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Subject:
From:
Susan Burger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 27 Jun 2009 09:20:50 -0400
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Dear all:

I have already posted on one of the myths that a lactopia exists in developing countries 
with hard core evidence to the contrary.  

In fact, there is evidence to show less exclusivity in the countries with the highest 
mortality rates and worst poverty.  The rates of exclusive breastfeeding are higher in 
Eastern and Southern Africa than in Sub-saharan Africa.  Within Sub-saharan Africa, the 
rates of exclusive breastfeeding are lowest in Western and Central Africa.  How low?  
Four out of five infants under six months of age are NOT exclusively breastfed.  
Moreover, the last time UNICEF had statistics on this, the drop off occurred in the 0-3 
month range.  At the same time, the mortality rates are just the opposite.  The infant 
mortality rates are lower in Eastern and Southern Africa than Sub-saharan Africa. Within 
Sub-saharan Africa, the rates of infant mortality rates are extremely high in Western and 
Central Africa.

There are strong myths about some blissful pastoral prior existence we all had with a 
marvelously wonderful diet that was perfect for our optimal development -- the Eden that 
disappeared as we industrialized and overpopulated the planet.  Yet, I do not believe that 
we ever had more than a few pockets of Eden surrounded by struggle and challenge. 

Here's what was available when I first joined Peace Corps:
Main protein sources:  
peanuts (often moldy -- the aflatoxin from these molds has been implicated in liver 
cancer and certain forms of malnutrition)
dried and salted fish
termites (only in the rainy season -- very yummy)

Rare protein sources:
fresh fish
chicken & eggs (never an everyday item)
forest game (when you could shoot it -- tiny antelopes, porcupine, monkey -- and rarely 
okapi - an endangered species) -- this was often sold smoked or dried and maggots were 
common

Beans were VERY expensive and almost impossible to find (bugs ate big chunks out of the 
beans I managed to find, so these were put out in the sun to kill the bugs -- which then 
interested the chickens next door who ate the bugs -- I kept the beans)

Main starches:
cassava - the bitter kind that you had to soak for three days to remove most, but not all 
of the thiocyanate -- which interferes with iodine absorption -- goiter, cretinism and 
hypothyroidism were rampant in this area and THEN you had to turn it into something 
edible by pounding it, wrapping it in banana leaves and then fermenting it)
plantain bananas
sweet potatoes

Rare starches:
rice -- always came with bugs
wheat flour -- always came with bugs -- had to sift it

Greens:
Cassava leaves, spinach, and some green that had the texture of tough grass -- you had 
to chop it into tiny little bits to be able to swallow it

Fruits:
Mangos, pineapple and a couple of other weird things I never identified.

Fats:
Palm nuts and palm oil

Condiments:
Hot peppers

And that is the ENTIRE list.  The main deficiencies were iodine among the whole 
population, and protein-energy malnutrition among children 6-23 months of age.

In developed areas of the world, we have the luxury of choice to either create a healthy 
or an unhealthy diet.  In less developed areas, availability of food limits those choices 
and it often takes a lot of hard work and creativity to combine the few foods you have 
available in a healthy way.  Environmental conditions such as a low iodine content of the 
soil can make it simply impossible.

Best, Susan Burger

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