SOCH111 – History of Healing
www.endeavour.edu.au
Session 18
Nutrition and Diet
Department of Social
Sciences
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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
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Let food be thy medicine, and
medicine be thy food.
~Hippocrates
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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
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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
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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
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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
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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,
https://commons.wikimedia.org/w/index.php?curid=15556807
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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
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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
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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
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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,
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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
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from the United States Library of
Congress's Prints and Photographs division
under the digital ID. Public Domain,
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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
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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?
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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,
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By
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7/c46485a7bb57099a2568b95585f3.jpg, CC BY 4.0,
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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
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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
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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
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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
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“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,
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/w/index.php?curid=8654708
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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
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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,
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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
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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
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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
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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
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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)
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Current Dietary Guidelines
By United States
Department of
Agriculture Public
Domain,
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imedia.org/w/index.p
hp?curid=38658432
By Lionfish0 - Own
work, CC BY-SA 3.0,
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imedia.org/w/index.p
hp?curid=18187630
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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?
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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,
https://commons.wikimedia.org/w/index.php?curid=183
39673
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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
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Pe/Pauling-Linus.html, Public Domain,
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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,
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php?curid=425974
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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,
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wikimedia.org/w/i
ndex.php?curid=
50320869
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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)
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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,
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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?
© Endeavour College of Natural Health www.endeavour.edu.au 39
References• Byrnes, S 2000, Healing with nature: the salts of the earth, Healthy & Natural Journal, vol. 7, no.
34, viewed 5 Oct 2016
<https://login.ezproxy.endeavour.edu.au:2443/login?url=http://search.ebscohost.com/login.aspx
?direct=true&db=awh&AN=6086685&site=eds-live&scope=site>.
• Carpenter, K 2003, A short history of nutritional science: part 1 (1785-1885), Journal of Nutrition,
vol. 133, no. 3, 638-645, viewed 4 Oct 2016 <http://jn.nutrition.org/content/133/3/638.full>.
• Carpenter, K 2003, A short history of nutritional science: part 2 (1885-1912), Journal of Nutrition,
vol. 133, no. 4, 975-984, viewed 4 Oct 2016 <http://jn.nutrition.org/content/133/4/975.full>.
• Carpenter, K 2003, A short history of nutritional science: part 3 (1912-1944), Journal of Nutrition,
vol. 133, no. 10, 3023-3032, viewed 4 Oct 2016
<http://jn.nutrition.org/content/133/10/3023.full>.
• Carpenter, K 2003, A short history of nutritional science: part 4 (1945-1985), Journal of Nutrition,
vol. 133, no. 11, 3331-3342, viewed 5 Oct 2016 <http://jn.nutrition.org/content/133/11/3331.full>.
• Cordain, L 2005, Origins and evolution of the western diet: health implications for the 21st
century, American Journal of Clinical Nutrition, vol. 81, no. 2, 341-354, viewed 7 Oct 2016
<http://ajcn.nutrition.org/content/81/2/341.full>.
• Erickson-Weerts, S 1999, Past, present, and future perspectives of dietetics practice, Journal of
the American Dietetic Association, vol. 99, no. 3, 291-293, viewed 5 Oct 2016
<http://www.sciencedirect.com.ezproxy.endeavour.edu.au/science/article/pii/S00028223990007
60>.
© Endeavour College of Natural Health www.endeavour.edu.au 40
References• Healthy Eating Politics, USDA Food Pyramid History, viewed 11 Oct 2016 <http://www.healthy-
eating-politics.com/usda-food-pyramid.html>.
• Kiple, K & Ornelas K (eds.) 2000, Cambridge world history of food, Cambridge University Press,
Cambridge, viewed 10 Oct 2016
<http://search.credoreference.com.ezproxy.endeavour.edu.au/content/title/cupfood>.
• Martin & Pleasance, 2008, Schuessler tissue salts, Martin & Pleasance, Port Melbourne,
Victoria.
• Monin, B & Szczurek, LM 2014, Food and culture. In Adam B. Cohen's (Ed.) Culture
reexamined: broadening our understanding of social and evolutionary influences, Washington,
DC: American Psychological Association, viewed 17 Oct 2016 <http://www-
psych.stanford.edu/~monin/papers/Food%20and%20Culture%20chapter%20(Monin%20&%20S
zczurek%202014).pdf >.
• NHMRC, Guidelines & Publications, viewed 12 Oct 2016
<https://www.nhmrc.gov.au/guidelines/search>.
• Nutrition Australia, A Brief History of the Pyramid, viewed 11 Oct 2016
<http://www.nutritionaustralia.org/national/healthy-eating-pyramid/brief-history-pyramid>.
• Underwood, BA & Galal O (nd), Nutrition: an overview, UNESCO Encyclopedia of Life Support
Systems, The Role of Food, Agriculture, Forestry and Fisheries in Human Nutrition, vol. IV,
viewed 10 Oct 2016 <http://www.eolss.net/sample-chapters/c10/E5-01A-07.pdf>.
• US Department of Health and Human Services, History of dietary guidelines for Americans,
viewed 12 Oct 2016 <https://health.gov/dietaryguidelines/history.htm>.