Micronutrient nutrition and traditional
food systems of indigenous peoples

H.V. KUHNLEIN

Harriet V. Kuhnlein is Professor of Human Nutrition and Founding Director of
the Centre for Indigenous Peoples' Nutrition and Environment (CINE), based at
McGill University in Montreal, Canada.

Within both developed and developing coun-tries, indigenous peo-ples are often the most marginalized and dis-advantaged groups in terms of receiving the resources needed for well-being, including food and health care, along with other amenities considered important for a good quality of life. Extreme poverty often characterizes these groups, but indigenous peoples themselves may consider resources other than money as important, such as an intact environment, land for harvesting their traditional food and medicines and a peaceful existence. Because government health services in areas inhabited by indigenous peoples are often either of low quality or missing, most governments designate their indigenous peoples as those most in need of public health attention.

Indigenous peoples are well aware of their food-security risks. An international meeting held in Atitlán, Guatemala, described the difficulties and frustrations of indigenous peoples in protecting their food environments and livelihoods (Kuhnlein et al., 2002b). As this is one of the most pressing of the problems identified by indigenous peoples, the recently created United Nations Permanent Forum on Indigenous Issues will ensure that all possible avenues within the United Nations agencies are explored in order to protect the rights of indigenous peoples with respect to their traditional food resources.

The development, health and scientific communities do not usually understand the food resources that indigenous people know and use. Scientific identifications and laboratory data for nutrients and other phyto-chemicals for a food system may be unknown for many species. This means that the usual processes for nutrition assessment must be modified, and that the recognition and promotion of local food for alleviating micronutrient malnutrition will require preliminary studies. Investigations on this issue were recently carried out by FAO collaborators in five case studies of indigenous peoples in rural areas of Asia. It was found that, of 716 species of traditional food reported by the five community areas, 93 still required original scientific identification, and for approximately 147 species there was not even the most basic nutrient data on file (Kuhnlein, 2001).

Arguments that attempt to justify the scientific neglect of these food resources often claim the need to give more priority to food species that are commonly used nationally and that are available through commercial distribution. Certainly, work on commercial food needs to be carried out; however, it is equally important to pay attention to the traditional food resources of indigenous peoples. Arguments in favour of scientific work on traditional food systems species are that the traditional knowledge of indigenous peoples about the diversity of world food resources must be preserved, and that this knowledge should be combined with basic scientific data. If, in fact, indigenous peoples risk micro-nutrient problems, local traditional food resources should be investigated for items with which to build food-based strategies to alleviate these peoples' malnutrition. Protection of rural environments where indigenous peoples live and harvest their unique food species is a logical prerequisite for health-promotion activities.

As residents in rural developing areas, indigenous peoples may be subject to the consequences of the "lifestyle and nutrition transition" resulting in increasing obesity and chronic disease (Popkin, 2001). A shift away from natural traditional food resources generally means a decrease in the consumption of fish, domestic animals, locally grown agricultural crops and uncultivated (wild) vegetable and plant foods with a simultaneous increased consumption of industrially processed food. Poor micronutrient intake is a likely consequence, in addition to obesity and other conditions associated with increasing dietary energy, carbohydrate and fat. Understanding the micronutrient contents of species in traditional food systems would be an essential and positive step towards the goal of building health-promotion activities that could incorporate these foods.

Background work needed

When it has been recognized that indigenous peoples require health-promotion activities to improve their micronutrient status, there are several steps that need to be carried out in the assessment process before programme activities can be implemented. Background work requires first determining what the local traditional food system resources and their micronutrient contents are, and any other micronutrients. Carotenoids and preformed vitamin A, iron, zinc, vitamin B₁₂, ascorbate, folate, and iodine are key micronutrients, but physiological response to them depends on adequate amounts of total energy, protein and fat in the diet (Institute of Medicine, 1998, 2001).

Focus groups and individual interviews with community members can be conducted to furnish the spectrum of local species used as food. Market surveys and focus groups can then be used to provide understanding of the kinds of food that can be purchased. Once the list of local food items used by a group of indigenous peoples is known, local or regional scientists can then search for identifications and any existing nutrient data. When no data exist, samples of the food can be collected when in season and submitted for analysis.

Additional qualitative data are also required to understand the potential of each food resource for the community. A certain number of questions should be asked: what is the agricultural potential, and what land is available for cultivation? How is the food harvested, stored and prepared? What is the general acceptability pattern within the community? Is this a reasonable food for the population groups especially vulnerable to dietary deficits in micro-nutrients, such as pregnant and lactating women and young children? If not, how might it possibly be adapted for consumption by these vulnerable groups?

Methods for gathering this information in communities of developing countries are available (Kuhnlein and Pelto, 1997; Blum et al., 1997). However, procedures that remain sensitive to the local issues of indigenous peoples must also be employed. In addition to extensive scientific attention to wild and uncultivated food, these methods include the need for local collaboration, respect for and inclusion of the local culture and circumstances, the possible need to work in a local language and the requirement for local capacity-building to assist the project. These very practical requirements may exceed the resources regularly allocated by public health agencies for the population within a given country.

Several health-promotion pro-grammes for micronutrients that use indigenous peoples' traditional foods have already been documented. In Viet Nam, the gac fruit [Spiny gourd] (Momordica cochinchinensis Spreng.) was used in a controlled food-supplementation trial among preschool children and was shown to significantly increase plasma beta-carotene. In addition, gac improved haemoglobin concentrations of individuals with low or borderline haemoglobin levels (Vuong et al., 2002). Several micronutrient-rich local fruits and vegetables in northern Viet Nam have been identified for health-promotion potential, and gac contains the highest levels of beta-carotene, at approximately 45 mg or 45 000 µg/100g fruit (Vuong, 2000).

In Micronesia, the Karat banana (Musa troglodytarum) is another local food with excellent potential to provide protection against micronutrient deficiencies. Containing 160 RE (retinol equivalent)/100 g of fruit, this banana has been used extensively in the Family Food Production and Nutrition programme sponsored by UNICEF (Engelberger, 1999).

In western British Columbia, the Nuxalk food and nutrition programme was conducted in an isolated rural area of the coast among the Nuxalk Nation. The programme demonstrated how tra-ditional food can improve micronutrient health status. After a health-promotion programme emphasized that good-quality local foods (both wild and purchased) should be included in the diet, the levels of retinol, carotene, ferritin and folate improved in adults and teens (Kuhnlein and Burgess, 1997).

The traditional knowledge of indigenous peoples about the diversity of world food resources must be preserved, and this knowledge should be combined with basic scientific data

In studying the local natural food resources of indigenous peoples, it is also important to investigate the levels of potential environmental contaminants. Generally speaking, fish and sea mammal species are known to contain both organochlorine and heavy metal contaminants at much higher levels than land mammals or plant food resources. Attention should be given to both local and non-local sources of environmental pollution (Kuhnlein and Chan, 2000). Anxieties about potential contaminants and destruction of land and water resources are key issues and challenges for indigenous peoples' food-security and health status. It is hoped that the greater attention given to the traditional knowledge of indigenous peoples in the domain of food-system biodiversity will drive policy-makers to recognize the pressing need to protect these peoples' environments.

Some of the practical implications of using traditional food resources for health-promotion activities must be considered. For example, all food-based strategies for improving nutritional status simply take longer, because they treat the root of the problem of insufficient nutrient-rich food and involve attitude and food behaviour change instead of trying to "patch up" a problem for the short term. However, "taking longer" also means that there are greater possibilities for long-term sustainability of food resources in the community. This is especially true when traditional knowledge and the sociocultural values inherent in the group are revived and the community embraces the targeted behaviour change. In the case of rural-dwelling indigenous peoples, this is a welcome strategy, and it is also the most practical solution where coverage of pharmaceutical nutrient supplements or availability of fortified market food may be limited.

Using traditional food resources for indigenous peoples in health promotion is most reasonably applied in rural areas where such food is most likely to be recognized by the group and readily available. Transporting unique food resources from rural areas to indigenous peoples in urban settings is case specific. Some groups are quite proactive in seeing that their city-dwelling relatives gain access to these foods, as has been documented for developing a market for quelites (boiled green herb) in Mexico City. In the case of traditional varieties of agricultural species, it is possible that urban agriculture and home gardens can be promoted to assist indigenous urban migrants. Transporting favoured cultural food items from rural to urban areas may not always be possible, depending on the extent of food availability, distance, fragility of the food items, and whether or not a market for the food has been developed - indeed, if such development is even wanted by the rural community. It is well known that indigenous peoples often live according to value systems that may conflict with a more dominant global value system based on economic returns. An investigation of the factors affecting indigenous urban migrant access to traditional foods would be well worth pursuing.

Micronutrients in traditional cultural foods

In addition to the examples noted above, it has been demonstrated that many unique foods used by indigenous peoples are good sources of micronutrients. The Journal of Food Composition and Analysis regularly reports findings on the nutrient composition of non-cultivated, non-commercial foods from different areas of the world (Burlingame, 2002).

Four green plants used by indigenous peoples are ivy gourd (Coccinia grandis Voigt.), roselle, sweet potato leaves and wild betel leaves (Piper sarmentosum Roxb.). Ivy gourd and wild betel leaves, used by the Karen People in Thailand, are among the best local sources of beta-carotene (3 095 µg/100g and 4 036 µg/100g). As shown in Table 1, they also contain a large amount of vitamin C (13-17 mg/100 g; Puwastien et al., 1999). The table also shows two additional varieties of green leaves that are significant for improving beta-carotene content, used by the Aetas of the Philippines and the Hausas of Niger (Kuhnlein, 2000).

Narwhal mattak is a favourite food of the Greenland and Arctic Canadian Inuit. This food, consisting of both skin and fat (blubber), is a rich source of retinol, vitamin C, vitamin E as alpha-tocopherol and omega-3 fatty acids. Narwhal meat is also an excellent source of iron (Kuhnlein and Soueida, 1992; Fediuk et al., 2002; Kuhnlein et al., 2002a). Another rich nutrient source that is a legacy of Canada's indigenous peoples in British Columbia is the fat from the small fish called ooligan (Thaleichthys pacificus), prepared by several groups of First Nations. Ooligan grease contains 2 500 ± 1 200 µg of retinol/100 g, 14 mg of alpha-tocopherol, and 19 ± 5.2 g of omega-3 fats/100 g - a truly remarkable source of these micronutrients (Kuhnlein et a., 1996).

TABLE 1: Examples of micronutrient-rich sources
in the traditional cultural foods of indigenous peoples

Conclusions

The traditional food systems of indigenous peoples contain a wealth of micronutrients that have been poorly described and reported in scientific literature. This lack of scientific coverage prevents the information from being included in health training programmes and public-health promotion pro-grammes. While indigenous peoples are often the most marginalized and disadvantaged subgroups of a population, their traditional knowledge and diverse food resources may be substantial enough to be used to improve their own micronutrient status.

People working in the health sector who wish to incorporate traditional knowledge about locally available food should first enlist the collaboration of indigenous communities. Local and regional nutrient data centres will define existing data that can be used in health-promotion strategies, and provide the addresses of the nearest laboratories that can assist with nutrient analyses of any other important and frequently consumed food items.

Agricultural and public-health sector agents who are working with indigenous peoples need to be aware of the potential of the local food resources to provide micronutrients and other basic nutrients required for good health. As indigenous peoples leave their rural homelands for employment opportunities or engage in other types of economic activities, awareness must be raised so that their traditional food knowledge can be preserved for future generations.

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