Sustainable Agriculture and Food: Four volume set (Earthscan Reference Collections)

Diet and Health: Diseases and Food 273

Could the proponents of Productionism have anticipated the scale of these most
recent health concerns? To some extent, they could not. Even excessive intake of fats
as causing ill health might have been something of a shock for the Productionist
paradigm, as it was almost heretical to argue that too much of a nutrient could be
harmful to health.^9 Part of the problem here was the essential paternalism of the
paradigm which assumed total knowledge of all variables needed to make good food
policy: governments and companies could be trusted to look after the public health;
the consumers’ role was to select products to create their own balanced diets. Recent
history, however, has shown that governments and the food supply chain failed to
adapt to new scientific knowledge in relation to food and health. Nationally and
internationally, the influence of health scientists on public policy has been minimal.
Consumerism triumphed. To some extent, too, the public health world has colluded
in its own marginalization from ‘live’ policy making by its fixation with deficiency
diseases: for example, on programmes of food fortification or on protein shortages
which could be made up by increased meat and dairy production. Despite a success-
ful worldwide campaign to increase intake of folic acid following the discovery of its

Table 13.1 Some major diet-related diseases

Problem Extent/comment

Low

birthweights

30 million infants born in developing countries each year with low

birthweight: by 2000, 11.9 per cent of all newborns in developing

countries (11.7 million infants)

Child under-

nutrition

150 million underweight preschool children: in 2000, 32.5 per cent of

children under 5 years in developing countries stunted, amounting to

182 million preschool children. Problem linked to mental impairment.

Vitamin A deficiency affects 140–250 million schoolchildren; in 1995,

11.6 million deaths among children under 5 years old in developing

countries

Anaemia Prevalent in schoolchildren; maternal anaemia pandemic in some

countries

Adult chronic

diseases

These include adult-onset diabetes, heart disease and hypertension,

all accentuated by early childhood under-nutrition

Obesity A risk factor for some chronic diseases (see above), especially

adult-onset diabetes.^7 Overweight rising rapidly in all regions of the

world

Underweight In 2000, an estimated 26.7 per cent of preschool children in

developing countries.

Infectious

diseases

Still the world’s major killers but incidence worsened by poor

nutrition; particularly affects developing countries

Vitamin A

deficiency

Severe vitamin A deficiency on the decline in all regions, but sub-

clinical vitamin A deficiency still affects between 140 and 250 million

preschool children in developing countries, and is associated with

high rates of morbidity and mortality

Source: Adapted from ACC/SCN 2000^8