Nutrition matters: people, food and famine
H. Young and S. Jaspars. 1995. London, UK, Intermediate Technology Publications. ISBN 1-85339-243-X.
Nutrition matters: people, food and famine is based on the authors' experiences as field workers in situations of food insecurity and famine. Young and Jaspars had found that the existing descriptions of the role of nutrition in relation to famine were unclear or oversimplified. The practical constraints they encountered and the ineffectiveness of standard interventions led them to consider new approaches to nutritional assessments and response which are generally applicable in situations of famine.
The first part of the book discusses contemporary views of nutrition and famine; nutritional surveillance for famine early warning; and methods for assessment and surveillance. The authors emphasize that famine is not simply lack of food leading to hunger, starvation and death. Particularly during peacetime, famine is often a slow process of depletion of people's resources and ability to cope. The relationship between nutritional status and the different stages of famine is complex. The authors suggest that severely reducing food intake may be a strategy for long-term survival of the family and that high rates of malnutrition, particularly wasting, may occur before people become completely destitute and need relief assistance.
A practical chapter on methods of nutritional assessment and surveillance describes a mixture of anthropometric methods and qualitative approaches to gathering information, such as rapid assessment procedures and participatory rural appraisal. Young and Jaspars advocate a combination of strategies and alternative approaches to strengthening household food security which require long-term commitments to community development. However, at present this tactic is incompatible with the short-term commitments and funding arrangements of most relief agencies.
The second part of the book presents a detailed case-study of nutritional surveillance carried out in Darfur, the Sudan, from 1984 to 1991. The authors illustrate their theories by explaining the historical context of vulnerability to food insecurity and famine during the mid-1980s, pointing out the various effects of the famine on different population groups. They describe the development of a new community-based approach to surveillance, considering also its main constraints. While interesting, this section lacks a general conclusion which would help the reader to link the case-study with the more theoretical discussion in the first part of the book.
Part three points towards the future and brings together past experience and knowledge to generate a conceptual framework for understanding the many factors determining the role of nutrition in times of food insecurity and famine, aiming to "shed light on the relationship between nutritional status, malnutrition, food security and the risk of famine deaths". The practical implications of the framework for planning and assessment, interpretation of nutritional data and interventions are discussed. Issues of sustainability, community surveillance and the role of food aid, including targeting strategies, are addressed.
Finally, the contribution of the discipline of nutrition in addressing nutritional problems of famine-affected populations and refugees is assessed. Young and Jaspars are critical of nutritionists who confine themselves to marginal roles in famine situations, focusing primarily on anthropometry and supervision of supplementary feeding programmes. The authors advocate a reorientation in the field and in nutrition training programmes. In assessing nutrition situations, nutritionists should focus on the underlying causes and the wider context of malnutrition; they should analyse the resources available and plan and implement interventions accordingly.
Humanitarian aid is increasing at the expense of development activities, and the scope of work of relief agencies has been expanding in recent years. At present these agencies are limited by their funds, which usually reach a peak at the height of an emergency. The authors argue that relief agencies should be able to develop an earlier response to the effects of famine and food insecurity, aiming at reducing vulnerability and supporting livelihoods. While the need to foster food security is widely accepted, the role of both development and relief agencies is a current issue of debate. Certainly all who are active in the field of development should be aware of the causes of different types of emergencies and famine situations, which can occur anywhere in the world.
The authors' attempt to mix theoretical background information in nutrition with practical guidance is not fully satisfying. This is unfortunate, since the publication is targeted to nutritionists working in relief and rehabilitation situations. Another weakness is that the forward-looking strategies are not well developed. Nevertheless, the authors of Nutrition matters: people, food and famine deserve credit for accurately reflecting the key issues and constraints in the ongoing discussion about the uses and needs for nutrition information among nutritionists, relief agencies and others working to alleviate emergency situations. This book is a valuable contribution to the discussion about linking relief to development, and it is refreshing in its criticisms.
Marion Herens
Associate Professional Officer,
Nutrition Programmes Service
(Household Food Security Group)
Science, agriculture and food security
J. Hulse. 1995. Ottawa, Canada, National Research Council of Canada. 241 pp. ISBN 0-660-16210-5.
At the outset of this ambitious book, the author asserts that food security should be viewed as a basic human right, and he rejects pessimistic assumptions that the world lacks the capacity to increase food production to meet population needs. Science, agriculture and food security presents a very broad range of topics, including nutrition, agricultural technology, food and agriculture policies and the environment.
The author provides a condensed review of recent literature, including numerous papers by leading development agencies and academics. His commentary, which draws upon his years of experience in agricultural development, illustrates some of the ways in which technology and social and economic policies converge and conflict. The book defines basic concepts, provides factual information and raises a number of thought-provoking, candid points about the political and financial constraints to achieving food security.
A brief discussion of the global demographic and economic situation is followed by a comprehensive presentation of standard nutrition concepts. Then, after a general discussion about agricultural resources and policies, the author describes various concepts of sustainable agriculture. He points to the difficulties of reaching a consensus on natural resource management when many notions of ecological conservation come into conflict with the urgent needs to increase food production. The author gives an overview of post-production systems of preservation, storage, processing, transportation, distribution and marketing, stressing the challenges of feeding the world's growing urban population.
While recognizing that technology alone cannot solve the problems of food insecurity, the author gives relatively little attention to economic issues. Unfortunately, coverage of development of human resources is sparse, although the author does stress the need to train more men and women to take interdisciplinary approaches to improving food systems.
Hulse advocates more support for agricultural research in developing and developed countries, particularly with respect to sustainable development and processing and marketing aspects of the food system. He draws attention to the contributions of international agricultural development institutions, including FAO.
Many factors affect global food security, and it may be inevitable that a book that is broad in scope lacks in-depth explanations. At many points in the book the reader wishes to understand more of the reasoning behind the author's arguments. An additional drawback is that much of the book deals with nutrition and agriculture in the United States, while coverage of other countries, particularly those with the most severe food security problems, is uneven.
In spite of these weaknesses, Science, agriculture and food security will help students of international development, agriculture, nutrition and economics to identify some of the key issues that affect global food security and international development. It may also serve as a quick reference for those already working in these fields.
Janice Albert
Nutrition Officer,
Office of the Director,
Food and Nutrition Division
Training for Agriculture and Rural Development 1995-96
FAO. 1996. Rome. 158 pp., softcover. ISBN 92-5-103726-4. Price: US$25.
In keeping with Agenda 21 of the United Nations Conference on Environment and Development (UNCED), "The role of human resources development in sustainable agriculture and rural development" is the theme of the 1995-96 issue of Training for Agriculture and Rural Development. Eleven articles by various authors, covering a wide range of subjects, emphasize the importance of human resources development in achieving sustainable agriculture and rural development.
The first article focuses primarily on actions aimed at upgrading the productive potential of people who make their living in agriculture. It indicates the many dimensions of human resources development which are the objectives of development, such as literacy, health and nutrition, and it stresses that enabling human beings to be effective and productive economic agents is more important than providing natural resources and physical capital.
Several articles provide viewpoints on and experiences in training of agriculturists in sustainable agriculture and rural development, including environmental management.
The important role of women in the utilization of environmental resources is addressed, and the need for instructing both males and females on new approaches to resource management is highlighted. Strategies for implementing group-based extension programmes to improve agricultural practices and to strengthen conservation of natural resources are described.
The publication assesses a variety of participatory approaches and remarks on the need to link environmental issues with participatory rural appraisal methods. It notes the importance of developing learning skills and critical reflection in problem-solving among extension workers and farmers. Rethinking of training and practice for extension workers is proposed.
The publication draws lessons from a number of countries in Asia and Africa. It will be interesting reading for nutritionists involved in agriculture and other professionals in rural extension, agriculture and development.
Teresa A. Calderón
Nutrition Officer,
Nutrition Programmes Service
Nutritional epidemiology - possibilities and limitations
L. Langseth. 1996. Brussels, Belgium, International Life Sciences Institute (ILSI) Europe. ISBN 0-944398-87-1. 40 pp.
This brief volume contains a comprehensive overview of methods and techniques used in epidemiological research in general, and their application to nutritional epidemiology. It describes the goals of nutritional epidemiology such as monitoring of food consumption patterns, nutrient intakes and the nutritional status of populations. It also explains the advantages and limitations of this particular area of epidemiology.
The book begins by discussing key features of the different types of epidemiological studies, both observational and experimental; it points out their advantages and limitations, as well as the potential for bias, which needs to be considered in every type of study. Key terms and concepts are explained and illustrated by interesting examples of historical research investigations. Methods of assessing nutritional exposure and examining the complex relationship between nutrition and disease are introduced.
Major topics covered include measures in epidemiology, techniques relevant to the analysis of food consumption data and issues to be considered in the interpretation of study findings such as internal and external validity. Finally, guidelines for critical evaluation of the quality of epidemiological studies are provided. The book concludes with a glossary and reference list.
In summary, this volume provides considerable insight into the field of nutritional epidemiology. In addition, it clearly states that scientists need to be aware of the inherent limits of epidemiological research in the detection of weak associations between nutritional exposure and disease; they must also be aware of the complexities involved in measuring dietary intake, avoiding bias, dealing appropriately with confounding factors and analysing data. The publication is an excellent introduction for every health professional interested in this complex field of research.
Johannes Schmidt
Consultant,
Nutrition Planning, Assessment and Evaluation Service
Food-based approaches to preventing micronutrient malnutrition: an international research agenda
G.F. Combs Jr, P.M. Welch, J.M. Duxbury, N.T. Uphoff and M.C. Nesheim, eds. 1996. Ithaca, NY, USA, Cornell International Institute for Food, Agriculture and Development. 68 pp.
This publication summarizes the findings of an international workshop of the same title which included participants from 29 countries. The primary purpose of the workshop was to develop a consensus on a research agenda which would outline key needs and opportunities for research on food-based approaches to preventing micronutrient malnutrition. The second purpose was to facilitate communication among sectors and individuals interested in obtaining sustainable solutions for malnutrition.
For addressing micronutrient malnutrition in a sustainable manner, a systems approach is proposed. In contrast to a sectoral approach, a systems approach would provide a better means of analysing all relevant causal variables and would call for multidisciplinary action.
An analysis by the participants brought forth good arguments regarding the barriers and limitations to using current knowledge for overcoming micronutrient malnutrition through food-based approaches. The participants noted the current absence of multidisciplinary coalitions to address food, nutrition and health issues better among nutritionists, public health professionals, food industry technicians and agricultural specialists. They pointed out that agricultural production does not usually have improved micronutrient outcomes as its goal. They recognized that little effort has been made to address the need for cultivation of edible, indigenous plants as a source of micronutrients.
An excellent analysis of current research needs is also presented. Research is proposed for making better use of food technology, communications, farming systems, etc. However, the participants indicated that research is also necessary to generate new knowledge in areas such as micronutrient availability and micronutrient crop enrichment. These suggestions could be useful to academic and research institutions dealing with issues related to food, agriculture and nutrition.
This publication makes a significant contribution to efforts to move micronutrient programmes into the mainstream of agricultural development planning. It highlights the great potential of food-based approaches as long-term, sustainable solutions for micronutrient deficiencies. The document will be of interest to a variety of professionals dealing with food and nutrition issues, including agronomists, nutritionists, social scientists, economists, public health specialists and development planners.
Teresa A. Calderón
Nutrition Officer,
Nutrition Programmes Service
Manual of nutrition
Ministry of Agriculture, Fisheries and Food, United Kingdom. 1995. Reference Book 342. London, HMSO. 10th ed. 165 pp. ISBN 0-11-242991-2.
The Manual of nutrition is an easy-to-use guide suitable for health educators, home economics instructors, science teachers, journalists and the general public. This small book provides brief information sufficient to address common questions about food and diet. The first part, "Nutrients and their utilization", describes carbohydrates, fats, protein, vitamins, minerals, digestion and absorption. The United Kingdom's dietary reference values (DRVs), which have replaced recommended daily allowances (RDAs), are provided.
The second part, "Nutritional value of food and diets", discusses the characteristics of various types of foods (e.g. dairy products, meat, fish, pulses, vegetables, roots and tubers) and the nutritional effects of food preparation and processing. Advice about planning meals is given, and the nutritional needs of people in different phases of life (e.g. infancy, pregnancy, old age) are addressed. The United Kingdom's National Food Guide is described as well.
The appendixes provide food composition tables and methods for estimating basal metabolic rate and the nutritional value of foods. Very brief information about food additives and United Kingdom and European Community food legislation is also given.
This manual has a few shortcomings. It contains some concepts that are outdated, for example, P/S (polyunsaturated/saturated) ratio. Some other terms are not widely accepted, such as "intrinsic" and "extrinsic" sugars. The short reading list comprises primarily United Kingdom government publications; it would have been helpful to add other nutrition references. The scope of the manual is limited to foods and health issues that are common in the United Kingdom. Nevertheless, the Manual of nutrition gives a range of important nutrition information that many readers will find useful.
Janice Albert
Nutrition Officer,
Office of the Director,
Food and Nutrition Division
Food chemistry
O.R. Fennema, ed. 1996. Food Science and Technology Series No. 76. New York, NY, USA, Marcel Dekker, Inc. 3rd ed. 1088 pp. Hardcover, ISBN 0-8247-9346-3. Price: US$185. Softcover, ISBN 0-8247-9691-8. Price: US$55.
Food chemistry is primarily a textbook for upper-division undergraduates and beginning graduate students. It is also a valuable reference work for professionals. This recently released edition follows the format of the second edition (published ten years ago) and contains a wealth of new information. It provides updated chapters on all of the standard areas of interest in food chemistry such as water, carbohydrates, lipids, amino acids and enzymes. Separate chapters are devoted to vitamins and minerals, which were combined in the second edition. This logical step allows fuller coverage of both topics.
Another major change which greatly enhances the book's value both as a text and as a reference is the addition of a chapter entitled "Dispersed systems: basic considerations". This chapter covers physical and chemical considerations for foods in a dispersed state, such as liquid dispersions, gels, emulsions and foams. In the previous edition, these considerations were scattered in several different chapters, such as those on carbohydrates and lipids.
Food chemistry' textbooks must, almost by definition, include a considerable amount of classical food chemistry. Of course, they must also include the newer advances in the science, regarding both theory and practice. The editor has reached an excellent balance between the two in this text.
John Weatherwax
Consultant,
Food Quality and Standards Service
The contemporary and historical literature of food science and human nutrition
J. Brogdon and W.C. Olsen, eds. 1995. Ithaca. NY. USA, Cornell University Press. 296 pp. ISBN 0-8014-3096-8.
This book is a practical, comprehensive literature review giving a historical perspective of food science and human nutrition. It provides a brief history of both disciplines, highlighting the main discoveries and events. An extensive reference list is provided, ranking the publications in terms of their historical importance and usefulness.
The historical summary will be interesting for students and others. For instance, methods of food preservation (drying, salting, smoking, sugaring) were considered arts until their scientific basis was understood. In the nineteenth century, food science and nutrition evolved with such developments as Appert's canning and Pasteur's discovery that microorganisms cause fermentation and spoilage of foods. More recent innovations (e.g. aseptic packaging, microwave ovens, controlled atmospheric storage) and changes in consumer behaviour are discussed.
Benchmarks in human nutrition in the nineteenth century such as Beaumont's description of the physiology of digestion and Bernard's study on the role of liver in metabolism are noted. In the first part of the twentieth century, understanding of vitamins was advanced with Funk's work on thiamine and McCollum and Mellanby's work on fat-soluble vitamins. Diseases caused by nutritional deficiencies were explained around this time; for instance, Williams described kwashiorkor in the 1930s. Since the 1950s, links between nutrition and chronic diseases have become more established. Recent knowledge on nutritional deficiencies (e.g. immune function, role of antioxidant nutrients) are covered as well. Collaborative international studies and the role of the United Nations agencies in promoting health and alleviating nutritional problems are addressed.
Brogdon and Olsen present their method for determining the core publications and characteristics of food science and human nutrition literature. They analysed monographs, journal articles and several electronic databases. In almost all subjects, English-language publications were predominant. In food science there were very few references concerning developing countries, while this was not true of human nutrition. The few titles from developing countries were ranked as being of major importance.
A chapter by Jean Pennington concentrates on databases on nutrient composition, dietary intake and food adulteration. Regrettably, the book was written before the Internet explosion.
The contemporary and historical literature of food science and human nutrition is recommended as a helpful guide for academics and others interested in the history of food science and nutrition.
Simon Chevassus-Agnès
Nutrition Officer,
Nutrition Planning, Assessment and Evaluation Service
(Impact Assessment and Evaluation Group)
The living fields, our agricultural heritage
J.R. Harlan. 1995. Cambridge. UK, Cambridge University Press. 271 pp. ISBN 0-521-40112-7.
All those interested in the origins of today's food might wish to read Jack Harlan's The living fields, our agricultural heritage. Starting with the myths about the origins of agriculture in the ancient Egyptian, Greek and Roman worlds, among the native Americans and in the Chinese and aboriginal traditions, Harlan takes the reader around the world, tracing the processes of domestication of many of the foods known today. People's perceptions of their food and agricultural needs and their development of responses to these needs are highlighted. The author, a specialist in crop evolution and plant domestication, explains the various origins of agriculture and shows that most myths and tales view agricultural knowledge as a blessing from the gods. People only began fairly recently to look upon agricultural development and heritage in a more scientific way - with Darwin's work, for example.
The book provides a clear view on processes of domestication of a variety of foods, including weeds and animals. In describing the origin and evolution of different crops the author draws upon his personal experiences, which gives a nice personal note although the relevance is sometimes unclear. A good introduction to general archaeology is given, describing different archaeological sites and methods of dating and their biases, especially for plant materials. The author attempts to highlight the relation between the evolution of human beings and human culture and the domestication of plants and animals.
Several chapters review the developments in different regions in the world: the Near East, Africa, the Far East and the Americas. Although these chapters differ in structure, they give a clear picture of the crops originating from these regions, describing their evolution up to the present. An interesting feature of these chapters is the attention to the dispersal of original crops to other regions in the world. For example, the roots and tubers originating from the Americas found worldwide destinations. Potatoes are now consumed all over the world, but predominantly in the West, particularly in northern Europe. Manioc and cassava are today the main staple foods in many countries in Africa. It is notable that Europe is not included as a region. Some elements of European crop evolution can be found in the Near East section, which may lead the reader to believe that agricultural development in Europe was primarily based on the experiences in Near Eastern agriculture. During ancient times in the Near East and Europe it was acknowledged that Egypt was the grain store of the world because of its relatively stable agricultural system.
An overview of some traditional techniques is given, including hunting and gathering, soil preparation, water management, sowing and reaping, and preservation and processing. Most of the techniques described are still in use in some regions of the world.
In the concluding chapter, the author briefly describes the current world food situation according to FAO data (corrected for moisture content and wastage) and identifies some major institutions involved in agricultural research. Harlan ends his book expressing his concern about the possible loss of indigenous genetic resources of cereal and other crops and, more generally, about the loss of traditional cultures giving way to modernization.
The book follows a strong historical and archaeological approach, including many details about crop development and crop genetics. For those who are not archaeologists or plant scientists this information may be overwhelming at times. However, as a lay person, the reviewer found these ideas new and enjoyed the book. The living fields, our agricultural heritage is recommended.
Marion Herens
Associate Professional Officer,
Nutrition Programmes Service
(Household Food Security Group)
Trace elements in human nutrition and health
World Health Organization. 1996. Geneva, Switzerland. 343 pp. ISBN 92-4-156173-4. Price: SwF85.-/US$76.50; in developing countries, SwF59.50. Order No. 1150431. Available in English; French in preparation.
Recognizing the advances in knowledge related to trace elements, FAO, the International Atomic Energy Agency (IAEA) and the World Health Organization (WHO) convened a meeting of experts to evaluate the role of trace elements in human health and nutrition in Geneva in 1990. This book represents the consensus reached by these international experts and other scientists. Its aim is to give scientists and those responsible for nutrition planning a solid basis for assessing dietary intakes of trace elements, detecting deficiencies and excesses and recognizing the clinical features of related disorders. The publication provides the latest scientific knowledge about the consequences of specific dietary intakes and gives practical advice on how to identify related nutritional disorders more efficiently. Throughout the book, guidelines and advice are given based on greatly expanded knowledge about the significant impact that even subtle differences in trace elements can have on health and disease. This book provides authoritative recommendations concerning nutritional requirements and safe ranges of intake for 19 trace elements important to human health.
The book has 24 chapters presented in five parts. The first part establishes a framework for the evaluation. Its chapters provide background information about the significance of trace elements, explain the methods used to estimate requirements and safe ranges of intakes, and discuss the influence of physiological and dietary variables on bio-availability. As readers are reminded, awareness of these variables is particularly important when attempts are made to determine whether a given level of dietary intake is actually meeting nutritional requirements.
The core of the report, which has three parts, provides authoritative recommendations on the nutritional significance, requirements for health and safe range of daily intakes for 19 trace elements. These elements are presented in three categories: essential elements, such as iodine and zinc; probably essential elements, such as manganese and silicon; and potentially toxic elements, such as fluoride, lead, cadmium and mercury, which may also have some essential functions at low levels. Recommendations for individual elements are presented in the form of safe ranges of intake for population groups, representing the limits of adequacy and safety for the mean intakes of whole populations.
Chapters in the final part provide detailed guidelines for the design and interpretation of research on trace elements. A chapter on analytical methodology concentrates on the problems encountered in determining trace elements in biological samples and dietary materials and on the feasibility of monitoring trace elements through analysis of blood, hair, urine, faeces and milk. The next chapter uses data from dietary surveys in 27 countries to discuss methods for assessing dietary intakes and to highlight problems of data interpretation. The final chapter offers advice on how to determine whether the dietary habits of specific communities will increase the risk of disorders related to trace elements. Brief information on the factors that modify susceptibility to such disorders and influence the environmental supply of trace elements is followed by a discussion of the limitations of existing diagnostic criteria and the need to draw on evidence from a wide variety of sources. The report concludes with a series of technical notes on the derivation and application of requirement estimates for population averages, as opposed to individual intakes.
Preventing micronutrient malnutrition: a guide to food-based approaches
· Manual for policy makers and programme planners
· Overview: Why policy makers should give priority to food-based strategies
FAO and International Life Sciences Institute (ILSI). 1997. Washington, DC, USA, ILSI. Manual, 116 pp. ISBN 0-944398-89-8. Overview, 16 pp. ISBN 0-944398-94-4.
Preventing micronutrient malnutrition: a guide to food-based approaches describes the prevalence, causes and consequences of micronutrient diseases. The manual covers such issues as implementing diet- and food-based approaches to reducing deficiencies; planning programmes; monitoring, surveillance and evaluation; and special needs of vulnerable groups. A useful guide to agencies working to combat micronutrient malnutrition and a list of references are provided. A companion overview publication, Why policy makers should give priority to food-based strategies, briefly summarizes the key issues.
Nutrition education for the public - Discussion papers of the FAO Expert Consultation
FAO Food and Nutrition Paper No. 62. 1997. Rome. 212 pp. ISBN 92-5-103936-4. Price: US$22.
As part of the commitment to improving nutrition in developing countries, FAO organized the Expert Consultation on Nutrition Education for the Public in September 1995. During the meeting, 14 international experts discussed six papers which are presented in this publication. The papers cover past experiences and needs for nutrition education; a framework for nutrition education programmes; nutrition education and communication strategies for different groups and settings; training needs for nutrition education; evaluation of nutrition education programmes; and new developments in computer-mediated technology for nutrition education. This publication complements FAO Food and Nutrition Paper No. 59, published in 1995, which presents the report adopted by the Expert Consultation.
