Fifteen years of change in the food environment in a rural Mexican community: the Maycoba project.
Indigenous populations worldwide who are shifting to a westernized lifestyle experience high rates of type 2 diabetes and obesity. These conditions are commonly the result of genetic predisposition and environmental factors that promote excess energy intake and decreased energy expenditure. The purpose of this study was to examine changes in the food environment, specifically looking at retail and subsistence-food availability, and food-acquisition behaviors in the rural Mexican town of Maycoba and surrounding communities between 1995 and 2010. The population in this area includes indigenous Pima, genetically-related to the Pima Indians in Arizona who have the highest documented rates of diabetes, and non-Pima Mexican (ie non indigenous and other indigenous). An initial study in 1995 compared the prevalence of diabetes and obesity in the Maycoba population with that of Pima Indians of Arizona and found a dramatically lower type 2 diabetes prevalence in the Maycoba region due to the protective effect of a traditional lifestyle despite a genetic predisposition to diabetes. The 2010 follow-up study was undertaken to determine the prevalence of obesity and type 2 diabetes as well as to examine lifestyle changes over the 15 year time span, following changes to housing and the local environment. This study focused on the food environment, examining changes in food acquisition behaviors in the retail and subsistence aspects. The study included a household survey (n=71), two focus group discussions, and participant-observation. To determine changes in retail food availability, seven stores throughout the study region were audited. The main findings were an increasing presence and use of retail stores for food: an expansion in the selection of processed foods, their prominent placement, and refrigeration allowing more perishable foods to be available to the local population. Subsistence activities remained significant, although some aspects of specific subsistence activities are in decline, such as the area allocated to home gardens and a reduction in the variety of crops cultivated in them. Although there have been a number of changes in the food environment during the 15 year period, a traditional subsistence-based lifestyle prevails.