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Home arrow Political science arrow From Hunger to Malnutrition: The Political Economy of Scientific Knowledge in Europe, 1918-1960

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Nutrition, Public Health and Education

In the opening lecture of the National Vitamin Foundation Conference held in 1957, John Boyd Orr, the first Director-General of the FAO, talked about Nutrition in programming for public health[1] He started his speech by directly recognizing “scientists who have made such a great contribution to the New Science of Nutrition”. He told the story of how ten years earlier, when feeling ill, he met the chairman of the conference, Russell Wilder, for the first time: “He told me - me- who had devoted the best part of my life to research in nutrition, that I was suffering from vitamin deficiency. He prescribed vitamin capsules made by one of the Companies which give financial support to this Foundation”.[2] He introduced himself, therefore, as “an ambulatory advertisement of the value of a generous intake of vitamins for warding off the premature onset of senile decay and maintaining, in old age, the vigor and sprit of youth”.[3]

At the time of the economic crisis that was punishing the world in the 1930s, when the governments of industrialised countries were battling with the problem of large-scale unemployment, John Boyd Orr was a colleague of Boudreau, Sebrell and Hazel Stiebeling in the League of Nations Committee of Experts on Nutrition. He summarised the origin of the political economy of nutrition in those years perfectly:

The idea was that, as there are more people in the world engaged in the production and distribution of food than in all other industries, a market for the great amount of additional food needed to provide a diet adequate for health for the whole human family would bring prosperity to agriculture which would flow into other industries and so help to solve the problem of the economic crisis. That movement, which was approved by 22 nations, was brought to a halt by the outbreak of the Second World War. It was revived by the Hot Springs Conference. When the world becomes sane, that great ideal of adjusting the production and distribution of food to human needs will be realized, and the promotion of economic prosperity will coincide partly at least with the promotion of human welfare.4

Orr situates the time when research first got an inkling of the cause of nutritional deficiency diseases in the second decade of the 20th century. The first discovery, he said, was made when diets assumed to be adequate by chemical analyses were tried out on animals and found to be inadequate. Physics and chemistry in research in nutrition then began to be superseded by biological tests and clinical examinations. Vitamins, minerals and other nutrients emerged as essential elements for health; nevertheless, during the inter-war period, there was great difficulty in getting this new scientific knowledge on nutrition applied, because it was not easy to change the prevailing mentality, convincing senior public health officers and authorities of the key idea: controlling infectious diseases and improving the population’s health came through providing a healthy diet to the whole population. The old medical style of thinking changed after the results of combined dietary and clinical surveys and feeding experiments with large groups of children carried out in several countries. Experimental and clinical research, as well as social surveys, showed that freedom from deficiency diseases and better health and physical condition were correlated with the level of income. This was one of Boyd Orr’s first major contributions.5 The incidence of food deficiencies increased in times of crisis, particularly because the poor were unable to afford the more expensive vitamin and mineral rich foods. Malnutrition was largely a disease of poverty, and Boyd Orr was convinced that the challenge to combat poverty was a political issue. The fight was therefore carried into the arena of politics and ideological debate:

The old politicians were honestly confused. They thought that malnutrition was just a new fancy word for hunger and, as bread was so cheap, that hunger, which was the food problem of the nineteenth century, had been almost completely eliminated; the agitation about malnutrition was the work of food faddists. Some even took the view that the high death rate among the poor was due to the beneficent natural law of the elimination of the unfit, their poor physique being evidence of their unfitness, and to interfere with this law would be unwise. Further, public health measures to improve the diet of the poor would involve a good deal of government expenditure, and a demand for higher wages for the worst paid workers. These objections [4] [5]

had to be overcome before nutrition became an important part of public

health work.

When there was ample evidence that the children of the poor, when they received a diet as good as the children of the well-to-do, grew at the same rate and were as healthy and vigorous, some research workers and public health officials in Western countries applied a lot of high-pressure salesmanship to sell the idea that, as a Belgian public health officer put it, life and health could be bought, or in the words of a great American, Dr. Hermann Biggs, that public health was “purchasable”. Then the advertising appeared. The attractive advertisements of companies selling vitamin preparations or vitamin-rich food, occasionally making exaggerated claims, and popular articles by journalists, sometimes a little inaccurate, made the public food-conscious. The mysterious “magic vitamin” caught the imagination. The new science of nutrition became popular and strong public opinion arose in favour of its application.[6]

The drive to get the new knowledge on nutrition applied to improve the diet and health of the population coincided with the 1930 slump in food in Western countries, so it was relatively easy to persuade governments to use any surplus food to palliate the hunger of the poor and unemployed for the mutual benefit of health, agriculture and trade, although at the taxpayer’s expense. Boyd Orr recognised that the increase in unemployment benefits and family allowance for the children of the unemployed had enabled poor children to be better fed. These extensions of public health and social services were followed by the inspection of school children, prenatal care of mothers and education about the value of food. These measures provided awareness about the social dimension of deficiency diseases and contributed to the elimination of acute forms “which had affected more than 50 per cent of the children in industrial towns, of nutritional anaemia and other forms of malnutrition not acute enough to be called diseases. Pellagra in the Southern States of America and in Eastern European countries and beriberi in the East almost disappeared, and the control of these diseases was accompanied by improved health and vigour”.[7]

In most European countries, the expansion of industrial areas caused malnutrition to become prevalent among lower social groups, a situation seriously impaired by wars and economic crises. Food rationing became an essential policy, giving priority to mothers and children for milk and fresh fruit, and allowing them a minimum intake of proteins, cod liver oil and cereals; this policy made them available for all children,

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independently of their social level, with the result that the health and organic condition of children continued to improve even in times of food shortage. All branches of experimental medicine had contributed towards greatly improving the health of the population, but Orr estimated that “none in the last 30 years has made a greater contribution than nutrition, with its elimination of deficiency diseases and its promotion of positive health”.8

Medical authorities recognised that the new science of nutrition had made a great contribution to public health, occupying a central place in social medicine and politics. It required financial support to ensure that every family needing attention could receive the necessary advice and assistance. The emphasis was initially on the more vulnerable groups, mothers and children, but more attention was paid to the increasingly large number of elderly couples, whose diet in many cases degenerated to no more than bread and other cheap foods.

  • [1] Orr, J.B., Nutrition in programming for public health. Address delivered before theNational Vitamin Foundation, March 6, 1957, National Vitamin Foundation Reportto the Board of Governors by Scientific Director for the period Jan. 1, 1956-Dec. 31,1956, New York, National Vitamin Foundation. 1957.
  • [2] Ibidem, p. 11.
  • [3] Ibidem, pp. 11-12.
  • [4] Ibidem, p. 12.
  • [5] Orr, J.B., Food, Health & Income: Report on a Survey of Adequacy of Diet inRelation to Income, London, Macmillan & Co, 1936.
  • [6] Orr, J.B., 1957, pp. 16-17.
  • [7] Ibidem, p. 18.
 
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