Indigenous perspectives of a culturally tailored dietary intervention: Qualitative findings from the CHEERS study

Nutritional interventions have been included in government policy to improve the health of Aboriginal and Torres Strait Islander peoples, whose social and emotional wellbeing (SEWB) is closely linked to culture. Given the connection of traditional food and food practices to culture, Country and community, promoting traditional food and food practices through community-led interventions may be a solution to improving health and nutrition interventions. However, a greater understanding of traditional knowledge transmission and acquisition is required. Currently there is a limited body of research on transmission of traditional food knowledge regarding young adults. The aim of this study was to gather the perspectives, attitudes and concerns of young adults regarding traditional food and food knowledge. This was achieved through in-depth, semi-structured interviews with young adults aged 25 to 35 living on Yuin land. Results showed that traditional food knowledge was important for identity and SEWB by facilitating connection to family, community, culture and Country. Young adults had a strong desire to gain more traditional food knowledge and to transmit this knowledge to subsequent generations. However, this was limited by disconnection from knowledge-bearers and difficulties balancing knowledge acquisition with work and home responsibilities in their mainly Western cultural context. Hence, interventions promoting traditional food knowledge amongst young adults have the potential to improve SEWB. However, as a pilot study, saturation was not reached, and larger-scale studies are required to support the results and conclusions.

PurposeThis manuscript focuses on theoretical past, present and future models for defining food culture and cuisine, comparing these principles with contemporary literature evidence of transformative global food practices during public health and environmental crisis. The purpose of this study, therefore, is to explain the point at which traditional practices are discernible from the effects of modern technology, globalization, marketing and the virtualization of consumption. The paper explains how current local and global ecologies contribute to the retainment or disassembly of established culinary borders.Design/methodology/approachThis is a theoretical paper that highlights seminal and present discourse on food cultural practices. Furthermore, it underlines the cultural changes during environmental crises and whether these cultural transformations in food practices will be lasting. The authors suggest a perspective model for the future.FindingsDeciphering whether traditional foodways are moderated by modernity and environmental changes is very complex and multifactorial. This is likely nuanced by the availability of commodities and the steadfastness of particular cultures. Whether or not consumers embrace a new food product is likely contingent on their fundamental familiarity with and availability of the product's traditional components. The integrity of traditional foodstuffs will continue to be valued and demanded by broad groups of consumers into the foreseeable future.Research limitations/implicationsAs a primary objective, food producers, manufacturers and governments should not seek to actively diminish cultural borders and markets. Industry and governmental strategists should embrace and promote cultural food messages in any interventional strategies on household food security or marketing strategies and campaigns. The gathering of information from grassroot cultural groups about traditional food practices should ground the development of new policies and products.Practical implicationsUnderstanding the complexities surrounding traditional cuisines and food ways gives insight into the future of traditional food cultures and how they change. The food industry is undergoing profound transformation due to climate change; the decrease of arable land; environmental crisis, such as floods and droughts; war; food insecurity; aging populations; and chronic food-related diseases and disorders. Therefore, new food products are essential to adjust to these issues. However, the use and effectiveness of these foods would likely be enhanced if they were tailored with ingredients and techniques that have meaning to particular cultural groups.Social implicationsSocial connectivity, the shared experiences of eating together (and the contingent health benefits) may have been subject to contemporaneous or permanent change due to transformation in local and global food ecologies. Whether or not consumers embrace new food products may be contingent on their fundamental familiarity with its traditional components. The integrity of traditional foodstuffs is likely to continue to be valued and demanded by broad groups of consumers into the foreseeable future.Originality/valueSeminal food culture theories are still being utilized in recent publications to explain contemporary practices, particularly in times of crisis such as the recent pandemic. Current scholarship has indicated, to degrees, that links to traditional food practices may be strong, evolving or are becoming more obscure as they are incorporated into a global fabric. There are gaps in the literature that necessitate more exportation of the impact of environmental changes and health crisis on cultural and traditional food practices. This further raises questions about how the formative theories on food culture apply to modern and future food practices.

BackgroundThe displacement of traditional dietary practices is associated with negative nutritional consequences for rural Indigenous people, who already face the brunt of both nutritional inadequacies and excesses. Traditional food (TF) consumption and production practices can improve nutritional security by mitigating disruptive dietary transitions, providing nutrients and improving agricultural resilience. Meanwhile, traditional agricultural practices regenerate biodiversity to support healthy ecosystems. In Ecuador, Indigenous people have inserted TF agricultural and dietary practices as central elements of the country’s agroecological farming movement. This study assesses factors that may promote TF practices in rural populations and explores the role of agroecology in strengthening such factors.MethodsMixed methods include a cross-sectional comparative survey of dietary, food acquisition, production and socioeconomic characteristics of agroecological farmers (n = 61) and neighboring reference farmers (n = 30) in Ecuador’s Imbabura province. Instruments include 24-h dietary recall and a food frequency questionnaire of indicator traditional foods. We triangulate results using eight focus group discussions with farmers’ associations.ResultsCompared to their neighbors, agroecological farmers produce and consume more TFs, and particularly underutilized TFs. Farm production diversity, reliance on non-market foods and agroecology participation act on a pathway in which TF production diversity predicts higher TF consumption diversity and ultimately TF consumption frequency. Age, income, market distance and education are not consistently associated with TF practices. Focus group discussions corroborate survey results and also identify affective (e.g. emotional) and commercial relationships in agroecological spaces as likely drivers of stronger TF practices.ConclusionsTraditional food practices in the Ecuadorian highlands are not relics of old, poor and isolated populations but rather an established part of life for diverse rural people. However, many TFs are underutilized. Sustainable agriculture initiatives may improve TF practices by integrating TFs into production diversity increases and into consumption of own production. Agroecology may be particularly effective because it is a self-expanding global movement that not only promotes the agricultural practices that are associated with TF production, but also appears to intensify affective sentiments toward TFs and inserts TFs in commercial spaces. Understanding how to promote TFs is necessary in order to scale up their potential to strengthen nutritional health.

Urban Indigenous populations encounter distinctive challenges in maintaining traditional dietary practices, compounded by the complexities of socio-economic and environmental factors and the modern urban lifestyle. This qualitative study explores the perceptions of healthy eating, along with the facilitators and barriers to such practices, among urban Indigenous peoples in Saskatoon, Regina, and Prince Albert. Through virtual interviews, we engage 14 participants from these cities. Utilizing NVivo for thematic coding, we apply inductive thematic analysis to reveal relevant themes. The study highlights a preference for nutrient-rich, natural, and minimally processed foods, with a significant emphasis on incorporating traditional Indigenous foods into diets. These preferences are deeply entwined with cultural identity and underscore the importance of traditional foods in maintaining cultural heritage and promoting well-being. Despite the intrinsic value of these traditional foods, participants face several barriers to healthy eating, including economic constraints, limited access to traditional foods, and the psychological impacts of historical trauma. Nevertheless, facilitators such as community and family support, engagement in traditional food practices, and a growing awareness of nutritional knowledge are identified as being crucial in supporting healthy dietary choices. This research underscores the complex interplay of cultural, economic, and environmental factors in shaping the dietary practices of urban Indigenous peoples.

Cultural beliefs and practices can markedly influence a woman’s pregnancy and childbirth experiences, and may shape her mothering behaviour. In addition, dietary intake before and during pregnancy and through lactation is often influenced by cultural beliefs and practices. As some traditional health care beliefs and food practices favoured in different cultures appear to result from efforts to address specific environmental challenges, it is important to recognize and respect these beliefs while guiding women towards optimum nutrition and away from harmful practices or prohibitions. This chapter discusses the implications of some common food practices, as well as cultural practices that are specific to pregnancy and lactation, on maternal and infant health.

The choice of food practices can be influenced by one's identity in many societies, but has mostly been evaluated in light of the maintenance of cultural identity in migrant populations. This study focused on understanding the influence of identity on food practices among individuals in multicultural societies. We conducted 18 focus group discussions (n = 130) among Indian, Chinese and Malay women in Singapore. Focus group transcripts were analysed using Thematic Analysis both inductively and deductively. Deductive analysis was framed within a Social Representations Approach, a social psychological theory that allows a deeper understanding of the contextual aspects of identity. Participants highlighted the central position of food in social events, cultural celebrations, and persistent traditional beliefs about health (such as ‘hot-cold balance’). These beliefs extended to the perception of certain traditional foods possessing medicinal properties. Importantly, the consumption of these traditional foods was accepted as necessary for the maintenance of health by the women. We propose that while cultural food practices are integral to identity preservation and identity continuity for Singaporean women from all three racial groups, this is different to other multicultural societies such as Canada where communities preserve their cultural food practices, in part, due to fear of cultural identity loss. In addition, cross-cultural food practices are readily adopted in participants' daily lives for a number of reasons such as the promotion of health, convenience, and variety. At times, this adoption blurred boundaries between different cultural cuisines. Food practices in multicultural societies like Singapore are thus a reflection of everyday multiculturalism, multicultural social policies, and attitudes towards traditional healthful food practices, and these aspects need to be considered in the development of public health policies and interventions.

This paper focuses on a series of cookbooks published by Indigenous Australian groups. These cookbooks are typically produced with government funding, and are developed by nutritionists, dieticians, and health workers in consultation with local communities. They are designed to teach Indigenous Australians to cook healthy, nutritious, low-cost meals. In this paper, Fredericks and Anderson identify the value of these cookbooks as low-cost, public health interventions. However, they note that their value as health interventions has not been tested. Fredericks and Anderson question the value of these cookbooks within the broader context of the health disadvantage faced by Indigenous Australians. They argue that the cookbooks are developed from a Western perspective of health and nutrition that fails to recognise the value of traditional Indigenous foodways. They suggest that incorporating more Indigenous food knowledge and food-related traditions into cookbooks may be one way of improving health among Indigenous peoples and revitalising Indigenous knowledge.

It is well established that the Dietary Approaches to Stop Hypertension (DASH) eating plan, which emphasizes increased consumption of fruits, vegetables, and reduced dietary saturated fat, cholesterol, and sodium, improves blood pressure.1 Intervention studies, for example the Exercise and Nutrition Interventions for Cardiovascular Health (ENCORE) studies, have demonstrated have demonstrated that DASH can be implemented with other lifestyle changes including weight loss and physical activity, which also addresses other ongoing epidemics in our society, including obesity and diabetes. DASH was formally adopted into the Dietary Guidelines for Americans, 2010.2 Despite recommendations, widespread adoption of and long-term adherence to DASH has been limited, particularly among low-income and racial/ethnic minority groups, who are also at greatest risk for hypertension and the resulting poor health consequences. In this issue, Monsivais and colleagues3 highlight the relationship of the DASH eating pattern to food costs using data from the 2001–2002 National Health and Nutrition Examination Survey (NHANES). The authors scored diets reported by 4744 adults based on accordance with DASH and determined estimated retail costs for reported foods per 2000 kilocalories. DASH accordance was positively related to diet cost; specifically, the foods reported by those in the top 20% of adherence to the DASH dietary pattern cost 19% more to obtain than foods reported by those in the lowest DASH adherence category. The mean diet cost for the healthiest quintile was 34% higher for white adults and 21% for black adults, both statistically significantly higher than the cost for the lowest quintile in either race/ethnic group. In marked contrast, Hispanic adults (predominantly Mexican American in this sample) in the top DASH accordance quintile were consuming foods costing only 6% more than the lowest quintile. The authors conclude that DASH-accordant diets need not necessarily cost more than less healthy diets, given the diets being reported by Hispanics. It is worth delving into the supplemental tables to better comprehend these surprising results. First, it should be noted that, on average, non-Hispanic white and Hispanic adults had similar DASH accordance scores, and both groups had significantly higher concordance scores than non-Hispanic black adults; however, accordance scores were generally low across all 3 groups. Second, the general trend of higher cost for healthier components of DASH (eg, fruits and vegetables, lower-fat dairy products) as well as higher costs for less unhealthy forms of foods avoided (eg, meats) was of a similar magnitude in non-Hispanic white and non-Hispanic black adults. The principal novel finding is that for Hispanic adults, the trend toward more expensive costs for the healthier components of DASH was of a similar magnitude as the other 2 race/ethnic groups (P = .09); however, there was no difference in cost for the components to avoid (−3%; P = .26). Some limitations apply to these data. The retail cost for foods may not represent the true costs because food may be purchased and/or consumed at restaurants. Details about which specific foods were reported by participants are not included in this analysis; however, other studies have reported that the traditional Mexican diet is richer in fruits, vegetables, and fiber (via corn and beans) and that among Mexican Americans, those with less acculturation to the United States are more likely to retain these patterns.4 It is also not clear whether Mexican Americans purchase the majority of their food through resources that would have been included in the retail cost database and/or whether food costs in stores that might be more likely to be frequented by Mexican Americans are equivalent to costs in chain stores. Also, these data might not apply to other Hispanics such as Puerto Ricans, Cubans, Dominicans, or Central and South Americans. The data presented in this report should encourage a lively debate about how best to improve the proportion of Americans consuming diets consistent with DASH. In addition to cost, barriers to adopting DASH include income, education, and cultural and family attitudes about DASH foods.5 The local food environment is also influential; living in areas with few or no supermarkets or less availability of foods in the DASH dietary pattern has been shown to be associated with worse dietary quality.6 The national food environment also plays an important role. The supply of refined grains and fats on a per capita basis exceeds the US Department of Agriculture’s per capita dietary recommendations, but there is insufficient availability of fruits and vegetables to supply the population with even 5 servings per day, much less the 7 to 9 servings recommended by DASH.7 Additional research is needed to elucidate the relative importance of food costs compared with other determinants of food choices, such as access or taste preferences, for DASH adherence. Policy makers should consider which changes at the macroeconomic level might be necessary to provide an enhanced food environment, facilitating healthier food choices by the population. For example, modeling studies have suggested that changing the price of healthier foods (eg, subsidies on fruits and vegetables) and taxes and/or reduced subsidies on unhealthy foods (eg, sugars and fats) might lead to beneficial dietary change.8 National levers that might influence the food supply include federal farm subsidies and the Supplemental Nutrition Assistance Program (food stamps); at more local levels, economic development programs, zoning, and/or tax incentives could be structured in ways that promote access to healthier foods. Municipalities have been pursuing measures such as moratoriums on fast food restaurant permits (Los Angeles)9 and requiring calorie labeling on menus (New York)10; thus far there is no consensus on whether such approaches have made substantial progress in altering food consumption patterns. One need only look at tobacco use, however, to realize that large-scale behavior change over a 20- to 40-year horizon.

This study explores the critical role of traditional foods in shaping the social and cultural identity of Indonesian society, with a focus on strategies for their preservation amidst modern challenges. The primary objective is to examine the interconnection between traditional foods and cultural practices, analysing their symbolic meanings and the threats posed by globalization and urbanization. Employing a document study approach, this research reviews relevant literature, journals, and historical records to understand definitions, concepts, and case studies related to traditional foods and their role in cultural identity. The analysis highlights the multifaceted roles of traditional foods in Indonesian society. Beyond serving as sustenance, these foods hold symbolic significance in rituals, ceremonies, and daily life, representing values such as unity, respect, and heritage. Specific examples include the use of tumpeng in celebrations and lemang during cultural ceremonies, which embody shared traditions and reinforce social bonds. However, modernization and shifting lifestyles have led to a decline in traditional food practices, posing a threat to their preservation. The findings underscore the urgency of preserving traditional foods as a vital component of Indonesia’s diverse cultural legacy. Strategies such as integrating traditional food education into school curricula, promoting traditional cuisines through cultural festivals, and leveraging technology to document recipes and practices are essential for safeguarding this heritage. The study concludes that preserving traditional foods requires heightened societal awareness and proactive efforts to balance modernization with cultural conservation. This research contributes to understanding traditional foods as a cornerstone of Indonesian identity and offers practical recommendations for their sustained relevance.

Traditional Food Practices, Attitudes, and Beliefs in Urban Alaska Native Women Receiving WIC Assistance

Biotechnology is as old as human civilization and has been an integral part of the human life and is believed to originate more recently to its modern form from an indigenous knowledge of African traditional food and beverage fermentation practices. The application of modern biotechnology methods in the food and agricultural industry is expected to alleviate hunger today and help avoid mass starvation in the future. Nowadays, modern food biotechnology has been transforming our traditional way of food production and preparation far beyond the traditional scope. Currently, at global level, food biotechnological research has focused on; traditional process optimization (starter culture development, enzymology), food safety and quality, nutritional quality improvement and food preservation (improving shelf life). Special emphasis has also been given to the newly growing concept such as functional foods and probiotics. To this regard, the science has gone more beyond our expectation and exemplary achievements are described here. In this review, food biotechnological research on Ethiopian indigenous traditional fermented foods and beverages was assessed in view of this global achievement. Microbiological study on Ethiopian traditional fermented foods and beverages has focused more on Isolation, identification, characterization of fermentative microbes, attempts to develop starter culture, physicochemical, biochemical, nutritional composition change during fermentation, depicting general traditional processing and recently on probiotics. Most of the researches have been concentrated on some very commonly and widely known traditional fermented foods and beverages nearly around the central and southern part of the country. The research was also fragmented and not progressive for a given food and/or beverage. Biotechnological researches on Ethiopian traditional fermented foods and beverages have not gone far beyond some attempts on molecular characterization study of fermentative microorganisms. The reasons for this limitation could be linked to the fact that; biotechnological research is capital intensive, requires the use of sophisticated equipment, reagents, chemicals and needs sufficient trained man power in the field. Lack of funding, little attention from government policy and the endemicity of the traditional fermentation techniques may also have contributed for the less/no advancement of the techniques. In conclusion, to promote Ethiopian indigenous traditional fermented foods and beverages into commercialization/ industrialization, using currently advancing food fermentation biotechnology, we need to: realize the economic benefits of these indigenous traditional knowledge, develop our human, technical and institutional capability, go out to assess the cultural and geographical diversities of the country, broaden our research topics far beyond the current, and keep on continuous and progressive research.

This chapter aims to highlight the importance of nature and describe how it sustains Siswati indigenous knowledge systems (IKS) in Eswatini. Grounded in the Biocultural Diversity Framework and descriptive qualitative design, data for analysis was collected from secondary sources. Thematic analysis was employed to explore how nature supports traditional Siswati practices, beliefs, and knowledge systems. The results revealed that traditional food, medicine, attire and religious practices are embedded in natural features. The study also found that challenges such as land deforestation, wildfires and overharvesting contribute to the scarcity of plants and trees as well as animal products used for traditional medicines and food. Strategies that could alleviate some of these challenges such as environmental acts, establishing botanical gardens and involving conservatory stakeholders were proposed. Therefore, this study contributes to a deeper understanding on the relationship between biocultural diversity and Siswati IKS, offering insights into their maintenance.

Traditional Food Knowledge (TFK) is needed to define the acculturation of culture, society, and health in the context of food. TFK is essential for a human’s cultural, economic, and health aspects. Variations of ethnicity, culture, and lifestyle affect the diversity of traditional Indonesian food. Recognition of food is needed to maintain the sustainability of traditional food. Nowadays, there are many food dataset collections, but there needs to be a dataset that specifically collects standard food datasets. Our main contributions to the TFK research field are professional food image data acquisition, innovative development of an automatic, scalable food recognition system, and multi-process inference service. There are 34 variations of traditional foods from all regions in Indonesia that were acquired in this dataset. The dataset comprises 1644 high-quality images captured by professional cameras and 1020 by a smartphone. Several deep learning models are implemented in food recognition systems. This system can accommodate the addition and reduction of food variations in the knowledge recognition system and is capable of multiple concurrent requests at a time. The current prototype incorporates traditional types of food from Indonesia. However, the food model can also be expanded to other countries traditional foods. The automatic recognition systems are evaluated using several deep-learning network models. The experiment results have shown that the AUROC score is 0.99, and the request success rate can be improved by 70% with a multiprocess inference service.

This intergenerational study within Liverpool communities employed embodied memory as an analytical tool to explore the changing nature of food practices and the consequent implications for diet and health. The methodology had a qualitative focus using a phenomenological approach that employed the ethnographic methods of participant/nonparticipant observation, natural conversations, document analysis and in-depth interviews with eight families that comprised three and four generations of mixed gender and socioeconomic backgrounds spanning almost one hundred years. Memory is a multi-faceted phenomenon through which I have explored a range of concepts in relation to food and familial practices; history, inter-generational transmission, identity, tradition, community and health. The notion of embodied memory involving the senses and emotions, revealed the cultural and social meanings my participants afforded to traditional, ritual and everyday foods and food practices and the extent to which these organised and embodied their relationship with the past bound up in life experiences that included transitions, turning points and significant events and relationships. Within particular temporal, social, economic and historical contexts such memories moulded food and eating practices that in turn, intersected with the major influences on food choice including available resources, corporate marketing, personal attributes and knowledge, family values and health concerns. The study produced evidence that health and illness are not independent variables that can be tested and measured, but rather are subjective experiences embodied in everyday life attention to which can help us develop a better understanding of why the relationship between food and health has become problematic. Food stories across time revealed that people draw on, and respond to, different knowledges that may, or may not, lead them to improvise or make adjustments to their food practices. A common sense stock of knowledge bound up in the notion of tradition once embedded in the community and family has, to a large extent, been superseded by 'expert' knowledge derived from surveys that provide evidence base for government advice on healthy eating from which, despite inconsistencies, the individual is expected to make rational, informed choices. My study challenges this ethos of individualism wrapped up in the aphorism 'you are what you eat', arguing that we need to focus our attention on the social and cultural ways in which food 'gets done', food as it is valued and practiced, that in turn may lead to more effective health promotion strategies.

Protecting traditional cultural food practices: Trends in diet quality and intake of ultra-processed foods by Indigenous status and race/ethnicity among a nationally representative sample of adults in Canada