,....------------------ Nutritional analysis of foodlmedicinal plants used by Haitian women to treat the syn.ptoms anemia By Johanne Jean-Baptiste School of Dietetics and Human Nutrition Macdonald Campus of McGill University, • Montreal, Quebec . March,1994 A Thesis submitted to the Faculty of Graduate Studies and Research in partial fulf1Jlment of the requirements for the degree of Master of Science. • © Johanne Jean-Baptiste, 1994 -;SortfllNlIlE 'SEf)tJ- BftPTÔTé. Nome Dissertaftofi Abslrads Infernatlono/ls orronged by brood, general sublect categories t'Iease select the one sublect which most neorly descnbes the content 01 your dissertation Ent~r the correspondmg four-digit code ln the spaces provlded NU 1r1/11 ON [ols 1 ~ 101 U·M-I SUBJECT TERM SUBJECT coo~ Subject Categories THI HUMANI"ES AND SOCIA'.. SCIENCES COMMUNICATIONS AND THE ARoTSn 9 Plyrhdogy 0525 PHILOSOPHY, RELIGION AND Anc,ent 0579 A,dllhff IUrf RI)(J(!,ng 0535 THEOLOGY Medieval 0581 (AUrlNlflllr"JI ,,'t 00397070 PS(ellp,rgK,(o>u~, 00751247 PRhelrllCojs!oonp hy 0422 MBloadcek rn 00352882 IrDJnUOuIlO(tn'J lt'Am'f.~H ftIJI Ip1\ t(r)lf I t"}f IPrlt f' (000n373972')1837 SS~'ope0CCoctluUoo~on lldS oCagy!r ye 0 n1c cs 0000553531423409 CHBC",llSbeenltr'ogcerroyyol l0 S1t ud,~s 0000333321121890 ACAEusafnr,noacap,ad enA,aa unns lralra and Oceanra 0000333333331~45 IIIHmy rJ~IP'lfP 0399 fead'N T rOlnlng 0530 Philosophy 01 0322 latin Amerrcan 0336 Mm\ (()"HlIIHJI((Jllml~ 0108 TechnolJ9~ 0710 ïher.lvgy 0469 Middle Eastprn 0333 McfUfl"f,I.(r Il ( OITUTlt/lll(otlon (0M.11Y Il VL,,o~tcs ontlno nal easuremcnt5 00278487 SOCIAL SCIENCES HlStUonryi te01d SSc tlaetnecs e 00538357 E11Df1UoCt,.A, TION O>16'i LLAlNNGGUUISATGICES, lITERATURE AND AAnmtehArrrolel:phaoonel oSo9loukdg, eys 00332234 PLaowl,G t,ceanl eSrCaile nce 00369185 (AAIAAl;,ldd,lf'IillIlu ll'"'1ll)llw"'l JHlff( "J'H.l1I,lI r, !r' J,J l,t, ir1(tf .J!oI l1Mll HuIIhJ"lI l,Q," u, 01 O0000025755S11811I342675 llilpOrM"Alo'r~tnolu~Hr8dnrlpcueeerl nrs 0ntt1l r s 0000262297891990 BusGCABPinh:oueecynlnsotsskueur lrcrAnnaaagrtllll; n mgm l5trotlon 00000733327221706702 RSSoeoccc1Pirlnaoe ultal RebotWrelIgro nlcycana rtA hlkoo dnnmla ll nL"atrwo liaonnd 0000866411154672 Cl1IOho Jurr"rl"1ylrlf Il'((l~lu "Wh)l u,lIlmdtyl tu(" n"(,dJJ!l r I mq<l'r uc tlon 00o0.67'n>8717858 M(GCIomeerndn<pei.elorcvnrooal ltl 1 vc 0000422209991457 CEcaonMMnaoaadmnr,oklaCcngsle l Snmlgued ,ncls 000334385854 GCEDrteehrnmnmerl"crnga oarlanl apo ~.l ,oa cn 1d01 PSetundo,leosg y 0000669632321687 (1I,I1tI mU01IIIW"l1If'H'''1 e''' Y(I lld ( o\Hl'""I, nu O00552U1>91! MAArIon"dcceorl.nrno n 000523991186 GCAgoermnrcemurelatUrlc iea l BUSiness 000555000135 1In" ddS'uvtu.ltddr,ureaasl la anndd LFaabmolrl y 0028 I1IIl1q·l"thelr, 0061R450 CA!o,IrO,qf)d ,,,n IlngllSh) 00330552 HFi"ntaon,cye 00550089 PuRbelrlca tiaonnds SoclOi Welfare 00662390 1HIO11l11lP0 0ryC ,,1O flOJlli( ~ 00757780 CEnOglllrosdhi on french) 00539535 TLaheboorry 00551110 SoDceiovie lSotprumcetunret and 07C:J I1n{]t'lI"~,ltJ"l,l,1q( und (11('wh. . !f" 00~72719 Glactrmrn OAf.l"leCl lcon 00331i 12 Gro elkolgorroep hy 00335686 TranTshpeoortraytr coond Methods 00374049 MoIU-f1ltJIH.., 0280 Middle Emlern 0315 Gerontology 0351 Urban and Rdi,onal Planning 0999 MU\lr 0572 Romance 0313 HlStory Women's Stu le. 0453 Phll"'''phy ,,1 0998 SlavlC and Eml European 0314 Gem'rol 0578 Phy,.',,1 0571 IHE SCIENCES AND ENGINEERING IIOLOGICAL SCIENCES Geodmy 0370 Speech Pathology 0460 Englneerrn~ Aqllllllt\Jff' Geology 0372 TO><leology 0383 Genera 0537 ln·l1('r\.ll 0411 Gcophy"c. 0373 Home Economlcs 0386 AerosRace 0538 Aq,onomy 0785 ~drology 0388 Agrlcultural 0539 An"",,1 (ult,,"·nnd rncmlogy 0411 PHYSICAl SCIENCES Automolrve 0540 AIrrl'Onll n""NTo"nnIpud,!tl<,·h ,,.~PS1.ht Irttfn" WlyPIlolltl'lnI'ill"n(lllll)l" lnU(rl y'oqI W louy' nlYlldd. l,l" 000O0034144M.77'71J>O~8699 PPPPPPPohhoannlyyllleeclS~Syooooilcccnznbo'cloloollo ootlOllolomoCnoC~g<9y('y', ylY o l gl'oogprlwc, ,)hy 0000000344934441861225858567 CPuhlr'GAABmegn ,eloSSronldCclteyriieuyertlam lnclulca lrsela lsrl t 0000474484885967 CHBCIHEnlih,yeedo,edc,umoitmrIsrtae ot lraudncrnlilaaCcldclla s Tl ahnerdm Eodle)c'ntrarcmallc s 0000000555355544444441238456 0llJ'0n1llCt~V1MMlRMWBRAlN/llolR 'lr~'H(l~\"llI,''glt".nfn1 '"n'o'tl,lo1"l'1" OIl'I""H,y".ll t.l",I"nI1lld f1thkI1"l lu, hO~llH1.tl{.,hl'tt''J',,.,1'"n<1x,1'. r JL,.t.IIhrr{.1 1~)tl,.fy'!lW;~1 llH1ll,l"IIoI' l '' 1lhl1 'Ilvlll\l'. 'lM1.llitll<YI l.~ty 1' ,plt'l;l l'l]ll"',I I'rqllI Yl\,r l O 1,hv\ H(' ,~ Y (nIll!'1'{ll'"l j lIyll'Y,' Ix1hT .I1Yt'P llt 0OOoO000000000O000000lr:111'723734477344RR 'Cll1l10O 6J885901377217I2~<<- t1O8''097137638t790:.>>.'. ,' HHESCnE"vA,IEOMMCOOG1DHHNNPPP,fAlL"dlN"oClihL"huuUuOTepbp,1,TnuraC n'lcHetdlmnnohIslSlhh"c',rrlE'usp mumtl ,ItntCtto,lno.oSptLmf"oAlh'l''e1,lrtl'r'lOot oleOnilooto°loonNuron gorntlfg nyCltrHll llrWDcD C oo o"nolyy Me,le jlq Pole n a o r EoanylvanISago nlpcN dClnlgy"d ly l oVayc H SnpG I[Rceluretny.aO,'r-eg:nnl"Ntle1 hfe'Mtnr cyCtE o lnNclTj YA L 000000000000000000035179535373519534558765865606468965171188244760979027092 0- MSPhlaaytlGOOArAAAsNRREEPPMNPIShFns,eh lhollrccloacouteu'puee":omAlHghmso ;oelfddlrcncrsttcyeTSr rcranrsluI,t'otlaedmnmoC! o acI?rer en0Cessctr tlro'ueIrvonel,lullSalrnopa~lC oo l"ilcc"l,rctharllla CE a rdnc cln' l. retrn ' t u, vy,·n reS t ' rciirorParcg cnsnSyosodm ljCr tEolice llneeccset n acnl X 0000000000000000000000<4647446746967777467661910839950080495560501911A8845455068826379900 GGOEPBDPPlCTPneS lhxeeeelpeorxgyYovrhunesnMMMMMNPPstSSseetCrostlr'eoell?lreaylaecaoeuatevaHolrrnaCrnstcs mtl'entatpcrrroOoialteo Tkohroa rhem llSeITrlnoLr enlneltlnlamoelratn,c ugecOogyeaacsunlrcth nllr yoo Glo n 'mlhSgsn cRt llggana CY oyo eySl onl i loe s dlConge igcyoMeey rn c uchne icipal 0000000000000000000000567557557574779366666952454944659299982222281112748954086544234509 EUTH SCIENCES PPlhi bIs,lcc oHl l'OI"llh"o py 00537832 Applied 5<iences PPs.yye-hhoombleotlnocgsy 00633429 8l,.r.'o:"'''-1th'(t'' lhnt'''f'Il1tItY\t r'\ 0u4QQ2~5 RR(c'C'dr'eoolotJgoyn 00557745 CApopmllpeu-dte Mr f~,CcIh€o'nnclce s 00938446 SOCIO\ C045i1' Short Title ofM.Sc Thesis of JohaImc Jean-Baptiste School ofDietctics and l luman Nutntion, Macdonald College of McGiIl Ur!.1versity March, 1994 Analysis of plants used by Haitian women to treat anemia ü • ABSTRACT Ethnobotanical and dietary questiollnaires weœ used to éllSsesS the utilization of plant~ 10 treat the signs and symptoms of anemia by women in La Cha]pclle. Haiti. The usual diet of the respondents was found to tx! low to intermediate in iron bioavailahility. "l1te ethnobotanical questionnaire showed that most respondents (82%) used plant-based home rernedies to treat anernia. Amaramhus dubius. Citrus aurantium, Corchorus olilOr;us, Moringa oleifera, Phaseolus vulgaris and Portu/aca oleracea used in the diet and as rernedies for anemia were analyz.ed. Amaranthus dubius was found to have the highcst iron availability by in-vitro dialysis, 30%. The intra species variation in iron availabilily was influenced by st orage and cooking times. The interspecies variation in iron availabilily was t'xplained by the acidity of the plant species' cooked homogenatc (r=O.4168, • p=O.007) . • iii RÉSUMÉ Des questionnaires ethnobowliqul!s et diététiques furent administrés pour évaluer l'utilisation de plantes pour traiter h~s symptômes de l'anémie par les femmes de La Chapelle, Haïti. L'enquête diététique révéla que la diète des répondantes est faible à moyenne en fer bio-disponible. Le que,stionnaire ethnobotanique démontra que la majorité (82%) des répondantes utilisaient des remède-maisons à base de plantes pour traiter les symptômes de l'anémie. Les plantes Amaran.rhus dubiuS', Citrus aurallt;um, Corchol'us olitorius, Moringa oleifàa, Phaçeo!u.5 vulga.ris et Portu/aca o/eracea utn;~es dans la di~te et comme remèdes contre l'anémie furcnt analysées. Le plus haut taux de biodisponibilié du fer, par dialyse, fut trouvé chez Amaranthus dubius (30%). La variation intra-spécicllc en bio-disponibilité du fcr fut trouvé dépendante du temps d' entreposage et de cuisson; celle intcr-spëciellc, de l'ac:idité de l'espèce végétale cuite (r=O.4168, p=O.OO7) . • iv ACKNOWLEDGMENTS More people than is possible to mention have contributed to the completion of my study. 1 would like to thank flfst the School of Dietetics and Human Nutrition and my supervisor Dr. T. Johns for accepting me as a Masters Student; Mrs. M. L. Rouzier whose articles inspired me to pursue research in the field of nutritional ethnobotany in Haiti; the ",,,men of La Chapelle who se knowledge and wisdom gave substance to my thesis. 1 must thank my supervisory committee Di. T. Johns, Dr. H. V. Kuhnlein and Dr. A. Rohjani for advising me and for giving me the freedom to define and pcrsonalizc my research project. For fmancial assistance, 1 lhank the Canadian Society for International Hcalth and my supervisor Dr. T. Johns. • an 1 want to thank aIso the students in Canada and Jarnaica who have helped, supported, advised and encouraged me from the literature review, projcct claboration, proposaI, laboratory work, analysis of results right through to the thesis writing. 1 must name in particular Dr. Sarah Booth, Mrs. Febronia Viso, Dr. A. Adish, Mr. Josephus Cline, Ms. A. Onyango. Jamal, Jaffar, Nicholas Urbani, Alvin Holder and Harold Jcan Baptiste . • v TABLB OF CONTENTS Ahstracl. ... ..... ... .. ... ............ . ...................................................................................................... ii Résumé ............................................................................................................................................. iii Acknowledgrnent.<. .............................................................................................................................. iv Table of Contents ............................................................................................................................... v I. Intr(j{fucuon ...................................................................................................................................... 1 Il. Lilcrature review ............................................................................................................................. 3 II A. Selected background on Haiti ......................................................................................... 3 Il.B. Concepts of anemia in Haiti ........................................................................................... 4 II.C. Etbnobotany of green leafy vegetables ............................................................................ 5 II D. Dlet and nutntional anemias ........................................................................................ 10 Il.IJ.I. Bioavrulablhty of dietary iron ....................................................................... 10 Il D.2. Dctenninants of iron availability ................................................................... 15 n.D.3. Dietary folatc ................................................................................................. 22 Il D.4 Folate avrulabihty ......................................................................................... 22 • II.E. Nutritional ancmia as a public bealth problem ................................................................ 23 H.F. Summary .................................................................................................................... 24 III. DeSign and metllodology ................................................................................................................ 26 lItA. RationaJe for the project ................................................................................................ 26 III B. Statement of purpose .................................................................................................... 27 I!I C. ObjeclJvcs ..................................................................................................................... 27 III.D. Hypotheses ....... , ........................................................................................................... 29 III E Overview of study design .............................................................................................. 29 Ill.F. Summary ofstudy phases .............................................................................................. 30 III.G. field study ..................................................................................................................... 30 III.G .1. Siudy area ................................................................................................... 30 III.G.2. Sarnphng ..................................................................................................... 32 III.G.3. Dletary intake questionnaire ......................................................................... 33 III.G.4. Eth lobotanical questionnaire ....................................................................... 34 I1I.H. Plants analyses .............................................................................................................. 35 III.H.l. Drying procedures ....................................................................................... 36 III.H .2. Moisture content .......................................................................................... 36 • III.H.3. Iron content ................................................................................................. 36 HI.H.4. Iron Avrulability ........................................................................................... 36 III.H.5. Measurement of iron by coJorimetry ............................................................. 38 VI m.H 6. Measurernenl of Vltamin C ..... . ...3~ III.H.7. Measurerncnt of CllriC ACld .. .. . .............. 40 nI H.8. Fiber content.. .... . ..... . ................ ....................... .. ............. 40 III.H.9. Measuremenl ot Tannms....... ................ ...... ................... ...... .. ....... 40 III.H 10. Measuremenl of Pbytales ...................................................................... 41 IIL!. StaUstical analyslS. ................ ........... ..... .................................... .., ................ 42 IV. Results and discu!lsion ........................................................................................................... 43 IV.A. Comparability of the groups sampIed............................................... . ................... 43 IV.A.!. Discussion ............................................................................................... 44 IV.B. Dietary survey ........................................................................................................... 45 IV.B.L Discu!.sion ............................................................................................. 48 IV.C. EtbnobotanicaI survey ............................................................................................. 49 IV C.I. Prevalence ofùInesses ................................................................................ 49 IV.C.2 Symptomalology ....................................................... '" .. , . . ........... 49 IV.C 3. Etiology .................... .................................................. .. ..... " ............... 50 • IV. C 4. Resources of treaunent ........................... ............... ............ ................ ... . . 50 IV.C.S Sources of treatnlent..................... .............................. ...................... ..... 52 IV .C.6. Home remedies ............ ............... ................. ........................ . ................. 53 IV.C.7. Cost ofremedies ..................................................................................... 58 IV.C.S Diellfood and trcabllent ofFcblès ............................................................... 58 IV.C.9. Comparison Wlth Icaf doctors .................................................................. 59 IV.C.lO. Discussion ............................................................................................ 59 IV.D. Plant analyses ......................................................................................................... fil IV.D.1. Iron Content and Iron Dialysability ........................................................... 61 IV.D.2. Ascorbate and Citrate Content ................................................................... 66 IV.D.3. Fiber, Tannins and Phytates content.. ......................................................... 67 IV.D.4. Discussion .................................................................................................. 68 V. General discussion and conclusions .............................................................................................. 70 References ......................................................................................................................................... 78 • vit on LIst able:> Tahle III: Rc.,ult of mm supplcmcntation tnal. .... . .............. ............ ................ .. .................... 7 Tahlc I12 Nulnenl valuc" ofsclected plant:> ................................................................................ 9 Table II 3. Recommcnded uon mtake mg/day .................................................................................. 12 Tahle Il 4 Intcraction of vltamm C, phytates and tannins in iron abwrption ...................................... 20 Tahlc IV 1 Sclccled rC'ipondcnls vanablc~ by ruraJlty ....................................................................... 43 Tahle IV 2 OccupatIOn of rcspondcnts by rurabty ............................................................................... 43 Tahlc IV.3 F<xKl" catcn by thc rc<;pondcnLS .................................................................................. 46 Tahlc IV 4 SymplOm\ of anernia dcscnbcd by respondcnts ................................................................ 49 Tahlc IV 5 Plant spccles most commonly used to treat the symptoms of anemia. ................................. 55 Tahlc IV 6 Iron analyses uf plant SpeclCS . ..... .. .......................................................................... 62 Tahle IV 7 Dlffcrence., m aCldlty of the plant specics ....................................................................... 65 Tablc IV 8 A .,corblc and CltrtC aCld analyses .................................................................................... 66 Tahle IV 9 M()J:>lurc, Flbcr, Phyt.lte and Tannin analyses .................................................................. 67 Viii ListofF~ Figure Ill: Erfeet of pH and ascorbate on 1I"0n solubllity ...... . . .17 Figure II.2: Competition between ascorblC and phyllc acid .. . 21 Figur-= HU: Conceptual framework of the study .. '" ........... . . .. . . .. 2S Figure IV l' Resources for the treaunent of ancmlC symptoms ....... ... . . .. .. ...... 51 Figure IV.2: Resource for the trealfficnt of Feblès.. .. ..... ........... .. ................ . .. ...... 51 fIgure IV.3. Sources of remedles for the treatrnent of anemlC symptoms ...... .. .... . .. ............ 52 Figure IV 4: Sources of treatrnent for Feblès ................................ '" ........... .. ........... 52 Figure IV.5: Types ofhorne rernedies: .............................................................. .. 53 fIgure IV 6 Sununary of vaIue of plant SpeCles ...... .............. ......... ...... ..... .. ...... .. . ........ 54 Figure IV 7: Plants use.d to treal the symploms of anemla per Illncss tenn . .. .. 56 Figure IV 8: Effe::::t of storage ume on iron dlalysability... .... ........... . ................. .. .. 63 Figure IV.9. Erfect of cooking tilne on tron dlalysability ........................................ . ..64 fIgure IV 10: Effeet of aCldlty on iron dtalysabihty ....... .......... ........... ...... .... ... .. .65 •
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