A blind spot in food and nutrition security: where culture and social change shape the local food plate
It is estimated that over 800 million people are hungry each day and two billion are suffering from the consequences of vitamin and mineral deficiencies. While a paradigm shift towards a multi-dimensional and multi-sectoral approach to food and nutrition insecurity is emerging, technical approaches largely prevail to tackle the causes of hunger and malnutrition. Founded in original in-depth field research among smallholder farmers in southwest Kenya, we argue that incorporating cultural or social dimensions in this technical debate is imperative and that by systematically overlooking these dimensions, food insecurity cannot be accurately captured nor properly addressed. Based on a sub-location in rural southwest Kenya where the food plate is rapidly narrowing towards a high-calorie low nutrient diet and where over 80 % of households experience food shortages at least once a year, conclusions suggest that preferences, the local function of food, and the practices that emerge therefrom can affect the regularity of meals and their composition. The findings allow us to complement emerging research and program development with a more comprehensive and locally adapted approach to tackle food and nutrition insecurity.
KeywordsFood security Nutrition security Nutrition transition
Centre for African Bio-Entrepreneurship
Food and Agriculture Organization of the United Nations
Scaling up nutrition
Discussions about food security frequently culminate in a sum-all question, ‘how to feed 9 billion people by 2050’ (Godfray et al. 2010). With over 800 million people facing hunger every day and an estimated two billion suffering from malnutrition or ‘hidden hunger’ (micronutrient rather than just macronutrient deficiencies), the magnitude of the issue begs attention (Johns and Bhuwon 2004; Micronutrient Initiative 2009; Fanzo and Mattei 2010). While formerly addressed from different sectors, linkages between food and nutrition security are increasingly gaining attention. Whereas nutrition was tackled largely by the health sector, food security received more attention in agricultural debates and thereby focused on increasing quantities of food produced and accessed. In recent years, however, agriculture’s narrow focus to increase yields to enhance calorie-intake has been increasingly challenged. In 1996 the FAO declared at the World Food Summit in Rome that food security can be defined as a situation “when all people, at all times, have physical and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for a healthy and active life” (FAO 1996). This comprehensive definition far exceeds yield, calorie, or micronutrient measures and requires a long-term perspective and multi-dimensional approach.
Food security is a critical but insufficient condition for adequate nutrition (Gillespie and Mason 1991). While food security captures macro intake of food, nutrition security captures micronutrient intake, health, and sanitation because micronutrient deficiencies can remain hidden.1 Food and nutrition security are increasingly addressed with a ‘twin-track’ approach adopted by the FAO and other food and agriculture agencies to provide immediate hunger relief while simultaneously developing long-term strategies for sustainable development. Unfortunately, ‘technical fixes’ are often used as a means to tackle both. The survey instruments of food security indicators2 do not collect information on how food is utilized (prepared and consumed) in a particular social or cultural context. For example, information on the intra-household distribution of food quantities and categories, quality of foods produced, cultural acceptability of food, the function of food, taste and color preferences, traditional food preservation and processing methods, and how decisions are made are largely missing from these surveys. While the twin-track approach is gaining ground, it would benefit considerably from being embedded within the cultural context. In this article, we argue that such in-depth, cultural understanding of inter- and intra-household decision-making regarding food production, consumption, and distribution norms and practices is necessary for confronting local food challenges effectively and sustainably. The importance of such an inclusive approach are illustrated in the sections below as captured in the context of seven villages in rural southwest Kenya.
While under- and over-nutrition are omnipresent, sub-Saharan Africa hosts the highest percentage (27 %) of malnourished people in the world (FAO 2012). Located on the East African equator, the Republic of Kenya is home to an estimated 43 million people (IFAD 2012), a number that has tripled since the 1980s (IFAD 2012). Eighty percent of Kenyans live in rural areas, and of those, the majority are engaged in agriculture. While Kenya is recognized as one of the most developed nations in East Africa (IFAD 2012), every second person is deemed food insecure (in terms of quantity), consuming on average 1,690 calories a day (Kenya National Bureau of Statistics 2008). Estimates suggest that despite years of agricultural development, food insecurity has remained relatively unchanged in Kenya since the 1990s (IFPRI 2012), but has increased in absolute terms from 9 million in 1990–1992 to 13 million in 2010–2012. This is respective of population growth, resulting in a nearly unchanged malnutrition rate since the 1990s stagnating just above 30 % (FAO 2012). While the FAO (2012) has recognized that “overcoming micronutrient malnutrition is a precondition for ensuring development” (p. 23), the alleviation of hunger and malnutrition has proved challenging. The fortification of staple foods, mainly cereals, is one of the dominant interventions in the Kenyan agricultural sector. Yet, it carries a risk of simplifying the diet to one or two staples if diversified vegetative species are not targeted, value addition and food wastage are not improved, and local food cultures are overlooked (Johns and Eyzaguirre 2006). Diet simplification is already an ongoing trend in many sub-Saharan African countries, of which the consequences can be captured, for example, in stunting measurements (FAO 2013). As approximately 38 % of children under five in sub-Saharan Africa are stunted (compared with the worldwide average of 25 %) (IFPRI 2014), capturing changes in diets is essential for ensuring food and nutrition security and thereby also physical and cognitive development.
Over millennia, human diets have changed in composition and quality congruent with shifting lifestyles, environmental pressure, culture, demographic changes, transportation, technological developments, and epidemiological transitions (Popkin 1993; WCRF 2007; Johns and Bhuwon 2004; Hawkes 2006). Following food trends in North America and western Europe, diets in developing countries are presently shifting at an accelerated pace towards a high-energy but low-nutrient ‘western diet’ (Popkin 2006).3 These trends are often associated with excessive consumption of sugars (including from a few grain varieties), oils and fats, and meat—which are known to be detrimental to human health (Lairon 2010; Hawkes 2006)—and a reduction in fiber, vegetable, and fruit intake (Popkin 2002; WCRF 2007). Non-communicable diseases (NCDs), formerly associated only with over-consumption in industrialized countries, are adding a ‘double burden’ to areas that previously experienced only seasonal under-nutrition.4 The consequences of the current rapid nutrition transition are troubling especially in Africa as NCDs exacerbate pre-existing health concerns such as HIV-AIDS and nutrition-related weaknesses (Raschke and Cheema 2008). These consequences “seem to originate in the erosion of the traditional ways of life and culture as the new western/North American food model and system spread over the world” (Lairon 2010, p. 31). Studies among Native Alaskan populations have shown that the erosion of traditional foods replaced with prepared and processed supermarket foods has improved ‘food security’ but has also coincided with the increased prevalence of health problems (Loring and Gerlach 2009). The implications and consequences of adopting technical short-term approaches to food and nutrition are manifold as they may exacerbate the increase of NCDs, impede physiological and cognitive human development, and hinder sustainable agricultural development (Johns and Bhuwon 2004; Popkin 1993; Frison et al. 2011a, b; Ruel 2003; Raschke and Cheema 2008; Fanzo and Mattei 2010; Lairon 2010).
It is our contention that current approaches to food security, even when including nutrition, tend to negate the social side of food. While social causes of food insecurity are considered important (Devereux 2000), they are frequently simplified as socio-economic (income and class) and demographic causes. The social intricacies underlying nutrition transitions remain largely overlooked despite carrying the potential to curb or handle them in a physiologically and socially appropriate manner. These processes, while time-intensive to unpack, must be well understood in order to tackle local food challenges effectively and sustainably. The purpose of this article will therefore be to unravel the social and cultural processes that have shaped the narrowing of the food plate in western Kenya, a phenomenon that we have observed throughout many rural areas in Sub-Saharan African countries. As of yet, few studies have provided empirical evidence of the complexities of the social dynamics and processes in determining food security or presented integrated approaches to complement or to move beyond technical fixes (FAO 2012; Maxwell and Smith 1992; Ericksen 2008). Even the Food and Agriculture Organization (FAO), perhaps the most recognized institution in this field, struggles to conceptualize, measure, and develop programs to tackle food and nutrition insecurity in a socially aware manner, giving equal weight to short- and long-term perspectives and objectives (FAO 2012).
Our research findings draw on 5 months of field research conducted in seven villages in Luchululo, Samia District, Western Province of Kenya, among a population of mostly poor and medium-wealthy smallholder farmers from the Luhya tribe. The research is part of an on-going research program between the Centre for African Bio-Entrepreneurship (CABE) and the University of Amsterdam, on smallholder farmer livelihoods and well-being in Samia District.
Our findings highlight the value and gendered dimensions of the staple food, ugali, the increasing significance and dislike of colored food, and how food conservation is increasingly stigmatized. These three examples make the case for how food and nutrition (in)security can in part be understood by the changing food plate and how food and nutrition security studies could benefit from including cultural and social dimensions.
Including the social dimension in a technical debate
“Food availability: The availability of sufficient quantities of food of appropriate quality, supplied through domestic production or imports (including food aid).
Food access: Access by individuals to adequate resources (entitlements) for acquiring appropriate foods for a nutritious diet. Entitlements are defined as the set of all commodity bundles over which a person can establish command given the legal, political, economic and social arrangements of the community in which they live (including traditional rights such as access to common resources).
Utilization: Utilization of food through adequate diet, clean water, sanitation and health care to reach a state of nutritional well-being where all physiological needs are met. This brings out the importance of non-food inputs in food security.
Stability: To be food secure, a population, household or individual must have access to adequate food at all times. They should not risk losing access to food as a consequence of sudden shocks (e.g. an economic or climatic crisis) or cyclical events (e.g. seasonal food insecurity). The concept of stability can therefore refer to both the availability and access dimensions of food security” (FAO 2006, p. 1).
The inclusion of ‘utilization’ as one of the three pillars in the above definition, as pointed out by Gross et al. (2000), signals that food security is more than having food available or securing access to it: “[food] utilization refers to the ability of the human body to ingest and metabolize food” (p. 5). The increasing awareness of public health has allowed for the inclusion of bodily needs and wants. Gross et al. (2000) emphasize that the body requires not only nutritious and safe diets, a proper health care system, and an adequate biological environment, but also an adequate and safe social environment. However, while definitions have evolved since the late 1970s, “[food] utilization is [still often] only discussed from a biological perspective” (Gross et al. 2000, p. 5). Consumption patterns and preferences (and their effect on nutrition) are implied and usually recognized as vaguely important but are rarely wholly integrated in projects and programs.
This argument is similarly captured in the Life Sciences approach, a paradigm presented in the book Food Wars by Lang and Heasman (2004). The book frames the current food and nutrition security debate within three dominant paradigms. The post-Second World War Productionist paradigm emphasizes food security as the (macro) sufficiency of supply. Immediate gains can be derived from mass (industrial) production through intensification, whilst overriding food quality, human health, and environmental concerns (Lang and Heasman 2004). With the emergent predominance of biological sciences in the mid-1990s, the Life Sciences Integrated paradigm overtook the Productionist paradigm. New biotechnologies, including genetically modified foods and nutrigenomics, are applied to also achieve nutrition security at the individual level. However, the human and environment health effects of these technical fixes are highly contested (Lang and Heasman 2004).
Lang and Heasman (2004) distinguish a third paradigm, the Ecologically Integrated paradigm, which has gained ground in recent years, but has a longer history dating back to the organic food movements in the 1970s. The paradigm presents itself as a healthy and environmentally friendly alternative, moving away from monocropping to whole-farm systems approaches, biodiversity, and long-term sustainability. It proclaims a multidisciplinary and integrated approach to environmental and social policies and (citizens’) knowledge as empowerment. Such an approach would probably favor the attention given by us to the social side of food, although in-depth case studies from developing countries have not yet informed this paradigm and it is important to refrain from idealizing the ‘family farmer’ who is self-sufficient. We recognize farmers as active agents connected to markets and embedded within a wider institutional framework. Issues within this context cannot be tackled from a single-sector approach.
In this paper, we argue that food and nutrition security can only be achieved when ‘sufficient culturally adapted food’ is available and accessible to a household or community to meet physiological and social needs. While this is not a novel approach, the empirical findings suggest that ignoring socio-relational dimensions in programs and policies (even if definitions include them) has consequences and conversely, that the potential of integrating such dimensions is enormous for ensuring food and nutrition security. This requires not only knowledge of what is ‘culturally adapted food’, but also of the social environment in which it is utilized—the kind of knowledge that cannot be distilled easily from an outsider’s perspective. We need to think, therefore, how to draw in ‘poor’ people’s own evaluations of food utilization—including food production and processing, storing, and creating an adequate (physiologically satisfactory and social-relational) environment for its consumption. This idea, when applied to food and nutrition security, creates room for bringing in a socio-relational and subjective dimension, in addition to the material (physical and biological) dimensions in line with McGregor et al. (2009)approach to human well-being. As such, we promote a step away from a crisis-focused welfarist approach to a more comprehensive approach in which human well-being is centrally featured.5
As the human well-being approach considers agency, social embeddedness, and context-specific subjective aspirations, it offers a comprehensive approach to study the complexity and social dynamics of food and nutrition security rather than relying on the assessment of technical “needs.” Food is often normalized as a “basic need”; “needs” are often prioritized over “wants” where basic needs are referred to as a descriptive target, a “requisite for achieving an objective,” or a “normative priority” (Gasper 2007, pp. 54–55). In this case, “needs refers (implicitly if not explicitly) to a particular category of goals that are believed to be universalizable, whereas wants are goals that derive from an individual’s particular preferences and cultural environment” (Gough 2004, p. 292). However, needs and wants are integrated, multi-dimensional, and heterogeneous; they differ significantly between countries, cultures, communities, and even within households. As will be explored in this paper, food wants often determine how people strive to ensure their food needs. Drawing on the well-being approach, it is possible to capture subjective food needs and wants while also relating these to larger conceptual definitions of food and nutrition security. Rather than adopting a rigid theoretical framework or methodology, the well-being approach lends itself as an overall guiding lens to conduct inductive and grounded research.
The design for this study was motivated by the understanding that past food security research and interventions have been guided widely by technical agricultural, economic growth, and medical approaches. In this light, a mixed-methods approach was adopted with emphasis placed on participatory methods to highlight perceptions, aspirations, and preferences. Instead of conducting research on people, their nutritional intake, and the factors that may compromise or enhance consumption, this study was conducted to capture the voices of those who are most affected by food and nutrition insecurity. Research was conducted in Luchululo sub-location in rural southwest Kenya over the course of a 5-month period from August to December 2012.Research methods included group discussions, focus groups, semi-structured interviews with smallholder farmers, key informant interviews, and a household survey. Based on the survey sample (n = 96), 80 % of the population faces food insecurity annually and 37 % twice a year. In an area with two growing seasons increasingly challenged by erratic weather and population growth, food and nutrition security are pressing and multifaceted concerns.
Participatory research methods
Participatory research methods were used at both the beginning and end of the fieldwork to tease out and cross-check information regarding local dynamics of food and nutrition security and the social dimensions in which they are embedded. Participatory methods included the following:
Ten (10) group discussions with 71 people were facilitated to understand overall and prioritized issues in the community and then to discuss food-related themes including agriculture, markets, weather patterns, changing diets, diseases, irrigation, and information flow. The first four discussion groups were relatively open and unstructured as questions were posed to discern similar, complementary, and contradictory dimensions of food security to orthodox definitions as well as to identify key challenges, actors, and basic social structures. This inductive method allowed for the emergence of social dimensions in food and agriculture discussions at the very beginning. Later groups were conducted intermittently to cross-check information pertaining particularly to local understandings, gender roles, and preparation and conservation practices.
Five (5) focus groups with 44 people were organized. These had two main purposes: (1) to specifically explore perceptions of food security and (2) to tease out local processes and dynamics. Themes included: gender and food from an intergenerational perspective; challenges of youth in agriculture; opportunities and obstacles in agriculture with regards to biodiversity and crop specialization; different opportunities between genders with regards to food and agriculture; and conservation and preparation methods.
A community timeline was prepared together with four elderly men and women to capture the community’s 50–100 year history. Findings were triangulated with government officials, extension officers, and a nutritionist at the local hospital. Topics discussed included agricultural interventions, climate disasters, health and medical services, diseases, education, changes in the gendered division of labor, colonization, and present government institutions. The community timeline was important to facilitate an understanding of recognized community-level changes.
Seasonal diagrams were drawn in order to visualize the overlap and seasonality of agricultural surpluses and shortages, crop diversity, illnesses, and weather patterns. These were administered by research assistants with three smallholder farmers and triangulated with questions posed to extension officers.
Attending community meetings was a central part of the research to gain a general understanding of gender and youth representation in community affairs and to meet with people outside of Luchululo engaged in topics related to this study, especially information flow, agricultural information dissemination, and local program challenges and opportunities.
During our stay in Luchululo, we had the opportunity to shadow three individuals to participate in their everyday activities in order to fully appreciate cooking methods, routines, and the division of labor.
Semi-structured interviews and household survey
Interviews with smallholder farmers and key informants focused on exploring processes and the perceived reasons for local food security dynamics. Extensive overlap between focus groups and interviews facilitated cross-checking but interviews served the purpose of extracting more specific examples and details.
Eighteen (18) interviews with smallholder farmers were conducted to discuss beneficial or mediating factors for food and nutrition in Luchululo and to unpack local processes of decision-making. Scenarios were used (e.g., lack of staple foods) to elicit information regarding the importance of ‘traditional’ foods and meals for the local diet and for social gatherings. Interviews focused firstly on the types of foods cultivated, preferred, prepared, valued, consumed, and changed over time. Reasons for seasonal shortages and what actions (short and long-term) are taken in these situations and to avoid such circumstances were unpacked in these 1–2-h sessions.
Twelve (12) key informant interviews were conducted with government officials (an irrigation officer, crop officer, livestock officer, two agricultural extension officers from the Ministry of Agriculture, KAPAP service provider, Busia County Director of the Environment), a nutritionist from Sioport Hospital, a female elder from Luchululo, and three private agricultural service providers. The key informant interviews were conducted to capture matches and mismatches in the timeline of changes, the perceived state of food and nutrition (in)security in the area, the determinants and outcomes of changes with regards to food in the area, and the strategies advocated. This type of comparison and triangulation was imperative because some agricultural methods for example may be subjectively perceived as crucial to ensuring food security or may be identified by external actors as important but may be depleting the area’s groundwater reserves.
Ninety-six (96) surveys were administered to elicit basic descriptive information about the sample population pertaining specifically to agriculture, food, information access, and value positions regarding change and social dynamics in the area. A team of nine trained research assistants helped to cover all seven villages in Luchululo, to pilot ten, and to gather a total of 114 surveys, 18 of which had to be discarded because they were found to be invalid.
For purposes of inter-household triangulation, the household was used as the unit of analysis and subsequently the community in order to gain an impression of the area’s history and agricultural, socio-economic, and cultural diversity. Random quota sampling was used to target certain individuals to join focus and group discussions, complete the survey, and participate in interviews. This was facilitated by gathering a statistically representative sample based on the weighted division of the overall population by wealth categories based on a previous baseline survey covering 312 households in 11 villages conducted in Samia (Odame and Pouw 2011). This survey captured subjective wealth measurements of all the households residing in the villages, leading to a distribution in five wealth categories reflecting national estimates. Snowball sampling was used for key informant interviews.
The range of mixed-method research techniques was used in order to comprehensively capture the dynamics of food security among different population groups and through time. After conducting four inductive discussion groups, the other methods were deployed simultaneously in order to discern causes, manifestations, and perceived impacts of food and nutrition insecurity in Luchululo and beyond. See Noack (2013) for further details regarding our methodology.
Situating the case study
Samia District, located in Western Province, is one of the poorest constituencies in Kenya despite being situated on the border to Uganda, having access to Lake Victoria, and home to lush agricultural land. The District hosts a predominantly patrilineal agrarian society where 95 % of Samia farmers cultivate corn closely followed by beans and sorghum on family plots of land (Pouw et al. 2012a). Agriculture not only serves the purpose of subsistence in Samia, but also has multiple functions that range from income, food and fiber cultivation, and livelihood occupation. Cash in East Africa is often derived from surplus agricultural production of both commercial and traditional food crops (Fleuret and Fleuret 1980) to meet the increasing need for money to pay taxes and school fees and purchase monetized goods such as paraffin (Von Braun and Kennedy 1994). According to all respondents, and supported by extensive research, crop choices continue to be shaped by the perceived marketability of foods to serve the dual purpose of income generation and food for home consumption as well as fodder for livestock (Berti and Jones 2013).
Anything associated with cooking—cultivating crops, and preparing and serving food—is the responsibility of women in Samia; “Africa is the region of female farming par excellence” (Boserup 1989, pp. 4–5). In Kenya, 70 % of rural women are smallholder farmers placing them in charge of providing their families with food and nutrition (IFAD 2012). As women often enter the community through marriage, they conform to the traditional lifestyle of people in Luchululo and adhere to men’s instructions. “It is the husband who decides the loose menu. The woman cooks freely within this menu” concluded one group. Gender-sensitivity in research and interventions is paramount. While many studies have revealed that child nutrition is positively affected when women are in control of household income (Hoddinott and Haddad 1994), spending represents only one facet of nutritional access.
While most people still reside on family compounds, the Samia do not live an isolated life. With the advent of colonialism, widespread labor migration, and urbanization, many people (especially men) moved away from home to make money, leaving room for the “delocalization” of markets and the weaning of family cohesiveness (Cattell 1992). In the early 1900s cotton was introduced by the colonial government promising a source of income, an increasing necessity with the influx of formalized schools and tax systems. Cotton and the increased mobility of people brought with it changes including “medical facilities, new languages (Kiswahili and English), mission stations and schools” (Cattell 1989, p. 233). Traditional cereal crops were largely left in its wake (Olenja 1991). When the cotton industry collapsed in 1975, maize was quickly adopted as a replacement and became a major source of income and food for home consumption.
The contemporary food plate
Meals in Luchululo and Samia at large are based mainly on carbohydrates and do not usually change on a quotidian basis. Uji, thin porridge, is generally prepared for breakfast accompanied by black tea sweetened with several spoons of sugar; lunch and dinner are preferably based on cassava or maize or if stocks are low, on potatoes. The main meal is served in the evening usually shortly after dusk and is based on ugali, a polenta-like thick porridge used as a utensil and base for the meal. At the present time, this dish is made of maize whereas it was formerly comprised of sorghum and millet giving it a dark red or even black tint. The food plate today does not usually contain a large variation in color. Staple carbohydrates are preferably complemented by proteins (either beans or some small amounts of meat or fish) with a side of vegetables (almost always sukumawiki, collard greens, or imported cabbage). As Lake Victoria is only a few kilometers away, small dried fish called omena are often most accessible and affordable. Meals can also include a mixture of maize kernels and beans boiled for 5–6 h, pilau (rice with spices and small vegetables), kachumbari (fresh thinly sliced tomatoes with onions and chili), chapatti fried in palm or vegetable oil, sweet potatoes with groundnut stew, and sometimes beef, goat, chicken, or pork always accompanied by ugali.
From the survey it may be deduced that meals do not differ greatly between households of different socio-economic status, though they do seem to vary in terms of quantity and frequency. Despite intermittent meal diversification, a group of key informants explained that on average, most of the food wheel or food pyramid is composed of staple starches. The survey shows that people eat a small amount of fresh fish or meat once a week on average. As there are two harvests and two lean seasons, access to and availability of vegetables, tubers, and grains is concentrated in a few months each year. This can result in a shortage of vitamins and minerals as cereals and starchy roots and fruits contribute only minimally to daily micronutrient requirements. In other words, the current meal may be partially contributing to ‘hidden hunger’. This was confirmed by the lead nutritionist at Sioport Hospital.
Food and nutrition security in Luchululo
The typical food plate in Luchululo and Samia District is largely a reflection of what is cultivated on the shamba (farm or garden in Kiswahili). Access to food is facilitated either by home production or by purchasing power. However, with less than 30 % of farmers selling their produce on the market in Samia, many rely on their own production for food and nutrition security (Pouw et al. 2012b). Based on the survey (n = 96), 98 % of farmers cultivate maize closely followed by beans (90 %), potatoes (78 %), and cassava (72 %). Staple foods in Luchululo are comprised largely of these foods.
Availability of food in Samia is determined largely by agricultural yields. As Samia is situated in an equatorial zone, it receives plenty of sunshine and rain. Rainfall is concentrated in two periods; the long rains can start as early as February and peak in April and May and the short rains usually fall in November and/or December. This climate coupled with its topographical diversity allows for various high-potential growing zones (K’Okul 1991) but is also challenged by the lack of irrigation to tide over droughts between rain seasons. This is only exacerbated by the increasing unpredictability of rains in recent years, which makes for difficult planting and harvest planning. As a result, Samia usually faces seasonal and even biannual food shortages. These often take place from March to April and from July to August due to the off-harvest season and consequently also high prices (Pouw et al. 2012b).
According to the Samia Development Plan 2008–2012, the incidence of poverty in the location is estimated at 51 % and the prevalence of food poverty at 61 % (Kenya Ministry of State for Planning, National Development 2009). While current statistics are difficult to find, it was concluded that cases of marasmus6 or kwashiorkor7 are rare though maternal anemia was quite common (K’Okul 1991). With minimal improvement, this incidence is considered to have remained unchanged according to the hospital staff at Sioport. Most concerning, however, is that according to the vast majority of interview respondents, the incidence of food insecurity and the changing food plate can be expected to increase due to erratic rainfall, poor agricultural practices, infertile soil, overdependence on older women for home production (Kenya Ministry of State for Planning, National Development 2009), lack of financial capital, small land sizes, population growth, crop diseases and pests, new technologies and crops, infrastructure, and macroeconomic trade policies among other factors (Von Braun and Kennedy 1994). However, as will be argued in the following sections, these exogenous factors are only part of the local nutrition transition, which seems to be compromising food and nutrition security by way of micronutrient deficiencies and seasonal shortages.
Despite widespread recognition that scant diversity on the food plate has significant health consequences, there seem to be many factors accelerating the pace of dietary changes including changing tastes, customary practices, and preferences. The consequence of the narrowing and changing food plate include NCDs (such as hypertension, diabetes, ulcers, cancers, and high blood pressure), which some authors have called the latest threat to the very existence of the indigenous African population (Raschke and Cheema 2008; see also McCann 2005). To understand the local conditions, processes, and outcomes of food and nutrition (in)security in the sub-location of Luchululo, it is important to consider the local recognition of these consequences in line with shifting preferences and practices and how these inter-relate. As will be elucidated, the historical and social context has and continues to work in conjunction with the physical environment and cannot be understood in isolation. The following three sections will elucidate the imperative inclusion of social dimensions by providing examples regarding preferences for taste, color, and conservation practices.
No ugali, no food
Ugali is the traditional staple food sometimes referred to as the “meat of Africa” where its absence is often considered more severe than a shortage of calories and other food stuffs. Regardless of the quantity of other foods or even carbohydrates, people seem to forego the cultivation of or access to more diverse crops to obtain maize or cassava in order to make “real food” or ugali. The value and importance of ugali was stressed in nearly every interview and group discussion and indicates the importance of preferences and tastes for what people cultivate, how they prepare food, and when and how frequently they consume it. “It doesn’t matter how much we have eaten until we have had ugali” concluded one focus group. Nearly 60 % of respondents believe that without ugali, they do not have food at all. Remarkably, the unequivocally central position of ugali in local diets has received little recognition in the literature (Ohna et al. 2012), but was mentioned by all respondents. “If you eat rice and beans, we still feel that we haven’t eaten well.” “This is cultural. We believe that we need ugali. Even if we take five chapattis, we will wait for the ugali to come.” The absence of ugali in much of East Africa is even regarded as a colloquial indicator of poverty (Ohna et al. 2012).
Food “wants” in Luchululo largely take precedence over food “needs”; while women for example often come from other areas where cuisines differ, there is very little inter-marital exchange of food cultures and therefore minimal mixing of rural culinary traditions. This seems to contribute to the homogenization of the local diet despite widespread awareness of its consequences. Drawing on previous research, it appears that young people, and especially those returning from urban areas, have a greater impact on the household food plate (exerting their preferences on older generations) than inter-marital sharing where choices are rather preset (Fischer and Qaim 2012). The pursuit of perceived “modern” foods has seemingly permeated most strata of society where traditional foods are adapted to “western” ways as will be explored in the following section. In Luchululo, traditional foods and cooking methods have largely been abandoned to satisfy growing preferences for white ugali.
Not only is ugali necessary as a staple food, but its particular composition is also of utmost importance. This was exemplified by a young boy who, at the suggestion of his mother to mix sweet potatoes into the maize ugali in order to stretch their rations, declared, “I prefer no food over sweet ugali.” To some surprise, the young boy made this remark despite only having eaten porridge for 2 weeks as the lean season had just begun. Although not historically an ingredient in ugali, maize has gained an invaluable position on the local food plate especially among younger people who place great social value on “western” white foods. In Luchululo, some foods can connote higher social status (maize ugali and proteins for example), whereas others can suggest the opposite. In sum, food is not “just food” in Samia District. Food is considered to be ugali typically made of maize today; a supper without ugali is not a supper.
Parting from color
A traditional meal in Samia 50 years ago would have included a generous grapefruit-sized lump of red, brown, or black ugali, a color that is derived from millet or sorghum mixed with white cassava roots (Manihot esculenta crantz), and milk. This mixture of tubers, grains, and milk creates a nutritious accompaniment for the previous diversity of indigenous vegetables and conserved meats. Originally from South America, cassava is consumed in over 100 countries worldwide and is widely valued for its potency to thrive in poor soils and its conservation qualities as it can be left in the ground until needed or dried in the sun for later use (Taylor et al. 2012). While plain cassava is rather tasteless, it is favored in much of East Africa for its texture and volume to be mixed with nutritious, colorful, and flavorful grains. However, despite widespread recognition that it is a food security crop par excellence, it appears to be losing its place on food plates (Taylor et al. 2012).8 Today, ugali is widely composed of maize flour (Zea mays) simply boiled in water replacing its traditional darker hues and cassava constituent.
While this transition in staple composition may seem rather trivial, it is important to take note of the importance placed not on any type of maize, but on white maize. Over 90 % of maize consumed in sub-Saharan Africa is white as its yellow counterpart is often deemed only fit for animal fodder (McCann 2005) or as relief food (De Groote and Kimenju 2008). In a study on the value and growth of maize consumption among the neighboring Luo tribe in Siaya District, Mango and Hebinck (2004) describe that white maize varieties were first introduced by colonizers and henceforth associated with the elite white man. As white maize increasingly became an ingredient consumed by those more educated and in power, it gained in social value and “seeped into the diet and the production of the people” (Mango and Hebinck 2004, p. 294). Despite a general lack of research on consumer preferences for white maize, unequivocal partiality for its color due to its embodiment of “modernity” appears to still shape diets in Luchululo and beyond today (De Groote and Kimenju 2008; Mango and Hebinck 2004).
Another respondent echoed this statement and added, “my generation and above will prefer brown ugali but the younger generation has just gotten used to white.” However, a man from a neighboring sub-location elaborated:
It [sorghum] has more energy so you feel stronger. But it is tasteless. Your taste for it depends on the generation. The color especially drives people away. Sorghum used to be mixed with cassava. It tastes funny with maize. If you go to the toilet, it is hard to help yourself to such a lump. It is the older generation that uses it… Many relate sorghum to feces.
You cannot live from maize alone. If you have four bags of maize and another has one bag of sorghum, the man with the sorghum will survive the whole year whereas the man with the maize will only live from his sacks for three months. From sorghum you can make ugali with milk and cassava, you can make porridge, flour… If you eat this type of ugali, you can walk for three days without food.
The health benefits of former crops are widely recognized among local inhabitants as well as the consequences of their loss for physical well-being especially with regards to eyesight, immunity, and strength. Studies have found that the increased cultivation of cereals and especially maize has negatively impacted nutrition, whereas crop diversity can actually increase functional nutritional levels of the farm and aggregate farm production (Graham et al. 2007; Remans et al. 2011). However, the overall reluctance and even resistance to the reversal of the narrowing food plate is anchored in social processes, which at times contend ‘objective’ measures for physical well-being.
This has severe implications for widely commended and funded nutrition interventions promoting bio-fortified foods, especially vitamin A fortified crops. These crops contain carotenoids, which are always yellow or orange in coloration. Unfortunately, yellow maize as well as orange-fleshed sweet potatoes are largely disliked and rejected in Samia. As a result, they are not cultivated as most smallholder farmers also wish to sell any surplus production to meet local demand. The multi-functionality of local crops as explained in the context description is important to consider in this case. When the social side of food security is considered, it becomes clear that people’s underlying preferences and accustomed diets widely shape the foods that are cultivated, processed, exchanged, and consumed. This challenges common approaches aimed at eradicating immune-system weaknesses and eyesight problems in East Africa with technical fixes. Color partialities illustrate the importance of anchoring interventions in local social systems where taboos, preferences, traditions, and aspirations often mediate decision-making processes that can determine caloric and nutritional intake. These processes of decision-making enhanced by awareness-raising, trust, and familiarization can determine whether vitamin supplementation programs or bio-fortification interventions will take root or dissolve. While these empirics are based on a small case study, there is reason to believe based on previously cited research and observation that Luchululo is not an isolated example in East Africa. The following example of food conservation will further elucidate the importance of considering social context, culture, and history.
Food conservation as ‘backward’
The conservation of food, by drying, refrigerating or cooling, jarring, or pickling would appear to be an effective practice to tide over seasonal food shortages and surpluses that are experienced by the vast majority, if not all respondents. For example, twice each year in Luchululo the trees are heavy with ripe mangoes (incidentally high in vitamin A) that are consumed en masse for approximately 2 weeks and subsequently left to rot. While grains,9 legumes, and tubers (only cassava, not potatoes10) are dried in the sun, meats, fish,11 vegetables, and fruits (which are highest in micronutrients) are only accessible intermittently throughout the year. Despite the lack of electricity, canning jars, and vacuum pumps to conserve goods, the drying of these specific foods (e.g., the cooling of potatoes in an underground cellar) is not practiced notwithstanding the fact that these were formerly common measures familiar among the eldest in the community. Food conservation, except for the drying of cereals and cassava (with modern techniques), is increasingly ignored and even labeled as “primitive.”
In the old times, we never ate fresh meat. We roasted it and preserved it in ash. When it was ready to use, we would cut a small piece and pound it with a stone. It was then cooked in a pot with liquid ash [sodium bicarbonate] … Anytime you wanted some [beef], you washed, boiled, and enjoyed … Every homestead had a meal with preserved foods in case a visitor came by.
Indigenous vegetables were also preserved in a similar fashion by cooking, then drying, and then hanging the vegetables wrapped in banana leaf packages. But today this is considered ludicrous by the young generation according to all elderly respondents.
When we had ghee, we had no dairies. People didn’t sell their milk. There was lots of milk. But these days, people bring their milk to dairies. There is no milk today because people just immediately sell it for cash. It’s like meat and vegetables too.
While market prices may not be high during the harvest season, smallholders prefer to sell their produce immediately in order to generate some money. One respondent said: “At harvest time, people are out of money for cooking oil, paraffin, soap, etc. They want to buy these and fish. So they sell their foods immediately.” Some attribute the lack of conservation to the proximity of Luchululo and Samia at large to Uganda where goods and especially grains can be purchased at a very low price in times of need. Others attribute it to a lack of awareness and skills. Ultimately, however, these losses diminish stocks and the lack of conservation measures compromise the availability of these foods throughout the year. This occurrence is captured in the latter part of the term, food and nutrition security. Unfortunately, insecurity only further perpetuates and shapes the ‘normalized’ narrowing and intermittently diversified food plate and provides a frame for other practices to develop or to disappear.
By recognizing the importance of social dimensions and including them in food and nutrition security, it becomes possible to make sense of the rejection and laughter often uttered in response to questions posed about food conservation. In sum, by considering people’s understandings and preferences that are socially and historically embedded, it becomes possible to discuss decision-making processes and practices such as conservation measures that have unquestionable consequences. While exposure, awareness-raising, and providing access to conservation materials, for example, may seem simple responses to tackle seasonal shortages and crop diversity losses, these interventions are less likely to take root and truly tackle food and nutrition insecurity if they are not embedded in a grounded understanding of the local context.
Discussion: implications for definitions, research, programs and projects, and policy
Adding a cross-cutting social and nutrition pillar
Already in UNICEF’s first flagship report, State of the World’s Children published in 1980, it was recognized that “the major lesson of the last 20 years is that reductions in malnutrition cannot be achieved only by increases in food production” (p. 10). As discussed earlier, definitions and approaches to food security have come a long way. However, in practice, nutrition and social issues are usually packed into the third pillar of food security labeled “utilization.” In this paper we argue that food systems are complex, partly determined by production but also by a host of other processes. For example, immediate determinants such as conservation measures may be just as determining for food and nutrition security as on-farm production or purchasing power. However, the intermediate causes including values, norms, and preferences shape how and what is produced, prepared, and consumed, thereby ultimately determining food and nutrition security. We argue that each pillar should be underlined by nutrition and social dimensions so that practitioners and researchers can focus on the availability of nutritious food, secure access to culturally appropriate and nutritious foods, and effectively address food utilization or preparation. In sum, agricultural production and market access have enormous potential to tackle food security but only when anchored in the social context with the ultimate aim of improving nutrition. Food security in our view should fully integrate nutrition and social dimensions in every pillar (complementing “stability”), allowing for the engagement of multiple sectors (private and public) and stakeholders, to meet the “needs” and “wants” of people.
Culturally appropriate food basket
The cultural lens has helped us to understand the dominance of specific food crops, preferred colors and food types, historical changes therein, and the role of youth and urban influences in determining the local food plate. By accounting for culturally appropriate foods and fostering discussions and knowledge exchange on the exact nutritional impacts of food production and conservation choices, food interventions are likely to be more effective than crop intensification strategies of the Productionist paradigm or the technical fixes propagated by the Life Sciences Integrated paradigm (Lang and Heasman 2004). One way to incorporate social dimensions into food and nutrition indicators and underlying survey instruments, could be to develop a number of different food baskets that are considered culturally appropriate in order to measure the nutritional values of preferred and consumed foods. In this way, people can grasp the nutritional impact of their different choices. This would be based on in-depth mixed-method research of the kind underlying the present paper, but enhanced by data on the frequency of meals consumed and the nutritional value of certain foods.
Participatory programs and projects
From a very young age, our exposure to foods shapes what we seek in our diet. As argued above, food is not just a basic need but its consumption is also shaped by preferences. The “western diet” is easy to grow accustomed to especially when it is associated with status. By engaging in participatory discussions about food choices and their perceived consequences and implications, it becomes possible to identify room for action and hamper trends that are compromising people’s nutrition without ignoring their cultural integrity. For example, by introducing a culturally appropriate and environmentally viable varied diet from a young age (for example though school feeding programs) coupled with participatory discussions and awareness-raising rather than just suggestions about high-nutrient and economically lucrative food crops, a range of practices can emerge. These could consist of more sustainable agricultural practices, nutritious cooking methods, and conservation measures. While some traditional practices may be riddled with cultural taboos, others may have been forgotten with the rapidity of the changing food plate. By openly discussing these changes, preferences, and values, it becomes possible to guide people to help themselves in order to generate greater food and nutrition security. As social priorities and preferences often override ‘objective’ benchmarks of nutritional and caloric intake, by including social dimensions, the potential for alleviating malnutrition becomes wide-ranging. Knowledge building on nutritious food and sustainable production methods, as in the Ecologically Integrated paradigm (Lang and Heasman 2004) can empower small-scale farmers, both men and women of different ages, to consider production and consumption choices.
Gender mainstreaming has increasingly become a buzzword in development; however, it is intrinsically related to nutrition. Not only are women usually in charge of growing and preparing food for the entire family, but they are also required to follow a ‘menu’ as set by men. This menu dictates the composition of the food plate and thereby family nutrition security. Adopting a gender-sensitive approach in projects and programs does not infer that women should be the primary targets; instead, men and women must be engaged equally in discussions (though perhaps differing in content and structure) about the multiple dimensions of food and nutrition security. Grounding programs in an understanding of why and how people choose to access what types of foods can further serve as a platform for policy development at the District level. Political support to stimulate such debate is imperative in enhancing and distributing knowledge on diet diversity and the human and environmental health risks of a narrowing food plate.
In line with Ericksen’s (2008) work, a further step to integrating nutrition and social dimensions into policy could be to adopt a food systems approach. While heavily dependent on the understanding of power relations, which can be politically contested (McMichael, 2007), such an approach would allow stakeholders to adopt a comprehensive view of production through processing to retailing and finally consumption. By building on ethnographic studies such as this one, a process can be instigated to engage multiple stakeholders in an intersectoral exchange of information and knowledge as well as designing and implementing policies, programs, and investments.
Instead of involving specialists from every field, including nutrition and social dimensions as cross-cutting themes demands sensitivity of all stakeholders involved. This may require extensive training and sensitization programs. Platforms for bringing multiple stakeholders together already exist such as the Scaling Up Nutrition Movement, which has been at the forefront of aligning stakeholders and governments to collectively and coherently tackle malnutrition. While this has been challenging at times as agriculturalists and health experts frequently speak different ‘languages’, 47 countries are participating currently in the effort to scale up nutrition (SUN 2014). Focusing on mainstreaming these concepts and capacity building is key to ensuring that decision-makers directly approach and tackle the issues at stake in a comprehensive and effective manner.
We argue that agricultural and rural development interventions should be nutrition-sensitive to the furthest possible extent. As nutrition is inherently linked with other sectors, it has the potential to simultaneously positively impact investment objectives aimed at stimulating economic growth, improving human well-being, equity, or health, supporting environmental sustainability and enhancing resilience. For example, studies have found a positive association between on-farm crop diversity and dietary variety and thereby nutrition in Kenya and Tanzania (Herforth 2010). In sum, by taking nutrition and social dynamics into consideration, rural development objectives and food security targets can be met effectively and sustainably.
In this paper, we have made the case that the contemporary diet in Samia is rapidly changing, favoring a simplified food plate, and that this lack of diversity is a root cause of food and nutrition insecurity. We have illustrated that (1) people’s preferences shape the food plate, (2) the substitution of traditional foods (such as black or red ugali) with white maize ugali (which is laden with greater social status) seems to have aggravated food insecurity, and (3) the stigmatization of conservation methods as “backward” has hindered possibilities for curbing seasonal surpluses and shortages. It could be argued that sufficient nutritious food could be produced in Samia if the nutrition transition were to be addressed and conservation methods properly (re)introduced. Given this context, technical short-term approaches will most likely not tackle regional food and nutrition insecurity; instead, awareness-raising along the food chain, sound research and policies, knowledge sharing, and education are imperative. By integrating nutrition and social dimensions as cross-cutting themes in our understanding of caloric deficiencies in regional research, projects, and policies, the potential to boost food and nutrition insecurity, and thereby human well-being, becomes promising.
The most critical deficiencies include vitamin A, iron, zinc, iodine, and folic acid (Micronutrient Initiative 2009). Vitamin A deficiency can cause mortality and blindness; lack of iron can result in anemia and builds resistance to infection; zinc shortage can lead to diarrhea and stunting; salt iodization promotes cognitive development; and a lack of folic acid can lead to disability (Micronutrient Initiative 2009).
Food and nutrition indicators extensively inform the measurement and monitoring process and policy interventions. These indicators typically include calories per capita measures based on Food Balance Sheets, household consumption data using Household Surveys, and dietary intake measures using Food and Nutrition surveys.
According to the World Cancer Research Fund: “‘Western’ dietary patterns are energy dense, and increasingly made up from processed foods. They are high in meat, milk and other dairy products, fatty or sugary foods such as processed meats, pastries, baked goods, confectionery, sugared and often also alcoholic drinks, with variable amounts of vegetables and fruits. The starchy staple foods are usually breads, cereal products, or potatoes. A feature of the global ‘nutrition transition’ is that ‘western’ dietary patterns are becoming ‘exported’ globally with accelerating speed. ‘Western’ diets defined in this way are associated with overweight and obesity, type 2 diabetes, cardiovascular disease, stroke, some cancers, and other chronic diseases. However, the term ‘western diet’ is potentially confusing: variations of such diets consumed within ‘western’ countries can and do have very different nutritional profiles” (2007, p. 192).
In 2008 ODI estimated that the vast majority of overweight and obese adults are found in developing countries (904 million compared with 557 million in the industrialized world) (ODI 2014).
The human well-being approach (hereafter referred to as the well-being approach), launched at the University of Bath, UK in 2002, suggests well-being as a way to understand the outcomes and processes of development. Rather than infer well-being or development with proxies such as income, the approach is multi-dimensional; it posits that well-being is based on three interconnected pillars of physical, social, and psychological/subjective well-being.
Starvation or acute disease exhibited by the shrinking of the stomach where the body lives off of the fat under the skin and then eats away the muscle.
A disease made visible when a second child is born and does not leave enough milk for the firstborn.
Due to the mosaic virus, which attacked the cassava root and increased value placed on maize over cassava, the cultivation of sorghum and millet has also declined (Mango and Hebinck 2004) as these grains are too bitter to eat alone or with maize according to local tastes (I29).
Sun drying cereals is practiced frequently. Once dehydrated, they are stored in sacks or granaries with chemicals to reduce insect infestation, formerly prevented by drying and burning manure into ash to mix with the grain. However, due to fear of theft, they are increasingly kept in sacks within the home rather than outside in an unprotected granary constructed of twigs.
Potatoes and cassava are customarily left in the soil until needed, a long-practiced method of conservation.
Except for little fish or omena, fish is purchased fresh.
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