Contents - Previous - Next

This is the old United Nations University website. Visit the new site at http://unu.edu

Food-consumption patterns

The traditional Tunisian diet is dictated by the ecology of the Mediterranean basin. it is characterized by a high consumption of durum wheat and olive oil, with a moderate and uneven intake of animal products (mutton, eggs, milk), and is very diversified with regard to vegetables and fruits. This pattern, however, is not static but is undergoing changes under the influence of economic development and the gradual urbanization of households.

The urbanization process entails deep changes in the composition of the diet. These changes become significant with time (table 2) and influence the levels of energy and nutrient intake (table 3). In 1975 the consumption of locally grown durum wheat products in the smaller cities was half as much as in rural areas, and in the larger cities it was only one-fourth as much. A sharp decrease has been noted in the consumption of couscous, semolina, and traditional pancakes that are usually prepared at home in rural areas. Similarly, the customary consumption of barley (that of maize and sorghum being negligible) has fallen rapidly as a result of urbanization, and the grain has become a cultural relic without any nutritional significance.

TABLE 2. Food-consumption patterns (kilograms per person per year) in relation to urbanization in Tunisia, 1975 and 1985

R = rural; U = small and medium-sized cities: C = major cities (see Text)

A change that is clearly taking place is a strong increase in the consumption of imported soft wheat flour in the form of bakery bread, whereas the use of the same imported flour at home is being discontinued. This increased use of soft wheat is far from making up for the drop in consumption of durum, so that the level of cereal intake is diminishing notably as the population becomes urbanized.

Other commodities such as sugar and blended oils show some increase in consumption, although only to a moderate extent. Because these have already been strongly integrated into traditional recipes and beverages (green tea) for some considerable time, their use is not altered by increases in income. The consumption of olive oil is higher in the smaller cities, where most of the owner-producers live.

Urbanization is, however, followed by sharp increases in the consumption of meat (mutton and beef), poultry, fish, fresh or reconstituted milk, and yoghurt. Typically, when settling in a city, Tunisians diversify and improve the palatability of their diet by eating fewer staple foods and more animal products. With regard to legumes, vegetables, and fruit, such changes are less pronounced, and rather take the form of consumption of more exotic varieties to the detriment of home-produced vegetables and fruit or the yield from gatherings.

The results given by the different surveys are remarkably consistent. In general, the decreasing trend noted in 1975 with regard to traditional staple foods and the increasing trends for complementary foods were confirmed in 1980 and 1985. A minimum threshold of about 30 kg per capita seems to have been reached for durum wheat in the larger cities and a maximum peak for bread of about 100 kg. For a few commodities, such as milk in urban (1975) and rural (1980) areas, and poultry in all three areas (1985), a number of seemingly accountable decreases have occurred. They are discussed later in relation to changes in income because they seem to be the consequences of policy decisions and not just inconsistencies in the survey records.

TABLE 3. Levels of energy and nutrient intake per person per day in relation to urbanization in Tunisia, 1975-1985.

Nutrient intake

The above changes have obviously affected the energy, nutrient, vitamin, and mineral content of the average diet. Table 3 shows the changes in per capita consumption of various nutrients in relationship to the level of urbanization. Intake of energy, fat, vegetable protein, iron, and thiamine is greatest in the rural areas and decreases with urbanization. This decrease is attributable to lower consumption of cereals, which, in rural areas, are by far the principal source of calories, protein, calcium, iron, and water soluble vitamins, and the second source of fats. In addition, the rapid replacement of traditional durum wheat by soft wheat (poorer in protein and industrially milled with a high extraction rate) accelerates the loss of nutrients even further. In the case of iron, however, it is probable that urban intake, although lower in quantity, is definitely more easily assimilated because of its higher content of iron of animal origin.

Conversely, animal protein intake increases with urbanization through the consumption of meat, fish, milk, and eggs. Fat intake is also on the increase because of a higher consumption of imported vegetable oils and some animal fats. The intake of vitamin A is increasing because of a higher consumption of leafy vegetables, peppers (harissa), and, above all, offal, eggs, and milk products. With respect to vitamin C, the gap is noticeable between rural populations and the inhabitants of smaller cities because of the higher consumption of vegetables and citrus fruits in the latter.

In the case of calcium and riboflavin, and also thiamine and niacin, the effects of urbanization are generally positive, although not quite as markedly as for other nutrients because they are the result of two contradictory trends. On the one hand the drop in cereal consumption lowers the levels of these elements significantly, and on the other hand they are raised by higher consumption of milk (calcium), eggs, milk, and offal (riboflavin), and meat (niacin); the final result depends on the predominance of one trend over the other. Thus, in 1975 deficiencies in calcium and riboflavin were most marked in the smaller urban areas. The positive changes in nutrient content observed in 1975 in relation to urbanization occurred to a larger extent in 1980 and 1985.

Consumption and income

The budget servey makes it possible to determine total cash expenditures and cash expenditures on food per capita per year, to which should be added the value of home-produced, home-consumed commodities, and gifts at current market prices. The total expenditure may be taken as an approximation of income, as income per se is not determined. Table 4 and figure 1 show the changes in total and food expenditures in diners per capita per year from 1965 to 1985.

Over the past 20 years, income (in current dinars) has increased more than 51/2 times in rural areas and almost six times in the larger cities. While the gap between the two sectors has not noticeably widened, food expenditure in the major centres, which alone was equal to the overall per capita income in the rural areas in 1965-1968, in 1985 was still very close to that in the smaller cities. As in the case of the consumption levels shown in table 2, the smallercity dwellers were in an intermediate position from the point of view of income.

In 1965-1968 the average per capita income in the small and medium-sized cities was barely higher than in the rural areas. In 1975, however, those same urban areas were in a particularly unfavourable position with regard to intake of animal products (noticeably milk products) in spite of improved and higher incomes (table 2). This can be explained by the fact that, thanks to home production and consumption in the rural areas, and to the use of reconstituted milk in the major centres, milk consumption was higher than in the smaller urban areas, which probably experienced supply difficulties. In nutritional terms, this results in a drop in calcium and riboflavin intake (table 3).

This situation, which could have had serious consequences for the vulnerable population, was entirely resolved by 1980. This is explained by the fact that during the oil boom of 1975-1980 a large number of agricultural development projects were undertaken, creating jobs in the rural areas, but this seems mainly to have benefited the population of the smaller cities, where landowners and traders are concentrated. Moreover, on the suggestion of the World Bank, the government decided in 1977 to liberalize public transportation and to encourage its growth through investments in road development and maintenance, which contributed to better market organization and generated income.

Income having grown (in current dinars) at a higher rate in the smaller urban areas than in the other sectors, the income levels there became noticeably closer to those in the major cities (figure 1). Food expenditure went up in the same proportion; as a result the consumption of meat increased by 20%, that of eggs and fresh milk doubled, and that of poultry and yoghurt trebled (table 2). This is illustrated in table 3 by an increase in intake of riboflavin and calcium, as well as vitamin A, the intake of which in retinol equivalent exceeds the levels recorded in the major cities.

Between 1980 and 1985 the rate of household income fell very slightly in the smaller urban areas, remained unchanged in relation to the previous period in the major centres, and went up sharply in the rural areas (figure 1). It should be noted that 1985 was a good crop year in most agricultural areas. The increase in cash expenditure was reflected in a sharp increase in the consumption of bread and blended oils, prestige commodities for people with modest budgets. No parallel increase was observed in the consumption of animal products - status symbols too, but far more expensive ones. Conversely, the consumption of poultry, which had doubled during the previous prioed, fell; that of fish, which was already low, decreased still further, as was also the case for milk (table 2). (The number of households surveyed in April 1985 was unusually low. Because the supply and consumption of home- produced milk usually reaches one of its peaks at that time of year, it is likely that the average level may have been underestimated, but this alone would not seem to account for the overall drop in consumption.)

FIG. 1. Changes in total expenditures and food expenditures in relation to urbanization

TABLE 4. Changes in total expenditures and food expenditures (dinars per person per year) in relation to urbanization

The position was roughly the same in urban areas. Intake of oils and sugar increased, but that of poultry, meat, fish, and eggs dropped. Examination of the data by region shows that nutritional levels deteriorated in the north-eastern and particularly in the southern areas, whereas they remained stable or even improved in the other areas in comparison with 1980. The closing of the Libyan border in 1984, followed in 1985 by the return of expatriated workers, very probably accounts for this regional degradation (less remittances from workers abroad, less border trade, more workless members in households).

Let us consider whether inequalities in the distribution of income within each population group changed over the time of the surveys. (A presentation of the data by deciles of population could help, but these are not available yet.) The 1975 survey showed that 33% of the rural population, 18% of the population in the smaller cities, and only 3% in the larger cities fell in the lowest income classes (below D 60 per year). Four per cent of the rural population, 9% in the smaller cities, and 21 % of the inhabitants of the major centres were in the highest two income classes (over D 300 per year). The limits of the income categories were readjusted upward in successive surveys to take into account both depreciation of-the dinar and the rise in income resulting from economic development, but the arbitrariness of the choice of those limits precludes any valid comparison of income distribution patterns. To find out whether income disparities increased or decreased, Gini's coefficient, which indicates the degree of concentration (or dispersion) of overall income in the various population groups, was used (table 5). All three surveys showed that disparities in income distribution increased with the degree of urbanization: incomes were more evenly distributed in rural areas than in the cities. But no clear trend emerged from one survey to the next, save that Gini's coefficient remained stable for the whole of Tunisia between 1975 and 1985.

The level of food intake and per capita income are related and depend on the age and sex of household members. These in turn influence the level of per capita income. The average number of persons per household is highest in populations at the bottom of the income scale and decreases steadily as per capita income increases. Statistically, large families have a high probability of having a low income, which is not surprising. When we divide total income by the number of members, households with few active individuals and many young children are most likely to have a low total income and, consequently, a modest per capita income. High-income households are those with more working members, and per capita income is proportionately higher as there are fewer children and dependents.

Given equal income, the number of individuals per household is slightly higher in the large cities than in urban or rural areas, suggesting that the dependency coefficient increases with population density.

Income, energy requirements, and energy intake

Households in the same per capita income group are, to some extent, similar with respect to age of members, sex distribution, and anthropornetric features. This affects the calculation of energy requirements. Indeed, the 1975 data showed that the average per capita energy requirements increased as household income rose [1). The same pattern was shown, although less distinctly, by the results of the 1980 and 1985 surveys.

For all urban and rural groups, the average per capita energy intake grows faster than requirements when the household income increases. In both affluent and poor households, the gap is always wider in rural than in urban areas. Similarly, when a deficit occurs, it is lower in rural groups.

If one compares minimum energy requirements and intake for each household in each income category of the three strata, one can identify the families that are at risk of suffering from an energy deficiency. The probability of undernourishment is higher for urban families than for rural ones. This analysis, already partly published [1], is based on the results of the 1975 survey (table 6). A comparison of household intake and requirement distribution on the basis of the 1980 and 1985 surveys gives the same results. That is, the percentage of households suffering from energy deficiency is higher in the two urban groups than in the rural ones. This normally should be reflected in the physiological condition of urban con- sumers. We will see later whether this assumption is confirmed by facts.

TABLE 5. Gini's coefficient values in relation to income distribution

TABLE 6. Food expenditure, energy intake, and cost of calories by per capita income level in relation to urbanization, 1975

a. 1 millime = 0.001 dinar.

TABLE 7. Cost of energy by food group and income level, in relation to urbanization, 1975

1 millime = 0.001 diner.

Contrary to expectations, the budget data for those same families showed that, for the same income level, the proportion of income spent on food was virtually the same in rural and urban areas. Yet expenditure on goods and services other than food was greater in urban than in rural environments, and one might expect rural populations to use a larger part of their income to enjoy a qualitatively better diet like their urban counterparts. It would seem, however, that such is not the case.

As is shown in table 7, the cost of 1,000 calories in each food group increases with the income of the consumers. Cereals, sugar products, and animal products are cheaper in rural areas; only oils and fats are cheaper for the urbanized populations because of the greater use of subsidized blended oil, Given the same income, rural dwellers could try to diversify their diet like their urban counterparts; however, they prefer a more plentiful and less inclusive diet (more cereals but less oil, fewer animal products, and fewer vegetables and fruits) that meets their energy requirements, which is essential to their continuing productive activities. In other words, for the same income, whether high or low, the cost of 1,000 calories is lower in the rural areas, and for the same amount of money rural dwellers can eat more (figs. 2 and 3).

FIG. 2. Composition of diets by food groups ( Percentage of total energy intake per person), and cost of calories, by income level in urban areas (U and C), 1975

The cost of those 1,000 calories increases very quickly with changes in consumption patterns from one income category to the next, but the difference between urban and rural areas remains unchanged all along the income scale. One may therefore consider that for the same income, urban life, with its better market supply, offers greater possibilities for diet diversification because it does not demand the same degree of energy expenditure. For the same amount spent on food, the savings realized in expenditure can be used by urban dwellers to diversify their diet and increase its palatability. This, in our view, is a specific effect of urbanization.

This fact, observed under conditions of constant income levels, cannot be accounted for entirely by economic considerations. For a large part, physiological needs constitute the reason rural dwellers find themselves compelled to adopt less expensive consumption patterns for the same income than urban dwellers. To summarize, changes in diet are imposed by income (in the present case, the amount spent on food), and energy intake is dictated by the degree of urbanization.

FIG. 3. Composition of diets by food groups, and cost of calories, by income level in rural areas, 1975

Figures 2 and 3 show that, for very low income levels in both rural and urban areas, consumers have little if any scope for changing consumption patterns to lower the cost of their diet further. They cannot significantly reduce their consumption of expensive calories (meat, fish, milk) and fruit, because they are already eating minimum amounts of these items compatible with a palatable diet. They are therefore extremely vulnerable to increases in the price of cereal products. A limited increase may create a temporary inconvenience for middle-class households, who can adjust their budgets by cutting down on less essential items without any serious effect on their nutrition. The same increase becomes a nightmare for the poorer population, not only because their budgets are weaker but also because it affects a larger proportion of their total diet, and there is danger of its causing energy and nutrient deficiencies.

TABLE 8. Minimum acceptable levels of income and percentage of the population below those levels

This leads us to the question of food subsidies. Table 8 gives estimates of the percentage of the population too poor to meet their minimum energy needs, based on the poverty-line method suggested by the World Bank and data from the three surveys [2]. No critical analysis of the method and the appropriateness of the income level selected as the threshold point will be attempted here. The decision made by the government to help the disadvantaged population with incomes below the selected threshold seems important enough to be reported. In 1986 the government created a Solidarity Fund to distribute a fixed amount of money by household. The National Institute of Statistics (NIS) was asked to determine from the survey data and the socio-professional profile of the heads of families the number of families in each administrative region who were statistically at risk (profession, family size). The government requested the provincial governors to work with local authorities to identify and list the critically poor. About 120,000 households had been listed locally when the NIS calculated that there were 230,000 rural and 325,000 urban persons-about 100,000 households-at risk.

Subsidies

A subsidy system was instituted in 1970 to stabilize the prices of staple commodities and to keep the cost of certain items down. Those subsidies, which rose from D 1.3 million in 1970 to D 262 million in 1985, have become a burden on the national budget. The General Equalization Fund (Caisse générale de compensation) intervenes at the production level by subsidizing the prices of some items {fertilizers, fuel, animal feeds), and at the consumption level by making up for the difference between the cost price and the selling price of staple goods (semolina, flour, bread, blended oils, milk and milk products, sugar, tea, coffee), which are then sold at fixed prices.

The results of the 1985 survey were used as a basis to assess the redistribution effect of subsidies on household budgets 13, 4]. Properly used and focused on the needy, such subsidies ought to apply first and foremost to those commodities whose consumption is reduced as income increases. Thus, the consumption of barley, durum wheat, and wheat flour for making bread decreases with urbanization at the same time that household incomes rise. Barley, which is essentially home grown and home consumed, is only a negligible component of the diet. The consumption of flour for bread making is on the wane, but this is because commercially baked bread is increasingly popular. Logically, subsidies should apply only to processed durum wheat (semolina, noodles). As income rises, the consumption of the other subsidized commodities increases moderately (sugar, wheat), fairly sharply (blended oils), or sharply (milk, eggs, meat}, with the result that subsidies on these commodities are of greater benefit to the urban than the rural population.

The 1985 survey showed that wheat consumption increased at the same rate as income for all population groups, even in the larger centres. A saturation point was reached only in the second- and third highest income categories (D 350-500 and D 500-800), and consumption decreased slightly for the highest income category only (over D 800). It is therefore unavoidable that the richer populations derive far greater benefit from this policy than the poorer ones.

In 1980 "the least-favoured fourth of the population only account[ed] for 12.5% of the total subsidies, whereas the uppermost fourth enjoy[ed], three times that amount, i.e., 37.3%" 141. In 1985 the least favoured one-fourth received 14%, the most affluent one-fourth 35%. "Between 1980 and 1985, the rate of subsidies increased by 26% while annual private consumption only went up by 1396 in current dinars" [3]. The cost to the national budget, however, is higher than the social transfer thus achieved, as subsidies are of greater benefit to urban than to rural populations, and to middle- and upper-income groups than to poorer ones.

Subsidies represent a not inconsiderable part of the total budget of the poor: about 7%. If this bonus were eliminated, it would lead to a shortage of about 150 calories per day for each individual concerned. At the other end of the income scale, subsidies involve an inadmissible waste of certain commodities such as bread. Any sudden decision implying a return to more realistic price levels could very well result in the kind of explosive situation among urban populations that Tunisia and other countries have already experienced, unless it were supported by compensatory measures of public aid to the target groups. To avail themselves of those subsidies, the rural populations have given up a thousand-year-old system of home production and home consumption in the course of a decade (table 9).

TABLE 9. The importance of home-produced, home-consumed durum wheat (kilograms per person per Year) in rural areas

This dramatic change has benefited the rural population and partially contributed to the rapid progression of the cereal subsidies (D 20 million, 34% of the total, in 1975; D 158 million, 60% of the total, in 1985). Nevertheless, one of the brighter aspects of this process so costly to the state has been the integration of the rural population into a market economy. With less food stored at home, however, they will, like the urban populations, react more sharply to measures that might be taken toward a return to more realistic price levels in an effort to set the Equalization Fund on its feet again.

Body measurements

The 1980 and 1985 surveys recorded data on the weight, height, and age of consumers to provide a means of evaluating energy and protein requirements. These data were collected from samples of 8,520 males and 8,890 females in 1980, and 7,940 males and 8,100 females in 1985, classified according to place of residence as rural (R) or urban (U and C). So far, only the median height and weight data according to age and sex are available for 1980; they have been compared with those for 1985. To the best of our knowledge, this is the first time it has been possible both to study household consumption levels and the body measurements of the individuals concerned simultaneously and to follow their evolution over a period of five years on the basis of a national sample. The anthropometrical study is not a longitudinal one, however.

In 1980 the average weights of males up to five years old and females up to eight years old were not different for rural and urban groups. The two curves then spread out slightly but steadily for adolescents in favour of the urban group and separated more distinctly for adults (fig. 4). The maximum difference in weight is observed in females 45 years old.

The more favourable position of the urban population contradicts what would be expected on the basis of the consumption data, which consistently show a lower energy intake for this group. It is quite unlikely that urban consumption was underestimated and/or rural consumption overestimated at all income levels. The only explanation is that, in the absence of specific data on time budgets, the energy requirements of the more active occupations were underestimated. This underestimation would lead to a mistaken conclusion that energy intake levels are more satisfactory in the rural areas. It seems, in fact, that the urban diet, which is lower in calories but far more diversified and richer in nutrients, results in better growth of body weight.

FIG. 4. Differences in body weights between urban and rural populations, by sex, 1980 (provisional)

FIG. 5. Changes in male body weights between 1980 and 1985 (provisional)

FIG. 6. Changes in female body weights between 1980 and 1985 (provisional)

In the period between the two surveys, the weight curves of the population groups changed (figs. 5 and 6). By 1985 the weight of young rural males and females up to 11 years old had caught up with, and even exceeded, that of their 1980 urban counterparts, coinciding with the 1985 curve of urban dwellers. The latter gained 2 to 3 kg at each age level between the ages of 4 and 11. Rural adolescent males (between 12 and 18 years old) and females (between 12 and 16 years old) were heavier than those surveyed in 1980, and were on the 1980 weight curve of their urban counterparts. They did not, however, catch up with the latter, who during the same period gained 2 kg (males) and 4 kg (females) at each age level. Adult males, both rural and urban, lost 2 kg at age 25 in relation to those of 1980, regained them at age 30, and at age 45 were on the 1980 curve.

They gained additional weight beyond age 55 in relation to their elders, but the difference between urban and rural populations persisted.

Between the ages of 20 and 80 years, rural females kept just above ( + 1 kg) their 1980 curve. Among all groups, they were the only ones not to have increased in weight. On the other hand, urban women from age 45, gained 2, then 4 kg in relation to those surveyed in 1980.

In five years, except for males between 20 and 45 years of age, all age and sex groups gained from 1 to 4 kg. Unless an analysis of weight distribution for each age group shows a shartp increase in the numbers of overweight people, it may be assumed for the time being that the body growth patterns of all three groups changed for the better in Tunisia. The change was greatest in the urban population.

The contradiction noted between consumption data and the body-weight curve of the 1980 survey reappeared in 1985. Indeed, food intake did not change significantly between the surveys. The higher weight increase is attributable to the urban diet, which is poorer in energy, more diversified in nutrients, and richer in fats and high-quality proteins. These considerations fail to explain why the rural groups went beyond the 1980 median curve on a diet that, except for retinol, was slightly less rich in nutrients. Obviously, the 1985 survey is only one point on the trend and cannot provide all the information on what was happening during the period under review.

continue

Contents - Previous - Next