Food Taboos: A Powerful and Invisible Driver of Malnutrition
Studies have shown that pregnant women and children often suffer malnutrition because these beliefs prevent them from eating nutritious foods packed with vitamins and proteins.
By Raphael Mweninguwe (Malawi), Justina Asishana (Nigeria) and Srishti Jaswal (India)
Faith Bikiyere, 6, sits listlessly at the Nutrition Rehabilitation Unit at Mitundu Health Centre in Malawi’s capital, Lilongwe, suffering from stunting, or low weight for height. Her mother, Daina Bikiyere, 24, is also undernourished.
Daina says the doctors told her that their poor health is a result of a poor diet. Diana explains she followed the advice of women in her community and her family who told her not to eat certain foods such as okra, catfish, pork, eggs, milk and bananas during her pregnancy.
"And when the child was born", she says, "she was underweight but I was advised by some people not to breastfeed her or give her certain dietary foods."
This advice is a far cry from UNICEF's recommendation to breastfeed exclusively for up to six months.
About 3,800 kilometres away, in Nigeria, three-year-old Hamisu Garba looks like a one-year-old child. Hamisu suffers from wasting (low weight for height). His mother, Ladidi Garba, explained that Hamisu was 16 months old and near death when he was admitted in February to the Severe Acute Malnutrition (SAM) Center at the General Hospital in Minna, Niger State.
"I never knew that the food I was told not to give to him, which included eggs and milk, were the ones affecting him", she said.
Food taboos, based on cultural and religious beliefs, can have a negative impact on the health of pregnant women and children.
Studies have shown that pregnant women and children often suffer malnutrition because these deep-rooted beliefs prevent them from eating nutritious foods packed with vitamins and proteins. Poor weaning practices further compound the problem
Statistics show that 37.1% of children under five years are stunted in Malawi, 32% in Nigeria, and 35.5% in India. (See infographic)
Nearly half of all deaths in children under five globally are attributable to under-nutrition, says UNICEF. Under-nutrition puts children at greater risk of dying from common infections, increasing the frequency and severity of such infections, and delaying recovery.
Food Taboos across the World
Food taboos are not limited to Malawi or Nigeria but are quite common in other African and Asian countries, like India.
In India, Hindus consider a cow a holy animal. Eating beef, as well as drinking clarified butter, milk and other dairy products is taboo. Upper caste Hindus believe that eating onions and garlic leads to unholy behaviour. A practising Muslim considers it taboo to eat pork.
In Malawi, among the Zion City Church, Zion Christian Church and Apostolic Church, eating pork, catfish, seafood, rabbit and duck are taboos.
Chancy Lutere, a leader of Zion Christian Church, says eating such foods is against their religious beliefs, pointing out that both the Bible and the Koran are very clear about what kind of food are not to be eaten.
Religious leaders argue that there are alternative foods that can be consumed to supplement the dietary needs of a person.
In Minna, Garba says that within her community exclusive breastfeeding is culturally not encouraged. Giving children eggs, milk, tea and some meats is believed to be harmful to them. In some parts of Nigeria, pregnant women don’t eat nutritious and cheap groundnuts.
"When I gave birth to my son, I was told not to do exclusive breastfeeding with him. In Magama, we do not give our children eggs because we believe that eating eggs will turn them into thieves. I did it because I felt it was the best for them," Garba explains.
A 2019 study among teen mothers in Malawi showed correlations "between dietary diversity and improved pregnancy outcomes,” including a protective effect against low birth weight.
A 2021 study in India about maternal diets found that between six and eight out of 10 Indian mothers believe that various fruits, vegetables along with meat, fish and eggs should not be consumed during pregnancy because these are head-producing in nature and consequently lead to miscarriage and foetal malformations.
In Nigeria, the study “Food taboos and myths in South-Eastern Nigeria”, published in 2016, established that food taboos contribute to unhealthy nutritional practices during pregnancy and early childhood, and are detrimental to a child’s growth and development.
The study found that two in every ten pregnant women in South-East Nigeria avoid eggs, snails and bush meat during their pregnancy, although most began eating these foods after giving birth.
The SAM Center in Minna admits an average of 15 cases of malnutrition among women and children under five years of age. Aisha Abdullahi, a health worker at the Center, explains that many adult patients are weak but do not willingly go along with the meal plan provided. However, when told they will die if they don’t follow the recommended diet, they accept it.
Children like Hamisu and Faith showed improvement after a few weeks on the recommended diets, according to the local healthcare staff.
Abdullahi and other healthcare workers interviewed say lack of education, coupled with poverty and cultural beliefs, are the driving force of malnutrition in Nigeria and Malawi.
Food Taboos Can Be Harmful
Dr Mary Shawa, a nutritionist in Malawi , says that the non-consumption of foods high in nutrients, coupled with the belief that a reduced meal frequency will help to have a smaller baby who will be easier to deliver, are frequent causes of malnutrition among mothers and their babies.
She adds that the prohibition of eating foods such as eggs, fish, pork, and beef results in protein-calorie malnutrition among children, maternal depletion, premature ageing, and general malnutrition in women.
Hajiya Asmau Mohammed, the Niger State Nutrition Officer, points out that the state has lots of farming and food, “but misconceptions and taboos prevent people from getting optimal nutrition.”
Setting up Kitchen Corners at hospitals and primary healthcare centres across Niger State, where women learn how to prepare different kinds of nutritious foods, helps them have a healthier and varied diet.
Growing vegetable gardens in one's backyard is also part of the solution, especially in view of rising prices of fruits and vegetables.
In Malawi, outreach programmes on community radio stations, such as Ulyelo Wamapha translated as ‘Good Eating’ on Chirundu Community Radio Station, provide listeners with nutritional information. The content for radios is developed by the Malawi government as part of its nutrition insecurity interventions.
Another programme, ‘Foundation for Good Health’ on Madziko Community Radio, targets farmers in discussions about nutrition, improved diets, health and sanitation. Health workers and nutrition experts use community radio stations to disseminate nutrition information.
Dr Shawa proposes increasing the number of required antenatal visits for pregnant women from four to eight so they can receive additional nutrition education. However, this would involve more time and transport costs for women and more work for understaffed health centres.
In Niger state, nutritionist Mohammed says that increased sensitization is key in changing perceptions of food taboos. She adds that, while cultures and traditions should be respected, alternatives to the food taboos can be presented to the communities. The change would gradually make them embrace the food they now reject and thus improve the nutritional status of women and children.
This work was supported by a Global Nutrition and Food Security Reporting Fellowship from the International Center for Journalists and the Eleanor Crook Foundation.