Dimensions, domains and principles of the new nutrition science

A ciência da Nutrição no “Novo Regime Climático”

Uma das maiores preocupações da humanidade no momento atual, denominado por Bruno Latour de um “Novo Regime Climático, é o impacto negativo produzido pelas mudanças ambientais, uma vez que seus efeitos repercutem em todo o planeta. A deterioração do meio ambiente natural tem sido acompanhada de um correspondente aumento dos problemas de saúde dos indivíduos. Nos encontramos numa fase de crise de paradigma na Ciência da Nutrição, em que a mudança se torna cada vez mais necessária e urgente; o caminho que vem sendo apontado é o da ampliação das noções existentes rumo a uma visão sistêmica e holística para enfrentar os desafios e oportunidades do século XXI. Este ensaio reflexivo teórico tem como base a obra de Bruno Latour, e tem como objetivo identificar as intersecções da Ciência da Nutrição e o exercício profissional do nutricionista com a ideia da reorientação ao vetor que Latour chama de “Terrestre”, como novo ator-político no período do Antropoceno. Torna-se necessário estender o mandato da prática baseada em evidências para adotar modelos mais relacionais de pensamento crítico para a aprendizagem transformacional em nutrição, sendo uma oportunidade de colaboração para todos os profissionais da área apoiarem as pessoas a combinarem uma alimentação saudável com uma alimentação sustentável. O redirecionamento da ciência da Nutrição vai ao encontro das ideias recentes de Latour em relação a uma possível mudança do sistema de produção para o sistema de geração sintonizado com a sustentabilidade

GORDURA, DISCRIMINACIÓN Y CLASISMO: UN ESTUDIO EN JÓVENES DE SANTIAGO DE CHILE

Resumen El estudio de la obesidad desde la psicología social se ha realizado principalmente desde una aproximación cognitivo conductual omitiendo los contextos sociales en que se realizan juicios discriminadores. Con el objetivo de comprender los significados con que se construye la gordura y su interacción con otras formas de exclusión social, hemos realizado un estudio cualitativo de jóvenes de Santiago de Chile. Trabajamos con tres grupos de discusión, que analizamos siguiendo las directrices de la teoría fundada. Presentamos los resultados relativos a la construcción de la gordura y su vinculación con las clases sociales. La gordura se constituye como una condición que define a la persona como ansioso/a, perezoso/a y deforme, lo que justifica la acción de discriminación. Los atributos por los que son excluidos las personas gordas coinciden con los utilizados históricamente para discriminar a los/as pobres, de ahí que concluimos que se constituye como una nueva forma de clasismo.

Wholesome Nutrition: an example for a sustainable diet

'Wholesome Nutrition' is a concept of sustainable nutrition that was developed at the University of Giessen in the 1980s. In this concept, health and the ecologic, economic, social and cultural dimensions of nutrition are equally important. In 1992 at the UN-Conference on Environment and Development in Rio de Janeiro the definition of 'Sustainable Development' comprised the dimensions environment, economy and society. Additionally to these three 'classical' dimensions of sustainability, we included 'health' as the fourth dimension because nutrition has far reaching effects on human health. The fifth dimension, 'culture', became part of the sustainability dialogue since many years; the respective cultural background influences food habits. Presently, mankind has to cope with huge global challenges such as poverty and food insecurity in low-income countries as well as climate change. Therefore the objective is to identify prospects for actions to respond to these global challenges. The concept of 'Sustainable Nutrition' analyses the food supply chain at all stages from input-production and primary production to processing, distribution, preparation, consumption and waste disposal. The present analysis leads to the following seven principles: preference of plant-based foods, organic foods, regional and seasonal products, preference of minimally processed foods, Fair Trade products, resource-saving housekeeping and enjoyable eating culture. This concept is based on holistic thinking and has the potential to reduce the global challenges in the field of nutrition. Scientists, stakeholders, multipliers and consumers are asked to consider environmental, economic, social and cultural aspects in addition to the biological (health) aspects.

Insights into nutritionists' practices and experiences in remote Australian Aboriginal communities

OBJECTIVE

To explore and describe methods of communication, education practices, perceived challenges and the potential role of nutritionists working in remote Australian Aboriginal communities in order to inform future public health efforts.

METHODS

Nutritionists who work or have worked in remote Aboriginal communities in Australia's Northern Territory within the past decade were identified via purposive and snowball sampling, and responded to a semi-structured survey in 2012. Content and interpretive thematic analysis was used to generate themes.

RESULTS

Working approaches of 33 nutritionists are presented, representing 110 years of working experience in the Northern Territory. Emerging themes included: 'Community consultation is challenging', 'Partnering with local people is vital', 'Information is not behaviour', 'Localisation of nutrition education is important' and 'Evaluation is tricky'. Available time, training background and workforce structure were said to constrain practice and those nutritionists with longer experience described a more culturally competent practice.

CONCLUSIONS

Modifications in structure, training and support of the public health nutrition workforce, facilitation of professional and cultural partnerships, outcome evaluation and localisation and evaluation of health messages may promote more meaningful nutrition communication in remote communities.

IMPLICATIONS

Findings can inform further investigation into the structures needed to improve public health skills for nutritionists transitioning from mainstream practice into the challenging cross-cultural context of Aboriginal health settings.

Vegetarian nutrition: past, present, future

Early human food cultures were plant-based. Major religions such as Hinduism and Buddhism have recommended a vegetarian way of life since their conception. The recorded history of vegetarian nutrition started in the sixth century bc by followers of the Orphic mysteries. The Greek philosopher Pythagoras is considered the father of ethical vegetarianism. The Pythagorean way of life was followed by a number of important personalities and influenced vegetarian nutrition until the 19th century. In Europe, vegetarian nutrition more or less disappeared during the Middle Ages. In the Renaissance era and in the Age of Enlightenment, various personalities practiced vegetarianism. The first vegetarian society was started in England in 1847. The International Vegetarian Society was founded in 1908 and the first vegan society began in 1944. Prominent vegetarians during this time included Sylvester Graham, John Harvey Kellogg, and Maximilian Bircher-Benner. A paradigm shift occurred at the turn of the 21st century. The former prejudices that vegetarianism leads to malnutrition were replaced by scientific evidence showing that vegetarian nutrition reduces the risk of most contemporary diseases. Today, vegetarian nutrition has a growing international following and is increasingly accepted. The main reasons for this trend are health concerns and ethical, ecologic, and social issues. The future of vegetarian nutrition is promising because sustainable nutrition is crucial for the well-being of humankind. An increasing number of people do not want animals to suffer nor do they want climate change; they want to avoid preventable diseases and to secure a livable future for generations to come.

Re-imagining the 'social' in the nutrition sciences

OBJECTIVE

In response to The New Nutrition Science Project's Giessen Declaration, we provide here a case for a more fully described and integrated 'social' dimension within the nutrition sciences.

DESIGN

This paper explores what we mean when we argue for socially engaged nutrition sciences (SENS), and describes the disciplinary fields, epistemologies and methodologies that contribute to SENS' potential rich diversity and value. Additionally, the current positioning of 'social nutrition' research within the nutrition sciences is critiqued.

RESULTS

There is fairly broad acceptance of the 'social' as an important contributor to successful public health nutrition situation analyses, intervention planning and implementation. However, we assert that the 'social' is not merely a contributor, the usual position, but is central. Implications for policy and practice that could follow from this shift in approach are outlined.

CONCLUSIONS

We call for researchers, educators, policy makers and practitioners alike to re-imagine the role and purpose of social science enquiry that could enable the delivery of more socially engaged nutrition sciences.

Molecularization in nutritional science: a view from philosophy of science

SCOPE

Over the past decade, a trend toward molecularization, which could be observed in almost all bioscientific disciplines, now appears to have also developed in nutritional science. However, molecular nutrition research gives birth to a series of questions. Therefore, we take a look at the epistemological foundation of (molecular) nutritional science.

METHODS AND RESULTS

We (i) analyze the scientific status of (molecular) nutritional science and its position in the canon of other scientific disciplines, (ii) focus on the cognitive aims of nutritional science in general and (iii) on the chances and limits of molecular nutrition research in particular. By taking up the thoughts of an earlier work, we are analyzing (molecular) nutritional science from a strictly realist and emergentist-naturalist perspective.

CONCLUSION

Methodologically, molecular nutrition research is bound to a microreductive research approach. We emphasize, however, that it need not be a radical microreductionism whose scientific reputation is not the best. Instead we favor moderate microreductionism, which combines reduction with integration. As mechanismic explanations are one of the primary aims of factual sciences, we consider it as the task of molecular nutrition research to find profound, i.e. molecular-mechanismic, explanations for the conditions, characteristics and changes of organisms related to the organism-nutrition environment interaction.

Beyond foodscapes: considering geographies of Indigenous well-being

Direct associations between food and health have been pursued traditionally through nutrition and health policy studies; however, geography has much to offer in providing a disciplinary context that can support a critique of this literature and the recognition of the critical significance of broader associations between culture, environment and well-being. This paper explores the potential of these opportunities by reviewing existing interests in food geographies and the wider attention being given to geographies of health and well-being. We then turn to consider dimensions of Indigenous life, health and well-being and we highlight the complex intersection of people, place and 'nature-culture' relations. In particular, we propose the need to move beyond a foodscape approach and suggest how a more culturally complex reading of food and food practices may be made to enhance research and policy concerning Indigenous health and well-being.

Worldwide trends in dairy production and consumption and calcium intake: is promoting consumption of dairy products a sustainable solution for inadequate calcium intake?

BACKGROUND

Adequate calcium intake is critical for good health. Inadequate calcium intake is a worldwide problem and is more serious in countries where consumption of dairy products is low.

OBJECTIVE

To analyze worldwide trends in production and consumption of dairy products and in calcium intake.

METHODS

Data were taken from Food and Agriculture Organization food balance sheets, from published studies, and from surveys of four countries with large populations and large dairy production (China, India, the United States, and Russia). Linear regression models were fitted to estimate average annual changes and to project future trends.

RESULTS

Overall global dairy production and supply (total and per capita) have increased since 1980, especially in developing countries. There are large between-region and between-country differences in the levels of production, supply, and consumption and in the trends. In 1997 India surpassed the United States to become the largest dairy producer. Consumption of dairy products in China has more than tripled since 1982 and has increased sevenfold among urban residents. The increase has been more dramatic during recent years. In spite of increases in dairy production and consumption in China and India, calcium intake has decreased in these countries. The average daily per capita consumption of dairy products was more than 200 g in the United States in 1999-2004 but less than 27g in China in 2002; the average daily per capita intake of calcium was 962 mg in US men and 756 mg in US women in 1999-2004, but less than 400 mg in China in 2002.

CONCLUSIONS

Global production and supply of dairy products have been increasing since 1980, which has an impact on the environment. Dairy consumption and calcium intake remain low in most countries examined as compared with recommended amounts of dairy products and calcium. Promotion of consumption of dairy products does not necessarily increase total calcium intake.

Nutrition change strategies: the new frontier

OBJECTIVE

To advance understanding of nutrition change dynamics and strategies needed to tackle complex global nutrition challenges.

DESIGN

Two frameworks, a descriptive framework of orders of change and a change model (Theory U), are introduced to advance understanding of how to promote effective action on a complex social problem like nutrition. The descriptive framework explores the types of change pursued by four current global nutrition initiatives and the strategies they use to achieve their goals. Theory U provides a conceptual model to help understand breakthrough or transformative change, i.e. change that shifts the entire system.

SETTING

The focus is on global and regional nutrition initiatives.

RESULTS

Using the criteria of desired outcomes, purpose, participation and process, the orders of change framework categorizes programme strategies according to the levels of change likely to be achieved. Such a framework can help to structure conversations among actors about prerequisites for, and the likelihood of, transformative change. Theory U provides a conceptual framework to facilitate transformative change by providing insight into change processes and levers for action.

CONCLUSIONS

Nutrition is a complex social issue, and not only a biological or technical challenge. But nutritionists seldom inquire into the nature of changes required to achieve goals or the processes through which change occurs. Lack of understanding and failure to address such change processes directly mean that nutrition policies and programmes continue to fall short. There is a need to understand the dynamics of change in nutrition; to learn from current change experiences; and to create dynamic learning communities.

Food, livestock production, energy, climate change, and health

Food provides energy and nutrients, but its acquisition requires energy expenditure. In post-hunter-gatherer societies, extra-somatic energy has greatly expanded and intensified the catching, gathering, and production of food. Modern relations between energy, food, and health are very complex, raising serious, high-level policy challenges. Together with persistent widespread under-nutrition, over-nutrition (and sedentarism) is causing obesity and associated serious health consequences. Worldwide, agricultural activity, especially livestock production, accounts for about a fifth of total greenhouse-gas emissions, thus contributing to climate change and its adverse health consequences, including the threat to food yields in many regions. Particular policy attention should be paid to the health risks posed by the rapid worldwide growth in meat consumption, both by exacerbating climate change and by directly contributing to certain diseases. To prevent increased greenhouse-gas emissions from this production sector, both the average worldwide consumption level of animal products and the intensity of emissions from livestock production must be reduced. An international contraction and convergence strategy offers a feasible route to such a goal. The current global average meat consumption is 100 g per person per day, with about a ten-fold variation between high-consuming and low-consuming populations. 90 g per day is proposed as a working global target, shared more evenly, with not more than 50 g per day coming from red meat from ruminants (ie, cattle, sheep, goats, and other digastric grazers).

The new nutrition science project

Objective

To show that nutrition science, with its application to food and nutrition policy, now needs a new conceptual framework. This will incorporate nutrition in its current definition as principally a biological science, now including nutritional aspects of genomics. It will also create new governing and guiding principles; specify a new definition; and add social and environmental dimensions and domains.

Method

A narrative review of nutrition science, its successes and achievements, and its dilemmas, paradoxes, shortcomings, dissonances and challenges. Reference is made to 16 associated papers. Equal use is made of continuous text and of boxed texts that extend the review and give salient examples.

Results

Recent and current interrelated electronic and genomic discoveries and linked sequential demographic, nutritional and epidemiological shifts, in the context of associated and interlinked global social, cultural, environmental, economic, political and other developments, altogether amount to a world in revolution, requiring all disciplines including that of nutrition science to make comparably radical responses.

Conclusion

Nutrition in principle and practice should be a biological and also an environmental and social science. This new broad integrated structure brings much recent and current progressive work into the centre of nutrition science, and in some ways is a renewal of the period when nutrition science had its greatest impact. It amounts to a map charting well-known and also new worlds. The new nutrition science is concerned with personal and population health, and also with planetary health – the welfare and future of the whole physical and living world of which humans are a part. In this way the discipline will make a greater contribution to the preservation, maintenance, development and sustenance of life on Earth, appropriate for the twenty-first century.

The principles, definition and dimensions of the new nutrition science

Objective

To specify the principles, definition and dimensions of the new nutrition science.

Purpose

To identify nutrition, with its application in food and nutrition policy, as a science with great width and breadth of vision and scope, in order that it can fully contribute to the preservation, maintenance, development and sustenance of life on Earth.

Method

A brief overview shows that current conventional nutrition is defined as a biological science, although its governing and guiding principles are implicit only, and no generally agreed definition is evident. Following are agreements on the principles, definition and dimensions of the new nutrition science, made by the authors as participants at a workshop on this theme held on 5–8 April 2005 at the Schloss Rauischholzhausen, Justus-Liebig University, Giessen, Germany.

Result

Nutrition science as here specified will retain its current [classical] identity as a biological science, within a broader and integrated conceptual framework, and will also be confirmed as a social and environmental science. As such it will be concerned with personal and population health, and with planetary health – the welfare and future of the whole physical and living world of which humans are a part.

Indigenous peoples' food systems for health: finding interventions that work

This is a short report of a ‘safari’ held in conjunction with the International Congress of Nutrition in September 2005, in Futululu, St. Lucia, South Africa. Participants were several members of the International Union of Nutritional Sciences Task Force on Indigenous Peoples' Food Systems and Nutrition, other interested scientists and members of the Kwa Zulu indigenous community. The paper describes the rationale for and contributions towards understanding what might be successful interventions that would resonate among indigenous communities in many areas of the world. A summary of possible evaluation strategies of such interventions is also given.

Integrated nutrition science: from theory to practice in South Africa

OBJECTIVE

To describe an integrated, holistic conceptual framework and research paradigm for a better understanding of the nutrition transition in middle- and low-income countries.

MOTIVATION

Current inability effectively to prevent the increasing burden related to changes in food consumption patterns and other health behaviours of populations in transition motivates a new approach for nutrition research and practice. In this proposed approach, broader and integrated dimensions of science and practice may be applied for a better understanding of this complex phenomenon.

RESULT

Examples from our own studies are given and quoted to illustrate how results from transdisciplinary studies were used to design an integrated, holistic programme to improve quality of life of people infected with HIV.

CONCLUSION

Based on these experiences it is argued that the more holistic and integrated approach should and could lead to more effective and sustainable interventions to prevent the adverse health consequences of the nutrition transition. At the same time such an approach will contribute to efforts to conserve the environment and also human, living and natural resources.