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Factors affecting food intake

Vitamin A in Breastmilk

Although no interviewee could recall any eye signs of vitamin A deficiency in infants, this group may be at risk for vitamin A deficiency, since Aetas exclusively breastfeed until about eight months of age. If the breastfeeding mother is deficient herself or has minimal vitamin A stores, it is likely that her child will not get sufficient vitamin A from her milk, since vitamin A in breastmilk is largely a product of maternal intake. Bongga's study of the nutrient content of breastmilk of Filipinas showed a mean retinol content of 36 mg/dL (Bongga, 1986). This is far below estimates made from U.S. mothers of 67 mg/dL (NAS, 1991). While it has been observed that infants who consume as low as 100 to 151 mg of RE per day do not show signs of vitamin A deficiency, the Filipino values are still a cause for concern. While Bongga did her work among urban poor Tagalogs, and the retinol content of the Aetas' breastmilk may vary, it raises the possibility that breastmilk as a source of vitamin A for infants may be less adequate in populations with marginal vitamin A intake.

It was difficult to elicit responses from the Aetas suggestive of micronutrient deficiency, other than that of vitamin A. The strongest evidence of nutritional deficiency seems to be the well-recognized observation that during times of hunger and inadequate intake, people get thinner and children get sick more often. However, a more specific link between an illness and a deficiency state cannot be made. This results from the concept that illness is caused by evil spirits. Signs of vitamin A deficiency were therefore elicited by showing pictures and describing the eye signs of deficiency, rather than by asking about deficiency states as a whole.

Food Availability

Among Aetas, three factors affect the availability and absorption of vitamin A-rich food: cost, season, and the site of the procurement (whether food is purchased, homegrown, gathered from the wild, etc.).

Most plant sources of vitamin A are homegrown and available throughout the year. Except for carrots, that they do not grow and are very expensive, the Aetas frequently have leafy vegetables such as talbos ng kamote (camote tops), or malunggay (horseradish tree leaves) with their rice. Animal sources of vitamin A, such as liver, are rarely eaten as these are usually bought from the market or caught in the wild. Except for chickens, few animals are raised for food. Recently, the government distributed piglets to some families. This was a gift with which the Aetas were not entirely happy, because the breed of piglets given to them are perceived to be prone to disease and selective in feeding.

The abundance of a particular nutrient source at any given time may vary. For instance, kalabasa (squash) is a wet season crop and may be unavailable or expensive during the dry season; mangga (mango), on the other hand, is a dry season fruit and can be had for the asking at this time, yet is exorbitantly priced the rest of the year. Year-round sources are also abundant, such as malunggay, papaya, and kamote tops.

The nearest market, about thirty minutes by foot, was the PRPC market which closed in mid-1994. This market was important, not only as a source of food, but also because it was where the Aetas sold their produce. It was here that crops commissioned by the cooperative were brought for selling and where foods such as rice, meats, fish, canned produce, candies, snacks, and tobacco were purchased. To get to the next nearest market, the town market, the Aetas either have to ride a tricycle (which costs about five pesos per person) or walk an additional forty-five minutes. Another option, especially with a lot of goods to carry, is to ride in a caribou-driven cart, which is difficult given the narrow mountain trails; the trails could be widened to accommodate the carts. Unfortunately, there are very few caribous, and these are used in the fields. Thus, this option would probably not be used often. Given the market cost of vitamin A-rich animal sources, it is unlikely that the Aetas would spend much on these foods, even if an easier (and cheaper) way to town could be found.

Hunting wild animals, as the Aetas ancestors did, will probably become rarer as the forest diminishes. During the time of the fieldwork (about half of the year), there was only one occasion when two wild pigs were caught. There may have been other instances when the adults who tend their remote fields have eaten food from the wild, but these would not be available to the children, or the lactating women who usually stay in the village, and are the most at risk for deficiency.

Food Beliefs

Food beliefs would be a secondary consideration in deciding what to eat. If food were abundant, concepts, perceptions, and personal preferences might prevail. For example, a lactating woman would probably opt to take malunggay leaves rather than take pechay (Chinese cabbage) if both were available, because she believes the former would increase her milk supply. A man with loose stools might choose a latundan banana (a variety of banana believed to cure diarrhea) over a mango because he thinks the banana will cure his diarrhea. However, a child would select mangoes over vegetables because fruits are more delicious, even if vegetables are believed to be mas masustansiya (more nutritious). Other food items perceived as masustansiya are meats, fish, eggs, and rice. But being masustansiya alone will not guarantee that the food would be eaten. Carristel, a masustansiya fruit abundant during the dry season, is rich in vitamin A and calories, but is seldom eaten because people do not like its taste. During taghirap (pert oafs of difficulty) when only vegetables would be available, they would be eaten regardless of beliefs and taste preferences. Beliefs would take a major role in food selection only in times of plenty and can therefore be considered independent of seasonality. However, they may play a bigger role in food selection during seasons of abundance.

The perceptions of food seem to be independent of season. The most important food for the Aetas is rice, referred to as gatas ng langit (milk from heaven). During times of scarcity, all remaining resources (i.e., cash) would be directed towards its procurement.

The desire for wet season tubers, such as kalot and boloy, was expressed during the dry season phase of the field work. Food for taghirap, such as batong-patay (literally dead stones) and sisila (grubs), are readily recalled without regard for season. The only effect seasonality may have is to affect the hierarchy or preference, as some foods may be more abundant than others at a certain time. For example, during the rainy season a wider variety of fruits and vegetables is available, so that year-round vitamin A-rich food such as malunggay and papaya may be ignored in favor of tubers like boloy or kalot that are low in vitamin A, but considered delicious. The Aetas might prefer the tubers because these are available only during this time of the year and thus take on the attributes of a delicacy.

Food Supply and Acquisition

The Aetas eat whatever is available from their environment. They harvest most fruits and vegetables from their fields and gardens (see Table 4.1). However, there are plants in the wild that produce fruits like bananas and carristel, and vegetables like pako (a fern).

Although much of their food consists of homegrown vegetables, there is an increasing proportion bought from the markets. These include rice (the staple), as well as eggs, meat, fish, canned goods, milk (including powdered infant formula), coffee, snack foods, and alcoholic beverages (beer, gin). Most of these market products are not affected by seasonality, however, travel becomes more difficult during the rainy season. The cost of these items is dictated by middlemen, who in turn blame typhoons, the oil crisis, the distance from Manila, and the residues from Mt. Pinatubo eruptions (which threatens critical bridges on the highway to Manila) for the high prices and the irregularity of supply.

Rice is especially crucial since the Aetas consider this the center of their food world. Many of them say that as long as there is rice, they are satisfied. Unfortunately, none of the families are self-sufficient in this staple. The Maluniks, who seem to be the most self-reliant, only plant about a two month supply and buy the rest from the PRPC market. Other families do not even plant rice. They say that the land is not suitable for planting rice, and when they try, the yield is not enough. Attempts to introduce better methods of farming and better varieties of rice have not been successful. The farmers say that representatives from the DENR and the Department of Agriculture (DAR) do not visit often enough. However, the DENR and DAR claim that the people are uncooperative and lazy.

Food from the wild is still an important, though unreliable food source, particularly of animal protein. Aside from honey and wild pig, other foods obtained are: bananas, coconuts, alupag (a kind of fruit), bulaig (a tuber also used as pig feed), ferns (pako, lagulo, and bago), lima-lima (a tuber), ubod ng yantok (rattan trunk), fresh-water shrimps and fish, birds, monkeys, deer, labuyong gubat (forest chicken), abaw (beetles), and bayawak (forest lizard). Two interesting foods that Mang Aquino recalls eating during times of extreme want are sisila (grubs), and batong-patay (dead rock). The latter has been described as a stone that looks like bread and is edible. It is said to "pampatigas ng tuhod" ("strengthen the knees") and is considered good for the body. Food from the wild is more likely to be sought during the dry season when other sources are not available. There is, however, some food from the wild (such as kalot, boloy and buli), that is available only during the wet season. Most of these items do not have species identification or food composition information.

TABLE 4. 1
List of Important Plant Foods by Seasonal Availability and Retinol Equivalents

* Data not available

There is no division of labor as far as food acquisition is concerned. Both men and women are responsible for procuring food. However, because women become pregnant and need to take care of their infants, they may be confined to the village more often than men.

Aetas of all ages are involved in looking for food for the household. Children as young as five have been observed to dig their own camote while old women, like Aling Juanita (Mang Aquino's wife, one of the oldest and one of two women in the village who can still perform the kagon), are seldom found in the village because they are usually tending their fields.

Since almost everyone is family, the Aetas tend to share their food not only with household members but with neighbors as well. It is not unusual for a woman returning from the fields to be carrying a large bundle of string beans which she distributes to the houses she passes along the way. The whole village made a feast of two wild pigs caught by one of the young men, though a large portion was brought to town to be sold.

This generosity extended even to the study team, much to our discomfort, as we were aware of how limited their resources were. Yet it was a rare visit to Canawan that we would come down empty-handed. Someone usually pressed on us a few papayas, some camote, a bag of vegetables, or some bananas.

A typical meal

The typical meal of an Aeta would probably vary depending on the season of the year, whether he or she is at the village, near the fields, or in the forest. Age, of course, would also be a determinant, since all infants are breastfed. There was only one infant in the entire village who was not breastfed at the time of the field work, and this was because his mother became mentally ill soon after giving birth. Weaning takes place when the child begins to have teeth and begins to reach out for food ("nagsisimula nang umabot-abot ng pagkain"). Once the child starts raking solids, he is fed whatever the older members of the household are having.

The Aetas start the day by going to their fields. They may take a midmorning meal consisting of coffee made from burnt rice, and any leftovers from the previous evening's supper. The women, children, and older men who are left behind in the village have lunch at midday. This would consist of boiled rice and boiled or broiled vegetables, again usually leftovers. The main meal would be taken at dusk. The men and women who have returned from the fields bring home vegetables from their fields or plants growing in the wild (such as mushrooms) or, when lucky, birds or fish caught on the way. These are cooked by roasting or boiling and are eaten with rice. Meals are prepared with a minimum of utensils and little seasoning (usually salt, and occasionally bagoong or salted fish paste). There are times when a meal would consist only of rice and salt.

Seasonal variation would be reflected in the types of vegetables available for cooking. Those who stay near their fields with minimal cooking implements may opt to partake of foods from the wild (ferns, fruits, mushrooms) the availability of which will also be affected by the season.

More elaborate meal preparation is done during feasts, held to celebrate events, such as the opening of a new school or the Baptism of a child. On these occasions, noodles and meats with sauces may be prepared. The recipes, however, are of Tagalog origin.

Dry Season

The typical meal during the dry season would consist of rice (provided there is money to buy it from the market, or leftover grain stored from the previous harvest) and whatever vegetables are in season (mustasa, munggo, pechay). The vegetables would most likely be boiled. With luck, there could be freshwater fish or wild birds, either of which would be roasted. As their economy becomes more and more market-oriented, however, fish and birds when caught might well be brought to the market for cash to buy rice. Fruits like mangoes, carristel, cashew, black plums, Spanish plums, star apple, and pineapple are plentiful during the summer, so that it is common to see children walking about munching on some fruit.

Wet Season

Rice is scarce during the wet season that is also the planting season. When money is tight, or travel to the market impossible, the people turn to alternative staples, such as camote, kalot, and boloy (all tubers). Fortunately, vegetables are plentiful at this time, as are ferns and mushrooms. Fruits are limited to those available year-round, such as papayas or bananas. However, after a bad storm, even these are hard to find.

Suggested dietary modifications

Food intake is a complex behavior affected by a web of factors, only a few of which are mentioned above. It may seem that the Aetas would respond readily to suggested modifications as long as food is available. The perception of tiesa (carristel) should caution such optimism. People know that it is masustansiya (nutritious) and mabuti para sa mata (good for the eyes) and it is abundant in the summer months, but they would prefer not to eat it because they do not like its taste. There is need to experiment with recipes that would make tiesa more palatable, since this is in season during the dry months when not many food items are available. It is also rich in energy and vitamin C.

Our suggested modifications were directed toward improving the absorption of vitamin A and increasing body stores. We also recommended ways to improve the overall diet, keeping in mind other factors that could affect intake, such as taste and ease in preparation.

The first set of recommendations would help increase the fat in the diet. One way would be to use coconut milk more often. The Aetas already eat dishes in which vegetables are cooked in coconut milk. However, extracting the milk from coconut meat can be tedious and this may be the reason it is seldom done, even if coconuts are available. They would have to be convinced that the outcome would be worthwhile. Although coconut milk can be bought in ready-to-use form in Manila, it is unlikely that people from Morong and Canawan would buy it, given the availability of coconuts and the limited cash available.

A second way to add more fat in their diet is to encourage them to eat more nuts, such as peanuts, cashews, and sesame seeds. They, of course, need to be convinced to plant these crops. Cashew is already being produced, but peanut and sesame seeds could be introduced, both as cash crops and for personal consumption.

The Aetas also need to increase the amount of protein in their diets. One way would be use the nuts noted above. Another would be to eat more legumes, such as munggo (mungbean). Yet another would be to find ways to procure animal sources more readily. We proposed that more animals, such as chickens, pigs, and goats be raised.

Chicken would be a good source of nutrients. The eggs and skin are rich in fat, the liver in vitamin A, and the meat in protein. Pigs and goats would also be good sources of protein, and their livers of vitamin A. The Aetas would probably prefer the native breed of chickens and pigs, that are hardier and require little care. Goats will eat almost anything, so feeding should not be a problem, and their milk could be an additional source of fat as well. Perhaps, if the Aetas are hesitant to use goat or even caribou milk (they believe that this would make them behave like animals), they could be taught to make cheese from their milk and eat this instead. Cheese would be a good source of fat and protein.

A far more expensive way to increase vitamin A intake would be to fortify the foods that the Aetas eat often, such as rice and condiments like salt and soy sauce. However, marketing and distribution would be problematical for remote locations such as Canawan. On the other hand, this method could be implemented on a regional or national scale, which would require policy and legislative changes.

These suggestions could be implemented through a concerted effort involving community mobilization and health education. People like the Aetas have become wary of suggestions, even from well-meaning sources. It may be a good strategy to start with a few families who will adopt these changes by raising more animals, and planting a wider variety of crops. When this succeeds, other families will follow.

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