Grant: Tm. Gr: GACD 2021: NCD risk prev. acr. the life -PRIOR. 1: Lifecycle Approach

Indigenous farmers in Guatemala are disproportionately affected both by diet- and pesticide-related noncommunicable diseases (NCDs). While they grow food on their farms, they often sell the most nutritious products and instead purchase cheap calories in obesogenic markets. Meanwhile, some use pesticides on their own land, and others apply pesticides during seasonal plantation labour. Regrettably, diet- and pesticide-related NCDs compound each others' health impacts, and among mothers, they affect the next generation. For these linked problems, we propose an integrated solution based on existing evidence and practice. Our research will work with farmers who are regaining control over their food and farms by practicing agroecology. An organic farming paradigm based on ecosystem interactions, agroecology has demonstrated links to NCD risk reduction. For example, by increasing production diversity and promoting consumption of own production, it provides nutritious foods and reduces unhealthy purchases. As an organic strategy, it interrupts on-farm pesticide exposure, and by providing a secure livelihood, it reduces labor migration to pesticide-intensive plantations. We deploy implementation research objectives to assess how such linkages can be strengthened in existing agroecology interventions, as well as scaled locally and internationally. We will focus on women of reproductive age, given intergenerational health effects and gender inequalities. Key methods include: a validated tool to evaluate how agroecology's production, social and dietary factors reduce NCD risk; participatory co-learning workshops to understand farmer norms, values and beliefs implicated in health behaviours; and, an action-research communication strategy to integrate evidence-based knowledge into intervention, advocacy and outreach. Local impact is built into our research design, and the project is expected to produce a global impact given the growing interest in agroecology-health linkages.