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Nutrition and Consumer Protection Division,

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Harriet V. Kuhnlein

Centre for Indigenous Peoples’ Nutrition and Environment (CINE)

McGill University

21,111 Lakeshore Rd.,

Ste. Anne de Bellevue, Quebec, Canada

Fax (1) 514 398 1020

E-mail: harriet.kuhnlein@mcgill.ca

Website: www.mcgill.ca/cine

Table of contents

Preface

Acknowledgements

Foreword

Introduction

Why are Indigenous Peoples’ food systems important and why do they need documentation?

Harriet V. Kuhnlein

Chapter 1

Back to the future: using traditional food and knowledge to promote a healthy future among Inuit

Grace M. Egeland, Guylaine Charbonneau-Roberts, Johnny Kuluguqtuq, Jonah Kilabuk, Looee Okalik, Rula Soueida and Harriet V. Kuhnlein

Chapter 2

The Nuxalk food and nutrition program, Coastal British Columbia, Canada: 1981–2006

Nancy J. Turner, Thelma Harvey, Sandy Burgess and Harriet V. Kuhnlein

Chapter 3

Gwich’in traditional food for health: Phase 1

Harriet V. Kuhnlein, Margaret McDonald, Dina Spigelski, Elizabeth Vittrekwa and Bill Erasmus

Chapter 4

Traditional food system of an Awajun community in Peru

Hilary Creed-Kanashiro, Marion Roche, Irma Tuesta Cerrón and Harriet V. Kuhnlein

Chapter 5

Ingano traditional food and health: Phase 1, 2004–2005

Camilo Correal, Germán Zuluaga, Liliana Madrigal, Sonia Caicedo and Mark Plotkin

Chapter 6

Documentation of the traditional food system of Pohnpei

Lois Englberger, Adelino Lorens, Amy Levendusky, Podis Pedrus, Kiped Albert, Welsihter Hagilmai, Yumiko Paul, Douglas Nelber, Pelihna Moses, Sarah Shaeffer and Marcella Gallen

Chapter 7

Traditional food systems of Indigenous Peoples: the Ainu in the Saru River Region, Japan

Masami Iwasaki-Goodman, Satomi Ishii and Taichi Kaizawa

Chapter 8

Thailand: food system and nutritional status of indigenous children in a Karen community

Sinee Chotiboriboon, Sopa Tamachotipong, Solot Sirisai, Sakorn Dhanamitta, Suttilak Smitasiri, Charana Sappasuwan, Praiwan Tantivatanasathien and Pasamai Eg-kantrong

Chapter 9

Traditional food system of Dalit in Zaheerabad Region, Medak District, Andhra Pradesh, India

Buduru Salomeyesudas and Periyapatna V. Satheesh

Chapter 10

The Bhil food system: links to food security, nutrition and health

Lalita Bhattacharjee, Gopa Kothari, Vidya Priya and Biplap K. Nandi

Chapter 11

The Maasai food system and food and nutrition security

Shadrack Oiye, Joseph Ole Simel, Ruth Oniang’o and Timothy Johns

Chapter 12

The Igbo traditional food system documented in four states in Southern Nigeria

Elizabeth C. Okeke, Henrietta N. Ene-Obong, Anthonia O. Uzuegbunam, Alfred Ozioko, Simon I. Umeh and Nnaemeka Chukwuone

References

Species Index – Indigenous Peoples’ food systems species by scientific name

Photographic section (out of text)

Preface

It was 1944 when the first draft of FAO’s constitution was prepared. Since then, and to this day, that constitution holds that the Organization shall collect, analyse, interpret and disseminate information relating to nutrition, food and agriculture; shall promote and recommend action with respect to scientific, technological, social and economic research relating to nutrition, food and agriculture; shall promote the spread of public knowledge of nutritional and agricultural science and practice; and encourage the conservation of natural resources.

In the letter and spirit of this responsibility, we are privileged to be involved in the preparation and publication of Indigenous Peoples’ food systems: the many dimensions of culture, diversity and environment for nutrition and health.

As its title makes clear, the traditional food systems of Indigenous Peoples touch the full spectrum of life in ways that modern food systems do not. Agriculture’s technological developments in the six decades of FAO’s existence have led to great disconnections between people and their food. Globalization and homogenization have replaced local food cultures; high-yield crops and monoculture agriculture have taken the place of biodiversity; industrial and high-input farming methods have degraded ecosystems and harmed agro-ecological zones; and modern food industries have led to diet-related chronic diseases and other forms of malnutrition. The successes of modern agriculture are many – and these should not be minimized. Food production now meets the food needs of the planet (albeit not always reaching the communities, households and individuals in need). However, there have been some casualties and unintended consequences along the way, and these cannot be ignored.

There will always be methodological difficulties in evaluating whole intact systems; and sensitivities and sensibilities are vital when dealing with diverse peoples and cultures. In this way, the work is groundbreaking in bringing together the community indigenous leaders and international scientists who managed to converge on the topic – even though from completely divergent entry points. The 12 case studies presented in this book show the wealth of knowledge in indigenous communities, in diverse ecosystems, and the richness of their food resources.

In preparing the food composition data for the traditional foods, the gold standards for data quality were not achieved. Some compromises were made in the areas of sample collection, numbers of samples analysed, and the coverage of nutrients – yet important data are presented. It is clear that people have the potential to solve their problems and the promise of this research will lead to solutions with local food resources.

This book, from project formulation to final publication, and all the heroic efforts in between, is the result of the resolve, vision and hard work of Harriet V. Kuhnlein. She praises and credits the vast network of indigenous leaders and their communities, the chapter authors, and collaborators around the world, who indeed, do deserve credit. But the project as a whole was guided through to its conclusion, with the firm yet gentle leadership of Professor Kuhnlein. Her dedication to the rights of Indigenous Peoples and the importance of their traditional food systems is the reason for the success of this project and the many projects she has led, including others with FAO, with the same successful outcome.

Forward planning benefits from looking back, and the Indigenous Peoples’ food systems: the many dimensions of culture, diversity and environment for nutrition and health contributes to the evidence base and body of knowledge for critically evaluating successes and failures in food systems, in valuing and conserving the future – with policy instruments that enable the conservation and sustainable use of food genetic resources.

This book shows that there are two worlds operating in the same space and time. The future wants and deserves both worlds, and they are not mutually exclusive. This project’s goal, and its enduring legacy, will surely be to bring into focus the importance of biodiversity for food and nutrition and traditional food systems for the benefit of all Indigenous Peoples •

Barbara Burlingame Ph.D.

Rome, 2009

Acknowledgements

Each chapter in this book acknowledges those individuals who have contributed specifically to the chapter’s research contributions. In the context of the overall programme, including the six group meetings that we have held, we thank our International Union of Nutritional Sciences (IUNS) committee members, the community leaders of the Indigenous Peoples who have collaborated with the case studies and their academic partners. We also recognize the excellent support that many skilled staff members have provided – both within the Centre for Indigenous Peoples’ Nutrition and Environment (CINE) and in the case study teams. In particular, we thank Timothy Johns, Grace Egeland, Nancy Turner, Thelma Harvey, Bill Tallio, Rose Hans, Irma Tuesta, Marion Roche, Adelino Lorens, Kiped Albert, Nkechi Ene-Obong, Igwe P.E. Eze, M. Ozioko, Liliana Madrigal, Mark Plotkin, Camilo Correal, Natividad Mutumbajoy Janasoy, Eva Yela, Hazel Nerysoo, Elizabeth Vittrekwa, Margaret McDonald, Rhonda Francis, Gopa Kothari, Motiram Chaudhary, P.V. Satheesh, Martina Schmid, Joseph Ole Simel, Shadrack Okoth Oiye, Jonah Kilabuk, Looee Okalik, Masami Iwasaki-Goodman, Koichi Kaizawsa, Miwako Kaizawa, Sakorn Dhanamitta, Suttilak Smitasiri, Solot Sirisai, Sinee Chotiboriboon, Sopa Tamachotipong, Anon Setaphan, Sompop Sungklachalatarn and Benjamas Chumvorratayee.

“A photograph is worth a thousand words”: we would like to especially thank Peter and Lisa Kuhnlein for providing the high-quality photo and video documentation of the case studies. All the case study partners and the CINE team applaud the artists’ skill and sensitivity in depicting the images of the research so beautifully. Full sets of images were returned to case study partners, and DVDs that portray the case studies will assist policy discussions.

For preparation of case-study food lists and food-composition tables in the chapters, we thank Dr Nelofar Sheikh for her knowledgeable assistance, and students John Antony and Sandra Cohen. We are very grateful to Elizabeth Ansell, Donna Leggee and students Kathleen Shaw, Jessica McNeill and Nandita Perumal for editing and reference checking and to Donna-Michele D’Costa for her work on preliminary map preparation. Lauren Goodman, Tanya Nancarrow, Laura Kaufer and Jennifer Jamieson also assisted in preparing the final chapters. We thank Winifred Power (Editor), Chiara Caproni (Designer) and Maddalena di Giorgio (FAO Staff, for species name check).

We are continually appreciative of financial support for segments of the programme from McGill University; the Canadian Institutes of Health Research (Institute of Aboriginal Peoples’ Health, Institute of Population and Public Health, and Institute of Nutrition, Metabolism and Diabetes); the International Union of Nutritional Sciences, the International Development Research Centre (Canada); Indian and Northern Affairs Canada; the United Nations World Health Organization, the Convention of Biological Diversity (UNEP), the United States Agency for International Development, the United States Centers for Disease Control, Sight and Life, the Amazon Conservation Team, and several in-country Non-Governmental Organizations, universities, agencies and research institutes.

A “big thank you!” to The Rockefeller Foundation for grants to bring our case study partners together three times – at the lovely Bellagio Study and Conference Centre, in Bellagio, Italy. Our case study partners’ meetings were made possible because of grants from three Canadian agencies: the Social Sciences and Humanities Research Council, the International Development Research Centre, and the Canadian Institutes of Health Research. We are very grateful for these contributions to our research efforts.

We are especially indebted to Barbara Burlingame, Senior Officer, Nutrition Assessment and Evaluation, of the United Nations Food and Agriculture Organization, Rome, for her encouragement and assistance for this work from 2001 to the present time, and for this publication. Barbara has contributed outstanding leadership and vision as the champion for development of the sciences of food composition and food use throughout the world, and we are honoured that she included our work within her mandate •

Project leaders: Harriet V. Kuhnlein, Ph.D., R.D., F.A.S.N., LL.D. (hon.), Founding Director, CINE, and Professor of Human Nutrition, McGill University; Bill Erasmus, Chair of the CINE Governing Board and Regional Chief, Assembly of First Nations and National Chief, Dene Nation; and Dina Spigelski, R.D., M.Sc., Coordinator.

2009

Foreword

Iam a member of the Yellowknives Dene and live in the community of Ndilo adjacent to Yellowknife, the capital of the Northwest Territories, Canada. I grew up with a great respect for my parents’ and our community Elders’ knowledge about our Dene food. We learned that our foods are essential to keep our good health, and that the land, water and air in which we live – together with the animals and plants – must be respected and protected. I went on to a university education in Political Science and Anthropology and am now the National Chief of the Dene Nation and Assembly of First Nations Regional Chief of the Northwest Territories, Canada’s largest organization dealing with the issues of Indigenous Peoples. It is in this context that I became involved with the Centre for Indigenous Peoples’ Nutrition and Environment (CINE) and the project that forms this book.

I have learned that “Food is a human right” and that Indigenous Peoples everywhere want to protect their heritage and the health of their culturally determined foods. They are concerned about the potential loss of both food species and the knowledge about how to use them. They worry that the loss of Elders in the natural cycle of life may mean that knowledge about indigenous foods will not be passed on to the generations that follow. This raises anxieties about the demise of cultural and traditional knowledge associated with their foods and lifestyles. Inidgenous Peoples want to preserve their ecosystems that for so long have provided a healthy environment for animals, plants and people.

This book will help indigenous communities realize that they can understand their own food resources by using tools created by this project. These 12 case studies from different parts of the world are just that – examples that demonstrate the wealth of indigenous knowledge around ecosystems providing food. This book demonstrates how to list the foods and how to understand their healthy properties. It also identifies and demonstrates the importance local foods play in indigenous cultures, and why it is important to protect this knowledge for future generations.

This research originates from the Centre for Indigenous Peoples’ Nutrition and Environment (CINE, see www.mcgill.ca/cine), the multidisciplinary research and education resource established in 1992 by Canada’s indigenous leaders and McGill University, Montreal. CINE maintains research programmes that address food-system concerns. Its objectives include understanding the benefits for and the risks to Indigenous People in using traditional foods. CINE is unique – it is recognized nationally and internationally for both its research and its method of participatory working with Indigenous Peoples. Indeed, CINE’s governing board is made up mainly of indigenous organization representatives, and I am pleased to have chaired the Governing Board of CINE for several years, and to have participated in building the project described here.

Each research area described in the 12 chapters in this book has been fortunate to have had excellent collaboration with academic partners and community leaders. In addition to documenting the food species and varieties/cultivars in the food system, the research looks too at the percentage of energy and nutrients obtained from local food in comparison to that obtained from commercial food items. Using qualitative methods, it documents the many changes in food sources (local versus commercial), environmental quality, physical activity and food security. The chapters present the communities’ and their academic partners’ perspectives on interventions that could improve nutrition and food security.

We found many common themes across all of the communities – for instance, the twin aims of both increasing the availability of traditional food to communities and of improving the quality of imported industrialized purchased food. The themes of “connection to the land” and “access to resources” prevailed throughout all 12 case studies, underlining the common struggle to protect indigenous cultures and emphasizing the need to conserve those ecosystems that contain the food resources necessary for community health. At the same time, information on nutrient density of what people eat and how to improve the quality of food imported to communities was highly appreciated.

Twelve fascinating and unique stories of descriptions of Indigenous Peoples’ food and health circumstances await the reader. The unique styles of conceptualizing food systems and writing about them were preserved as much as possible. The photographs that accompany each chapter help convey the meaning and beauty of local foods.

Our entire team is convinced of the necessity of efforts to protect Indigenous Peoples’ food systems because of the many benefits they offer to physical health and the continuity of indigenous cultures. This can be seen in many ways – in terms of self-sufficiency, cultural morale, as resources around social activities, for educating children in terms of cultural principles and environmental connectedness. These food systems also provide many economic and nutritional benefits and are an important foundation of food security for Indigenous Peoples in their home regions. Without doubt, for Indigenous Peoples collectively, these resources are of global significance. They need to be protected environmentally and fostered for sustainable use – not only among the women, men and children who hold the traditional knowledge of these cultural treasures, but for our collective human knowledge •

Dene National Chief Bill Erasmus

Yellowknife, NWT, Canada

2009

Introduction

Why are Indigenous Peoples’ food systems important and why do they need documentation?

• HARRIET V. KUHNLEIN, PH. D

This book is about the food that is close to the hearts of Indigenous Peoples in their local cultural environments. The authors and chapter writers describe 12 diverse global examples of how Indigenous Peoples themselves researched their food diversity, cultural understanding of their food, the impacts of the environment on their food and how these resources they know so well are critical for their nutrition and health. We worked together to figure out ways to capture these essential principles and how to present them to readers who may be indigenous or not, and who may be students, researchers, development advocates and/or policy makers in diverse interdisciplinary fields. By documenting this remarkable knowledge we want to encourage greater appreciation for Indigenous Peoples’ food systems and enforce the call for their promotion and protection.

These stories show how Indigenous Peoples’ food systems contain treasures of knowledge from long-evolved cultures and patterns of living in local ecosystems. The dimensions of nature and culture that define a food system of an indigenous culture contribute to the whole health picture of the individual and the community – not only physical health but also the emotional, mental and spiritual aspects of health, healing and protection from disease. However, these food systems which are intricately related to the complexities of social and economic circumstances are becoming increasingly more affected by the forces of globalization. Within the larger society in which they live, despite the wealth of knowledge rural Indigenous People have of their local environment and food system, they often face vulnerabilities derived from extreme poverty, discrimination and marginalization. This can mean that access to their resources becomes limited, causing unnecessarily poor health outcomes. It is within this context that the scientific work described in this volume seeks to define and describe the diversity contained in circumstances surrounding 12 rural Indigenous Peoples’ food systems that are windows to Indigenous Peoples everywhere. Our long-term goal is to find solutions to difficulties faced in using, developing and sustaining this knowledge to improve the well-being and health of Indigenous Peoples globally.

Context of research

Who are Indigenous People? The definition of indigeneity varies in different global regions, with no single criterion that can be applied universally, except to note the accepted principle that people have the right to define themselves according to their culture. Within the context of the work described here, we maintain that Indigenous People are those who retain knowledge of the land and food resources rooted in historical continuity within their region of residence. The local food systems that they are currently using are those we define as “traditional food systems”, which invariably include some foods that may be used by many outside of the indigenous culture (e.g. salmon). In essence, we describe as “traditional foods” those foods that Indigenous Peoples have access to locally, without having to purchase them, and within traditional knowledge and the natural environment from farming or wild harvesting. Alternatively, we define “market foods” as those foods that enter communities often through global industrially sponsored retail outlets, and which must be purchased (e.g. sugar, oil). In some circumstances, Indigenous Peoples may purchase some of their culturally based traditional foods (i.e. wild meat, local rice varieties) from others with land and/or time to harvest them. In other cases, Indigenous Peoples count as their own species that were introduced from other regions (e.g. Karen chilis). Throughout, it is the intent of this volume to document how Indigenous Peoples today think about and use local food resources that are identified within their cultures.

We aspire to strengthen the evidence base of current circumstances surrounding food systems and health by using 12 community groups of Indigenous Peoples located in different global regions: Ainu (Japan), Awajun (Peru), Baffin Inuit (Canada), Bhil (India), Dalit (India), Gwich’in (Canada), Igbo (Nigeria), Ingano (Colombia), Karen (Thailand), Maasai (Kenya), Nuxalk (Canada), and Pohnpei (Federated States of Micronesia). The chapters themselves are presented geographically – from North America to South America, Pacific, Asia and Africa (see Map).

Indigenous People case studies with traditional food descriptions

In these 12 case studies, the Centre for Indigenous Peoples’ Nutrition and Environment (CINE), leaders of the communities of Indigenous Peoples and their academic partners in the same country collaborated for research in two phases: 1) documentation of the cultural food system with a defined protocol (see http://www.cine.mcgill.ca/documents/manual.pdf) and 2) implementation of health promotion interventions using culturally sensitive and environmentally relevant elements of the local food system. This volume describes the first phase of the research: documentation of the inherent strengths of the local traditional food system, the influx of industrialized and purchased food, and the circumstances of the nutrition transition in these indigenous communities.

This information sets the stage for the second phase of the research: to demonstrate how these local foods contribute to food security, nutrition and health. Our long-term objectives are to address scientific issues, public health, and policy, with the goal of influencing local, national and international policies for environmental protection of Indigenous Peoples’ land and food resources. In this way, communities can be encouraged to strengthen their use of local food and sustain knowledge of their local food systems for essential contributions to cultural protection, well-being and health.

International initiatives stimulating this programme

This effort of Indigenous Peoples and their academic partners takes place within the International Decades of the World’s Indigenous Peoples, and the recent Declaration of the Rights of Indigenous Peoples approved in the General Assembly of the United Nations. The research has been supported and presented in several fora of the United Nations System. A basic chronology demonstrating the evolution of the Task Force (TF) on Indigenous Peoples’ Food Systems and Nutrition of the International Union of Nutritional Sciences (IUNS) and this project is as follows:

2001. Creation of the TF following the IUNS meeting in Vienna, with the objective to secure support from the Food and Agriculture Organization of the United Nations (FAO) and the International Development Research Centre of Canada (IDRC) to document traditional food systems (TFS) of five groups of Asian Indigenous Peoples: Bhil (India), Dalit (India), Karen (Thailand), Miao (China), and the Mogh and Nayakrishi (Bangladesh).

2001. Meeting of Asian case study partners in Salaya, Thailand, to draft the food system documentation methodology.

2002–2003. Preparation of a United Nations World Health Organization (WHO) publication on Participatory Health Research with Indigenous Peoples: Planning and Management and Preparing Research Agreements (http://www.who.int/ethics/indigenous_peoples/en/index1.html).

2004–2006. Funding quest for 12 case studies for Phase 1 and Phase 2 of the research.

2004. Meeting of case study partners at The Rockefeller Foundation’s Bellagio Study and Conference Center in Italy. Confirmation of Phase 1 research methods and plans for intervention proposals. Creation of CINE web document (project Book 1) for Indigenous Peoples’ food system methods (http://www.cine.mcgill.ca/documents/manual.pdf).

2005. Meeting of Awajun and Ingano partners in Lima. Preparation of draft versions of adaptable food-security and physical-activity interview methods.

2005. Convention on Biological Diversity (CBD) initiative with the United Nations System Standing Committee on Nutrition (SCN) established in Brazilia.

2005. Funding established for photo documentation of case-study food systems.

2005. Meeting of case study partners in the Futululu Environmental Centre in St Lucia, South Africa. Preparation of publication on intervention methods and evaluation (Public Health Nutrition 9(8): 1013–19, 2006).

2005–2006. Four FAO and IDRC posters prepared and distributed internationally to highlight food diversity and for the International Decades of the World’s Indigenous Peoples: Global, Asia, Africa, Pacific Islands.

2006. Case study partners’ meeting in Montreal to compile Phase 1 results publications.

2007. Second meeting of case study partners at The Rockefeller Foundation’s Bellagio Study and Conference Center. Finishing details on book of chapters of Phase 1 results.[1] Consideration of appropriate definitions of Indigenous Peoples and policy activities for case studies at several levels.

2007. The project is considered in the Standing Committee on Nutrition (SCN) of the United Nations System – the Working Group on Household Food Security and the Working Group on Nutrition, Ethics and Human Rights-Task Force on Indigenous Peoples and the Right to Food.

2007. The publication of this volume was described at the 7th International Food Data Conference in Sao Paulo, Brazil.

2008. This book (Project book 2) was described at the Second International Conference on Health and Biodiversity (COHAB2) in Galway, Ireland.

2008–2009. Phase 2 of case study interventions are discussed at our third meeting at The Rockefeller Bellagio Study and Conference Centre in preparation for a book (Project Book 3) to be presented at the IUNS International Nutrition Congress in Bangkok.

Overview of findings

The information presented in these chapters provides a detailed understanding of the diversity, complexity and cultural appreciation of these food systems of Indigenous Peoples. An impressive array of food species and varieties is documented, some of which still require scientific identifications and nutrient-composition analysis. Locally available food-species numbers varied considerably depending on the ecosystem. For example, the Maasai of Kenya documented 35 food species in an arid, drought-prone zone, while there were 381 local food species/varieties documented for the Pohnpei culture in the Federated States of Micronesia. Other results show 220 species in the Igbo environment in West Africa, 223 for the Amazonian Awajun and 387 for Karen (Table 1). Detailed data on each food system are presented in the chapters.

The extent of use of these impressive food systems also varied (Table 1). For example, the adult Awajun and Igbo were found to consume close to 100 percent of dietary energy from these local food resources. The Maasai, Pohnpei, Ingano, Bhil and Dalit cultures are shown here to have considerable erosion of dietary energy, supplanting traditional species in the form of commercial (or donated) cornmeal or white refined rice. The Canadian Gwich’in and Inuit have less than 45 percent of dietary energy as traditional, local food, with the majority of the balance of energy derived from refined flour, fats and sugar.

Nutrition assessments were made in most cases, using anthropometry and dietary intake, and other biological measures that were accepted within the culture and/or otherwise available. Food composition databases were used as developed within the countries of the academic collaborators, and standards for determination of nutritional adequacy, including views on stunting and other nutrition parameters, were reflective of the home countries.

There are many common themes in the chapters. First, it is important to recognize the need for research methods that are suitable for this diverse set of rural communities of Indigenous Peoples. Academic research partners worked together with community leaders to agree on the goals, objectives, methods and ultimate use of the research findings by creation of meaningful research agreements (see http://www.mcgill.ca/files/cine/partreresearch_english.pdf). It was recognized that this is information from “the people” is to be used for their benefit. In all cases, work was conducted with groups of communities with a total population size that was usually less than 1,000. In several areas it was necessary to overcome skepticism toward the research in these grass-roots communities, so that the necessary in-depth studies within the culture could take place. Assurances had to be given that the research was for the people directly involved, and not for the benefit of pharmaceutical bioprospecting. Usually, there was a reluctance to include blood samples as part of the research process for both adults and children. Nevertheless, we had important and necessary assurance of the willingness and enthusiasm of communities to undertake this work for their benefit. In fact, the research methods, process, goals and end-products became very popular in communities, and in spreading word of success of the projects. Indigenous leaders would like to expand the work to other communities so they may also consider the benefits of greater understanding and use of their local food.

In the 2007 meeting at The Rockefeller Foundation’s Bellagio Study and Conference Centre all case studies recognized the value of using traditional food/medicine resources as a platform to conduct awareness building and education on nutrition and health and to conduct education activities. Several of the case studies (Awajun, Nuxalk, Bhil, Ainu, Karen) have prepared photo books of the traditional food resources to be used as educational resources in local schools and at community meetings.

Commonalities also existed on the intention to increase traditional food availability to communities, and to improve the quality of imported industrialized purchased food. The theme of “connection to the land” prevailed throughout all case studies, as a common struggle to protect indigenous cultures, with attention also to the need for conservation of ecosystems containing these resources. At the same time, information on nutrient density and quality of food imported to communities was highly appreciated. Attention to women as gatekeepers to family food availability was consistent across the case studies, with imperatives to increase women’s self-esteem and to find ways to lighten the burden of food preparation methods by including food scientists and engineers in project intervention plans. Morevoer, attention to food safety of these food resources was noted.

Understanding the science of these local food resources was recognized to be at the heart of projects in each area, and attempts were made to build the scientific notation and food composition data to benefit community food education, nutrition education and local abilities toward understanding health benefits of foods, especially for youth in the regions. Efforts at food composition analysis were mixed, with some case studies completing more of this work than others. The logistics of sampling and the expense of laboratory work were key factors that limited additional work.

Case study partners had to make compromises when implementing the suggested methodology to collect data. As noted above community areas, by requirement of budget and logistics, were small and limited in numbers participating in age and gender groups. For example, there were small numbers of school-aged children, but sample sizes were still meaningful in identifying anthropometric issues of stunting or obesity. Another example was the difficulties faced in the Ainu study when it was realized that many in the targeted communities were reluctant to identify themselves as Ainu because of the history of discrimination. Throughout, and despite our best efforts, there were few case studies that could give complete information on all the species and varieties of foods in their area. While the frustrations of missing data are recognized, it also highlights the imperative to continue this work.

Even in recognition of these constraints, this book provides 12 fascinating and unique chapters of descriptions of Indigenous Peoples’ food and health circumstances. The unique styles of writing and presentation were preserved as much as possible, and the photos presented capture the people, food and environments of these unique traditional food systems. Each of the case studies proceeds independently with publications on their findings, and the reader is encouraged to seek these additional resources.

Policy implications of the research

This project has captured the attention of leaders in many sectors of local, national and international governments and agencies. A forward-looking approach is needed in all sectors to address Indigenous Peoples’ food security, and for building attention on the rights of Indigenous Peoples to maintain their cultures, environments and preferred food systems •

Chapter 1

Back to the future: using traditional food and knowledge to promote a healthy future among Inuit

• GRACE M. EGELAND, PH. D.[1] • GUYLAINE CHARBONNEAU - ROBERTS[1] • JOHNNY KULUGUQTUQ[2] • JONAH KILABUK[2] LOOEE OKALIK[3] • RULA SOUEIDA[1] • HARRIET V. KUHNLEIN, PH. D.[1]

1

Centre for Indigenous Peoples’ Nutrition and Environment (CINE) and School of Dietetics and Human Nutrition, McGill University, Montreal, Québec, Canada

2

Community Steering Committee Member, Pangnirtung, Baffin region, Nunavut Territory, Canada

3

Inuit Tapiriit Kanatami, Health Office, Ottawa, Ontario, Canada

Photographic section >> III

“Give thanks to our food, Elders and ancestors daily.”

Inuit saying

Abstract

Evidence of nutrition and epidemiologic transition in Inuit communities prompted a case study where traditional knowledge and traditional food is used as a basis for a community health-promotion effort to help improve overall diet quality including healthy market food choices. The current Inuit diet in the Baffin community involves a mix of traditional and market food. Caribou was the most commonly consumed traditional food item. Overall, 41 percent of energy was obtained from traditional food among 62 percent of respondents reporting traditional food consumption within the past 24 hours in the community health screening. Simultaneously, 58 percent of adults reported consuming an average of two cans of carbonated beverages in the past day, amounting to 10 percent of energy intake. Furthermore, the percent of n-3 fatty acids in plasma as a marker of traditional food consumption was inversely related to the percent of trans-fat in plasma as a marker of unhealthy market food choices (Spearman rho = -.44, p-value ≤.01). The data illustrate that traditional food is replaced by unhealthy market food choices.

A high prevalence of metabolic syndrome was observed (34 percent of 47 non-diabetic participants) using the new International Diabetes Federation criteria. Further, food insecurity was commonly reported, with 48 percent indicating that it was true or sometimes true that they “eat less or skip a meal because there isn’t enough money to buy food”; and 28 percent indicating “yes” to “in the last month there was not enough to eat in your house”. Fortunately, nearly all respondents (82 percent) indicated that friends and relatives shared their traditional food. The data illustrate that costs of market food items need to be considered in health promotion campaigns, and that traditional food promotion and sharing networks can help mitigate the rapid acculturation and transitions being observed. Finally, using traditional knowledge of indigenous food systems may be an effective way to promote healthy market food choices in an effort to prevent the adverse effects of acculturation.

Introduction

Rapid changes spanning all dimensions of life are occurring throughout Inuit communities. Key concepts integral to promoting Inuit health and well-being include maintaining cultural identity, positive family dynamics, social support, spirituality, and environmental integrity. Traditional food (called country food among Inuit), features prominently at the centre of Inuit identity and well-being. The hunting, harvesting and sharing of country food ensured survival and provided social cohesion, as they continue to do. The climate and landscape certainly fostered an Inuit spirit of thriving in the face of adversity that is rooted in strong collaboration and a sense of commitment to one’s community. With this strength and resiliency, Inuit are now facing new challenges associated with climate change and environmental degradation, market economies, globalization, acculturation, and nutrition transition – all with far-reaching societal and health implications.

Inuit country food is a rich source of antioxidants, omega-3 fatty acids, monounsaturated fatty acids, protein, and micronutrients (see www.mcgill.ca/cine/resources/nutrient). The dietary composition of country food likely provides invaluable health benefits, as suggested by early observations of the heart-healthy Inuit diet (Bang, Dyerberg and Nielsen, 1971; Bang and Dyerberg, 1972; Dyerberg and Bang, 1978), which inspired decades of nutrition research on the role of fatty acids in health. Today, chronic conditions are emerging that have historically been lower among Inuit than among southern populations (Bjerregaard and Young, 1998). The emerging health patterns likely reflect a response to transition in all facets of life, of which nutrition transition is only one component. Work toward protecting the environment and its ecosystems from further degradation and finding ways to ensure availability of and access to country food will undoubtedly feature prominently in strategies to promote Inuit health and thriving.

Purpose of study

The purpose of the Inuit community case study in Pangnirtung is to utilize traditional knowledge, Inuit story telling, and country food to promote the health and well-being of community members. The study highlights the importance of Inuit culture and country food and the integrity of the Arctic ecosystem for the promotion of Indigenous Peoples’ health. The current report discusses two projects. The first was the Baffin component of a five-Inuit region dietary and traditional food-use survey, and the second project is the community health promotion project in which selected results of a baseline adult assessment are reported.

Participatory research

The Baffin component of the five Inuit region dietary survey was developed through participatory processes initiated in 1997 and 1998 by the Centre for Indigenous Peoples’ Nutrition and Environment (CINE). Initially, a total of 39 communities sent representatives to workshops to discuss research methods and to identify participating communities. For the community case study reported here, participatory processes were also followed (WHO and CINE, 2003). Comments and feedback were also requested of the Inuit Tapiriit Kanatami (ITK), which is a member of the CINE Governing Board, the Government of Nunavut Health and Social Services Department, and Nunavut Tunngavik Incorporated. Approvals for the community health screening were obtained from the McGill Ethics Review Committee, the Nunavut Research Institute, and the community. A community and CINE research agreement was developed and approved by the Hamlet Council. A community steering committee guided and helped in all aspects of the fieldwork and ensured appropriate and accurate translations of consent forms and questionnaires into Inuktitut. Informed consent was obtained from each participant. The steering committee is self-directed and active in hiring staff and supervising the ongoing work in the community.

Overall description of research site and Indigenous People

Geographic and environmental characteristics

The Territory of Nunavut was formed in 1993, and represents an Inuit self-ruled territory, the name meaning “our land” in Inuktitut (see www.gov.nu.ca/Nunavut). The Baffin Region of Nunavut is the most traditional of Canadian Inuit regions and is home to approximately 12 700 Inuit. The community of Pangnirtung, home to 1 300 Inuit, is situated on a beautiful fjord in South Eastern Baffin in Cumberland Sound (Figure 1.1). The name of Pangnirtung denotes a place of plenty, translating as the place “abundant of bull caribou”. By northern standards, Pangnirtung remains a privileged community in terms of access to traditional food. In addition to subsistence food harvests, the local economy is fuelled by commercial fishing and processing at Pangnirtung Fisheries, where Arctic char, shrimp, and Baffin turbot (Greenland halibut) are harvested, then shipped internationally (see http://www.gov.nu.ca/Nunavut/English/about/communities.shtml).

The local economy is also supported by the territorial government sector as it is home to the Baffin region’s Government of Nunavut administrative offices. The hamlet municipality is also an employer, and the community is well known for the number and quality of artists in print-making, woven tapestries, and carving. There is some seasonal tourism, which employs local guides as the community is situated near the scenic Auyuittuq National Park.

Cultural characteristics and historical perspectives

Inuit enjoy a rich history of story-telling and subsistence harvesting. They historically travelled in small family groups to ensure year-round access to subsistence species. The Canadian government policies led to forced settlements in the 1950s and families continued to move in to settlements from semi-nomadic existence through the 1970s. The rapid changes from traditional hunting and nomadic life to modern amenities in settlements to the formation of a self-rule government in 1993 illustrate the rapid changes occurring in Northern Canada and the adaptive nature of Inuit.

General description of the food system

Dietary surveys have found that food security is a primary concern throughout Northern Canada (Lawn and Harvey, 2001; Lawn and Langer, 1994) and that five out of six households were food insecure in one Inuit community (Lawn and Harvey, 2001). Also, in the earlier CINE surveys, which included the five Inuit regions, food security concerns were commonly expressed by respondents. More than 50 percent of women respondents in Nunavut and Labrador reported not being able to buy all needed food from the store. Further, many Inuit (up to 45 percent within age groups) reported that they could not afford to go hunting or fishing (Lambden et al., 2006). In a recent market food costs survey, the weekly cost of a food basket for a family of four residing in a remote Baffin community was $CAD265 compared to $CAD144 in Montreal (see www.ainc-ianc.gc.ca/ps/nap/air/fruijui/nfb/nfbbafnuna_e.html). In the context of food insecurity, nutrient-dense country food is replaced by abundantly available and low-cost refined carbohydrates. The Inuit dietary survey conducted by CINE demonstrated that days with country food provided more protein and micronutrients than days without country food, and that carbohydrate intake, particularly refined carbohydrates, increased on days without country food (Kuhnlein et al., 2004; Kuhnlein et al., 2000). Also as younger generations consume less country food, dietary intakes of key micronutrients are more likely to be suboptimal among younger than older Inuit as demonstrated by the striking differences in retinol intake by age in the five Canadian Inuit regions surveyed by CINE in 1998 (Egeland et al., 2004).

The prevalence of overweight and obesity has risen throughout Canada (Statistics Canada and Shields, 2005; Statistics Canada, 2001). Likewise, overweight and obesity is occurring in Inuit communities in Canada (Kuhnlein et al., 2004). In developing countries, nutrition transition has been associated with both under and over-nutrition being noted within the same communities and even the same households (Popkin, 2002). Likewise, both overweight and obesity and sub-optimal nutrient intakes co-occur in Inuit communities and households (Kuhnlein et al., 2004).

In addition to costs, language is a barrier to healthy food choices. During story-telling interviews with Inuit living with diabetes, English food labelling and signs at the grocery store were identified as important factors that hindered the identification of healthy food choices by unilingual Inuktitut adults (Bird et al., 2008).

On a positive note, the Hunters and Trappers Association, and individual hunters within Inuit communities, provide support networks for the sharing of country food with Elders and others who are not able to hunt. Community feasts and informal gatherings provide another avenue for traditional food sharing and the social networks that enhance food security.

Overall health status

Given the different jurisdictions in which Inuit live, available data regarding the leading causes of mortality and morbidity among Inuit represent fragmented information over time and geographic locations. Nonetheless, the picture that emerges from infancy to adulthood is that Inuit suffer from disparities in health and longevity from that of other Canadians (Jenkins et al., 2003; Statistics Canada, 2001). Nonetheless, a key feature of Inuit health is the importance of social networks. In a recent analyses of Statistics Canada Aboriginal Peoples’ Survey, social support featured prominently as a key determinant of thriving health among Inuit (Richmond, Ross and Egeland, 2007). Social networks and cohesion often involved the traditional food system (sharing in hunting and harvesting, in preparation of food, in making traditional garments and in community feasts) and represent another avenue in which traditional food systems can indirectly promote health and well-being among Indigenous Peoples.

In terms of the health care system in remote and northern communities, there are many challenges. Two primary challenges are the high employee turnover rate in Nunavut and the lack of Inuit-speaking nurses (Archibald and Grey, 2000; Ellerton et al., 1999). Community health representatives help bridge the cultural and linguistic gap between health care providers and community members, and are the backbone of public health and health care delivery in northern Inuit communities.

Methodology

Background on Baffin food systems and food-use patterns

As part of the large five Inuit region CINE study noted earlier, baseline assessments in Baffin included: 1) deriving estimates of traditional (country) and market food intake, 2) completion of a nutrient and contaminant database, 3) defining the benefits of traditional food in terms of nutritional, socioeconomic, and cultural significance, and 4) defining levels of dietary exposures to contaminants. Details regarding the methodologies and findings have been presented elsewhere (Kuhnlein et al., 2000; Kuhnlein et al., 2004; Kuhnlein et al., 2005). Data gleaned from these activities, particularly from the Baffin region, provide a necessary background for the development of the Inuit community case study under way in Pangnirtung.

Pangnirtung community health promotion project

Through discussions with representatives of the Inuit Tapiriit Kanatami, the parent organization for Canadian Inuit, CINE investigators became aware of a community member interested in facilitating work to combat the adverse health effects associated with the rapid changes occurring in northern Inuit communities. An invitation was extended to CINE investigators and community meetings were held. During community brainstorming sessions and follow-up meetings, community members and community health representatives identified the following needed activities:

1.An adult health screening to generate individual and community awareness.

2.A youth active living and healthy eating survey.

3.Story-telling interviews with Inuit living with diabetes to inform health-care service policy development.

4.Story-telling with Elders regarding their traditional knowledge (Inuit Qaujimajatuqangit regarding the role of country food in health, including spiritual, mental and physical health).

5.Utilization of all of the above information in the development of a culturally appropriate community-based health promotion intervention.

6.A follow-up survey of adults and youth to determine whether the intervention was successful in reducing health risks and improving nutrition.

The long-term goal of the community project is to develop a model intervention that can be adapted to other Inuit communities. To date, the first four community activities have been completed. The initial story-telling activities and selected results of the adult health survey are presented elsewhere (Charbonneau-Roberts et al., 2007; Bird et al., 2008). The current chapter focuses on a description of the traditional Inuit food system, extent of reliance upon traditional food, food security, and data regarding nutrition and epidemiologic transition from the regional Baffin survey and the adult screening conducted in Pangnirtung.

Community adult health screening

The adult health survey took place during eight working days in May 2005, with preparations including translations of questionnaire items and review of appropriateness and relevance of all assessments. For the adult health screening, volunteers were recruited through community radio announcements and information sessions where bilingual community research assistants explained the screening, informed consent forms, and its importance to community members. The health-screening data included 24-hour dietary recalls, market and traditional food frequency questionnaires, food security, a health and demographic status questionnaire, a physical activity assessment and anthropometric measures. In addition, a fasting venous blood sample was taken in the morning after an overnight fast of at least eight hours, and a two-hour 75 gram OGTT was administered. Details of the fasting serum lipid, glucose and insulin measures are described elsewhere (Charbonneau-Roberts et al., 2007). In addition, plasma fatty acids (as a marker of recent dietary fat intake) were analysed using a Varian 100 m capillary column – Select CB for analyses of fatty acid methyl esters (FAMEs) (Varian 3400 CX Gas Chromatograph, Varian Inc., Palo Alto, CA). Individual FAMEs were quantified and multiplied by a conversion factor for converting FAMEs to their corresponding fatty acids as reported by the Association of Official Analytical Chemists (AOAC) method 996.06D. Fatty acids are expressed as a percentage of total fatty acids present.

In total, 52 adults participated in the health screening, which represented one in ten adults and one in ten community households. The ages of adult participants ranged from 19–77 years of age, with a mean age of 45 years (SD = 17). The majority of participants were women (77.1 percent).

Results

Background of Baffin food systems and use patterns

The background Inuit survey work in the Baffin region identified numerous species of fish and shellfish, marine and land mammals, birds, plants and berries, and season of harvest for the traditional food system (Table 1.1). Seventy-nine species were identified, with English and Inuktitut names. It is evident that a rich diversity of wildlife foods are available year-round in the Baffin food system.

A table of nutrient composition of selected Baffin Inuit foods illustrates the rich nutrient qualities of the Baffin food system (Table 1.2). The food system provides an excellent source of micronutrients such as vitamin A, D, and C, iron, folate, and zinc, all of which enabled Inuit to survive with little or no access to fruit and vegetables. Historically, the nutrients in narwhal, seal, caribou, and beluga when consumed regularly and in ample quantities likely yielded all necessary nutrients for all Inuit.

For adults, caribou ranked highest as the most liked and appreciated country food species. For children, adults responded that children most often disliked seal and walrus meat and liver, and fish. By far, the top contributor to protein in the Baffin adult diet in the 1998–1999 survey was from caribou meat (20.8 percent of energy in the autumn and 32.6 percent of energy in the late winter). This was followed by ringed seal meat and Arctic char, which contributed 17 percent and 7.4 percent of energy as protein, respectively in the autumn and 11.5 and 10.4 percent of energy as protein in the late-winter. Traditional food was also a top contributor to micronutrients, with ringed seal contributing to 42.6 percent of iron consumed in the autumn, and 35.4 percent of iron consumed in late winter, while caribou contributed 24.6 percent of the zinc intake in the autumn and 36.9 percent of zinc intake in the late winter. In contrast, the top contributors to carbohydrate intake were from table sugar, soft drinks, and bannock (18.1 percent, 11.8 percent, 10.3 percent, respectively in the autumn; and 13 percent, 10.9 percent and 9.2 percent respectively in the late-winter). Market and traditional food items contributed to vitamin C (12.9 percent from orange juice and 10.5 percent from narwhal maktaaq in the autumn and 16.6 percent and 15.3 percent respectively in the late-winter). Leading contributors to folate intake included bannock, spaghetti, and bread following the introduction of fortification of flour in Canada.

Traditional food and diet quality

Overall, 31 percent of total energy came from traditional food sources in the Baffin region during the 1998–1999 CINE survey among 69 percent consuming traditional food in the past day. In contrast, in Pangnirtung (2005–2006), 41 percent of energy came from traditional food among 62 percent of adults consuming any traditional food in the past day (Figure 1.2). The data indicate the current-day importance of the Inuit traditional food system.

In addition to the cultural and nutrient value of traditional food, country food replaced market food items that pose health risks. For example, the percent of energy from traditional food was inversely related to the percent of energy from saturated fat in all five Inuit regions combined (Figure 1.3) – results were similar in the Baffin region when examined separately. When no traditional food was consumed, the average percent of energy as saturated fat was twice (12 percent) that of when the majority of energy was from traditional food (6 percent). Similarly, in Pangnirtung’s adult health survey, traditional food intake as a percent of energy was positively correlated to plasma n-3 fatty acids (Spearman rho = 0.58, p <.001) and inversely correlated to plasma trans-fats (Spearman rho = -.44; p <.01) as percent of total fatty acids in plasma. As n-3 fatty acids increased (as a marker of the degree of recent country food intake) the percent of fatty acids as trans-fat decreased (Figure 1.4, rho = -0.53; p <.001). These data illustrate the multiple nutritional exposures that are simultaneously influenced by the loss of traditional food in the contemporary Inuit diet.

While country food remained an important source of nutrients and energy for the Inuit, the Pangnirtung survey of adults indicated a high prevalence of carbonated beverage consumption: 86 percent reported consuming carbonated beverages in the past year and 58 percent of adults reported drinking carbonated beverages in the past day, with an average consumption of two cans (12 fluid ounces each) per day (which contributed to nearly 10 percent of energy intake/day among consumers). While Inuit historically received their carbohydrates from the glycogen of raw meat and blood, and from plants, berries, and caribou stomach contents, overall historical carbohydrate intake was relatively low. Against this relatively recent dietary context, the current exposures to high amounts of refined carbohydrates are alarming and will undoubtedly have implications for excess energy intake and subsequent increases in obesity and obesity-related health complications.

Food security

Responses to food security questions indicated that in this relatively well-off community by northern Inuit standards, food insecurity remained an issue. A total of 80 percent of adults surveyed in Pangnirtung reported that it was often true or sometimes true that “we worry that our food will run out before we get money to buy more”. Sixty percent reported that it was often true or sometimes true that “we can’t afford to eat healthy meals”. Forty-eight percent indicated that it was true or sometimes true that “I eat less or skip a meal because there isn’t enough money to buy food”. Fifty-two percent indicated that it is often true or sometimes true that “there is no ‘country food’ to eat when I want it”, and 28 percent indicated “yes” that they agreed with the statement that “in the last month there was not enough to eat in your house”. Fortunately, nearly all respondents (82 percent) indicated that friends and relatives shared their country food.

Nutritional status assessed by anthropometry

Overweight and obesity prevalence among the randomly selected Inuit participating in the 1998–1999 Baffin survey indicated that 36 percent of men and 38 percent of women were overweight (BMI 25–29.9), and that 37 percent of women and 18 percent of men were obese (BMI ≥ 30). It is anticipated, however, that these figures may overestimate to some degree obesity and overweight among Inuit, given that BMI overestimates adiposity in individuals with a long torso relative to standing height (Charbonneau-Roberts et al., 2005; Norgan, 1994). However, BMI does not capture the extent of visceral adiposity. Among the adults in the Pangnirtung survey, a high prevalence of central fat patterning was observed and all measures of obesity were identified as strong predictors of insulin resistance (Charbonneau-Roberts et al., 2007). The findings are noteworthy in that they suggest the emergence of obesity among Inuit will have health consequences contrary to previous research which has suggested that obesity is not as metabolically active among Inuit as it is in non-Inuit comparison populations (Young, 1996; Jorgensen et al., 2002).

Epidemiologic transition

Among adult participants in the Pangnirtung Health screening, evidence of an epidemiologic transition was observed. While no new diabetic cases were identified through the screening, five participants had pre-existing Type 2 DM, which was confirmed by medications prescribed and used. After excluding the pre-existing cases of Type 2 DM, a high prevalence of lipid abnormalities were noted: 61.7 percent (29/47) had low HDL-cholesterol (chol) according to new gender-specific International Diabetes Federation (IDF) criteria (IDF, 2005); 19 percent (9/47) had high LDL-chol (>3.4 mmol/l); 34 percent (16/47) had a high total chol to HDL-chol ratio (>5.0), and 19 percent (9/47) had a high triglyceride level (>1.7 mmol/l). In addition, a total of 34 percent (n = 16) of those without pre-existing diabetes met the IDF criteria of metabolic syndrome, which requires the presence of central obesity with two additional metabolic syndrome risk factors (IDF, 2005).

In linear regression analyses, the homeostasis model assessment for insulin resistance (HOMA-IR) developed by Mathews and colleagues (1985) and fasting insulin were inversely related to HDL-chol and accounted for a large percent of the variance in HDL-chol (22 percent and 20 percent, respectively). HOMA-IR remained a significant predictor of HDL-chol in additional analyses adjusting for age and gender. Similar findings were observed for triglycerides in regard to insulin indices. HOMA-IR and fasting insulin were positively related to triglyceride levels when considered separately in age and gender adjusted linear regression analyses (p <.01), with HOMA-IR accounting for 27.5 percent and fasting insulin accounting for 19.8 percent of the variance in triglycerides (Figure 1.5). Similarly, the insulin sensitivity index (ISI 0,120) developed by Gutt and colleagues (2004) significantly predicted systolic blood pressure.

The current results are noteworthy in that insulin resistance as measured by HOMA-IR, fasting insulin, and the ISI 0,120 were identified as important underlying determinants of dyslipidemia and systolic blood pressure among the health-screening participants in the Baffin community. Insulin resistance is now considered the underlying common mechanism explaining the coexistence of Type 2 DM and atherosclerotic cardiovascular disease. Also, as dyslipidemia has been noted to precede the development of Type 2 DM in normoglycemic populations followed over time (McPhillips, Barrett-Connor and Wingard, 1990; Mykkanen et al., 1993), the high prevalence of participants with dyslipidemia is of concern. In Finland, those with an HDL-chol less than 1.0 mmol/l had a 2.1 fold (95 percent CI = 1.2-3.6) increase and those with triglyceride levels greater than 2.5 mmol/l had a 2.7 fold increase (95 percent CI = 1.5-4.6) in developing Type 2 DM over a 3.5 year period (Mykkanen et al., 1993). Also, among 1 847 normoglycemic men and women in Rancho Bernardo, California, Type 2 DM increased with every quartile of baseline triglyceride levels (McPhillips, Barrett-Connor and Wingard, 1990). Furthermore, insulin sensitivity was inversely related to incident cardiovascular events in Framingham offspring (Rutter et al., 2005).

Intervention strategies and future plans

Prompted by the findings of the survey, the community embarked (in 2006–2007) upon an intervention strategy that was designed by and with the community of Pangnirtung and respects the traditional knowledge principles of Inuit Qaujimajatuqangit (IQ) as a framework for the proposed intervention. The activities suggested are:

1Document traditional knowledge of country food and its spiritual and health-giving attributes and use this knowledge to promote country food use and healthy market food choices in the community.

2Engage in radio drama and story-telling in Inuktitut to provide entertainment and information regarding the health-giving attributes of country food and healthy market food choices.

3Coordinate local radio programmes with grocery store initiatives to increase healthy food choices.

The Pangnirtung Health Screening and Promotion Committee requires that the interventions be fun, and involve the community radio, schools and grocery stores. The activities should be cost effective and be able to be implemented across all Inuit regions. Radio programmes will be taped and those that are successful (as evidenced by grocery store sales data) could be utilized in other communities. Radio is a common means of communication in northern communities and may prove to be an effective public health intervention tool for marketing social change/behaviour. For youth, a youth-led initiative is likely be the best approach.

Summary and future policy considerations

The current data provide evidence of nutrition transition and they provide an early warning for the emergence of cardiovascular disease and Type 2 DM in this Inuit community. These data add to the accumulating evidence suggesting that Inuit are losing the protection that spared them from the epidemic in Type 2 DM that emerged among Canadian First Nations and American Indians decades ago (Brassard et al., 1993). The findings are relevant in that interventions at the early stages of insulin resistance are more likely to be successful than after the development of Type 2 DM (McAuley et al., 2001).

While traditional food features prominently in the modern-day Inuit diet, the total diet is a mixed diet high in market food carbohydrates, particularly refined carbohydrates. Also, consumption of traditional food items is being replaced by market food sources of trans-fat as evidenced by the striking inverse relationship of these fatty acids in plasma. Programmes and policies are needed to improve food security, encourage healthy market food choices and to promote locally available traditional food in an effort to mitigate the nutrition and epidemiologic transition.

Similarly, the work done in Pangnirtung stimulated interest in a Canadian-wide Inuit Health Survey with International Polar Year funding and in international collaborations to conduct an International Inuit Cohort study to inform policy to help prevent the nutrition and epidemiologic transition. Finally, global policies to prevent further environmental degradation, food chain contamination, and global warming are needed to promote long-term ecosystem and human health •

Acknowledgements

The work described here was initially supported by grants from Inuit Tapiriit Kanatami and the Max Bell Foundation, which in turn led to fully funded research grants from the Canadian Institutes of Health Research and the Social Sciences & Humanities Research Council. We appreciate the warm support of the community, the Government of Nunavut and the Nunavut Research Institute toward ensuring the success of this project. Also, the authors wish to acknowledge the laboratory expertise of Ms Donna Leggee who conducted the fatty acid analyses reported herein, and Dr Nelofar Sheikh for her editorial assistance. Finally, the authors thank Markus Wilcke of Arctic College, Iqaluit, Nunavut Territory, who has been an inspiration and partner in the community work conducted in Pangnirtung.

> Comments to: grace.egeland@mcgill.ca

>> Photographic section p. III

Chapter 2

The Nuxalk Food and Nutrition Program, coastal British Columbia, Canada: 1981 – 2006

• NANCY J. TURNER, PH. D.[1] • THELMA HARVEY[2] • SANDY BURGESS[2] • HARRIET V. KUHNLEIN, PH. D.[3]

1

School of Environmental Studies, University of Victoria, Victoria, B.C., Canada

2

Nuxalk Nation, Bella Coola, B.C., Canada

3

Centre for Indigenous Peoples’ Nutrition and Environment (CINE) and School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada

Photographic section >> VI

“The old foods are the new foods!”

Dr Margaret Siwallace, Nuxalk Elder

Abstract

The Nuxalk have occupied their home territory along the rugged British Columbia coast for an unknown amount of time – certainly thousands of years. For many generations, the people relied on a diversity of fish, game, berries, roots and other nutritious food. However, within the past 50 years or so, their traditional food resources have been eroded, salmon runs and other aquatic resources have been depleted, and lifestyle changes have decreased the time available for hunting, fishing and berry picking. As with many other indigenous communities, the Nuxalk experienced a dramatic dietary shift towards consumption of less nutritious, processed and packaged foods higher in calories and unhealthy fats. Younger people have been most susceptible to this dietary change.

The Nuxalk Food and Nutrition Program, originating in 1980, was a collaborative effort to document past and contemporary Nuxalk diet, assess nutritional values of traditional food, determine overall health status, and promote healthy traditional food. With Elders’ advice and knowledge, a multifaceted programme began with emphasis on documenting the food system: nutrient analysis of fish, berries and other foods, and dietary and health assessments. This led to education programmes aimed at raising awareness and knowledge of harvesting and preparing traditional food, as well as workshops and community meetings to promote healthy lifestyles and diet. The publication of a Nuxalk Food and Nutrition Handbook and a companion recipe book, Kanusyam a Snknic, were very popular. Many publications have been produced documenting various aspects of the overall programme. Over twenty years on, the positive effects of the Nuxalk Food and Nutrition Program are still evident, and it stands as an example for other initiatives to promote traditional food systems in indigenous communities. This chapter describes the Nuxalk food system and nutritional status, the ecological setting, and the background for establishing an intervention initiative by Nuxalk leaders in partnership with their academic colleagues.

Introduction

The Nuxalk (‘Noo-halk’) Indigenous People have occupied their traditional territory for thousands of years, living from the bounty of the land, river and ocean. Bella Coola, the home community of the Nuxalk, is situated at the mouth of the Bella Coola River within a steep-sided scenic valley on the central coast of British Columbia. Over centuries, they developed an immense base of knowledge and skills to enable them to harvest and process their food efficiently, effectively and sustainably generation after generation. However, as with many indigenous communities, the traditional food system of the Nuxalk has been eroded – especially over the past 50 or 60 years – and their diet has become less healthy. It is within this context of concern for dietary change and its effects on health that the Nuxalk Food and Nutrition Program was established.

In the early 1980s, a study of Nuxalk food and nutrition was initiated in collaboration with local and regional Nuxalk leaders. A constellation of related health and nutrition studies was initiated, involving the community health centre, Band Council, as well as Elders and Nuxalk youth. This was a pioneering venture – the first of its kind in Canada at this level of engagement between academic researchers and an entire indigenous community. The goals of the programme were to promote health through traditional food use, using traditional food as a venue and pathway for understanding and promoting good health.

Research as community-based and participatory

The Nuxalk Food and Nutrition Program began officially in January 1983, but it was preceded by background research on food system documentation and planning. Prior to the initial study in 1980 the Union of British Columbia Indian Chiefs identified the Nuxalk Nation as being interested in participating in research on indigenous food use and community health. Agreement was reached between the research leader and the Band Council outlining how initial studies would proceed, budgeting and planning of activities. Initial studies focused on ooligan (Thaleichthys pacificus), a traditionally important small fish used in many cultural ways. In 1983, the research group obtained a major grant to begin health promotion activities, with an ethics review by the University of British Columbia. The Nuxalk community health nurse and community health representative worked in close collaboration with the researchers with guidance by Elders and Band Council members. Individuals who were interviewed were informed about the project and its goals and how the information they provided would be used. Throughout the entire programme, Nuxalk community researchers and health promotion staff were hired to undertake the interviewing and health promotion activities, including various activities in the schools and the health centre.

Throughout the research protocols, the confidentiality and anonymity of respondents were maintained. All papers and publications derived from the project were shared and reviewed by the Nuxalk Nation. A primary outcome was the production of two books for community households: one a reference guide to Nuxalk traditional food and its processing and production, and the second a popular recipe book for preparing healthy meals (Nuxalk Food and Nutrition Program Staff 1984, 1985). These books were well received and were found to be in use in schools and community centres as resource materials more than 20 years later.

The people of the Nuxalk Nation in historical and ecological setting

The Nuxalk language is classed in the Salish language family. However, the Nuxalk are geographically and linguistically isolated from other Salishan peoples, and their language forms a separate division, indicating a relatively long period of separation from other Salishan-speaking peoples. The Nuxalk territory is bordered by Wakashan-speaking peoples (Haisla and Hanaksiala, Heiltsuk, and Kwakwaka’wakw) on the north, west and south sides respectively, and by the Ulkatcho Dakelh (Carrier) Athapaskan-speaking people to the east. Culturally, the Nuxalk are closely aligned with their western neighbours, the Heiltsuk, and this similarity is reflected in their rich and complex ceremonial traditions, including elaborate winter dances, feasts and potlatches. Nuxalk trade with the Heiltsuk and other coastal groups provided food from the outer coast, such as dried seaweed, edible mussels and clams. In exchange, the Nuxalk facilitated trade from inland groups, the Ulkatcho and Tsilhqut’in (Chilcotin), providing outer-coast peoples with some interior resources. Although the Nuxalk traded and intermarried with their various neighbours, they also are known to have historically engaged in war with them on occasion (Kennedy and Bouchard, 1990).

At the time of the first contact with Europeans in the late-eighteenth century, the Nuxalk Nation peoples occupied a number – as many as 30 – of permanent villages situated along the major waterways of the Bella Coola Valley, North and South Bentinck Arms, Dean Channel and Kwatna Inlet. These last two regions were shared with the Heiltsuk (or Bella Bella) people – for a map of the original settlements in the Nuxalk territory, see Kennedy and Bouchard (1990). From this time, and especially as they endured waves of disease epidemics during the trade and colonial periods, the Nuxalk began to abandon their villages, and by the early 1900s almost all had moved to a village called 7alhqlaxlh, at the mouth of the Bella Coola River, on the north shore. A major flood in 1936 forced relocation to the south side of the river, to the present village of Bella Coola. A newer subdivision about 8 km east and up the valley was developed in the 1980s and many Nuxalk reside there today (see Figure 2.1).

The Nuxalk traditional territory covers a diverse landscape and geographic region, ranging from deep ocean inlets, valley bottoms and rugged mountainous terrain, with many rivers and fast moving streams, ponds, marshes, rocky slopes and dense forested areas. These lands and waters provide a range of habitats for a wealth of traditional foods. The ocean inlets are very significant for food resources – various sea mammals (seal, sea lion, etc.), and many types of fish and shellfish have always been available. The rivers provide spawning and rearing habitat for all five common species of Pacific salmon, as well as steelhead. In past years, the rivers, especially the Bella Coola, served as a major spawning destination for ooligan (also eulachon), a type of smelt that spawns in the lower reaches of coastal rivers. The ooligan was second only to salmon in importance to the Nuxalk (Kennedy and Bouchard, 1990), and the grease rendered from ooligan has been a key food and condiment (Kuhnlein et al., 1996).

The estuarine tidal marshes are host to a number of different root vegetables that people traditionally harvested, as well as areas of prime hunting for ducks, geese, deer and bear. Various food resources are found in the low valley bottoms – huckleberries, blueberries, red elderberries, salmonberry, thimbleberry, cow parsnip and fireweed (for green shoots), wood fern (rootstocks), and black cottonwood (inner bark) – as well as a wide range of different medicinal and material plant resources. Most notably, western red cedar provided wood for canoes, houses and food storage and cooking boxes, and inner bark for mats, clothing and baskets. More types of berries and other food plants grow on the lower slopes of the mountains, as well as material and medicine plants, and game animals like mule deer and black-tailed deer. At the head of the valley are soapberries, black mountain huckleberries and other types of berries that are not available lower in the valley. On the upper slopes, mountain goat continue to be hunted for meat and fat, as well as for their skins. Lepofsky, Turner and Kuhnlein (1985) describe the main resource harvesting zones of the Nuxalk, while Pojar and Mackinnon (1994) provide a good general reference on coastal vegetation, including that of the Nuxalk territory.

To access food and other resources, the Nuxalk historically employed different types of dugout canoes, including a long, narrow river canoe and four types of sea-going canoes. Sometimes they used sails for these canoes, and paddles were often made from red alder. Snowshoes of two main designs were used for winter hunting. A variety of containers, especially cedarwood bent boxes and cedarbark baskets, were used to transport and store the foods they relied on. In recent times these have given way to burlap sacks, metal pots, and glass jars, and more recently plastic buckets, plastic bags and useable salvage.

Demographic characteristics

Population estimates vary for the Nuxalk, with pre-contact numbers around 2 000 or possibly more (McIlwraith, 1948). Diseases, such as smallpox, took a heavy toll on all First Nations communities in the region, and Boyd (1990) noted that the smallpox epidemic of 1836–1837 caused a 46 percent loss for the Nuxalk, with their population falling from 1 940 to 1 056 in a single year. The population has increased, however, and in 2000, there were approximately 1 200 Nuxalk Band members, of whom around 980 lived in the Bella Coola Valley. During the research period in the 1980s, there were 675 residents in 125 households on the Bella Coola Reserve, with another 200 members living in the valley or in urban areas of the province.

During the study period, census data revealed that about half of the adult population attained a Grade 9 education, and unemployment was at about 20 percent, with an average family income at about half that of the provincial average, typical of First Nation communities at the time. An average of 5.3 persons occupied homes, many of which had only two rooms. Two food stores operated in the community that provided an array of market food, but with limited fresh food availability (dependent on season and time of the week). There was a once-weekly delivery of food supplied to the Coop food store overland on an unpaved road from Williams Lake (500 km distant), and minor supplies of fresh beef, chicken, milk and eggs and some produce from valley farmers (Kuhnlein, 1984).

A community health centre has been maintained on the reserve, including services for Elders, pregnant women, infants and toddlers and diabetics. A hospital in the Bella Coola community has a staff of three physicians, several nurses and a diagnostic laboratory.

Nuxalk culture

The household is the prime unit of the Nuxalk social structure. Traditionally, high-ranking individuals maintained their position and status through generosity to their family members; the more they were able to provide for their family, the larger the extended family group they attracted to their household. A high position carried with it the responsibility of sharing and distributing resources. The social organization of the Nuxalk is based to some extent on the region of origin of one’s lineage. People strongly identified with their ancestral villages, which were founded by one or more mythical ancestors, as described by McIlwraith (1948). Each lineage claimed its own private origin stories, considered private property, which were validated and perpetuated by ceremonial enactments during the winter dance season. These traditions are still maintained to some degree, although the amalgamation of the villages along with subsequent lifestyle changes have resulted in an erosion of cultural traditions, particularly by the 1970s. However, some of these are being renewed and revived today.

General ethnographic references for the Nuxalk (formerly known as Bella Coola) include Boas (1898), McIlwraith (1948), and Kennedy and Bouchard (1990). Smith (1928) and Edwards (1980) provide information specifically on Nuxalk medicines, and Turner (1973, 1995) describes Nuxalk ethnobotany. A detailed article by Edwards (1979) describes a traditionally important root vegetable, springbank clover, now little used anywhere on the coast (Turner and Kuhnlein, 1982).

General description of the Nuxalk food system and health

The dietary intake of the Nuxalk follows the general trend for Indigenous Peoples of Canada. The approach of Canadian Indigenous Peoples towards their traditional food is as relevant for the Nuxalk as for others:

The traditional diet consisted mainly of meat or fish supplemented by berries, wild greens, roots, bulbs, nuts and seeds. As long as supplies were plentiful, people were able to maintain a healthy diet. The native people learned, through experience, to select those foods in proper amounts to supply the body with the nutrients it needs. Respect for the land, and the food it provided, led to the wise use of animals, fish and plants. Very little was wasted. Food was considered sacred.

(Health and Welfare Canada, 1985, p. 7)

As noted previously, the Nuxalk traditional food system is a healthy one. When local foods were the only dietary source for sustenance and survival, the food system required physical work and a great deal of skill and knowledge applied at all stages of food production, from harvesting to processing, storage and serving. Traditionally, Nuxalk families moved from location to location throughout their traditional territory over the course of the seasons to harvest and process different food as it became available. The harvested food was carefully preserved – usually by dehydration, but also by smoking, and in some cases fermenting or storing fresh in cache pits and containers. This lifestyle kept people active and fit, as they often travelled long distances by foot or canoe, working outdoors, particularly during the growing season. Winters were more sedentary, but people remained active with household activities, special ceremonies and social activities.

During the period of this study, the generally recognized health problems with nutritional implications were alcoholism, poor dental health, obesity, diabetes and those associated with high-risk infants. Before the initiation of this study, there were no reports of dietary intake or adequacy for the Nuxalk.

As well as the ethnographic and ethnobotanical references mentioned previously, a number of publications relating to Nuxalk foods and nutrition resulting, in whole or in part, from the Nuxalk food and Nutrition Program, provide information on specific Nuxalk foods, and are cited in the references: Kuhnlein (1989b, 1990); Kuhnlein, Turner and Kluckner (1982); Kuhnlein and Turner (1986); Turner and Kuhnlein (1982, 1983); Turner et al. (1992). A description of traditional and contemporary Nuxalk foods was reported in Kuhnlein (1984). The two community books (Nuxalk Food and Nutrition Program Staff 1984, 1985) also provide important information on Nuxalk food. Lepofsky, Turner and Kuhnlein (1985) provide specific habitat information for 42 plant species, including harvesting efficiency tests for 14 of the 20 most readily available species. Two more general publications that incorporate Nuxalk food are Kuhnlein and Turner’s Traditional Plant Foods of Canadian Indigenous Peoples (1991) and Turner’s Food Plants of Coastal First Peoples (1995). Other articles by Kuhnlein (1984, 1989a, 1992) and Kuhnlein and colleagues (Barr and Kuhnlein, 1985; Kuhnlein and Moody, 1989; Kuhnlein and Burgess, 1997) discuss how the Nuxalk diet has changed over time.

Methodology

The Nuxalk Nation Council approved and encouraged the Nuxalk Food and Nutrition Program from its inception. The protocols for interviewing, recording, photography and health assessments followed the dual approval requirements of the University of British Columbia’s ethics regulations and those established for the work by the Nuxalk Nation in consultation with the researchers. The programme serves, even 25 years later, as a model for community-based collaborative research, one on which much of the subsequent research from CINE, and its Indigenous Peoples’ Food Systems for Health Program, is based.

A number of methods for collecting and analysing data were applied for different aspects of the research:

1.Community Interviews on Food Use, Dietary Intake and Change: Elders’ meetings (1980–1982), family interviews (1981, 1985) and grandmother-mother-daughter interviews (1982 to 1983).

2.Food Availability Assessment (1982).

3.Traditional Food Nutritional Quality Assessments (1980–1986).

4.Health Status Assessments (1983, 1986).

5.Health Promotion Activities (1983–1986): Use of traditional Nuxalk foods, use of available marketed foods of good quality, enhancing healthful lifestyle habits and educational programmes.

6.Revisiting the Nuxalk Food and Nutrition Program (2006).

Community interviews on food use, dietary intake and change

The initial requirements of the programme were to establish foods the Nuxalk used in the past, those which current residents still have a working knowledge, and how people’s diets have changed over the years. Information from existing literature (McIlwraith, 1948; Turner, 1973) needed elaboration and confirmation through interviews with contemporary Nuxalk community members. From 1980 to 1982, in a series of meetings organized by the research team, Elders were consulted about what traditional foods they had eaten, which foods were considered to be important, which were still being used, and how these foods were traditionally harvested, processed and prepared. The format enabled discussions and comparisons among Elders, as well as helped to directly inform younger community members about Nuxalk food traditions. Meetings were informal and social occasions, and were usually accompanied by serving traditional food.

In 1981, two community residents interviewed Nuxalk households, both on their reserve and in urban centres, about overall dietary intake and food use. Family members (mainly women) who actually did the food shopping and cooking were asked about their use of traditional foods in general, as well as what foods, store-bought and traditional, were eaten on the day of the interview. Analyses of the diet reports were compared to Canadian Recommended Nutrient Intakes at the time (Kuhnlein, 1984). Frequency and quantity of traditional foods were also asked about during the 1981 survey, and repeated in 1985 (Kuhnlein and Moody, 1989).

In 1982–1983, an interview study intended to track and document dietary change and food-use frequency was conducted with grandmothers, mothers and daughters of the same families living on the Nuxalk reserve. In 1983 and 1985, interviews on dietary intake were undertaken as part of the health assessment process.

Food-availability assessments

In 1982, an ecological study with Nuxalk student assistants evaluated the availability of traditional Nuxalk plant foods within the traditional territory as well as people’s accessibility to berries and other traditional food resources, including fish and game. Forty-two plant species were included in the study, and standard ecological survey techniques were applied in measuring their abundance, frequency and cover. Twelve cover-types based on the type of vegetation predominating were identified and, within each, randomly placed quadrats were used to facilitate estimates of cover for various species (Lepofsky, Turner and Kuhnlein, 1985). In addition, harvesting efficiency data were gathered for several of the plant foods; the time required to harvest 250 ml of food by one person, and the area needed to collect this amount, were recorded, as well as the traditional harvesting sites and seasons for each type of food.

Traditional food nutrient composition

Throughout the programme, nutrient analyses were undertaken on traditional Nuxalk foods to determine key nutrients, which could then be matched with dietary intake information to determine any risks or deficiencies that people might be incurring. Standard practices for sample collection and nutrient analysis were applied (Kuhnlein, 1986). Several Nuxalk salmon and ooligan grease preparations were described and analysed (Kennelly, 1986; Kuhnlein et al., 1982; Kuhnlein et al., 1996). Wild berries and wild greens, as well as some of the root vegetables, were also analysed (Kuhnlein, Turner and Kluckner, 1982; Turner and Kuhnlein, 1983; Kuhnlein and Turner, 1987; Kuhnlein, 1989b).

Health status assessments

In May 1983, the programme ran a health assessment clinic, which was free to all Nuxalk Band members and relatives. In total, 370 people – from infants to Elders – took advantage of the clinic, with sessions of approximately one hour that included several measurements. Interviews were made on diet and physical activity, general fitness level assessed by riding a stationary bicycle and skinfold thickness, blood pressure, and examinations for dental health, hearing and vision. Height and weight measurements were found, using a stadiometer and beam balance, and body mass index (BMI) was calculated as kg/m^2.

Approximately 30 ml of non-fasting venous blood from 199 Nuxalk participants (teens ≥13 years and adults) was portioned, frozen, shipped to the laboratory and frozen at -70º C until analysis, which was within three months of collection. Successful analysis of all measures was completed for 187 samples. Serum ferritin was determined using an ELISA assay (New England Immunology Associates, Cambridge MA). Hemoglobin and hematocrit were measured in the Nuxalk clinic prior to shipment using the cyanomethaemoblobin and electronic reading and centrifugation in capillary tubes. Red cell folate (RBC folate) was determined by microbiological assay using L. casei, with ascorbate as preservative. Plasma retinol and carotene were determined by a micromethod, and carotene was determined to reflect dietary sources of provitamin A and antioxidant protection. Serum cholesterol and HDL cholesterol were determined with enzymatic procedures (Barr and Kuhnlein, 1985). The Statistical Package for the Social Sciences (SPSS) was used for Pearson correlation analysis and partial correlations of BMI and HDL cholesterol (Kuhnlein and Burgess, 1997; Barr and Kuhnlein, 1985).

In 1986, follow-up assessments of many of these measures took place to determine impact of the health promotion activities. This report emphasizes anthropometry and blood results from the pre-intervention assessments; a following publication will report the health promotion intervention activities led by Nuxalk health staff, Elders and Council, and evaluation of the programme.

Revisiting the Nuxalk Food and Nutrition Program

In July 2006, the community and several original programme participants were revisited, with discussion including many of the original Nuxalk participants. The objective of discussions with Elders and leaders was to obtain information on the use of key traditional foods 20 years following the programme, and to document elements of the project on film.

Results and discussion

Community interviews on food use, dietary intake and change

The Elders’ meetings and household interviews yielded important baseline information on which the main programme was based. They provided an extensive list of traditional foods being used, many which were noted in the literature reviewed earlier, and which became the focus of the research. These foods included all types of salmon and salmon roe, steelhead, trout, cod, herring, ooligans, sea urchins, crab, clams, seal, abalone, sea cucumbers and mussels. Game animals included moose, duck, grouse, mountain goat, deer and rabbit. Tree foods used were cottonwood inner-bark, hemlock inner-bark and crabapples. Many kinds of berries were used, plus rose hips, silverweed roots, clover roots, cow-parsnip, seaweed, young stinging nettles, and the shoots of fireweed, thimbleberry and salmonberry. Labrador tea and salmonberry bark tea were also used (Nuxalk Food and Nutrition Program Staff, 1985).

Table 2.1 lists 67 species of foods known and used traditionally by the Nuxalk. It is derived from earlier ethnographies and from key informant interviews conducted with Elders during 1980–1984. It presents the scientific names, common names, local names in linguistic terminology, season of use, food preparation and an appreciation score. Seasonality and appreciation scores are from Kuhnlein (1992).

Interviews determined that all household members of the Nuxalk community took most of their dietary energy from store-bought food, and that, except for fish, very little traditional food was being consumed (cf. Kuhnlein, 1984). The Nuxalk families on the reserve were much more likely to use traditional food than those off the reserve. All on-reserve families interviewed used fish, and their use was five times more than that of the city families; on-reserve families (average household size of 5.3 individuals) consumed an average of 428 pounds of salmon and an additional 150 pounds of other fish and shellfish during the 1981 survey year. Of other traditional food, 65 percent of on-reserve families and 57 percent of off-reserve families used berries, 46 percent of on-reserve families and 21 percent of off-reserve families used game foods, and 35 percent of on-reserve and 29 percent of off-reserve families used other traditional foods (Nuxalk Food and Nutrition Program Staff, 1985). Only 51 percent of the on-reserve adults interviewed and 31 percent of the off-reserve adults had eaten fruit or juice on the day of the interview and, other than potatoes, only 39 percent of on-reserve adults and 56 percent of city adults had eaten vegetables.

In general, reserve families were consuming limited amounts of iron, vitamin A and folic acid, as well as low calcium, vitamin E, vitamin D, vitamin C and fibre (Kuhnlein, 1984; Kuhnlein and Moody, 1989). In contrast, intakes of phosphorus and sodium were high and exceeded recommended balance with calcium and potassium. Women in their childbearing years and pregnant women were seen to be particularly at risk. The identified foods that could provide these nutrients included fruits and vegetables (vitamin C, A, E and folic acid) and ooligan grease (vitamins A and E). Preserved salmon and other fish with bone and skin were recommended foods containing calcium, while meat, fish and shellfish were obvious sources of iron. At the time of the interviews, diabetes was emerging in this population, but this research study had not yet identified it as a major health problem. Locally available and cost-efficient foods could supply all of the nutrients that were seen as sufficient, and could provide people with a complete and healthy diet (Nuxalk Food and Nutrition Program Staff, 1985).

Fifty-four foods were discussed in the grandmother, mother and daughter interviews, including game, fish, shellfish, teas, berries, roots and greens. Of these, 34 species (mostly fish and seafood, berries and some game) were still being used by women of all three generations, but there was a general decline over time in frequency of use, as well as in the total numbers of foods being used. Of all the foods, several fish species accessed from the Bella Coola River were maintained as those most frequently harvested and used, and most highly appreciated for taste appeal. Decline in use of traditional food took place in the early twentieth century, as indicated by the frequency of use of each traditional food across the three generations of women. The research also showed that taste appreciation was linked to declining traditional food use, in that when a particular food was not consumed frequently women did not have as high an appreciation of its taste. It also showed not surprisingly that loss of easy access (proximity and time for harvest) to traditional food was a factor in its declining use. Factors influencing this change were noted as legislation restricting use of traditional food increasing pressure on local resources by increasing population, availability of new foods – and acceptability of these – by gardening and food markets; employment and concerns for time, money and personal energy for harvesting and preparation activities; and interruption of knowledge transfer to younger generations about food harvest and use (Kuhnlein, 1989a, 1992).

These interviews showed that there was a marked change in the foods used by Nuxalk women and families over the three generations. The grandmother generation remembered using a number of foods but, as of 1983, many of them were rarely or no longer being eaten by their daughters and granddaughters. These included: gray currants and trailing currants, red elderberries, highbush cranberries, salal berries, wild gooseberries, bunchberries, wild crabapples, cottonwood inner bark, hemlock inner bark, clover roots, silverweed roots, salmonberry shoots, herring sea urchin, abalone, mussels, seal, mountain goat and rabbit. Grandmothers remembered liking all foods that they had eaten in former times. Foods still being used by the younger generations included all the salmon, steelhead, trout, herring, ooligans, cod species, salmon eggs, crab, clams, some of the berries (e.g. blackcaps, wild raspberries, salmonberries, soapberries), thimbleberry shoots, seaweed, Labrador tea, cow-parsnip, deer, moose, duck and grouse.

Nuxalk foods were harvested throughout the year, and each month produced important components of the diet, although most of the plant foods in particular were harvested in the spring, summer or autumn. Many of the fish and shellfish, including steelhead, trout, ling cod, flounder, mussels, sea urchin and crabs, were available during the winter months, and some of these could be harvested year-round. The herring spawning and ooligan spawning season marked the times when herring roe and ooligans could be obtained, and this was generally in early spring, around February and March. The greens – nettles, cow parsnip, fireweed and thimbleberry and salmonberry shoots – are tender and good to eat only for a few weeks in the spring, and seaweed, obtained from the Heiltsuk on the outer coast, was harvested usually in the month of May. From May onwards, the berries ripen in succession: salmonberries, wild strawberries, red elderberries, huckleberries and blueberries, currants and gooseberries, thimbleberries, raspberries and blackcaps, and finally, in late summer and autumn, wild crabapples and highbush cranberries. The salmon species each have their spawning season. In July, for example, people netted the last runs of spring salmon, as well as pink (hump) salmon, sockeye salmon and dog salmon. Dog salmon and coho salmon predominate in the autumn. Root vegetables were generally harvested in the autumn, after the leaves started to die back but while they were still visible; they could also be harvested through the winter until they start to sprout in spring. In earlier days, entire families would travel to harvesting locations within their territories to take advantage of the different resources as they became ready. Often the men hunted and fished, while the women picked berries and other plant foods, and processed the food for winter.

The traditional ways of preserving food included: dehydrating (in the sun or over a fire) for berries, salmon, halibut and some other food; smoking (for some of the salmon and salmon eggs, clams and some meat); storing in cedarwood boxes under water or in ooligan grease (e.g. crabapples and highbush cranberries); and fermenting (used for some salmon roe). Cedarwood frames were used to support a surface layer of skunk cabbage leaves or other large leaves, and the berries were mashed, cooked to a jam-like consistency and dried in large cakes, first on one side and then turned over and dried on the other. Dried berry cakes could be rolled up and stored in openwork baskets or in cedarwood boxes in a dry place, and, to use, were simply reconstituted in water overnight. After sugar was introduced in the late-ninetenth century, many people learned to prepare jam and jelly from wild berries. Canning and jarring technologies allowed people to store many types of food more conveniently. Many people started partially smoking their fish and then jarring it. Finally, during the 1950s home freezers were introduced and first used, often with vacuum packing, to retain the maximum freshness for fish and seafood, as well for berries and other foods. Some people de-bone their salmon and make it into patties, then jar it with their own homemade salsa; others marinate salmon with demerara sugar and salt before barbecuing or adding other flavourings. Of all the types of traditional food, as of 2006, salmon was still the most popular in Nuxalk households.

Shortages and lack of accessibility to some traditional Nuxalk foods meant that fewer were being used regularly, but most were still remembered in the community and there was interest in them among the current generations of youth and young adults. The inner bark of trees and root vegetables were traditional plant foods scarcely used.

Food availability assessments

The results of the 1983–1984 ecological study on food availability and accessibility showed that all of the salmon species, steelhead and ooligan were still available and could be harvested in the Bella Coola River. Other fish (e.g. cod, flounder and halibut) and shellfish were available on a more limited scale, mostly brought home by Nuxalk fishers from the outer coast. Herring eggs and seaweed, brought in from Bella Bella on the outer coast area, were sometimes in limited supply. Game, including deer and moose, were still used, but mountain goat and duck were little used, and game in general were seen to have become scarcer than in previous times. Plant foods still readily available included some fruits (Pacific crabapple, Saskatoon berries, wild gooseberries, rose hips, wild raspberries, thimbleberries, salmonberries, red elderberries, oval-leaved blueberries, highbush cranberries, bunchberries); inner bark (black cottonwood, western hemlock); greens (fireweed, cow-parsnip); root vegetables (springbank clover, Pacific silverweed); and Labrador tea (Nuxalk Food and Nutrition Program Staff, 1984; Kuhnlein, 1989a, 1989b; Kuhnlein et al., 1982; Lepofsky, 1985; Lepofsky, Turner and Kuhnlein, 1985).

At least 18 plant foods of a total of 42 were identified that were readily available to the Nuxalk within the Bella Coola area. These included several types of berries, greens, and root vegetables, as well as the trees from which the inner bark can be harvested. It was noted that the berries were harder to find because many of the places where people used to pick them (blueberries, huckleberries, gray currants and others) have grown over and, although the bushes still grew there, the berries tended to be small and unproductive. The fish and shellfish available in the 1980s included all the salmon, steelhead, ooligans, as well as the shellfish, cod, flounder, and halibut. Of game foods, deer and moose were the most commonly used, with mountain goat and duck hunted rarely, and seal was infrequently used (Lepofsky, Turner and Kuhnlein, 1985).

Traditional food nutrient composition

Analysis of ooligan grease (Kuhnlein, Turner and Kluckner, 1982; Kuhnlein et al., 1996) showed that this culturally valued product contained more vitamin A and vitamin E than other fats commonly used for cooking on the reserve. It was also noted that it contained a good balance of fats, with about 65 percent monounsaturated fat, 33 percent saturated fat, and the rest polyunsaturated fat, as well as meaningful amounts of protein, calcium, and vitamin K. Ooligan grease was also documented to contain several organochlorine contaminants (Chan et al., 1996). Of the berries, thimbleberries and salal berries had higher vitamin C and calcium than store-bought strawberries and blueberries. Salmonberries and soapberries were good sources of calcium, with salmonberries being found to be a source of carotene (Nuxalk Food and Nutrition Program Staff, 1984; see also Kuhnlein, 1989b, 1990). Most analyses included levels of protein, fat, total calories, and dietary fibre, as well as selected minerals and vitamins. Nutrients from traditional plant foods are summarized in the appendices in Kuhnlein and Turner (1991). Table 2.2 shows selected nutrient composition data for Nuxalk food.

The nutrient analyses from the programme confirmed that the traditional Nuxalk foods provided the full complement of nutrients required for good health. Table 2.3 summarizes key nutrients, including micronutrients, and traditional foods and food groups known to provide them.

Health status assessments

The 1983 assessment results showed several health measures influenced by nutrition. Table 2.4 demonstrates that women aged 20 to 60, in particular, and some younger men, were iron deficient. In addition, many adults, both male and female, were low in blood folic acid and vitamin A as both retinol and ß-carotene. Of 187 persons evaluated, those at risk for deficiency of retinol, iron (ferritin) and folic acid were 27 percent, 18 percent, and 26 percent, respectively. Deficiencies in these essential nutrients put people at risk of poor vision, unhealthy pregnancy, various infections and poor dental health. As a result of the health assessments, several individuals were referred for dental care, hearing aids and glasses.

As shown in Table 2.5, all age and gender categories demonstrated obesity expressed as a proportion of the population exceeding the Nutrition Canada Survey 95th percentile of weight for height (boys and girls) or high body mass index (BMI) (Demirjian, 1980). Adults and teens tended to have poor diets and to develop overweight or obesity, although teens were the most active and fit. Regular physical activity, combined with better diets and less dietary energy, was recognized as the best remedy (Kuhnlein and Moody, 1989; Barr and Kuhnlein, 1985; Nuxalk Food and Nutrition Program Staff, 1984).

As expected, cholesterol levels were positively correlated with age and BMI, and total cholesterol was higher than Caucasian values reported in the Nutrition Canada National Survey of 1975. HDL cholesterol was negatively correlated with BMI, and was not different by gender.

Health promotion activities

Following the 1983 health assessments, efforts were made within the programme to improve traditional food use and use of quality market foods. Attention was given to improving physical activity for the entire community and focusing on improving nutrient intakes of iron, folate and vitamin A i terms of general dietary improvements. Two community assistants worked under the guidance of the community health nurse and community health representative to conduct a broad range of programme activities (Kuhnlein and Moody, 1989).

In summary, intervention activities included promotion of traditional Nuxalk foods through food-gathering outings and expeditions, and through luncheons and feasts featuring healthy traditional foods. Often, younger researchers and participants gathered and prepared the food under the advice and direction of Elders, with the Elders hosted by the youth when the food was served. The project participants made ooligan grease each year in 1983, 1984 and 1985, and also cut, smoked and barbecued salmon. Other activities included: classes promoting traditional foods, good nutrition and healthful lifestyle habits for school children and adults; fitness classes from Bogie’s Fitness (a Vancouver consultant) – including sessions at the school for those who were overweight as well as the general public; designing and installing a demonstration traditional food garden in the yard of the health centre; displays, posters, flyers and pamphlets on good nutrition; publication of the two books by the Nuxalk Food and Nutrition Program Staff (1984, 1985); nutrition classes for pregnant women and mothers; dental health classes; workshops for diabetics; and classes for children and adults on healthy lifestyles and disease prevention. These activities of the intervention programme will be discussed in more detail in a future publication.

Revisiting the Nuxalk Food and Nutrition Program

Discussion with Nuxalk leaders in 2006 reaffirmed continued use of programme materials, particularly the community handbooks used in local schools and the recipe books used by families. Use of fish from the Bella Coola River was still the most important traditional food activity, employing traditional preservation and processing methods of drying and smoking with alder wood.

Council members and former leaders of the programme expressed concern with increasing diabetes and related health problems, as well as continuing interest in preserving their traditional food practices for the nutritional and cultural benefits provided. A recent update of incidence of chronic disease among residents in the Bella Coola Valley was made using a mail-in survey by Thommasen and Zhang (2006). They confirmed that chronic disease, including obesity and diabetes, were serious problems for valley residents, with diabetes mellitus documented at 7 percent. However, this survey of valley residents included less than 50 percent aboriginal people, most of whom were Nuxalk.

Major environmental deterioration resulted in the decline and disappearance of several important Nuxalk cultural food resources. For example, ooligan from the Bella Coola River declined to the extent that during the 2002–2006 period it was not possible to net enough fish to make ooligan grease. Further, Nuxalk residents reported some salmon, particularly the favored sockeye, becoming rare in the Bella Coola River. Abalone harvesting has been banned after it declined drastically following the opening of a commercial harvest. Commercial harvesting of herring and herring roe was believed to greatly reduce the availability of herring. Finally, the tidal flats were reported to have become so polluted from village sewage that residents were advised not to harvest traditional root foods from the area.

Conclusion

This documentation of the Nuxalk traditional food system included extensive data collection and measurement, giving important information on food use, food quality and health status of the Nuxalk. The knowledge of unique and diverse species in the Nuxalk food system in the coastal rain forest environment of British Columbia, Canada, is extensive, including many species of fish, plants and wild animal foods. Nutrient-rich foods contained in the Nuxalk food system include ooligan fat, salmon and shellfish, all excellent sources of fat-soluble vitamins and omega-3 fats; and several species of berries, roots and greens. As expected, the amount of traditional food consumed by reserve-residents was much greater than by those living in urban areas, but reserve families each consumed an average of about 570 lbs of fish and shellfish, particularly salmon. This extent of use may have contributed to the high levels of healthy HDL cholesterol among adults in the 1980s. Overweight and obesity among children and adults were present, and there were lower than desirable levels of ß-carotene, retinol, ferritin, hemoglobin and red cell folate in blood, which followed from dietary reports of limited vitamin A, iron and folate.

All data derived from the programme were shared widely in the community, which led to Nuxalk community leaders expressing great enthusiasm for development of an education-based intervention to improve nutrition and health emphasizing traditional food knowledge. This led to funding for activities to promote greater use of local traditional foods and improving quality of locally available market foods and active lifestyles. Discussions held by researchers in the community in 2006, 20 years after completing the intervention, revealed that enthusiasm for traditional Nuxalk foods remained high, and continued to be promoted through the Band Council, the health clinics, and in health classes in the local schools. The intervention, its success, and its evaluation will be presented in a future publication.

Unfortunately, despite these successes, obesity and diabetes – in both Nuxalk and non-Nuxalk – became prominent in the valley in the intervening years, raising concerns about an increase in related chronic diseases. Simultaneously, environmental shifts created declining availability of some key Nuxalk foods, particularly ooligan, salmon and herring, which are excellent nutrient sources. It is hoped that attention to this threat of losing key environmental treasures will lead to more effective environmental protection programmes within the Nuxalk territory and in surrounding areas affecting the food system.

The loss of practice of local food traditions reflects a general, global trend among indigenous and local peoples, with increasingly more of the food that is produced, processed and marketed at a global scale being readily available and purchased in low-income areas. For many indigenous communities in North America this creates diets high in energy density but poor in nutrient quality, leading to obesity and other global lifestyle and health concerns (Kuhnlein et al., 2006; Pelto and Vargus, 1992; Turner and Turner, 2006; Popkin, 2007).

Further research to build on the results of the Nuxalk Food and Nutrition Program could improve understanding of the forces driving negative environmental change that is decreasing availability of key food resources, and how to reverse these trends with local, regional and national policies. Understanding how to improve food choices, particularly among young reserve residents, of both traditional and purchased foods with education and other incentives is greatly needed in low-income First Nations areas.

The Nuxalk food system and active practice and use of it in Bella Coola clearly have many excellent health benefits. Combining these benefits with cultural activities that promote fitness and social events can serve the Nuxalk well. Most importantly, protection of the land and sea environments that produce the Nuxalk traditional food system will add immeasurably to the overall picture of health determinants for the Nuxalk, as it will for all citizens in the coastal region of British Columbia •

Acknowledgements

We would like to recognize all Elders, advisors and participants of the Nuxalk Nation who took part in the several studies within the Nuxalk Food and Nutrition Program. Participating in any research of this scope involves investment of time, energy and trust, and the people of Bella Coola were willing to make this investment and take the risk that this project would make a positive difference in their community. We acknowledge their trust and participation with gratitude. In particular, we acknowledge the Elders who were steadfast anchors for the programme from the outset, and without whom it never could have been undertaken; these include, especially, Dr Margaret Siwallace (Kuhnlein, 1985), Felicity Walkus, Alice Tallio, Elsie Jacobs, Willie and Hazel Hans, Lucy Mack, Katie Nelson, Eliza Saunders, Lillian Siwallace and Andy Siwallace. Key community researchers were Sandy (Moody) Burgess, Rose Hans, Louise Hilland, Emily Schooner and Grace Hans. Sarah Saunders, Aaron Hans, David Hunt, Theresa Barton, Mary Lynne Siwallace, Don Hood and Karen Anderson also contributed in various important ways.

Chiefs Edward Moody, Archie Pootlass, and Lawrence Pootlass and the Band Council members are acknowledged for their support and leadership in the research. We also express our appreciation to Chief Archie Pootlass and the 2006 Council of the Nuxalk Nation for their willingness and interest in film documentation of the Nuxalk traditional food system and health. UBC Graduate students participating in the original project included Dana Lepofsky (Lepofsky, 1985) and Anthea Kennelly (Kennelly, 1986). David Bogoch (of Bogie’s Fitness) provided enthusiasm and exercises for the fitness awareness programme. Professor Dick Ford (University of Michigan) provided encouragement and advice. Later work on analysis of ooligan grease was assisted by Faustinas Yeboah, Maggie Sedgemore, Scotty Sedgemore and Hing Man Chan. More recent participants in the programme included: Rose Hans, Lillian Siwallace, Andy Siwallace, Grace Hans and Louise Hilland, as well as Chief Archie Pootlass, Jason Moody, Megan Moody, Melvina Mack, Greg Hans and Don Hood.

Funding for the initial food research was provided by the Natural Sciences and Engineering Research Council, through a grant to Harriet Kuhnlein. The programme was funded by Health Canada with Margo Palmer supporting and facilitating this work as Health Promotion Contribution Program Officer, and funding for the programme evaluation was provided with a grant from the National Health Research and Development Program. Inclusion of the Nuxalk programme in the global health initiative of the Centre for Indigenous Peoples’ Nutrition and Environment (CINE) was made possible by funding from the Canadian Institutes of Health Research.

> Comments to: harriet.kuhnlein@mcgill.ca

>> Photographic section p. VI

Chapter 3

Gwich’in traditional food for health: Phase 1

• HARRIET V. KUHNLEIN, PH. D.[1] • MARGARET MCDONALD[2] • DINA SPIGELSKI[1] • ELIZABETH VITTREKWA[2] • BILL ERASMUS[3]

1

Centre for Indigenous Peoples’ Nutrition and Environment (CINE) and School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada

2

Tl’oondih Healing Society (THS), Fort McPherson, Northwest Territories, Canada

3

Assembly of First Nations (AFN), Ottawa, Ontario, Canada

Photographic section >> IX

“Caribou blood gives strength and warmth, and it keeps you from getting hungry for a long time.”

Woody Elias, Gwich’in Elder, 2006

Abstract

The objective of the research described in this chapter is to present the food system and nutrition situation of the Tetlit Gwich’in community, and to understand many of the nutritional and cultural circumstances that lead to planning an intervention to promote health through improved food use.

The Tetlit Gwich’in reside in a First Nation community in the northern Northwest Territories of Canada. Several research studies have taken place in partnership with this community and the Centre for Indigenous Peoples’ Nutrition and Environment since the 1990s. As a result, this effort to document the Tetlit Gwich’in food system has been welcomed and considered successful. Within the larger Dene community, the Gwich’in in this region recorded 50 species of traditional animal and plant foods, all of which are wildlife foods, and many parts are edible and enjoyed.

Nevertheless, market foods are available in this Arctic community, and in early 2000 approximately 33 percent of adult energy was derived from traditional Gwich’in food, but children’s diets contained much less traditional food (about 6 percent of energy). Caribou and several species of fish were popular in all seasons.

Children’s diets were found to contain more than 40 percent of daily energy from fat and sweet foods, but the small amounts of traditional meats and fish ensured adequate protein, iron, zinc, copper and vitamin B_6. Calcium, vitamin D, vitamin A, vitamin E, magnesium and fibre were probably inadequate for both adults and children. Results of anthropometry studies revealed that the incidence of overweight and obesity in adults was more than 50 percent.

Traditional Gwich’in food holds many cultural attributes, and community members were aware of the healthy, low-fat properties of their food. Women responding to interviews (n = 69) said they would like to have more traditional food if it was easier to get. At the same time many said they could not afford to buy all the food they needed from the stores. The community is poised to engage in an intervention that will make more traditional food available, and improve purchasing habits of higher quality market food.

Introduction

In this report we aim to provide an understanding of the nutritional diversity of food consumed as both traditional and market items and the impact of food on culture and health among the Tetlit Gwich’in of the Northwest Territories (NWT). The Gwich’in people reside in communities in the NWT, northern Yukon Territory and in northern interior Alaska (Gwich’in Council International, 2007). Political organizations represented in Canada are the Dene Nation, the Métis Nation of the NWT and Yukon First Nations. Data reported here are from Gwich’in communities in the NWT (Tsiigehtchic, Aklavik and Tetlit Zheh – originally spelled Teetl’it Zheh) and from Old Crow in the Yukon. Traditional food-systems data from studies in the region conducted with the Dene and Dene/Métis, which include the Gwich’in, are also included to highlight and support basic concepts.

As part of research activities conducted by the Centre for Indigenous Peoples’ Nutrition and Environment (CINE), studies with Gwich’in were conducted during the mid-1990s on the benefits and risks of use of Arctic indigenous food. The NWT Gwich’in were part of these studies conducted with 16 communities in the Dene/Métis component of this research that also included Yukon First Nations and Inuit. In early-2000, studies on anthropometry and dietary patterns with Dene/Métis children in three Dene communities in the NWT (including Tetlit Zheh) and two in Yukon (including Old Crow) were conducted. In 2005, the community of Tetlit Zheh engaged in a dietary improvement intervention study to demonstrate benefits of using local Gwich’in cultural food; results of which are intended to apply to Gwich’in communities in the NWT region; young women (20–40 years of age) and youth (10–15 years of age) were the indicator population subsets upon which measures were taken. Throughout all of these studies, documentation was made of traditional Gwich’in food species and their use, and this forms the basis of this report.

The Tetlit Zheh Gwich’in

The Tetlit Zheh Gwich’in community in the NWT was established in 1840 by the Hudson’s Bay Company as a trading post to purchase furs from the Gwich’in and Inuvialuit (Inuit). In 1848, the community was moved 6 km down the Peel River to its present location (Figure 3.1) and was named Fort McPherson after the chief trader of the Hudson’s Bay Company, Murdoch McPherson. The traditional name for the community is Tetlit Zheh, after the Gwich’in name for the Peel River (Gwich’in Social and Cultural Institute, 2007). A comprehensive land claims agreement was signed in 1992 with the Governments of Canada and the NWT, with administration for all beneficiaries conducted through the Gwich’in Tribal Council, which is based in Inuvik. In Tetlit Zheh there are two local governments: the Tetlit Gwich’in Council and the Fort McPherson Hamlet Council. The Dempster Highway runs through the community connecting to Inuvik in the north and Dawson in the south.

Geography and environment

The Gwich’in are a nation of Athabascan people who maintained a nomadic hunting, fishing and gathering lifestyle until the mid-1800s, after which communities developed around forts and trading posts established by fur traders. Since the 1960s, residents of Tetlit Zheh are settled year round, but still retain knowledge and access to their food system which comprises 75–100 species of animals, fish and plant food species. The climate of the region is “interior Subarctic” with long, cold winters and short, warm summers. The area is covered with Boreal forest and includes some of the delta of the Mackenzie River (early ethnographic accounts have been summarized by Slobodin [1981]).

The Gwich’in closely identify themselves with the Porcupine caribou (Rangifer tarandus granti), culturally regarded as the most important food species, seen to be a source of traditional food energy. This population of migratory barren ground caribou ranges across the Yukon, the NWT and the state of Alaska. A photocensus in 1989 estimated the population size as 178 000 (Russell and McNeil, 2005); the current population estimate is between 110 000 and 115 000 (Porcupine Caribou Management Board, 2007). The herd is named after the Porcupine River, which they cross each spring and autumn.

The region is rural (without farming) and very beautiful. Current environment issues of concern to the community in 2006 were the protection of the Porcupine caribou calving grounds, climate change (Russell and McNeil, 2005), environmental pollution, and development of natural resources including a proposed natural gas pipeline and drilling in the Arctic National Wildlife Refuge (Porcupine Caribou Management Board, 2005). Divided perspectives exist on the proposed multi-billion dollar industry of the Mackenzie Gas Project that may offer employment, but would involve far-reaching social, economic and environmental change for the region (Nuttall, 2006).

Demography and community situation

In 2005, there were 823 residents in Tetlit Zheh, with most having aboriginal ancestry, either Tetlit Gwich’in or Métis. Both Gwich’in and English are spoken in Tetlit Zheh. More than 70 percent were 15 years or older and 38 percent had completed high school or higher education. Thirty-four percent of adults 15 years or older were employed. The average family income (2004) was $CAD 62 138, with 33.3 percent of households in the community having less than $CAD 25 000 annually. Cost of living and food costs in market stores in Tetlit Zheh were about 50 percent greater than in cities in southern areas of Canada (NWT Bureau of Statistics, 2005). The primary employment in the community was with the public sector (government, education, policing, highway maintenance, recreation, wellness), and there were two general stores, a hotel-restaurant and gas station, and a canvas-tent manufacturing centre and outlet.

Missionaries established a community school in 1900, which became part of the federal school system in 1946. During much of the twentieth century, education was conducted in residential schools operated by the religious sector. The codes of conduct in these schools for Aboriginal children from Tetlit Zheh were harsh, and many suffered abuse. Community members expressed this abuse as being responsible for high rates of alcohol, tobacco and drug use and abuse, and other social ills such as family violence and criminal activity (Auchterlonie, 2005).

Culture

The traditional diet is based on large animals, primarily caribou and moose, although Dall sheep and bear were also eaten in the past. Small mammals include rabbit, beaver, muskrat, squirrel, porcupine, etc. Fish are important with whitefish, char, trout, loche, and inconnu being most dominant in the traditional diet. Birds include migratory ducks, geese and swan as well as ptarmigan and spruce hen. Plants of several kinds are harvested for food and medicine (Andre and Fehr, 2002; Murray et al., 2005). The Gwich’in have traditional cultural values which require the full use of all edible parts of animals and plants, taking only what is needed, and sharing within the community. Careful attention is given to the protection and preservation of animal and plant species. For example, in spring when migratory birds land, only male birds are harvested. Children are taught these values at an early age and are expected to pass this knowledge to the next generation. Elders are very important in the community and form an Elders’ Council who focus on community harmony. They work with issues of language, traditional knowledge and lifestyles.

Volunteer activities support many cultural functions (Auchterlonie, 2005), and provide a means to promote healthy communities. For example, an annual music festival is held in the summer of each year bringing in musicians and local talent, in an alcohol- and drug-free environment. Volunteers contribute organization, meals, beverages, etc., for these carnival festivities and other annual events. Community feasts, canoe races, hockey, curling, and snowshoeing are promoted as family and community events.

Patterns of acculturation for the Gwich’in have progressed steadily since establishment of the community. Today the food system includes both traditional Gwich’in food as well as market food. Dietary studies have shown that the latter contributed the majority of energy for both adults (average of more than 60 percent) and children (over 90 percent) as described in the following sections.

Research methods

Research agreements

Three research agreements have been made with the Tetlit Zheh Gwich’in and CINE. The first agreement was for the project in cooperation with the Dene Nation and the Métis Nation of the Northwest Territories, and negotiated with the community using a format originating with the Dene Nation (Masuzumi and Quirk, 1993). CINE researchers collaborated with the community to conduct the food use and dietary research and to prepare a research report (Receveur et al., 1996). The second agreement was in the context of the children’s research project with five Dene communities and followed a similar format with each participating community. The research agreement for the intervention study was prepared only with Tetlit Zheh using the format now universally recognized for its process with participatory research (Sims and Kuhnlein, 2003). For all studies, data were archived at the offices of the Dene Nation in Yellowknife and at CINE, McGill University, in Montreal. The community was provided with research summaries, hard copies and electronic forms of the data.

Research process

Implementation of the first project was conducted in four stages with each of 16 Dene/Métis communities, representing about 18 000 Dene/Métis in the region. Stage I was conducted from May to October 1993, and consisted of community consultation, development of the food list, and pilot projects to test interview instruments. Stage II, conducted in 1994, consisted of interviews (24-hour recalls and traditional food frequency) and food sample collection during two seasons: the season of highest traditional food use (October–November) and the season of lowest traditional food use (March–April). Stage III, conducted in January to September 1995, consisted of data management and analysis, and Stage IV, conducted in October 1995 to September 1996, was the reporting period. Dietary assessment interviews with Gwich’in were conducted in Tetlit Zheh, Tsiigehtchic and Aklavik in 1994. These data provided the Dene and Gwich’in food lists, frequency and seasonality of traditional food use and market food use, perceptions of traditional food and food security, and understanding of dietary adequacy (Kuhnlein et al., 2007; Kuhnlein and Receveur, 2007; Kuhnlein et al., 2004; Lambden and Kuhnlein, 2007; Lambden et al., 2006; Receveur et al., 1997; Receveur et al., 1996).

The second project on children’s food use and anthropometry, and factors influencing mothers’ food choices for family provisioning, was conducted during two seasons: November 2000–January 2001 and August–October 2001. All children 10–12 years of age (n = 114) and their mothers (n = 69) in five Dene/Métis and Yukon communities (Fort McPherson, Tulita, Fort Resolution, Old Crow and Carcross) were invited and encouraged to participate. Dietary 24-hour recall interviews were conducted and anthropometric measurements were taken. Results were returned to communities by researchers and Gwich’in project assistants in March 2001 (Nakano et al., 2005a; Nakano et al., 2005b).

The third project to develop an intervention to improve nutrition and health with emphasis on locally available traditional food is currently (2006–2009) in process. Baseline data were collected in February 2006, and selected preliminary data are reported here.

Results

Food species diversity in the Gwich’in traditional food system

Within the entire Dene territory 101 species of wildlife animals and plants were found to form the traditional food system (Kuhnlein et al., 2001). Within the Gwich’in area of the Northern NWT, 50 species were noted in frequency interviews (Table 3.1). This food list includes species reported used for all Gwich’in communities, and includes the scientific names, common names and local language names, as well as seasonality in Tetlit Zheh. Animal and fish species dominated the traditional diet, with several parts of the animals being used as food.

Caribou was found to be the most popular traditional food, with barrenland and woodland caribou harvested, as well as moose. Many parts of the large mammals were consumed regularly: flesh, blood, bone marrow, heart, tongue, head, kidney, liver, brain, fat, and stomach, etc. Organs and parts of smaller animals were also consumed in addition to meat: liver, brain, ribs, etc. Of fish, the most popular were whitefish, inconnu, Arctic char, loche and trout. In addition to the fish flesh, other parts consumed included the skin, eggs, intestine, head, liver, and for some species the fins and tail. Birds were also important, and seasonally present. Again, eggs and organ meats were regularly consumed (gizzard, heart, liver, kidney, eggs, etc.) (Receveur et al., 1996). In general, most meats can be stored frozen or dried, with favourite dried foods being caribou, moose and fish. Meats were always cooked with common methods being roasting, boiling, stewing or cooking on a barbeque fire. An exception is the use of raw muktuk of beluga by some community members who may share a heritage with Inuvialuit.

Plants were also important, with berries (including cranberries, blueberries, cloudberries, raspberries, gooseberries, currants, crowberries) very popular in season, and frozen or jarred for use during the winter. Berries can be included in muffins, cakes or made into jelly or syrup; they can also be mashed and pounded with meat or fish into pemmican. Murray et al. (2005) estimated 7 670 litres of the most common berries (cloudberries, blueberries, currants) were harvested by Tetlit Zheh households in the summer of 2000. Labrador tea (muskeg tea) can be harvested during most of the year, with tea being made from the leaves, stems, and flowers (in spring). For a complete list of berries and other plants used by the Gwich’in, refer to Andre and Fehr (2002).

Several unique Gwich’in foods and their preparation techniques are presented with nutrient composition data in Table 3.2. Sample sizes and variance in values are found in the published papers presented in the footnotes. It is clear that the diversity of species and their organs and other parts created a highly nutritious traditional diet. When combining these highly nutritious foods with the physical effort needed for traditional food harvest, processing and cooking, the Gwich’in have the potential to be very healthy people.

Contemporary traditional food contributions to daily dietary nutrients

Of all 16 Dene/Métis communities where adult recalls were taken, Tetlit Zheh had the highest community average of daily energy supplied by traditional food (33 percent) (Receveur et al., 1997) – often large daily portions (up to 600 g) of wildlife were consumed by individuals. In the children’s survey, the Gwich’in communities of Old Crow and Tetlit Zheh had the highest community averages of traditional food use (10.7 percent and 5.9 percent, respectively) (Nakano et al., 2005b). Analysis of adult diets from Gwich’in communities showed that caribou (various parts) was the most important food source of daily energy, protein, vitamin A, iron, and zinc, and within the top ten contributors of fatty acids (saturated and unsaturated). Although children’s diets had much less traditional food as a percentage of daily energy, caribou was still within the top ten contributors to intake of energy, protein, iron and zinc. In considering food contributions to energy from the 24 hour data, the majority of energy was provided by market food. More detailed observation of the types of market food consumed by adults in Tetlit Zheh, Tsiigehtchic and Aklavik (n = 195 recalls) during the 1994 research, and of all Dene/Métis children in the 2000/–2001 survey (n = 222 recalls), showed the kinds of market food contributing to dietary energy for both men and women (Table 3.3). The top 20 frequently consumed foods were highly processed and least-cost foods, with major emphasis on sugars and carbohydrates.

Further analysis of Dene/Métis children’s diets showed more than 40 percent of energy being contributed by fat and sweet foods (Figure 3.2). High intakes of sucrose (18–19 percent of energy) and total sugars (25–26 percent of energy) were contributed by sugar added to beverages, powdered drinks, commercial cereals, commercial cakes, fruit drinks, cookies, candy and other sweets. It is therefore clear that use of market food in large measure decreases nutrient density of Gwich’in diets and especially that of children. Nevertheless, use of traditional, cultural foods ensured that both adults and children have adequate intakes of protein, iron, zinc, copper and vitamin B_6. In contrast, contemporary intakes of calcium, vitamin D, vitamin A, vitamin E, magnesium, and fibre were limited and probably inadequate (Kuhnleinet al., 2006; Kuhnlein et al., 2007; Nakano et al., 2005a, 2005b).

Cultural attributes of traditional food

Exploring the cultural attributes of Gwich’in traditional food took place during all three surveys. In the 1993–1994 study of adults, a series of interview questions addressed agreement on whether harvesting and using traditional food by the family contributed important cultural attributes. More than 85 percent (n = 59) of Gwich’in respondents agreed that these practices around traditional food provided physical fitness and good health, favourite outdoor recreation, healthy food, as well as keeping people “in tune with” nature, favours sharing in the community, saves money, is an essential part of culture, is a way for adults to display responsibility for children, brings respect from others, builds pride and confidence, provides education on the natural environment, contributes to children’s education, provides survival skills, provides food-preparation skills, and is an opportunity for children to learn patience and other personality qualities (Kuhnlein et al., 2001). Further, adults were well aware of the healthy, low-fat qualities of their traditional food, and that it was fresh and additive/pesticide free while being of comparatively low cost. Adults also recognized that the purchase of market food was convenient and provided variety to the diet (Lambden et al., 2006).

During the study of children in 2000–2001, mothers (n = 69) were asked for their reasons for selecting traditional and market foods for the family. The most frequent responses for selecting traditional food were that it was considered healthier than store-bought meat, it tastes better and it is less expensive. Mothers also responded that they would serve more traditional food if it was easier to get, and if they were less concerned about environmental contaminants. The major barriers to having more traditional food were the time and costs for hunting, fishing and gathering, but that having a hunter/fisher in the family, and sharing with family and friends, all help in having traditional food. Regarding women’s perceptions of why children eat less wild meats and fish than adults, replies centred on the fact that children spend more time in town, and both women and children have less opportunity to harvest and prepare traditional food.

Infant-feeding practices

At the time of this study, breastfeeding was promoted and in practice by about 70 percent of mothers of infants in Tetlit Zheh (Tena Blake, personal communication, 2007). Formerly, breastfeeding was exclusive during infancy with first introduced foods being meat-based. Examples of these foods are meat and fish broth, pre-masticated meat and fish and other table food. Teething aids were bones (ribs) of mammals, rabbit, and other animals (McDonald and Vittrekwa, personal communication, 2006).

Anthropometry

Results from anthropometry of children from the five Dene/Métis communities during the children’s study in 2000–2001 showed that there are few underweight children in the sample (Table 3.4). All children in the 10–12 year age range were invited to the study, and most children were measured in both seasons. Results showed that over half the children were normal weight, and about one-third were either overweight or obese (Nakano et al., 2005a). Preliminary results from women’s (n = 45) anthropometry data in 2006 showed 33 percent as overweight (BMI 26–30) and 47 percent obese (BMI >30). The extent of those overweight and obese children and adults leads to concerns for diseases associated with the nutrition transition – obesity, diabetes, heart disease and certain kinds of cancer – and is one focus of the need for change during the planned intervention.

Food security

A cross-sectional survey of Yukon First Nations, Dene/Métis and Inuit used socio-cultural questionnaires to evaluate women’s access to traditional and market foods. In all three regions, including the subset of Gwich’in women, women’s food security was found to be affected by affordability of market food and accessibility to hunting and fishing (Lambden et al., 2006). The percentage of respondents who could not afford to buy all their food from the store in Tetlit Zheh was 86 percent (Receveur et al., 1996).

Outlook

Project activities in the intervention with the Tetlit Zheh community have been ongoing or planned subsequent to baseline measures of diet and overall health (January–March 2006). Strategies focus on healthy eating and healthy physical activity. A Gwich’in recipe book based on local foods is being developed using recipes gathered from members of the community. Activities to encourage healthy eating in school-aged children have included the “Drop the Pop NWT Challenge” (Department of Health and Social Services, 2007), where students were challenged to stop drinking pop (carbonated soft drink) for five days, a field trip to pick edible plants, a community fish cookout that encouraged different methods of fish preparation and promotion of the benefits of eating traditional food at an annual health fair. A physical activity programme for women in the community includes group walking in the evenings and courses given by the school physical education teacher. Other activities will be planned with community leaders based on the findings from the studies reported here for implementation during the two-year project.

Throughout food-use research with Dene adults and children, and specifically with the Gwich’in, it is clear that traditional food is critically important to maintain dietary quality and that community members recognize that it is important to make more traditional food available for all families. This will not only improve dietary quality, but also enhance food security and cultural continuity. It is also recognized that improving availability and access to high-quality market food will contribute to positive dietary intakes, and that attention to positive lifestyle and health habits should be fostered to reverse the current trends in overweight and obesity •

Acknowledgements

We recognize the many researchers’ contributions to the overall research with Dene/Métis communities.

Team members 1994–1996

For this first study with Dene/Métis, Olivier Receveur, Université de Montréal, Département de Nutrition (formerly of McGill University, Centre for Indigenous Peoples’ Nutrition and Environment [CINE]) was the overall data collection supervisor. Marjolaine Boulay, McGill University, was CINE’s data and statistical assistant, William Carpenter, Métis Nation (Northwest Territories) was the Environment Manager, and Carole Mills, The Dene Nation, Lands and Environment Department facilitated local arrangements. This project was successful thanks to the support and hard work of community members, staff and volunteers at Dene Community Councils, the Dene Nation and CINE. The participants of the methodology development workshop that finalized the study design included Charlie Furlong, Roy Doolittle, Mary Lafferty, Pat Larocque, Violet Beaulieu, Martie Kunnizie, Bella T’Seleie, Don Antoine, Antoine Michel, and Barney Masuzumi. Members of the Tetlit Zheh Community Council that supported implementation of the project were Chief Joe Charlie and Richard Wilson. The project coordinator was Laurie Chapman and interviewer was Patricia Stewart. Funding for this project was provided by the Arctic Environmental Strategy (AES), Department of Indian Affairs and Northern Development (DIAND), Hull, Quebec.

Team members 2000–2001

There were several contributors to the second study with children, which was funded by the Northern Contaminants Program of DIAND. Initial arrangements for the five Dene communities were made by Karen Fediuk and Norma Kassi. Within Tetlit Zheh, process and arrangements were facilitated by Liz Wright and Sharon Snowshoe. Data entry was completed by Karen Fediuk and analysis completed by Tomoko Nakano and Rula Soueida at CINE.

Team members 2006

The research, which began in 2006 for this case study, included several community members and researchers. Funding, provided by the Canadian Institutes of Health Research (Institutes of Aboriginal Peoples’ Health and Nutrition, Metabolism and Diabetes), was awarded to Harriet Kuhnlein, Olivier Receveur, Laurie Chan and Bill Erasmus. The community contacts for the Council at the time of submitting the proposal were Sharon Snowshoe and Hazel Nerysoo. Those responsible for the project in the Tetlit Zheh community were Margaret McDonald, Elizabeth Vittrekwa, Rhonda Francis and other colleagues in the Tl’oondih Healing Society and in the community. Data preparation for the study, and for this report, was guided by Dina Spigelski, Rula Soueida, Lisa Elvidge, Jill Lambden, Lauren Goodman and Nelofar Athar Sheikh.

> Comments to: harriet.kuhnlein@mcgill.ca

>> Photographic section p. IX

Chapter 4

Traditional food system of an Awajun community in Peru

• HILARY CREED - KANASHIRO[1] • MARION ROCHE[2] • IRMA TUESTA CERRÓN[3] • HARRIET V. KUHNLEIN, PH. D.[2]

1

Instituto de Investigación Nutricional (IIN), Lima, Peru

2

Centre for Indigenous Peoples’ Nutrition and Environment (CINE) and School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada

3

Organización de Desarrollo de las Comunidades Fronterizas de Cenepa (ODECOFROC), Cenepa, Peru

Photographic section >> XII

“Ina yutai namakia ajatmay, sinchn sukagtawai nantsaptin ekantawai.”

“With our foods from the wild, the river and our fields we are strong and alert.”

Awajun saying

Abstract

The traditional food system of the Awajun population of Bajo Cenepa in the Peruvian Amazon is described in this chapter, using a variety of quantitative and qualitative participatory techniques. A wide diversity of food exists – a total of 223 are listed. However, the availability of several of these foods has diminished in recent decades due to changes in community living, farming, hunting and collecting patterns. Scientific identification and nutrient composition data for these foods were found for 82 foods, but such information was not available for the remaining indigenous foods.

Most foods included in this research were produced, collected, hunted or fished locally. Only 12 of the foods listed were purchased from outside of the area, and seven foods were available through government donation programmes. Most foods identified in this study were prepared by boiling, roasting and smoking. Dietary energy intake, evaluated by 24-hour dietary-evaluation recall, appeared to be adequate; the major sources of energy were cassava and banana. Intake of animal source foods, particularly meat and fish, were generally low and infrequent and depended on seasonal availability.

Thus, micronutrient intakes, especially from high bio-available sources of iron (meat and fish products), were low for children. The consumption of vegetables, seeds and fruits was varied and seasonal. Infectious diseases and parasites were predominant health problems and there was a high prevalence of stunting among children. Thirty-four foods, potentially rich micronutrient sources, were selected for further study of their potential promotion in dietary interventions. Mothers’ perceptions of these foods were mostly favourable. The information obtained through this study was developed for application to interventions focusing on increased production, knowledge and use of these traditional foods to enhance the health, nutrition and culture of the population.

Introduction

In Peru there are 45 Indigenous Peoples in the Amazon rain forest, comprising a total population of around 300 000 Peruvians (Peru, Ministerio de Salud, Oficina General de Epidemiología, 2003). Although information regarding the nutrition and health situation of these various peoples is scarce, that which is available indicates that 50 percent die before reaching 40 years old and 25 percent before reaching 9 years. Rates of illiteracy (25–45 percent) and fecundity (7.9 children per woman) are high, as well as infant and maternal morbidity and mortality, parasitosis, malnutrition and anaemia (Peru, Ministerio de Salud, Oficina General de Epidemiología, 2002; Peru, Instituto Nacional de Estadística e Informática, 2005).

One of the most important of these Indigenous Peoples is the Awajun, comprised of more than 45 100 inhabitants and living principally in the Department of Amazonas (Peru, Instituto Nacional de Estadística e Informática, 1993). A recent study of the Awajun population described prevalences of chronic malnutrition at 33.4 percent, anaemia at 77 percent in children under three years, and prevalence of anaemia at 50 percent in women of fertile age (Huamán-Espino and Valladares, 2006); the highest prevalences were found in the population of Cenepa. Reasons for this situation have been attributed to the changing ecological, cultural and food systems in that part of Peru (Huamán-Espino, 2006).

The purpose of this study is to describe the traditional food system of the Awajun population of Bajo Cenepa of the Amazon rain forest of Peru, through the application of the guidelines developed by the Centre for Indigenous Peoples’ Nutrition and Environment (CINE) to document traditional food systems of Indigenous Peoples. This assessment was designed to provide essential information to help understand the nutrition and food system of the population with the objective of finding ways to design appropriate food-based interventions to improve micronutrient nutrition in the community. The procedure involved a number of steps using a variety of participatory research methodologies with the community.

Overall description of Cenepa and the Awajun

Geographic location

The Awajun people are indigenous to the tropical rain forest of the Amazon in north-east Peru, residing along the Upper Marañon river and most of its tributaries, at elevations ranging 200–2 000 metres above sea level (Figure 4.1). While the precise geographic limits of the rain forest’s extension are not known, it may encompass as much as 22 000 km^2, stretching from the eastern boundary of the river Santiago to the Cordillera del Cóndor to the west, the Pongo de Maseriche to the south, and almost to the Peru-Ecuadorian border to the north (Berlin and Markell, 1977). The district of Cenepa extends from the mouth of the Cenepa River where it joins the Marañón, between the cordilleras (mountain ranges) to the frontier with Ecuador. The source of the Cenepa river is in the Cordillera del Cóndor and extends for a length of 185 km (AECI et al., 2000). In the last two decades the frontier conflicts between Peru and Ecuador have affected the lives of many of the local communities.

This area is known as “high jungle” (seja de selva), it is covered by dense rain forest vegetation and the climate is tropical. The annual rainfall is around 3 000 mm, the maximum is during March to April and the minimum is in December to January, humidity is 91 percent. The average annual temperature is 26 °C (AECI et al., 2000), while the maximum rises to around 40 ºC and minimum to 15 ºC.

Demographic characteristics

Traditionally the Awajun lived in widely dispersed hamlets, each consisting of several related households. At the time of this study the majority resided in communities on or near the major rivers of the region. In the 1950s, the Peruvian government coordinated with Jesuit and Protestant missionaries to build schools and missions in the Upper Marañon. Subsequently, many new Awajun communities formed near these schools (Berlin and Markell, 1977). The Jesuits brought the Catholic religion to the Awajun, and in the twentieth century Protestant, and more recently Evangelical, denominations have been introduced.

The district of Cenepa was created by law in September 1941, and in 2000 had an estimated population of 8 000 inhabitants, with a density of 1.5 inhabitants/km^2 (AECI et al., 2000). There are three principal areas: Low Cenepa, Middle Cenepa and High Cenepa with a total of 52 communities. Most of the population settled in the Low and Middle Cenepa. It is the only district in all the Alto Marañón without colonial settlements from other parts of Peru. The present study was conducted with the Awajun communities living on the river in Low Cenepa (Bajo Cenepa).

The population of Cenepa was Awajun with the exception of the district capital Huampami, where 15 percent of the population was of mixed race (mestizo). Several public institutions including the district municipality, governor, justice of the peace, police, a health centre and primary and secondary school were located in Huampami.

The economic activity of the Awajun of Cenepa was mostly subsistence farming, hunting and fishing (Ramos Calderon, 1999). The Awajun generally did not sell their produce, which was, for the most part, produced for their families and communities. The few who had cash primarily worked with local organizations or had their own small shops, although collecting gold has been a more recent source of income. Money that was obtained was mostly spent on wood for their housing, medicines, clothes or cooking saucepans.

The principal network of transportation was by river and the feasibility of transport depended on the volume of water in the river. At times of low tides, boats could not enter the river and the small canoes floated with difficulty; when the water level was high it was often dangerous to navigate. The high cost of fuel posed limitations. Cenepa did not have direct access to any of the highways that link the Alto Marañon to the rest of the country. Communication between communities was also on foot along narrow and steep trails (AECI et al., 2000). Thus, the communities within Cenepa were limited in their connections within the locality, the rest of the province and the outside world. Some communities had a radiophone service and a few had a public telephone, but the service had limited access. The Spanish-speaking radio broadcasting stations of Ecuador and Colombia covered this area and their stronger signals often blocked the scarce transmissions from Peruvian radio broadcasts.

The river and streams were the main sources of water for the population. There was no potable water treatment service in the district; in Huampami there was a water network installed but the water was untreated. There was no sewage system. Rubbish was thrown into the river and faeces elimination was in the open vegetation, or more recently, by use of latrines installed during the last decade by a government agency for development. People washed in the rivers or gorges. Masato (fermented cassava) was the most common drink, although when water was drunk it was usually taken directly from the rivers and streams.

There was no electricity in the communities. Only the district capital had electricity, limited to a few hours per day but with frequent interruptions, because of lack of fuel and capacity to support a sustainable service. Generators were present in a few of the communities, primarily used to power radio communication.

Cultural characteristics

Linguistically, the Awajun are one of the four large tribes of the Jivaroan family (Shell and Wise, 1971; Guallart, 1964). They are the largest indigenous population in Peru.

In the Alto Marañón region, Cenepa rates third for its agricultural and forestry potential. This comprises 16 000 hectares for farming and 131 000 hectares available for forestry. At the time of this study, it was estimated that 22 percent of the agricultural potential was being used. In general, the land is agriculturally poor, aggravated by the frequent erosion to which the area is exposed. The physical geographic characteristics also make any interventions difficult. According to the Farming Census of 1994 only 4 percent of land was used for agrarian farming; 95.5 percent was monte (wild land) and forest.

Ownership of the land by different extended Awajun families resulted from their occupation of it for numerous generations – sometimes it was obtained peacefully, while at others it came into their possession (as trophies of war) because of conflicts with neighbours. The Awajun are not traditionally sedentary agrarian, but semi-nomadic with economic activities consisting of collecting, hunting, fishing, extraction of wood and resin in small quantities and agricultural activities by clearing. This explains many of the local customs and the search for an ecological balance which leads to periodic migrations to prevent the extinction of hunting and fishing activities and the depletion of the land used for agriculture.

A population centre of the Awajun traditionally comprised several nuclear families related to each other, in a semi-dispersed pattern with houses next to cultivated fields, yet relatively near to each other. These families extended as the daughters married and their new husbands came to live on the lands occupied by his wife’s family. In recent times there has been a tendency for several extended families to group together. The family structure was primarily patriarchal, where the man was the principal authority.

In 2000, 99 percent of the houses were built with local material, mostly wood with palm leaf roof, although corrugated iron usage was becoming more common. A house generally consisted of a single rectangular room with a very limited amount of furniture, with small stools and benches used for sitting. At one end of the room was the kitchen, although some families cooked in a separate area (AECI et al., 2000).

The traditional dress of the men is the Itiak (men’s skirt), but at the time of the study few men used this: the general tendency was to use western clothing, such as trousers and shirts. The women used the Tarachi, generally of garnet or blue in colour and traditionally made with cotton fabrics and woven on a traditional loom. The tendency was to use dresses made of tocuyo (a purchased linen-type cloth). The women adorned themselves with bracelets, necklaces and belts, made from seeds, monkey teeth, small snail shells, feathers and bird beaks.

The Awajun Apu, or Chief, holds the maximum authority in the community, accompanied by the Vice Apu, and two other members, each elected by the community assembly. This assembly, according to the Peruvian Constitution, has autonomy and can apply justice. In the assembly all members including the women must agree when making a decision. At the district level the authorities are the mayor, lieutenant governor and justices of the peace. In only one community was there a notary clerk responsible for registering births.

The primary school curriculum was bilingual. However, the education level was deficient, primarily because of the inadequate training, high turnover of teachers and low salaries. The education infrastructure was precarious with a lack of general educational material, and that which did exist was not adapted to the local context. For instance, there was no educational content relating to their local and traditional foods – in terms of their production, nutritional or cultural roles. Although most of the boys attended primary school, many of the girls did not and very few went to secondary school: hence, the high prevalence of women who were unable to read and write.

Overall health and nutrition status at the time of the study

National data in 2001 reported 25.5 percent of children in Peru under five years of age was stunted, although the prevalence of acute malnutrition was low (Instituto Nacional de Estadistica e Informatica, 2001). However, the nutritional status of children in the rain forest areas was poorer than the national average. Thirty-six percent of children under five years in the Department of Amazonas, including both indigenous and mestizo (mixed) populations, was stunted (Instituto Nacional de Estadistica e Informatica, 2001). Further, 42 percent of children suffered from anaemia, probably owing to low iron intakes and high parasitic load (a nutritional situation similar to that described by Huamán-Espino and Valladares [2006] for the Awajun).

In the Awajun culture there are many taboos affecting women, especially during pregnancy. A pregnant woman tends not to identify her pregnancy because she fears the transmission of bad spirits and believes these may interfere with her pregnancy. The husband attends childbirth and there is a fear that bad spirits may enter the women if another person is present. It is believed that when a woman is menstruating she should not participate in the activities of sowing seeds or fishing.

The most prevalent health problems in the district were shown to include skin infections, poisoning from serpents, helminth infection, intestinal and respiratory infections, mycosis, women’s reproductive health problems, as well as suicides and accidents, among others (Instituto Nacional de Salud, Ministerio de Salud, 2000). Medicines provided by the health posts, local shops and medicinal plants are used for treating illness.

In Cenepa, there was a health centre in Huampami serving 1 721 people (20 percent of the population of the district) at the time of this study. Additionally, there were health posts in 14 of the communities. In general terms, the situation of the health sector in the district was deficient, because of both the precarious infrastructure and inadequate implementation of the health posts. The lack of technical and medical personnel, no remuneration for health promoters and the long distances and difficulties of access to the different communities aggravated this situation. Programmes offered in the principal health centre of Huampami included immunization, treatment of diarrhoea and respiratory infections, a growth and development monitoring programme, oral health, food and nutrition, family planning, perinatal health, malaria and tuberculosis control. Parallel to the government health sector, health care was provided by missionary nuns who served community-administered first aid units in 32 communities, with training for health promoters and medicines sold through a government programme.

Vaccination campaigns, carried out by house-to-house visits, using vaccines provided by the Ministry of Health were conducted by health promoters or the health technician responsible for the local health post. The vaccines given include BCG, polio, DPT, measles, tetanus, rabies and yellow fever. However, the percentage of children between 18 and 29 months who received all their vaccines in the Department of Amazonas was 53 percent, one of the lowest of the country at that time (Instituto Nacional de Estadistica e Informatica, 2001).

As well as the health networks the parallel practice of seeking empirical healers and witchcraft was important to locals, especially for serious diseases.

Methodology

The project was presented initially to the authorities of Organización de Desarrollo de las Comunidades Fronterizas de Cenepa (ODECOFROC) and was approved by the Ethics Committee of the Instituto de Investigación Nutricional, Lima, and the Research Ethics Board of McGill University, Canada. A research agreement was made between the research institutions and ODECOFROC and signed by all parties. The project objectives and participatory methodologies were presented to, and agreements obtained from, each of the participating village assemblies before starting – these placed emphasis on those aspects in which the communities had particular interest, namely further knowledge of their foods, and respecting the limits of the study requested by some communities. Each person interviewed during the course of the study gave prior verbal consent, as did all people photographed.

The study was conducted in six communities in Bajo Cenepa (Table 4.1).

A total of 20 multidisciplinary researchers and assistants, from the four participating institutions and the communities, participated in the fieldwork conducted from February to May 2004. The data collectors were trained and standardized in the research methods using the CINE Manual (Kuhnlein et al., 2006) over a period of two weeks. All interviews were conducted with the assistance of two male translators and one female translator (Awajun-Spanish) who participated in the training process.

Preliminary information on the list of local foods and their seasonality was obtained initially through interviews with nine local key informants recognized as having knowledge of the local food system. This list of foods was presented to groups of 25 adults in three community discussion group sessions, lasting two and a half hours each in Mamayaque, where a consensus of the accessibility, preference, and seasonality of Awajun food items for Bajo Cenepa was established and a seasonal calendar developed. Seven Elders were interviewed, one from each of the study communities, to explore foods that were used now infrequently but had been used in the past.

An exercise to identify micronutrient-rich foods was conducted by the project team, including community members and key informants. From the list of all foods, 34 were selected as potentially micronutrient-rich foods for further exploration, with a view to selecting foods for promotion in an intervention to improve the dietary intake of the population, particularly for women and children.

Because of a lack of scientific identification of several plants, 40 plants with Awajun names were selected for identification. Plant specimens (mostly leaves) were prepared according to established procedures and taken to Lima for identification by a botanist, (specialist in plants of this rain-forest region).

Four foods from the region (suri, ugkush, macambo and masato) were submitted for proximal analysis for energy, protein, carbohydrate and fat content. The total amount of each of the foods received (suri 59.6 g, ugkush 108.9 g, macambo 246.3 g and masato 442.4 g) was lyophilized and homogenized and three samples of each were submitted to standard analytical procedures in the IIN laboratory.

The exploration of the cultural context of the key foods and the diet was conducted through interviews with 49 mothers who had children under six years of age. Several women preferred to have the interview and dietary recall at a central place in the hamlet rather than at their homes. The qualitative exercises, such as understanding the grouping of foods through pile sorting, the exploration of the perceptions of the attributes of foods for young children and taste preferences were conducted with 37 mothers.

Drawings of the different foods were made on cards, or in some cases, the actual foods themselves were used, for these interactive exercises with mothers. Each card was numbered to facilitate coding and subsequent analysis. At the start of each interview the cards were validated to ensure that each mother recognized the foods represented. The pile sort exercise was conducted with 34 mothers with children under two years. Mothers were asked to group the foods freely according to their own perceptions of which foods go together using the cards, and then describe the reasons for each group. This was not an easy task for some of the mothers, as they found it difficult to understand what to do, particularly in giving the reasons for their groupings. The ANTHROPAC software (Analytic Technologies, Harvard, MA) was used for analysis, showing the composite groups and clustering of the foods by all the mothers using Multiple Dimensional Scaling.

Taste preferences were explored for the key foods with 37 mothers and for their 22 children under two years and 29 children over two years. The perceived attributes of the foods for young children were explored with mothers of 31 children under two years and of 30 children over two years. Using the cards, mothers were asked to describe whatever they thought about each of the individual 34 key foods, in relation to their young child. Thirty-one mothers with children under two years of age were interviewed regarding the early feeding patterns of their young child.

A 24-hour dietary recall was conducted with 49 mothers from the six communities who also reported on the dietary intake for their children under two years (n = 25) and two years and over (n = 40). The 24-hour dietary intake was conducted on two consecutive days for each individual with the assistance of a translator. Several foods (such as cassava, banana, etc.) with known weights and local utensils (cups, plates and pinig [bowl for drinking]) provided by the mothers were used as references for quantifying food intake and a food scale with precision to 1 gram was also used to assist assessing portion sizes (Roche et al., 2007, 2008). Mothers reported food consumed for themselves and for their children.

A questionnaire was applied to each of the mothers to explore the frequency of consuming the key list of 34 foods by 48 mothers and 32 children under two years of age. These foods were explored for “daily”, “weekly”, “monthly” or “rarely” or “never used”.

Heights and weights of all 48 mothers, 32 children under two years and 39 children over two years were measured as described elsewhere (Roche et al., 2007) using standard methodology (WHO, 1995). Height was measured using a vertical measuring board and recumbent length for children under two years using a rigid stadiometer accurate to 0.1 cm. Weight was measured using a level and digital Salter bathroom scale and for children under two years of age on hanging scales accurate to 100 grams. Body mass index (BMI) was calculated for the adults and Z-scores relative to international reference data for the children (NCHS, 1977).

Results and discussion

General description of the food system

The land cultivated by the families consulted with in this study was dedicated mainly to the production of cassava, banana, peanuts, maize and cacao. In most cases, families had mixed orchards and/or mixed the larger crops with others of less importance. The indigenous vocation was for polycultivation, a system that better adapts to the reality of the rain forests and its soils. Other plants grown included sugar cane, rice, coffee, papaya, citric fruits, achiote, pituca, pineapple, sacha papa, sweet potato, tumbo, red pepper, medicinal plants such as sangre de grado, piri piri, ajengibre, hierba luisa, sacha garlic, and aromatic plants such as sacha coriander. New fruit trees were being cultivated including arazá, carambola, aguaje and pijuayo. In past years there has been considerable production of cacao in Cenepa. Production diminished due to fungal disease and lack of technical management. Organic coffee was being cultivated in the higher part of the Cenepa.

The majority of native families raised hens, turkeys, ducks, guinea pigs, and pigs; these last two were raised only in some communities and on a small scale. Animals were raised for family consumption as well as for monetary income by their sale. Recently, private and public institutions have started fish farms and poultry-raising. In both cases, the technology available for these ventures was precarious, although efforts were being made to follow up on the feeding and sanitary aspects, as well as providing technical training. Frequent diseases, affecting the raising of poultry, have been reported. Further, many animals were lost through attacks by wild animals. The women traditionally cultivated the fields – although recently this was limited to cassava and banana – and raising small animals near their homes.

Traditionally the Awajun men dedicated a great part of their time to hunting. The preferred mammals were the sajino, hungana, American tapir (sachavaca), deer, tigrillo and otorongo. Less frequently hunted animals included ronsoco, achuni, añuje, armadillo, and different kinds of monkeys and birds. Over-hunting has diminished the number of animals populating traditional hunting grounds. The products obtained from hunting (meat, leather, feathers, teeth and bones) were used for nutritional, artisanal, medicinal and witchcraft use. Contact with non-native groups has led to the commercialization of some of these products – especially skins, snake venom and meat (to a lesser extent).

More than 150 varieties of fish were identified – constituting a major source of the animal products available to this population – along with a number of other aquatic animals, such as snails, shrimps, crabs, frogs, sábalo, palometa, liza, doncella, boquichico, corvina, yahuarachi, Hungarian ray, fasaco, among others. Fish was used for family consumption. However, there was less fishing (traditionally done by the men) as there were fewer fish resulting from indiscriminate fishing and contamination of the river because of mining activity in the hills of the Cordillera del Cóndor as described for other Amazon populations (Passos et al., 2003).

Our study showed that it was women who mostly collected the wild fruits from palms and other trees (such as the uvilla). They also gathered shrubs, as well as the sprouts of palms, stems, cortex and resins. Edible larvae (suris) and other insects were collected for food. More recently however, with the over-harvesting of fruit and fruits trees including palms, the collection of several of these foods has diminished.

Cassava and banana constituted the basis of the food of the Awajun population, supplemented with small portions of meat, and sometimes a little fish. The preparation of food was a women’s activity, and foods were prepared most usually by roasting and boiling. Masato, a drink prepared from cassava by the women, was an important food, which could be consumed either fermented or unfermented and contributed a high proportion of energy to the diet. Meat and fish were generally smoked or kept dried with salt and wrapped with leaves, or placed directly over the wood fire. The slow drying and smoking allowed the meats to be kept for relatively long periods. Owing to the contact with urban culture, feeding habits modified and new foods purchased from outside traders who sold their produce through the few small, local shops, although in relatively very small quantities. These included sugar, rice, canned fish, canned milk, pasta, onions, oats, cakes, biscuits and bread among others.

During the research period the government offered food programmes through the Ministry of Women’s Affairs (Programa Nacional de Asistencia Alimentaria [PRONAA]) providing rice, beans, oil and tuna fish. The municipal “Glass of Milk” programme provided children with milk and sweetened oats, although irregularly.

There was little commerce in the area, mostly due to the lack of surplus production and the high cost of transport required to take produce to main population centres. The communities of the Alto Cenepa did not trade their products; those of Bajo Cenepa sold small volumes of banana and wood outside of the area, transported by boat; and Middle and Bajo Cenepa sold products such as banana, cassava, hens and small birds to larger population centres, such as Huampami and Kusu Kubaim. The main consumers of these latter products, although on a small scale, were government officials, teachers and the military located in the area.

List of foods

A total of 223 foods were identified within the food system of the Awajun, the majority having local Awajun names. Many of the foods did not have Spanish names: thus it was difficult to find equivalent English names. This was reported on previously (Hauamán-Espino and Valladeres, 2006), where 100 currently used foods were listed. The full list of Awajun foods and their nutritional composition where known, was given to ODECOFROC and each of the participating communities and can be viewed at www.mcgill.ca/cine/resources/data/

The complete list of Awajun food species is presented in Table 4.2; in Table 4.3, a shortlist of unique foods is presented with nutrient composition. Four foods/preparations for energy and macronutrient content were analysed. Foods selected included a green leaf (ugkush), seed (macambo) and an animal source food (suri), potentially rich sources of nutrients, and the community also wanted to know the nutritional composition of their staple drink, masato. Of note is the nutritional value of suri, which is an important source of nutrients, although not as high as edible worms reported elsewhere in Latin America (Paoletti et al., 2003; Paoletti et al., 2000).

Scientific names and published nutritional composition were found for only 82 of the foods. Among these foods, 34 were mentioned by Awajun Elders as being popular in the past, but no longer in use at the time of this study. They belong to the following groups: animals (10), birds (10), fruits (8), vegetables (1) and tubers (5). A significant reason why these foods were not used as frequently as before, or were no longer consumed, was that they were much further away in the wild hill country, particularly the animals and birds. Also, as the Awajun lived in larger communities, there was over-hunting and harvesting of several animals and plants, while some fruits and vegetables were no longer being planted and harvested.

Locally produced food was bought and sold between families and communities when harvested. Only 12 of the total foods were listed as being bought from the local village shops – these are not local, but industrially produced: rice, noodles, sugar, salt, oil, milk (evaporated and dried), tinned tuna fish, eggs, soda, cookies and sweets. In general, there was a lack of commercialization in the area, as well as low cash resources among the Awajun population. As such, the community population rarely, if ever, went to a market or local urban centre to buy food.

There were also several government assistance programmes that brought donated industrialized foods into the area. These included rice, oil, beans, tinned tuna, tinned salmon, evaporated milk and sugared oats. They were donated through PRONAA and the “Glass of Milk” programme.

Scientific identification and analyses

To help complement the scientific identification, 40 plants with Awajun names were selected for identification, of which 25 were identified by a botanist.

Key micronutrient-rich traditional foods

From the 223 foods listed, 34 were selected as potentially micronutrient-rich foods for further exploration, with a view to selecting foods for promotion in an intervention to improve the nutritional intake of the population, particularly women and children’s (Table 4.4). Foods were selected from the different food groups and chosen on the basis of (a) frequency of mention, (b) probable micronutrient content and potential for making a contribution to nutrition of the population, (c) mentioned as being liked by the population, and (d) availability during different seasons. A few less-frequently used foods with possible potential for increased use were included.

Patterns of harvest, storage and preparation of the key foods

Awajun women went daily, or every other day, to their fields to obtain food: thus, there was little storage of foods. Fish were regularly caught from the rivers or fish ponds and mostly consumed fresh. They were harvested from the fish farms approximately every three months, but were caught individually at other times. Meats hunted from the wild were preserved; they were most commonly dried with salt and then smoked. There were also some recent initiatives to preserve fruits by making jams at the time of high production, such as with cocona.

In general, the form of preparation of foods was simple: boiled, roasted, smoked, raw or in patarashka (the food is wrapped in banana leaves and placed over the wood stove). It was rare to find fried foods in the Awajun diet. Foods such as cassava and banana were used to prepare masato and chapo drinks, respectively. Other drinks were made from fruit juices.

Mothers’ and children’s preferences for foods

Preferences were explored for the 34 key foods for mothers and children and most were reported as liked by both mothers and children, except for squash and cassava leaf. The mothers also reported that, in contrast to their children, they did not like wasp larvae and that their children did not like the green leafy vegetable ugkush.

Foods most available nearby

Cassava, banana and cocona were the foods most available locally, and sugar cane, sweet potato, pineapple, sachapapa, fish, hens, pituka and tuca, as well as the fruits sachamango, chupé, aguaje and yarina were available seasonally.

Dietary evaluations

Estimated dietary intake by 24-hour recall

Intakes of energy and macronutrients were evaluated by two successive dietary recall days. Imputed nutrient values from similar foods were used when needed. Overall, women’s intake of local Awajun food formed 93 percent of total dietary energy, with the balance being from purchased food. For children aged 2–12 years, 85 percent came from local Awajun food, with 15 percent from purchased or donated (primarily rice and tuna) food. Table 4.5 shows the mean, median and standard deviation of the intakes for energy and macronutrients for the mothers, children under two years and children over two years.

Mean and median energy intake of mothers was apparently high (3 738 and 3 388 kcal per day, respectively), although only 6 percent of energy came from animal sources; 6.5 percent of energy was from protein and 7.9 percent from fats, indicating that the major source of energy was carbohydrate. The fibre content of the diet was also high (29 g) – however, there was a wide variation. The food preparations that provided most of the energy were boiled foods, followed by roasted foods. The boiled foods were mainly bananas, tubers and roots, including cassava, sachapapa and pituka. The roasted foods included cassava, banana, macambo seeds and fish. The preparations from animal sources that provided most energy were milky drinks and soups – mostly due to the use of chicken or egg in the ingredients.

Twenty-five children between six months and two years old were included in the 24-hour recall for complementary foods (non-breastmilk). Eight children under six months were excluded. Mean energy intake from complementary foods was 997 kcal per day; 12.6 percent of energy came from animal sources, 8.4 percent from protein, and only 10.6 percent from fats, again indicating that the principal source of energy was carbohydrate. Again, the food preparations that provided most of the energy were the boiled foods, mainly banana, and the tubers and roots (cassava, sachapapa and pituka) followed by milk preparations and cereals such as rice. The preparations providing most energy from animal sources were milk (and milk preparations), and soups (again mainly because of the presence of chicken or egg).

The mean daily energy intake of the 40 children between two and eight years of age was 2 516 kcal, and only 6.2 percent of the energy was provided by animal sources. Only 6.7 percent of energy came from protein and 7.1 percent from fats. The food preparations providing most energy (mainly from animal sources) were very similar to the younger children.

Mean and median total micronutrient intakes for adult women appeared to be adequate although, as mentioned below, there may have been some over-reporting of food intake. The principal source of minerals in the diet was vegetables, while intakes from high bio-available animal sources were low. The lowest intakes of several micronutrients were those of the infants and young children, specifically for iron with a median intake of 4.9 mg/day for children 6–24 months (mean recommended intakes are 9.3–5.8 mg/day depending on age and assuming medium bio-availability) (FAO/WHO, 2002), especially iron from haeme sources (median 0.33 mg/day). Total zinc intake was near to recommended (4.1 mg/day) intakes (median 3.89 mg/day), but zinc from animal sources (median 0.8 mg/day) and calcium (median 134 mg/day) were low (mean recommended intakes for calcium 400–500 mg/day depending on age), although some calcium would be obtained from breast milk by these children.

The foods or food preparations that were most commonly consumed by the mothers and children were cassava, banana and masato. Although fermented for normal adult use (and fermented for a longer period of time for celebrations or parties), masato was given to the children when freshly prepared and non-alcoholic.

The large variability in reported amounts of food and high intakes of energy obtained through the 24-hour recalls was surprising. Although the women and children were physically active in their daily work routines, these intakes were not consistent with their body weights. A typical meal consisted of the family sharing food from a common plate of banana leaves, and it is believed by the researchers that some mothers may have reported what was served for the family, or did not know how much each of the individual children ate, thus there may have been some over-reporting. This will be verified in future studies.

Sources of food

Table 4.6 shows that a high proportion of the energy of the diet came from locally produced foods and that comparatively little food was from outside sources. This was slightly higher with children, due to the donated “Glass of Milk” programme.

Food frequency

The frequency of consuming the foods in the key list of 34 foods by the mothers and children (under two years of age) is presented in the Table 4.7. The foods are listed under the most commonly reported frequency, whether daily, weekly, monthly or rarely/never. Cassava and banana were consumed daily, as also reported by Huamán-Espino and Valladares (2006); other foods were seasonal.

Infant-feeding practices

All mothers reported breastfeeding their child, and 74 percent reported giving colostrum. Boys and girls were treated equally in this regard. At the time of the interviews, 26 of the 30 children under two years were still being breastfed. Mothers considered the appropriate age for stopping breastfeeding to be around 20 months. Those children who were no longer breastfed had stopped on average at 12 months.

Liquids other than breastmilk, such as unfermented masato or chapo, were given to the infant during the first few months of life. Thirty-nine percent (n = 12) had received another type of milk in addition to breastmilk. In the majority of cases this was evaporated cow’s milk; only one child received an infant formula. The mean age for first giving other milk was eight months.

Physical health assessments: anthropometry

The majority of the mothers (92 percent) had a BMI within the normal range (18.5 to 24.9 kg/m^2); 6 percent were above this range and 2 percent below. However, mean maternal height was low (148.4 cm), similar to that reported elsewhere for the Awajun population (Huamán-Espino and Valladeres, 2006) and other Amazon populations (Santos and Coimbra Junior, 1991). The proportion of children under two years with stunting (growth retardation, length for age <-2 SD) was high (43.8 percent), and continued into the older age group as shown in Table 4.8, similar to that reported elsewhere (Huamán-Espino and Valladares, 2006, and Buitrón and Hurtig and San Sebastian, 2004). A smaller proportion of children showed low weight for age (<-2 SD), although this is also higher than the national average. Although there were no children over two years with acute malnutrition (weight for height <-2 SD), 25 percent of children under two years showed undernutrition.

Qualitative information

Pile sorts

Mothers’ perceptions of food groups were explored through a pile sort exercise. A diagrammatic representation of this is shown in Figure 4.2.

In this exercise, the main reasons mothers gave for grouping the foods were: (1) how the foods are prepared and which foods are prepared together; (2) the source of the food, for example whether from the wild or whether they grow together; (3) the perceived value of the food; and (4) good taste of the food. The principal food attributes as perceived for young children by the mothers were in relation to their benefit or otherwise for the child, the child’s preferences, and source and use of the food. Mothers commented that different foods “are good for growth and development of the body so that the child is not weak”, “the food tastes good, it is smooth”, “it is eaten daily”, “it is boiled or cooked in patarashka”, “it can harm the child”, “it comes from the wild” and “it was used by our ancestors”.

Conclusion

The major dietary sources of the Awajun population of Cenepa were the locally produced, collected or hunted foods (a wide variety) that they traditionally had access to. However, through changes in community living, farming, hunting and collecting patterns not all of these foods were currently available (Huamán-Espino, 2006). The major sources of energy in the diet were the staples: cassava and banana. Intake of animal source foods, particularly meat and fish, was seasonal, but generally low and infrequent and depended on availability. The consumption of vegetables, seeds and fruits was varied and seasonal. The perceptions towards micronutrient-rich foods were mostly very favourable. The main limitation was infrequent consumption because of availability, replacement by government-donated foods and the small amounts consumed, especially by young children. Infectious diseases and parasites were predominant health problems among this population, and there was a high prevalence of stunting among children.

As a result of this exploration potential nutrient-rich foods have emerged that can be used for intervention to increase both production and consumption, especially for women and young children. Using this understanding of the traditional food system of the Awajun population of Bajo Cenepa, the research group designed interventions to enhance the health, nutrition and well-being of the participating communities through the promotion of key aspects of the traditional food system and culture, working with the community organizations, as well as health and nutrition promoters. A study with the Tsunamé in the Bolivian Amazon indicated that foods high in animal products, access to foraging technology and traditional knowledge of medicinal plants were related to better anthropometric indices of the population (Godoy et al., 2005). The selection of the food-based interventions with the Awajun incorporated these elements. The proposed interventions focused on three principal areas:

1.Production: Increase the accessibility of the communities to traditional foods, emphasizing those traditional foods that have high nutritional values. Enhance women’s role in food production activities to increase the variety of foods through the collecting and planting of traditional fruits seeds and palms, thus contributing to land protection (and possibly reducing the effects of contamination in fish) (Passos et al., 2003), as well as raising more small animals including suri and taking an active role in the fish farms. Involve school children in projects of planting seeds in their schools and learning about the value of traditional foods to reduce the loss of this traditional knowledge among young people.

2.Education: Increase knowledge regarding the nutritional value and perceptions towards the importance of, and promotion of, traditional foods in the communities, particularly with school children using the information gained from the qualitative explorations.

3.Participation and use: Increase the use of a wide variety of traditional foods through incorporation into food preparations, recipes and diets of the family with special attention to young children to benefit their nutrition.

The information gained from this study, although specific to the Awajun of Bajo Cenepa, contributes to the scarce information available describing the traditional foods and dietary intake of Indigenous Peoples living in the Amazon rain forest. Although differences in food varieties and diet have been reported between different Amazon populations (Milton, 1991), this methodology and its results can contribute to the development of appropriate interventions to preserve the rich traditional food culture and benefit the nutritional and health situation of these populations, who are currently experiencing critical changes in their nutrition and environment •

Acknowledgements

We are grateful to our research team of nutritionists; Melissa Abad, Miluska Carrasco and Sandra Vidal for the data collection and processing, Maria Luisa Huaylinos for the food analysis, Hamilton Beltran for the plant identifications, Lizette Ganoza for valuable assistance with the food composition data and Karla Escajadillo for excellent secretarial support. We especially wish to thank the community members of Bajo Cenepa and Organización de Desarrollo de las Comunidades Fronterizas de Cenepa for their active participation in the project, including Fermin Apikai and the members of the Women’s Programme: Alicia Majiano, Lindura Chimpa, Rosita Chimpa, Maria Apikai and Felimon Mayan; the translators Rubén Giukam and Alvaro Antumtshi and the boat pilots: Adán Bermeo and Francisco Kantuash. Peter Kuhnlein photographed plants and animals, the environment and the communities.

> Comments to: hmcreed@iin.sld.pe

>> Photographic section p. XII

Chapter 5

Ingano traditional food and health: Phase 1, 2004–2005

• CAMILO CORREAL, M. D.[1] • GERMÁN ZULUAGA, M. D.[1] • LILIANA MADRIGAL[2] • SONIA CAICEDO[1] • MARK PLOTKIN, PH. D.[2]

1

Instituto de Etnobiológica, Bogotá, Colombia

2

Amazon Conservation Team (ACT), Washington, DC

Photographic section >> XV

“Let’s return to our food, our life and our tradition. With our food, we will improve our health, will recover our culture, and will take care of the natural world. We need our plants and our jungle in order to have strength and to live better.”

Eva Yela, Ingano community member

Abstract

This chapter presents the results of a study on the ethnonutrition of the Ingano people of the Colombian Amazon. The study was carried out by Colombian, American and Canadian scientists working in close collaboration with the Inganos themselves.

The Inganos are a tribe of Amerindians living in the western-most Colombian Amazon, primarily in the state of Caquetá. Like most Indigenous Peoples, their contact with the outside world has had a serious (and primarily negative) impact on their diet. Particularly serious factors causing the decline in the quality of their nutritional input includes acculturation (particularly with the degradation of local knowledge of, and pride in, traditional agricultural practices) and access to low-quality Western foods (especially carbonated drinks and refined flour) – factors common to many of the indigenous studies carried out by the Center for Indigenous Peoples’ Nutrition and Environment (CINE) and presented in this volume. Factors relatively unique to the Colombian example are the degree of deforestation, the ongoing political violence, and the levels of water contamination due to byproducts of the local cocaine trade.

The study focuses at all stages on the process of maximizing community involvement. Representatives of every age group participated, from Elders – born prior to colonial contact – to newborn infants. Prior consultation, consensus decision-making, and human rights issues were integral cornerstones of the study.

The study documented – for the first time ever – the complexity of the original Ingano diet: over 160 types of food, ranging from roots to insects to palm tree products. Pre-contact health status is assumed to have been better than the current situation in terms of diversity of foods, although precise data on health status were not available. Eight items from the traditional diet were deemed necessary for maintaining and improving local health: (1) milpesos palm, (2) yoco liana, (3) cayamba mushroom, (4) bitter cane, (5) beetle larvae, (6) churo snail, (7) cucha fish and (8) the cimarron herb. By using local Ingano knowledge and working closely with Inga communities to better understand traditional diet and current nutritional deficits and needs, this study hopes to contribute positively to Ingano health and well-being.

Introduction

In the western Colombian Amazon, a region of exceptionally high biological diversity, live several indigenous tribes who have expertise in traditional medicine, medicinal plants, and the art of shamanism since pre-conquest times. Their traditional system of resource management entails slash and burn agriculture – primarily based on manioc (a form of cassava), corn and several varieties of fruit trees – hunting, fishing, and harvesting of wild forest products. Their cosmovision, connected intimately with the natural world, is closely aligned with their ceremonies and the consumption of their sacred plant – yagé, or ayahuasca – that enables them to communicate with their spiritual world and helps determine their social order, environmental ethics and holistic health management system.

For geographic and historic reasons, these groups (referred to by anthropologists as the “yagé culture”) have been able to preserve their traditions and their traditional systems of production and nutrition better than many others in lowland Amazonia. Nevertheless, during the last hundred years, the religious missions, the increased presence of the state and the extractive economy of quinine, rubber, gold and petroleum, the indiscriminate felling of the forest, plus the recent expanded cultivation of illicit crops and increased presence of armed forces, have produced a demographic and cultural debacle, with loss of indigenous territories, destruction of environment, and marked changes in Ingano customs. All of this has almost led to their physical and cultural extinction and has given rise to illness and malnutrition, in addition to serious damage to their cosmovision and their traditional medicine.

Among these tribes are the Inganos, fragmented and scattered among three Colombian provinces who, since 1986, have been united within the organization known as the Association of Indigenous Communities (Tandachiridu Inganokuna), and who have written a “Plan de Vida” (“Life Plan”) that proposes innovative solutions to the challenges of cultural preservation and the conservation of their territories and environment. With the support of NGOs like the Amazon Conservation Team (Amazon Conservation Team, Washington DC, 2004), these tribespeople have developed successful programmes of ethno-education, territorial recovery, environmental conservation, practice and perpetuation of traditional medicine, and sustainable agricultural production, among others.

Historically, the Inganos have been recognized as a relatively healthy group, with a long life expectancy. Current health problems are derived from recent effects of colonization, the loss of territories, the decrease in protein sources, the acculturation and loss of traditional medicine and the changes in eating habits. The reduction of their territories has resulted in diminished access to wild foods such as meats, fish and fruits. One of their most important medicinal species – yoco (Paullinia yoco) – is valued as a stimulant, a food and a medicine. Yoco has traditionally been used by the Inganos and is now in danger of eminent extinction – leading to increased reliance on non-traditional foodstuffs that cause health problems. Social “development” projects, such as cattle ranching and intense agriculture, have caused more problems than they have solved. The acculturation that comes with schools, health centres and publicity in mass communication media has worsened the eating habits of the youth, who abandon traditional foods to embrace processed food, which is more expensive, less nutritional and often harmful to their health.

This case study in Colombia (Figure 5.1) has become integrated into the Life Plan of the Association of Indigenous Communities in the Amazon district, and has four fundamental pillars: (1) the ethno-education programme of the local Yachaicury School, with the indigenous youths implementing a traditional food recovery programme to improve nutrition and health; (2) a biological resource and food supply security programme which relies on the indigenous agro-ecological promoters who work toward the recovery of traditional seeds and the development of productive farms; (3) the traditional medicine programme in which various shamans from several ethnic groups oversee the protection, defence and recovery of their medicine and the use of medicinal plants; and (4) the environmental conservation programme, essential since the Association partnered with the Colombian government to establish the country’s first protected area for biocultural conservation, the Indi Wasi National Park. Therefore, the CINE programme with which we are associated is very much in line with the Indians’ stated intention to taking charge of the cultural and environmental destiny based primarily on indigenous wisdom and traditions.

Description of Ingano research site and Indigenous People

Geographic and environmental characteristics

Southern-most Colombia at the eastern slopes of the eastern-most Andean chain is the area inhabited by the tribes in this study. This region is located between 150 and 500 m above sea level. Because it is located on the equator, there are no significant seasonal differences in solar radiation, which means that the variation in average monthly temperatures is minimal. Seasonality in this region is affected and defined by changes in precipitation periods.

The piedmont region is greatly influenced by pluvial cycle peaks, which have caused serious avalanches over time. Showers of more than 100 mm in 24 hours are actually frequent (Mejía, 1993). Average precipitation varies between 3 500 mm/year and 4 300 mm/year. The months with the highest precipitation levels are April, May, June and July. Those with lower precipitation levels are December, January and February. Moderate precipitation can be observed during March, August, September, October and November. Relative humidity oscillates between 64 percent and 93 percent (Agenda Unitaria del Caquetá, 2002; Lozano et al., 2001).

Soils are quickly eroding because of agricultural exploitation. Another related problem is illicit crop production, involving extensive use of agrochemicals. Generally speaking, there are two types of soils: 1) those found in the high plains of humid or very humid weather (haplorthox and dystropepts); and 2) those found in zones of very humid and pluvial weather, with plain or undulated relief, well or poorly drained (fluvaquents, tropaquepts) (IGAC, 1986).

According to the morphology and relief of the eastern chain’s eastern slope, it is possible to divide the region into sectors with respect to the vertical distribution of the slopes. Schematically, it can be said that in high-mountain areas vertical slopes are very cragged, gradually becoming less pronounced towards lower areas. Below are plains with slopes containing desiccated or elevated terraces. The piedmont belongs to the transition area between steep slopes and plains. The transition between the Amazonian lowlands to the east, and the Andes mountain chain at the west, characterizes this region. When grouping the distribution of the slopes according to their altitude, three elevation ranges were established. Flat areas are most common below 400 m above sea level. A transition can be observed between 400 and 900 m, where both gentle and pronounced slopes are found, while steep slopes predominate over 900 m above sea level (Sarmiento and Alzate, 2004). In addition to these precipitation characteristics, there are some erosion problems caused by loss of vegetable layer, high temperatures and precipitation levels that cause accelerated loss of soil nutrients.

As for water quality, contamination is now common. As streams run through populated areas, quality considerably decreases for there is no adequate treatment for domestic and agricultural residues. Many water sources have been diminished or even dried up by erosion, and others disappear during months with low precipitation. For this reason, availability of potable water is a growing problem.

The fumigation of coca crops has also become a serious problem. The sprayed pesticides fall onto grazing pastures or farmlands. When this happens in mature crops – especially manioc and banana – inhabitants harvest and consume them rapidly to avoid their loss, even if that means ingesting toxic chemicals. Another factor that considerably reduces water quality is the way in which cocasa (cocaine processing waste) is discarded – because this is released into the water supply, rivers and streams become toxic.

There are no fixed pollution sources in the area. Agricultural and livestock activities are based on the periodic burning of pastures during low precipitation months. This common activity reaches considerable proportions, although there are no detailed analyses of the phenomenon. The impact of acid rain is considered to be low or null, for cloudy masses are formed in the Amazon where emissions are not toxic enough. However, there are no studies that can offer precise data on the level of rain contamination.

According to the general ecosystem map (Márquez, 2003), this region marks the transition between lowland humid forests, submontane forests and, finally, mountains and high mountains. Below 1 000 m above sea level, lowland humid forests are characterized by high average temperatures and pluvial indexes above 1 500 mm/year, with a high canopy that varies between 20 and 50 m. Between 1 000 and 2 000 m above sea level, the submontane forests include elements of the ecosystems located above and beneath them. This ecosystem is characterized by both high humidity and pluvial levels, for it is located just where cloudy masses are charged with water and collide with the mountains along their way west through the Amazon. Canopies have an average height of 35 m. According to studies carried out on this region, satellite images can help to establish the increment on deforestation, gracing lands or naked soils rates in these forests (Sarmiento and Alzate, 2004).

Deforestation started during the 1940s when people from other regions in the country began to colonize the area. According to the inhabitants, during that time forests were continuous, but extensive livestock activities during the subsequent decades turned the forests into pastures. Today, plains and savannas have also been turned into pastures. In smaller farms, pastures share the area with banana and manioc crops. Deforestation has also increased near the mountains during the last years because of the arrival of additional peasants seeking land to cultivate coca.

These activities have all but exterminated the wild animals that previously constituted the indigenous communities’ main source of proteins. Plant species important for traditional medicine have also been diminished.

Caquetá: Departmental profile

Rural areas in the Department of Caquetá are suffering from overpopulation and low income because of the influx of landless peasants fleeing violence in other parts of the country. This regrettable situation has forced people living in rural areas to become involved in illicit alternatives to generate incomes. Of the 5 million acres surveyed by the Department, 99 percent were used for illicit crops and stockbreeding (Aguirre, 2004).

The main crops of Caquetá are rice, beans, corn, soy, cocoa, cocona, chontaduro, lulo, mandarin oranges, African oil palm, pineapple, manioc, banana and sugarcane. The acre yield for all these crops is relatively low. As for cattle rearing, studies show a considerable deficiency, with low milk and meat production. Deficiencies in roads and telecommunications infrastructure also exacerbate this problem, as they hinder contact and exchange between market centres as well as increasing the inputs and production costs.

Facing this critical situation, there are insufficient financial resources to invest in technology transfer and technical assistance. Some regional and national institutions have developed and disseminated technology for sustainable forestry and agricultural extension. However, because of the lack of resources and adequate agricultural policies, this technology has not yet been consistently developed or applied. This issue has led to depopulation of some rural areas and diminution of the agricultural business profitability, explained by the evident increase of the price of inputs, such as labour. In addition, the social situation of the country strongly affects that of the departmental rural areas, for abandonment of the countryside further aggravates the original problem (Aguirre, 2004).

Caquetá Department is part of the Amazon basin. Virgin forests exist on nearly 60 percent of this territory, mostly placed on the eastern slope of the eastern Andes where the headwaters of the Caquetá river – one of the major tributaries of the Amazon – are located. Nearly 70 percent of Caquetá’s territory is governed by laws enforcing protection or special management of its natural resources (Aguirre, 2004), but these are poorly enforced.

The General Social Security Health System seeks to provide social protection to the most vulnerable part of the population and assure that they receive appropriate healthcare and access to basic services. However, this department’s healthcare goals have never been met fully. In fact, many reserves and settlements do not have basic health services. Caquetá’s inhabitants generally poor health situation is, in general terms, the result of several factors: fast urbanization accelerated by displacement, presence of illicit crops such as coca, and armed conflict. Poverty is severe, and there is low insurance coverage because of scarce economic resources. Therefore, healthcare services are inadequate for the population. The department has additionally identified the following problems: high maternal and infant morbidity rates (one of the highest in the country) resulting from difficulties to access prenatal care; lack of safe delivery programmes and lack of monitoring of children’s growth and development; and lack of coordinated policies that ensure suitable food for pregnant women and children under five years of age. In addition, high incidence and presence of pathologies related to poor water quality are aggravated by weather conditions and primitive basic drainage infrastructure. With regard to education, average lower school enrollment and graduation is under 70 percent, while middle school coverage is less than 15 percent (Aguirre, 2004).

Displaced populations caught in the middle of the armed conflict, or whose lands have been affected by fumigation of illicit crops, presents still another challenge. Human rights violations because of the ongoing conflict compound these challenges. The Social Solidarity Network of Caquetá lists almost 7 927 displaced families or 38 000 displaced people (Aguirre, 2004).

Since the creation of the 1991 Constitution, indigenous communities have their own legislation, which allows them to ensure the existence and proper implementation of their traditional socio-political organization. However, communities are not fully capable of undertaking these processes and therefore protecting their culture and traditions. Lacking effective voice capable of dealing with the government and the outside world in general, these communities continue to be isolated and receive little support for their programmes and activities.

Caquetá is not properly covered by aqueduct or adequate sewer systems, especially in rural areas, and this is one of the most significant causes of morbidity, gastrointestinal and diarrhoeal diseases. Aqueduct distribution networks have a 25 percent deficit in the urban area, and 60 percent in the rural area. “Department municipalities do not have an efficient system that allows them to properly dispose of solid residues. Although most of this work (62.5 percent) is carried out through garbage collection, there are no adequate sanitary dump stations, but dumps with no kind of control or respect for environmental protection laws” (Aguirre, 2004).

The San Jose del Fragua Municipality traditionally belongs to the Ingano people, who arrived from Puerto Limon and Mocoa escaping Catholic missions and colonization. The municipality was officially created in 1985, although it had been established as a town as early as 1959 (Parra, 2004). The municipality is located in eastern Caquetá, 37.28 miles south of Florencia. It covers 76 367 square miles, 540 m above sea level. Its average temperature is 27 °C, with relative humidity of 87 percent. Average precipitation is 3 500 mm a year. Yurayaco is located at 297 m above sea level. The most important agricultural products are banana, sugarcane, pineapple and corn. Other significant products are rubber, cocoa, araza, cocona, copoazu, chontaduro, caimarona grape, coffee and borojo (Parra, 2004).

The most common botanical and faunal resources from the forest (Parra, 2004) are shown in Table 5.1.

Seven watersheds are found within the municipality’s territory, most originating in the mountains. These rivers all flow into the Amazon. They are rich in sediment and vegetable material. Deforestation also contributes to sediments entering the rivers. Because of the steepness of slopes, these rivers have a strong current (Parra, 2004).

As for health care, traditional indigenous medicine is widely accepted and practised. However, only 42 percent of Ingano families receive healthcare aid. Typically, rural areas have the lowest access to western healthcare. Common diseases in Caquetá include malaria, dengue, yellow fever, trypanosomiasis, schistosomiasis, oncocercosis and leishmaniasis. Diarrhoeal diseases and respiratory infections also present especially high rates. Unfortunately, tuberculosis and some diseases that could be forestalled through immunization are present. Chronic non-transmissible diseases are not among the most critical contributors to morbidity or mortality rates, but their incidence has been increasing lately (PAHO, 1994).

Besides medical and dental assistance, the Departmental government provides some promotion and prevention activities, including the Extended Immunization Plan as required by national law. However, the indigenous populations receive even less of this attention than other inhabitants of Caquetá.

Ingano people

Ingano indigenous communities in Caquetá are organized into cabildos – the community’s maximum authority – that elect a governor as well as a mayor, sheriff or constable, secretary, treasurers and other necessary officers. These posts are elected by popular vote at indigenous assemblies:

The Ingano come from several indigenous ethnos: the migratory groups living in the Colombian Amazonian piedmont come from the Peruvian and Ecuadorean Amazon; those inhabiting the lower Putumayo, known as Mocoas; and some are the last survivors of the Andakies, fighting people that never surrendered to the Spanish conquerors.

The most important settlement is located in Sibundoy Valley, located near the upper Putumayo River at 2 200 m over sea level. They also inhabit some rural territories in the Departments of Putumayo, Caquetá and Cauca. However, their migratory spirit has led them to some of the big cities of Colombia and neighboring countries. Over the last few years, they have experienced a great demographic recovery, and up to this moment 35 000 Ingano people are estimated to live throughout the country.

The Ingano people speak the Inga language, a linguistic form of Quechua. There is no exact information about their Mocoas and Andakies ancestors’ original dialect. With the latest colonization movement at the beginning of the last century and the presence of Capuchin missionaries, Ingano people were isolated and fragmented into five groups: a) those inhabiting at Sibundoy Valley, b) those at the neighboring regions of Mocoa, Bajo Putumayo, c) those living in the Bota Caucana, d) those at the region of el Fragua in Caquetá, and e) those who have migrated to villages in Nariño, Valle, Amazon, or to the big cities. This is the reason why the Ingano people are represented by several political organizations: Musu Runacua, OZIP and the Asociación de Cabildos del Valle de Sibundoy in Putumayo, Zonal de la Baja Bota Caucana in Cauca Department, and Tanda Chiridu Inganokuna in Caquetá.

Besides their demographic recovery, the Inganos have managed to consolidate more than 18 reservations properly acknowledged by the state. Although these territories are relatively small, they are distributed throughout the immense geography of the Amazon piedmont.

There are two main groups of Ingano people: the largest group, inhabiting the highlands, which incorrectly led them to be anthropologically classified as “High Andes” people; the other group inhabits the lowlands. The geographic diversity has also made the cultural variety extremely significant, although both groups share language, traditions, and especially traditional medicine like the use of medicinal plants.

(UMIYAC, 1999)

Geographically, these communities are located at the western part of the Department. The territory is close to Cauca and Putumayo Departments, only divided by the Caquetá and Fragua River that runs through the lower part of the Bota Caucana:

The territorial occupation of the indigenous settlements exemplifies how the community uses their land, for the Ingano people need the entire territory for their sustenance and recreation. Each family daily uses basic elements of the surroundings to survive and satisfy their needs. Each year, these communities occupy around 4.94 acres for cultivation, using a rotating cropping system in permanent crop areas.

One of the most important cultural expressions of the Inganos is the “Calusturinda”, carnival or party in honour of the rainbow. This carnival takes place during mid-February or beginnings of March, and it is considered the most important popular event of the year. It is also called Atun Puncha, or “big day”, and represents for the Ingano people the beginning of the year, joy, reconciliation, and the return of those who had left. Special dancing events take place during this festivity. People drink chicha [corn beer] and sing. Typical costumes are colourful and there are lots of games and music. As for religious traditions, the most important rite is drinking Ambi Huasca or Yagé. This drink is obtained from the plant called [ayahuasca], and it is sacred and medicinal for the Ingano people.

(Parra, 2004)

Colombian nutritional condition

According to statistics presented by UNICEF-Colombia, in terms of global malnutrition (weight/age), 10 percent of the country’s population suffered from severe malnutrition or was below two standard deviations during 1990. This percentage went down to 8.4 percent in 1995 and to 6.7 percent in 2000. On the other hand, 21 percent of the population was found to suffer from chronic malnutrition (height/age) during 1990, 15 percent in 1995 and 13.5 percent in 2000. As for acute malnutrition (weight/age), there are no records for 1990, but 1.4 percent was reported for 1995, and 0.8 percent for 2000.

UNICEF also declared Colombia free of iodine deficiencies in 1998, after establishing the presence of iodated salt in 91 percent of families, and just 7 percent of level I goitre, representing a very low risk for school-going age children. In Colombia, all wheat flour produced within the country must be fortified with iron, vitamin B_1, vitamin B_2, niacin and folic acid. With regard to anaemia, 25 percent of children under five years presented less than 11 g/dl haemoglobin in 1995, with those under two years of age being the most affected. The same percentage was recorded for groups of women of reproductive age, with the percentage increasing to 43 percent in gestating women (UNICEF-Colombia, n.d.).

These figures show an improvement in nutrition. However, rural areas located far from municipality administrative centres, such as in Caquetá where many Inganos live, do not receive adequate attention or services generally present the lowest of all health and nutrition indexes.

Many of the positive changes observed in nutrition indexes are attributed to the National Nutrition Plan developed in Colombia for the period 1999 to 2005. Nevertheless, the important gap between different areas of the country cannot be ignored. The Caquetá Department, for example, has the second highest malnutrition figures in the country (UNICEF-Colombia, n.d.).

According to UNICEF:

… death risk among children under five is extremely high, as well as the possibility that their adequate development suffers serious limitations. Many of today’s undernourished children did not receive the benefits of breast milk, or belong to families who have been displaced by the armed conflict. Women in these families are often undernourished, incapable of hygienically caring for their babies, or otherwise attending to their children. The Pacific Coast region has the highest figures of children under five suffering from chronic malnutrition. In this region, for the year 2000, only 12 percent of women were exclusively breastfeeding their children during the first six months. This fact reveals that cultural practices established by industries producing baby food products during the 1960s or 1970s are very hard to change.

(UNICEF-Colombia, 2007)

Methodology

We discussed, modified and signed with the indigenous leaders the collective consent that was drafted by the Centre for Indigenous Peoples’ Nutrition and Environment (CINE): prior consultation, consensus decision-making and the protection of their rights as indigenous communities were guaranteed. For the Inganos, the project was not considered research, but rather an instrument to improve and implement their Life Plan and to help them move towards cultural, environmental, productive, and community health recovery. Because of the civil conflict in Colombia that has its epicentre in Caquetá and Putumayo, the project strategy must be one of gradual extension and replication on the part of the indigenous groups. On the other hand, the Inganos do not recognize divisions between shamanism, health, diet, plants and nature. Therefore, the project was viewed as integrating all these issues in a holistic manner.

Given the prior instances of exploitation and of abuse of intellectual property, the Inganos do not approve of the collection of blood samples and subsequent medical laboratory analysis. It is the opinion of the indigenous leaders that these types of projects should result in better conditions for access to food and food availability than in diagnoses and documents. Initially, the expected project’s development was hindered by the occasional political difficulties that took place in the area, obstructing access to the Ingano region.

An interdisciplinary research team was created for the project, Nutrición y Alimentos Tradicionales (Traditional Foods and Nutrition), which began its activities on 1 May 2004. The project was developed with the communities belonging to the Asociación de Cabildos Tandachiridu Inganokuna (Tandachiridu Inganokuna Indigenous Cabildos Association). Participating reservations included Yurayaco, Brisas, San Miguel, Niñeras and Cosumbe, all in the Department of Caquetá. The participating communities with which the group had established a previous relationship signed a collaboration letter at the beginning of the project. The participation of each member was subsequently established, presented and discussed. The collaboration agreement and general consent were adjusted to the communities’ expectations and signed. A training workshop followed, which focused on the development and management of survey instruments: data format, surveys, anthropometric analysis and community workshops.

Research in the community was conducted as outlined in the methodology from CINE (www.mcgill.ca/cine/research/global.pdf). Research activities comprised focus groups to determine species in the traditional food list, and the ways that the Ingano foods are perceived and used. In addition, interviews with 34 women and 8 men, including several shamans, were completed. Twenty-four hour diet recalls were conducted with adults. Anthropometry was conducted on 116 individuals – 43 children (0–12 years) and 73 adolescents/adults (>12 years) – with standard scales and tape measures used in health clinics in the region. Several discussions were held with an additional 20–25 adult Ingano community leaders and health personnel, and existing reports on traditional medicines were reviewed.

Excel formats were used to enter a list of traditional foods to make the information easy to handle and process. Individual interviews with people belonging to the Ingano culture elaborated the food information. Food classification according to traditional attributes or categories was derived from personal interviews. Particularly emphasized were the hot and cold foods, the irritating and soothing foods, and the tonic and purgative foods.

Results

Over 160 types of food were described. Some were varieties of the same species, and, in some cases, parts of the same species were referred to separately. The research on traditional food confirmed the loss of many traditional resources, especially game animals and fish, insects and tubers, roots, seeds and leaves of indigenous plants. These foods have been divided according to the suggestion of focus groups in the following categories: small animals, big animals, traditional animals, traditional furry animals, monkeys, insects, birds, small fish, big fish, traditional fish, palm trees, platanos (varieties of banana), fruits, root foods, other plants, carbohydrates and cereals. This division allowed clarification of some characteristics of the classified species. The availability calendar of most of these foods was not especially significant. Since the communities are located in tropical areas, weather variations are not drastic enough to be distinctive. However, wild species do appear in specific seasons, while those that are grown are available depending on where they are planted. This provides food year round. Table 5.2 records a list of Ingano traditional food, containing 160 species.

Generally, the reason that certain traditional foods remained in the diet has been availability rather than demand, although some traditional Inga foods were also highly appreciated for their nutritional value. Since in many cases foods were wild, information on their nutritional value was difficult to acquire. It appears reasonable to consider that the good health attributed to these indigenous populations prior to contact has to (in part, at least) be strongly related to traditional diet, which has been disrupted by contact with the outside world.

Primary meat processing and storage techniques were salting and smoking. Many of the listed foods were only eaten fresh; food gathering among the Inganos was carried out on a daily basis, and most of these foods were consumed relatively quickly.

For food-analysis sampling, priority was given to those with potentially high nutritional value. Of the 19 foods chosen for additional analysis, we learned both from the literature and the lab that the following species are nutritionally important and need to be a part of the current and future diet:

1Caña agria: bitter cane employed in the preparation of refreshing drinks.

2Cayamba: large and tasty edible mushroom.

3Churo: edible riverside snail.

4Cimarrón: edible and medicinal herb.

5Cucha: edible fish.

6Milpesos: Palm tree fruit used for consumption and for edible oil.

7Mojojoy: edible beetle larva from fallen palm trunks.

8Yoco: liana used to prepare stimulating beverage.

Some elements of important traditional foods are presented in Table 5.3. Samples were sought for laboratory analysis of nutrients of yoco, cucha, caracol, mojojoy, cilantro, cimarron, caña agria and milpes. Samples were gathered at San Miguel del Fragua, at a height of 540 metres above sea level, by Fabio Quevedo in February 2005, following all the technical specifications suggested by the laboratory. Table 5.3 presents laboratory results in dry weight of these food items.

A literature search of nutrient values of selected key Ingano food species was conducted, and results are presented in Table 5.4. The need for further work on nutrient composition of Ingano food samples is evident from the lack of published data.

Qualitative aspects of Ingano traditional food importance

The characteristics of traditional foods were agreed in the groups. Following the selection of attributes, the same foods were used to derive a taste-appreciation score for children and adults on a 5-point scale. Table 5.5 reports the average scores for each food. With this information it was then possible to summarize attributes of each of the foods (Table 5.6).

It is clear that these foods were well accepted and that both children and adults enjoyed them. In some cases, the taste of certain items may not have been very pleasant, but their importance to the community was considerable.

Nutrition of infants, children and adults

Interviews conducted with mothers about the nutrition history of infants revealed that breastfeeding was prevalent with cessation from 3–24 months. Complementary food was given early in life. Many children were already taking complementary foods after the first month, and almost all of them had these foods after the fourth month. Milk formula and supplements were used rarely. Complementary food in the infant diet was initiated gradually, generally well accepted and did not produce any health problems.

In the 24-hour dietary surveys, it was found that food diversity was good but somewhat limited because of the scarcity of food resources (including traditional foods) obtained from the surroundings. Also important were the financial difficulties limiting access to other high-quality foods from markets. Using dietary recalls to understand the significance of market food sources, the percentage of dietary energy from both traditional food and market sources was calculated (Table 5.7). Of total daily dietary energy, 58 percent of children’s diets and 47 percent of women’s diets comprised traditional Ingano food.

Results of the anthropometry assessment of Inganos are given in Table 5.8. It can be seen that the population represented the early stages of the nutrition transition where most children are normal in their height and weight, but that underweight (low weight-for-height) and stunting (low height-for-age) are present, and there was little childhood overweight or obesity. At the same time, the incidence of overweight and obese adults was evident.

Summary of the current situation

The research has shown that at the time of the research an impressive diversity of traditional food resources from the local environment were known and consumed by Ingano families. While commercial food was encroaching, the majority of dietary energy was still derived from traditional Ingano food. These local resources were highly regarded by adults and children alike for their many attributes. Environmental concerns for the local food-producing areas are significant.

A meeting was held with project personnel to evaluate the project’s development, executed activities and participation of the work group, as well as to establish the expectations for the future. During this meeting, the group commented on several matters of the investigation conducted and concluded that the community had gained awareness about the loss of certain cultural aspects and people were starting to give importance to the products included in the diet. Generally speaking, the support offered by the Inganos to this project in the first months of work was good. The visits carried out were well received by the community. For members of the community, the experience of just remembering the traditional names of their food products was extremely enriching, and allowed them to learn and exchange knowledge. Since the topic was interesting, the work was easily done, especially because Elders like to share this information, although they are always cautious when doing so to protect their traditional knowledge. Indigenous authorities were also supportive and made it easy to access the communities and to carry out individual and group activities.

Problems the group encountered were also discussed during the meeting. One topic was the rejection and wariness that domiciliary visits and surveys sometimes caused. The reason for this reaction was that many members of the community were not aware of the overall purpose of the research and the benefits it would potentially mean to them. Some didn’t want to participate because they believed the project was only trying to obtain information that depreciated indigenous groups.

The community work group as a whole considered that this project had gathered information that is of great importance if the traditional elements are to be rescued, in order to make the community more independent from external markets, when it comes to health and nutrition.

Looking to the future of the project

Project participants involved in evaluation meetings suggested that all activities should be carried out with the support of community leaders. In this way, acceptance and understanding of this project and its objectives can be assured. Another suggestion was to share project methods with all Ingano communities in the region.

Community work must try to involve everyone: Elders, women, adults, young people and children. It is also necessary to create campaigns designed to promote the protection of the resources the community already has, as well as trying to recover what has been lost or damaged. This is only possible by creating awareness (especially among young people) and improving technical management of crops and wild species.

Nineteen Ingano traditional foods were chosen for promotion and recovery for the following reasons:

- Traditional: foods that were part of the traditional diet.

- Nutritive: foods known for their nutritive value (protein, polyunsaturated fats and important micronutrients).

- Necessary: foods that have not been replaced or that serve a fundamental role in the cosmovision of the culture.

- Available: foods that are easy to obtain.

- Enjoyable: foods that will be eaten and enjoyed by the communities.

- Affordable: foods that are inexpensive to obtain.

Ingano representatives who attended planning sessions requested that: (1) crops of the ancestral foods be cultivated, (2) an environmental protection plan for the ecosystems required to maintain these food resources be designed, (3) support or subsidy be offered toward the acquisition of the crops obtained from the gardens maintained in the traditional agriculture programme, (4) a Nutritional and Epidemiological Monitoring System to monitor the condition of the participating population, and (5) a programme be established to promote the consumption of traditional food. These measures should be included in the education offered to the indigenous persons in the Yachaicury School so that they may serve as “multipliers” of this information, beyond the activity in community workshops carried out by the promoters and the professional team.

Discussion

One of the characteristics of the crisis the world is currently undergoing is the loss of diversity, both biological and cultural. With this loss, threats to shamanism – a belief system central to the well-being of many indigenous groups – can be seen. This is important for a world that seems to have lost the way in its effort to maintain health and respect the natural world.

The problems our societies are currently facing result from a tendency to homogenize culture (underestimating the traditional values of peasant groups and Indigenous Peoples). We face crises in health services management, serious contamination problems and dramatic loss of biodiversity. Also damaging is the reductionist perspective of scientific thought, and in ethical terms, the secularization of human culture.

To overcome these problems, a long-term social transformation is required. First of all, it is important to strengthen the scientific and technological advances accomplished during the twenty-first century, the creation of new paradigms, and incorporation of new scientific perspectives regarding the world and humans who live in it. The growing awareness on the “environmental problem” has encouraged a search for urgent solutions. After its timid appearance with the ecologic movements of the 1970s, this awareness first evolved into an “ecodevelopment” proposal (UNEP, 1972) and finally into the concept of “sustainable development”, which is understood as the development that satisfies the needs of the present generation without compromising the capacity of future generations to satisfy their own needs (United Nations, 2002). This concept is still in force, despite the conceptual divergences and conflicts of interests that surround it.

Sustainable development policies have followed four main lines: 1) preservation and/or recovery of ecosystems and flora and fauna diversity in several regions of the world; 2) application of economic models that encourage a decrease on the economic growth; 3) creation of new technologies considered as soft, clear or less contaminant; and 4) control of demographic growth.

Thus, the following question arises: would Indigenous Peoples prefer to disappear as a culture if they lose the sense of collective property and/or their shamanic systems? Shamanism cannot be strictly defined as medicine, although healing is its main objective. Strange ceremonies and rituals, chants and dances, colourful outfits, perfuming with incense and invocations are part of the shamanic world. The shamanic functions are characterized by a deep sense of the sacred, great wisdom regarding nature, utilization of trance-inducing techniques, and a strong belief in other worlds; it also implies consumption of plants that are regarded as sacred (wrongly called hallucinogenic), and a vast knowledge on the medicinal properties of plants. For the Western world, the shamanic universe remains strange and mysterious (UMIYAC, 1999).

The pillar of the indigenous culture and its productive systems is shamanism. In those groups where the shaman disappears or loses his authority, and the traditional medicine man loses validity, extinction and acculturation are more serious and immediate. That is why any social, environmental, cultural, economic or politic development project should start by strengthening the shamanic institution and the traditional medicine system. The indigenous culture highly depends upon the survival of shamanism. Therefore, – and this should be considered by all bioprospecting programmes – strengthening of the shamanic institution is paramount to the conservation of cultural diversity. Actions that seek to preserve traditional societies are crucial:

It is necessary to value and protect cultural diversity, because of the alarming current diminishment of the little adaptative social forms still existing. To lose and destroy civilizing systems implies losing unique models of social, political, economic, and linguistic organization, as well as intellectual, scientific, artistic and philosophic expressions… Cultural diversity is as important as biologic diversity: they both guarantee the wealth of life forms… Cultural pluralism is paramount to a biosocial evolution that optimizes all life forms and cultural creativity… Cultural diversity increases all human creativities in order to achieve different forms of collective coexistence.

(Barón et al., 1995)

Environmental conservation policies face the conflict of focusing either on biologic or cultural conservation. There are very few experiences that integrate both concepts. For indigenous traditional medicine, health implies harmony or equilibrium of reality. The human being is not just a body, but also thoughts, memories, emotions and spirituality. This harmony also refers to social relationships: family, neighbourhood, community; and finally, it also means harmony between and within nature, harmony among vegetables, animals, the invisible beings and sacred places. It could be stated then that the concept of health within the indigenous traditional medicine focuses on the triad person-society-nature that greatly exceeds the current definition of modern medicine.

The Western perspective typically refers only to the extrinsic values, while the indigenous perspective refers to intrinsic values. Both the orthodox approach of modern economics and the environmentalist discourse refer to the concept of development. Progressive economic growth or sustainable development always implies “development”. The modern economic model seeks to measure development through an indicator known as Unsatisfied Basic Needs (UBN),[2] which – through a series of complex calculations – includes categories of material character: housing, access to public services, transportation, formal education level, consumption capacity (electrical household appliances and luxury goods), among others (UNDP, 1996). But the UBN does not consider other “unsatisfied basic needs” that might be intangible but not because of that, less important. We’re talking about health, joy, production methods, access to formal and informal education systems, capacity to develop the need of transcendence and finding the meaning of life.

The Indigenous Peoples have managed to remember that “life” is not just about consumption, welfare and acquisition of material goods. Their cosmovision, their way of life with a collective property perspective, and their easy access to other awareness levels that bring a transcendence feeling are lessons that should not be forgotten at the moment of negotiating or establishing the concept of development.

Culture, nature and health

To understand the indigenous analysis of reality, the perspective Culture-Nature-Health can be utilized (Figure 5.2) (Zuluaga, 1998).

Culture here refers to cosmovisions, production methods, form of social relationships and the interpretation of daily reality. Nature refers to natural resources, defined as the vegetable, animal and mineral kingdom by the western culture, and as “mother earth” – a more global concept – by the Indigenous Peoples. However, to understand the interrelationship between the three concepts, one cannot fragment the analysis into independent categories.

In this perspective, culture is studied by social sciences, nature by biological sciences, and health by health sciences. There is still missing an interdisciplinary science that considers these aspects as a whole and not as the arithmetic sum of each discipline, not only when dealing with the indigenous reality, but with reality at any level.

There are four interstices among the three circles. It is precisely in those spaces where new reflection and work strategies for environmental, social and health projects can be found:

1.Relationship health-nature: This firstly refers to nature’s health or health of the ecosystems, meaning the state of biologic resources. It secondly refers to the important role that environment plays on the matter of human health. Water and air quality, availability of fertile soils to guarantee food security, accumulation of rubbish and toxic residues, contamination with nuclear radiation, etc., are factors that directly affect health conditions. Recent World Health Organization (WHO) documents have justly concluded “the planet is sick”, and the opening to new health policies state: “Our planet, our health” (WHO Commission on Health and Environment, 1992). Finally, there is a close relationship between health and nature, established through more reliance on traditional medicinal plants. Indigenous shamans and traditional medicine men and women are masters of these medicinal plants. And these sacred plants play an essential role in cultural maintenance and well-being.

2.Relationship nature-culture: Although biology also refers to culture when talking about animal behaviour – well known by shamans – this category must be considered with respect to nature and human culture. This is how cultural ecology starts to discover the important role of environment and resource availability in the development of cultural, ethic and power manifestations of human societies. It is surprising to examine the origin rites of many tribal peoples, who consider the domestication of a plant the genesis of their society; that is the case of the Maya people, who consider themselves to be “sons of corn”, or of several Amazon peoples that call themselves “sons of yuca”, etc. Ethnobiology is precisely the discipline which seeks to study the interrelationship between nature and human culture in its different branches (ethnobotanics, ethnoecology, etc.),

3.Relationship culture-health: Traditional medicine is understood as the medicine system used by indigenous or peasant communities to manage health and sickness. Contrary to modern medicine and psychiatry, traditional medicine considers illnesses to be more than body or mind problems; they also include work or marital difficulties, bad luck in hunting and fishing activities, or bad relationships with others.

4.Relationship health-nature-culture: Western scientific thinking and its several disciplines still lack a science able to approach the integrality of the three relationships, but authentic shamanic systems can teach us about this integration of concepts. We have to accept our condition of listeners and apprentices of the indigenous Elders’ wisdom, and listen to what they have to explain about a reality that does not admit differences between culture, nature and health.

For centuries, Indigenous Peoples have managed to obtain from the forests satisfaction for all of their needs – including culture and spirituality – without destroying these ecosystems. This type of intervention has been called “anthropogenic forest” or “humanized forest” (Correa, 1993). The process of “humanization” of the forest has been led by the Elders of communities. Availability of sacred, stimulant and medicinal plants, the overlapping of natural resources with “invisible people”, the establishment of annual calendars based on ecologic events characteristic of the forest, the ethic codes for fishing, hunting and gathering of wild fruits, and a frugal use that guarantees resource sustainability – among others – are characteristic elements of shamanism for territorial ordering and sustainable use of resources.

Each culture, within its process of historic development, has identified different ways to face fundamental problems… As for the specific problem of sickness, we can identify very particular categories, models, ideas, practices, etc., that depend on the cosmovision, social and economic history and geographic conditions – nature – of each culture. That’s why the answer to those problems is not necessarily identical or valid for every culture.

(PAHO, 1995)

On the other hand, it is also evident that younger indigenous generations, due to their more frequent contact with modern society, are leaving aside or failing to learn many of their traditions and production systems. Acculturation, as a result of governments’ influences and classic models of western development, is a common phenomenon among all Indigenous Peoples.

It is necessary to recover, cultivate and protect the food and medicinal resources: germplasm banks, botanic gardens, house gardens and greenhouses can be used to reinforce species propagation. At the same time, we need to protect cultural memory that strengthens traditional medicine. Dialogue is necessary among medicine men and women, midwives, and herbalists in order to transmit traditional values and techniques to younger generations •

Acknowledgements

We want to thank the Ingano communities of Colombia, in particular those that make up the Asociación de Cabildos Tandachiridu Inganokuna, without whom this work would not have been possible. We especially appreciate the assistance of our health promoters: Eva Yela, Antonia Mutumbajoy, Lida Garces, Diva Devia, and Bernarda Deisy Burgos (RIP). We acknowledge with sincere gratitude the support received from the Centre for Indigenous Peoples’ Nutrition and Environment, for partial funding for this research from the Canadian Institute of Health Research and the Institute of Aboriginal Peoples’ Health. We are also deeply grateful to our colleagues at the Instituto de Etnobiología and the Amazon Conservation Team for their support and dedication to this process.

> Comments to: mplotkin@amazonteam.org

>> Photographic section p. XV

Chapter 6

Documentation of the traditional food system of Pohnpei

• LOIS ENGLBERGER, PH. D.[1] • ADELINO LORENS1, 2 • AMY LEVENDUSKY1, 3 • PODIS PEDRUS[4] • KIPED ALBERT2, 4 • WELSIHTER HAGILMAI[6] • YUMIKO PAUL[5] • DOUGLAS NELBER[7] • PELIHNA MOSES[4] • SARAH SHAEFFER[8] • MARCELLA GALLEN[5]

1

Island Food Community of Pohnpei (IFCP), Pohnpei, FSM

2

Pohnpei Agriculture of the Office of Economic Affairs, Pohnpei, FSM

3

Peace Corps Micronesia, Pohnpei, FSM

4

Community of Mand, Pohnpei, FSM

5

Pohnpei Department of Health, Pohnpei, FSM

6

College of Micronesia (COM)-FSM, Pohnpei, FSM

7

Pohnpei Department of Land and Natural Resources and Historic Preservation Office, Pohnpei, FSM

8

Emory University, Atlanta, GA, USA

Photographic section >> XVIII

“God made us to eat our own foods. We need to go local!”

Pohnpei community leader

Abstract

The Pohnpei case study presented here, is centred in the Mand community of Pohnpei, Federated States of Micronesia in the Western Pacific Ocean. The study aims were to document the Pohnpei traditional food system and test the Centre for Indigenous Peoples’ Nutrition and Environment’s methodology, using a participatory, multiple-methodology, ethnographic approach.

There was a great diversity of local foods (381 items), but use of the traditional food system has declined. Local foods provided 27 percent of the energy and 38 percent of the protein consumed by adults (compared to 16 percent of energy, 27 percent of protein for children), while the rest came from imported foods, many which are of nutritionally inferior value. Few participants met the vitamin A and C recommended intakes. Seventy percent of women and 60 percent of men were overweight or obese in all age groups except for the men in the 15–19-year-old age group in which most were of normal weight. Of the participants 40 years and older, 63 percent of women and 58 percent of men had abnormal blood sugar levels (fasting blood sugar ≥126 mg/dl) and were, thus, either diabetic or at risk of diabetes. Stunting, vitamin A deficiency and dental decay among children were serious problems. Intervention activities for increasing local food production and consumption were set in place.

The study raised great community interest and signs of positive project impact have already been recorded. It is likely that a similar approach may be valuable in other Pacific islands.

Introduction

Preparations for participatory research in the community

In early 2005, the Island Food Community of Pohnpei (IFCP) was invited to join the Centre for Indigenous Peoples’ Nutrition and Environment (CINE) Food Systems for Health Program as the twelfth case study, representing the Oceania region (Kuhnlein et al., 2006).

In mid-January 2005, partner agencies, including the Pohnpei Department of Health, became involved and discussed the selection of the target community. The criteria were: rural community, population of 500 to 1 000, accessibility and willingness to participate in a three- to four-month survey, followed by a two-year intervention. Three villages were suggested, and Mand was chosen, as it fit the criteria most closely and partner agencies had project officers available there with community links.

Initially, community members were sceptical about the project, but they gave full support after learning more. The Governor’s Office concurred with the research project, and assistance was provided by Professor Kuhnlein during a visit to Pohnpei (5–11 March 2005). A research agreement was signed with these research aims:

- To understand the traditional food resources of the community in order to improve health, and to conduct and evaluate a health improvement programme using traditional food resources.

- To include Pohnpei traditional food system data and establish the link to improved health status as a consequence of greater traditional food consumption, as part of a 12-case study programme with CINE to demonstrate that traditional food resources of Indigenous Peoples around the world should be protected.

- To prepare a 20-minute DVD on issues related to Pohnpei traditional food.

A consent form presenting the study purposes was developed for obtaining verbal consent for participation in the study (including interviews and photographs). Interviewers were trained on research methods and procedures, including data confidentiality.

Overall description of case study research site and Indigenous People

Geographic and environmental characteristics

Pohnpei is one of the four states of the Federated States of Micronesia, a developing country located in the western Pacific Ocean (Figure 6.1). The Federated States of Micronesia, including also Chuuk, Yap, and Kosrae, consists of 607 islands (volcanic and atoll)[3] spread over a million square miles of water.

Pohnpei State comprises the main island of Pohnpei and five outer atoll island groups: Mwoakilloa and Pingelap (located east of Pohnpei), and Sapwuafik, Nukuoro and Kapingamarangi (located south). Pohnpei Island lies at 6° 55’ north latitude and 158° 15’ east longitude.

Pohnpei Island has rugged mountains, verdant tropical plants with year-round heavy rainfall (250–500 cm annually in populated areas) and high temperatures (annual average 27 °C). In general, agricultural resources are adequate throughout Pohnpei (and the Federated States of Micronesia), with atolls generally having poorer soils and less rainfall than volcanic islands. Subsistence farming and fishing are the primary domestic economic activities (CIA, 2006).

Demographic characteristics

The Federated States of Micronesia’s population is approximately 107 000, with that of Pohnpei State being 34 500 (FSM, 2002). Pohnpei’s total land area is 355 sq km. Historically, the Federated States of Micronesia was colonized from 1885 to 1945 by three foreign powers: Spain, Germany and Japan, respectively. After 1945, the islands making up what is now the Federated States of Micronesia came under United States administration as part of the Trust Territories of the Pacific Islands (TTPI).

In 1986, the Federated States of Micronesia became independent, along with the 15-year Compact of Free Association with the United States through which substantial funds were provided.[4] The close relationship with the United States was maintained by the signing of a second Compact in 2004, which will end in 2023 (CIA, 2006). These formal agreements have generated most of the funds of the nation’s economy, including a large public sector employment (Drew, Alavalapati and Nair, 2004). As to poverty, lack of food is not a problem in Pohnpei, but it is estimated that 29.5 percent of the population falls below the poverty level – the definition of poverty includes low access to adequate medical services, education, and clean water (Abbott, 2004).

As the second Compact provides less funding for state and national governments than previously, the public sector is presently being downsized, thus providing lower incomes for Pohnpei and the rest of the Federated States of Micronesia. It is expected that agriculture will be taking on a more important role in household food and income production in the future (Drew, Alavalapati and Nair, 2004). Although there are limited data on the level of remittances sent to Pohnpei by family members, there are increasing numbers of Pohnpeians working overseas, mainly in the United States of America (Hezel, 2006).

Mand, the target village of this study, consists of a group of Pingelapese people who maintain their distinct language and culture (Damas, 1994). Mand is located in rural Madolenihmw, one of the five municipalities of Pohnpei on the main island. In the 2000 census (FSM, 2002), Mand had a population of 462 residents and it is estimated that the population in 2005 was over 500.

Cultural characteristics

Pohnpei Island is the largest of the state’s six major island groups. Pohnpeian and English are the state languages (Rehg and Sohl, 1979). However, Pohnpei’s atolls have distinct languages and culture. Pohnpei has a great mixture of cultures and ethnicities and it is the seat of the Federated States of Micronesia National Government where English is the official language. Due to overcrowding on Pingelap atoll, land was obtained in the early 1950s from the leader of Madolenihmw Municipality of Pohnpei. The first group of 60 Pingelapese settlers arrived in Mand in 1954. Although around half of Pohnpei State’s people are Catholic, most people in Mand are Protestant and there is one main church in the village, with a well-built community hall adjacent to that church. There is also a Mormon church in the village and a few residents are followers of the Bahai faith. The village has a small school with classes up to the fourth grade. This is located next to the traditional meeting house (nahs) – an open-air structure used for informal and formal meetings. More advanced primary and secondary schooling can be obtained in a nearby village, and there is a community college at the College of Micronesia (COM)-FSM Pohnpei Campus in Kolonia, the town centre of Pohnpei and another at the COM-FSM National Campus in Palakir, an area near Kolonia.

General description of the food system

In Pohnpei, there is great plant diversity (Adam, Balick and Lee, 2003) and many varieties and cultivars[5] for the staple food crops, including 55 banana, 133 breadfruit and 171 yam cultivar names (Raynor, 1991). Almost all production is through the agroforestry system, which consists of multi-storied gardens of trees and shrubs grown among annual and perennial crops and, often, domestic animals. Pohnpei also has a wealth of seafood: 1 196 species of edible fish and 4 species of inedible fish (Ashby, 1993). However, there has been a decline of traditional agriculture and local food use in recent years, owing to a complex set of factors including changing lifestyles, inconsistent external and internal government policies for supporting indigenous food crops, increased available cash, and food aid programmes (Hezel, 2001; Englberger et al., 2003a). There is concern about the loss of traditional knowledge. Despite this, there is still a considerable reliance on local foods and still a wealth of traditional knowledge relating to local foods (Corsi, 2004).

Mand is reached from the town centre of Pohnpei, Kolonia, by a 40-minute drive on a paved road. The village is located along a river, featuring a waterfall directly behind the settlement. The lands surrounding the village consist of rich soils on which a variety of crops are grown. There is no distinct rainy season, although there are distinct seasons for the harvest of the two main staple foods (breadfruit and yam).

The village has no direct access to the sea, but is within walking distance of it. Many people fish on a regular basis; some of the catch is consumed by fishermen and the rest is sold. Agriculture is carried out mainly on a subsistence level. There is no established local foods market in Mand, but three small shops sell imported processed food, and major food shopping is done in Kolonia.

Overall health and nutrition status

Nutrition-related disorders, including both micronutrient deficiencies and nutrition-related chronic diseases (i.e. diabetes, cardiovascular disease, and cancer), have become serious health problems of epidemic proportion in Pohnpei and FSM (Elymore et al., 1989; Coyne, 2000; Pohnpei STEPS, 2002; Englberger, Marks and Fitzgerald, 2003).

Writings from earlier in the twentieth century indicate little evidence of malnutrition. A United States Navy study after World War II noted an almost complete absence of obesity in Pohnpei; physiques were described as lean, and diabetes was unusual (Hezel, 2004; Richard, 1957). However, now over half of the Pohnpei preschool children have vitamin A deficiency and a third may be anaemic (Auerbach, 1994; Yamamura et al., 2004). There are high levels of stunting among children (Elymore et al., 1989). Approximately one-third of Pohnpei adult women are overweight in every age group (Elymore et al., 1989; Pohnpei STEPS, 2002). Around 20 percent of 45–55 year old Pohnpeians have diabetes (Hezel, 2004; Pohnpei STEPS, 2002).

Present-day dietary disorders appear to be the consequences of significant dietary and lifestyle changes, most of which gathered momentum after the 1970s. The diet has greatly shifted from the consumption of traditional foods[6] towards increased consumption of imported foods, including white rice, flour products, sugar, fatty meats (including turkey tail),[7] and other fatty, salty and sweet processed foods.

Methodology

The data collection took place from May to August 2005 using the CINE methodology with its ethnographic participatory multiple-methodology approach (Kuhnlein et al., 2006; INMU, 2003). The primary research team was composed of ten officers from eight agencies. Team members were first trained on the survey protocol, consent form, interview guides and questionnaire forms. Visits to the community were scheduled for two days per week.

Preparations for the health, dietary and agroforestry assessments

An informal census of the village identified 71 households. Households were then numbered, random numbers were electronically generated and 47 households were randomly selected for the study, aiming at reaching over half of all households. All adult members (aged 15 to 65 years) in the randomly selected households were asked to join the adult health assessment for weight, height, fasting blood sugar and blood pressure measurements, and relevant other information, including physical activity levels and food purchases.

In order to maximize dietary variation, one adult (females were generally targeted) and one child (aged one to ten years) were selected per household for the dietary assessment. The adult was chosen according to best knowledge of foods consumed and knowledge of the child’s diet. In cases where there were multiple children in the targeted age group, the youngest child was selected.

Methodology for dietary assessments

Two dietary assessment methods, a repeated quantitative 24-hour recall for two non-consecutive days and a seven-day food frequency questionnaire (FFQ), were used in order to better assess the usual diet in Mand. The dietary assessment questionnaires were adapted from forms already developed for FSM (Englberger, 2003; Englberger et al., 2005c), but were further developed to specifically distinguish between imported and locally grown foods. As requested by the interviewers, the forms were in English (to improve precision), but the questions were asked in the vernacular.

All five interviewers spoke Pohnpeian, Pingelapese and English fluently and had ties with the Mand community. Interviewers were involved in developing and pre-testing the questionnaires, aiming at relevant, clear and culturally appropriate questions. Each completed questionnaire was reviewed for detecting omissions or inconsistencies. The interviewers alternated so that the second 24-hour recall for a household was administered by a different interviewer in order to reduce interviewer bias.

A standardized 24-hour recall protocol was followed, describing amounts eaten (standard cups, spoons, pieces), cooking methods, maturity of food crops (i.e. banana, breadfruit), brand names and recipes. For bananas – which can be identified by cultivar name and which vary greatly by carotenoid content – the names of the cultivars consumed were recorded in order to increase the accuracy of the dietary assessment. A standard portion size list previously used in the Federated States of Micronesia (Englberger, 2003; Englberger et al., 2005c) was adopted, as the foods were similar to those in Mand. Actual foods and utensils (tablespoon and teaspoons) were used during interviews to help the participant describe the foods and amounts consumed and to serve as memory aids. Efforts were made to determine any fortified foods and to ensure that consumption of these would be correctly entered into the dietary analysis.

Data of the 24-hour recall were entered into the FoodWorks software, grouping foods as local or imported and analysing for energy, protein, fat, ß-carotene equivalents, vitamin A and vitamin C. There were no missing nutrient values for food consumed. The food composition table was augmented using data of ß-carotene equivalents or vitamin A determined in the ongoing food composition study, as well as some local recipes. A focus was placed on vitamins A and C because of previously identified problems and concern about low consumption of fresh foods. Information was collected on lactation among participants, but not on pregnancy status, due to sensitivity and lack of confirmation about this in some cases. Individual means of the two days’ intake were calculated and entered into Excel computer software. Group means were calculated separately for the mothers and children.

The seven-day FFQ provided a qualitative assessment of food intake over seven days.[8] Thirty-seven foods and other items were included, including alcoholic beverages,[9] local sakau drink (kava),[10] betel nut and tobacco. In addition to these 37 items, there were over 200 sub-items, which helped the interviewers in probing and provided further information. Interviewers circled these if the item had been consumed at least once. Some food terms including local cultivars with no English name were presented in the local language for improving clarity. Excel computer software was used for the analysis.

A further questionnaire on activity levels and topics relating to diet and health was developed and administered. An infant-feeding survey was carried out later in the study period in order to provide specific information on breastfeeding practices and complementary feeding.

Methodology for health data assessments

Community members were encouraged to participate in the fasting blood sugar (FBS) study in order to know their status relating to diabetes. The study was offered free of charge and at a site in the village to facilitate participation. It was explained to all individuals that a fully fasted condition was required for the test.

When participants arrived at the survey spot in early morning, they were registered, measured for weight and height and asked if they had previously taken a FBS measurement and whether they already had diabetes. Weights were taken using electronic scales (Seca Model 890), while wearing light clothing. Height was measured by using a microtoise. Waist circumference was measured at the narrowest point (at the navel or slightly above). Standard methods were used for measuring blood pressure and FBS using the Accu-check mobile instrument. Participants were asked to sit five minutes prior to the blood pressure check (repeating for cases outside normal ranges), and were excluded for the FBS check if they had consumed food or a beverage after midnight.

For assessing the vitamin A status in the community, an arrangement was made for partnering with a hepatitis B study conducted by the Centers for Disease Control and Prevention (CDC) so that a portion of the blood sample of the children and their mothers/caretakers could also be analysed for serum retinol. The analyses were performed at the CDC, in a United Nations Children’s Fund East Asia and Pacific Regional Office-supported project. Serum vitamin A was measured using high-performance liquid chromatography and UV-visible detection. Specimens were also tested for C-reactive protein (CRP), a measure for infection, using immunoturbidimetry and the QuikRead®101 CRP instrument. As infection is known to lower serum retinol (Thurnham et al., 2003), cases with high CRP (≥5 mg/L) were excluded from the study in order not to overestimate the prevalence of vitamin A deficiency in the sample. Quality-control protocols included internal (three levels of quality control pools in each assay) and external quality assurance (participation in the National Institutes of Standards and Technology and College of American Pathologists quality assurance programme).

Results and discussion

Table 6.1 presents a summary of the project activities. Developing the Mand map (Figure 6.2) was an important initial activity. The waterfall, river, road, community hall, sports ground, two churches, three small shops, school, traditional meeting house, graveyard and individual households were featured.

Health-related socio-economic indicators

Of the randomly selected households, one member per household[11] was asked about certain aspects relating to food consumption, income, food purchase and food preparation.

Most Mand families (80 percent) had at least one family member with salaried employment (government or private sector). However, there were families who lived mostly by subsistence. Idleness and over-dependence of unemployed family members on those with salaried employment were self-reported problems in the community.

Electricity and telephones were available in the community. However, at the time of the survey, a few households had no electricity and only about a third had telephones. Housing varied greatly, from small wood structures to larger concrete-based houses. A problem identified during the survey was that not all families had a toilet. Waste disposal was a problem and families often used the river as a waste disposal system, causing problems with villages below Mand. A health problem in Mand, which has arisen from time to time, was that of leptospirosis – a serious bacterial disease related to water contamination. Mand Community is also one of the areas in Pohnpei with a problem of leprosy, which is related to poverty, poor housing and over-crowding.

As to the proportion of income spent on food, 72 percent of the households reported were spending half or more of their income on food (despite the rural location of Mand and ready availability of land with good agricultural potential); 17 percent said that they spent less than half of their income on food and the rest reported lack of knowledge on this. Cooking was mostly done by kerosene cookers, open-fire cooking, or with a traditional earth oven. Food preparation was done mainly by the women although male members of the household also helped. Both the respondent and others in the household carried out the food purchasing.

Similar to the larger Pohnpei population, most Mand families’ cash income was important for obtaining daily food. The price of local foods was much higher than imported staples (rice at US$0.30 per pound versus breadfruit at US$0.50 per pound), with local food prices including peels and inedible parts making the cost per pound of edible food even greater.

Mand traditional food list

In total, 381 local food items (including distinct cultivars of food crops and many species of fish) were identified (Table 6.2). A list of 240 distinct species is given in Table 6.3. The names in both local languages, Pohnpeian and Pingelapese, were specified for each item, in addition to the English and scientific names. The community asked to include some crops that are not presently growing in Mand, but which grew nearby (e.g. avocado), since the community planned now to start cultivating them. Some foods (e.g. freshwater eel and several types of sea cucumber) eaten by some Pohnpeians, but not by Mand people, were removed from the list.

Free listing, key informant interviews (including house-to-house visits), semi-structured interview guides and informal focus group discussions were used to determine the foods of Mand and selected parameters. To help develop the Mand food list, a literature search was conducted and data collated in order to construct a list of foods potentially available (Adam, Balick and Lee, 2003; Ashby, 1993; Bascom, 1965; Damas, 1994; Merlin et al., 1992; Pollock, 1992; Ragone, Lorence and Flynn, 2001; Ram, 1994; Raynor, 1991; Rehg and Sohl, 1979; Sacks, 1996; Sasuke, 1953; St John, 1948). After collating these data, the most important descriptors were selected and the food items were ordered in two separate databases according to commonly used food groups.

One database (Englberger et al., 2005d) was constructed for the food items categorized by species and identified by Pohnpei, Pingelap, English and scientific names. Data provided on each of these foods included: parts used, cultivated or wild, if seasonal, whether marketed and whether a photograph or sketch was available. A second database was constructed to describe specific cultivars. Data provided on each of these foods included: availability, growth, nutrient content (if well known), acceptability and priority for promotion. All descriptions were checked using repeated key informant interviews and informal focus group discussions. The complete set of data collected on these foods is presented by Englberger et al. (2005d).

Group meetings of the Mand Community Working Group were initiated in mid-May 2005, since it was determined that a group consensus was needed to finalize many of the food item names and information describing those specific food items. These meetings became multi-purpose in nature, collecting information, providing training and planning intervention activities. The meetings also served as a way for sharing and photographing traditional food dishes and the person preparing it, collecting information for local newspaper articles and acknowledging those community members active in the project. Posters with photographs of fish (US Fish and Wildlife Services/FSM DNR, 1983a, 1983b), shellfish (Ministry of Fisheries, Government of Tonga, 1997), and birds (FSM National Government, n.d., a, b) provided the Mand Community Working Group with a basis for discussing animal food items. Detailed discussions were held to document local names and characteristics. A local fish expert assisted in identifying species by scientific name, using available literature (Kobayashi, 1994; Masuda et al., n.d.; Okamoto, 1988a, 1988b; Takashi, 1994).

As giant swamp taro and pandanus were important foods for Pingelap, a careful review was made of the cultivars grown on Pingelap (Damas, 1994; St John, 1948; Englberger et al., 2005a). Also, photographs of Mwoakilloa pandanus (Englberger et al., 2004) were shown to informants in order to help identify and characterize Pingelap cultivars that were introduced to Mand, or which may still be introduced.

Scientific identification and/or composition analysis of selected species

Photographs and descriptions of some food crops not identified by English and scientific names were emailed to two regional networks, Pestnet and the Secretariat of the Pacific Community (SPC) Pacific Agricultural Plant Genetic Resource Network. This and consulting photograph collections of Pacific island foods assisted in the identification of species.

A series of ongoing assessments of Pohnpei foods (Englberger et al., 2003b, 2003c, 2003d; Englberger et al., 2006; Shovic and Whistler, 2001) have identified banana cultivars with the highest levels of ß-carotene[12] in the world (Table 6.4). Karat banana, unique for its erect bunch, fat-shaped finger, and yellow/orange flesh colour has captured international attention (Coghlan, 2004; Kuhnlein, 2004; Radford, 2004). In 2005, Karat was named the Pohnpei State Banana and was featured on postage stamps. As many of the local foods and food cultivars of Pohnpei have not yet been assessed for nutrient content (Englberger et al., 2005b), regional data or data from previous studies of nearby regions were also consulted for providing insight on nutritional value (FAO, 2004; Murai, Pen and Miller, 1958). Many giant swamp taro and pandanus varieties have also been identified as rich in provitamin A carotenoids[13] and minerals, including zinc, iron, and calcium (Englberger et al., 2003b, 2003c). A general characteristic of these carotenoid-rich foods is a deep yellow or orange colouration of the edible flesh, which is visually recognizable. This provides a meaningful way of communicating about nutrient content to members in the community and selecting the most nutritious foods and cultivars for the greatest health benefits.

List of key micronutrient-rich traditional foods

Table 6.5 presents the 20 key micronutrient-rich foods agreed upon by the Mand Community Working Group. Primarily the nutrients vitamin A and vitamin C were considered. Yellow-fleshed giant swamp taro and banana cultivars were ranked as the most important to promote. Seeded breadfruit, formerly an important Pingelapese food, but little used today, was also selected for promotion. Some foods that have not been traditionally eaten (greens), but which grow easily in Mand and are nutrient-rich, were included in the list.

Patterns of harvest, storage and preparation of key traditional foods

The harvest patterns were uniform throughout Pohnpei Island. The main breadfruit season was from May to August, peaking in July, with a minor season from October to February. The yam season was from September to March, peaking in December. Banana and taro, the other main staple foods, were harvested throughout the year. Many fruits including papaya and citrus were harvested throughout the year, whereas mango and pineapple were seasonal, peaking in June and July. Vegetables were harvested year-round.

The traditional method of storing breadfruit by preserving in earthen pits for making mahr[14] was rarely used. However, there was a modernized version of this method, consisting of peeling and coring the breadfruits and storing them in plastic bags and containers. The products were baked and sold in local markets, popular among the older generation. The Pingelapese method of preparing this product of preserved breadfruit mahr produced a tasty product[15] and did not have the strong taste (distasteful to many) of the regular Pohnpeian mahr. Cooking was mostly done on kerosene cookers and by open-fire methods. A traditional earth oven (uhmw) may be prepared for special events. Boiling and frying were also common cooking methods.

Preferences of families, especially mothers and children within the food list

Key informants first developed the list of little-used or unused foods in Mand, giving an availability score, which was finalized by the Mand Community Working Group. This list was used to help gain a general understanding about the locally grown foods presently consumed. Informants stressed that there were many foods that used to be commonly grown in Mand, but which are now grown to a much lesser extent. This included cultivars of sugar cane and banana (Karat and Utin Iap) and other staple food crops, fruits and vegetables.

A variety of local foods was ranked according to preferences of taste, consumption, ease of growing and agricultural factors, and then by order of priority for promotion, as agreed upon by group consensus (Table 6.6). The priority for promotion in Table 6.6 is somewhat different from that in Table 6.5. The priorities agreed upon in Table 6.6 included factors of taste preference, consumption and agricultural factors, whereas the priorities agreed upon in Table 6.5 focused on nutrient content.

Dietary evaluation

Quantitative dietary assessment for female adults and young children

Tables 6.7 and 6.8 present the overall results of the 24-hour dietary recall, repeated for two non-consecutive days. Of the 47 households, 47 adults (45 females, 2 males) participated in the seven-day FFQ and 44 female adults (aged 19–68 years) and 27 children (aged 1–10 years) participated in the 24-hour recall. Of these adults (the same for whom FFQ and other data were collected), the education level ranged from two to 13 years of schooling, with a mean of nine years. The number of members per household ranged from 1–11, with a mean of four members. The mean number of children per household was three, ranging from zero to eight. The mean age at which women had their first child was 19 years, ranging from 13 to 36 years of age. Five adult female participants had no children.

The female adults consumed only 27 percent of their energy and 38 percent of their protein from local food sources, with the rest from imported foods (Table 6.7). The children had an even greater reliance on imported food (16 percent of their energy and 27 percent of protein was from local food). Few reported intakes met the recommended intakes for vitamins A and C (Table 6.8). The non-lactating female adult mean vitamin A intake was very low at 225 Retinol Equivalents (RE) whereas the recommended intake for non-pregnant, non-lactating women is 500 RE (WHO/FAO, 2002). The child mean vitamin A intake ranged from 97 to 154 RE per day, varying by age group, whereas 400–500 RE is the recommended intake for children 1–10 years old. The predominant sources of vitamin A and vitamin C intake were local food. Few imported foods were fortified.

Although individual activity levels were not estimated, it is likely that many individuals consumed energy intakes exceeding their requirements. The average individual energy requirement for a standard reference female weighing 55 kg is estimated at 2 210 kcal (WHO/FAO, 2002), whereas the mean female adult energy intake in Mand was 2 445 kcal. The mean female adult fat intake was 83 g, providing 30.6 percent of total mean energy intake.[16] The child mean fat intake was similar at 29.7 percent of total energy. There was a high female mean adult protein intake, 109 to 120 g/day (Table 6.8), far exceeding estimated requirements, 45 g and 61 g protein per day respectively for non-lactating and lactating females (FAO/WHO/UNU, 1985).

Qualitative dietary assessment for adults

As FFQ responses for the child’s diet were similar to those of the adult for the household, only the adult results were analysed. FFQ data revealed that rice was the most commonly consumed food item and was consumed by 100 percent of participants at least once per week and by 95 percent on three or more days. Flour products (mainly ramen noodles and doughnuts) were consumed by 71 percent of participants on three days or more. Of local root crops and starchy fruits, breadfruit (ripe and green unseeded) was the most frequently consumed item (52 percent of participants).[17] White-fleshed banana cultivars were more commonly consumed (36 percent) than the yellow-fleshed banana cultivars (31 percent), with Daiwang (17 percent) and Sendohki (8 percent) topping the list of these yellow-fleshed cultivars. Adding sugar to the local staple food, breadfruit, was common (44 percent).

Local fish/seafood was the most commonly consumed source of animal protein (73 percent consuming this item on three days or more), followed by imported fish and seafood (39 percent). Reef fish, local tuna and pork were the most common local animal protein sources. Of imported animal protein food items, canned mackerel and canned tuna were most commonly consumed (59 and 54 percent respectively). The most frequently consumed fat was shortening (reported by 34 percent of the participants), which was of concern because of its high level of trans-fatty acids. Imported vegetable oil was consumed by 29 percent of the participants and local coconut cream by 21 percent.

Vegetables were rarely consumed (30 percent consumed this item on three days or more). Fruits were commonly consumed (89 percent), but mainly in the form of ripe banana. The consumption of imported drinks on three days or more was about the same (41 percent of participants) as consumption of local drinks (40 percent). The most common local drink (63 percent) was coconut water, but imported soft drinks were also common (40 percent). Sugarcane was consumed as a snack by 21 percent of the participants and potato chips were the most common imported snack food.

Although giant swamp taro was described by survey participants as important culturally, only 24 percent had consumed it. Imported turkey tail,[18] normally a common part of the diet in Pohnpei, was not consumed. However, participants explained that the reason for this was that the ship had not arrived and none was available. Imported fat was more commonly consumed than local coconut fat.

No participant reported alcohol consumption; one reported sakau drinking (or kava, see footnote 10) on one day. Six participants reported chewing betel nut and seven reported consuming tobacco on mostly a daily basis.

As assessed from 24-hour dietary recalls, rice was consumed frequently – on average 1.9 times per day – followed by flour products, banana, breadfruit and giant swamp taro. Of protein items, fish was most frequently consumed throughout the day (1.2 times per day), followed by chicken, pork and tinned meat. Vegetables and fruits were infrequently consumed (0.3 and 0.2 times per day, respectively).

Infant-feeding practices

The Pohnpei State Hospital was awarded “Baby Friendly Status” according to international standards in 2004, and staff members were active in promoting breastfeeding throughout the island. Most women in Pohnpei, including Mand, delivered their babies at this hospital[19] and were encouraged to breastfeed, give colostrum, “exclusively breastfeed”[20] and continue doing so for two years and beyond.

However, there was a common use of breastmilk substitutes in Mand, despite the low incomes of most families. A short questionnaire was administered to mothers/caretakers of ten infants (including a set of twins) in order to better understand infant-feeding practices and attitudes. The children’s ages were: one month (n = 1), three months (n = 3), nine months (n = 2), 11 months (n = 1), 13 months (n = 1), 25 months (n = 1) and 26 months (n = 1). Initiation of breastfeeding was universal (100 percent). Seven of the infants were delivered at Pohnpei State Hospital, the twins were delivered at a privately run clinic and one infant was delivered at home in Mand. Of the ten infants, eight were still breastfeeding, including two children over two years old. A caretaker for one of the two infants who was no longer breastfed reported that the mother had stopped because of a colour change in her milk and the baby refusing breastmilk at around three months of age. The other infant was given other milk as the mother claimed that she had ceased to produce milk.

Of the six infants older than six months, four were given their first solid food (kepeloal)[21] at six months of age, following Pohnpei public health staff and international advice, with one given kepeloal at five months and one at seven months. The foods reported as kepeloal for these infants were grated, boiled green banana (n = 3), ripe karat [22] (n = 2) and imported cereal (n = 1).

Few mothers followed the internationally advised practice of exclusively breastfeeding. Seven infants were given coconut juice before the age of six months, and five were given water prior to that age. One caretaker reported that a medical officer advised her to give water and coconut juice to her infant younger than six months, contrary to present recommendations. Four infants were fed infant formula; the twins were fed breastmilk and infant formula. Karat and other ripe banana, ripe papaya, pumpkin and giant swamp taro were considered to be the five healthiest infant foods. Many changes in attitudes and practices in infant-feeding since 1960 were reported in the study. Imported baby food and imported foods such as bread, flour cooked in water, rice soup, doughnut, ramen and biscuit were more commonly fed compared to the 1960s.

Anthropometry: a window into the nutrition transition

Body Mass Index, overweight and obesity among adults

Table 6.9 presents the results of the Body Mass Index (BMI)[23] data for Mand. Weight and height measurements were taken for 167 adults of the randomly selected households.[24]There were two bed-ridden adults for which height and weight could not be measured.

A high prevalence of overweight[25] and obesity was found in all age groups, particularly among females. Even in the age group 15 to 19 years of age, 71 percent of the females were either overweight or obese. From the 20 to 29 year-old age group and above, over 85 percent of females were either overweight or obese. The mean BMI generally increased with greater age. There was a low prevalence of overweight/obesity among males 15 to 19 years of age, but over 60 percent were either overweight or obese in all older age groups.

Informants explained that big body size is often perceived as healthy and attractive. One informant explained, “When I was a child, I remember going from Mand to the big town and seeing that other people there were heavier. We were poor, and so when I saw the heavy people, I thought they were healthy and asked myself what is wrong with me”.

Waist circumference measurements among adults

Waist circumferences denoting increased health risks[26] were found among both males and females in all age groups from 20 years of age; in all cases the mean was greater than the cut-off indicating substantially increased health risks (WHO, 1997). The greatest mean waist circumferences were among individuals in the 40 to 59 year-old age groups (from 103 to 105 cm for males, and from 103 to 114 cm for females).

Blood pressure measurements among adults

Among younger adults, mean blood pressures were within normal range (WHO, 1997).[27] However, mean blood pressure increased with age and was greater than optimal, for both males and females over 40 years of age. Some borderline and definite hypertension (high blood pressure) cases were identified in people who had not previously known that they might have this problem. Of the participants of 40 years and older (40 males and 33 females), three males (7.5 percent) and two females (6 percent) had borderline hypertension, and five males (12.5 percent) and two females (12.5 percent) had definite hypertension. All cases were referred for further medical checks.

Anthropometry among children

A purposive sample of 96 children aged 1–14 years old was measured for weight and height and birthdates were recorded. Epi-Info 6.04 software was used for analysis. Standard cut-offs for assessing protein-energy malnutrition[28] (WHO, 1995) were used. With all ages combined, 48.1 percent of males and 42.9 percent of females were classified as stunted (low height for age), indicating a serious long-term nutrition problem; 15.1 percent of males and 9.3 percent of females were underweight, and none were wasted. Table 6.10 describes the nutritional status of children surveyed.

Other health measures

Fasting blood sugar (FBS) and abnormal FBS levels among adults

Table 6.11 presents the results of the FBS measurements and highlights abnormal FBS levels (≥126 mg/dl),[29] reflecting either diabetes or those at risk for diabetes. Of 73 males and 74 females of the randomly selected households, a total of 37 new cases of diabetes or at risk cases were identified, exclusive of volunteers.[30] The mean FBS levels increased with age: from a mean of 94 mg/dl for females 15 to 19 years and 105 mg/dl for males 15 to 19 years up to means of 172 mg/dl for females over 60 years and 191 mg/dl for males over 60 years. In one case, the fasting blood sugar level was greater than the capacity of the instrument (>500 mg/dl). Of the participants 40 years and older, 63 percent of women and 58 percent of men had abnormal fasting blood sugar levels. All participants with abnormal FBS levels were advised for further medical checks.

Vitamin A status of children

Preliminary results showed that 31.6 percent of the children aged two to ten years who were tested in Mand were vitamin A-deficient as defined by serum retinol <20 μg /dl. This indicates a serious problem, as the cut-off for a problem of public health significance is 15 percent (IVACG, 2002).

Dental health status of children

Dental screening was conducted for 85 children aged 1–14 years, who were measured for their weights and heights. Only three children (3.5 percent) had healthy teeth. Many children had teeth that were so damaged that they were indicated for extraction or permanent teeth had already been extracted. Few children had dental treatment for unhealthy teeth (filled teeth). Most children had multiple caries (up to 16 caries per child). The number of caries was greatest in the five to six year old children (around seven caries per child). There appeared to be more caries among girls than boys.

Agroforestry survey

The neglect of the agroforestry and food production systems in Pohnpei has been documented for some time (Raynor, 1991). However, a systematic documentation in Mand was needed in order to present an up-to-date assessment of the degree of the neglect in Mand and to help guide plans for increasing local food production. A main survey finding was that the agroforestry system is under-utilized (Shaeffer, 2006). Of the 43 randomly selected households participating in the survey, 70 percent of the respondents reported that traditional farming has declined since they were children. However, 98 percent said that they believed that the community should keep family food production as a high priority. A village water study showed that there are problems with the community piped water system with fecal contamination at different sites.

Other qualitative information

Table 6.12 provides insight into attitudes and perceptions of Mand community members relating to local food production and consumption and actions needed for increasing it. In preparation for the intervention, the Mand Community Working Group listed the major reasons that they believed have caused the decrease in local food production and consumption. Responses were recorded individually and then discussed as a group. On analysing the data, inconsistencies were seen, which led to further discussions and comments.

One member explained how this study had motivated his community to start planting and eating local food, saying, “We thought we were healthy but then this study showed that we are not healthy.” He also expressed his amazement at the richness of their food resources, stating, “Look at all the foods that we have on our food list. We have so many and they are so good for us … People are now really talking about local foods. Now they are starting to know that what they valued (like rice) was wrong and that their food is really better for them.” Another member stressed, “God made us to eat our own foods. We need to go local!”

Some food taboos and beliefs were explored, specifically relating to foods that cannot be eaten by lactating and pregnant adult women. Distinctions were made between beliefs held in Pohnpei and those more distinctly held by people originally from Pingelap.

Intervention strategies

A mix of intervention strategies was planned during the documentation phase, including: community meetings, training in cooking and farming techniques, a drama club for the youth, newspaper articles, recipe collection, a programme working with elementary students promoting rare banana varieties and the initiation of a smokeless charcoal oven construction programme – which would facilitate baking (a healthy cooking method). New partner agencies were involved in the project, which added further impetus to the project. The study results were presented at a seminar in Kolonia (the main town of Pohnpei) for partner agencies and Mand Community members and a further meeting was held in Mand to present the study results to the community.

In addition, a half-day “strategy planning” workshop for partner agencies, facilitators and community members was held on 5 June 2006, with the purpose of reviewing project aims, study findings and initial intervention activities. A visit by Professor Harriet Kuhnlein and Chief Bill Erasmus from CINE coincided with this workshop, and helped greatly in providing information on the CINE food systems programme and on experiences elsewhere related to the promotion of traditional food systems. The workshop was important for increasing understanding of the project, cementing relationships and planning project strategies and activities.

Future policy considerations

The CINE methodology for documenting traditional food systems has proven to be a useful tool in this environment and culture, and helped communities learn the value of their traditional food systems and health status. The project in Mand enhanced interest among other communities in Pohnpei, which have requested arrangements for similar projects. Plans are now in place for extending some components to these communities, in particular, training on the new findings of high nutrient values of Pohnpei foods and varieties, guidance on growing and preparing vegetables and charcoal oven construction and use. However, in the future the focus will be on programmes that have state-wide outreach (i.e. church, school, radio, etc.) in order to maximize the impact of the work throughout the state. Regional leaders learning about the Mand project became interested in the approach and suggested initiating similar programmes in other parts of the Pacific. Staff resources were identified as the substantial limiting factor to that expansion. Efforts were needed to secure staff for IFCP and to extend the work. On the other hand, many agencies within Pohnpei became partners in the project and initiated new programmes to further promote local foods within their own work plans. Future policy considerations should stress the importance of strengthening the collaboration with key community players, in particular, leaders in the traditional sector, church and the youth.

Conclusion

The Mand community has serious nutrition-related problems, notably vitamin A deficiency, obesity and diet-related non-communicable diseases. Greater consumption of locally produced foods could contribute to alleviation of these nutritional disorders. Awareness of the unique local food resources and innovative approaches suitable to the situation in Mand and other Pohnpei communities is needed. For example, many people in Pohnpei still did not know that some of their older Pohnpei banana cultivars, including karat and utin iap, are very nutrient rich and contain provitamin A carotenoid substances – which are important for maintaining good health – and many people did not understand the relationship between diet, healthy lifestyles, and specific health problems. The importance of interagency, community-based efforts in this work is essential.

This is the first comprehensive set of data related to both traditional food resources, dietary intake and health status collected for a community in Pohnpei and it is unique for the Pacific region. This area of the world has been involved in very few health and nutrition research projects related to both documentation of the food resources and health problems, and yet the health and nutrition problems are serious. Thus, this study was significant for Pohnpei as well as for the other parts of the Pacific •

Acknowledgements

Warm thanks are extended to Professor Harriet Kuhnlein and the Centre for Indigenous Peoples’ Nutrition and Environment (CINE) for involving Pohnpei in this project and providing expert guidance, to Gail Harrison and Rally Jim for comments on this chapter, Robert Andreas and Eugene Joseph on the local food names, and Rosemary Schleicher and Stephanie Bialek for their assistance in the assessment of vitamin A status. Thanks are also extended to the Mand Community and partner agencies: Island Food Community of Pohnpei Board, Pohnpei Office of Economic Affairs/Pohnpei Agriculture and Marine Development, Pohnpei Department of Health/Public Health and Dental Divisions, College of Micronesia-FSM Land Grant Program, Pohnpei Department of Land and Natural Resources/Historic Preservation Office, FSM National Government, Pohnpei Environmental Preservation Agency, Peace Corps Micronesia, Japanese Overseas Cooperation Volunteers, Emory University, KP Studios, Secretariat of the Pacific Community (SPC), SPC/GTZ Pacific-German Regional Forestry Project, SPC Lifestyle Health Section, SPC Pacific Agricultural Plant Genetic Resources Network, SPC Regional Germplasm Centre, Sight and Life, Centers of Disease Control and Prevention, United Nations Children’s Fund, Xyris Software Australia, University of the South Pacific, DSM Nutritional Products and University of Adelaide.

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Chapter 5 | Ingano

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Chapter 6 | Pohnpei

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Species Index – Indigenous Peoples’ food systems species by scientific name

Species listed in this index, and cross-referenced in chapter tables and text, were checked, modified in some cases and confirmed by experts at the Food and Agricultural Organization of the United Nations, Rome, June 2008.

(Scientific name / Case study / Table number)

Birds

Aburria aburri / Awajun – Table 4.2

Ahas boschas domesticus / Karen – Table 8.2

Alca torda / Inuit – Table 1.1

Anas / Igbo – Table 12.1

Anas acuta / Gwich’in – Table 3.1; Inuit – Table 1.1

Anas americana / Gwich’in – Table 3.1

Anas platyrhyncha / Dalit – Table 9.2

Anas platyrhynchos / Gwich’in – Table 3.1

Anas sp. / Nuxalk – Table 2.2

Anous stolidus / Pohnpei – Table 6.3

Anseranatidae (general) / Ingano – Table 5.2

Anthracoceros albirostis / Karen – Table 8.2

Aplonis opaca / Pohnpei – Table 6.3

Aythya fuligula / Pohnpei – Table 6.3

Aythya valisineria / Gwich’in – Table 3.1

Branta bernicla / Inuit – Table 1.1

Branta canadensis / Gwich’in – Table 3.1; Inuit – Table 1.1

Brosimum utile / Ingano – Table 5.2

Canachites spp. / Nuxalk – Table 2.2

Centropus sp. / Karen – Table 8.2

Cepphus grylle / Inuit – Table 1.1

Cheirodon axelrodi / Ingano – Table 5.2

Chen caerulescens / Gwich’in – Table 3.1

Chen caerulescens caerulescens / Inuit – Table 1.1

Clangula hyemalis / Gwich’in – Table 3.1; Inuit – Table 1.1

Columba livia intermedia / Dalit – Table 9.2

Columba sp. / Awajun – Table 4.2

Columba spp. / Ingano – Table 5.2

Columba subvinacea / Awajun – Table 4.2

Columbia livia intermedia / Bhil – Table 10.1

Cracidae / Ingano – Table 5.2

Crus sp. / Dalit – Table 9.2

Cyanocorax violaceous / Awajun – Table 4.2

Cygnus buccinator / Gwich’in – Table 3.1

Cygnus columbianus / Gwich’in – Table 3.1

Dendragapus canadensis / Gwich’in – Table 3.1

Ducula oceanica / Pohnpei – Table 6.3

Egretta sacra / Pohnpei – Table 6.3

Fregata minor / Pohnpei – Table 6.3

Gallicolumba kubaryi / Pohnpei – Table 6.3

Gallus bankiva murghi / Bhil – Table 10.1; Dalit – Table 9.2

Gallus domesticus / Pohnpei – Table 6.3

Gallus gallus / Awajun – Table 4.2; Igbo – Table 12.1; Karen – Table 8.2

Gavia adamsii / Inuit – Table 1.1

Gavia arctica / Inuit – Table 1.1

Gavia immer / Inuit – Table 1.1

Gavia stellata / Inuit – Table 1.1

Gygis alba / Pohnpei – Table 6.3

Haliastar spherus / Bhil – Table 10.1

Icteridae / Ingano – Table 5.2

Icterus sp. / Awajun – Table 4.2

Lagopus lagopus / Gwich’in – Table 3.1; Inuit – Table 1.1

Lagopus mutus / Gwich’in – Table 3.1; Inuit – Table 1.1

Larus argentatus / Inuit – Table 1.1

Leptotila rufaxilla / Awajun – Table 4.2

Melanitta fusca / Gwich’in – Table 3.1

Melanitta perspicillata / Gwich’in – Table 3.1

Meleagris gallopavo / Igbo – Table 12.1

Melleagris sp. / Ingano – Table 5.2

Mergus merganser / Gwich’in – Table 3.1; Inuit – Table 1.1

Mergus serrator / Gwich’in – Table 3.1

Monasa nigrifrons / Awajun – Table 4.2

Munida meleagris / Igbo – Table 12.1

Myzomela rubratra / Pohnpei – Table 6.3

Oryctolagus cuniculus / Awajun – Table 4.2

Penelope jacquacu / Awajun – Table 4.2

Penelope purpurascens / Ingano – Table 5.2

Phaethon lepturus / Pohnpei – Table 6.3

Phasianidae / Ingano – Table 5.2

Picoides pubescens / Bhil – Table 10.1

Psarocolius angustifrons / Ingano – Table 5.2

Psittaciformes / Bhil – Table 10.1; Ingano – Table 5.2

Psittacula sp. / Karen – Table 8.2

Psophia crepitans / Awajun – Table 4.2

Ptilinopus porphyraceus / Pohnpei – Table 6.3

Pyrrhura sp. / Awajun – Table 4.2

Ramphastus ambiguus / Ingano – Table 5.2

Ramphastos cuvieri / Awajun – Table 4.2

Sciuridae spp. / Igbo – Table 12.1

Somateria mollissima / Inuit – Table 1.1

Somateria spectabilis / Inuit – Table 1.1

Squamata spp. / Igbo – Table 12.1

Steatornis caripensis / Awajun – Table 4.2

Sterna paradisaea / Inuit – Table 1.1

Strigidae / Bhil – Table 10.1

Sula sula / Pohnpei – Table 6.3

Thraupis sp. / Ingano – Table 5.2

Tinamus tao / Awajun – Table 4.2

Uria aalge / Inuit – Table 1.1

Uria lomvia / Inuit – Table 1.1

Zenaida asiatica / Awajun – Table 4.2

Fish, seafood & marine mammals

Abudefduf sordidus / Pohnpei – Table 6.3

Acanthocybium solandri / Pohnpei – Table 6.3

Acanthurus gahhm / Pohnpei – Table 6.3

Acanthurus lineatus / Pohnpei – Table 6.3

Acanthurus triostegus / Pohnpei – Table 6.3

Acanthurus xanthopterus / Pohnpei – Table 6.3

Acanturus guttatus / Pohnpei – Table 6.3

Aeginella longicornis / Inuit – Table 1.1

Aequidens latifrons, / Ingano – Table 5.2

Alectis ciliaris / Ingano – Table 5.2

Anadara antiquata / Pohnpei – Table 6.3

Ancistrus sp. / Awajun – Table 4.2

Aphareus rutilans / Pohnpei – Table 6.3

Arius sona / Dalit – Table 9.2

Artediellus atlanticus / Inuit – Table 1.1

Artediellus uncinatus / Inuit – Table 1.1

Astacus / Igbo – Table 12.1

Balaena mysticetus / Inuit – Table 1.1

Bentheogennema borealis / Inuit – Table 1.1

Brachycerus latro / Pohnpei – Table 6.3

Bolbometopon muricatus / Pohnpei – Table 6.3

Boreogadus saida / Inuit – Table 1.1

Brachyplatystoma flavicans / Ingano – Table 5.2

Brycon sp. / Awajun – Table 4.2

Brycon spp. / Ingano – Table 5.2

Canthopomus sp. / Awajun – Table 4.2

Caprella laeviuscula / Inuit – Table 1.1

Caranx cynodon gibbus / Awajun – Table 4.2

Caranx ignobilis / Pohnpei – Table 6.3

Caranx melampygus / Pohnpei – Table 6.3

Caranx sexfasciatus / Pohnpei – Table 6.3

Carassius auratus / Pohnpei – Table 6.3

Carcharhinus amblyrhinchos / Pohnpei – Table 6.3

Carcharhinus melanopterus / Pohnpei – Table 6.3

Carcharias sp. / Bhil – Table 10.1

Catla catla / Dalit – Table 9.2

Cephalopholis argus / Pohnpei – Table 6.3

Cephalopholis miniata / Pohnpei – Table 6.3

Cetopsis coecutiens / Ingano – Table 5.2

Cetoscarus bicolor / Pohnpei – Table 6.3

Chaetodon auriga / Pohnpei – Table 6.3

Channa obscurus / Igbo – Table 12.1

Channa limbata / Karen – Table 8.2

Chanos chanos / Pohnpei – Table 6.3

Characiformes caranx / Awajun – Table 4.2

Characiformes charanx moenkhausia / Awajun – Table 4.2

Characiformes mylosoma / Awajun – Table 4.2

Cheilinus trilobatus / Pohnpei – Table 6.3

Cheilinus undulatus / Pohnpei – Table 6.3

Chelonia mydas / Pohnpei – Table 6.3

Chionoecetes opilio / Inuit – Table 1.1

Cichlasoma sp. / Awajun – Table 4.2

Clupea pallasi / Nuxalk – Table 2.2

Coilia dussumieri / Bhil – Table 10.1

Coregonus artedii / Gwich’in – Table 3.1

Coregonus clupeaformis / Gwich’in – Table 3.1; Inuit – Table 1.1

Coregonus nasus / Gwich’in – Table 3.1; Inuit – Table 1.1

Coregonus sp. / Inuit – Table 1.1

Coryphaena hippurus / Pohnpei – Table 6.3

Cottunculus microps / Inuit – Table 1.1

Cottunculus thomsoni / Inuit – Table 1.1

Ctenochaetus striatus / Pohnpei – Table 6.3

Cudanonantas / Igbo – Table 12.1

Cyclocheilichthys apogon / Karen – Table 8.2

Cynodon sp. / Awajun – Table 4.2

Cyprinodontiformes poecilidos / Awajun – Table 4.2

Dangila siamensis / Karen – Table 8.2

Delphinapterus leucas / Inuit – Table 1.1

Delphinus leucas / Gwich’in – Table 3.1

Distichodus rostratus / Igbo – Table 12.1

Echidna polyzona / Pohnpei – Table 6.3

Elagatis bipinnulatus / Pohnpei – Table 6.3

Eleginus gracilis / Inuit – Table 1.1

Elops saurus / Bhil – Table 10.1

Ensis directus / Inuit – Table 1.1

Epibulus insidiator / Pohnpei – Table 6.3

Epinephelus coeruleopunctatus / Pohnpei – Table 6.3

Epinephelus fasciatus / Pohnpei – Table 6.3

Epinephelus macrospilos / Pohnpei – Table 6.3

Epinephelus malabaricus / Pohnpei – Table 6.3

Epinephelus merra / Pohnpei – Table 6.3

Epinephelus morrhua / Pohnpei – Table 6.3

Epinephelus polyphekadion / Pohnpei – Table 6.3

Epinephelus septemfasciatus / Pohnpei – Table 6.3

Eretmochelys imbricata / Pohnpei – Table 6.3

Erignathus barbatus / Inuit – Table 1.1

Etelis carbunculus / Pohnpei – Table 6.3

Etelis coruscans / Pohnpei – Table 6.3

Euthynnus affinis / Pohnpei – Table 6.3

Gafrarjum tumidum / Pohnpei – Table 6.3

Garra fuliginosa / Karen – Table 8.2

Gasterosteus aculeatus / Ingano – Table 5.2

Gastropoda sp. / Inuit – Table 1.1

Geocarcordea natalis / Pohnpei – Table 6.3

Geophagus steindachneri / Ingano – Table 5.2

Gerres abbreviatus / Pohnpei – Table 6.3

Gerres oyena / Pohnpei – Table 6.3

Grammatorcynus bilineatus / Pohnpei – Table 6.3

Gymnarchus niloticus / Igbo – Table 12.1

Gymnosarda unicolor / Pohnpei – Table 6.3

Gymnocanthus tricuspis / Inuit – Table 1.1

Gymnothorax javanicus / Pohnpei – Table 6.3

Gymnotiformes gymnotid / Awajun – Table 4.2

Haliotis spp. / Nuxalk – Table 2.2

Harengula thrissina / Ingano – Table 5.2

Harpodon nehereus / Bhil – Table 10.1

Hemibagrus nemurus / Karen – Table 8.2

Hemiramphus guoyi / Pohnpei – Table 6.3

Hippoglossus hippoglossus / Inuit – Table 1.1

Hippopus hippopus / Pohnpei – Table 6.3

Hipposcarus longiceps / Pohnpei – Table 6.3

Hirundichthys oxycephalus / Pohnpei – Table 6.3

Hoplias malabaricus / Awajun – Table 4.2; Ingano – Table 5.2

Istiophorus platypterus / Pohnpei – Table 6.3

Katsuwonus pelamis / Pohnpei – Table 6.3

Kyphosus cinerascens / Pohnpei – Table 6.3

Lambis lambis / Pohnpei – Table 6.3

Leiognathus equulus / Pohnpei – Table 6.3

Lethrinus harak / Pohnpei – Table 6.3

Lethrinus kallopterus / Pohnpei – Table 6.3

Lethrinus lentjan / Pohnpei – Table 6.3

Lethrinus microdon / Pohnpei – Table 6.3

Lethrinus ramak / Pohnpei – Table 6.3

Lethrinus xanthochilus / Pohnpei – Table 6.3

Liza vaigiensis / Pohnpei – Table 6.3

Lobocheilos quadrilineatus / Karen – Table 8.2

Lota lota / Gwich’in – Table 3.1

Luciocephalus sp. / Awajun – Table 4.2

Lutjanus argentimaculatus / Pohnpei – Table 6.3

Lutjanus bohar / Pohnpei – Table 6.3

Lutjanus fulvus / Pohnpei – Table 6.3

Lutjanus gibbus / Pohnpei – Table 6.3

Lutjanus kasmira / Pohnpei – Table 6.3

Lutjanus monostigmus / Pohnpei – Table 6.3

Lutjanus rivulatus / Pohnpei – Table 6.3

Lutjanus semicinctus / Pohnpei – Table 6.3

Macrobrachium hirsutimanus / Karen – Table 8.2

Macrobrachius brasiliensi / Awajun – Table 4.2

Makaira nigricans / Pohnpei – Table 6.3

Margaritifera margaritifera / Ainu – Table 7.2

Matapenaeus moyebi / Pohnpei – Table 6.3

Megalonema platycephalum / Ingano – Table 5.2

Menticirrhus panamensis / Ingano – Table 5.2

Microgadus tomcod / Inuit – Table 1.1; Inuit – Table 1.1

Mirounga angustirostris / Inuit – Table 1.1

Monodon monoceros / Inuit – Table 1.1

Monotaxis grandoculus / Pohnpei – Table 6.3

Mulloides flavolineatus / Pohnpei – Table 6.3

Mya arenaria / Inuit – Table 1.1

Myoxocephalus / Inuit – Table 1.1

Myripristis berndti / Pohnpei – Table 6.3

Mystacoleucus marginatus / Karen – Table 8.2

Mytilus edulis / Inuit – Table 1.1; Nuxalk – Table 2.1

Naso lituratus / Pohnpei – Table 6.3

Naso unicornis / Pohnpei – Table 6.3

Naso vlamingii / Pohnpei – Table 6.3

Neptunes sp. / Nuxalk – Table 2.2

Octopus aculeatus / Pohnpei – Table 6.3

Odobenus rosmarus / Inuit – Table 1.1

Oncorhynchus / Ainu – Table 7.2

Oncorhynchus gorbuscha / Nuxalk – Table 2.2

Oncorhynchus keta / Nuxalk – Table 2.2

Oncorhynchus kisutch / Nuxalk – Table 2.2

Oncorhynchus nerka / Nuxalk – Table 2.2

Oncorhynchus tshawytscha / Nuxalk – Table 2.2

Ophiocara porocephala / Pohnpei – Table 6.3

Ophiocephalus striatus / Dalit – Table 9.2

Ophiodon elongatus / Nuxalk – Table 2.2

Ostracion cubicus / Pohnpei – Table 6.3

Palaemon seurifer / Pohnpei – Table 6.3

Panaque nigrolineatus / Ingano – Table 5.2

Panilurus spp. / Pohnpei – Table 6.3

Paraglyphidodon melas / Pohnpei – Table 6.3

Parastichopus californicus / Nuxalk – Table 2.2

Paratephusa spinigera / Bhil – Table 10.1; Dalit – Table 9.2

Parupeneus barberinus / Pohnpei – Table 6.3

Parupeneus cyclostomus / Pohnpei – Table 6.3

Parupeneus indicus / Pohnpei – Table 6.3

Pelanus laturus / Awajun – Table 4.2

Phoca groenlandica / Inuit – Table 1.1

Phoca hispida / Inuit – Table 1.1

Phoca sp. / Nuxalk – Table 2.2

Placopecten magellanicus / Inuit – Table 1.1

Platichthys stellatus / Nuxalk – Table 2.1

Plectorhinchus chaetodonoides / Pohnpei – Table 6.3

Plectorhinchus goldmanni / Pohnpei – Table 6.3

Plectorhinchus obscurus / Pohnpei – Table 6.3

Plectorhinchus orientalis / Pohnpei – Table 6.3

Plectorhinchus picus / Pohnpei – Table 6.3

Plectorhynchus celebicus / Pohnpei – Table 6.3

Plectropomus areolatus / Pohnpei – Table 6.3

Plectropomus laevis / Pohnpei – Table 6.3

Pomacea sp. / Awajun – Table 4.2

Potamotrygon hystrix / Awajun – Table 4.2

Pristipomoides argyrogrammicus / Pohnpei – Table 6.3

Prochilodidos leoprinus / Awajun – Table 4.2

Prochilodus nigricans / Ingano – Table 5.2

Prochilodus sp. / Awajun – Table 4.2

Prosopium cylindraceum / Gwich’in – Table 3.1

Pseudancistrus sp. / Ingano – Table 5.2

Pseudomystus siamensis / Karen – Table 8.2

Pseudopimelodus sp. / Awajun – Table 4.2

Pseudoplatystoma fasciatum / Ingano – Table 5.2

Pseudoplatystoma filamentosum / Ingano – Table 5.2

Pseudoplatystoma tigrinum / Ingano – Table 5.2

Puntioplites proctozysron / Karen – Table 8.2

Quadricornis / Inuit – Table 1.1

Reinhardtius hippoglossoides / Inuit – Table 1.1

Rhinecanthus aculeatus / Pohnpei – Table 6.3

Rivulus sp. / Awajun – Table 4.2

Roeboides sp. / Awajun – Table 4.2

Ruvettus pretiosus / Pohnpei – Table 6.3

Salmo gairdneri / Nuxalk – Table 2.2

Salmo sp. / Nuxalk – Table 2.2

Salvelinus alpinus / Gwich’in – Table 3.1

Salvelinus alpinus sp. / Inuit – Table 1.1

Salvelinus fontinalis / Inuit – Table 1.1

Salvelinus namaycush / Gwich’in – Table 3.1

Salvenilus namaycush / Inuit – Table 1.1

Sardinella aurita / Ingano – Table 5.2

Sargocentron spiniferum / Pohnpei – Table 6.3

Sargocentron tiere / Pohnpei – Table 6.3

Scarus frontalis / Pohnpei – Table 6.3

Scarus ghobban / Pohnpei – Table 6.3

Scarus gibbus / Pohnpei – Table 6.3

Scarus rubroviolaceus / Pohnpei – Table 6.3

Scomberoides lysan / Pohnpei – Table 6.3

Scylla serrata / Pohnpei – Table 6.3

Sebastes ruberrimus / Nuxalk – Table 2.2

Selar crumenophthalmus / Pohnpei – Table 6.3

Sepidenthis lessoni / Pohnpei – Table 6.3

Seriola dumerili / Pohnpei – Table 6.3

Siganus argenteus / Pohnpei – Table 6.3

Siganus doliatus / Pohnpei – Table 6.3

Siganus puellus / Pohnpei – Table 6.3

Siganus punctatus / Pohnpei – Table 6.3

Siganus spp. / Pohnpei – Table 6.3

Siganus vulpinus / Pohnpei – Table 6.3

Siluriformes astroblepidae / Awajun – Table 4.2

Siluriformes callichtyidos coridoras / Awajun – Table 4.2

Siluriformes cetoposids / Awajun – Table 4.2

Siluriformes diplomistidos / Awajun – Table 4.2

Siluriformes doradidos pseudo-doras / Awajun – Table 4.2

Siluriformes loricardididos / Awajun – Table 4.2

Siluriformes loricardididos loricaria / Awajun – Table 4.2

Siluriformes pimelodids / Awajun – Table 4.2

Siluriformes pimelodids sorubim / Awajun – Table 4.2

Sphyraena barracuda / Pohnpei – Table 6.3

Sphyraena genie / Pohnpei – Table 6.3

Stenodus leucichthys / Gwich’in – Table 3.1; Inuit – Table 1.1

Sticopus japonicus / Pohnpei – Table 6.3

Strongylocentrotus sp. / Inuit – Table 1.1; Nuxalk – Table 2.2

Syncrossus beauforti / Karen – Table 8.2

Teterotis niloticus / Igbo – Table 12.1

Thaleichthys pacificus / Bhil – Table 10.1; Nuxalk – Table 2.2

Thunnus albacares / Pohnpei – Table 6.3

Thymallus arcticus / Gwich’in – Table 3.1

Tor sp. / Karen – Table 8.2

Triaenodon obesus / Pohnpei – Table 6.3

Tridacna maxima / Pohnpei – Table 6.3

Trochus niloticus / Pohnpei – Table 6.3

Turbo argyrostomus / Pohnpei – Table 6.3

Turbo petholatus / Pohnpei – Table 6.3

Valamugil seheli / Pohnpei – Table 6.3

Variola albimarginata / Pohnpei – Table 6.3

Fruits, nuts and seeds

Abelmoschus esculenta / Igbo – Table 12.1

Acacia drepanolobium / Maasai – Table 11.2

Acacia tortilis / Maasai – Table 11.2

Achras sapota / Bhil – Table 10.1; Dalit – Table 9.2

Adenanthera pavoniva / Pohnpei – Table 6.3

Aegle marmelos / Bhil – Table 10.1; Dalit – Table 9.2; Karen – Table 8.2

Aframomum danielli / Igbo – Table 12.1

Allium sativum / Ingano – Table 5.2

Amelanchier alnifolia / Nuxalk – Table 2.2

Anacardium occidentale / Dalit – Table 9.2; Karen – Table 8.2

Anacardium occidentalis / Igbo – Table 12.1

Ananas comosus / Awajun – Table 4.2; Ingano – Table 5.2; Pohnpei – Table 6.3

Annanas comosus / Karen – Table 8.2

Annona cherimolia / Ingano – Table 5.2

Annona muricata / Pohnpei – Table 6.3; Ingano – Table 5.2

Annona reticulata / Bhil – Table 10.1; Dalit – Table 9.2

Annona squamosa / Bhil – Table 10.1; Dalit – Table 9.2

Anonas comosus / Igbo – Table 12.1

Anonas muricarta / Igbo – Table 12.1

Arachis hypogaea / Dalit – Table 9.2

Arctostaphylos uva-ursi / Nuxalk – Table 2.2

Areca catechu / Dalit – Table 9.2

Artocarpus altilis / Awajun – Table 4.2

Artocarpus altilis/mariannensis / Pohnpei – Table 6.3

Artocarpus communis / Igbo – Table 12.1

Artocarpus heterophyllus / Bhil – Table 10.1; Dalit – Table 9.2; Karen – Table 8.2; Pohnpei – Table 3

Artocarpus sp. / Karen – Table 8.2

Astrocaryum chambira / Awajun – Table 4.2

Averrhoa carambola / Karen – Table 8.2; Pohnpei – Table 6.3

Azadirachta indica / Igbo – Table 12.1

Bacaurrea ramiflora / Karen – Table 8.2

Balanites aegyptiaca / Maasai – Table 11.2

Bassia latifolia / Bhil – Table 10.1

Bassia longifolia / Bhil – Table 10.1; Dalit – Table 9.2

Bouea macrophylla / Karen – Table 8.2

Brassica nigra / Dalit – Table 9.2

Buchanania latifolia / Dalit – Table 9.2

Calycopteris floribunda / Dalit – Table 9.2

Canarium schweinfurthii / Igbo – Table 12.1

Canthium dicoccum / Dalit – Table 9.2

Carica papaya / Bhil – Table 10.1; Dalit – Table 9.2; Igbo – Table 12.1; Ingano – Table 5.2; Karen – Table 8.2; Pohnpei – Table 6.3

Carissa carandas / Dalit – Table 9.2

Carissa edulis / Maasai – Table 11.2

Carthamus tinctorius / Dalit – Table 9.2

Caryodendron orinocensis / Awajun – Table 4.2

Castanopsis diversifolia / Karen – Table 8.2

Catunaregam spinosa / Dalit – Table 9.2

Chrysophyllum albiduim / Igbo – Table 12.1

Chrysophyllum cainito / Pohnpei – Table 6.3

Citrullis vulgaris / Pohnpei – Table 6.3

Citrullus vulgaris / Dalit – Table 9.2; Igbo – Table 12.1

Citrus aurantifolia / Dalit – Table 9.2; Igbo – Table 12.1; Pohnpei – Table 6.3

Citrus aurantium / Dalit – Table 9.2; Igbo – Table 12.1

Citrus grandis / Karen – Table 8.2

Citrus limon / Awajun – Table 4.2; Ingano – Table 5.2

Citrus reticulata / Karen – Table 8.2

Citrus sinensis / Awajun – Table 4.2; Ingano – Table 5.2; Dalit – Table 9.2; Karen – Table 8.2

Clavia sp. / Awajun – Table 4.2

Clerodendrum infortunatum / Karen – Table 8.2

Cocos nucifera / Awajun – Table 4.2; Dalit – Table 9.2; Igbo – Table 12.1; Ingano – Table 5.2; Karen – Table 8.2; Pohnpei – Table 6.3

Cola acuminata / Igbo – Table 12.1

Cola lepidota / Igbo – Table 12.1

Cola nitida / Igbo – Table 12.1

Cola spp. / Igbo – Table 12.1

Cordia rothai / Bhil – Table 10.1

Cornus canadensis / Nuxalk – Table 2.2

Couma macrocarpa / Awajun – Table 4.2

Crataegus douglasii / Nuxalk – Table 2.2

Crataeva speciosa / Pohnpei – Table 6.3

Cucumis melo / Dalit – Table 9.2; Karen – Table 8.2

Cucurbita pepo / Igbo – Table 12.1

Curcurbita pepo / Igbo – Table 12.1

Dacryodes edulis / Igbo – Table 12.1

Dennettia tripetala / Igbo – Table 12.1

Dialium guineense / Igbo – Table 12.1

Diospyros chloroxylon / Dalit – Table 9.2

Durio zibethinus / Karen – Table 8.2

Elaeagnus latifolia / Karen – Table 8.2

Elaeis guineensis / Igbo – Table 12.1

Embilica officinale / Dalit – Table 9.2

Emblica officinalis / Bhil – Table 10.1

Empetrum nigrum / Gwich’in – Table 3.1; Inuit – Table 1.1; Nuxalk – Table 2.2

Eugenia jambos / Pohnpei – Table 6.3

Eugenia stelechantha / Pohnpei – Table 6.3

Eugenia stipitata / Ingano – Table 5.2

Fabaceae / Awajun – Table 4.2

Ficus carica / Dalit – Table 9.2

Ficus chartacea / Karen – Table 8.2

Ficus glomerata / Dalit – Table 9.2

Ficus racemosa / Bhil – Table 10.1

Ficus sp. / Karen – Table 8.2

Ficus tinctoria / Pohnpei – Table 6.3

Flueggea virosa / Karen – Table 8.2

Fragaria vesca, F. virginiana / Nuxalk – Table 2.2

Garcinia kola / Igbo – Table 12.1

Gardenia gummifera / Dalit – Table 9.2

Grewia asiatica / Dalit – Table 9.2

Grewia bicolor / Maasai – Table 11.2

Grewia spp. / Igbo – Table 12.1

Grewia tembensis / Maasai – Table 11.2

Grias peruviana / Awajun – Table 4.2

Guizotia abyssinica / Bhil – Table 10.1; Dalit – Table 9.2

Helianthus annus / Dalit – Table 9.2

Herrania mariae / Awajun – Table 4.2

Husolandia opprosita / Igbo – Table 12.1

Icacemia spp. / Igbo – Table 12.1

Inga feuillei / Ingano – Table 5.2

Inga nobilis / Awajun – Table 4.2

Inocarpus fagifer / Pohnpei – Table 6.3

Irvingia gabonensis / Igbo – Table 12.1

Irvingia spp. / Igbo – Table 12.1

Landolphia owariensis / Igbo – Table 12.1

Landolphia spp. / Igbo – Table 12.1

Latina camera / Dalit – Table 9.2

Linum usitatissimum / Dalit – Table 9.2

Litchi chinensis / Karen – Table 8.2

Lycopersicon esculentum / Bhil – Table 10.1; Dalit – Table 9.2

Lycopersicum esculentum / Igbo – Table 12.1

Magnifera indica / Bhil – Table 10.1; Igbo – Table 12.1

Malus sylvestris / Dalit – Table 9.2

Mangifera indica / Dalit – Table 9.2; Karen – Table 8.2; Pohnpei – Table 6.3

Matisia cordata / Ingano – Table 5.2

Mauritia flexuosa / Awajun – Table 4.2

Moraceae / Awajun – Table 4.2

Morinda citrifolia / Pohnpei – Table 6.3

Morus sp. / Dalit – Table 9.2

Musa balbisiana / Awajun – Table 4.2

Musa paradisiaca / Dalit – Table 9.2; Igbo – Table 12.1

Musa regia / Ingano – Table 5.2

Musa sapientum / Igbo – Table 12.1; Ingano – Table 5.2; Karen – Table 8.2

Musa sp. / Awajun – Table 4.2; Ingano – Table 5.2

Musa spp. / Pohnpei – Table 6.3

Myrianthus arboreus / Igbo – Table 12.1

Nephelium lappaceum / Karen – Table 8.2; Pohnpei – Table 6.3

Oenocarpus bataua / Awajun – Table 4.2

Pachira aquatica / Ingano – Table 5.2

Pachystela breviceps / Igbo – Table 12.1

Pandanus tectorius / Pohnpei – Table 6.3

Pangium edule / Pohnpei – Table 6.3

Passiflora edulis / Dalit – Table 9.2; Ingano – Table 5.2; Pohnpei – Table 6.3

Passiflora edulis f. flavicarpa / Ingano – Table 5.2

Passiflora foetida / Karen – Table 8.2; Pohnpei – Table 6.3

Passiflora ligularis / Awajun – Table 4.2

Passiflora multiflora / Ingano – Table 5.2

Persia americana / Awajun – Table 4.2; Igbo – Table 12.1; Ingano – Table 5.2; Pohnpei – Table 6.3

Phoenix dactylifera / Dalit – Table 9.2

Phoenix sylvestris / Dalit – Table 9.2

Phyllanthus acidus / Karen – Table 8.2

Physalis angulata / Karen – Table 8.2

Phytelephas sp. / Awajun – Table 4.2

Piper umbellata / Igbo – Table 12.1

Pithecellobium duke / Dalit – Table 9.2

Pourouma cecropiifolia / Ingano – Table 5.2

Pouteria campechiana / Pohnpei – Table 6.3

Pouteria sapota / Awajun – Table 4.2

Prunus amygdalus / Dalit – Table 9.2

Pseudolmedia laevigata / Awajun – Table 4.2

Psidium guajava / Awajun – Table 4.2; Bhil – Table 10.1; Dalit – Table 9.2; Igbo – Table 12.1; Ingano – Table 5.2; Karen – Table 8.2; Pohnpei – Table 6.3

Punica granatum / Dalit – Table 9.2

Renealmia alpinia / Awajun – Table 4.2

Rheedia madruno / Ingano – Table 5.2

Rhus natalensis / Maasai – Table 11.2

Ribes bracteosum / Nuxalk – Table 2.2

Ribes divaricatum / Nuxalk – Table 2.2

Ribes hudsonianum / Gwich’in – Table 3.1

Ribes lacustre / Nuxalk – Table 2.2

Ribes laxiflorum / Nuxalk – Table 2.2

Ribes oxyacanthoides / Gwich’in – Table 3.1

Ribes parviflorus / Nuxalk – Table 2.2

Ribes triste / Gwich’in – Table 3.1

Rollinia microcarpa / Awajun – Table 4.2

Rosa acicularis / Gwich’in – Table 3.1

Rosa nutkana / Nuxalk – Table 2.2

Rubus chamaemorus / Gwich’in – Table 3.1; Inuit – Table 1.1

Rubus idaeus / Gwich’in – Table 3.1; Nuxalk – Table 2.2

Rubus leucodermis / Nuxalk – Table 2.2

Rubus spectabilis / Gwich’in – Table 3.1 Nuxalk – Table 2.2

Saccharum officinarum / Awajun – Table 4.2; Karen – Table 8.2; Pohnpei – Table 6.3

Salacca wallichiana / Karen – Table 8.2

Sambucus racemosa / Nuxalk – Table 2.2

Sandoricum koetjape / Karen – Table 8.2

Schleicheraoleosa / Karen – Table 8.2

Semecarpus anacardium / Dalit – Table 9.2

Senecio herreanus / Awajun – Table 4.2

Senna occidentalis / Igbo – Table 12.1

Sesamum indicum / Dalit – Table 9.2; Igbo – Table 12.1; Karen – Table 8.2

Shepherdia canadensis / Nuxalk – Table 2.2

Sicana odorifera / Awajun – Table 4.2

Socratea exorrhiza / Awajun – Table 4.2

Solanum coconilla / Awajun – Table 4.2

Solanum macrocarpum / Igbo – Table 12.1

Solanum sp. / Awajun – Table 4.2

Solinum nigrum / Dalit – Table 9.2

Spondias dulcis / Pohnpei – Table 6.3

Sterculia spp. / Igbo – Table 12.1

Syagrus sp. / Ingano – Table 5.2

Syziguim cumini / Bhil – Table 10.1; Dalit – Table 9.2

Syzygium malaccensis / Pohnpei – Table 6.3

Syzygium sp. / Karen – Table 8.2

Telferia spp. / Igbo – Table 12.1

Terminalia catappa / Pohnpei – Table 6.3

Tetracarpidium conophorum/Plukenetia conophora / Igbo – Table 12.1

Theobroma bicolor / Awajun – Table 4.2; Ingano – Table 5.2

Theobroma cacao / Ingano – Table 5.2; Pohnpei – Table 6.3

Theobroma cocao / Awajun – Table 4.2

Theobroma sp. / Awajun – Table 4.2

Theobroma subincanum / Ingano – Table 5.2

Treculia africana / Igbo – Table 12.1

Uraria chamae / Igbo – Table 12.1

Vaccinium alaskense / Nuxalk – Table 2.2

Vaccinium membranaceum / Gwich’in – Table 3.1; Nuxalk – Table 2.2

Vaccinium myrtilloides / Gwich’in – Table 3.1

Vaccinium myrtillus / Inuit – Table 1.1

Vaccinium ovalifolium / Nuxalk – Table 2.2

Vaccinium oxycoccus / Gwich’in – Table 3.1; Inuit – Table 1.1

Vaccinium parvifolium / Nuxalk – Table 2.2

Vaccinium uliginosum / Inuit – Table 1.1; Nuxalk – Table 2.2

Vaccinium vitis-idaea / Gwich’in – Table 3.1; Inuit – Table 1.1

Viburnum edule / Gwich’in – Table 3.1; Inuit – Table 1.1; Nuxalk – Table 2.2

Vitis vinifera / Dalit – Table 9.2

Ziziphus sp. / Karen – Table 8.2

Zizyphus enoplia / Dalit – Table 9.2

Zizyphus jujuba / Bhil – Table 10.1; Dalit – Table 9.2

Grains

Amaranthus paniculatus / Bhil – Table 10.1

Echinochloa crus-galli / Ainu – Table 7.2

Eleusine coracana / Bhil – Table 10.1; Dalit – Table 9.2

Hordeum vulgare / Dalit – Table 9.2

Oryza glaberrima / Igbo – Table 12.1

Oryza sativa / Bhil – Table 10.1; Dalit – Table 9.2; Igbo – Table 12.1; Karen – Table 8.2; Maasai – Table 11.2

Panicum italicum / Ainu – Table 7.2

Panicum miliaceum / Ainu – Table 7.2; Bhil – Table 10.1; Dalit – Table 9.2

Panicum miliare / Dalit – Table 9.2

Paspalum scrobiculatum / Dalit – Table 9.2

Penisetum typhoideum / Dalit – Table 9.2

Pennisetum spp. / Igbo – Table 12.1

Pennisetum typhoides / Maasai – Table 11.2

Pennisetum typhoideum / Bhil – Table 10.1

Setaria italica / Dalit – Table 9.2

Solanum tuberosum / Ainu – Table 7.2

Sorghum bicolor / Maasai – Table 11.2

Sorghum vulgare / Bhil – Table 10.1; Dalit – Table 9.2

Triticum aestivum / Bhil – Table 10.1; Dalit – Table 9.2

Zea mays / Awajun – Table 4.2; Bhil – Table 10.1; Dalit – Table 9.2; Igbo – Table 12.1; Ingano – Table 5.2; Karen – Table 8.2; Maasai – Table 11.2

Insects, mollusks and larvae

Achatina spp. / Igbo – Table 12.1

Atta sp. / Ingano – Table 5.2

Atta spp. / Ingano – Table 5.2

Cleoptera grylligaee / Igbo – Table 12.1

Coleoptera / Awajun – Table 4.2; Ingano – Table 5.2

Gryllus bimaculatus, degeer / Karen – Table 8.2

Hymenoptera brachygastra / Awajun – Table 4.2

Hymenoptera formicidae / Awajun – Table 4.2

Pomacea maculate / Ingano – Table 5.2

Termitidae / Igbo – Table 12.1

Land animals (including amphibians and reptiles)

Alces alces / Gwich’in – Table 3.1; Nuxalk – Table 2.2

Alouatta seniculus / Awajun – Table 4.2; Ingano – Table 5.2

Antilocarpa americana / Igbo – Table 12.1

Antilope cervicapra / Dalit – Table 9.2

Ateles sp. / Awajun – Table 4.2

Atherurus macrourus / Karen – Table 8.2

Bos spp. / Igbo – Table 12.1

Bos taurus / Bhil – Table 10.1; Dalit – Table 9.2; Karen – Table 8.2; Maasai – Table 11.2; Pohnpei – Table 6.3

Bubalus bubalis / Karen – Table 8.2; Pohnpei – Table 6.3; Dalit – Table 9.2

Cabassous unicintus / Ingano – Table 5.2

Cabassous unicintus and Geochelone carbonaria / Ingano – Table 5.2

Callicebus sp. / Awajun – Table 4.2

Canis cupus / Igbo – Table 12.1

Canis familiaris / Igbo – Table 12.1; Pohnpei – Table 6.3

Capra eagagrus / Igbo – Table 12.1

Capra hircus / Karen – Table 8.2; Maasai – Table 11.2; Pohnpei – Table 6.3

Capra hyrchusb / Bhil – Table 10.1; Dalit – Table 9.2

Castor canadensis / Gwich’in – Table 3.1

Cavia porcellus / Awajun – Table 4.2

Cebuella pygmaea / Ingano – Table 5.2

Cebus albifrons / Ingano – Table 5.2

Cebus apella / Ingano – Table 5.2

Cervu elaphus / Pohnpei – Table 6.3

Cervus nippon / Ainu – Table 7.2

Chiropotes satanas / Ingano – Table 5.2

Colostethus sp. / Awajun – Table 4.2

Crocodilus fuscus / Ingano – Table 5.2

Crocodiles mississipiensis / Igbo – Table 12.1

Cuniculus paca / Awajun – Table 4.2; Ingano – Table 5.2

Dasyprocta aguti / Awajun – Table 4.2

Dasyprocta fuliginosa / Ingano – Table 5.2

Daypus noremcinctus / Awajun – Table 4.2

Didelphis albiventris / Ingano – Table 5.2

Duicker / Igbo – Table 12.1

Erethizoatidae / Igbo – Table 12.1

Erethizon dorsatum / Gwich’in – Table 3.1

Geochelone carbonaria / Ingano – Table 5.2

Hyaenidae / Igbo – Table 12.1

Hystrix brachyura / Karen – Table 8.2

Iguana iguana / Ingano – Table 5.2

Kaloula pulchra / Karen – Table 8.2

Lagothrix logothricha / Ingano – Table 5.2

Lagothrix sp. / Ingano – Table 5.2

Lepridae sylvilagus / Dalit – Table 9.2

Lepus americanus / Gwich’in – Table 3.1; Inuit – Table 1.1

Lepus arcticus / Inuit – Table 1.1

Lepus capensis-Leporidae / Bhil – Table 10.1

Macaca sp. / Karen – Table 8.2

Mazama americana / Ingano – Table 5.2

Mazama rufina / Ingano – Table 5.2

Mazama sp. / Awajun – Table 4.2; Ingano – Table 5.2

Myoprocta pratti / Ingano – Table 5.2

Myrmecophaga tridactyla / Ingano – Table 5.2

Naemorhedus sumatraensis / Karen – Table 8.2

Nasua brasiliensis / Ingano – Table 5.2

Nasua nasua / Awajun – Table 4.2

Odocoileus spp. / Nuxalk – Table 2.2

Ondatra zibethicus / Gwich’in – Table 3.1

Oryctolagus cuniculus / Igbo – Table 12.1

Oreamnos americanus / Nuxalk – Table 2.2

Ovibos moschatus / Inuit – Table 1.1

Ovis aries / Dalit – Table 9.2; Maasai – Table 11.2

Ovis dalli / Gwich’in – Table 3.1

Pitechia monachus / Ingano – Table 5.2

Podocnemis expansa / Ingano – Table 5.2

Podocnemis unifilis / Awajun – Table 4.2

Polychrotidae / Awajun – Table 4.2

Potos flavus / Ingano – Table 5.2

Rangifer tarandus granti / Gwich’in – Table 3.1

Rangifer tarandus spp. arcticus, caribou, granti, groenlandicus, pearyi, tarandus / Inuit – Table 1.1

Rattus norvegicus / Bhil – Table 10.1

Saguinus inustus / Ingano – Table 5.2

Saimiri sciureus / Ingano – Table 5.2

Sciuridae / Ingano – Table 5.2

Sciurus igniventris / Ingano – Table 5.2

Sclurus sp. / Awajun – Table 4.2; Dalit – Table 9.2

Spermophilus adocetus / Ingano – Table 5.2

Squamata spp. / Igbo – Table 12.1

Sus cristatus / Dalit – Table 9.2

Sus scrofa / Awajun – Table 4.2; Bhil – Table 10.1; Dalit – Table 9.2; Igbo – Table 12.1; Karen – Table 8.2; Pohnpei – Table 6.3

Sylvilagus brasiliensis / Awajun – Table 4.2

Sylvilagus sp. / Nuxalk – Table 2.2

Tamandua tetradactyla / Ingano – Table 5.2

Tapirus terrestris / Awajun – Table 4.2; Ingano – Table 5.2

Tayassu pecari / Awajun – Table 4.2

Tayassu tajacu / Awajun – Table 4.2; Ingano – Table 5.2

Tupaia glis / Karen – Table 8.2

Ursus americanus / Gwich’in – Table 3.1

Ursus arctos / Gwich’in – Table 3.1

Ursus maritimus, Thalarctos maritimus / Inuit – Table 1.1

Varanidae varanus / Dalit – Table 9.2

Varanus bengalensis / Karen – Table 8.2

Vranus flavescens (yellow) or Varanus bengalensis / Bhil – Table 10.1

Varanus salvator / Karen – Table 8.2

Legumes

Arachis hypogea / Igbo – Table 12.1

Cajanus cajan / Bhil – Table 10.1; Dalit – Table 9.2; Igbo – Table 12.1

Canavalia ensiformis / Igbo – Table 12.1

Cicer arietinum / Dalit – Table 9.2

Dolichos biflours / Bhil – Table 10.1

Dolichos biorus / Dalit – Table 9.2

Dolichos lablab / Bhil – Table 10.1

Dolichos lablab / Dalit – Table 9.2

Faba vulgaris / Dalit – Table 9.2

Glycine max / Igbo – Table 12.1

Glycine max merr. / Bhil – Table 10.1

Kerstingiella geocarpa / Igbo – Table 12.1

Lathyrus sativus / Dalit – Table 9.2

Lens esculenta / Bhil – Table 10.1; Dalit – Table 9.2

Mucuna spp. / Igbo – Table 12.1

Pentaclethra macrophylla / Igbo – Table 12.1

Phaseolus aureus / Bhil – Table 10.1; Dalit – Table 9.2

Phaseolus mungo / Bhil – Table 10.1

Phaseolus vulgaris / Ingano – Table 5.2

Pisum sativum / Bhil – Table 10.1; Dalit – Table 9.2

Sphenostylis stenocarpa / Igbo – Table 12.1

Tetrapleura tetraptera / Igbo – Table 12.1

Vicia faba / Dalit – Table 9.2

Vigna subterranea / Igbo – Table 12.1

Vigna catjang / Dalit – Table 9.2

Vigna catjung / Bhil – Table 10.1

Vigna sesquipedalis / Pohnpei – Table 6.3

Vigna sinensis / Igbo – Table 12.1

Vigna spp. / Igbo – Table 12.1

Vigna subterranea / Igbo – Table 12.1; Maasai – Table 11.2

Vigna unguiculata / Karen – Table 8.2

Miscellaneous (including drinks, herbs, condiments, spices, mushrooms)

Acacia kirki / Maasai – Table 11.2

Acacia nilotica / Maasai – Table 11.2

Acacia nubia / Maasai – Table 11.2

Acacia senegal / Maasai – Table 11.2

Aframomum danielli / Igbo – Table 12.1

Aframomum melegueta / Igbo – Table 12.1

Afzelia africana / Igbo – Table 12.1

Albizia amara / Maasai – Table 11.2

Allium sativum / Dalit – Table 9.2

Auricularia auricula / Ingano – Table 5.2

Brachystegia eurycoma / Igbo – Table 12.1

Capsicum annum / Dalit – Table 9.2

Capsicum annuum / Ingano – Table 5.2; Karen – Table 8.2; Pohnpei – Table 6.3

Capsicum annuum, Capsicum frutescens / Awajun – Table 4.2

Capsicum frutescens / Igbo – Table 12.1; Karen – Table 8.2

Capsicum sp. / Karen – Table 8.2

Capsicum var. grosa / Dalit – Table 9.2

Cinnamomus carolinense / Pohnpei – Table 6.3

Citrillus vulgaris / Igbo – Table 12.1

Coriandrum sativum / Dalit – Table 9.2

Cuminum cyminum / Dalit – Table 9.2

Curcuma domestica / Dalit – Table 9.2

Curcuma longa / Pohnpei – Table 6.3

Cymbopogon citratus / Pohnpei – Table 6.3

Detarium macrocarpum / Igbo – Table 12.1

Elettaria cardamomum / Dalit – Table 9.2

Ferula asafoetica / Dalit – Table 9.2

Hibiscus rosa-sinensis / Pohnpei – Table 6.3

Hippocratea welwischtii / Igbo – Table 12.1

Lannea schweinfurthii / Maasai – Table 11.2

Mansoa alliacea / Pohnpei – Table 6.3

Mucuna flagellipes / Igbo – Table 12.1

Myristica fragrans / Dalit – Table 9.2; Igbo – Table 12.1

Mystrolyxon aethiopicum / Maasai – Table 11.2

Ocimum basilicum / Pohnpei – Table 6.3

Osyris lanceolata santalaceae / Maasai – Table 11.2

Papaver somniferum / Dalit – Table 9.2

Parkia biglobosa / Igbo – Table 12.1

Pimpinella anisum / Dalit – Table 9.2

Piper guineense / Igbo – Table 12.1

Piper methysticum / Pohnpei – Table 6.3

Piper nigrum / Dalit – Table 9.2; Pohnpei – Table 6.3

Pleurotus tuber / Igbo – Table 12.1

Prosopsis vitex / Igbo – Table 12.1

Ricinus communis / Igbo – Table 12.1

Saccharum officinarum / Dalit – Table 9.2; Maasai – Table 11.2

Salvadora persica / Maasai – Table 11.2

Secamone punctulata / Maasai – Table 11.2

Sterculia africana / Maasai – Table 11.2

Syzygium aromaticum / Dalit – Table 9.2

Tamarindus indica / Dalit – Table 9.2

Trachyspermum amoni / Dalit – Table 9.2

Trigonella foenum-graecum / Dalit – Table 9.2

Vatovaea pseudolablab / Maasai – Table 11.2

Vitex doniana / Igbo – Table 12.1

Ximenia americana / Maasai – Table 11.2

Xylopia aethiopica / Igbo – Table 12.1

Zingiber officinale / Dalit – Table 9.2; Pohnpei – Table 6.3

Vegetables (including roots, tubers, leaves, bark)

Abelmoschus esculentus / Bhil – Table 10.1; Dalit – Table 9.2; Karen – Table 8.2

Acacia pennata / Karen – Table 8.2

Acacia rugata / Karen – Table 8.2

Acalypha malabarica / Dalit – Table 9.2

Acanthacean sp. / Igbo – Table 12.1

Acanthoceae sp. / Igbo – Table 12.1

Achyranthes aspera / Dalit – Table 9.2

Aegle marmelos / Karen – Table 8.2

Agaricus bisporus / Bhil – Table 10.1

Agarum turneri / Inuit – Table 1.1

Ageratum conzoides / Igbo – Table 12.1

Alchornea cordifolia / Igbo – Table 12.1

Allium cepa / Dalit – Table 9.2; Pohnpei – Table 6.3

Allium fistulosum / Karen – Table 8.2

Allium sativum / Dalit – Table 9.2

Allium schoenoprasum / Pohnpei – Table 6.3

Allium sp. / Ingano – Table 5.2

Allium victorialis / Ainu – Table 7.2

Alocasia macrorrhiza / Pohnpei – Table 6.3

Alpinia galanga / Karen – Table 8.2

Alpinia sp. / Karen – Table 8.2

Alternanthera sessillis / Dalit – Table 9.2

Alternanthera sissoo / Pohnpei – Table 6.3

Alternanthera tenella / Dalit – Table 9.2

Amaranthus gangeticus / Dalit – Table 9.2

Amaranthus paniculatus / Dalit – Table 9.2

Amaranthus polygonoides / Dalit – Table 9.2

Amaranthus sp. / Dalit – Table 9.2; Karen – Table 8.2

Amaranthus spinosus / Bhil – Table 10.1; Dalit – Table 9.2

Amaranthus spp. / Igbo – Table 12.1

Amaranthus tristis / Dalit – Table 9.2

Amaranthus viridis / Dalit – Table 9.2

Amaranthus viridius / Igbo – Table 12.1

Amorphophallus campanulatus / Bhil – Table 10.1

Amphicarpa bracteata / Ainu – Table 7.2

Anacardia occidentale / Karen – Table 8.2

Ananas comosus / Karen – Table 8.2

Anemone flaccida / Ainu – Table 7.2

Angelica edulis / Ainu – Table 7.2

Arachis hypogaea / Awajun – Table 4.2

Aralia cordata / Ainu – Table 7.2

Archidendron jiringa / Karen – Table 8.2

Artocarpus heterophyllus / Karen – Table 8.2

Asparagus racemosus / Bhil – Table 10.1

Aspilia / Igbo – Table 12.1

Asplenium nidus / Pohnpei – Table 6.3

Astrocaryum chambira / Awajun – Table 4.2

Astrocaryum sp. / Awajun – Table 4.2

Asystasia gangetica / Igbo – Table 12.1

Auricularia polytricha / Karen – Table 8.2

Aurthum graveolus wild / Dalit – Table 9.2

Baccaurea ramiflora / Karen – Table 8.2

Bactris gasipaes / Awajun – Table 4.2

Bambusa affinis / Karen – Table 8.2

Bambusa arundinacea / Bhil – Table 10.1

Bambusa bambos / Karen – Table 8.2

Bambusa sp. / Karen – Table 8.2

Bascilla sp. / Dalit – Table 9.2

Baselia sp. / Dalit – Table 9.2

Basella alba / Karen – Table 8.2

Basella rubra / Dalit – Table 9.2

Begonia plebeja / Ingano – Table 5.2

Benincasa hispida / Dalit – Table 9.2; Karen – Table 8.2

Beta vulgaris / Dalit – Table 9.2

Boerhavia diffusa / Igbo – Table 12.1; Dalit – Table 9.2

Boesenbergia rotunda / Karen – Table 8.2

Borassus flabellifer / Dalit – Table 9.2

Brassaiopsis ficifolia / Karen – Table 8.2

Brassica alboglabra / Karen – Table 8.2

Brassica campestris var. / Dalit – Table 9.2

Brassica chinensis / Karen – Table 8.2; Pohnpei – Table 6.3

Brassica oleracea / Maasai – Table 11.2

Brassica oleracea var. botrytis / Dalit – Table 9.2

Brassica oleracea var. capitata / Dalit – Table 9.2

Brassica pekinensis / Karen – Table 8.2

Brillantaisia nitens / Igbo – Table 12.1

Bryophyllum pinnatum / Igbo – Table 12.1

Burseraceae / Awajun – Table 4.2

Caesalpinia mimosoides / Karen – Table 8.2

Cajanus cajans / Karen – Table 8.2

Caladium bicolor / Awajun – Table 4.2

Canavalia gladiata / Dalit – Table 9.2; Karen – Table 8.2

Canna edulis / Karen – Table 8.2

Canthium spinosa / Dalit – Table 9.2

Capparis horrida / Dalit – Table 9.2

Carica papaya / Dalit – Table 9.2; Karen – Table 8.2

Carludovica palmata / Ingano – Table 5.2

Carissa carandas / Bhil – Table 10.1

Carthamus tinctorius / Dalit – Table 9.2

Caryodedron orinocensis / Awajun – Table 4.2

Cassia ariculata / Dalit – Table 9.2

Cassia fistula / Dalit – Table 9.2

Cassia sophera / Dalit – Table 9.2

Cassia tora / Dalit – Table 9.2

Celosia argentia / Dalit – Table 9.2

Centella asiatica / Karen – Table 8.2

Chenopodium album / Nuxalk – Table 2.2

Chlorophytum borivilianum / Bhil – Table 10.1

Chlorophytum tuberosum / Bhil – Table 10.1

Chromolaena odorata / Igbo – Table 12.1

Chrysophyllum mexicanum / Ingano – Table 5.2

Cicer arietinum / Bhil – Table 10.1; Dalit – Table 9.2

Cissampelos mucrumata / Igbo – Table 12.1

Citrus aurantifolia / Karen – Table 8.2

Citrus medica / Karen – Table 8.2

Citrus sp. / Karen – Table 8.2

Cleome gynandra / Dalit – Table 9.2; Karen – Table 8.2

Cnidoscolus chayamansa / Pohnpei – Table 6.3

Coccinia grandis / Karen – Table 8.2

Coccinis cordifolia / Dalit – Table 9.2

Cocculus hirsutus / Dalit – Table 9.2

Coffea sp. / Karen – Table 8.2

Colocasia antiquorum / Bhil – Table 10.1; Dalit – Table 9.2

Colocasia esculenta / Awajun – Table 4.2; Igbo – Table 12.1; Karen – Table 8.2; Pohnpei – Table 6.3

Colocasia spp. / Igbo – Table 12.1

Commelina benghalensis / Dalit – Table 9.2

Corchorus olitorius / Dalit – Table 9.2; Igbo – Table 12.1

Corchorus spp. / Igbo – Table 12.1

Coriandrum sativum / Dalit – Table 9.2; Karen – Table 8.2

Costus speciosus / Karen – Table 8.2

Crateva magna / Karen – Table 8.2

Cucumis melo / Karen – Table 8.2

Cucumis sativus / Dalit – Table 9.2; Ingano – Table 5.2; Karen – Table 8.2; Pohnpei – Table 6.3

Cucumis sp. / Karen – Table 8.2

Cucurbita maxima / Awajun – Table 4.2; Bhil – Table 10.1

Cucurbita moschata / Karen – Table 8.2; Pohnpei – Table 6.3

Cucurbita pepo / Igbo – Table 12.1; Pohnpei – Table 6.3

Curcuma parviflora / Karen – Table 8.2

Cyamopsis tetragonoloba / Dalit – Table 9.2

Cyclanthera pedata / Awajun – Table 4.2

Cymbogon citraus / Igbo – Table 12.1

Cymbopogon citratus / Karen – Table 8.2

Cyrtosperma chamissonis / Pohnpei – Table 6.3

Dalbergia latifolia / Bhil – Table 10.1

Daucus carota / Dalit – Table 9.2; Inuit – Table 1.1

Dendrocalamus asper / Karen – Table 8.2

Dictyophora sp. / Bhil – Table 10.1

Dygera arvensis / Dalit – Table 9.2

Dillenia indica / Karen – Table 8.2

Dioscorea alata / Igbo – Table 12.1; Ingano – Table 5.2; Karen – Table 8.2

Dioscorea bulbifera / Dalit – Table 9.2; Igbo – Table 12.1

Dioscorea cayenensis / Igbo – Table 12.1

Dioscorea dumentorum / Igbo – Table 12.1

Dioscorea esculenta / Bhil – Table 10.1; Karen – Table 8.2

Dioscorea praehensilis / Igbo – Table 12.1

Dioscorea rotundata / Igbo – Table 12.1

Dioscorea sp. / Awajun – Table 4.2

Dioscorea spp. / Pohnpei – Table 6.3

Dioscorea trifida / Awajun – Table 4.2

Diospyros mespilifomis / Igbo – Table 12.1

Diplazium esculentum / Karen – Table 8.2

Dolichos lablab / Dalit – Table 9.2

Dracaena sp. / Karen – Table 8.2

Dryopteris expansa / Nuxalk – Table 2.2

Eichhornia crassipes / Karen – Table 8.2

Elaeis guineensis / Igbo – Table 12.1; Pohnpei – Table 6.3

Enicostema hyssopifolium / Dalit – Table 9.2

Entada sp. / Karen – Table 8.2

Entoluma macrocarpom / Dalit – Table 9.2

Epilobium angustifolium / Nuxalk – Table 2.2

Eryngium foetidum / Ingano – Table 5.2; Karen – Table 8.2

Erythrina indica / Dalit – Table 9.2

Erythropalm scandens / Karen – Table 8.2

Euphorbia hirta / Igbo – Table 12.1

Euphorbiacae / Igbo – Table 12.1

Euterpe precatoria / Awajun – Table 4.2

Ficus glomerata / Dalit – Table 9.2

Fritillaria camschatcensis / Nuxalk – Table 2.2

Glycine max / Dalit – Table 9.2

Gnetum africanum / Igbo – Table 12.1

Gnetum gnemon / Karen – Table 8.2

Grongronema latifollis / Igbo – Table 12.1

Guilielma gasipaes / Ingano – Table 5.2

Gymnema sylvestre / Dalit – Table 9.2

Gynura crepidioides / Pohnpei – Table 6.3

Heinsia crinita / Igbo – Table 12.1

Heliotropium indicum / Igbo – Table 12.1

Heracleum lanatum / Nuxalk – Table 2.2

Hibiscus cannabinus / Dalit – Table 9.2

Hibiscus esculentus / Pohnpei – Table 6.3

Hibiscus manihot / Pohnpei – Table 6.3

Hibiscus sabdariffa / Karen – Table 8.2

Husolandia opposite / Igbo – Table 12.1

Hydrocotyle umbellata / Karen – Table 8.2

Ipomoea aquatica / Karen – Table 8.2; Pohnpei – Table 6.3

Ipomoea batatas / Awajun – Table 4.2; Bhil – Table 10.1; Dalit – Table 9.2; Igbo – Table 12.1; Ingano – Table 5.2; Karen – Table 8.2; Maasai – Table 11.2; Pohnpei – Table 6.3

Ipomoea longituba / Maasai – Table 11.2

Jatropha curcas / Igbo – Table 12.1

Kaemferia sp. / Karen – Table 8.2

Lactuca runcinata / Dalit – Table 9.2

Lagenaneria siceraria / Karen – Table 8.2

Lagenaria siceraria / Dalit – Table 9.2; Pohnpei – Table 6.3

Lagenaria vulgaris / Bhil – Table 10.1

Lasia spinosa / Karen – Table 8.2

Ledum groenlandicum / Gwich’in – Table 3.1; Nuxalk – Table 2.2

Ledum palustre / Gwich’in – Table 3.1

Lemmaphyllum carnosum / Karen – Table 8.2

Lepidium peruvianum / Awajun – Table 4.2

Leptadenia spp. / Igbo – Table 12.1

Leucas aspera / Dalit – Table 9.2

Lilium cordatum / Ainu – Table 7.2

Lilium cordatum var. glehnii / Ainu – Table 7.2

Luffa acutangula / Dalit – Table 9.2; Karen – Table 8.2

Luffa cylindrica / Karen – Table 8.2

Lupinus nootkatensis / Nuxalk – Table 2.2

Lycopersicon esculentum / Awajun – Table 4.2; Dalit – Table 9.2; Ingano – Table 5.2; Karen – Table 8.2; Pohnpei – Table 6.3

Lygodium flexuosum / Karen – Table 8.2

Maerremial emarginata / Dalit – Table 9.2

Mangifera indica / Dalit – Table 9.2; Karen – Table 8.2

Manihot crantz / Igbo – Table 12.1

Manihot esculenta / Awajun – Table 4.2; Igbo – Table 12.1; Ingano – Table 5.2; Karen – Table 8.2; Maasai – Table 11.2; Pohnpei – Table 6.3

Maranta arundinacea / Awajun – Table 4.2

Marantha sp. / Karen – Table 8.2

Marsilea crenata / Karen – Table 8.2

Matteuccia struthiopteris / Ainu – Table 7.2

Melientha suavis / Karen – Table 8.2

Mentha cordifolia / Karen – Table 8.2

Mentha spicata / Dalit – Table 9.2

Merremia / Igbo – Table 12.1

Merremia tridentata var. hastate / Dalit – Table 9.2

Mirabilis jalapa / Dalit – Table 9.2

Momordica charantia / Bhil – Table 10.1; Dalit – Table 9.2; Igbo – Table 12.1; Pohnpei – Table 6.3

Momordica dioica / Dalit – Table 9.2

Morinda citrifolia / Karen – Table 8.2

Moringa oleifera / Bhil – Table 10.1; Dalit – Table 9.2; Igbo – Table 12.1; Karen – Table 8.2; Pohnpei – Table 6.3

Mormodica charantia / Karen – Table 8.2

Mormodica chochinchinensis / Karen – Table 8.2

Murraya koenigii / Dalit – Table 9.2

Musa sp. / Karen – Table 8.2

Myrianthus arboreus / Igbo – Table 12.1

Ocimum americanum / Karen – Table 8.2

Ocimum basilicum / Pohnpei – Table 6.3

Ocimum gratissmum / Igbo – Table 12.1

Ocimum sanctum / Karen – Table 8.2

Oenocarpus bataua / Ingano – Table 5.2

Oxalis corniculata / Dalit – Table 9.2

Oxalis oregana / Inuit – Table 1.1

Oxyria digyna / Inuit – Table 1.1

Pachyrrhizus tuberosus / Awajun – Table 4.2

Passiflora foetida / Karen – Table 8.2

Paullinia yoco / Ingano – Table 5.2

Petasites Japonicus / Ainu – Table 7.2

Phaselolus coccineus / Bhil – Table 10.1

Phaseolus coccineus / Dalit – Table 9.2

Phaseolus vulgaris / Dalit – Table 9.2

Phellodendron amurense / Ainu – Table 7.2

Philodendron sp. / Awajun – Table 4.2

Phyllanthus maderaspatensis / Dalit – Table 9.2

Physalis minima / Dalit – Table 9.2

Phytelephas sp. / Awajun – Table 4.2

Piper betle / Dalit – Table 9.2

Piper guineense / Igbo – Table 12.1

Piper sarmentosum / Karen – Table 8.2

Piper sp. / Awajun – Table 4.2

Piper umbellata / Igbo – Table 12.1

Pisum sativum / Karen – Table 8.2

Polygalaceae / Igbo – Table 12.1

Polygonum alaskum / Gwich’in – Table1

Polypodium glycyrrhiza / Nuxalk – Table 2.2

Populus balsamifera spp. trichocarpa / Nuxalk – Table 2.2

Porphyra abbottiae / Nuxalk – Table 2.2

Porphyra perforate / Nuxalk – Table 2.2

Portulaca grandiflora / Dalit – Table 9.2

Portulaca oleracea / Dalit – Table 9.2

Portulaca sp. / Dalit – Table 9.2

Portulaco oleracea / Igbo – Table 12.1

Potentilla pacifica / Nuxalk – Table 2.2

Pouteria sp. / Ingano – Table 5.2

Psophocarpus tetragonolobus / Pohnpei – Table 6.3; Karen – Table 8.2

Psychotria spp. / Igbo – Table 12.1

Pteridium aquilinum / Nuxalk – Table 2.2

Pterocarpus soyauxii / Igbo – Table 12.1

Ptychosperma spp. / Pohnpei – Table 6.3

Pyrus fusca / Nuxalk – Table 2.2

Raphanus sativus / Dalit – Table 9.2; Karen – Table 8.2; Pohnpei – Table 6.3

Rheum rhaponticum / Gwich’in – Table 3.1

Rubus parviflorus / Nuxalk – Table 2.2

Rubus spectabilis / Nuxalk – Table 2.2

Rumex acetosella / Nuxalk – Table 2.2

Rumex vesicarius / Dalit – Table 9.2

Salix arctica / Inuit – Table 1.1

Sauropus androgynus / Karen – Table 8.2; Pohnpei – Table 6.3

Saxifraga oppositifolia / Inuit – Table 1.1

Saxifraga sp / Inuit – Table 1.1

Sechium edule / Ingano – Table 5.2

Securingea virosa / Dalit – Table 9.2

Senna alata / Igbo – Table 12.1

Senna occidentalis / Igbo – Table 12.1

Sesbania aegyptiaca / Dalit – Table 9.2

Sesbania grandiflora / Dalit – Table 9.2

Socratea exorrhiza / Awajun – Table 4.2

Solanum macrocarpum / Igbo – Table 12.1

Solanum melongena / Bhil – Table 10.1; Dalit – Table 9.2; Karen – Table 8.2; Pohnpei – Table 6.3

Solanum nigrum / Dalit – Table 9.2

Solanum torvum / Karen – Table 8.2

Solanum tuberosum / Bhil – Table 10.1; Dalit – Table 9.2; Maasai – Table 11.2

Spathodea campanulata / Igbo – Table 12.1

Sphaeranthus africanus / Karen – Table 8.2

Spinacia oleracea / Dalit – Table 9.2

Spondias pinnata / Karen – Table 8.2

Tacca leontopetaloides / Pohnpei – Table 6.3

Talinum triangulare / Igbo – Table 12.1

Tamarindus indica / Dalit – Table 9.2; Karen – Table 8.2

Taraxacum lacerum / Inuit – Table 1.1

Tectona grandis / Bhil – Table 10.1

Telferia occidentalis / Igbo – Table 12.1

Trachyspermum ammi / Dalit – Table 9.2

Trianthema decandra / Dalit – Table 9.2

Trichosanthes anguina / Dalit – Table 9.2

Trifolium wormskioldii / Nuxalk – Table 2.2

Trigonella foenum / Dalit – Table 9.2

Trigonnella foenum graecum / Bhil – Table 10.1; Dalit – Table 9.2

Urtica dioica / Nuxalk – Table 2.2

Uvaria chamae / Igbo – Table 12.1

Verbenaceae / Igbo – Table 12.1

Veronia amygdalina / Igbo – Table 12.1

Xanthosoma mafaffa / Igbo – Table 12.1

Xanthosoma sagittifolium / Pohnpei – Table 6.3

Xanthosoma sp. / Awajun – Table 4.2

Xanthosoma spp. / Awajun – Table 4.2

Zingiber officinale / Dalit – Table 9.2

Photographic section

Inuit

Nuxalk

Gwich’in

Awajun

Ingano

Pohnpei

Ainu

Karen

Dalit

Bhil

Maasai

Igbo

Inuit

“Give thanks to our food, Elders and ancestors daily.”

Chapter 1 >> 9

Nuxalk

“The old foods are the new foods!”

Chapter 2 >> 23

Gwich’in

“Caribou blood gives strength and warmth, and it keeps you from getting hungry for a long time.”

Chapter 3 >> 45

Awajun

“With our foods from the wild, the river and our fields we are strong and alert.”

Chapter 4 >> 59

Ingano

“…We need our plants and our jungle in order to have strength and to live better.”

Chapter 5 >> 83

Pohnpei

“God made us to eat our own foods. We need to go local!”

Chapter 6 >> 109

[1]At the 2007 meeting of case study partners in Bellagio, Italy, considerable discussion was held on the title for this book. It was agreed to include both nutrition and health in the title, and that a footnote be made to the many dimensions of Indigenous Peoples’ food systems that were expressed. These included the concepts of food diversity and/or biodiversity, culture, environment, food security, economy of family food, food self-sufficiency, and self-esteem and cultural morale in using local, cultural food. It is hoped that this introduction captures the diversity of the discussion, and includes the many thoughtful perspectives of our excellent team.

[2]The UBN is used by entities as the World Bank, the International Monetary Fund and the Ministries of Treasury and National Planning in most countries of the Third World.

[3]An atoll is a ring-shaped low-lying coral island or group of islands, often consisting of only a narrow strip of land with seawater on both sides, circling a lagoon. Atoll island climates are considered among the harshest in the world because of the poor rainfall and poor soils.

[4]Exclusive military access is provided to the United States of America as a part of the agreement of the Compacts.

[5]In this paper cultivars refer to varieties produced upon cultivation.

[6]Local food is the commonly used term in Micronesia and the Pacific for traditional food.

[7]Turkey tail is literally the tails of turkey. This item is imported as a frozen product from the United States of America, eaten fried or in other recipes and is generally considered by Pohnpeians as a delicious food.

[8]For each item, the participant was asked, “How many days in the last seven days did you consume (the item)?” Participants were also asked for the number of times that rice was generally eaten each day.

[9]Although alcoholic beverages are illegal in the municipality of Madolenihmw where Mand is located, they are still consumed and include hard alcohol, imported beer and some locally made alcoholic beverages. However, these are unacceptable by the Protestant church community in Mand and are commonly consumed mainly by the youth.

[10]Sakau is a non-alcoholic drink prepared from the freshly pounded roots of the Piper methysticum plant. The psychoactive substances are kavalactones, which produce a mildly euphoric anxiety-reducing feeling along with muscle relaxation. It has cultural importance and is frequently consumed by native Pohnpeians.

[11]The respondents included 44 females and 2 males, selected according to familiarity with family diets.

[12]ß-carotene is the most important of the provitamin A carotenoids contributing to vitamin A status.

[13]In contrast to these locally grown foods, rice, a commonly consumed food, contains no provitamin A carotenoids.

[14]Previously in Pohnpei breadfruit was often preserved in a pit with as many as 500 to 1 000 peeled and cored breadfruit placed in the ground for a fermentation process that required about three months. After this time the doughy mass can be kneaded and prepared as bread, which has a cheese-like fermented taste. Preserved breadfruit could be left in the pit for many years. As breadfruit is a seasonal crop, this preservation method provided a supplement to the diet in off seasons and provided food security in times of natural disasters.

[15]The sour taste is removed by rinsing the raw preserved mahr.

[16]Fat intake should supply a minimum of 15 percent of total energy, but should not exceed 30–35 percent (WHO/FAO, 2002).

[17]The seven-day FFQ was administered during the breadfruit season. It is likely that there was a higher consumption of local foods than would have been the case if the survey had been conducted when breadfruit was not available.

[18]Turkey tail is literally the tail of the turkey (see footnote 7).

[19]Health officials report that around 90 percent of deliveries in Pohnpei are carried out in Pohnpei State Hospital.

[20]Exclusive breastfeeding refers to giving breastmilk only, not even water, for the first six months.

[21]The term in the Pingelapese language for the first solid food given to an infant is kepeloal.

[22]Karat (a banana cultivar) is a traditional infant food of Pohnpei. See section on scientific identification.

[23]BMI = weight in kg divided by height in meters squared.

[24]Measurements were also taken for 30 additional adults not in the randomly selected households, but these data are not included in the analyses.

[25]Overweight was defined as a BMI >25 and obesity was defined as a BMI >30.

[26]The cut-offs used for waist circumference with substantially increased health risks were: >88 cm (females) and >102 cm (males).

[27]Guidelines used were: optimal <120/80 (systolic/diastolic); normal/high 130–139/85–89 (systolic/diastolic); borderline hypertension 140–159/90–94 (systolic/diastolic); and definite hypertension ≥160/95 (systolic/diastolic).

[28]Two standard deviations (SD or Z-score) below the National Center for Health Statistics (NCHS) median values for height for age, weight for age, and weight for height.

[29]Levels of FBS were classified as: normal <126 mg/dl, and abnormal ≥126 mg/dl (American Diabetic Association 2003).

[30]All adults were invited to take a FBS measurement, if they wanted. There were 30 volunteer adults for this.