Maasai Research

Food Restriction in Third Trimester of Pregnancy

UNIVERSITY OF CALGARY Maternal Diet and Infant Brain Sparing Among Ngorongoro Maasai by Christopher David Powell

FACULTY OF MEDICINE CALGARY, ALBERTA SEPTEMBER, 2012

Protein:

• Trimester 1-2
  • Approx 48 grams (about 4 fried eggs)
• Trimester 3
  • Approx 38 grams (just under 3 fried eggs)

Fat:

• Trimester 1-2
  • Approx 50 grams (3 avocados)
• Trimester 3
  • Approx 25 grams (1.5 avocados)

Carbohydrates:

• Trimester 1-2
  • Approx 300 grams (302) (23 slices of whole wheat bread)
• Trimester 3
  • Approx 100 grams (105) (8 slices of whole wheat bread)

http://www.maasai-association.org/maasai.html  (Kenya)

• Maasai diet
  • Traditionally, the Maasai rely on meat, milk and blood from cattle for protein and caloric needs. People drink blood on special occasions. It is given to a circumcised person (o/esipolioi), a woman who has given birth (entomononi) and the sick (oltamueyiai). Also, on a regular basis drunk elders, ilamerak, use the blood to alleviate intoxication and hangovers. Blood is very rich in protein and is good for the immune system. However, its use in the traditional diet is waning due to the reduction of livestock numbers.
  • More recently, the Maasai have grown dependent on food produced in other areas such as maize meal (unga wa mahindi), rice, potatoes, cabbage (known to the Maasai as goat leaves), etc. The Maasai who live near crop farmers have engaged in cultivation as their primary mode of subsistence (the action or fact of maintaining or supporting oneself at a minimum level). In these areas, plot sizes are generally not large enough to accommodate herds of animals; thus the Maasai are forced to farm. Our people traditionally frown upon this. Maasai believe that utilizing the land for crop farming is a crime against nature. Once you cultivate the land, it is no longer suitable for grazing.
• Maternity Clinic
  • Our maternity clinic is a family oriented unit developed to provide excellent medical services and care to mothers and their newborns. The maternity clinic have a fully integrated approach program where trained nurses work side-by-side with traditional birth attendants (TBAs) to provide medical and family care services to our patients. This facility, without a doubt, will help us avert infant and mother mortality problem in the area.

http://www.everyculture.com/wc/Tajikistan-to-Zimbabwe/Maasai.html

• The Maasai are thought of as the typical cattle herders of Africa, yet they have not always been herders, nor are they all today. Because of population growth, development strategies, and the resulting shortage of land, cattle raising is in decline
• Today, Maasai cattle herders may also be growing maize (corn) or wheat, rearing Guinea fowl, raising ostriches, or may be hired by ecologists to take pictures of the countryside.
• European explorers considered the Maasai formidable warriors for their conquests of neighboring peoples and their resistance to slavery
• …When the British unintentionally introduced rinderpest (a cattle disease), the Maasai lost 80 percent of their stock. The British colonizers further disrupted Maasai life by moving them to a reserve in southern Kenya. While the British encouraged them to adopt European ways, they also advised them to retain their traditions. These contradictions resulted, for the most part, in leaving the Maasai alone and allowed them to develop almost on their own. However, drought, famine, cattle diseases, and intratribal warfare (warfare among themselves) in the nineteenth century greatly weakened the Maasai and nearly destroyed certain tribes.
• Wage and cash economy is replacing the barter (trade) system. Consequently, the Maasai have begun to integrate themselves into the modern economies and mainstream societies of Kenya and Tanzania, albeit with considerable reluctance.
• Rights of passage
  • Ear piercing for both boys and girls comes next. The cartilage of the upper ear is pierced with hot iron. When this heals, a hole is cut in the ear lobe and gradually enlarged by inserting rolls of leaves or balls made of wood or mud. Nowadays plastic film canisters may serve this purpose. The bigger the hole, the better. Those earlobes that dangle to the shoulders are considered perfect.
  • Circumcision (for boys) and excision (for girls) is the next stage, and the most important event in a young Maasai’s life. It is a father’s ultimate duty to ensure that his children undergo this rite. The family invites relatives and friends to witness the ceremonies, which may be held in special villages called imanyat . The imanyat dedicated to circumcision of boys are called nkang oo ntaritik (villages of little birds).
    • Girls must endure an even longer and more painful ritual, which is considered preparation for childbearing. (Girls who become pregnant before excision are banished from the village and stigmatized throughout their lives.) After passing this test of courage, women say they are afraid of nothing.
  • Guests celebrate the successful completion of these rites by drinking great quantities of mead (a fermented beverage containing honey) and dancing. Boys are then ready to become warriors, and girls are then ready to bear a new generation of warriors. In a few months, the young woman’s future husband will come to pick her up and take her to live with his family.
• FAMILY LIFE
  • The Maasai are a patriarchal society; men typically speak for women and make decisions in the family. Male elders decide community matters. Until the age of seven, boys and girls are raised together. Mothers remain close to their children, especially their sons, throughout life. Once circumcised, sons usually move away from their father’s village, but they still follow his advice. Girls learn to fear and respect their fathers and must never be near them when they eat.
  • A person’s peers (age-mates) are considered extended family and are obligated to help each other. Age-mates share nearly everything, even their wives. Girls are often promised in marriage long before they are of age. However, even long-term engagements are subject to veto by male family members.
• Food
  • The traditional Maasai diet consists of six basic foods: meat, blood, milk, fat, honey, and tree bark.
• Girls help their mothers with domestic chores such as drawing water, gathering firewood, and patching roofs.

http://www.africanmeccasafaris.com/travel-guide/tanzania/parks-reserves/serengeti/maasai-tribe

• The men are responsible for security, fencing their circular kraal with acacia thorns to keep marauding lions from attacking their cattle. The boys act as herdsmen while women and girls build houses or Inkajijik, collect wood and water and prepare food. Today, some families often live independently. The girls are as ambitious as the boys, keen to learn trades and develop skills as cooks, housekeepers, artists, teachers and even as AfricanMecca game guides and camp manageress around East Africa.

https://tanzania.go.tz/

• Besides the richness it has of natural resources like wildlife, water bodies like the ocean, lakes & rivers and minerals, Tanzania is well endowed with abundant significant cultural and natural heritages  which include  archaeological, palaeontological and historical resources ranging from the Pliocene period about four million years ago to the present time.
• Agriculture:
  • In Tanzania the Agricultural Sector is the foundation of the Tanzanian economy. It accounts for about half of the national income, three quarters of merchandise exports and is source of food in addition to provision of employment opportunities to about 75% of Tanzanians. Agriculture has linkages with the non-farm sector through forward linkages to agro processing, consumption and export; provides raw materials to industries and a market for manufactured goods. Tanzania produces approximately 97% of its food requirement. Production of food crops varies from year to year depending on the amount of rainfall received.
  • Agricultural development has been in the domain of government/public funding for a long period of time. However macro-economic reforms have and continue to have had significant impact on the agriculture sector. The economic reforms have led to the opening up of the sector to private investment in production and processing, input importation and distribution and agricultural marketing. Most production, processing and marketing functions have been assigned to the private sector. The Government has retained regulatory and public support functions or facilitation role.
  • The Government of the United Republic of Tanzania is a unitary republic based on multiparty parliamentary democracy. All state authority in the United Republic is exercised and controlled by the Government of the United Republic of Tanzania and the Revolutionary Government of Zanzibar. Each Central Government has three organs: the Executive; the Judiciary; and the Legislature that have powers over the conduct of public affairs. In addition, Local Government Authorities assist each central government.

https://www.google.ca/maps/place/Tanzania/@-2.8204441,35.3788583,8.18z/data=!4m5!3m4!1s0x184b51314869a111:0x885a17314bc1c430!8m2!3d-6.369028!4d34.888822

• http://www.kilimo.go.tz/index.php/en
  • Ngorongoro_Soil_Map:  http://www.kilimo.go.tz/maps/Ngorongoro_Soil_Map.jpg
  • Ngorongoro_Agro_Ecological_Map: http://www.kilimo.go.tz/maps/Ngorongoro_Agro_Ecological_Map.jpg
  • Ngorongoro_Crops_Suitability_Map: http://www.kilimo.go.tz/maps/Ngorongoro_Crops_Suitability_Map.jpg
  • Serengeti_Soil_Map:

http://www.kilimo.go.tz/maps/Serengeti_Soil_Map.jpg

• Serengeti_Agro_Ecological_Map: http://www.kilimo.go.tz/maps/Serengeti_Agro_Ecological_Map.jpg
• Serengeti_Crops_Suitability_Map: http://www.kilimo.go.tz/maps/Serengeti_Crops_Suitability_Map.jpg

http://www.kilimo.go.tz/index.php/en/resources/view/southern-maasai-agro-pastoral-livelihood-zone-february-2016

Southern Maasai Agro-Pastoral Livelihood Zone February, 2016

• The man owns the boma’s cattle and he distributes them among his wives, for her use. The livestock numbers in the chart above refer to the average number of livestock per wife. Thus, it is not surprising for a better off household to be in possession of over a thousand cattle if he has five wives, each with 200 cattle. Very poor households, on the other hand, have almost no livestock by Maasai standards, and are just barely scraping by
• The graph below presents the sources of food for households in different wealth groups in the livelihood zone for the period April 2014 to March 2015. April represents the start of the consumption year because it is when people begin to consume green crops and it marks the end of the hunger period. Food is presented as a percentage of 2100 kcal per person per day for the 12-month period. This was considered an average year
• Livestock, which are the basis of the household economy, are also fundamental to the household diet in this zone. Milk and meat from households’ own livestock bring in a substantial portion of required calories over the year. Own crop production, purchased food and gifts (for those on the lower end of the wealth spectrum) provide the remaining calories
• The traditional Maasai pastoral diet used to be comprised of milk, purchased grain, meat and (occasionally) blood. Over the past thirty years, the diet itself has not changed much, but the balance in how people source their food in years with relatively good rainfall has shifted away from purchased grains and towards their own production. In the reference year – which was deemed by community leaders to be an average year – the calories supplied by households’ own crops accounted for 35-65% of minimum food energy requirements. Most of this was from maize, planted during the masika season; and the rest was from beans. A typical very poor household, cultivating around two acres of land was able to produce around 870 kg of maize and 210 kg of beans. On the upper end, better off households, cultivating around 10 acres of land, generated around 3,180 kg of maize and 1,000 kg of beans. Households sold between 40% and 60% of the maize they produced, generating an important source of cash income. All three of the upper wealth groups also sold a good portion of their beans (50-70%), with this proportion increasing with wealth; it was more common for very poor households to consume rather than sell their beans. Whereas maize and beans provide a large proportion of the calories for households in this zone, milk is still a critical part of the diet, both in nutritional and in cultural terms. Milk provides a primary source of food for young children and all members of the household continue to drink large amounts of it (both fresh and curdled), especially in the wet season, when yields are high. The contribution of milk to the household food basket increases with wealth, since wealthier households are, by definition, those with larger herds. Food is managed at the household level, with each wife allocated a particular number of cattle which provides milk for her children and other household members. Very poor households rely on the milk from around 2 cows and 6-7 goats; poor households have around twice that number of cows; middle and better off households have between 12 and 18 cows milking, and 16 to 18 goats milking. On average, cows here (which are the Zebu variety) produce 2 litres of milk a day during the first rainy season (lasting around four months) and 1 litre of milk a day in the second season (which lasts around two months). Goats yield only around ¼ of a litre a day and lactate for a period of around 2 months. When added together, these sources of milk generated around 700 litres of milk for very poor households and as much as 5,640 litres of milk for better off households during the reference year. Some of this milk was sold by households in the top three wealth groups, but the milk that was consumed accounted for around 10-40% of the calories required by households. Meat (from animals that were either Southern Maasai Agropastoral Livelihood Zone Profile 8 slaughtered or died naturally throughout the year) contributed an additional source of food, especially for middle and better off households, for whom it covered 10-20% of their minimum food needs. The market accounted for almost all the remaining calorie needs of households, comprising around 17-47% of the reference year’s food basket. Those in the upper two wealth groups bought less (17-19% of minimum calories) than those in the bottom two wealth groups (34-47% of minimum calories). This is, in part, because the poorest wealth group did not produce enough of its own food – either in the form of crops or milk and meat, to cover all of its calorie needs, even though it was a relatively good year. Poor, middle and better off households, on the other hand, could have feasibly met all their calorie needs with their own crop production if they had not sold any of their harvests or milk. If very poor households had not sold any of their crops, (they generally do not sell milk) they would have been left with a deficit of over 20% of minimum calorie requirements (assuming no gifts). On the other hand, poor households in the same scenario would have had a surplus of over 20% of minimum food needs; and a typical middle household produced 135-140% of minimum calorie requirements in the form of food, with an additional 45% of minimum calorie requirements produced in the form of milk. Finally, a typical better off household produced 208% of minimum calorie requirements in the reference year in maize and beans and 68% of minimum calorie requirements in milk. Nevertheless, all households sell part of their harvests in average years in order to meet their cash needs, which means that those in the two bottom wealth groups, have a real food deficit (after sales) that needs to be met with purchased food. This is supported by the observation that these two wealth groups bought 18-35% of their calorie needs in the form of maize grain. Middle and better off households did not buy any maize at all, rather buying food to add variety to their diet, including rice, beans, sugar, and oil. Finally, providing assistance to poorer relatives is part of a long tradition of community assistance that forms a vital part of Maasai culture. Gifts of food (mainly milk and meat) made up 2-8% of minimum calorie needs for poor and very poor households during the reference year.

Eating practices:

• https://ghrp.biomedcentral.com/articles/10.1186/s41256-017-0028-9
  • Interpretive description methodology was used to reveal five themes: (1) Eating less food makes baby come easier, (2) Not producing food means more dependence, (3) Working hard harms my baby, (4) Knowing what is needed for a good pregnancy and (5) Preferring our traditional ways for pregnancy and birth.
  • The Maasai rely on their herds of cattle, goats, and sheep as primary sources of income by selling or trading the meat and milk [17]. Traditionally, the diet was primarily meat, milk, and blood from domesticated animals. Due to land and grazing constraints, some Maasai, living outside of the NCAA, have begun to cultivate maize, rice, potatoes and cabbage to meet their nutritional needs [17].
  • Traditionally, Maasai women consume a modified diet, restricting caloric consumption during the third trimester, reducing intake of protein rich foods, and increasing water intake
  • women viewed these nutritional restrictions as necessary for a safe delivery and to limit adverse medical outcomes. The women felt the dietary restrictions keep their bodies ‘clean’ during pregnancy in order to readily absorb nutrients contained in the perinatal die
  • Maasai pregnancies and neonatal outcome are concerning. On average, Maasai women are observed to gain only 11% of their body weight during pregnancy [20] compared to their American and European cohorts with 15 to 25% gain [20, 24]. Approximately 13% of Maasai infants are categorized as low birth weight compared with an average 6.9% in the Organization for Economic Co-operation and Development countries [23, 24]. Many factors influence pregnancy outcomes, such as poor maternal nutrition, birth spacing, maternal age (under 15 years or over 35 years), inadequate prenatal care, lifestyle behaviors, and poverty [22, 23, 24]. It is in this context of the changing food availability and food insecurity affecting the maternal-child dyad that we framed our study.
  • “If I eat meat it will make the baby fat that would make me go to the hospital and deliver through surgery.”
  • … any sweet foods aren’t allowed, I am not allowed to eat the fat separated from the milk (butter) until I am closer to birth… We avoid those foods because we don’t want the baby to get really really fat…
  • The women told of the Maasai traditions surrounding food during pregnancy which restricted or prevented them from consuming unpasteurized milk, meat, or milk from cattle (other than their own), eggs, sweet foods, and butter. Also, they shared that women were to restrict caloric intake, especially from sweet or fatty foods throughout their pregnancies.
  • Since I’ve been pregnant and am told not to eat certain foods, they don’t see me as a priority to have to eat first. Sometimes I’m not full but I’m supposed to stop eating (be)cause I’ve reached my limit…and sometimes if we run out of food I have to drink tea with milk instead. There’s nothing that I can do because it’s the tradition.
  • This research described traditional and current dietary practices of select Maasai women during pregnancy and their perceptions on how diet and nutrition impact maternal and child outcomes. The women interviewed variably described restricted dietary intake throughout their pregnancies, especially during the third trimester, with the intent of reducing the size of the baby to facilitate easier delivery. Added chores, excessive walking, and difficult workloads during pregnancy further increases metabolic expenditure, further reducing fetal size.
  • The study findings may contribute to improving nutritional status of pregnant Maasai women by providing knowledge of cultural practices related to pregnancy nutrition. Community leaders, family members, and traditional birth attendants are influential in how and when the Maasai women seek medical care throughout their pregnancy.
  • By promoting an understanding of the mechanisms and risks of fetal growth restriction, cultural practices may change and encourage the reconsideration of food restrictions in pregnant Maasai women.

 

Some questions …. revolved around miscarriages, and what other solutions to pregnancy woes … has this always been practised. Had the number of mothers dying in labour raised or dropped

Our Solutions

• Provide training for midwives – they trust in midwives to provide aid, and would accept new ideas easier coming from them compared to an outside source (western doctor)
• Provide education and evidence on cognitive impairment
• More comfortable with Tanzanian doctors
• Doctors provide resources such as some form of birth control (Planned parenthood)
• Inform on ways to improve overall health without accusing
• Because they have lost grazing land and have changed diets convince them that these alternative ways will help them improv pregnancies for both Mother and Child.

 

• The study findings may contribute to improving nutritional status of pregnant Maasai women by providing knowledge of cultural practices related to pregnancy nutrition. Community leaders, family members, and traditional birth attendants are influential in how and when the Maasai women seek medical care throughout their pregnancy.
• By promoting an understanding of the mechanisms and risks of fetal growth restriction, cultural practices may change and encourage the reconsideration of food restrictions in pregnant Maasai women.

(https://ghrp.biomedcentral.com/articles/10.1186/s41256-017-0028-9 )^^^

Works Cited

Google Maps, www.google.ca/maps/place/Tanzania/@-2.8204441,35.3788583,8.18z/data=!4m5!3m4!1s0x184b51314869a111:0x885a17314bc1c430!8m2!3d-6.369028!4d34.888822.

A Travel Directory for Kenya, www.findingkenya.com/single-post/Fascinating-Maasai-Rituals.

Food Composition Databases Show Foods List 09037, ndb.nal.usda.gov/ndb/search/list?qlookup=09037.

“Fomu Ya Maoni.” Tovuti Kuu Ya Serikali: Welcome, tanzania.go.tz/.

Lennox, Jessica, et al. “Eating Practices during Pregnancy: Perceptions of Select Maasai Women in Northern Tanzania.” Global Health Research and Policy, BioMed Central, 2017, ghrp.biomedcentral.com/articles/10.1186/s41256-017-0028-9.

“MAASAI OF SERENGETI AND NGORONGORO IN TANZANIA.” Maasai Of The Serengeti & Ngorongoro In Northern Tanzania – AfricanMecca Safaris, www.africanmeccasafaris.com/travel-guide/tanzania/parks-reserves/serengeti/maasai-tribe.

“Maasai.” Countries and Their Cultures, www.everyculture.com/wc/Tajikistan-to-Zimbabwe/Maasai.html.

“Maasai Cultural Experience.” Maasai Children EducationTanzania Children CentersTanzania Orphanages CentresTanzania VoluteersArusha Orphanages Centres Arusha Voluteers Arusha Maasai Foundation Arusha Maasai Educations Arusha Children Educations Arusha Maasai Children Education Arusha Culture Maasai Culture, www.maasaichildreneducation.org/programs/maasai-cultural-experience/.

“Maasai Tribe, People, Language, Culture and Traditions.” Softkenya.com, 2017, softkenya.com/kenya/maasai-tribe/.

Powell, Christopher David. “Maternal Diet and Infant Brain Sparing Among Ngorongoro Maasai.” MA thesis, University of Calgary, September 2012, ucalgary_2012_Powell_Christopher.pdf

Van, Riet. “Massai.” Pinterest, June 2014, www.pinterest.ca/pin/557883472565589734

Powell, Christopher David. “Maternal Diet and Infant Brain Sparing Among Ngorongoro Maasai.” MA thesis, University of Calgary, September 2012, ucalgary_2012_Powell_Christopher.pdf

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