Historical research about international health in the first half of the 20th century became an emerging field over the past decade. The European Union has configured a favourable framework for cooperation projects, scientific meetings and international networks. This process has also taken place in the case of international health and the transfer and circulation of medical knowledge, regarding the scientific production of knowledge, uses and social practices. Indeed, to understand the international character - as well as the role - of knowledge in various fields, it is crucial to understand how, where and why knowledge is produced, communicated and circulated. It is easy to understand that this is not a question of a singular type of process, but of many: from the centre of scientific breakthroughs to more peripheral areas, between countries and within countries, from the experts to the public, from the laboratories to the market, from the market to the kitchen, through institutional decisions or through the actions of individual actors. The transfer of knowledge, artifacts and practices entails a complex network or system that experienced deep transformations throughout the 20th century. The traditional spaces where knowledge is produced in the Modern Age - universities, academies, research institutes, public laboratories - have lost their exclusivity, getting involved in a wide social network linked to other agents such as trade and commerce, industry and public administration. The science-society pattern, shaped in the 20th century, is absolutely different to that initiated with the Scientific Revolution in the 17th century, and which was still alive and kicking at the end of the 19th century. The evolution of the science-society pattern in the second half of the 20th century makes it extremely important to analyse technoscience as a system in society, with the interactions between science, politics and the economy representing an essential approach. The interplay between science, technology and the political economy of knowledge will be discussed in more detail in the next chapter.
One of the general aims of this book is to investigate and discuss the production and circulation of knowledge about nutrition, hunger and diseases associated with chronic and acute malnutrition, the institutions and social groups involved, and the networks of power around the science and technology of hunger and health. The main point is not the reception of scientific knowledge in one direction from the experts to the public: how, when and why knowledge reached the general public. The interaction between hunger, food, diet and health essentially touches the relationship between science and society, assuming that science is not external to society, a sort of autonomous and objective reference, but a substantial element of it, which requires a historical and sociological explanation.
In recent decades, the interactions between society and science have been addressed in many ways by the social history of science. The sociology of knowledge has also contributed an original approach in this direction. Bruno Latour is one of the predecessors in this respect. He found the inner life of the scientific world, and made an intimate connection between science and social values. Of relevance is the shift suggested by Latour from an external science to society, to an internal science in society.
Some concepts are relevant to the orientation of this book: the role played by the authority of experts and its social and political use, the regulatory role of the state and international organisations, the changes in the food chain, the plural dietary culture and its transformation under the influence of scientific knowledge, market pressure and political action.
Generally speaking, up until the 1850s private institutions seemed to hold more authority than official ones as far as food was concerned, a situation that changed by 1900, when the general public expected official bodies to provide security by controlling the production, manufacturing, trade and preparation of food. By establishing these links, reference is made to the concept of the food chain, which assumes a direct and reciprocal relationship between production, distribution and consumption. In this context, the concept of dietary culture emphasises the importance of everyday life: the way people give meaning to objects and foodstuffs, connecting scientific ideas and traditions to daily practices. In addition to medical history, economic history, historical demography and anthropometric history, a cultural perspective has to be integrated in order to analyse hunger and health in times of crisis. This is a recent approach with a solid background, following contributions by Zigmunt Bauman, Ulrich Beck, Michael Gibbons, Bruno Latour, Helga Nowotny, Dominique Pestre, and Alain Touraine, among other influential authors who have opened up new avenues in the history and sociology of science. Hunger, food and health could represent an extremely fruitful topic of research.
Indeed, to analyse the transfer of health and nutritional knowledge, one should consider at least a plurality of aspects, such as the professional dimension of knowledge production, e.g. the role of experts and their importance as agents commissioned to legitimate knowledge and practice. New professional communities grew with a focus on expertise: nutritionists, physiologists of nutrition, clinicians, instructive programmes, vulgarisation campaigns, consumer and professional associations, expert commissions and conferences. Specialised journals were also developed. Another dimension of nutrition is the institutional perspective involving relations and influences among local, national, international institutions and organisms, governments and private laboratories, hospitals, dispensaries, institutes of food and hygiene, sanitary campaigns, health officers, experts’ boards, physicians, nutritionists and others. The plurality of stakeholders intervening in the process involves dynamic interaction between the circulation of knowledge through the networks of experts, local, national and international institutions and conferences, publications, media and the market. From this perspective, the political use of hunger, health and nutritional knowledge is most important. Other specific approaches such as gender, social inequalities and the rural-urban divide could contribute relevant aspects and add to the general picture.
The 20th century was a crucial period for the shaping of an international framework in the field of health, with the creation of public health administrations in Europe backed by local, national and international institutions. The Rockefeller Foundation and the League of Nations gave a boost to public health policies during the inter-war period and the middle decades of the century. New legislation and institutional developments in most states and the creation of committees of experts at influential organisations such as the United Nations (UN), the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) after World War II constitute an unavoidable reference when it comes to analysing the circulation of scientific knowledge on nutrition, hunger and dietary practices and values. Some works have contributed towards research on the United Kingdom, Central Europe and certain peripheral regions such as Latin America. These include: Paul Weindling’s work on the Rockefeller Foundation and the League of Nations; Marcos Cueto on the Rockefeller Foundation and the health activities of the Pan-American Health Office (PHO); Iris Borowy’s book about the League of Nations Health Organization; the series Bergen Workshops on History of Health and Medicine;S6 the orientation followed by the journal Social History of
Medicine; as well as the international conferences promoted by the European Association for the History of Medicine and Health. The STEP network (Science and Technology in the European Periphery) is also working on several aspects of the circulation of scientific knowledge.
This book considers hunger in relation to science and health, as a starting point for the analysis of a complex network of elements participating in the economy and politics of hunger. The crossroads between food and health makes concrete the claim that food studies reflect societal evolution. Indeed, bringing together food and health allows us to take into consideration a wide range of aspects such as state intervention, the definition of body standards of health, the design of statistics and social enquiries, political criticism, trends in scientific research, economic calculations, scientists’ prestige, people’s reactions, the role and use of education, the gender divide and, more particularly, dietary requirements, nutritional recommendations, household schools, and illnesses caused by nutritional deficiency. Considering food in relation to health has yet another great advantage: the constitution of an international context. Scientific production has traditionally had a national basis, but since long contacts between scientists from various countries were manifold and international organisations took the initiative, hunger and health entered the international agenda. International meetings, especially those associated with the notion of “public hygiene” - which included healthy food and food safety - have played a crucial role in the exchange of knowledge since the 1850s. International contexts and international networks have to be incorporated in order to understand the local.
This book also aims to fill significant gaps with regard to the representation, interpretation and application of scientific knowledge on hunger and nutrition in Europe in the 20th century. The research carried out involves the combination of three levels: the production, circulation and social use of knowledge, mainly connected through international political action. It tries to identify the connections between science and society throughout the 20th century, connecting politics (revolutions, Fascism, wars, education programmes) and economics (the crisis in the 1930s, protectionism, rationing) to nutritional science and public health policies.
A series of contributions have been devoted to the emergence of an experimental science of nutrition. The oldest one, which mostly concentrated on food fraud, was predominant until the end of the 19th century; a great deal of scientific research was focused on calories and vitamins during the early decades of the 20th century. Research on the ideal diet followed, up until the 1980s, and preoccupations with obesity and overweight people emerged at the turn of the century. Along with life scientists’ comprehensive research, social, political, economic and cultural historians have contributed to particular fields of dietary knowledge. In this respect, the publication of the collection of essays by H. Kamminga and A. Cunningham (1995) may be seen as a turning point. Research has been conducted in a number of fields focused on the search for the ideal diet, the life and work of scientists, food adulteration, the discovery and physiological research on vitamins and nutrients, the political dimension, as well as the constitution of international nutritional networks. All of this work is of crucial importance, as it provides either a clear outline or precise information, while displaying the richness of historical source material. Therefore, our research goes back to texts that were generated by nutritional researchers in the 20th century and to the large amount of information about nutrition and health produced by the international agencies. Most of this information was the point of departure of reports, surveys and political action. This work analyses the discourse of nutritional knowledge and experimental research, paying attention to the way in which science was produced, written and discussed and how research was reported, taking the trouble of defining new terms and new standards.
In the process of knowledge production it is not only laboratories and national food institutes that play a significant role. A fundamental issue also appears to be the knowledge exchange between specialists and the creation of networks of experts’ commissions that have scientific and political legitimacy. In addition, when talking about food and diet, it is essential to uncover the circulation of knowledge between experts, as well as between the experts and social actors: how nutritional science served as point of departure for political action, medical intervention and marketing strategies. During most of the 20th century, we witness a permanent tension between food production and the organising of trade, something absolutely determinant to understanding the limits of the experts’ recommendations when their proposals were to be transformed into political actions. The relations between nutritional knowledge and food policies, and their importance for the evolution of war and postwar situations, and the spread among the wider public, seem to be essential to understanding scientific trends from an internal social perspective.
Finally, the social application of nutritional knowledge encompasses several spheres: health and disease; nutritional policies in times of crisis (rationing policies); and public canteens for the groups at risk, such as the unemployed, children, industrial workers, pregnant women, refugees and deprived rural populations. It would also be interesting to find out how nutritional information was incorporated into daily practices. This is the most difficult part, since dietary information and guidelines fall within the context of social norms, habits and beliefs, i.e. within existing culinary traditions. Moreover, while nutritional science and the media changed drastically between 1900 and 2000 in Europe, society did too in terms of family structure, power relations, prosperity, state intervention, education, time management, expectations, etc.
The internal dynamics of the European society needs to be taken into consideration, as this would indirectly uncover the concern of households with food recommendations. Yet, the historical literature shows many research possibilities with regard to public kitchens. Of course, these differ from private kitchens (in terms of quality control, cost, tradition, cultural links), but the advantages of using source documents from public cooking institutions are too significant to neglect, while similarities between the two sorts of kitchens undoubtedly exist. European countries established different models of public kitchens, so a comparative approach could be instructive in understanding the circulation of nutritional information, as well as some aspects of the relations between nutrition and health. Public kitchens allow us to make a comparative approach to the social application of nutritional knowledge.
On the other hand, local and national regulations caused hospitals throughout Europe to pay attention to healthy food for their patients, especially from the last quarter of the 19th century. In some European countries, nutritionists and dieticians were trained in hospitals according to the principles of the new science of nutrition and appointed to public canteens, hospitals, schools, prisons and military institutions. Prisons and charitable institutions constitute complementary sources of information as well. Diets in public canteens for workers of large factories are similarly interesting. Investigations into school canteens and other initiatives such as school breakfast and milk distribution have become increasingly important in recent years from a historiographical viewpoint, most likely as a result of the recent intense attention paid to children’s history and particularly to children’s health. This includes the study of various aspects, such as food in relation to illness, the
practical organisation and the moral implications of school meals, the national social policies for the protection of children and mothers, as well as the way that pupils perceived food and school milk schemes.
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