SOCH111 History of Healing · SOCH111 –History of Healing Session 18 Nutrition and Diet ... more dispensable in the diet By Chemistry-grad-student - Own work, CC BY-SA 3.0,

SOCH111 – History of Healing

www.endeavour.edu.au

Session 18

Nutrition and Diet

Department of Social

Sciences

© Endeavour College of Natural Health www.endeavour.edu.au 2

Session Aims

o To examine the historical development of food

as medicine and the advent of nutritional

science

o To overview global perspectives on food and

nutrition and forces that shape them and their

impacts on health

o To describe the various modern disciplines of

clinical nutrition practice and public health and

how they developed


Let food be thy medicine, and

medicine be thy food.

~Hippocrates


Early European Medical Dieteticso Hippocrates & Galen: foundation

for food as medicine in the West

via the four humours and food

qualities of hot/cold and

dry/moist

o Avicenna departed from strict

humoral view, recognising that

some foods have therapeutic/

medicinal properties unrelated to

humoral influences

o Works of Avicenna and Galen on

food as medicine were in regular

medical curricula by the 13th

century

Public Domain,

https://commons.wikimedia.or

g/w/index.php?curid=360283

https://commons.wikimedia.org/w/index.php?curid=360283


Early European Medical Dietetics

o Eating habits were

emphasised, beyond what

foods were eaten

o By the 1700’s in English

hospitals, diet was strictly

prescribed following the

ancient Hippocratic

adage: “feed a cold and

starve a fever”

o By 1772, Dr William

Cullen noted that dietetic

prescriptions had fallen

out of use by doctors

By Annibale Carracci - Unknown, Public Domain,




Eastern Dietetics: Ayurvedao Foods prescribed with regard

to the effects that they have on

balancing the doshas

o Six tastes (sweet, salty, sour,

bitter, pungent, astringent) are

major influences on the doshas

o Examples:

• Sweet, sour and salty, warm, and

moist foods balance Vata

• Sweet, bitter and astringent, cool,

and heavy foods balance Pitta

• Pungent, bitter and astringent,

light, and warm foods balance

Kapha

By judepics -

http://www.flickr.com/photos/judepics/409841087/, CC BY 2.0,




Eastern Dietetics: Chinese Medicine

o Foods prescribed with regard

to the effects that they have

on yin/yang balance, the 12

organs, and on qi and blood

o Five flavours are major

influences on the five yin

organs

o Examples:

• Bitter – Heart

• Sour – Liver

• Sweet – Spleen

• Spicy – Lung

• Salty - Kidney

By Acceptable at English Wikipedia, CC BY-SA 3.0,




Evolution of Nutrition Practice

o Early 1800’s: physicians

following alchemical

methods had been using

minerals therapeutically for

centuries (some of those

being quite toxic), as well as

food as medicine

o Wilhelm Schuessler, German

physician and homeopath, in

1873: published theory of 12

mineral compounds

necessary to life, called

biochemic, tissue or cell saltsBy Unknown - Public Domain,




Influence of Agriculture on Dieto From ~40,000-20,000 BCE,

hunted meat of large

mammals contributed as

much as 50% of human

nourishment

o By ~17,000 BCE, humans

were scavenging wild

grains, including wheat and

barley

o Advent of agriculture and

animal domestication

~10,000 years ago changed

nutrient characteristics of

human diets

By Maître du Boccace de Genève -

http://ecole.orange.fr/college.saintebarbe/moyenage/travaux.htm

#Saison, Public Domain,




Influence of Agriculture on Diet

o During and after the

Industrial Revolution, food

processing procedures

were developed that

changed the character of

foods consumed

o With scientific isolation of

macro and micronutrients,

food processing essentially

was able to create entirely

novel “foods” that were

foreign to the human GIT

By Ewing Galloway - 300 ppi scan of Collier's New Encyclopedia,

Volume 1 (1921), opposite page 58, panel H., Public Domain,




Influence of Agriculture on Diet

Pre-agricultural human diet

compared to diet during the

Industrial Revolution—

adverse effects on:

o Glycaemic load

o Fatty acid composition

o Macronutrient

composition

o Micronutrient density

o Acid-base balance

o Sodium-potassium ratio

o Fibre content

By Photographic Collection - originally posted to Flickr as

Women working in a cannery, CC BY 2.0,




Early Nutrition Scienceo Late 18th century France:

“Chemical Revolution” firmly

identified the main elements

and methods of chemical

analysis

o Key early finding: the presence

of nitrogen in animal matter

and wheat but not in potatoes

o Query: what in foods is used to

build human (animal) tissues?

o Concept of metabolism

established: assimilation of

foods producing heat and CO2

By Geoffroy, Étienne-François, l'Aîné (1718). "Table des

differents rapports observés en chimie entre differentes

substances". Scan from the original work, Public Domain,




Early Nutrition Science

o 1808: John Dalton, English

schoolmaster, devises theory of

atoms and molecules

o 1816: research concludes that

animals cannot use nitrogen from

the air to build tissues, but must

consume it in food

o Early 1800’s: physicians theorised

that missing dietary factors were

responsible for beriberi and

scurvy, and by 1840’s, rickets and

night blindness as well

By Charles Turner - This image is available

from the United States Library of

Congress's Prints and Photographs division

under the digital ID. Public Domain,

https://commons.wikimedia.org/w/index.php

?curid=6204781



Protein: Early Experimentso 1839: common molecular base

of albumin, fibrin, casein, gluten

discovered, resulting in naming

these collectively “proteins”

o 1841: discovery that plants can

convert atmospheric or soil

nitrogen into the edible

nitrogenous proteins that make

up animal tissue

o Focus on protein in research

persisted until late 1800’s in

England and America, with fruits

and vegetables considered

more dispensable in the diet

By Chemistry-grad-student - Own work, CC BY-SA 3.0,


45656



Revision Questionso List three ways in which the human shift from

hunter-gatherer to agrarian lifestyle impacted food

and nutrition.

o What did early European medical dietetics and

dietetics of Eastern medical systems have in

common?

Other food for thought:o Reviewing your lecture on the Industrial Revolution,

how do you think those socioeconomic changes

influenced nutrition and diet going forward to the

present?


Nutritional Deficiency: Scurvyo By 1843, many periodic

outbreaks of scurvy in British

prisons; common factor found to

be when potatoes had been

omitted from the diet for a time

o 1845-1848: importance of

potatoes as a scurvy

preventive/cure confirmed with

rounds of failed potato harvests

in Europe

o Prison diets thereafter included

added green veggies for

preventionBy Agricultural Research Service, Public Domain,




By

http://wellcomeimages.org/indexplus/obf_images/8d/c

7/c46485a7bb57099a2568b95585f3.jpg, CC BY 4.0,


980175

Nutritional Deficiency: Night Blindnesso Old European folk remedy to

feed a person cooked liver for

most eye problems

o Early 1800’s, night blindness

and corneal ulcers treated with

fish or cod liver oil

o 1850’s: trial at sea with 60

sailors using ox liver curatively

for night blindness with success

o As late as 1884, this treatment

had not caught on widely, and

the popular opinion was a

cause of infection or “purely

vital or nervous” nature

http://wellcomeimages.org/indexplus/obf_images/8d/c7/c46485a7bb57099a2568b95585f3.jpg



Nutritional Deficiency: Goitero Old European folk remedy for

goiter was to feed a person

dried seaweed or sea sponges

(or the ash from burning them)

o 1812: iodine was discovered in

such ash, suggested for use in

treating goiter

o Initial dosing was too high and

resulted in toxicity

o Into the late 1800’s, this

treatment had fallen out of

favour, and cause was deemed

to be an infection

By えむかとー - Own work, Public Domain,


?curid=4306697



Nutritional Deficiency: Rickets

o Traditional folk remedy for

rickets in Northern Europe was

to expose infants to sunshine

o 1890’s: determined that

childhood rickets could be

prevented by adequate

exposure to sunlight plus

breastfeeding or an adequate

substitute

o 1919: UV lamps found to be

effective

o 1922: cod liver oil established as

an alternative effective treatment

By No machine-readable author provided.

Zerohund~commonswiki assumed (based on

copyright claims). - CC BY-SA 3.0,

https://commons.wikimedia.org/w/index.php?

curid=53070



Nutritional Deficiency: Beriberio 1880’s: believed to be a protein

deficiency, because helped by

adding more meat and milk to

the diet and reducing rice;

others believed it to be an

infectious disease

o 1905: Dutch researchers

demonstrated it resulted from

consumption of white rice,

lacking some unknown fraction

o 1911: Casimir Funk, Polish

chemist in London, claims to

have isolated that fraction from

brown rice

CC BY-SA 3.0,

https://commons.wikimedia.org/w/index.p

hp?curid=674165



“Vitamins”

o 1912: Funk generalised his

“antiberiberi factor” as having

an organic base with an amine

group

o Theorised that pellagra, scurvy

and rickets were caused by

deficiencies of similar factors in

foods with the common

characteristic of being amines,

and coined the term “vitamines”

o Later determined that they were

not amines, but the name stuck By Unknown photographer -

Poland, 1964, Public Domain,

https://commons.wikimedia.org

/w/index.php?curid=8654708



Vitamin Discovery Isolation Structure

Elucidated

Synthesis

Vitamin A 1909 1931 1931 1947

Pro vitamin A 1928 1931 1930 1950

Vitamin D 1918 1932 1936 1959

Vitamin E 1922 1936 1938 1938

Vitamin K 1929 1939 1939 1939

Vitamin B1 1897 1926 1936 1936

Vitamin B2 1920 1933 1935 1935

Niacin 1936 1935 1937 1894

Vitamin B6 1934 1938 1938 1939

Vitamin B12 1926 1948 1956 1972

Folic Acid 1941 1941 1946 1946

Pantothenic Acid 1931 1938 1940 1940

Biotin 1931 1935 1942 1943

Choline 1862 1866

Vitamin C 1912 1928 1933 1933

Source: Underwood & Galal


Calorimetry

o 1894: Wilbur Atwater, known

as the Father of Nutritional

Science in the US, made the

first accurate measurement

of kcals/g for carbohydrates,

fats and proteins

o 1939: research in rats

demonstrated that feeding a

calorically restricted diet

resulted in slower growth but

increased longevity and

fertility and vigorous offspringPublic Domain,

https://commons.wikimedia.org/

w/index.php?curid=1878735



Early 20th Century Medical Dieteticso From the early 20th century,

developments in nutritional

science essentially caused the

abandonment by conventional

medicine of much of the

medical dietetics originating in

the ancient world

o Medical doctors actively

debated the value or detriment

of a meatless (vegetarian) diet,

perhaps as a parallel to the

emphasis on protein in early

nutrition science research

CC BY 2.0,




Dietitians and Early Nutritionistso 1899: subgroup of the American

Home Economic Association

created a specialty in dietetics

and formed the ADA in 1917

o In early days of the profession up

to 1955, their role was to feed

people as ordered by a physician,

i.e., physician prescribed diet

o After 1955, role shifted toward a

more clinical focus following

nutrition science, and education

moved into schools of science or

allied health

By Seattle Municipal Archives -

CC BY 2.0,

https://commons.wikimedia.org

/w/index.php?curid=26185606



Dietitians and Early Nutritionists

o 1936: US government created

the first position related to

nutrition; positions in state and

local government followed

o Positions were filled by

Masters-level public health

professionals and they were

called “nutritionists”

o There was no clinical focus, so

the education and experience

of dietitians was not seen as

useful for these roles

By U.S. Department of Agriculture -

20111110-OC-AMW-0012\, Public Domain,


?curid=17794846



Early Governmental Involvemento 1917: first USDA food guide published, How to Select Foods,

by Caroline Hunt, nutritionist, emphasising newly discovered

vitamins and minerals

o 1940: first Recommended Daily Allowances (RDA) defined

by the National Academy of Sciences, forcing change to

USDA guidelines

o 1946: USDA National Nutrition Guide, too complex!

o 1956: Essentials for an Adequate Diet, basic four food

groups with serving sizes

o 1977: first set of US guidelines published that recommended

cutting animal fat intake and setting carbohydrate targets to

55-60% of daily calories


Governmental Recommendations

o 1980: first USDA Dietary Guidelines, which became the first

US food pyramid

o Nutrition Australia, a non-government community

organisation, published the first Australian food pyramid the

same year; both were based on a Swedish concept from the

70’s

o 1982: first Australian Dietary Guidelines published, updated

in 1992, 2003 and 2013, by the NHMRC

o 1991: first Australian Recommended Dietary Intakes (RDI’s)

published by NHMRC (updated and expanded in 2006

Nutrient Reference Values)


Current Dietary Guidelines

By United States

Department of

Agriculture Public

Domain,

https://commons.wik

imedia.org/w/index.p

hp?curid=38658432

By Lionfish0 - Own

work, CC BY-SA 3.0,

https://commons.wik

imedia.org/w/index.p

hp?curid=18187630




Revision Questionso What role did folk remedies and food as medicine play in the

development of nutritional science?

o How did the advent of germ theory temporarily detract from

developments in nutritional science?

o Describe the development of nutrition practice in healthcare

following on the major discoveries in laboratory nutritional

science.

Other food for thought:o Based on what you know of the developments of science in

Europe during that time period, why do you think early

nutrition scientists were focused on isolating and

synthesising single nutrients?


Clinical Nutritionistso 1972: American Nutrition

Association formed,

credentials multiple different

degreed levels of clinical

nutrition practitioners

o 1975: Nutrition Society of

Australia formed, manages

voluntary registration of

nutritionists

o 1986: American Clinical

Board of Nutrition

established, certifying

healthcare providers with a

specialty in clinical nutrition

Häggström, Mikael. "Medical gallery of Mikael

Häggström 2014". Wikiversity Journal of Medicine 1 (2).

DOI:10.15347/wjm/2014.008. ISSN 20018762, CC0,


39673



Orthomolecular/Functional Medicine

o 1967: Linus Pauling coined

the term “orthomolecular” to

describe the “alternative”

practice of administering

megadoses of isolated

nutrients in supplement form,

which started in the 1930’s

o 1990: concept of Functional

Medicine developed in the

US as an outgrowth of

conventional medicine and

merging with clinical nutrition

and holism

By Library of Congress -

http://www.notablebiographies.com/Ni-

Pe/Pauling-Linus.html, Public Domain,

https://commons.wikimedia.org/w/index.p

hp?curid=17802529



Global Issues in Nutritiono Under-nutrition limits both

individual development and

societal/national development

worldwide

o Low nutritional status impacts work

and mental performance and

social and economic growth of

nations

o Global food supply is presently

adequate to feed the world’s

population, but it is not distributed

in a way that accomplishes thisBy CDC/ Don Eddins - Public Domain,

https://commons.wikimedia.org/w/index.

php?curid=425974



Global Issues in Nutrition

Some interventions available to combat malnutrition globally:

o Dietary diversification via education

o Governmental policies on trade, food distribution, subsidis-

ation of farming, regulation of market infrastructure, etc

o Food fortification and use of specific nutrient supplements

o Public health measures to control disease

By Chris55 -

Data from WHO,

CC BY-SA 4.0,

https://commons.

wikimedia.org/w/i

ndex.php?curid=

50320869



Undernutrition vs. Overnutrition

o Mid-1900’s: focus of nutrition science and

practice shifted from being entirely on

malnutrition and deficiency to focus also on

affluent or overabundant diets

o Changes in world nutrition and public health in

recent centuries have created a shift from high

mortality to high morbidity (reduced death rates,

increased life expectancy, but higher rates of

chronic disease)


Undernutrition vs. Overnutrition


Cultural Attitudes About Foodo “Food is unique in that it ties

the intimate, domestic, and

familial with society at large,

and with institutional and

corporate forces that shape

and are shaped by individual-

level processes.” (Monin &

Szczurek, 2014)

o A society’s attitudes toward

food and food culture can have

major influence over health

and food-related illnesses

By Przykuta - Own work, CC BY-SA 3.0,




Revision Questionso Compare and contrast the histories of food as

medicine and the therapeutic use of isolated nutrients.

o What are some of the social and governmental forces

that impact the availability of sufficient food and

nutrients to the world population?

Other food for thought:

o Why might it be that the government is directly

involved in making food and nutrient

recommendations but does not generally regulate

clinical nutrition practice?


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Documents

SOCH111 History of Healing · SOCH111 –History of Healing Session 18 Nutrition and Diet ... more dispensable in the diet By Chemistry-grad-student - Own work, CC BY-SA 3.0,