Home Political science From Hunger to Malnutrition: The Political Economy of Scientific Knowledge in Europe, 1918-1960
A New Historical Context
As a result of the analysis of the various factors intervening in the political economy of scientific knowledge on hunger and nutrition mentioned in previous pages, this book offers a general discussion on the plural dimensions of hunger and health during the period 1918-1960. The aim is to show how the idea of a balanced diet and food availability became a central issue for the economy, scientific research and politics in the international agenda, a subject widely discussed in national institutions, parliaments, international organisms and scientific conferences. It also includes an overview of previous research that mainly focused on specific aspects and countries, and it represents a step forward from my previous work on the emergence of the problem of nutrition in Europe. The scientific, political and economic dimensions of hunger and nutrition allowed politicians and scientific experts - dieticians, nutritionists, physiologists and clinicians - to dream of a rational solution to the problem through the design of minimum and optimum standard diets for different income groups, professions and ages.
The problem I want to address is how the political economy of scientific knowledge on nutrition involved private and public institutions, international and national agencies, experts and citizens, education, health, politics, scientific rationality and cultural habits. Some aspects were particularly influential in understanding the evolution of the complex network shaped around hunger and health: the impairment of the global food system; the political tensions; the effects of the war and the devastating landscape of malnutrition in internment camps; the clinical and physiological research on the pathological effects of chronic nutritional deficiencies and long standing malnutrition; the rural-urban divide; and the emergence of new groups of population at risk, such as internees, refugees, soldiers, children, pregnant women and prisoners.
What was the role of national and international organisations such as the National Schools of Hygiene and the National Institutes of Food, the League of Nations, the International Labour Organisation, the International Institute of Agriculture, the Food and Agriculture Organisation, the World Health Organisation and the Red Cross? Thanks to their intervention, expert commissions built an international framework, which served to promote the circulation of legitimated knowledge, influencing government decisions, scientists, economists, food producers and the population’s habits.
Obviously, the first task was to cope with hunger and its negative effects upon public health. International agencies played an essential role in the establishment of a sort of cartography of hunger, which aimed to assess the dimension of the problem and identify the most affected areas: they promoted technical surveys on the nutritional state of the population in countries and regions; commissioned conferences of experts to implement international standards intended to improve the physiological knowledge of nutrition and the clinical consequences of nutritional deficiencies; checked the nutritional state of citizens (children, workers, soldiers, pregnant women...); and screened rural diets and nutritional habits in all corners of Europe. International historians, political economists and economic historians have mainly examined the problem in terms of the power of interest groups and state strategies, but the role of the international organisations in the impulse
of experimental science and health policies - the major dimension of the problem - have been scarcely considered. A global perspective should analyse all the factors that came together and influenced one another to shape a political economy of scientific knowledge on health, hunger and nutrition.
The critical period between 1918 and 1960, which was characterised by international conflicts, war and post-war, was a decisive time for the appearance of a new international vision of coordination in many aspects of state intervention. Rather than traditional protectionist-state centred politics on the one hand, and liberal market-based traditions on the other, an alternative emerged that connected elements of the civil society with mechanisms of global governance, including a view of mutual dependence. Historiography has shown that since the end of the 19th century, European countries showed different traditions regarding the global food system. Britain had a predominant free-trade tradition, quite different from protectionist Germany, France and Russia, and far from the more simple and self-sufficient agricultural communities in the Mediterranean area. Other countries, such as Sweden, Denmark, Belgium, the Netherlands and Switzerland, were more market and export oriented. Europe was a plural reality.
Therefore, the role of expert scientists when talking about dietary needs and optimum diet would not only influence nutritional knowledge but also inspire agricultural and health policies. It was the starting point of education and propaganda programmes on cooking and diet composition, aiming to civilise and change the population’s traditional habits considered to be pernicious for health. It was also the basis for diet in hospitals, charity meals, prisons, schools and other institutions. Proteins, fats, carbohydrates, nutrients, minerals and vitamins became common language.
A wide programme of intervention around nutrition and health was shaped with a view to disciplining, civilising and changing production and consumption patterns and modifying popular habits. The emergence of hunger as a social problem and nutrition as a scientific field of research contributed to the recognition of the social dimension of the self through the emergence of international and state social policies. Hunger, deficiency diseases, rational diet, healthy cooking, calorie intake, undernourishment and famine appeared as a core political and economic issue and therefore became a central locus of action for social and political stability, programmes of intervention, public health and social modernisation. A well-nourished population was healthier, taller and stronger. Local and international institutions and experts appeared in connection with the social and scientific transformation of nutrition, becoming principal agents for the development of public health and social welfare policies.
The emergence of nutrition as an experimental field of research, as a medical speciality, as an economic and political locus, was immediately connected to market and consumption, but also to cultural and sociohistorical factors and to the rise and increasing influence of the state as a social regulator. The international crisis that permanently affected the period studied, and the changing meaning of hunger and poverty as unacceptable social realities on the one hand, and the emergence of new governmental responsibilities in the public administration on the other, were some of the most meaningful factors.
As early as in the second half of the 19th century, social initiatives were put in place in order to fight hunger as an intolerable reality punishing most European countries. These initiatives included: school meals; charity meals for the poor, mothers, women and industrial workers; propaganda campaigns on dietary habits; experimental research on the physiology of nutrition and the clinical definition of deficiency diseases associated with a poor diet; as well as economic and agricultural policies. No specific political ideology monopolised this economic, social and scientific process, which indeed was more broadly related to a generally accepted value of progress and modernity widely spread in most Western societies, excluding hunger and deep poverty.
The new social ethics about hunger and deprivation from the perspective of human rights resulted in practical actions in order to determine minimum and optimum standard diets, reshaped dietary habits, planned agricultural production and implemented rationing policies aimed at designing school and family meals, and discipline citizens via education and campaigns. Hunger and feeding were no longer considered purely private matters, as the diet became a locus for economic, political and medical intervention, as well as a scientific field of knowledge and a practice associated with trade, public health and disease. All these aspects became responsibilities for the state as the main regulator and guarantor of the rights of citizens. For both national and international organisations, hunger, diet and health encompassed public and individual health, working conditions, agricultural production, clinical screening, social stability and scientific research.
During the 1930s the new culture of nutrition and its health dimension (optimum diet, dietary standards, nutritional deficiencies, malnutrition) entered the international scene. An increasing process of industrialisation of food production took place in order to guarantee the calorie intake and satisfy growing demands. This process became even more evident during the 1940s and the beginning of the Cold War. The regulation of food quality, as well as the scientific patterns for a balanced diet and their adaptation to cultural habits, were strengthened. The physiology of nutrition was considered to contribute more than merely nutritional benefits as, according to the new style of thinking, experts and authorities believed that the diet was to be adapted to scientific patterns on individual needs as a way of improving human development. They showed a eugenic perspective to improve the race and overcome long-standing shortcomings and superstitions.
Planning the food market was the starting point. In the opinion of scientists, practitioners, public health experts and some politicians, the science of nutrition was to have a civilising effect upon the population, mainly workers and peasants, mothers and children, prisoners and patients. Knowledge on nutrition was to become legitimated by science and expertise, to be spread from the laboratory to the school, hospital, factory and the kitchen, to influence food production, to improve and rationalise the economy, shape scientific knowledge, change dietary habits and become a technical tool for future generations. As a material instrument of statecraft, as well as a new development for trade and market, the political economy shaped around nutrition was an important tool of power, and most European governments were determined to use it. Indeed, nutritional knowledge had to become quantifiable so that political and scientific initiatives could challenge the international crisis.
J. George Harrar, President of the Rockefeller Foundation during the inter-war years, synthesised the complex dimension of nutrition and diet, as the discovery of the calorie as a unit of measurement had led directly to an “informal alliance” of “scientists, farmers, government agencies, educators, and processors” working to fight malnutrition worldwide. The political economy of nutritional knowledge pooled, in its public health dimension, national and international efforts during the middle decades of the 20th century. A plurality of actors took part in the process. The point of departure were the activities of the League of Nations’ Health Committee, often working in coordination with national schools of hygiene in several European countries in the 1930s, with the technical and financial support of the Rockefeller Foundation, and the collaborative expertise of the International Institute of Agriculture. After World War II the World Health Organisation and the FAO assumed food relief strategies in coordinating policies to fight hunger. But a powerful industry emerged in the meantime, and even though the states imposed regulations and quality control, the power of the industry grew more and more at the expense of the regulatory function of the state.
Hunger and poverty had already reinforced national social and public health dimensions in most European countries during the second half of the 19th century. Consequently, the state participated in the regulation of the social relations affecting labour legislation, the protection of mothers and children, other groups at risk, promoting health and sanitary campaigns, trying to control food quality and fighting adulterations, and promoting school reforms and nutritional education. School medical inspection and school canteens became a tool for medical intervention, checking the new generations within the framework of a eugenic policy intended to improve social hygiene.
Nutrition, food availability and diet became an essential component of the new state policies promoted by social reformers for human improvement. Summer camps not only sought a contact with the healing effect of nature, but also feeding undernourished lower-class children. The first municipal institution for school medical inspection was created in Brussels in 1878 and the initiative was extended to most European countries in the following decades. The First International Conference on School Hygiene was held in Nuremberg (1904), a Second Conference in London (1906) and also in Paris (1906). In April 1912 the First Spanish Conference on School Hygiene took place in Barcelona. It defined the inalienable rights of children, set up a Liga de Higiene Escolar [School Hygiene League] and requested the extension of medical inspection to schools. The health-at-school policy also comprised school meals and canteens, which emerged in Europe from the 1860s onwards in the context of a broad debate on compulsory education and an environment in which hunger and its links with health were becoming far more visible.
A second dimension of nutrition in the context of public health comes from the idea that good nutrition is essential for optimum health status, a condition necessary to fight infectious diseases, indeed the main health problem during the first half of the 20th century. Feeding was to be considered the basis of good body development and a healthy state, a source of organic energy and good defences against external aggression, something fundamental when faced with the threat of hunger and starvation.
The so-called organic energy was considered to be essential to the understanding of the spread of infectious diseases such as tuberculosis. The concept of the pre-tubercular condition in children as a predisposition to the disease was related to defective feeding, excessive work, a lack of hygiene and poor living conditions. These elements cause us to argue that before the emergence of nutrition as an experimental field of scientific research, especially in the 1930s, hunger and feeding became a subject for social concern and social action mainly associated with public health and an optimum health status in order to minimise the risk of suffering infectious diseases.
This stage was prior to the emergence of a new science of nutrition based on experimental research on vitamins, organic elements and specific deficiency diseases. The concept of organic resistance to infection - a useful concept among practitioners - was directly related to the nutritional state and optimum diet. Poor nutrition was claimed to be the main factor for impaired organic resistance as a previous stage leading to losing the battle against infection. From this perspective, vaccines and medicines were important in fighting tuberculosis and other infectious diseases, and also in preventing contagion. But this was not more important than a good nutritional condition, which was considered to be the basis of a good treatment of any infection. In the late 1920s poverty, the problem of children’s health and infectious diseases, as well as the economic crisis, paved the road for a new milestone, namely the big international boost to scientific research on nutrition.
The international will to improve nutrition and public health was even stronger after World War II. International agencies were established in order to fight nutritional deficiencies and malnutrition, such as UNICEF (1947), the WHO (1948), in addition to the FAO (1943). A United Nations Relief and Rehabilitation Administration- UNRRA was created to face the tragic effects of starvation and malnutrition in the Netherlands in 1944, with the specific target to offer relief to the liberated countries in Europe. Due to the scarcity of funds, the UNRRA received support from the USA and from nutritional experts who helped in the establishment of rationing strategies and food relief for the affected population in the Netherlands, Poland, Greece and other countries.
From the 1960s new agencies were founded to challenge food conflicts: the World Food Programme (WFP, 1963); the United Nations Development Programme (UNDP, 1965); the United Nations Environment Programme (UNEP, 1972); the International Fund for Agricultural Development (IFAD, 1977), which is closely related to the United Nations System the Consultative Group on International Agricultural Research (CGIAR, 1971).
From 1960 the World Bank and regional banks for development increased their contributions to the modernisation of agriculture and rural development. These strategies were promoted in Europe in the
1950s and in other world regions after the 1960s. Underdeveloped rural districts were the focus of most of the efforts.
As reiterated in previous pages, historical research that analyses the various factors behind the changes in the diet and nutritional condition of Europeans has highlighted the importance of taking into account a plurality of factors to explain the nutritional transition. These include the progress in scientific knowledge, changes in public health and hygiene and health educational programmes. In the areas of health care and community nutrition, research has been conducted on the pretransitional and transitional periods and on epidemiological, clinical and food-diet dimensions after the transition. But it also seems appropriate to delve into this analysis from the viewpoint of the history of health sciences. It should not be forgotten that the discovery of the role of active principles in caloric values and metabolic processes, together with the discovery of vitamins and nutrients, enabled the consolidation of nutritional science as a solid ground during the early decades of the 20th century. As interest in quantitative nutritional values waned amongst public health experts, research increasingly focused on the qualitative aspects of nutrition, which could have implications for the development of chronic disease, quality of life, physical and intellectual potential and longevity. This new knowledge, collectively applied in preventive programmes and public health campaigns, gave rise to a new functional concept termed community nutrition, the aim of which was to improve the nutritional state and the health condition of individuals and groups within a community.
Likewise, the problems associated with nutrition, which lay behind the high infant and child mortality rates that characterise pre-transitional demographic systems, have also been paid some historiographical attention. It is generally accepted that the 1920s and 1930s constituted a crucial period in the development of public health in European countries. The specific situation in each country cannot be considered in isolation from the international context. On the other hand, mass consumption and new impulses towards industrialisation and urban planning after 1950 resulted in an improved food intake. The diet became more diversified and changes took place both in its composition and in household consumption: meat, eggs, milk, and animal proteins generally became more abundant. Calculations by FAO experts attributed to the European population modern standards with a daily intake of over 3,000 calories per person. In the 1970s Mediterranean Europe had similar parameters to those in Northern and Western Europe before WWII.
In addition to an analysis of the principle elements that shaped institutionalisation processes, such as that of community nutrition, it would seem appropriate to consider the social, cultural, economic and political contexts within which these phenomena occurred, and to analyse the discourses and practices regarding diet and health that existed in the international context, as well as in European societies, in the middle decades of the 20th century.
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