A Way Forward?
Despite their important role in the diets of many people, street foods and beverages are commonly ignored in diet surveys at all levels—national, regional, local. Failure to take into account street food and beverage consumption reflects, in part, their great variety, but it ignores what is increasingly an important proportion of daily consumption. World-wide, these foods represent a significant proportion of aggregate annual incomes, and the percentage of labor forces involved in these micro-enterprises is sizeable. The U.S. Department of Agriculture (USDA 2006) reports that foods eaten outside the home—including street foods—tend to be fat-, cholesterol-, and sodium-dense with low fiber, vitamin, and mineral content, but the foods that are so characterized are not specified.
The conflation of street foods with fast foods implies the nutrient deficits of the latter, whereas careful observation of consumption and content, as outlined above, reveals numerous benefits of street foods. From an eco-nomic perspective, the street-food sector is complex and large and offers income-generating opportunities. Infrastructure, start-up and managing
costs, and training to the profession all are modest investments. Earnings can contribute to individual and family health via improved access to nutritionally diverse and pharmacologically active foods as well as in-come for health care and other resources.
Because of the enormous variety and complex mix of ingredients in street foods, it is difficult to say much about the nutrient potential of street foods. The few studies that have systematically documented street foods reveal their variety: more than two hundred items in Bogor, Indonesia, and in Iloilo, Philippines; more than three hundred in Ife-Ife, Nigeria, and in Chonburi, Thailand (Tinker 1997). One can generalize the cate-gory to highlight fresh ingredients prepared in relatively small batches;
additionally, the versatility of sources and preparations translates into nutrient diversity. The foods and beverages itemized for Greece, New York, and Mexico provide, particularly for lower-income people, good-quality animal protein; omega-3 and omega-6 fatty acids in fish and sea-food; a wide range of phytochemicals in vegetables and seasonings; anti-oxidants and vitamins in fruit and fruit juices; and significant sources of protein, energy, calcium, and fiber (Simopoulos and Bhat 2000). In Bogor, inexpensive meals provide almost 50 percent of daily protein and calorie needs and more than 50 percent of iron and vitamins A and C (Tinker 1997). Typically cuisines, or at least their central elements and food behaviors, are transported to new places; national cuisines histori-cally have been very stable. In the home, familiar foods offer comfort and continuity: ‘‘the immigrant’s refrigerator is the very last place to look for signs of assimilation’’ (Pollan 2006:295). Street foods that are marketed in mixed-ethnicity neighborhoods publicize and further cement identity in the diaspora. Indirectly, and immeasurably, this contributes to health through emotional well-being.
Risk Assessment
International, local governmental, and NGO entities concerned with the safety of street foods tend to focus on microbial and other contamination and perishability, on the theory that risk permeates open-air environ-ments, where potable water, refrigeration, refuse collection, and other in-frastructure might be inadequate. Common foodborne pathogens repre-sent a broad spectrum and include Escherichia coli, Salmonella, Listeria,
hepatitis A, Shigella, Staphylococcus, Clostridium botulinum, and Bacil-lus cereus (FDA 2007). In many cases, outbreaks of acute gastrointestinal disorders attributed to public foods have not been investigated with suffi-cient epidemiological rigor to identify the source of microorganism infec-tion (e.g., Mensah et al. 2002). In fact, research demonstrates that, despite theoretical risk, the incidence of street food contamination is low—not higher than in restaurant foods (Tinker 1997; Umoh and Odoba 1999;
Simopoulos and Bhat 2000). Studies that report contamination by listing the microorganisms isolated from foods or their places of preparation and sale leave out the important datum of contaminant titers, including what levels of particular microorganisms are tolerable. In other words, the very presence of pathogenic microorganisms does not necessarily constitute risk. Regulation thresholds established by the Food and Drug Administra-tion and analogous entities elsewhere vary and should be established in species- and context-specific circumstances rather than painting all street foods with the same brush of contamination. For example, Cardinale and colleagues (2005) tested street-vending sites and foods in Dakar, Senegal, and reported that 20 percent of 148 sites and 10 percent of the poultry dishes sampled contained Salmonella species, one of the most common causes worldwide of gastrointestinal disorders. Given its prevalence, the presence of Salmonella does not surprise, but the authors have not estab-lished relative titers of the microorganism or levels of risk.
The safety of street foods is supported by anecdotal accounts and the experiences of seasoned travelers, anthropologists, and others who con-duct research in urban and remote field settings. Fearless eaters stress that it is typically easier to monitor the preparation and further handling of street foods and beverages than their restaurant counterparts. The as-sumption that developing world peoples know less about food and bev-erage spoilage is illogical; a lack of refrigeration, expensive cooking fuels, and inadequate water supplies all contribute to high vigilance of some-thing so critical to well-being as food and drink. In small communities, it is generally common knowledge whose food handling does not conform to local understandings of hygiene, which in most locations are very similar to those in the West. Reputation goes a long distance in influenc-ing which vendors will continue to have a clientele. A general strategy to apply in selecting food vendors is to patronize establishments that are popular among locals, where turnover is rapid, and where one can
observe how foods and beverages are handled. There is an unsubstanti-ated assumption that in the developing world, street foods are a relatively new phenomenon, an artifact of urbanization that contributes to poor knowledge of food safety. To the contrary, as the Hausa example illus-trates, rural peoples have their own versions of street comestibles; more-over, rural and urban populations both have centuries of experience with the proper handling of foods and beverages, street and otherwise. Public foods are a vibrant, not ephemeral, sector of local economies. Further, regulatory entities have not paid much attention to what specifically is contained in these diverse foods and beverages, how they are prepared and stored, and their nutrient value and pharmacologic potential. It is not productive to generalize this category out of context.
Fortification
Food fortification is a common means of uniformly and inexpensively delivering micronutrients (e.g., iron, iodine, vitamins) to target and to general populations; it has been used successfully in developed and de-veloping countries to improve health from both preventive and thera-peutic perspectives. Street foods have not been included among the many items that serve as vehicles for fortification, however. Beginning a decade ago, many health and nutrition entities seized on the importance of street foods to consider them as vehicles for nutrient fortification. The rationale is that these foods are available, inexpensive, integral to diet, and con-sumed regularly across all social strata, especially by lower-income indi-viduals, including children (Green et al. 2005; Haas and Miller 2006).
Recommendations include programs that would identify commonly consumed street foods in culture-specific contexts and consider fortifica-tion according to a denotafortifica-tion that conflates the United Nafortifica-tions Food and Agriculture Organization’s (FAO) definitions of ‘‘fortification’’ (adding a nutrient to a food item that does not ordinarily contain that nutrient) with
‘‘supplementation’’ (increasing the amount of a nutrient to a significant level) (FAO 2007). Fortification may be ingredient- or food-based. The feasibility of fortifying public foods is challenged by the complexity of street food sectors, their variable cultural constructions, and the diversity of street foods and beverages in any given location. Note that these proposed fortifications apply across a spectrum of food and beverage categories,
which contrasts with the U.S. government- and industry-supported for-tification of milk (see chapter 1, section on lactose intolerance).
An exception to the received wisdom on the importance and safety of street foods is the work of Tinker (1997:3), who founded the Equity Policy Center (EPOC), a think tank based in Washington, D.C., to study im-proving street vendors’ incomes and the safety of their products, with a special focus on the asymmetrical impact of development on women.
EPOC studies have influenced the FAO to conduct its own research on street foods, to stand back from earlier efforts to enforce ‘‘unrealistically high food safety standards’’ (Tinker 1997:4) for street vendors, and to document the trade and identify the most serious health issues that might be addressed by municipal governments. EPOC and FAO studies con-tribute to our understanding of (micro)regional variations in street foods and beverages and emphasize how important for these microenterprises is the role of water in both preventing contamination and spreading disease (see chapter 5). An important practical outcome of EPOC’s work is insight into how vendors’ and government efforts can intersect, includ-ing the establishment of street food vendors’ associations.
Conclusion
How shall we better understand street foods and beverages from the per-spectives of their physiologic implications, cultural constructions, and meaning-generating contributions to cuisines? Inattention and generaliz-ing have not been instructive. More-systematic and otherwise rigorous research might explore, from very local perspectives, the physiologic, demographic, and economic implications of public food vending and consumption. How do these foods influence diet quality, and how do they impact the larger context of cuisine and health? To what extent, and to what specific end, should public foods be regulated? How practical are suggestions that these foods be fortified or otherwise serve as vehicles for improving diet diversity and nutritional health? Much research remains to be conducted on these important everyday elements of diet in the developed and developing world.