The impact of the newer knowledge of nutrition : nutrition science and nutrition policy, 1900-1939
Ideas concerning relationships between diet and health in the UK are traced from the 1904 Comittee on Physical Deterioration to the outbreak of World War II. Archive material is used to describe the often conflicting views of the Medical Research Council and the Ministry of Health and Board of Education concerning the public health applications of nutrition science. In particular, the work of the Ministry of Health's first Advisory Comittee on Nutrition, which was appointed in 1931, is reviewed and evaluated. The debate among public healh practitioners over the nature, cause and extent of the 'nutrition problem' is documented and the role in this debate of official dietary guidelines which appeared during the 1930s, is assessed. The Impact of the Newer Knowledge of Nutrition on welfare feeding policy Is evaluated in the context of the official promotion of milk feeding in schools. In particular, Corry Mann's experimental evidence which was used to endorse this policy, is reconsidered, and it is shown that the NRC view that the trial was proof of the presence in milk of a "growth factor" which produced preferential growth efficiency in adequately fed children , was in error. From a re-evaluation of the evidence it is suggested that the experiment merely recorded catch-up growth in a group of poorly nourished children. The view that there existed an extensive nutritional problem due to poor quality diets is examined and challenged. Both dietary survey data and anthropometric evidence are used to present the case that there was throughout the period studied a widespread problem of underfeeding among the poor and that intervention strategies based on the Newer Knowledge were not an appropriate method of dealing with this problem. This casts doubts on the widely held view that there was a need for nutrition education and suggests that the problem was one of poverty rather than Ignorance. Disaggregated anthropometric data located by the author are analysed according to NCHS standards to assess the prevalence of underfeeding. Significantly higher prevalences of stunting than low weight-for-age exist in all data sets; this phenomenon is considered in detail and low weight-for-age is proposed as the preferred index of malnutrition in 20th Century historical studies. Attention is drawn to the relevance of these studies for the current nutrition and public health debate.