Healthy Eating in Vulnerable Salvadorian Communities.
Fuster, Melissa.
2013
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Abstract: Food and
nutrition security interventions in resource-poor settings more often than not emphasize
food sufficiency over food quality. Globalization is driving changes in food
environments, where cheaper, energy-dense, manufactured foods are widely available, and
increasingly displacing traditional and often healthier food options. Availability and
access are essential to food consum... read moreption, but food choices are an important factor in
the process. The choice to eat healthy depends on different factors. This thesis focused
on healthy eating from the perspective of border, resource-poor Salvadorian communities,
through two Study Aims. Study Aim 1 compared perceived access to healthy diets (PAHD)
and actual consumption using secondary information from 140 households in border,
resource-poor communities in El Salvador. The data were collected by the Regional
Program for Food and Nutrition Security in Central America (PRESANCA) from a sample of
communities located in municipalities with high stunting rates and high vulnerability
from climatic conditions (e.g. droughts and floods). Households were classified
according to three different levels of PAHD (High, Moderate and Low) based on responses
to an item from the food security measurement scale, and its follow-up frequency
question. Diet quality was measured with the Household Dietary Quality Indicator (HDQI),
an 18-component indicator based on the Salvadorian Dietary Guidelines constructed as
part of this study. The sample presented overall low diet variety and HDQI scores. PAHD
was positively associated with overall diet quality and variety, and higher intakes of
animal products, fats, cholesterol, vitamin C, and sodium. High PAHD households had
higher levels of women's education and household food security. Study Aim 2 was an
ethnographic assessment of local definitions and perceptions concerning healthy eating
in four resource-poor, border communities in El Salvador. The study included focus
groups, key informant interviews, and observations of the food environment. The local
definitions elicited through focus groups were compared to the national Salvadorian
dietary guidelines recommendations, revealing areas of overlap (including the importance
of dietary variety, fruits, and vegetables, among others) and omissions (mention of
limiting sweets/candy, salt, sugar, and alcohol). Focus group participants expressed
concerns over the origin of their foods and harmful chemicals in food. Barriers to
healthy eating included economic and physical access to healthier food options and
personal preference for convenience foods, among others. The results from this study
highlight the importance of focusing on diet quality in contexts vulnerable to food
insecurity. The consumption of healthy diets is affected by a conflict between nutrition
knowledge and preference for often unhealthier, but convenient and more palatable
options, which are also perceived as more prestigious. The findings can influence future
nutrition and public health interventions targeted at improving the quality of the diet
among populations in similar resource-poor communities in developing countries.
Understanding factors associated with the consumption of a healthy diet in a Latin
American country will also have the potential to inform culturally appropriate
interventions for Hispanics living in the US, who often come from similar vulnerable
communities, as those included in this study.
Thesis (Ph.D.)--Tufts University, 2013.
Submitted to the Dept. of Food Policy & Applied Nutrition.
Advisor: Odilia Bermudez.
Committee: Ellen Messer, and Robert Houser.
Keyword: Nutrition.read less - ID:
- 6h441526j
- Component ID:
- tufts:20334
- To Cite:
- DCA Citation Guide EndNote
