the supply and uptake of nourishment, has been studied since ancient times. The Greek physician Hippocrates, who lived in the 5th century bc, and his followers over the next two centuries examined the connection between diet and health; many of their writings survive. Unfortunately they pursued the doctrine of the ‘four humours’ (See also composition of foods), which did much harm for many centuries afterwards. Chinese philosophers also studied nutrition, regarding all foods as having an influence on health so that there was no real distinction between foods and medicines; their beliefs live on in traditional Chinese medicine.
Only at the end of the 18th century did the science of nutrition begin to break free of the old theories. Gradually the basic constituents of food—proteins, carbohydrates, and fats and oils—came to be understood. This coincided with the Industrial Revolution, which over the following decades brought millions of people into towns, where they lived on foods increasingly impoverished by new techniques of food processing, and often heavily adulterated. The health of the working population declined. In Britain at the end of the 19th century, when large numbers of young men were called up to fight in the Boer War, they were found to be in such miserable condition that a commission of inquiry was set up. Its report (Watt Smith, Physical Deterioration: Its Causes and Cure, HMSO, 1907) recommended that schools should give instruction to both boys and girls in nutritional science. The School Meals Act of 1906 enabled local councils to provide meals for needy children.
At this time the role of vitamins and minerals in diet was becoming clear so that deficiency diseases such as rickets, once widespread, could be avoided. The British Medical Association produced the first recommendations for minimum requirements of nutrients in time for the food rationing imposed in the First World War to be organized on sensible lines.
After the war and at least until the slump of the 1930s, it was clear that public nutrition was much improved—though this was due more to prosperity than to ordinary people's knowledge of what constituted a healthy diet.
The first comprehensive control of public nutrition was in Britain during the Second World War. The nation was far from self-sufficient in food, but imports were now curtailed by submarine attacks on convoys. Basic foods were strictly rationed: meat including bacon and ham, eggs, fats of all kinds, cheese, sugar, even tea. Other foods were controlled by a system of ‘points’ to prevent hoarding. The Ministry of Food set up a Food Advice Division under Sir Jack Drummond, which issued information through advertisements, films, and the radio. Food advice centres in large towns gave practical demonstrations of how to make adequate meals from scanty supplies. All this sound guidance was mocked and resented, but reluctantly followed. In 1941 the Vitamin Welfare Scheme was set up to issue cheap milk, concentrated orange juice, cod liver oil, and vitamin A and D tablets to pregnant women and children under 5. The result, to everyone's surprise, was that, in spite of severe shortages of almost everything, public health improved to levels not seen before or since.
In western nations after the war, returning prosperity and the increasing availability of imported foods brought to ordinary people luxuries previously only for the rich. Ordinary people, too, began increasingly to suffer from the effects of overindulgence, and there was concern about the rate of heart disease. The public was increasingly bombarded with nutritional information from the Ministry of Health in Britain, the US Surgeon General, and pundits of all kinds. Much of this conflicted; for example, British and American lists of minimum daily requirements of vitamins and minerals were different, and still are.
Theories came and went. In the 1950s and 1960s people were encouraged to eat plenty of protein. Advertisements urged: ‘Drinka pinta milka day,’ and ‘Go to work on an egg.’ More recently, they have been supposed to follow a high-carbohydrate diet, eat eggs only occasionally, and drink semi-skimmed milk. It is small wonder that many become puzzled or sceptical as a result of all these S-bends and U-turns. But this is not a new phenomenon. Fernie (1905) observed that around the turn of the century one American authority advised that ‘Computing cards should be put into requisition at each meal; then when the day is over you can find out whether you have taken too much of one kind of food, or not enough of another.’ This prompted the Chicago Tribune to print a humorous verse of which the following is an extract:
Mother's slow at figures, so our breakfast's always late;The proteids, and the hydrates make the task for her too great;We never get a luncheon, since she figures on till noon,And finds we've overdone it, and that nearly makes her swoon;Mother's always tabulating every pennyweight we eat;Except the meals we smuggle from the cook-shop down the street.
One reason for recent changes in the advice offered was the observation that people in the Mediterranean countries suffered less from heart disease. This was attributed to their diet: plenty of vegetables, fruit, and carbohydrate foods of all kinds, some fish, not much meat, olive oil, wine. The health statistics were impressive. At the same time people were being influenced by the ideas of Elizabeth David and her followers, who were extolling the virtues of Mediterranean cuisine not for health reasons but because it was delicious.
A noticeable tendency in the West, especially in English-speaking countries, was a rise in vegetarianism. It is perfectly possible to gain proper nutrition from a vegetarian diet, but it needs care in choice of foods. Vegetable proteins are ‘incomplete’ and need to be combined; it is striking how many of the traditional cuisines of peoples who eat little meat have instinctively developed dishes which combine cereals and pulses to ‘complete’ their proteins—for example, dal and chapatis in India, rice and peas in Jamaica, succotash (maize and beans) in the south of the USA. Vegetarians risk deficiencies of some B-group vitamins and iron. These are particularly severe in the case of vegans, who eat no foods of animal origin at all, not even dairy products.
While Mediterranean influence was making itself felt in America, American eating habits spread to remote parts of the world, having a particularly striking influence in Japan, where the higher intake of protein caused children born from the 1960s onwards to grow several inches taller than their parents. Not all changes were welcome: heart disease, previously most uncommon, also increased.
At the end of the 20th century there was still no sign of an end to the division of the world into rich nations whose inhabitants ate too much and suffered the diseases of affluence and wondered how to dispose of surplus food, and poor nations whose people simply did not get enough to eat. See also protein and human history.
Ralph Hancock is an encyclopedist with a special interest in food history and food science.
Fernie, W. T. (1905), Meals Medicinal, Bristol: Wright.
