Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department


Major Professor

David Himmelgreen, Ph.D.

Committee Member

Rita DeBate, Ph.D., M.P.H.

Committee Member

Daniel Lende, Ph.D.

Committee Member

Barbara Piperata, Ph.D.

Committee Member

Nancy Romero-Daza, Ph.D.


Nutrition transition, prenatal nutrition, critical biocultural approach, practice theory


This study explores the relationship between tourism, the nutrition transition, and prenatal dietary practices in the Monteverde Zone, Costa Rica. This rural tourism community, located in the central highlands of Costa Rica, has seen rapid growth and development since the tourism boom in the early 1990s, leading to changes in the local food system and increased food insecurity. This investigation added to this work by identifying the ways that prenatal dietary practices have shifted over time in the context of increased tourism and the concomitant nutrition transition, and by describing the relationship between food insecurity and nutritional status among pregnant women. In applying a critical biocultural approach, this study drew on both quantitative and qualitative methods. Pregnant women were recruited to participant in twenty-four hour diet recalls (n=21), the Household Food Insecurity and Access Scales (n=20), and semi-structured interviews (n=22). Women who had older children were also recruited for semi-structured interviews (n=20) to explore prenatal dietary practices and decision-making over time. Focus groups (N=2, n=15) and surveys with a free listing component (n=52) were administered to better understand the cultural construction of nutrition in this region, and how tourism and the nutrition transition have interacted with the local dietary norms. Overall this study found that there was a relationship between tourism, the nutrition transition, and diet, although findings suggest that pregnant women may be buffered from these effects by cultural factors. Food insecurity was present in the sample (n=7) and was associated with numerous variables, including saturated fat and zinc intake.