Abstract
Peru is undergoing a nutrition transition and, at the country level, it faces a double burden of disease where several different conditions require dietary changes to maintain a healthy life and prevent complications. Through semistructured interviews in rural Peru with people affected by three infectious and noninfectious chronic conditions (type 2 diabetes, hypertension, and neurocysticercosis), their relatives, and focus group discussions with community members, we analyzed their perspectives on the value of food and the challenges of dietary changes due to medical diagnosis. The findings show the various ways in which people from rural northern Peru conceptualize good (buena alimentación) and bad (mala alimentación) food, and that food choices are based on life-long learning, experience, exposure, and availability. In the context of poverty, required changes are not only related to what people recognize as healthy food, such as fruits and vegetables, but also of work, family, trust, taste, as well as affordability and accessibility of foods. In this paper we discuss the complexity of introducing dietary changes in poor rural communities whose perspectives on food are poorly understood and rarely taken into consideration by health professionals when promoting behavior change.
Highlights
Over the past several decades, low- and middle-income countries (LMICs) have experienced a nutrition transition
We examine the perspectives on the value of food and the challenges of dietary changes among people living with type 2 diabetes (T2D), HT, and/or NCC from four rural communities in Northern
Our study shows the various ways in which people from rural northern Peru value food and the multiplicity of factors that play a role in identifying food as good/healthy or not
Summary
Over the past several decades, low- and middle-income countries (LMICs) have experienced a nutrition transition. Countries that have faced hunger and malnutrition as their main concerns are confronting an additional problem of overweight and obesity and are experiencing increasing rates of noncommunicable diseases (NCD) such as diabetes and hypertension [1]. LMICs are still struggling to reduce the incidence of infectious diseases that are often caused by contaminated food or poor hygiene practices. One example is neurocysticercosis (NCC), a neglected tropical disease (NTD) characterized by parasitic infection of the brain that primarily affects the poor [2]. The Ministry of Health of Peru has estimated that 20%
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