Indian Journal of Traditional Knowledge Vol. 15 (3), July 2016, pp. 355-362

Changes in eating habits and food traditions of Indo-Mauritians

1Trishnee Bhurosy & 2Rajesh Jeewon* 1Department of Applied Health Science, Indiana University School of Public Health, Bloomington, ; 2Department of Health Sciences, Faculty of Science, University of , Réduit, Mauritius E-mail: [email protected] Received 08 May 2015, revised 04 February 2016

Over the past two decades, there has been a shift towards consumption of energy-dense, imported processed foods and fast foods accompanied by a neglect of the traditional diets in many developing countries. A neglect of traditional food (TF) systems is related to nutrition transition marked by an increased consumption of unhealthy processed foods and significant lifestyle changes such as inadequate time for meal preparation. This nutrition transition (NT) has also resulted in a rise in diet-related chronic conditions. The current review aims to discuss the importance of TF and diets of Indo-Mauritians who constitute the majority of the general population in Mauritius as well as outline drivers behind the present NT. Understanding the functional properties of traditional foods is important in developing interventions to reduce the rising prevalence of chronic conditions such as obesity in Mauritius. A priority in view of the prevailing chronic disease burden could be to revive the use of neglected TF with high nutritive benefits through local nutrition education programs targeting the general population and in addition, to improve awareness of the high nutritive values of local TF in the education system as well as encouraging food companies to market these foods in an edible manner.

Keywords: Food traditions, Eating habits, Indo-Mauritians IPC Int. Cl.8: A47G 19/26, A47J 39/02, A41D, A61K 36/00

Located on the South-East coast of the African From a nutrition perspective, there has been a shift continent, Mauritius is a small island which has a from low-caloric and nutrient-rich foods to energy- population of about 1.3 million inhabitants. Being a dense foods, a greater consumption of fats and oils, multi-ethnic society, Mauritians whose ancestors come processed foods and a higher intake of animal-based from India, also known as Indo-Mauritians, make up foodstuffs, especially protein and fats5. Combined the majority (68%) of the entire population. More with lack of exercise, a transition from labour- specifically, the Mauritian population is composed of intensive work to sedentary jobs and the adoption of Hindus (51.2%), Muslims (17.1%), Creole (30.2%), the Western culture and lifestyle, chronic conditions Chinese (0.7%) and others (0.8%)1. In addition, the such as obesity are on the rise among Mauritians of Hindus can be further categorized into Biharis/North different age groups, whether it be older individuals, Indians–40%, Tamils–7%, Telegus–3% and Marathi– middle-aged adults or adolescents6,7,8. For instance, 2%. After having undergone through major economic the current prevalence of overweight and obesity changes in the late 1970s and the 1980s2 and originally, (2011-2014) among Mauritian adults is 35.7%9. The having a low-income and agriculture-based economy, adult prevalence rate has clearly increased since it Mauritius is currently classified as an upper-middle was reported to be 34.9% in 2009, compared to 30.5% income nation with a Gross National Income of US$ 9, in 1987 when the first Non-Communicable Disease 227 in 20133. Mauritius is now a diversified economy Survey had been carried out10,11. with growing industrial, financial, Information and Traditional foods commonly eaten among Communication Technologies, sea-hub and tourist Indo-Mauritians have been neglected over time, sectors4. Consequently, broader economic growth and making way to increased consumption of refined urbanisation, coupled with globalisation, have led to a processed ones, convenience foods and fatty meat decline in food prices and improved access to cheaper consumption. Indeed, foods such as plantains or raw and more food5. bananas, tapioca, jackfruit, cassava, boiled vegetables ______and seafood, which were long considered as the main *Corresponding author staples of the traditional Indo-Mauritian diet and 356 INDIAN J TRADIT KNOWLE, VOL. 15, No. 3, JULY 2016

having a high nutritive value, are now only Methods occasionally eaten among the younger generations. Using PubMed, Google Scholar and Science Similar trends have been reported among other Direct, we searched the English-language literature populations of Indian origin whereby traditional wild that documented changes in traditional food systems fruits are being less consumed although these in populations of Indian origin, including Mauritius. traditional foods have a higher protein, iron, mineral The following words “traditional foods”, “Indian”, and vitamin content12. Moreover, today food is more “changes”, “importance” and “Mauritius” were used often consumed for pleasure and not solely to appease in the initial search step. As a result, 45 journal hunger and to meet bodily energy demands as it was papers, reports and data sheets were included in the the case for many Mauritians decades ago. Along with present study. that, it has been reported that Mauritians prefer eating saltier and fattier fast foods with homemade meals Traditional food systems and their nutritional becoming a rare practice among Mauritian families13. benefits In particular, traditional cereal and root staples in Traditional foods (TF) can be defined as those many economically developing countries such as in foods which originate from local plant or animal Mauritius have been replaced by ready-to-eat bread resources through gathering and harvesting, and these 15 which requires less time and effort for preparation foods also bear cultural meaning . Before the advent before eating12. Moreover, the types of staple of industrialisation and economic changes in consumed often determine the types of condiments Mauritius, traditional foods of Indo-Mauritians with which they are eaten. As in the case of consisted mainly of wild grown vegetables also Mauritians, root staples and tubers such as bread fruit, known as ‘brèdes’ (leafy vegetables), root staples like ‘patate’ (sweet potato) and cassava were often cassava, tapioca, cassava, sweet potato, grains such as consumed with chutneys (plant-based products) and corn, beans, fresh milk obtained through rearing of sauces which are much less fatty and salty than animals like goat and cows, and marine sources of cheeses, processed meat, meat products and fat animal protein through fishing. Given the very spreads that are now commonly eaten with bread. In physical demands in fishing, rearing of animals, addition, there has been an increased tendency among gathering and harvesting along with travelling long Mauritians to eat away from home. Consumption of distances on foot, energy spent in obtaining food was street foods and eating in fast-food restaurants are very significant. Similar trends of obtaining food and more frequent due to the shift in work environment14. which required physical exertion have been reported Other factors include the mushrooming of food outlets likewise among other populations such as Indian 1,16 and convenience stores, more active social life, higher American and aboriginal communities . Most often, income and increased advertisements aiming to energy expenditure was quite high due to promote westernized diets. labour-intensive work such as farming-related Consequently, though some studies have reported a occupations and less use of transport vehicles coupled link between current eating habits of Mauritians and with significantly little time spent in watching the an increased risk of obesity or other chronic diseases, television. little data is available on the decline in the Composition of traditional foods consumption of traditional foods, the nutritional Surprisingly, cassava, breadfruit and sweet potato benefits of these traditional meals and their dietary were the preferred staples of the Mauritian diet components along with the evolution of the current instead of rice since during World War II, rice dietary practices of Indo-Mauritians. To the authors’ became scarce and had to be rationed13. Root knowledge, this is the first study to explore the vegetables were easily available and could be grown changes in traditional food practices which have in one’s backyard. Further, wild leafy vegetables, occurred in Mauritius. The main objectives of this known as “brèdes” in Mauritius, were often collected review are to: in different seasons, cooked and eaten with staple 1 Discuss the importance of traditional dietary foods like rice17. Consequently, rice became a practices of Indo-Mauritians. precious commodity during the 1970s and only 2 Outline the factors that trigger nutritional people, who could afford it, would buy good quality transitions in Mauritius. rice while rationed rice was of poor quality. Through BHUROSY & JEEWON: TRADITIONAL FOOD HABITS IN MAURITIUS 357

testimonies of elderly people, it has been known that a animal and plant-based foods. Aside from boiling, small amount of rice, when eaten, was boiled with broiling, roasting and heat or steamed methods of leafy vegetables and was prepared similarly to a soup cooking food were common. Smoking and drying consistency and then, eaten with chutneys, sauces or were often preferred methods of preserving and pickles. cooking meat or fish. In particular, fish products have There was no or little addition of cooking oil and been traditionally preserved by fermentation, salting, salt was used sparingly since both items were not drying and smoking in the Northeast and South East affordable to everyone. Once a week, fish was eaten parts of India, and these preserved fish products are 20 and which was the preferred source of animal protein consumed as a side dish with cooked rice . among Indo-Mauritians because of its easy availability and it was cheaper compared to other Benefits of traditional foods types of meat. Similarly, during the 1970s in India, Although infectious diseases and infant mortality instead of meat and meat products, whole grain were the most urgent health problems among our cereals, pulses, fruits and vegetables were more often ancestors, the traditional diets and consumption consumed18. Hence, it can be inferred that similar patterns among Indo-Mauritians provided many meat and fish consumption patterns were followed nutritional benefits along with advantages beyond among Indo-Mauritians during the 1970s to 1980s. As nutrition. For instance, growing, gathering, harvesting for grains and beans, varieties of dried beans such as and fishing activities related to TF systems confer ‘dholl’ and lentils were cooked together with rice and health benefits through increased physical activity and served while sometimes, seven varieties of dried it has been reported that some communities like the beans and grains were ground, roasted together with Innu people used to expend as much as 50 mega 14 salt or sugar and made into small balls. This was a Joules of energy daily . very popular item known as ‘satwa’ which means the The nutritional benefits can be attributed to the mixing of 7 beans or ingredients in one food only. following main factors: Most importantly, ‘satwa’ was and is still viewed as (i) The nutritional composition of TF: Traditional extremely nourishing by elderly Indo-Mauritians and wild plants are well known to be rich sources of in particular, it was commonly consumed during and essential micronutrients worldwide15,21. For post pregnancy or during times of illness. Similar instance, Artocarpus altilis, commonly known practices have been documented in areas of India such as breadfruit, is a rich source of starch, as in Himachal Pradesh where cereals and legume carotenoids, vitamin A and has been based foods are the common staples, and beans are traditionally used in the treatment of high blood often accompanied by rice or cooked flour dough 19 pressure, urinary infections, menorrhagia, known as ‘roties’ . Like in other similar cultures, diarrhoea, dysentery, stomach aches, skin wild grown fruits such as guavas were often eaten ailments, fungal infections22. This brings up the while green banana, when cooked, was consumed and 19 fact that increasing research is being done on the accompanied with chutney or chilies’ pickle . therapeutic and pharmacologic effects of TF and Popular snack items were maize pudding and steamed their bioactive components. Further, wild rice cakes, which is known as ‘poutou’ till today. traditional fruits such as jackfruit, papaya, guava Among the beverages, water and tea with milk were among others, although not as tasty and most commonly consumed. Soft drinks along with desirable like the current popular ones, have sweetened beverages were not common since they been reported to have a higher protein, iron, were not easily affordable. sodium, potassium content and other nutrients12. In addition, particular attention should also be paid While it is beyond the scope of this review to to the cooking methods of these TF. Similarly to other detail the therapeutic or medicinal effects, a native Indian cultures, boiling was the most common cogent link between food and medicine is 15 cooking method among Indo-Mauritians simply definite. because it was a cheaper and quicker way of (ii) Cooking methods: Boiling, broiling, roasting preparing meals. An earth oven, which was usually and steaming being the main cooking methods constructed outside of home and made of wooden among Indo-Mauritians required little or no use sticks and brick units, was used to prepare both of cooking oil. Hence, the amount of fat 358 INDIAN J TRADIT KNOWLE, VOL. 15, No. 3, JULY 2016

consumed suggests better blood lipid profiles particular, the import bill has more than doubled from and a reduced risk to chronic conditions such as 2001 to 2007 mainly due to the drastic increase in the cardiovascular problems and obesity. For import of processed food items28. The food habits of instance, non-communicable diseases surveys Mauritian consumers, including those of Indo- between 1987 and 1998 depict an increase of as Mauritians, have shifted towards processed and much as 60% for diabetes in Mauritius10. convenience foods, with an emphasis on quality, food (iii) Low salt content: Most meals and TF, when safety and brands. These data demonstrate a shift in consumed, had a low sodium intake and food habits among Mauritians, with changes in food numerous studies have reported a significant availability and receding famine, increases in chronic association between low salt consumption and diseases, and shifts to decreasing physical activity and reduced risk of hypertension and chronic kidney increasing use of processed food high in starch, fat disease23, 24. and sugar29.

(iv) Vegetarian practices: Those who followed Similar trends have been reported in developing the traditional Indian diet, practiced countries such as Malaysia as well. Changes in dietary vegetarianism and avoided meat or fish patterns have been characterised by a decline in the 25 products . Vegetarian diets, which provide consumption of traditional staple foods and crops, adequate levels of vegetables, fruits and fibre- alongside there is an increase of preference for animal rich grains, have been associated with a reduced protein30. Following economic growth among low 25 risk of oral, oesophageal, and breast cancers . income countries, an increase in the Gross Domestic Although carbohydrate content of traditional Product (GDP) is accompanied by changes in food diets was higher among Indo-Mauritians, meals consumption patterns31. And such patterns include a consisted of little fat and physical activity level rise in the consumption of food items, derived from was higher in terms of labour-intensive and animal sources, such as milk, cheese, animal fats, manual work. meat and meat products. Hence, it can be inferred that

(v) Use of spices and herbs: Spices and aromatic a similar scenario has occurred in Mauritius, vegetable products, such as certain parts of herbs following an increase in GDP as from the mid-1980s (seeds, leaves, barks, roots) were used to 26 and onwards. Even the staples eaten during breakfast, enhance taste and flavour in traditional diets . lunch and dinner have also considerably changed over While these spices such as ginger, turmeric, the past 10-15 yrs among Mauritians. Consumption of clove, cardamom, cumin seeds among others bread, rice, ‘roti’ made with flour is decreasing while have been known as home remedies for there is a high preference of highly processed foods, improving digestion, diarrhoea, sinus and colds, such as burgers, pizzas, French fries, chips, cakes, they are currently reported as chemo preventive biscuits and sweetened breakfast cereals. Such shifts agents having significant anti-oxidant and anti- 26, 27 in dietary habits are notable not only among Indo- inflammatory activities . Mauritians but as well as among South Asians

immigrants in Europe, such as those coming from Evolution of traditional diets and current dietary 32 practices India, Pakistan, Bangladesh and Sri Lanka . The last three decades have witnessed a In comparison to decades ago, homemade food has fundamental transformation of diets among essentially now become a rare commodity not only in Indo- all ethnic groups in Mauritius. At the beginning of Mauritian families, but among other ethnic groups as 1 this transformation was the agro-industrial revolution well . There has been a metamorphosis of the eating in developing countries which enabled people to practices among Mauritians, irrespective of age, produce and to consume increasingly sophisticated gender, ethnicity or social class. This is mainly due to food products5. Over the years, although Mauritius urbanisation which creates new and improved has succeeded in achieving a certain measure of marketing food strategies, attracts supermarkets and agricultural diversification in terms of crops like improves access to foreign suppliers in the overall food 5 beans, peas, potato, maize, tomato, onion, cabbage, supply . Consequently, there has been an increased cauliflower, brinjal, ginger, garlic, ladies finger, carrot reliance on fast foods due to busy work schedules of among others, a majority of foods including staples many Mauritians and less time for meal preparations. such as rice and cereals are still being imported2. In In addition, this has led to more frequent snacking in BHUROSY & JEEWON: TRADITIONAL FOOD HABITS IN MAURITIUS 359

between meals13. Although the literacy of the Mauritian decades, Mauritius has gone through an population has improved significantly over the years epidemiological transition in the profile of diseases. and many people are health-conscious, the majority of Maternal and child health problems have markedly places selling fast foods are usually overcrowded1. declined and are controlled more effectively than Interestingly, taking the example of India, eating out is decades back due to better healthcare programmes becoming more pervasive since eating out is a feature pertaining to immunization, ante and postnatal care38. not just of the urban living, but also of slums and rural However at present, non-communicable diseases areas34. While long ago, Mauritian school children and (NCDs) such as type 2 diabetes, obesity, high blood adolescents used to return home during lunch time to pressure, overweight and high blood lipid profile consume homemade meals consisting of rice, pulses or account for almost 85% of disease burden in the age grain with vegetables, nowadays, most children bring group 25 - 74 yrs9,38. In the past two generations, energy-dense packed lunches to school. A study chronic conditions like obesity have become a major conducted among Mauritian school children aged health problem and are believed to be associated with between 8-12 yrs old reported that most packed the easy availability of energy-dense foods and the lunches consisted of bread, eggs, sausages, red meat, rapid change from active to sedentary lifestyles. In poultry, burgers, ham and canned fish and with popular this section, trends in obesity condition will be snacks being salty corn-based ones, chocolates and discussed only as it is beyond the scope of this review sweets4. Similar trends have been observed in Kerala to cover all the other NCDs’ pattern in relation to diet (India) and in Nairobi (Kenya), respectively whereby and lifestyle. children spend more time watching television and reported increased caloric intake from fat, high sugar Obesity and refined cereal foods35,36. According to the World Health Organisation, The last 20 yrs have also witnessed a rise in the Mauritius is already at an advanced stage in its number of women in the Mauritian workforce due to the epidemiological transition whereby NCDs risk factors industrial revolution and emergence of the are on the rise, namely overweight/obesity (50.9%) manufacturing sector. The low percentage of women in due to urbanisation along with openness of the island the workforce in the late 1960s in Mauritius is consistent to the external world which has impacted on the with the idea that the predominant role of women was eating habits and overall lifestyle of Mauritians over that of a housewife and this occupation was typically time38. Recent studies indicate clearly that obesity is characterised by cooking, housecleaning, and childcare. on the rise among several target populations, namely, With the advent of the Export Processing Zone in among middle-aged, post-menopausal women, Mauritius in 1970s-1980s, there has been a surge in the adolescents and school children6, 39. Specifically, number of women in the Mauritian workforce37 and this the consequences of overweight and obesity are implies that the role of the homemaker, especially significant among Indo-Mauritians and African origin healthy meal preparation, has gradually decreased and as there is baseline evidence to suggest that as from nowadays, is very scarce. Along with that, technological childhood, people of these two ethnic groups are more advances in food preparation and the advent of insulin resistant than their white counterparts39. electronic appliances such as microwave ovens Moreover, in 2012, Mauritius had one of the highest and refrigerators might have revolutionised meal rates of type 2 diabetes and it is well-known that preparation, resulting in an increase in the consumption obesity is a major risk factor of impaired glucose of ready to eat and fast food which require minimal tolerance38. Similar findings of a high prevalence of preparation at home. Indeed, there have been notable obesity have been reported among distinct ethnic changes in the way food is cooked and stored, making groups, namely in American Indians40 and in British preparation of meals more convenient and less time South Asians41. Although the aetiology of obesity consuming, consequently reducing the workload of the is multi-factorial, factors such as genetics and working woman. environments are clearly determinants42, 43 and can be explained as follows: Health consequences of current dietary practices in Mauritius (i) Genetics: Historically, for many Indian tribes, Due to rapid industrialisation and significant as in the case of Indo-Mauritians, periods of improvements in living standards over the past plentiful food have been frequently alternated 360 INDIAN J TRADIT KNOWLE, VOL. 15, No. 3, JULY 2016

with periods of famine and it has been Recommendations and conclusions hypothesised that obesity results from the Eating habits of Indo-Mauritians and that of the introduction of a continuous and ample food general Mauritian population have changed over the supply to people who have developed, past 20 yrs. With regards to traditional staple foods, a through evolution, the ability to store energy decrease in intake has occurred alongside with higher efficiently and to survive through decades of consumption of refined carbohydrate-rich foods, feast-famine cycles44. This is known as the animal protein, processed meat and products while “thrifty gene” hypothesis which relates fruits and vegetables are consumed in less varieties obesity in certain ethnic groups to a thrifty and to a lesser extent. Consequently, these changes metabolism. have resulted in a higher intake of energy relative (ii) Environmental factors: Behavioural and to need, less fibre and low intake of micronutrients, lifestyle factors related to diet and physical phytochemicals and anti-oxidants which were activity levels are the major factors related to previously prominent in traditional food items. Other the rise in NCDs and their risk factors in the changes in food intake trends include increased intake Mauritian population. Indeed, statistics from of western franchised fast foods as well as local successive National NCD Surveys at 5-6 yrs energy-dense foods and snacks. intervals showed a rising trend in the The shift from traditional diets to the current prevalence of diabetes mellitus and hypertension westernised diet and lifestyle in Mauritius have brought over the period 1998-200938. This period about serious health concerns such as a rise in chronic corroborates with the point in history, namely conditions like obesity which are the main causes of post the 1970s, during which major macro- mortality and morbidity among Mauritians. While there level drivers such as economic growth, is unlikely one single solution to prevent and to market integration and foreign direct decrease the risk of nutrition-related NCDs, there is an investment produced radical changes in diet obvious need to identify strategies in order to promote and physical activity patterns. Contrarily to healthier choices in the Mauritian community. Most the past generations, the current one in importantly, nutrition education programs aiming to Mauritius follows a western dietary pattern promote the traditional diets of Mauritians should be characterised by a higher consumption of considered in light of the increasing scientific evidence palatable processed, high-sugar, high-salt available on the therapeutic and medicinal properties of foods, meat and fast foods39. traditional foods. Such an initiative has been fruitful in (iii) Socio-economic factors: In developing the Pohnpei Island whereby an intervention program countries as in Mauritius, food choice is resulted in a significant decrease in rice consumption, mainly dictated by its price. Globalisation of an increase in the consumption of local varieties of food markets, fast food chains, and the fruits and vegetables, and a positive attitude towards increasing availability of street vendors, local foods45. Hence, similar strategies need to be offers food at very competitive values, implemented among Mauritians since reviving the influence the eating habits of low socio- interest in the Mauritian traditional diet might be one of economic status (SES) people6. Differences in the solutions to tackle the rise in NCDs in Mauritius? diet quality arise as a result of higher SES individuals being able to purchase fresh, References 1 Suntoo R & Chittoo HB, Managing multi-ethnic Mauritius, nutrient-dense and better quality produce such Global J Hum Soc Sci, 12 (3) (2012) 33-42. as fresh fruits, vegetables, lean animal protein 2 Luximon Y & Nowbuth MD, A status of food security in sources such as fish which are sold at a higher Mauritius in face of climate change, Eur Water, 32 (2010) 3-14. price in grocery and convenience stores45. 3 The World Bank, Mauritius Overview, available at: Additionally, in Mauritius, food choices http://www.worldbank.org/en/country/mauritius/overview, (2014). among low SES individuals are influenced by 4 Aurisinkala-Appadoo S, Oogarah-Pratap B & Ruggoo A, 8 the price per weight of food products . Low Nutritional Status of School Children Aged 8-12 Years in fat protein items such as pulses, which cost Deprived Areas of Mauritius, Afr J Food Agric Nutr Dev, 13 less per weight, are the preferred choices of (4) (2013) 8077-8090. 5 Schmidhuber J & Shetty P, The nutrition transition to 2030 – low-income people. Why developing countries are likely to bear the major BHUROSY & JEEWON: TRADITIONAL FOOD HABITS IN MAURITIUS 361

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