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Ideal Conditions

Earlier this month it was announced that the sport scientist turned diet guru Tim Noakes is in talks with Derek Carstens, former First Rand executive and now Karoo farmer, about improving the diets of farm workers. The Cape Times reported:

Once the project begins, the families on the farm will be monitored for five to 10 years. With a diet high in offal – which is readily available in the farmlands of the Karoo – the families will stop consuming carbohydrates, which Noakes says are of no benefit to the human body.

‘This is an ideal set-up,’ said Noakes. ‘And it would be much harder to do research of this nature in a place like Cape Town.’

Since the emergence of nutrition as a field of scientific enquiry in the early twentieth century, the poor, the hungry, and the socially and politically disenfranchised have often been the subjects of research into diet and malnutrition. Last year, University of Guelph-based food historian Ian Mosby published evidence that during the 1940s and 1950s, scientists working for the Canadian government conducted a series of experiments on malnourished residents of rural Aboriginal communities and residential schools.

Rural impoverishment in the 1930s – brought about by the decline in the fur trade and cuts to government provision of poor relief – meant that First Nations people struggled to find enough to eat. They could not, in other words, afford to eat, and this knowledge informed the advice they provided to researchers for eradicating malnutrition. Mosby writes:

Representatives of the various First Nations visited by the research team proposed a number of practical suggestions for ending the hunger and malnutrition in their communities. In addition to more generous relief during times of extreme hardship, these included increased rations for the old and destitute, timber reserves to be set aside for the building and repairing of houses, and additional fur conservation efforts by the federal government, as well as a request that they be given fishing reserves ‘so that they could get fish both for themselves and for dog feed, free from competition with the large commercial fisheries.’

However, researchers decided to set up an experiment in which First Nations peoples were provided with vitamin supplements to gauge their relative effectiveness in combating the side effects of hunger. Crucially, researchers were well aware that ‘vitamin deficiencies constituted just one among many nutritional problems.’ In fact, they calculated that the average diet in these communities provided only 1,470 calories per person during much of the year.’ First Nations people needed food supplies, not vitamin supplements. Mosby concludes:

The experiment therefore seems to have been driven, at least in part, by the nutrition experts’ desire to test their theories on a ready-made ‘laboratory’ populated with already malnourished human ‘experimental subjects.’

In other areas, researchers regulated what kinds of food Aboriginals could purchase with their welfare grants (the Family Allowance):

These included canned tomatoes (or grapefruit juice), rolled oats, Pablum [baby food], pork luncheon meat (such as Spork, Klick, or Prem), dried prunes or apricots, and cheese or canned butter.

This experiment was also an attempt to persuade First Nations people to choose ‘country’ over ‘store’ foods. They were to hunt and to gather instead of relying on shops. To these ends, some officials tried to prevent some families from buying flour:

In Great Whale River, the consequence of this policy during late 1949 and early 1950 was that many Inuit families were forced to go on their annual winter hunt with insufficient flour to last for the entire season. Within a few months, some went hungry and were forced to resort to eating their sled dogs and boiled seal skin.

Perhaps unsurprisingly, there is little or no evidence to suggest that the subjects of these research projects consented to being part of them.

In South Africa, anxiety about the productivity of mine workers in the 1930s drove the publication of a series of reports into the health of the African population. Diana Wylie explains:

The Chamber of Mines in particular was alarmed at the 19 per cent rejection rate for Transkei mine recruits. Some of the researchers urged the government to concern itself with nutritional diseases ‘as an economic problem of first importance in which not merely the health but the financial interests of the dominant races are concerned.’ Another warned, ‘unless a proper food supply is assured, our biggest asset in the Union, next to the gold itself, our labour supply, will fail us in the years to come.’

In response to these findings, mining companies introduced supplements to miners’ diets to combat scurvy and generally boost immune systems. They did not, obviously, address the causes of miners’ ill health and poor diets – which were partly the impoverishment of rural areas and the system of migrant labour.

Mine workers in Kimberley.

Mine workers in Kimberley. (From here.)

The Canadian experiments and South African research projects were produced by a similar set of concerns: by an interest in civilising indigenous people, but also because, in the case of Canada, ‘it [was their] belief that the Indian [sic] can become an economic asset to the nation.’ Africans also needed to be well fed and kept healthy for the benefit of the South African state.

Noakes is correct when he says that conducting the research he proposes to do on rural farm workers would be almost impossible in a city. Although he insists that he will seek ethics approval, I wonder how he and other researchers will go about winning the informed consent of a group of people who are dependent on their employer – Noakes’s collaborator – for their livelihoods, and who have, historically, very low levels of education.

Also, Noakes seems to believe that only carbohydrates are at the root of farm labourers’ poor diets. As the First Nations people referred to above argued, malnutrition is caused by an inability to access good, nutritious food – and usually because of low wages. Instead of feeding Carstens’s employees offal, it might be worth considering how much they are paid, and how easy it is for them to afford transport to shops selling healthy food.

Noakes argues that ‘We can’t build this nation in the absence of sufficient protein and fat.’ To what extent is this project purely for the benefit of Karoo farm workers? And to what extent to prove a controversial theory proposed by a prominent researcher?

Sources

Ian Mosby, ‘Administering Colonial Science: Nutrition Research and Human Biomedical Experimentation in Aboriginal Communities and Residential Schools, 1942–1952,’ Histoire Sociale/Social History, vol. 46, no. 91 (May 2013), pp. 145-172.

Diana Wylie, ‘The Changing Face of Hunger in Southern African History, 1880-1980,’ Past and Present, no. 122 (Feb. 1989), pp. 159-199.

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Tangerine and Cinnamon by Sarah Duff is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License.

Green Revolutions

Recently, there’s been a lot of debate generated by a study done by a research team at the University of Caen in France. Last month, they published a paper in the peer-reviewed journal Food and Chemical Toxicology, in which they alleged that rats fed Monsanto’s genetically modified maize and exposed to the herbicide Roundup – also produced by Monsanto – over the course of a lifetime, developed tumours and suffered multiple organ damage.

Terrible photographs of some alarmingly lumpy rats circulated around the internet, and it seemed that the green movement’s vociferous opposition to GM crops was vindicated. But almost as soon as the study’s findings were announced, doubts – around the validity of the research itself and the way it had been communicated – began to emerge.

Not only have similar, more rigorous tests, demonstrated that GM crops had no impact on health, but, as the New Scientist reported:

the strain of rat the French team used gets breast tumours easily, especially when given unlimited food, or maize contaminated by a common fungus that causes hormone imbalance, or just allowed to age.

Moreover:

Five of the 20 control rats – 25 per cent – got tumours and died, while 60 per cent in ‘some test groups’ that ate GM maize died. Some other test groups, however, were healthier than the controls.

…the team claims to see the same toxic effects both with actual Roundup, and with the GM maize – whether or not the maize contained any actual herbicide. It is hard to imagine any way in which a herbicide could have identical toxic effects to a gene tweak that gives the maize a gene for an enzyme that actually destroys the herbicide.

This research isn’t entirely without value: it could suggest that even the smallest dose of weed killer or GM maize has the potential to cause physiological harm.

But even this conclusion is undermined by the circumstances in which the study was produced. The research team at Caen is open about its opposition to GM crops; and the anti-GM organisation which orchestrated the publicity around the release of the report, refused to allow journalists to consult other scientists about the paper.

As we’re right to be suspicious of studies undertaken by scientists affiliated to industry – the implications of which Ben Goldacre explores in his latest book on Big Pharma – so we must question the motives, however noble they may be, of this research team funded by anti-GM groups.

What I found so interesting about the response to the study was the vehemence of the anti-GM crop lobby. Like the debates around nuclear energy and, even, animal testing, it seems to me that the strength of feeling – on both sides – has a tendency to shut down all reasonable discussion. I was appalled when, earlier this year, a group of anti-GM activists threatened to destroy a field of GM wheat planted by scientists at the publicly-funded Rothamsted Research. Their work aimed partly to reduce pesticides sprayed on crops.

On the other hand, though, pro-GM scientists, economists, and others seem to be too quick to label those with – legitimate – concerns about the genetic modification of plants and animals as ‘anti-science.’ In an article from 2000, Norman Borlaug argued:

Extremists in the environmental movement, largely from rich nations and/or the privileged strata of society in poor nations, seem to be doing everything they can to stop scientific progress in its tracks. It is sad that some scientists, many of whom should or do know better, have also jumped on the extremist environmental bandwagon in search of research funds. …

We all owe a debt of gratitude to the environmental movement that has taken place over the past 40 years. This movement has led to legislation to improve air and water quality, protect wildlife, control the disposal of toxic wastes, protect the soils, and reduce the loss of biodiversity. It is ironic, therefore, that the platform of the antibiotechnology extremists, if it were to be adopted, would have grievous consequences for both the environment and humanity.

His point is that GM crops have the potential to end world hunger. As the Nobel Peace Prize winner credited with originating the Green Revolution during the 1950s and 1960s, Borlaug was in a position to argue– with some validity – that selective plant breeding had helped to feed a world of, now, seven billion people.

In 1943, concerned about the link between food shortages and political upheaval – particularly as the Cold War loomed – the Rockefeller Foundation began sponsoring research into the development of new drought-resistant and higher yielding plant species in Mexico.

Focussing on wheat, maize, and rice, Borlaug and other scientists affiliated with the programme cross-bred higher-yielding species. These new seeds were distributed at first in Mexico, India, and the Philippines. It’s difficult to underestimate the impact of this research, as Gordon Conway explains:

Cereal yields, total cereal production and total food production in the developing countries all more than doubled between 1960 and 1985. Over the same period their population grew by about 75 per cent. As a result, the average daily calorie supply in the developing countries increased by a quarter, from under 2,000 calories per person in the early 1960s to about 2,500 in the mid-80s, of which 1,500 was provided by cereals.

The Green Revolution has made it possible to feed a population of seven billion people. But it had substantial drawbacks. Conway writes that the ‘potential’ of the Green Revolution crops

could only be realised if they were supplied with high quantities of fertiliser and provided with optimal supplies of water. As was soon apparent, the new varieties yielded better than the traditional at any level of fertiliser application, although without fertiliser they sometimes did worse on poor soils. Not surprisingly, average rates of application of nitrogen fertilisers, mostly ammonium sulphate and urea, doubled and redoubled over a very short period.

We know now that we need a new Green Revolution – one which is not as heavily reliant on water, and which does not poison and destroy ecosystems. There’s a certain logic, then, to many activists’ arguments that it’s ‘science’ which is to blame for present food insecurity: that a return to small-scale peasant farming offers the best means of supplying food to an ever-growing population.

This suspicion of ‘science’ – whatever we may mean by this – is nothing new. During the 1970s, for instance, the green movement emerged partly in response to concerns about the implications of the Green Revolution for human health, biodiversity, and water supplies. Much of this early environmentalism advocated a return to nature, and a rejection of technology.

I haven’t made up my mind about the usefulness or otherwise of GM crops, but I hesitate over the whole-hearted embrace of ‘traditional’ methods of farming. It’s worth remembering that pre-industrial agriculture required the majority of the world’s population to be involved in food production in order to stave off hunger. Now, in developed nations, this number has plummeted to only a couple of per cent. In sub-Saharan Africa, seventy per cent of the population remains in engaged in agriculture, although this is also likely to decline.

Better technology and higher-yielding plant varieties have freed up the majority of the world’s population to do other forms of work. The world has changed a great deal since the eighteenth century.

What concerns me more, though, are the businesses which push GM crops – those which are at the receiving end of European and African bans on the planting of genetically modified wheat, maize, and other plants. Monsanto and Cargill are currently the target of a campaign to end the patenting of seeds – making them cheaper and more freely available to small farmers in the developing world.

These two companies, in particular, have a growing control over the world’s food supply. Not only do they own seed patents, but they provide pesticides and fertilisers. Cargill produces meat and grows grain – in fact, no one knows how much grain it has stored in its silos. Given that Cargill and the commodities trader Glencore have both admitted that their profits have increased as a result of the drought in the US and the resultant rise in food prices around the world, it’s exceptionally worrying that these organisations have so much control over our food chain.

What the GM debate reveals is a set of complex and shifting attitudes around the relationship between food, farming, and science – and around how we define what is ‘natural’. Instead of rejecting the potential benefits of GM crops out of hand, I think it would be wise to encourage more research into their implications both for human health, and for the environment. Moreover, I think we need to scrutinise and hold to account big businesses like Monsanto, Glencore, and Cargill. They represent a far greater threat to our ability to feed ourselves.

Further Reading

Norman Borlaug, ‘Ending World Hunger: The Promise of Biotechnology and the Threat of Antiscience Zealotry,’ Plant Physiology, vol. 124 (Oct. 2000), pp. 487-490.

Gordon Conway, The Doubly Green Revolution (London: Penguin, 1997).

Joseph Cotter, Troubled Harvest: Agronomy and Revolution in Mexico, 1880-2002 (New York: Praeger, 2003).

John H. Perkins, Geopolitics and the Green Revolution: Wheat, Genes, and the Cold War (New York: Oxford University Press, 1997).

Himmat Singh, Green Revolutions Reconsidered: The Rural World of Contemporary Punjab (New Delhi: Oxford University Press, 2001).

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Tangerine and Cinnamon by Sarah Duff is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License.

Brain Food

Recently I’ve been mildly obsessed with Elif Batuman’s The Possessed: Adventures with Russian Books and the People who Read Them (2011). It’s a collection of essays about Russian literature and her experiences as a PhD student at Stanford. In the first chapter, ‘Babel in California,’ Batuman describes a conference at Stanford, dedicated to the analysis of the work of Isaak Babel. Like so many academic conferences, it is simultaneously enlightening and farcical.

Read more

No Sweeteners

One of the best things about being an academic is the stuff that people send you in the – usually entirely correct – belief that you’ll find it interesting. I’ve had emails about pink slime (for the blog) and on programmes about children’s literature (for my research). Recently, my friend Elizabeth, who’s a lawyer, forwarded me this from Legalbrief:

New draft baby feeding regulations will forbid formula manufacturers from ‘aggressively marketing’ their products to mothers and from sponsoring meals and professional development courses for healthcare practitioners, says a Weekend Argus report. It adds the standards set in the draft regulations, which the Department of Health has released for public comment, intend to promote safe nutrition for babies and young children and restrict inappropriate marketing practices. The department stressed that the regulations would not stop baby formula and complementary foods from being sold at retailers. ‘Although breastfeeding is best, government recognises that some women cannot breast-feed or decide not to breast-feed. These regulations do not in any way compel women to breast-feed against their will,’ the department is reported to have stated.

The proposed regulations, which fall under Section 15 (1) of the Foodstuffs, Cosmetics and Disinfectants Act, 1972, make for fascinating reading. Other than banning trans fats and artificial sweeteners in baby formula, their emphasis is on curtailing the advertising and promotion of artificial foods.

For instance, the packaging of baby formula may not have pictures of infants, young children, or any other ‘humanised figures,’ except for those included in instructions for preparing the product. Tins and containers may not ‘contain any information or make any negative claim relating to the nutritional content or other properties of human milk’, and they’re not allowed to include toys or gifts. Packaging must include in English, in bold letters at least 3mm tall, the message: ‘Breast milk is the best food for babies.’

The regulations will also radically limit the advertising of baby formula shops, in print and online, ban the distribution of gift packs and free samples, and prevent formula manufacturers from sponsoring or donating equipment bearing the logo of their products. These manufacturers may not

provide research grants or any other financial assistance relating to infant or young child nutrition to health care personnel working in a health establishment or health care personnel linked to a health establishment.

Nor may they give doctors, nurses, and health workers gifts, and ‘heads of health establishments, national, provincial and local health authorities shall take measures to promote, support and protect breastfeeding.’

It’s an ambitious piece of legislation, but one which is entirely in line with the World Health Organisation’s International Code on the Marketing of Breast Milk Substitutes. The Code was adapted in 1981, and places stringent regulations on how baby formula is advertised: it advises that baby milk formula should not be allowed to market products directly to pregnant women and mothers with young children, including handing out samples. Products should also state that breast milk is superior to formula.

Implementation of the Code has been slow, and there is evidence to suggest that it has been particularly poorly policed in developing nations where oversight of the activities of powerful multinationals is often lax. The South African regulations are far stricter than the Code, particularly as regards the relationship between the pharmaceuticals industry and academic research, but address a problem which campaigners have long identified: that there is a link between the way in which formula is advertised and how women feed their babies.

This isn’t to suggest that women should have their choices about how they feed their babies curtailed – or that it’s only advertising which causes women to choose to use baby formula. Far from it. The problem, though, is that, particularly in poor nations, advertising or other promotional methods encourage breastfeeding mothers to switch to baby formula when it’s unlikely that they’ll be able to afford to buy more formula, and where they may dilute formula with too much water to make it go further. This water may not be clean, and it’s difficult to keep bottles and teats sterile without electricity or plumbing.

The purpose of these regulations is to ensure that formula manufacturers don’t use the often less than ideal conditions in which mothers in developing nations raise their babies, to their own advantage.

We tend to associate the WHO’s Code with the Nestle Boycott, which was launched in 1977. The Boycott was based on a pamphlet published by War on Want in 1974, titled ‘The Baby Killer’ and, in Switzerland, ‘Nestle Kills Babies’. The charity alleged that Nestle’s advertising strategies were responsible for high rates of child mortality. After a legal tussle as well as an attempt to refute the Boycott’s allegations, Nestle agreed to implement the Code in 1984, although there remains some scepticism as to Nestle’s, and other companies’, commitment to this.

But concern about the advertising of baby formula predated the 1970s, and even the 1940s, when breastfeeding began to decline globally. As I’ve sat in the National Library over the past few months, reading Child Welfare and other child health magazines from the first half of the twentieth century, I’ve been struck by the number of advertisements for baby formula. They all feature fat, healthy babies and testimonials from relieved mothers who claim that the child was fed from birth on Lactogen or whichever other patent food.

Even Truby King, early twentieth-century breastfeeding evangelical and founder of the global mothercraft movement, developed artificial baby food which was produced in New Zealand and then shipped all over the world. Kariol, Karilac, and Karil were meant to be prescribed for babies who were not, for whatever reason, breastfed either as a supplement to cows’ milk, or to be taken on their own.

Although King’s patent foods seemed to contradict his enthusiasm for breastfeeding – and he came under enormous criticism in New Zealand and Australia for his promotion of Kariol and Karilac – there was a certain logic to his decision to manufacture wholesome baby formula. During the early decades of the twentieth century, doctors in Britain and the United States noticed that bottle-fed babies were considerably more likely to die during early infancy than those who were breastfed. Artificial foods – which ranged from thin porridges and condensed milk to baby formulas – were often nutritionally inadequate, particularly in poor families who could not afford better and more expensive substitutes.

But they also identified a link between bottle feeding and diarrhoea, then, as now, one of the main causes of death in infancy. William J. Howarth, the Medical Officer of Health for Derby

arranged in 1900 to receive weekly lists of the births registered during the past seven days from the local registrar. From November of that year until November 1093 women inspectors enquired into the feeding method of each registered child by personally visiting the mother and infant at home.

The results of the study, published in 1905, were telling. Of the infants surveyed, 63% were breastfeed, 17% were partly bottle-fed, and 19% entirely bottle-fed:

The mortality rates from ‘diarrhoea and epidemic enteritis’ in addition to those from ‘gastritis and gastro-enteritis’ were as expected: 52, or 10 per 1,000 of the breastfed, 36 or 25.1 per 1,000 of the mixed-fed, and 94 or 57.9 per 1,000 of the bottle-fed babies died. In other words the mortality rate of the bottle-fed infants was nearly six times greater than that of the breast-fed babies.

Howarth concluded: ‘In not one single instance does the death-rate in any class of disease among hand-fed children even approximate that recorded among children who are breastfed; the rate is invariably higher.’

The problem, in terms of the link between bottle feeding and diarrhoea, was not so much the nutritional content of artificial foods, but the difficulties in keeping them free from contamination, and particularly during summer when infant mortality rates soared.

Indeed, South African advertisements for Lactogen emphasised that the product did not spoil in warm weather. As criticism of artificial foods grew louder, so advertising became more subtle, and better adept at appealing to mothers aware of the potential problems of bottle feeding. Doctors were, though, also aware of the effects of advertising on mothers’ choices, as a medical officer based in Johannesburg wrote in 1925:

No one can deny the fact that the proprietary foods of today are a vast improvement upon those of twenty years ago. They all contain very sound instructions as to the preparation of the food and the amount to be given. The advertising of such foods is carried out on a most extensive scale and in a clever and attractive manner. No hoarding today is without a picture of a flabby and over-fat infant alleged to have been reared solely on the proprietary food advertised thereon. Many a mother who for one reason or another, is not satisfied with the progress of her baby, sees this advertisement, and immediately rushes off to secure this particular food for non-thriving infant.

But not only mothers were influenced by this advertising. He admitted that it was ‘only too true that many medical men and trained nurses are also gulled by such advertisements and circulars’. Dr Cicely Williams, best known for her identification of the condition kwashiorkor in the 1930s, worked in the Colonial Medical Service in West Africa and southeast Asia before World War II and became particularly interested in the treatment of the diseases of early infancy.

She was critical of the introduction of baby formula to Singapore and Malaya, where white-coated sales reps distributed samples of artificial foods to poor mothers. In 1939 she published a pamphlet, ‘Milk and Murder,’ in which she pointed out the benefits to both mothers and babies of breastfeeding.

Nevertheless, Nestle and other companies were still using the same strategies to convince mothers in developing nations to use baby formula in the 1970s, and there are still concerns that they are not fully compliant with the Code on breast milk substitutes. The new South African regulations, if passed, are aimed at remedying this.

The cause for these new regulations and other measures introduced internationally to encourage mothers to breastfeed for the first six months of life, is a concern that rates of breastfeeding remain low in comparison to what they were during the early twentieth century. For all the good that the Code and other laws have done, it remains the exception, rather than the rule, for women to breastfeed for such an extended period of time.

However true it may be that advertising does have an impact on women’s choices, it’s certainly not the only factor which influences how women feed their babies. What’s missing from these measures is any attempt to communicate with mothers themselves. As doctors in the early twentieth century believed that mothers, whom they characterised as emotional and irrational, simply followed any and all advice which they read or heard, so campaigners and governments today seem to be too quick to seek only one reason for women’s decision to breast- or bottle-feed.

In fact, we need to make it easier for women to choose to breastfeed: to eliminate the ridiculous prejudice against breastfeeding in public spaces; for work and childcare not to be mutually exclusive; and for sympathetic advice and information to be made available for all new mothers.

Further Reading

Texts cited here:

Linda Bryder, A Voice for Mothers: The Plunket Society and Infant Welfare, 1907-2000 (Auckland: University of Auckland Press, 2003).

Deborah Dwork, War is Good for Babies and Other Young Children: A History of the Infant and Child Welfare Movement in England, 1898-1918 (London and New York: Tavistock Publications, 1987).

Philippa Mein Smith, Mothers and King Baby: Infant Survival and Welfare in an Imperial World: Australia, 1880-1950 (Basingstoke: Macmillan, 1997).

Other sources:

Rima D. Apple, Mothers and Medicine: A Social History of Infant Feeding (Madison: University of Wisconsin Press, 1987).

Linda M. Blum, At the Brast: Ideologies of Breastfeeding and Motherhood in the Contemporary United States (Boston: Beacon Press, 1999).

Marulyn Yalom, A History of the Breast (New York: Ballantine Books, 1997).
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Tangerine and Cinnamon by Sarah Duff is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License.