CENTRAL AMERICA

Maize-Based Diets Under Rapid Transition

A region of shared agricultural roots

Central America—Guatemala, Honduras, El Salvador, Nicaragua, Costa Rica, and Panama—shares a long-standing agricultural foundation rooted in Mesoamerican food systems.

Traditional diets were built around:

• maize (corn)
• beans
• squash
• vegetables
• fruits
• modest amounts of animal protein

This pattern reflects the classic maize–bean–squash system, adapted over centuries. The maize–bean–squash system remains one of the most metabolically balanced traditional dietary patterns anywhere in the world.

These diets were:

• high in fiber
• minimally processed
• low in added sugar
• structured around meals

They supported metabolic stability.

Then vs Now

Traditional Pattern

Maize-based meals (tortillas, tamales)
Beans and legumes
Vegetables and fruits
Low sugar exposure
Home cooking and structured meals

Modern Pattern

Refined flour products
Sugary beverages
Processed snacks
Packaged foods
Frequent eating

The transition has been rapid and widespread.

Loss of traditional staples

Key changes include:

• replacement of whole maize with refined flour products
• reduced consumption of beans and legumes
• decline in traditional mixed meals
• increased reliance on packaged foods

This represents a shift away from fiber-rich, structured diets.

Sugary beverages and liquid sugar

Sugary drinks are now a central feature of the diet.

Common patterns include:

• daily soda consumption
• sweetened beverages with meals
• sugary drinks between meals

These drinks are:

• inexpensive
• widely available
• frequently consumed

They introduce:

• rapid sugar absorption
• high fructose exposure
• repeated intake throughout the day

Liquid sugar becomes a major driver of metabolic change.

Urbanization and migration

Migration and urbanization reinforce exposure to processed foods and sugary beverages.

In cities:

• processed foods are more accessible
• home cooking declines
• eating frequency increases

Migration—particularly to and from the United States—has also influenced dietary patterns, including:

• adoption of processed foods
• increased portion sizes
• greater sugar exposure

These patterns often persist across generations.

The double burden

Central America faces a dual challenge:

• persistent undernutrition in some populations
• rising obesity and metabolic disease in others

This reflects uneven but rapid dietary transition.

Disease pattern

The region is experiencing:

• rising Type 2 diabetes
• increasing obesity
• metabolic syndrome
• fatty liver disease

These changes are:

• widespread
• occurring at younger ages
• affecting both urban and rural populations

The metabolic transition

The dietary shift introduces:

• rapid glucose and fructose exposure
• increased liver fat production
• insulin resistance
• dyslipidemia

These processes mirror global metabolic pathways.

Why Central America matters

Central America provides a clear example of:

• a strong traditional maize-based diet
• rapid dietary change
• widespread sugar exposure
• early and accelerating metabolic disease

It forms a key link between:

👉 Mexico (advanced transition)
👉 Andes (traditional strength)

Intervention opportunity

Important strengths remain:

• cultural familiarity with maize-based diets
• continued use of beans and legumes
• strong meal-based traditions

Practical strategies include:

• restoring whole maize and traditional foods
• reducing sugary beverage intake
• limiting refined flour products
• reinforcing structured meals

Bottom line

Central America reflects a transition from traditional maize-based diets to modern patterns dominated by refined carbohydrates and sugary beverages.

The result is rising metabolic disease driven by:

• increased sugar exposure
• reduced dietary structure
• loss of traditional food systems

Explore Full Atlas of the Global Metabolic Crisis