumed). Shown in Table III are those foods that contributed at least an average of 240kJ (50 calories)/individual/day in 1962, 1967 or 1985. For each of the 14 foods, the average daily energy contribution, percent caloric contribution and rank in the diet for each survey are listed. In 1962, over 75% of the daily energy intake was derived from three food items: chuno (stored dehydrated potato, potatoes and barley. For the 1967 and 1985 TABLE IV Change in consumption of local cereals in Peruvian households from the District of Nufioa: 1962, 1967 and 1984 Cereal Chenopods {Chenopodium spp.) Wheat ( Triticum spp.) Barley (Hordeae spp.)

Percent of Households Consuming 1962'(n=39) 19672 (N=22) 19843 (n=102) 90 74 80

68 23

55

'Mazess and Baker (1964), estimated for June and July Gursky (1969), estimates for June and July Derived from health/nutrition survey conducted in June/July of 1984 X2 chenopods = 26.3; 2 df; P < 0.001 X2 wheat = 68.4; 2 df; P < 0.001 X2 barley = 68.2; 2 df; P < 0.001 2

3

44 7 12

DIET ANDES

251

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Sources of Calories: Nunoa 1962-1985

Legend M %& ZH IS] C2

1962

1967

Local Caraalt Tubers Maat/Cabo Procattad Grain* Other

1985

FIGURE 1. Changes in energy sources in Nufioa, Peru between 1962 and 1985. Note the marked decline in the consumption of local cereal grains which include quinoa, canihua, barley and wheat. Conversely, an increase is seen in the consumption of processed grains. The small contribution of tubers to total energy intake in 1967 is due to the poor potato harvest.

surveys, the same proportion of calories were accounted for by six and seven foods respectively. Hence, in terms of caloric contribution, dietary variety has increased markedly relative to 1962 but has changed little since 1967. Figure 1 and Table III indicate that the items showing the greatest decline in caloric contribution since the 1960s are the locally-grown cereals: quinoa, canihua, barley and wheat. These items, on average, contributed over 500 calories per person per day in 1962 and 1967, as compared to only 58 calories in 1985. Declines in the cereals are paralleled by marked increases in the importance of such store-bought items as bread, rice, sugar and oatmeal. Three factors confound comparisons of the diet between the three surveys: First, the very poor potato harvest in 1967, second, the below average cereal harvest of 1985 and third, cornmeal consumed in 1967 was part of a supply of United States government surplus that had been sent to Peru. Thus, the apparent decline in potato and chuno consumption and the sharp increase in corn meal consumption are artifacts. Clearly, native tubers remain the staple of the Nuiioan diet (chuno and potatoes are ranked first and second in 1962 and 1985). Additionally, the apparent decline in the consumption of native cereals in 1985 may, in part, be a reflection of the substandard harvest for that year. Consequently, if cereals have decreased in importance since the 1960s, a decline must be demonstrated during a year with an adequate harvest. Table IV compares consumption

252

WILLIAM R. LEONARD AND R. BROOKE THOMAS

TABLE V Rank order correlations (rs) between the energy importance of 14 principal food items consumed by households from Nunpa, Peru (1962 vs. 1967 vs. 1985)

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1962 1967 1985

1962 1967 1985

1962

All Foods: 1967

1985

1.000 0.002 0.146

1.000 -0.227

1.000

1962

Excluding Cornmeal: 1967

1985

1.000 0.163 0.025

1.000 -0.033

1.000

data collected by recall during June/July of 1984f to similar data from Gursky (1969) and Mazess and Baker (1964). These seasonally-comparable data clearly indicate a decline in the importance of locally-grown cereals between 1962 and 1984. In 1962, 90% (35 of 39) of the households surveyed by Mazess and Baker consumed Chenopods (quinoa and/or canihua) in June and July, as compared with 68% in 1967 and only 44% in 1984. Declines in the percentage of households consuming barley and wheat are even more dramatic, from 70-80% in 1962 to 12% and 7% respectively in 1984. Chi-square analysis shows these differences to be significant in all three cases (x2 = 26.3 for Chenopods, 68.4 for wheat and 68.2 for barley; P < 0.001). A final consideration is how the relative importance of each of the 14 foods noted in Table III has change between 1962 and 1985. Using the rankings listed in Table III, Spearman's Rank Correlation technique (Dixon and Massey, 1969; Snedecor and Cochrane, 1967; Fox and Guire, 1976) is used to test hypotheses about the change in relative importance of food items. The specific hypothesis to be tested is whether or not the ranks of each of the 14 foods have changed significantly over time. If the caloric importance of the foods has remained unchanged over 20 years, high correlations are expected between the rankings of each survey. Table V shows that the pairwise correlations for all foods between the rankings in each of the survey (1962 vs. 1967; 1962 vs. 1985; 1967 vs. 1985) are low and non-significant. This is the case even when corn meal is removed from the analysis. Therefore, with the exception of potatoes and chuno, the important foods in Nufioa have substantially changed since the 1960s. Energy Intake To evaluate change in energy intake in Nuftoa, estimates from the present study are compared to those of Gursky (1969) and Thomas (1973). As shown in Table VI, comparisons of the present data to Gursky's by means of Student's t-tests fail to †

Heads of households were questioned as to the frequency of consumption of specific local and nonlocal products in three seasonal surveys (November/December 1983; June/July 1984; August/ September 1984). For comparative purposes, only data from the June/July survey were used.

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TABLE VI Comparison of estimates of daily energy intake for three samples of households from Nufioa, Peru: 1967, 1968 and 1985 19672 KJ Cals (SD)

n

798 (242) 1314 (252) 1247 (317) 1534(438)

28 19 18 14

3763 5270 6052 6437

899(489) 1259(377) 1446(282) 1538 (462)

0.49 0.32 1.12 0.02

O

7546 8057 8970

1803(-) 1925(979) 2143(681)

9 3 23

7333 6617 8844

1752(425) 1581(237) 2113(618)

0.63 0.10

> 2!

2

6395

7

6873

1528(460) - (-) 1642 (338)

1 2 29

11025 7957 7915

2634 (-) 1901(553) 1891(772)

0.88

36

6215

1485(563)

146

6508

1555(665)

0.56

Age Group

Sex

n

1968' KJ

Cals

n

1-3 4-6 7-9 10-12

M/F M/F M/F M/F

5 6 4 3

3750 3956 6563 7772

896 945 1568 1857

6 6 3 4

13-15 16-19 20 & above

M M M

3 2 6

7161 9434 9124

1711 2254 2180

1 2 5

13-15 16-19 20 & above

F F F

2 6

6416 7224

1533 1726

37

6575

1571

Total

M/F

'Data from Thomas (1973) Recalculated from Gursky (1969) (sample from town of Nunoa) 'Data from the present study ••Student's t-test for comparison of 1967 vs. 1985 intakes

3340 5500 5219 6421

19853 KJ Cals (SD)

t4

m on

254

WILLIAM R. LEONARD AND R. BROOKE THOMAS

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demonstrate significant differences at any age group. Moreover, estimates of per capita intake from the two surveys differ by only 70 calories*, and both estimates are very similar to the 1571 calorie estimate of Thomas (1973) from his 1968 Nufloa study. In summary, while a much wider variety of foods are now potentially available within Nufioa, the majority of these items are consumed only infrequently. Those foods that have been added to the diet (pasta and oatmeal) appear to be replacing traditional staples (cereals) in many households. Consequently, in spite of the increase in the number of items available in this community, the energy intake has remained constant since the late 1960s. SEASONALLY While many of the earlier studies of highland nutrition have indicated that the traditional Andean diet is seasonally variable (Pic6n-Re£tegui, 1976, 1978), all previous attempts to quantify seasonality have had problems. Only the surveys of Collazos and colleagues (1954, 1960) and Thomas (1973) have had sufficient time depth to directly address questions of seasonality. Collazos' studies, however, provided only household and per capita level analyses of seasonality, whereas Thomas' had a restricted sample size (n = 37) and did not monitor the families during the last part of the pre-harvest period (January-March) in which nutritional intake may be most limited. Additionally, no recent studies have examined whether the availability of market foods in the highlands has reduced seasonal fluctuations in energy consumption. Ferroni's (1980) study, because it drew on data from different ecological regions, provided no consistent picture of dietary seasonality in the Peruvian sierra. Data from this survey permit evaluation of seasonality in food consumption since they were collected on the same sample of households over a period that should encompass the maximal fluctuations in food availability (namely the end of the preharvest period through the immediate post-harvest period). Seasonality is evaluated in terms of diet composition and energy consumption. Diet Composition Figure 2 depicts seasonal changes in the contribution of several important food items to the energy intake in Nunoa. The most dramatic shift is seen in the importance of fresh tubers* which contribute about 13% of the total energy in the preharvest sample versus 40.1% during the post-harvest. Conversely, stored, dehydrated potatoes (eg. chuno and morayd) are a more important food source † Comparability in per capita intakes is obviously dependent upon similar age/sex distributions of samples. As can be seen in Table VI, the composition of the samples is very similar (52.8% aged 12 and under in 1967 vs. 54.1% in 1985; 13.9% adult males in 1967 vs. 15.7% in 1985; 19.4% adult females in 1967 vs. 19.9% in 1985).

‡ For this (pre- vs. post-harvest) comparison, the tuber category includes fresh chuño (k' achu' chuño), incompletely dehydrated potatoes that have only gone through one freezing. The chuño category includes only the completely dehydrated variety, chuño negro, that may be stored. These categories differ from those used in comparing the present data to Gursky's and Mazess and Baker's since both of the previous studies categorized k' achu' chuño as chuño.

DIET ANDES

255

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Sources of Calories: Pre- vs. Post-Harvest

Legend § • FrMh Tubtrt E3 Chunn/Monv ZZ1 Animal Product! tS Flour E l Rlc«/Oitt/Piiti C2 Othtr

Pre-Harvost

Post-Harvest

FIGURE 2 Differences in diet composition between the pre- and post-harvest in a sample of households from Nunoa, Peru. Note that during the pre-harvest period, store-bought grain products (flour, rice, oatmeal and pasta) contribute almost a third of all calories (31.2%), while processed tubers (chuno and moraya) contribute 11.0% and fresh tubers 13.0%. After harvest, fresh tubers contribute over forty percent of the calories, while store-bought grain products contribute only 18.7% and processed tubers only 3.7%. Consumption of animal products also increases after harvest (8.1% in the pre-harvest vs. 14.0% post-harvest).

during the pre-harvest season (11% of calories in the pre-harvest vs. 3.7% postharvest). Consumption of animal products (muscle tissue, organ meat, blood, milk), like fresh tuber consumption, increases during the post-harvest period (14% postharvest vs. 8.1% pre-harvest). Flour and other store-bought carbohydrates are preferentially consumed during the pre-harvest period. The pattern that emerges from Figure 2 is that during the pre-harvest period, when fresh tubers and other local foods are not readily available, stored potatoes and store-bought, high-carbohydrate foods (especially flour which is least expensive) greatly contribute to the energy intake. After the harvest, however, fresh tubers provide a substantial energy base. As a result, much of the money that was spent on inexpensive carbohydrates in the months before the harvest is now reallocated to purchase animal products. Clearly, when availability of local foods is constrained during the months immediately preceding the harvest, procurement of energy sources is the overriding consideration, and inexpensive foods such as flour are preferentially consumed. Energy intake Figure 3 shows seasonal differences in mean daily caloric intake for individuals that were monitored during both the pre- and post-harvest periods (n=96). For each

WILLIAM R. LEONARD AND R. BROOKE THOMAS

256

Seasonal Differences in Calorie Intake Legend

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2600 n

• Pr«-H«rv««t • i Pott-Htrvtst

1-3

4-8

7-9

10-12

13-19

20+M 20+ F

FIGURE 3. Seasonal differences in mean daily energy intake for a sample of households from Nufioa, Peru. Note that the magnitude of the seasonal differences is greater in adolescents and adults than in children.

age/sex cohort, the post-harvest value is greater than the pre-harvest; however, the differences are much more pronounced in the adolescents and adults. Seasonal differences of almost 500 calories (29%, P < 0.05) are seen in adult males and females. For children, the seasonal differences average approximately 250 calories/ day (15-20%) and are not statistically significant in any of the four age groups. Per capita caloric intakes for the pre- and post-harvest seasons differ by 330 calories (1186 vs. 1516; P < 0.05). TABLE VII Comparison of the energy contribution of six food groups in the pre- and post-harvest seasons for the lower and upper SES households in Nunoa, Peru. Food Tubers Chuno/Moraya Rice/Pasta/Oats Flour Bread Oil/Ev. Milk Total

Pre-Harvest Lower SES Upper SES 11.7 12.9 15.3 15.6 8.2 1.1 64.8

19.7 2.0 24.6 4.3 15.4 6.8 72.8

Post-Harvest Lower SES Upper SES 44.6 5.5 7.5 8.9 5.5 0.7 72.7

30.7 0.0 23.0 0.0 13.5 4.2 71.6

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257

Thus, the energy intake is subject to seasonal change according to the availability of locally-produced foods. In addition, it appears that children are protected from large seasonal fluctuations in energy intake whereas adults experience the largest reduction in sources of energy during the pre-harvest period. Given the importance of child labor in the Andes (Stinson, 1978; Thomas, 1973; Tucker, 1987), such a buffering mechanism would allow for the maintenance of levels of energy expenditure in children across seasonal boundaries. Household-level analysis of these data indicate that children are preferentially allocated food during the pre-harvest period (Leonard, 1987), a finding comparable to that of Galvin and colleagues (Galvin, 1985; Galvin and Little, 1987; Little and Johnson, 1987) for the Turkana pastoralists. SOCIOECONOMIC FACTORS Intrapopulational differences in diet and nutritition are to be expected since the external constraints on resource acquisition do not affect all members of a group equally. In Nunoa, it appears that many of the non-local foods are prohibitively expensive for most of the population (Leatherman et al. 1986). Socioeconomic (SES) factors should therefore be an important source of variation in food use and nutritional intake within this community. Diet Composition Table VII shows the season-specific socioeconomic differences in the percent caloric contribution of six food groups. Quite clearly, chuno negro, the stored, dehydrated potato, is a food that is more commonly eaten among the poorer families, especially during the pre-harvest period (12.9% vs. 2.0%). Another food that is particularly important among lower-income households is flour. Since its price is controlled by the government (Painter, 1983), flour represents the cheapest non-local source of calories available to the Nurioans. As with chuno, flour contributes a much larger share of calories in the pre-harvest period (15.6% vs. 8.9% for the poor). For the wealthier households, a much wider range of market goods is available on a regular basis. The more expensive grain products (rice, pasta and oatmeal) contribute almost a quarter of all energy consumed by the upper SES families (24.6% pre-harvest, 23% post-harvest). Likewise, food items with high fat content such as oil and evaporated milk, although not contributing a large portion of energy, are much more frequently consumed among the wealthier households. For both the upper and lower SES groups, the previously-mentioned pattern of consuming more store-bought products during the pre-harvest period is evident. However, for the poor, a relatively restricted set of non-local foods are used since many are prohibitively expensive. Following the harvest, the consumption of animal products increases. The poor purchase the less expensive items such as alpaca intestines and blood whereas the wealthier families are able to buy the more preferred sheep, llama (Lamaperuana) and alpaca parts (Lamapacos). Nutrient Intake Given that the poorer household must rely on fewer non-local foods to supplement their diets during the most stressful period of the year, socioeconomic differences in

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TABLE VIII Socioeconomic differences in per capita energy intake for a sample of households from Nunoa, Peru: Mid-season, pre-harvest and post-harvest Sample

n

Lower SES Upper SES

72 24

Mid-Season KJ Cals 5316* 1270* 6588 1574

n 93 26

Pre-Harvest KJ Cals 4946* 1110* 5922 1415

Post-Harvest n KJ Cals 99 47

6358 6793

1519 1632

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*Difference between lower and upper SES values is significant at P < 0.05.

TABLE IX Seasonal differences in daily energy intake for a sample of Nufioa adults, by socioeconomic group Socioeconomic Group Lower SES Upper SES

n

Pre-Harvest Intake

Post-Harvest Intake

27 7

1388 1807

1968 1976

Average Individual Average Individual Seasonal Difference Percent Difference (%) 588 131

29 3

caloric intake are to be expected. Table VIII presents estimates of per capita energy intake in the lower and upper SES for both seasons and a mid-season average for those individuals who were included in both the pre- and post-harvest samples. In calculating per capita intakes, age was adjusted for by means of analysis of covariance since the upper SES sample was significantly younger. Note that for both the pre-harvest and the mean samples, the upper SES households consume significantly more energy. Conversely, the energy intake is comparable for the two groups during the postharvest period. Also striking is the disparity in the seasonal differences of adult energy consumption in the lower and upper SES groups. Adults of upper SES had pre- and post-harvest energy intakes that differ by less than 200 calories whereas those of lower SES adults differ by almost 600 calories (see Table IX). For children, the mean energy intake is higher in the wealthier household, but the magnitude of the seasonal differences are comparable for the two groups. Finally, socioeconomic and seasonal influence on macronutrient intake are considered. Figure 4 depicts the magnitude of seasonal and socioeconomic differences in energy, protein, carbohydrate and fat consumption using age- and sexspecific Z-scores. Utilizing data from all consumption days observed during 1985 (n = 361), nutrient intakes for each were expressed as Z-scoresf (standard scores) relative to their age- and sex- specific cohort. Thus, each bar in Figure 4 represents the mean Z-score for the data in that SES and seasonal category. † For each of the four nutrients, cohort-specific means and standard deviations were calculated. Individual intakes were then assigned z-scores by standardization against cohort-specific values:

^ SD where: i = individual intake X = cohort-specific mean SD = cohort-specific standard deviation

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Lower SES

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Wean Z-Score 0.8-

Energy (Cals)

Protein

Fat

Carbohydrates

Upper SES Mean Z-score 0.80.60.4 0.20-0.2-0.4 Energy (Cals)

Protein

ElPre-Harvest

Fat

Carbohydrates

I Post-Harvest

FIGURE 4. Average z-scores for energy, protein, fat and carbohydrate intakes for a sample of households from Nunoa, Peru separated by season and socioeconomic status. During the pre-harvest period, poorer individuals have significantly lower intakes of all four nutrients. After harvest, caloric and protein intakes are comparable for the lower and upper SES. Carbohydrate intake is greater in the poorer families after the harvest whereas fat intake continues to remain well below that of the wealthier families. Overall, marked seasonal differences in all four nutrients are apparent in the poorer households while such seasonal shifts are only evident for protein intake in the wealthier families.

From Figure 4 it is evident that the seasonal differences among the poorer families are large and statistically significant for all four nutrients (P < 0.01). Differences of over half a standard deviation are seen in caloric and carbohydrate intakes. In contrast, minimal seasonal fluctuation is evident for the upper SES group. Only protein consumption shows a notable post-harvest increase within this group. This increase is associated with the consumption of greater amounts of animal products in the post-harvest period. During the pre-harvest season, the poorer group consumes less of all four nutrients, and these differences are statistically significant for three (P < 0.05; energy, fat and carbohydrates). However, in the post-harvest period, energy and

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protein intakes do not significantly differ between the two groups. Fat intake, on the other hand, remains significantly greater in the upper SES group while carbohydrate intake is significantly greater in the lower SES group. The pattern is one in which the poorer families match the energy intake of the wealthier families in the post-harvest season by consuming large amounts of tubers. Hence, their energy is derived primarily from carbohydrate sources while their fat intakes remain low because they still do not have access to high-fat store-bought foods such as canned milk and vegetable oil. Therefore, regardless of season, the wealthier households derive a significantly greater proportion of their calories from fat. SUMMARY This study has demonstrated that energy consumption in this community has remained the same since the 1960s despite the increase in the variety of foods available. For most families, non-local foods are replacing rather than augmenting traditional items. Such a shift is potentially problematic since the newly-introduced foods are, in many cases, less nutrient dense than the ones that they replaced. More detailed analysis of these data have indicated that the apparent decline in consumption of local cereals is associated with decreases in both protein and B-vitamin content of the diet (Leonard, 1987). The type of dietary change seen in Nunoa has been widely observed in other developing nations (cf. Gross and Underwood, 1971; DeWalt, 1983; Dewey, 1981). In Nuiioa, as in much of the Peruvian highlands, inequitable redistribution of land following the agrarian reform has fueled a shift away from subsistence farming and herding to market and wage-labor activities. Locally produced products that are sold in the town (such as meat, cheese, eggs) are generally too expensive for most of the population (Leatherman et al. 1986). As a result, many families now find it increasingly difficult to meet their basic needs. The families that are best off are those with sufficient income to purchase a wide variety of local and non-local products to supplement their home-produced foods. Those households with little supplemental income rely heavily on items such as flour and sugar that are inexpensive yet low in nutritional value. These socioeconomic differences are most apparent in the pre-harvest period when stores of home-produced foods are lowest. Caloric consumption is significantly lower among the poorer households. In fact, most of these families consume only two meals per day during this period of the year. Following the harvest, the energy intake is comparable in the two groups*. However, fat consumption remains significantly higher in the wealthier families, an indication that these households continue to consume items that are largely unavailable to the poorer households. These results are consistent with the health and anthropometric data that have also been collected on this community. For the families of the food weighing survey, children of the upper SES are significantly taller and heavier than their lower SES counterparts (Leonard, 1987). Likewise, upper SES children are taller



It is unfortunate that change in energy intake could be evaluated only within the post-harvest, when SES differences are less apparent. If dietary change is evaluated using only lower SES individuals from the 1985 sample, the results presented in the firt part of the paper are unchanged (for example per capita caloric intake for 1985 is 1519 rather than 1555).

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and heavier than children of comparable age who had been measured in Nunoa some twenty years before by Frisancho (1969). The lower SES children, on the other hand, do not differ from their age peers of twenty years ago for either height or weight. This apparent absence of a secular trend in growth for most of the population has been borne out on a larger anthropometric survey conducted during 1983 and 1984 (Carey and Thomas, 1987; Leatherman, Aelian and Carey, 1985). For health status, the data are much the same. Despite improved health care facilities in Nunoa, rates of mortality have changed little (Carey, Laliberte and Thomas, 1985; Carey and Thomas, 1987). As with nutritional status, differences in morbidity appear to be largely associated with household social and economic factors (Carey and Thomas, 1987). This study has demonstrated that the massive social changes since the 1960s have not perceptively improved dietary adequacy and nutritional status in this community. Seasonal food shortages remain severe in many lower-income households as evidenced by the sharp reduction in adult energy consumption during the pre-harvest period. Marginal nutrition and ill health remain critical problems for much of the Nunoan population. Unfortunately, the pattern seen in Nunoa is one that is not uncommon in the Third World — increased monitization of a rural economy producing benefits for a small sector of the population while leaving the majority of the population the same or worse than before (Hernandez et al. 1974; DeWalt, 1983; Fleuret and Fleuret, 1980). However, it is hoped that by demonstrating how environmental and political economic factors directly impinge upon diet and nutritional status, we can isolate critical problems and best suggest potential avenues of intervention. In Nufioa, it appears that improved access to local products through redistribution of land or government price control of a wider variety of market goods would go a long way towards improving the diet of many of the rural poor. ACKNOWLEDGEMENTS This research was supported by NSF Grant BNS-8306-186, NIMH Post-doctoral Fellowship MH15730-09 and Rackham Graduate School. We are extremely grateful to the people of Nunoa who participated in this study. This study benefitted from the assistance of L. Ramos, A. Villasante, C. Morse, C. Tucker, V.J. Vitzthum and J.S. Luerssen. We also thank A.R. Frisancho, S.M. Garn, M.L. Robertson, V.J. Vitzthum and three anonymous reviewers for their comments on previous versions of this paper.

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