Beyond pickles and ice cream: A biocultural investigation of pregnancy diet in South India

Leading evolutionary theories of women's diet in pregnancy postulate that unusual changes in diet occur as a response to increased risk of toxin and/or pathogen exposure (coined the "maternal-fetal protection" hypothesis). Women are therefore hypothesized to experience aversions to meat and vegetables, and experience cravings for nutrient-rich, high-calorie foods. Tests of these hypotheses, however, have been limited to industrialized societies with adequate food supply and low pathogen burden. The aim of this dissertation, therefore, was to test classic theories of the maternal-fetal protection hypothesis against others hypotheses of dietary shifts in pregnancy.;Research was conducted with non-pregnant (n=54) and pregnant (n=197) women in two states located in South India: Tamil Nadu and Karnataka. Semi-structured interviews were conducted with non-pregnant women regarding the cultural norms of diet in pregnancy. Pregnant women completed structured interviews and were asked to provide anthropometric measures. The structured interviews included self-reported cravings, aversions, and social avoidances, as well as markers for pathogen and toxin avoidance, psychological distress, resource scarcity, and demographics.;Findings revealed that cultural norms of diet in pregnancy, such as humoral theory, largely shaped the repertoire of dietary patterns among women and seemingly function to protect the woman and fetus from harm. Women in Tamil Nadu reported cravings and consumption of uncooked rice (amylophagy), which was strongly associated with indices of pathogen exposure; pica, which were linked to resource scarcity; cravings and aversions to humoral food items, which the latter were correlated with psychological distress; and meat aversions, which were correlated with pathogen exposure. Women reported "social learning" as the means by which they acquired most dietary preferences. In Karnataka, women reported aversions to staple food items and avoidances for high-quality items, such as fruits and nuts/seeds/legumes. This study revealed that aversions and avoidances are separate systems to protect the fetus and mother, and that the information was acquired by genetically-invested individuals (e.g. mothers, mothers-in-law, and grandmothers).;Overall, findings from these studies show a more complex picture of dietary preferences in pregnancy and point to the importance of using an interdisciplinary perspective when assessing women's dietary choices.