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Malnutrition is an unfortunate, but extremely prevalent epidemic in Guatemala. Causes
of the epidemic include a lack of economic, environmental, and agricultural resources, as
well as lack of nutrition-related education1. In order to prevent malnutrition from
occurring in the growing Guatemalan population in the United States, health care
professionals should be aware of their patients cultural practices and traditions. It is also
important to be conscious of each patients educational ability, which is currently lower
than the overall Hispanic populations ability2. The cultural competence of dietitians will
allow for the provision of individualized care and tailored nutrition-related education for
each patient, resulting in the best possible health outcomes.

Traditional Dishes
There is no official Guatemalan national
dish. However, there are many foods that
are popular and easily found all over
Guatemala, as well as in the USA.
Pepian: thick stew made with meat,
vegetables, and spices
Chiles rellenos: chili peppers with a Traditional Meal Patterns
variety of stuffing, including rice or
Guatemalan culture and cuisine have
strong Mayan and European influences,
Chicken pepian: chicken in a spicy which depend on the region. Most
sesame and pumpkin sauce Guatemalans consume three meals per
Kakik: turkey soup with spices day, and the content of their diet varies
Beans: red or black, served either between regions. Two staple foods in both
refried or mixed with rice rural and urban populations are corn and
beans. Guatemalans in rural regions tend
Licuado: milk mixed with sweetened
to suffer from higher poverty rates, forcing
fruit juice5 them to rely heavily on corn and beans3.
These individuals have minimal
consumption of animal proteins, fruits,
and vegetables. Malnutrition in urban
areas tends to manifest itself as obesity4.
High saturated fat consumption from
animal products and unhealthy cooking
methods contribute to the high rate of
obesity. Urban Guatemalans also consume
high carbohydrate beverages, such as
licuado or sugar-loaded coffee with milk3.
Health Beliefs and Practices
Leading causes of death include respiratory infections, heart disease, diabetes,
HIV/AIDS, stroke, diarrheal disease, liver cirrhosis, and malnutrition6.
Folk explanations and cures for diseases are common among the less educated and
include; herbal remedies, dietary adjustments, magical formulas, and prayers.
Shamans are believed to be healers and practice herbal medicine.
The majority of the population is Catholic or Protestant, but Mayan spirituality plays a
big role throughout their culture7.
Occupation is the most significant contributor to physical activity. Overall, activity is
low with 35% of men and 5% of women participating in sports and exercise 8.

Barriers to Good Nutrition Communication Guidelines

Traditional Guatemalan ingredients Include father in nutrition related
may be hard to find in the USA discussions. Fathers make all the food
Only 30% of Guatemalans in the decisions for the entire family.
USA have completed high school and Include the mother-in-law in discussions
less than 5% graduated college. regarding breastfeeding and
This low socioeconomic status is introduction of complementary foods
associated with increased weight and Mother-in-laws play a large role in
low physical activity among couples lives when they have a baby.
Hispanics in the USA. Be respectful of traditional religious
As they acculturate, Hispanics tend practices including hot and cold foods,
to adopt a typical high fat and calorie and the use of Shamans11.
American diet15. Be prepared with a translator. Many
Guatemalans speak Spanish while many
others speak different dialects.
Keep everything simple, easy to
understand, and memorable. Maintain a
low literacy rate.
Make recommendations specific, and
easy to understand. For example,
portion of meat is size of the palm12.

Nutrition Counseling Considerations

Increase intake of nutrient dense foods including fruits, vegetables, and whole grains to
prevent micronutrient deficiencies13.
Stick to whole or mashed beans in place of refried.
Replace saturated fats like lard with unsaturated fats like olive oil to decrease
saturated fat and cholesterol intake14.
Consume foods with complementary amino acid profiles (i.e. beans with rice or tortillas)
to increase overall protein intake.
Educate individuals on the importance of preventing health conditions as opposed to
treating them once they have set in11.

1. Guatemala. Food and Agriculture Organization of the United Nations Web site, Published 2010. Accessed November 10,
2. Brown A, Patten E. Hispanics of Guatemalan Origin in the United States. Pew Research
united-states-2011/. Accessed on October 25, 2016.
3. Guatemala. Food in Every Country.
japan/guatemala.html. Accessed October 20, 2016.
4. Adoption Nutrition: Guatemala. SPOON Foundation website. Accessed on
October 25, 2016.
5. Traditional guatemalan food and drink. About, Inc. Accessed
October 20, 2016.
6. Guatemala. WHO Statistcal Profile. World Health Organization. Updated January 2015. Accessed October
18, 2016.
7. Culture of Guatemala. Countries and their Cultures.
It/Guatemala.html. Published 2016. Accessed October 18, 2016.
8. Stein AD, Gregory CO, Hoddinott J, Martorell R, Ramakrishnan U, Ramirez-Zea M.
Physical activity level, dietary habits, and alcohol and tobacco use among young
Guatemalan adults. Food and Nutrition Bulletin. 2005; 26(2): 78-87.
9. Country Cooperation Strategy: Guatemala. World Health Organization. Updated May
2015. Accessed October 18, 2015.
10. Petrovick T. Five Reasons Why the Guatemalan Health System is in Deep Crisis. Mayan
Families. Published February 2, 2016.
Accessed October 18, 2016.
11. Overarching Communication Strategy for Programs in Family Planning, Maternal Child
Health, Nutrition, HIV/AIDS & Education in Guatemalan Western Highlands. C-Change.
Guatemala.pdf. Accessed October 10, 2016.
12. Guatemala. Infoplease. Accessed
October 10, 2016.
13. Guatemalans. Countries and their Cultures.
Jamaica/Guatemalans.html. Accessed October 10, 2016.
14. Diet of Central Americans and Mexicans.
Americans-and-Mexicans-Diets-of.html. Accessed February 15. 2017.
15. Morales LS, Lara M, Kingston RS, Valdez RO, Escarce JJ. Socioeconomic, cultural, and
behavioral factors affecting Hispanic health outcomes. J Healthcare Poor Undeserved.
2002; 13(4): 477-503. doi: 10.1177/104920802237532.