Intercultural communication in assessing dietary habits: Liberia as an example

Nutritionists in both clinical and field settings often work with populations whose cultures and languages differ from their own. Therefore, intercultural communication skills are often needed. This article presents a method used to collect dietary data for 125 children under 26 months old living in Liberia. The method was designed to reduce intercultural communication errors during collection of dietary data by avoiding terms directly related to the English language words "food" or "to eat," and by replacing such terms with words or phrases with a more general meaning, for example, "thing" for food or "had" for eat. By using this method the following results were obtained: mean age for introducing non-breast-milk foods to infants, 1.9 months (no. = 113, standard deviation [SD] = 2.1 months); mean age for introducing milk-based foods, 1.5 months (no. = 74, SD = 1.6 months); and mean age for introducing non-milk foods, 2.9 months (no. = 110, SD = 2.5 months). These ages are 2 to 4 months earlier than those determined in two previous studies conducted in Liberia. The difference is probably attributable to incongruity between the interviewer's and interviewee's definitions of words. The resultant impact on feeding recommendations because of differences in data and, therefore, in conclusions, demonstrates that accuracy of dietary data at the individual level may be critical for epidemiological studies. The method of using more general terms and avoiding restricting terms such as "food" and "eat" may help nutritionists improve the accuracy and completeness of dietary data during intercultural interviews. Additional research in wording dietary recall questions will help determine whether this method is generally applicable.