World Nutrition

Volume 3, Number 4, April 2012

Journal of the World Public Health Nutrition Association
Published monthly at www.wphna.org

The Association is an affiliated body of the International Union of Nutritional Sciences For membership and for other contributions, news, columns and services, go to: www.wphna.org

Short communications. Rio2012 

Looking into the future,
what do we see?


Marion Nestle, Philip James, Reggie Annan, Barrie Margetts,
Catherine Geissler, Harriet Kuhnlein, Claudio Schuftan,
Geoffrey Cannon (1), Agneta Yngve, Barry Popkin, Ricardo Uauy,
Urban Jonsson, Geof Rayner, Tim Lang
(1) Corresponding author: Email GeoffreyCannon@aol.com


Access pdf of associated editorial here
Access pdf of associated commentary here
Access pdf of these short communications here

Introduction

This series of short communications introduces and celebrates the occasion of World Nutrition Rio2012, and looks ahead. There will be another series published next month in our May issue, which will be on-line early, at 0001 GMT on Thursday 26 April, the day before Rio2012 begins.

The questions and answers

Our contributors, this month and next month, have been asked to write within a standard framework, based on their knowledge and experience, in a style comparable with those of the news and comment sections of journals concerned with public health. Their contributions are judgements, as any policy statements are and must be. The first question is about Rio2012 itself. The second question is addressed to young colleagues. All the questions are designed to look forward and to advise, warn and encourage.

  1. What do I hope Rio2012 will achieve?
  2. My advice to a young public health nutritionist
  3. When I am optimistic, what is my vision?
  4. When I am pessimistic, what do I foresee?
  5. My most highly recommended writer
  6. One choice of my own publications
The name of the game

The original plan was to run 12 short communications of more or less 1,000 words, give or take around 250, all in this month's issue. This plan went out the window. Here you will find 14 contributors, two of whom have written a joint piece, and as we mount this issue we already have received another six, with several others promised.

So we will run another 12 in our May issue, which as mentioned goes on-line immediately before Rio2012. This month is not the time to analyse the contributions for convergent or divergent themes. But already there are some strong views shared by most of this month's contributors. In the short sections immediately below here we extract some of the most striking, cogent and wise remarks in response to the first four questions. In each one, there is a highlighted 'editor's choice'. We will look at the choices of writers and publications next month.

What do I hope Rio2012 will achieve?

Editor's choice!

Geof Rayner and Tim Lang: 'Something it has already achieved. We think it's great that, for the first time with any big nutrition conference known to us, Rio2012 is not organised as an industry-fest. It is not going to pass itself off as a scientific forum within which conflicts of interests are disguised. Too many events now have become absolutely reliant upon covert advertising or product placement'.

Philip James: 'I hope Rio builds on the Brazilian perception of governmental as well as societal responsibility for human welfare, where rigorous scientific, statistical and economic analyses are linked to political reality, and the processes whereby national strategies can be changed'.

Barrie Margetts: 'The theme of Rio2012 focuses our attention toward what we can do to make a difference, for the health of people and our planet. It will show how important it is for us to step back and take into account the wider context in which we live and work, and how this shapes what we do, and how we do what we do'.

Claudio Schuftan: 'Make the Association an advocate of sorely needed changes in public health nutrition. Encourage members more often to engage and publicly discuss opinions expressed on our website, including in our monthly columns and World Nutrition commentaries. This should contribute to a consensual basis for shared and joint advocacy positions. Assemble a group of volunteers to make this happen'.

Barry Popkin: 'I began my own career by living in a squatter area in India and then being politically involved, so I understand how passion of politics and issues can get us to focus on topics and create our own internal truths. But we must keep our eye on science and being certain we have a strong basis for addressing the topics we do'.

Ricardo Uuay: 'I have not given up the idea that perhaps we can convince industry to change. Indeed, I believe that unless they do change they will be descending down a slope to a point when change becomes progressively unstoppable. Perhaps this will not occur now or even tomorrow; but I am convinced that sooner or later the public health imperative will prevail'.

Urban Jonsson: 'I hope that Rio2012 succeeds in attracting scholars and workers from areas not thought immediately relevant by many health and nutrition people, such as economists, sociologists, political scientists, social anthropologists, and human rights scholars and activists. [Ed. It has] This will stimulate discussion at the conference to move from the 'science of nutrition' to the 'science of nutrition issues in society'.

My advice to a young public health nutritionist

Editor's choice!

Barry Popkin: 'Ahead of Rio2012, email senior scholars you might like to speak to, and make a case for setting aside time with them to talk with you, and think ahead of the questions you would like to ask. Best of all, research a bit about what the people you contact are most interested in, and read some of their work – this is easy these days. Many email addresses are immediately available on our website, under members' profiles. Be bold, the worst thing that can happen is a 'no', and you may be surprised to find how many oldsters are pleased to be contacted in this way. Do it now! Also go beyond your comfort zone in meeting people, listening to new ideas, thinking about new methods, issues, problems, solutions'.

Marion Nestle: 'Understand that the goals of food companies and the goals of public health are not the same, and stay out of partnerships and alliances that compromise your integrity and your ability to help people stay healthy'.

Philip James: 'Do not get into general public health nutrition too soon. Become a valid expert in a biological science, or some other hard, rigorous endeavour, with publications to your name. This will protect you, because inevitably as a public health nutritionist you will be attacked as a woolly amateur dabbling in politics'.

Reggie Annan (himself young): 'Start getting involved in actions and initiatives to promote nutrition at the global level now. Start when you are young. When we are young we have energy, motivation and enthusiasm. Also we are the future leaders and we need to be in the position to take up the leadership in due time'..

Catherine Geissler: 'We all need specialist knowledge of the biological science of nutrition and malnutrition; but also knowledge of the underlying social, psychological and economic factors. You need to be aware of policies and interventions that have been successful in preventing or remedying malnutrition in many countries, whether undernutrition or obesity'.

Geoffrey Cannon: 'Have courage. Be prepared to stand up in meetings and speak your truth. Allow yourself to realise that you may learn most in life from people who have little or no formal education, but who have lived life, perhaps on the edge. Realise that truly brave people, when in new strange and especially dangerous situations, always feel fear. Get into the habit of exposing yourself to challenge or refutation'.

Agneta Yngve: 'If you are participating in Rio2012, make the best of it. Meet, communicate and reflect. Go home with at least three new email addresses to people you really would like to keep in touch with, three messages from the conference that you need to follow up in your own research or career, and three lessons learned that you will never forget'.

When I am optimistic, what is my vision?

Editor's choice!

Urban Jonnson: I am most of the time an optimist! My vision is a global community that has adopted the principles of peace, justice, freedom (democracy), and human rights. These are the four pillars of the United Nations Charter. Peace is not the same as 'absence of war'; it implies a world without soldiers and weapons. Justice implies a world in which equity or 'fairness' is realised. Democracy implies the full realisation of all civil and political rights, including for children. Human rights implies a world characterised by equality and non-discrimination, inclusion and participation, and accountability and the rule of law – all also for children!'

Marion Nestle: 'I am perennially optimistic and am thrilled beyond belief by the power and excitement of today's food movement. This movement takes many forms – agricultural sustainability, small farming, urban farming, animal welfare, worker rights, food safety, and promotion of organic, local, and slow food – all aimed at creating a food system that is healthier for people and the planet. As more and more people join one or another aspect of this movement, I am more and more optimistic'.

Philip James: 'First, that we assemble and display brilliantly, the data demonstrating the valid economic cost-benefits of national and governmental measures to change societal behaviour. Then second (please note, second) that we engage with key thinkers and doers in social, economic and political affairs'.

Catherine Geissler: 'Governments are being made more aware of the increasing scourge of obesity and its attendant ill-effects such as diabetes and cardiovascular disease, as well as the role of the food industry in the problem. Hopefully they will introduce or improve their policies concerning subsidies and taxes, advertising, and processed food composition, and those that encourage local food production, as well as physical activity'.

Claudio Schuftan: 'Of a strong and much fairer United Nations, and within the UN, WHO, FAO and UNICEF. Of a correspondingly weaker International Monetary Fund and World Bank. Of truly fair trade agreements. Of claim holders actively claiming their human rights worldwide. Of duty bearers, once and for all, abiding. …and then oh, I wake up...'

Geof Rayner and Tim Lang:. 'Our own vision is based on the general idea that people working in public health nutrition can share common goals. These may concern sustainability, the adequacy of diets, the importance of sustainable diets, and the learning about and sharing of food. Food is culture and culture is food. We should be generous with both'.

When I am pessimistic, what do I foresee?

Editor's choice!

Harriet Kuhnlein: 'Too many people in leadership positions in all countries are controlled by greed and crime, and think that money is the only answer to 'progress and development'. I wonder, how it can be that 'money' and 'things' are the ways in which success is judged and monitored, as the measures of national development and happiness of citizens?'

Philip James: 'More nutritionists feebly wailing about the difficulty of doing things, while health problems escalate, only to be 'solved' by the pharmaceutical industries claiming that they can cure the world, while at the same time having a financial bonanza!'

Geoffrey Cannon: 'I fear that we are long past the point of no return. Maybe the planet's carrying load of humans is 3 billion, as it was in 1960. Maybe less. Nobody is defending 10 billion with a definition of 'development' that implies exponential rises in exploitation and consumption in urban Asia and Africa. But that's the trend'.

Our 14 contributors for this month

Rio2012 keynote plenary speakers

Rio2012 will be interactive. This means, among other things, that there will be no long plenary lectures presented by one person, with an audience sitting in silence, applauding at the end, and then no questions. Our opening keynote plenaries, that set the scene, will be brief. The time conventionally given to one speaker will be shared by five people from different parts of the world: Asia, Africa, Latin America, North America, and Europe. They also have the challenge of summing up what they see is the vision coming from the conference, at its end. These keynote speakers are Srinath Reddy, Reggie Annan, Renato Maluf, Marion Nestle, and Philip James. Here we feature Marion Nestle from the US, Philip James from the UK, and Reggie Annan from Ghana.

Marion Nestle

What do I hope Rio2012 will achieve?

It will be lovely if Rio2012 comes up with some recommendations for real sustainability, focusing on the entire food chain from agriculture to public health. Industrial agricultural producers must find ways to use fewer inputs, produce less pollution of air and water, and replenish and revitalise soil. Small farms should be given the support they need to produce food as well as feed. And agricultural systems should be reorganised to promote public health as a major goal.

My advice to a young public health nutritionist

The first thing to understand is that if you are doing public health the way you are supposed to, you will inevitably encounter opposition. If you are trying to help people feed themselves and eat healthfully, you will come up against food industries whose sole job it is to sell more of their products. Understand that the goals of food companies and the goals of public health are not the same, and stay out of partnerships and alliances that compromise your integrity and your ability to help people stay healthy.

When I am optimistic, what is my vision?

I am perennially optimistic and am thrilled beyond belief by the power and excitement of today's food movement. This movement takes many forms – agricultural sustainability, small farming, urban farming, animal welfare, worker rights, food safety, and promotion of organic, local, and slow food – all aimed at creating a food system that is healthier for people and the planet. As more and more people join one or another aspect of this movement, I am more and more optimistic.

When I am pessimistic, what do I foresee?

I worry a lot about corporate control not only of our food system, but also of government and courts. I am particularly troubled by the way US courts are interpreting the First Amendment to the Constitution, as granting corporations the right to say anything they like to market their products. Corporate control represents a clear and present threat to democracy, in the US and everywhere, which is another reason why strengthening the food movement is so important.

My most highly recommended writer

Raj Patel is one clear thinker about these kinds of issues. In his key book he explains how capitalism leads inexorably to both undernutrition and overnutrition. You can access and buy the book at: http://www.amazon.com/Stuffed-Starved-Hidden-Battle System/dp/1933633492/ref=sr_1_3?s=books&ie=UTF8&qid =1332081878&sr=1-3

Patel R. Stuffed and Starved: The Hidden Battle for the World Food System. London: Portobello Books, 2007.

One choice of my own publications

This is like choosing among children, but it's good to start with Food Politics. The revised edition was published in 2007 and I am now working on a tenth anniversary edition. Access and buy the book at: http://www.amazon.com/ Food-Politics-Influences-Nutrition/California/dp/0520254031/ref=sr_1 _1?s=books&ie= UTF8&qid=1332082065&sr=1-1. Or:

Nestle M. Food Politics. How the Food Industry Influences Nutrition and Health. Updated edition. Berkeley: University of California Press, 2007.

Marion Nestle is an Association founding member
Her own website is www.foodpolitics.com. She has over 80,000 twitter followers She is giving one of Rio2012's opening and closing keynote plenary presentations

Philip James

What do I hope Rio2012 will achieve?

I hope Rio2012 will let us recognise that in public health circles there is endless talk about equity, transparency, societal involvement and so many other vague worthy statements that sound good, but somehow seem to get us nowhere! My message here is that we must mobilise with the support of both civil society and politicians, so that we not only influence governments but actually persuade them to change policies.

So I hope Rio builds on the Brazilian perception of governmental as well as societal responsibility for human welfare, where rigorous scientific, statistical and economic analyses are linked to political reality, and the processes whereby national strategies can be changed. I hope we do not hear too much about the type of 'bottom up' approaches favoured in the US because, as a member of the White House staff once told me, you cannot expect anything else in the US from the Congress or the White House as they are controlled by vested interests!

Within our own immediate capabilities as a profession, I also hope to see the beginning of new public health analyses of some of the major nutritional issues which so often are neglected. These include vitamin B12 and vitamin D deficiencies; the role of n-3 fatty acids in new public health dimensions; a reassessment of amino acid requirements, given the huge societal implications of any intrinsic need for milk or meat; and the importance of nutrition in auto-immune diseases, dementia and Alzheimer's disease.

I hope to hear a bit on new concepts relating to the human microbiome, and its role not only in stunting but in conditioning the gut and indeed metabolism and insulin resistance. What a challenge we have!

My advice to a young public health nutritionist

Do not get into general public health nutrition too soon. Become a valid expert in a biological science, or some other hard, rigorous endeavour, with publications to your name. This will protect you, because inevitably as a public health nutritionist you will be attacked as a woolly amateur dabbling in politics

When I am optimistic, what is my vision?

First, that we assemble and display brilliantly, the data demonstrating the valid economic cost-benefits of national and governmental measures to change societal behaviour. Then second (please note, second) we then engage with key thinkers and doers in social, economic and political affairs. Then just maybe, we will eradicate the plague of the Western food industries dominating the political agenda and perverting public perception of what as societies we should be doing.

When I am pessimistic, what do I foresee?

More nutritionists feebly wailing about the difficulty of doing things, while health problems escalate, only to be 'solved' by the pharmaceutical industries claiming that they can cure the world, while at the same time having a financial bonanza!

My most highly recommended writer

Richard Wilkinson, and his book written with Kate Pickett, The Spirit Level. Please get the latest 2010 Penguin edition in Penguin with its postscript which answers the critics. The book shows that societies with more equitable distribution of incomes have better health, fewer social problems such as violence, drug abuse, teenage births, mental illness, less obesity, and are more cohesive than ones in which the gap between the rich and poor is greater. Look at the website: www.equalitytrust.org.uk. This will challenge your thinking and help you to see the need for rigorous analyses as sound bases, in the behavioural, social and economic sciences. It was Richard Wilkinson who introduced Michael Marmot to the issue of inequity in health, which in turn led to the WHO commission and its report on the social determinants of health

Wilkinson R, Pickett K. The Spirit Level. Why More Equal Societies Almost Always Do Better. London: Penguin, 2010

This demands a new way of political and economic thinking. Here is some good news. As I write towards the end of March, in the UK the distinguished thinker Will Hutton, with the president of the Confederation of British Industries, has proposed a new form of capitalism. This report, of the Ownership Commission, calls for a bigger role for mutuals and co-operatives and employee-owned firms, and emergence of a more 'responsible capitalism'. Access: www.employeeownership.co.uk/.../ownership-commission-report/.I sense that a movement for global economic and political change is under way.

One choice of my own publications

Two reports come to mind – each produced in six weeks in the midst of political crises, when you can do almost anything if you know what you are writing about! The first was for Tony Blair, about to be UK prime minister: the plan for a Food Standards Agency. See http://archive.food.gov.uk/maff/archive/food/james/part1.htm.

The second was for a dramatic new plan to cope with the BSE epidemic at European Commission level. The original plan was to shut down the whole of the cattle, sheep and goat markets in Europe. This drastic plan would have cost € billions a year. So I developed a plan in December 1997 which involved looking at the graded risks of tissue and geographical origin, with an age limit to take account of the potential infectivity of the different species. The proposed scheme is the one which the world has followed to this day. It cost € hundreds of millions and limited the export policies of many lower income countries, but saved € billions a year and started the process whereby our new European Commission's Scientific Steering Committee realised we had to write scores of reports to cope with the global aspects of the problem.

If only the nutritional world were seen in an equivalent light! However, weird prions in our food that might have led to the deaths of hundreds of thousands of young people from vCJD (but in the event did not) were considered far more important than all the issues to do with food systems and dietary patterns that lead nutritionally to hundreds of millions becoming obese and diseased and dying from pandemic disease every year. These nutritional issues are supposed merely to reflect our 'food choices'! So they are not classified as toxicological and industrial in origin, as they should be. In both these cases, the reports I wrote led to far-reaching changes in food systems and their governance. But this was only possible when there was a political crisis.

However, readers may be more interested in nutritional issues closer to home, so perhaps the following is more appropriate: The paper cited below, summarised all the work I had done with Claudia Sanchez-Castillo from Mexico. We showed that the lithium marker technique we developed for tracking the sources of salt revealed that in the UK 85 per cent of salt came from bought foods and only 15 per cent from home cooking and table use. From that day on, there was no more serious talk about health education to reduce the home use of salt. The whole public health issue switched to salted manufactured foods.

James WPT, Ralph A, Sanchez-Castillo CP. The dominance of salt in manufactured food in the sodium intake of affluent societies. Lancet 1987, 1, 426 429.

Philip James is an Association Council member
He was chair of the WHO study group responsible for the 1990 '797' report Diet, Nutrition and the Prevention of Chronic Diseases
He is giving one of Rio2012's opening and closing keynote plenary presentations

Reggie Annan

What do I hope Rio2012 will achieve?

As the congress theme states, I hope that Rio2012 will end with concrete policies that can be translated into specific measurable actions and activities to address malnutrition globally and in Africa. When I leave Rio, I want to be able to say that I am going to implement this and that, and expect to achieve this and that. We all know that much as overnutrition has become a major issue in Africa, undernutrition remains with us. Unless policies and actions address the underlying causes of food and nutrition insecurity they may not achieve much. These underlying causes include poverty, lack of education, poor status of rural African women, political instability, poor governance and corruption. Public health nutritionists have roles to play in addressing these underlying causes.

My advice to a young public health nutritionist

Start getting involved in actions and initiatives to promote nutrition at the global level now. Start when you are young. Do not wait until you are coming to the end of your careers or when you have achieved academic laurels. When we are young we have energy, motivation and enthusiasm. Also we are the future leaders and we need to be in the position to take up the leadership in due time. Start now working closely with those who are further ahead and more experienced, learning from them along the way.

When I am optimistic, what is my vision?

I tend to be optimistic, sometimes to a fault. I see a developed Africa, especially the sub-Saharan region. I see Africa secure in food and nutrition, without undernutrition, and with only very little infant, young child and maternal morbidity and mortality. Once this is achieved we public health nutritionists will have done our jobs one hundred per cent. It also means that we have addressed all the underlying causes of these plagues.

When I am pessimistic, what do I foresee?

I prefer to be positive. When I am pessimistic, I fear that things will get worse in Africa. I fear this especially when I see us doing things that do not bring progress. I see poor work force capacity to promote the nutrition and health of Africans. I see policies not being implemented and policies that enable brain draining away from Africa. I see us waiting for external inputs before addressing simple issues which are clearly within our power. But I would rather not be pessimistic.

My most highly recommended writer

Dag Heward-Mills. He is a medical doctor, and a bishop, and founder of Lighthouse Chapel International, and he lives in my country of Ghana. I recommended his book The Art of Leadership. Its second edition was published this January. Why this book? The answer is simple and I have said it before. Our problem in Africa is lack of good leadership. We of the young generation need to read and equip ourselves with leadership capabilities. I encourage every young person who wants to be a leader to read this book. You can buy one from Amazon at http://www.amazon.com/Art-Leadership-Dag-Heward-Mills/dp/9988596987.

Heward-Mills D. The Art of Leadership. Second edition. Peabody MA: Parchment House, 2012

One choice of my own publications

I authored the malnutrition eLearning course titled Caring for Infants and Young Children with Severe Malnutrition. This was done as a collaboration between the International Malnutrition Task Force and the Faculty of Medicine, University of Southampton. I encourage every health worker in Africa to do the course because this work is a specific action to strengthen core competencies in the prevention and treatment of severe malnutrition, as resolved by the International Paediatric Association and African Nutrition Society in 2010. The course can be accessed at http://www.som.soton.ac.uk/learn/test/nutrition.

Reggie Annan is an Association member
He writes a column every month for the Association website
He is giving one of Rio2012's opening and closing keynote plenary statements.

Rio2012 masterminds

Rio2012 has been governed and guided by principles agreed between the Association and our Brazilian partners Abrasco. Thus, everybody attending the conference is invited to and will be able to be a participant. Rio2012 sees nutrition as part of the public health movement, with social (including cultural), economic, political and environmental dimensions. The programme reflects this philosophy. Overall executive secretary Inês Rugani has worked with three committees. Overall direction comes from the executive committee chaired by Barrie Margetts from the UK, Association president, featured below, together with Luis Facchini, Abrasco president. The operational committee has two facilitators: Luciana Castro, and Association general secretary Sabrina Ionata. Below we feature Catherine Geissler from the UK and Harriet Kuhnlein from Canada and the US, two of the four facilitators of the programme committee. The other two, representing Abrasco, are Fabio Gomes and Janine Coutinho.

Barrie Margetts

What do I hope Rio2012 will achieve?

That's me above, during the second whole-week meeting to plan Rio2012, which took place last October. As you can see, I was preaching interaction! First, I salute the sheer achievement of bringing people with an interest in public health nutrition together, from across the world. Next, that we have been able to mount such a congress with no funding from conflicted sources. No other congress organisers have, as far as we know, even attempted to do this. It is very much due to the amazing team of people that have worked on the congress from Brazil, and the support and commitment of the all levels of the Brazilian government, from federal to municipal, to the ideas and values of the meeting.

I hope Rio2012 will raise the profile of public health nutrition, and enable us to show that we as a profession have a lot to offer in helping identify and solve problems in ways that work, and that protect people and the environment. We need to see food as more than fuel and supply of nutrients in a narrow reductive sense, but as more being about how we as communities and society choose to live for the benefit of all in society, not just the lucky few.

The theme of Rio2012 focuses our attention toward what we can do to make a difference, for the health of people and our planet. It will show how important it is for us to step back and take into account the wider context in which we live and work, and how this shapes what we do and how we do what we do. I hope we can develop some clear guidance on addressing the big issues that confront us all today.

Rio2012 will, I hope, show how interconnected the big global challenges are. It will show how people, and the values and approach they bring to addressing problems, are vital to developing better more effective and sustainable solutions. I hope Rio2012 will show the value of thinking about what we as professionals need to do to be effective, and to ensure that now and in the future we develop the workforce to be able to drive improving global public health improvement

My advice to a young public health nutritionist

Follow the guidance of John F Kennedy, don't ask what public health nutrition can do for you, but ask what you can do for public health nutrition. Be prepared to stand up and be counted, engage, and the rewards will be great. Think about what you want to do and why, reflect on your motivation. You are the future. We need you to do better than we older professionals have done. But developing the skills to be effective takes time and effort; it will not be a quick stroll. If you build a sound philosophy you will have a great platform. Stay true to your core values and keep doing what you know is right despite the pressures pushing you off track. Don't be motivated by money. Find what you want to do, work hard and you will get work that will support you.

See the big picture. Most young people in Europe, where I am based, know very little about the Common Agricultural Policy and the impact this has on Europe, or about the World Trade Organization and the impact that global trade and debt repayments have on the capacity of low and middle income countries to look after themselves. The challenge is seeing the big picture and also seeing what you yourself can do.

When I am optimistic, what is my vision?

People are our greatest asset. It is amazing what can be achieved when good people come together with a common purpose and vision. All our work should be driven by improving the health and well-being of the worst off in society. This means giving such people a chance to control their own lives and live happily as part of healthy communities where people care for each other and the environment in which they live.

If we strengthen this connection between people, the way they live, and the context in which they live, I believe society will be much healthier. When people are empowered to be actively engaged in their own lives and the lives of others, amazing things can happen. Nutrition is not just thinking about where nutrients come from. It is more to do with thinking about how society works. We are all diminished when any one of us is not able to live a happy healthy life. Increasingly, people are seeing this. Over time we will see a new way to make things work better for the majority, not just the rich few who currently benefit most from how our world is organised.

When I am pessimistic, what do I foresee?

If we don't engage people, if we don't care what happens to ourselves and our neighbours and the world we live in, we allow vested interests to create a world that continues to benefit the few. This means more and more control in the hands of fewer and fewer people who just want to make money and become more powerful.

Apathy allows this to continue. We must engage young people and the disenfranchised and support them to take control back from the few who currently run things. Quick fame and easy success are not the foundation for a health sustainable and fair world. We must respect and value one other for what we are, not what we have. If we don't change the way we do things the gaps will get bigger and lead to even more divided societies with a few living behind closed doors in luxury and the masses left out in the cold – or heat – to survive off scraps in an increasingly fragile environment.

My most highly recommended writer

I want not to choose just one. Is that alright? [Ed: alright, then]. No one text or person has the answer. We each have to find a way forward that works for us. This requires a breadth of reading and reflection beyond what any one writer can provide. Read the work of Nelson Mandela and Mahatma Gandhi. Of our colleagues, read Urban Jonsson and Claudio Schuftan who make us think about the underlying philosophy and approaches that shape the world we live in. Read Tim Lang, Raj Patel, Michael Pollan, and Marion Nestle. Some choices of their publications are below.

Jonsson U. The rise and fall of paradigms in public health nutrition. [Commentary] World Nutrition, July 2010, 1, 3: 128-158. Obtainable at www.wphna.org

Schuftan C. Kinshasa: A tale of two cities [Column]. Website of the World Public Health Nutrition Association, April 2012. Obtainable at www.wphna.org

Rayner G, Lang T. Ecological Public Health: Reshaping the Conditions of Health. London: Routledge/Earthscan, 2012.
http://www.routledge.com/books/details/9781844078325/

Patel R. Stuffed and Starved: The Hidden Battle for the World Food System. London: Portobello Books, 2007. Available at: http://www.amazon.com/ Stuffed-Starved-Hidden-Battle System/dp/1933633492/ref=sr_1_3?s=books&ie=UTF8&qid =1332081878&sr=1-3

Pollan M. In Defense of Food. An Eater's Manifesto. New York: The Penguin Press, 2008.

Nestle M. Food Politics. How the Food Industry Influences Nutrition and Health. Updated edition. Berkeley: University of California Press, 2007

One choice of my own publications

The most recent book Roger Hughes and I have written is an attempt to provide a practical handbook for people starting out, who are trying to develop interventions or programmes. Previous books have been too theoretical or academic.

Hughes R, Margetts BM. Practical Public Health Nutrition. Oxford, Wiley-Blackwell, 2011

Barrie Margetts is Association president
He is chair of the Rio2012 executive committee

Catherine Geissler

What do I hope Rio2012 will achieve?

Here above I am taking a break in Rio's botanical gardens in May, after our first week's work planning the programme with many other colleagues.

Rio2012 has been organised to allow plenty of time for discussion, rather than passive consumption of presentations by eminent professionals. Eminent professionals will be giving short introductions to each topic of interest to public health nutrition and will then take part in live discussions, and will also answer questions from those participating by internet.

In addition all participants have declared any interests they might have in the food industry, and so the outcome of discussions should not be biased by any profit motive. Clearly the food industry is important for the provision of food in the increasingly urban context, but globalisation and excessive processing for profit motives have detrimental effects on nutrition. I therefore hope that Rio2012 will achieve awakening of minds to new concepts, and useful dissemination internationally of ideas and effective policies and practices, as well as collaborations for improving nutrition worldwide.

My advice to a young public health nutritionist

You will already know that the traditional weapons against malnutrition in our armoury, such as nutrition education, feeding programmes, vitamin and mineral supplements, and food fortification, are important in both prevention and treatment. But these tend to focus on the individual and the consumer, and do not adequately address the causes of the problems.

The underlying causes of malnutrition, both undernutrition and obesity, are economic and political. So for sustainable solutions you need to have an understanding of the social and economic structures that foster malnutrition, and be able to influence specialists in other fields such as agriculture, economics, commerce and politics to be aware of the effects of their policies and actions on the nutrition of populations, and to collaborate with them to try to effect desirable changes.

In our profession we all need specialist knowledge of the biological science of nutrition and malnutrition; but we also need to know about the underlying social, psychological and economic factors. You need to be aware of policies and interventions that have been successful in preventing or remedying malnutrition in many countries, whether undernutrition or obesity.

You will also know that nutrition is usually located in the health sector of government. But you need to be aware that this is not where the main underlying causes of malnutrition lie. You need to understand the role of other national and local sectors as well as of international bodies and multinational corporations on for example agriculture, employment, food prices, and town planning, and ultimately on the distribution of wealth and poverty. You need to consider the effects of policies such as subsidies and taxation on food production, processing, distribution and consumption on the environment, health and nutrition. Nobody can be expert in all these areas, but you should have enough knowledge to be able to communicate and collaborate with these actors.

When I am optimistic, what is my vision?

In recent years nutrition has had an increasing international profile. The UN agencies have begun to collaborate seriously to encourage less resourced countries to scale up nutrition efforts, so as to have a greater impact on mothers and young children which could have lifelong benefits.

Governments are being made more aware of the increasing scourge of obesity and its attendant ill-effects such as diabetes and cardiovascular disease in both economically rich and poor countries, as well as the role of the food industry in the problem. Hopefully they will introduce or improve their policies concerning subsidies and taxes, advertising, and processed food composition, and those that encourage local food production, as well as physical activity.

When I am pessimistic, what do I foresee?

I fear that widespread civil and international wars will continue to thwart efforts to improve health, nutrition and well being. For me, after being on a short term nutrition consultancy in Syria several years ago, the current devastation there has particular personal poignancy. I fear too that the globalised food industry, with its vast resources and profit imperatives, will defeat the efforts of poorly resourced national governments to control their power.

My most highly recommended writer

Impossible! There are many excellent writers in the field. But I will cite one who was influential in exciting my interest in nutrition. This is Josué de Castro, a Brazilian physician with a particular interest in nutrition and an activist against world hunger. He wrote Geopolitics of Hunger in 1952, which is translated into 26 languages, and he received the International Peace Prize in 1954. He argues that hunger is not the result of overpopulation but is human-made. He demonstrates that hunger is the cause, not the result of overpopulation, and his thinking remains influential in development policies.

This choice is particularly apt, as Josué de Castro taught at the University of Brazil, now UFRJ, a sister university of the State University of Rio (UERJ) where Rio2012 is being held. He was chairman of the UN Food and Agriculture Organization (FAO) and a member of parliament and a diplomat for Brazil. He epitomises the breadth of public health nutrition from science to politics. After the military coup in Brazil of 1964 he was exiled in Paris. He taught at Paris 8 University until his death in 1973.

De Castro J. Geopolitics of Hunger. New York and London: Monthly Review Press, 1952, revised edition 1977. ISBN-10: 0853453578 ISBN-13: 978-0853453574

One choice of my own publications

A cruel question, after the importance and influence of the book cited above. However, I shall choose one of my recent publications: The Fundamental of Human Nutrition, written with Hilary Powers. As described by the publishers it is 'an authoritative overview that will help you understand the complex subject of human nutrition. This book is a digest of material from the highly successful Human Nutrition 11th edition. Fundamentals is intended for a wide readership of students and practitioners who need a broad understanding of human nutrition but for whom an in-depth knowledge is not essential'

I have chosen this rather than a research paper, or our textbook Human Nutrition 12th edition for nutrition specialists. It is important that the breadth of nutrition ranging from the role of individual nutrients to public health nutrition, from authoritative sources, should be made easily accessible to specialists in related fields.

Geissler C, Powers H. Fundamentals of Human Nutrition – for Students and Practitioners in Health Sciences. Churchill Livingstone Elsevier. Edinburgh, London, New York, Oxford, Philadelphia, St Louis, Sydney, Toronto. 2009

Catherine Geissler is an Association member
She is a convenor of the Rio2012 programme committee

Harriet Kuhnlein

What do I hope Rio2012 will achieve?

Like Catherine I would like to emphasise that the planning of Rio2012 has been teamwork. That's me next to Catherine in the picture above, taken at the end of our second week-long meeting in Rio last October, with just some of the friends and colleagues engaged throughout the week.

Our relatively new organisation has impressive goals for improving public health nutrition throughout the world, with methods conducted in the best traditions of protecting human rights, protecting sustainable food systems, protecting healthy traditions and, when needed, to improve health in all of its dimensions. Rio 2012 brings together many interdisciplinary professionals who can address our goals. My hope is that it will sustain impetus for our organisation, and bring us new active members, new ideas, and new strategies, to make us an important organisation for the world's public health.

My advice to a young public health nutritionist

Be aware that you are there to make a difference. See the big picture of public health nutrition, and how your particular work fits into the grand scheme. Join in with a cohort of professionals in your area with which you can draw sustaining enthusiasm for your work, and who can provide leadership and ideas on how to accomplish particular goals.

Think of belonging to a local association in our field, as well as being aware of national and international movements. This can be through formal and informal continuing education activities, by meetings, and through the internet. Take advantage of opportunities to learn from others. Reach out, be aware of new ideas, and contribute to them. Don't be afraid to contact people that inspire you: you will find that your enthusiasm can also inspire them.

Keep an open mind. New science, new strategies and new goals for our work are always developing. Listen and learn, then apply what you think is best in your practice.

When I am optimistic, what is my vision?

I see that our profession is developing positively, and that public health nutrition will contribute to a world where everyone lives in a peaceful, healthful environment, enjoying their local culture and ecosystem as much as possible during an active and healthy life. I believe that our scientists, thinkers and doers can eventually control the negative aspects of climate change. I am hopeful that everyone in leadership positions in the world will apply the human rights philosophy to solve poor nutrition in all of its forms. I believe that leaders in the United Nations system are part of the movement towards international cooperation for peace, harmony and good health for everyone.

When I am pessimistic, what do I foresee?

I already see that too many people in leadership positions in all countries are controlled by greed and crime, thinking that money is the only answer to 'progress and development'. I wonder, how it can be that 'money' and 'things' are the ways in which success is judged and monitored, as the measures of national development and happiness of citizens? I am concerned that 'development agencies' do not look deeper into what really matters to people.

My most highly recommended writer

One of the largest public health problems in the world today is obesity and the diseases caused by obesity. Young professionals will undoubtedly be faced with dealing with obesity as a result of current trends to market and to consume more and more unhealthy food and to inactive and unrewarding ways of life. How to change this situation faces all of us in public health nutrition. To become aware of this situation all over the world, I recommend reading the works of Barry Popkin, from the US, and Carlos Monteiro, from Brazil. A recent journal paper is: Claro R, Levy R, Popkin B, Monteiro C. Sugar-sweetened beverage taxes in Brazil. American Journal of Public Health. January 2012, 102, 1:178-183. Epub 28 November 2011.

One choice of my own publications

Kuhnlein H, Erasmus B, Spigelski D. Indigenous Peoples' Food Systems: The Many Dimensions of Culture, Diversity and Environment for Nutrition and Health. Centre for Indigenous Peoples' Nutrition and Environment and Food and Agriculture Organization of the United Nations. Rome: FFAO, 2009. 2009. Available at: http://www.fao.org/docrep/012/i0370e/i0370e00.htm

Harriet Kuhnlein is an Association Council member
She is a convenor of the Rio2012 programme committee

Our website columnists

So far our website has included four regular columnists. Reggie Annan, now back home in Ghana, who has published 18 columns do far, is featured above, in his role as a Rio2012 plenary presenter. After 15 columns Fabio Gomes from Brazil has been taking a break since last summer, but will be back. Claudio Schuftan, originally from Chile, now living in Vietnam, soon to move to the US, publishes his 21st column this month. Geoffrey Cannon, a UK citizen who lives and works in Brazil, who started his columns earlier, publishes his 25th column this month. Yes, we need more from Asia, and more by women. We know!

Claudio Schuftan

What do I hope Rio2012 will achieve?

Responding to this question allows me to bring up some of the thoughts I had six months ago when I submitted three abstracts of presentations I proposed for Rio2012. All three were rejected... But I will be there!

Make the Association an advocate of sorely needed changes in public health nutrition. Encourage members more often to engage and publicly discuss opinions expressed on our website, including in our monthly columns and World Nutrition commentaries. This should contribute to a consensual basis for shared and joint advocacy positions. Assemble a group of volunteers to make this happen.

Decisively adopt the human rights-based framework to work in our field. Ask Association members to review their own work so as to reinforce or adopt the human rights-based approach.

You see I am in company in the picture above, with Italian colleagues and friends from the People's Health Movement. (I'm the one in the white shirt). That shows that I believe in partnerships, and also practice (and embrace) them. The Association should thus work with likeminded progressive organisations such as PHM, the FoodFirst Information and Action Network (FIAN), Oxfam, Medecins du Monde, the Third World Network, the South Centre, Medicus Mundi.

The Association should be pressing UN agencies on important and urgent issues, including the survival of the UN System Standing Committee on Nutrition. We need to collaborate closely with the UN Special Rapporteurs on the Right to Food, and on the Right to Health. Perhaps above all, we need to develop our networks and membership, especially in Asia, Africa, the Arab world, the countries of the former USSR, and in general in the most impoverished and under-resourced parts of the world.

The immediate question is: What do we do on Monday morning? This is the very practical question to face, when trying to come to concrete personal and organisational expressions of otherwise abstract ideas.

My advice to a young public health nutritionist

You are aware I trust, that knowledge in the sciences that deal with the social determinants of malnutrition, is already more than a sufficient basis to solve the major nutrition problems worldwide. But you must surely also be aware that the divide between that knowledge and the policies we read about, and commensurate actions, is still so wide. How much, do you feel, are your elders responsible for this lamentable and disgraceful state of affairs? Are they sufficiently committed to issues of rights, equity, justice? And if you feel they are not, what are you now going to do about this?

You are aware of the ongoing financial, food, energy, climate crises. You surely must know that impoverished countries are mostly victims of these crises, to which they have not contributed. Plus they have (and have had) little power to resolve them. The situation changes rapidly both in the interplay of these crises and how they affect poor countries, poor people and our own work in public health nutrition.

Expose yourself to wider realities. Explore realistic ways to address and resolve these crises in the crucial years to come. Keep an optimistic outlook. Prepare to become a leader of positive change in the dire circumstances the world is facing.

When I am optimistic, what is my vision?

My vision is of a strong and much fairer United Nations, and within the UN, WHO, FAO and UNICEF. It is of a correspondingly weaker International Monetary Fund and World Bank. Of truly fair trade agreements. Of claim holders actively claiming their human rights worldwide. Of duty bearers, once and for all, abiding.... and then oh, I wake up.

When I am pessimistic, what do I foresee?

Pretty much doom and gloom. I have periods in which I am overwhelmed and depressed about how much I have tried to influence world nutrition in the last three and a half decades, and how much the effort has resulted in two steps forward and one and three quarters steps backward. Or maybe the other way round. It is honest to God true that some mornings when I am looking at the mirror when I shave I ask myself: Isn't it time to enjoy my golden age and pass the baton, in this unending battle against the powers that be that have relentlessly brought us to the current world affairs? But the old social activist in me wins. You see it in my columns, letters and commentaries right here in these pages. I guess I am going to die fighting. (Perhaps I should apologise to you for this…).

My most highly recommended writer

You all know I am primarily a human rights activist. I see no clearer apologist of human rights in the literature than the writings of our fellow Association member Urban Jonsson. With his short sentences, and concise, almost mathematical logic he conveys the essence of human rights better than anybody I read. Can I make a number of selections? [Ed: Oh, alright then...] Here are samples over the last 30 years:

Jonsson U. The causes of hunger. Food and Nutrition Bulletin 1981, 3, 2, 1981.

Jonsson U. A Conceptual approach to the understanding and explanation of hunger and malnutrition in society [Chapter 2] Hunger and Society, Cornell International nutrition monograph series 17, 1983.

Jonsson U, Ljungqvist B, Yambi O. Mobilization for Nutrition in Tanzania. In: Rohde J, Chatterjee M, Morley D. (eds.), Reaching Health for All. Oxford: Oxford University Press, 1993.

Jonsson U. Nutrition and the Convention on the Rights of the Child, Food Policy 21, 1, 1996.

Jonsson U. Human Rights Approach to Development Programming, UNICEF, Nairobi, 2003.

Jonsson U. MDGs and other good intentions. How to translate rhetoric into action. In: Pinstrup-Andersen P (ed). Ethics, Globalization and Hunger, 2007.

Jonsson U. The rise and fall of paradigms in public health nutrition. [Commentary] World Nutrition, July 2010, 1, 3: 128-158. Obtainable at www.wphna.org.

One choice of my own publications

Some of you also know I upload a fortnightly column on several list-servers called The Human Rights Readers, fondly known to many as 'the food for thought column' See www.humaninfo.org/aviva for #69). This column is my response to not writing a book. Books take an enormous amount of effort and time plus struggles with the editor. If good, books enjoy a spike of attention; one may even get one or two encouraging reviews. With the Readers – which I recognise are obtrusive – I have a couple of messages I consider important on the screens of many of you, every two weeks. Now that is a thought to ponder, no?

Claudio Schuftan is an Association member
He writes a column every month for the Association website

Geoffrey Cannon

What do I hope Rio2012 will achieve?

My hope is that Rio2012 begins an era in which nutrition, in the grand sense, becomes as independent and influential as it once was, and as it needs to be now and in future. In some areas it already is. We can learn much from the breastfeeding movement led by civil society organisations such as the World Alliance on Breastfeeding Action, and the International Baby Food Action Network. In Brazil the work of CONSEA, the National Council for Food and Nutrition Security, an alliance between civil society and the federal government at presidential level, has reduced inequity and poverty in this vast country.

My advice to a young public health nutritionist

Realise that like money, nutrition is vital in itself, and also that it touches everything. It is what it is, and it also is what it means. Reflect on this.

Stay or be aware that public health nutrition is a branch of public health. It is not a branch of or subsidiary to clinical nutrition. Public health is political, in the sense of being constantly engaged both with policy, and with ideology. You surely need to know your technical stuff, but as means to greater ends. Be prepared to think and act as a citizen.

Read history and biography. We are living in a time when only what is new is valued. This is a mistake. For instance, understand public health by learning about Rudolf Virchow, especially when he was in his late 20s in Prussia. Understand nutrition by following the career of Cicely Williams, most of all when she was in the Gold Coast and Malaya in the 1930s and 1940s. Get a grip on the modern masters by learning about Ancel Keys, and in particular the Minnesota Experiment and the Seven Countries Study.

Learn to speak and write; which is to say, learn to think, and to express your thoughts. To do this is partly an art, which requires work, and mostly a craft, which requires much more work. Gain inspiration from marvellous writers, and think about how it is that they engage you and move you. Read anything and everything by Jorge Luis Borges, Pablo Neruda, Jean Rhys, Ernest Hemingway (start with A Moveable Feast), Ahdaf Souief, Isabel Allende (the earlier novels), Christopher Hitchens. Take every opportunity to experience great orators (a rare breed now, alas) and great actors, and think about and feel how they do what they do. Writing for publication and speaking in public is like playing the piano with an audience. You have to practice constantly.

Have courage. Be prepared to stand up in meetings and speak your truth. Realise that truly brave people, when in new strange and especially dangerous situations, always feel fear. Get into the habit of exposing yourself to challenge or refutation. Always remember that a lot in public health and in nutrition is controversial and that's all right.

When I am optimistic, what is my vision?

We all nourish our consciences, I am sure, and think about what contribution we are making and can make to a planet and a biosphere our children and grandchildren could thank us for. When Gabriel, my third son, who is 8 this month of April, complains that I won't let him use this computer but only my slower back-up machine for his games, he is annoyed because he wants the best. He reminds me that I had better go on making my account for him to understand when he is a man.

When I am pessimistic, what do I foresee?

The still-dominant political and economic ideology amounts to a sociopathic cult of individualism. Within this, the structures of public health and public goods, built up carefully and after great struggle since the nineteenth century, are crumbling. I fear that we are long past the point of no return. Maybe the planet's carrying load of humans is 3 billion, as it was in 1960. Maybe less. Nobody is defending 10 billion with a definition of 'development' that implies exponential rises in exploitation and consumption in urban Asia and Africa. But that's the trend.

My most highly recommended writer

On our topic, that is. Well, more or less… It's much easier to select fifteen. These could be Fernand Braudel, Manuel Castells, Claudia Roden, Alan Davidson, Mike Davis, Paul Farmer, Paul Feyerabend, Tim Flannery, Susan George, Ivan Illich, Frances Moore Lappé, Tony McMichael, Lynn Margulis, Michael Pollan, Amartya Sen. These are writers who give public health nutrition its context, all of whom are original, radical, challenging, compelling, and a challenge and delight to learn from.

My choice of one, is a visionary writer with a world view, and deep knowledge of the origins of food and the meaning of nutrition in its biological, social, cultural, environmental and yes, gastronomic dimensions. Plus I choose an advocate and campaigner, not for one cause, but for the future of the planet. This is Colin Tudge. I also have something to say about him in my column this month. See also his work with Ruth West in support of rational agriculture, at www.campaignforrealfarming.org. Since we seem to have given up on selecting just one publication:

Ruth West in support of rational agriculture, at www.campaignforrealfarming.org. Since we seem to have given up on selecting just one publication:

Tudge C. The Famine Business. London: Faber and Faber, 1977
Tudge C. Future Cook. London: Mitchell Beasley, 1980.
Tudge C. So Shall We Reap. The Concept of Enlightened Agriculture. London: Allen Lane, 2003.
Tudge C. The Secret Life of Trees. How They Live and Why They Matter. London: Allen Lane, 2006.

One choice of my own publications

What I wish I could now recommend is one of the three books I have outlines and substrate for, but which I have not yet written! Most of my UK-based work is insular and dated. Since then, most of my work has been collaborative, or as an editor. So my answer now is as an editor and joint author. (But that's alright, for everybody knows now that 'Shakespeare' was a committee). Here are my three finalists.

Third is the special September 2005 issue of Public Health Nutrition, in which the New Nutrition Science project was set out. This was a joint initiative with Claus Leitzmann. We also convened the working group responsible for The Giessen Declaration.which has guided the agenda for big picture thinking ever since, including Rio2012.

WN is now read in most countries in the world, including throughout Asia and Africa. I am proud of this. And thus, my second choice is WN itself.

My first choice is a little book, less than 100 pages, developed from my 2003 Caroline Walker Lecture given at the Royal Society. I moved from the UK to Brazil in 2000 as a result of realising that I could not trust my judgements concerning public health until I lived and worked in the South. So I moved. Why Brazil is another story. The book has chapters that see aspects of food and nutrition policy from a Southern point of view. It's available as a free download from the Trust site. Find it under 'lectures'.

Cannon G. The Fate of Nations. Food and Nutrition Policy in the New World. The 2003 Caroline Walker Lecture. London: Caroline Walker Trust, 2003. Obtainable at: www.cwt.org.uk

Geoffrey Cannon is Association Council member, publications secretary and editor of WN
He writes a column every month for the Association website
He is a member of the Rio2012 executive committee

Association Council and founding members

We asked all Association Council members for contributions. Here we feature Agneta Yvgve from Sweden, now mostly based in Norway, and Urban Jonsson who is also a Swedish national, who lives in Kenya, two Council members who will be participating in Rio2012 without being part of its organisation. We also feature founder members Barry Popkin from the US, and Ricardo Uauy from Chile.

Agneta Yngve

What do I hope Rio2012 will achieve?

The most important thing is to meet new and old colleagues and friends. Conferences give us a golden opportunity to network, to plan for joint research proposals, and to discuss posters and talks. Looking back, some of the more important acquaintances that I have made during my career have been made at meetings. I hope that Rio2012 will provide opportunities not only to meet with those I knew before, and for us all to make new friends for fruitful collaboration and exchange of ideas.

I hope that Rio2012 will bridge some gaps – between rich and poor, east and west, north and south, different language skills and different cultural backgrounds. Especially the language gap is a major challenge at a conference with two languages. Hopefully the participants will be able to communicate across this huge barrier.

My advice to a young public health nutritionist

If you are participating in Rio2012, make the best of it. Meet, communicate and reflect. Go home with at least three new email addresses to people you really would like to keep in touch with, three messages from the conference that you need to follow up in your own research or career, and three lessons learned that you will never forget. The take-home messages and lessons learnt do not have to come from gurus and keynote speakers. Those notes that we make to ourselves, or reflections that we make in the quiet of our hotel room at night, are just as important as the ones made by the high and mighty. By reflecting, we learn and we remember what we have learnt. Use all the social networks that you are so good at – Twitter, Facebook, Linkedin …

When I am optimistic, what is my vision?

My vision is that we will understand the importance of introducing public health nutrition into curricula of several professional groups, and more explicitly to develop the role as planner, evidence-base keeper, monitoring expert and evaluator for public health nutritionists.

When I am pessimistic, what do I foresee?

I do see a risk of us continuing as is, with many important professionals actually lacking necessary knowledge and skills, thereby leaving the field open to amateurs, charlatans and gold diggers, running parallel shows in the media and on the action frontline.

My most highly recommended writer

The first time I read something written by Ana Diez Roux, who is director of the University of Michigan school of public health, I saw the light. Here I found someone who had understood the importance of working on the local level to promote healthy ways of life. She took part in a dynamic 2007 four-hour seven-programme tv series called Unnatural Causes, on the social determinants of health, which you can access at www.unnaturalcauses.org. She is author of many enlightening publications. For now I suggest an introductory piece:

Diez Roux AV. Residential environments and cardiovascular risk. Journal of Urban Health 2003, 80, 569-589.

Another excellent person who is not actually a writer is Hans Rosling, who presents information about public health trends in an extraordinary dynamic new way. Go to www.gapminder.org to see what I mean.

One choice of my own publications

At the moment, my favourite is an invited commentary on the Women's Health Initiative study, published in PHN a few years ago. It is important to react to scientific reporting as well as to the flawed media coverage of large studies.

Yngve A, Hambraeus L, Lissner L, Serra Majem L, Vaz de Almeida MD, Berg C, Hughes R, Cannon G, Thorsdottir I, Kearney J, Gustafsson JA, Rafter J, Elmadfa I, Kennedy N The Women's Health Initiative. What is on trial: nutrition and chronic disease? Or misinterpreted science, media havoc and the sound of silence from peers? Public Health Nutrition 2006; 9, 269-272.

Agneta Yngve is an Association Council member
She is editor-in-chief of WN's sister journal, Public Health Nutrition

Barry Popkin

What do I hope Rio2012 will achieve?

I hope we in the public health community can energise our attack on both under- and over-nutrition, and help to bring a greater focus on large-scale regulatory and other efforts. These need to address the dual burdens of under- and over-nutrition, and the rapid transition to a stage of eating, drinking and moving linked with excessive weight gain and a vast array of related cardio-metabolic, behavioural and economic consequences.

Few countries are seriously trying to prevent obesity and all the related heart disease, cancers, and myriad of disabilities and complications of obesity. In general as a profession we have avoided fighting for massive changes, and instead focused on small educational and such-like efforts, rather than taking on the major causes of the problem and at the same time seeking meaningful solutions that will benefit the poor. Another issue of concern to me is equity. Some of us are far too focused on issues that are relevant to our lives and not those of the poor.

I also want to see us gain a greater understanding of the analytic rigour needed to address the problems we face, be they understanding the issues, evaluating and planning programmes and services, or designing and initiating new efforts to address these problems. First and foremost we must speak and act, from a basis of solid research and thinking, if we are to shift the agenda to public health approaches and away from medicalisation of all issues.

Our organisation, the Association, is new. It has potential to be an energising source for research and solutions focused far more on public health and prevention. But we need to work out how to nurture the young and gain from the wisdom of those with great research expertise. At the same time we must be careful not to fall into politically correct but unscientific pushes that can hurt our credibility. My biggest fear is stepping too far into political correctness and ignoring science and also focusing too much on issues affecting our own lives and those of the middle class rather than the poor.

I began my own career by living in a squatter area in India and then being politically involved so I understand how passion of politics and issues can get us to focus on topics and create our own internal truths. But we must keep our eye on science and being certain we have a strong basis for addressing the topics we do.

My advice to a young public health nutritionist

Network. Speak to older scholars and those of your cohort and gain understanding of issues – be these solutions, research methods, or problems common to those your community faces. Ahead of Rio2012, email senior scholars you might like to speak to, and make a case for setting aside time with them to talk with you, and think ahead of the questions you would like to ask. Best of all, research a bit about what the people you contact are most interested in, and read some of their work – this is easy these days. Many email addresses are immediately available on our website, under members' profiles. Be bold, the worst thing that can happen is a 'no', and you may be surprised to find how many oldsters are pleased to be contacted in this way. Do it now! Also go beyond your comfort zone in meeting people, listening to new ideas, thinking about new methods, issues, problems, solutions.

When I am optimistic, what is my vision?

A world concerned about economic and social equity and with it a will to address the major health inequities facing our planet.

When I am pessimistic, what do I foresee?

A world that becomes increasingly fat and riddled with the myriad of complicated non-communicable diseases, where the obese will be mobile only because of electric chairs to move them around, and drug and surgical solutions will abound; and we ignore the poor. In other words, a world in which we will not address preventive measures related to obesity and all its related complications, and instead leave the solutions to the medical profession for those societies and individuals with resources to afford solutions.

My most highly recommended writer

Impossible to pick one. Too few have a concern with poverty and inequity plus also solutions for the globe. So I will pick three. [Ed. OK,OK…] Jeffrey Sachs for his wide vision and concern with the poor, the collision between dynamics of global economics, food systems, economic changes, and the ability of the planet to survive and sustain itself. In our profession Tim Lang for his rigorous look at our food system from a broad perspective, and Carlos Monteiro for his concern for equity and his current drive to raise new issues.

One choice of my own publications

I will pick two! [Ed: very well]. My most recent update of the state of the world as it relates to obesity patterns, determinants, programmes, and then my books for all readers, expert and lay – now in 11 languages:

Popkin B, Adair L, Ng S (2011). Then and Now: Global nutrition transition and the pandemic of obesity in developing countries. Nutrition Reviews 2011, 70 (1):3-21.
Popkin B. The World Is Fat--The Fads, Trends, Policies, and Products That Are Fattening the Human Race. New York: Avery-Penguin Press, 2009

Barry Popkin is an Association founder member

Ricardo Uauy

What do I hope Rio2012 will achieve?

My hope and expectation for Rio2012 is that we are able to create a real movement towards achievement of our goals, and that these goals are identified and agreed – be these Millennium Development Goals, or otherwise. But it is not enough just to meet and discuss. Rio2012 should move us to take action.

I believe Brazil will show the way. At the moment our profession and our work is being slowed down – trumped, even. We need to be careful not to go for movement for its own sake. We need to be clear about its purpose. Our social movement needs to lead to action. For example, we need legal frameworks to control the marketing and sale of food. For example, government programmes that provide food and support for children, adolescents and other groups need to be based on what we know is most likely to encourage overall healthy diets and active lives.

I have not given up the idea, that perhaps we can convince industry to change. Indeed, I believe that unless they do change they will be descending down a slope to a point when change becomes progressively unstoppable. Perhaps this will not occur now nor even tomorrow; but I am convinced that sooner or later the public health imperative will prevail.

My advice to a young public health nutritionist

Do not accept only what is possible. Your job is to make what appears to be impossible, possible. That is your challenge…. Conformity is there to please the weak in spirit. The future belongs to the bold and courageous, so time is on your side.

When I am optimistic, what is my vision?

I have not given up the idea, that perhaps we can convince industry to change. Indeed, I believe that unless they do change they will be descending down a slope to a point when change becomes progressively unstoppable. Perhaps this will not occur now nor even tomorrow; but I am convinced that sooner or later the public health imperative will prevail.

When I am pessimistic, what do I foresee?

There again, the other side of the coin… I sense that most influential people have given in to the prevailing view, and are afraid to even consider changes. I get a sense that no matter how much we push, the beast will not move an inch.

My most highly recommended writer

Michael Pollan. He has the courage to fight the prevailing views, despite the low odds of winning. To navigate against the wind, is the real challenge. Courage is tested when you are swimming contrary to the current. If you are convinced enough you have to be willing to go at it alone if necessary. Access his website: www.michaelpollan.com. May I choose more than one book? [Ed: Why not, yes yes, most everybody else is…]

Pollan M. The Omnivore's Dilemma.The Search for a Perfect Meal in a Fast-Food World. London: Bloomsbury, 2007.
Pollan M. In Defense of Food. An Eater's Manifesto. New York: Penguin Press, 2008.
Pollan M. Food Rules. An Eater's Manual. London: Penguin Books, 2009.

One choice of my own publications

Can I mention teamwork? [Ed. Yes, you can]. This was the 2003 WHO/FAO report 916, Diet, Nutrition and the Prevention of Chronic Diseases. I had the honour to chair this consultation. The report was the product of the best work in the world, in my view and that of many others, and its findings, including those thought by some to be controversial at the time, have been vindicated. Indeed, were we to be preparing a new report to be published ten years later, its conclusions and recommendations would be stronger. This is what the evidence shows.

More personally, the paper written with Carlos Monteiro in 2004, the result of consultation convened by the Pan American Health Organization:

We were just starting to speak up then. Since then, Carlos has been stronger than I have been, in not tolerating the unacceptable.

Uauy R, Monteiro C. The challenge of improving food and nutrition in Latin America. The United Nations University. Food and Nutrition Bulletin 2004, 25, 2 :175-182.

Ricardo Uauy is an Association founder member
He was president of the International Union of Nutritional Sciences 2005-2009
He was chair of the joint WHO/FAO consultation responsible for the 2003 '916' report Diet, Nutrition and the Prevention of Chronic Diseases

Urban Jonsson

What do I hope Rio2012 will achieve?

First, I hope that Rio2012 will contribute to a well argued understanding of the fact that public health nutrition in any country is ultimately determined by historical, political, social, economic and cultural processes at different level of society, from the local to the global levels. This means that sustained improvement requires not just addressing the most immediate or proximate causes, but also at the same time addressing the basic causes of what emerge as public health issues.

Second, and in relation to the first, I hope that Rio2012 succeeds in attracting scholars and workers from areas not thought immediately relevant by many health and nutrition people, such as economists, sociologists, political scientists, social anthropologists, and human rights scholars and activists. [Ed. It has] This will stimulate discussion at the conference to move from the 'science of nutrition' to the 'science of nutrition issues in society'.

Also I trust that Rio2012 will be a time of good fellowship. I am on the left of the picture above, for those who don't know me, and I am amusing my good friend and colleague Claudio Schuftan, whose own thoughts are also included in this series of short pieces. The occasion was the IUNS congress in Bangkok, and I am delighted to know that Claudio will also be at Rio. He makes me smile, too!

My advice to a young public health nutritionist

You probably have learnt public health nutrition at a higher learning institution, most likely a university. If so I advise you to (1) complete a master level course in any of the subjects that deals with the socio-economic determinants mentioned above, (2) spend at least 2-3 years on a field assignment in a low-income country, preferably in a rural area, and (3) as soon as knowing where to do such a work, learn the local language as fluently as possible. It is well known that such an experience will guide you for the rest of your life.

When I am optimistic, what is my vision?

I am most of the time an optimist! My vision is a global community that has adopted the principles of peace, justice, freedom (democracy), and human rights. These are the four pillars of the United Nations Charter. Peace is not the same as 'absence of war'; it implies a world without soldiers and weapons. Justice implies a world in which equity or 'fairness' is realised. Democracy implies the full realisation of all civil and political rights, including for children. Human rights implies a world characterised by equality and non-discrimination, inclusion and participation, and accountability and the rule of law – all also for children!

When I am pessimistic, what do I foresee?

The few times I am pessimistic I am thinking of the strong force of individual greed. I am thinking of how neo-liberal capitalism is based on, thriving of and accelerating personal greed. Increasing disparities in the world, in almost all countries and communities, if not reversed, will favour the expansion of the private sector in areas where important public goods are produced and consumed, particularly in health, nutrition, education, child protection, and access to law. The world will increasingly not be divided between poor and rich countries any longer but between people living in poverty and people who live in abundance in all countries in the world.

My most highly recommended writer

Michael Latham, no doubt. I belong to those who believe that Michael Latham was one of the greatest nutrition scholars in history and an incredibly inspiring teacher. His work was always a great example of his understanding of the dialectics between theory and practice. It was very fitting that this journal, World Nutrition, was inaugurated in May 2010 with Michael's magnificent and correct account of the problems of universal vitamin A supplementation.

Latham MC. Human Nutrition in Tropical Africa. Rome: FAO, 1965, 1973
Latham MC. Human Nutrition in the Developing World. Rome: FAO, 1997.
Latham MC. The great Vitamin A fiasco. World Nutrition May 2010, 1,1, 12-44 (pdf linked here)
Latham MC, Jonsson U, Sterken E. Kent G. RUTF stuff. Can children be saved with fortified peanut paste? World Nutrition February 2011, 2, 2, 62-85 (pdf linked here)

One choice of my own publications

May I choose two? [Ed: Yes you may]

Jonsson U. The rise and fall of paradigms in world food and nutrition policy. World Nutrition July 2010, 1, 3, 128-158. (pdf linked here).

I select this paper because I had worked on it for 20 years! The history of nutrition approaches had become a hobby of mine. I started the work during my sabbatical from UNICEF in 1989, when I spent four months at Cornell University. I had the privilege of using Michael Latham's office and library, as he was doing research in Kenya. His library contained anything one needed to study the history of nutrition, as he was part of that history.

Ramalingaswami V, Jonsson U, Rohde J. The Asian Enigma; UNICEF, Progress of Nations 1996.

This rather short paper contributed to kill the myth that the region of the world with most malnutrition is Africa. It also showed that the major reason for the better nutritional status in Africa compared with South Asia, was the fact that women in South Asia were much more subordinated and exploited than in Africa. It was also noteworthy that the late Professor Ramalingaswami, a very distinguished nutrition scholar in India, was part of this work.

Urban Jonsson is an Association Council member
He is a former chief of the UNICEF department of nutrition in New York

This month's commentators

We have also included here, the joint contribution of Geof Rayner and Tim Lang, both from the UK, the authors of this month's main commentary. They are also the authors of Ecological Public Health, first published in the week before Rio2012. Their magisterial, deeply learned and brilliantly written book sets the scene for nutrition within public health, for now and in future. Their commentary, specially written for WN, focuses n specifically on nutrition in its broad context.

Geof Rayner and Tim Lang

What do we hope Rio2012 will achieve?

It's me Tim on the left above and me Geof on the right. On Rio 2012 we start with something it has already achieved. We think it's great that, for the first time with any big nutrition conference known to us, Rio2012 is not organised as an industry-fest. It is not going to pass itself off as a scientific forum within which conflicts of interests are disguised. Too many events now have become absolutely reliant upon covert advertising or product placement.

Moving on to what we hope Rio2012 will achieve, what we would like to see is public health becoming as a central aspect of sustainability. At the moment it seems at the sidelines; acknowledged by everyone but implemented by none. Our advocacy of ecological public health – the title of our new book – is based on emphasising the human health – eco-systems health connection.

Your advice to a young public health nutritionist

Go for breadth. Don't limit your view of nutrition, seeing it only through micro or small scale analysis. Think in historical, evolutionary and systems terms. In historical terms, ask how the current pattern of group or society-wide nutrition evolved and what the influences and drivers were – and are. In evolutionary terms, see the difference between humanity's biological needs, and current patterns of diet which may – but are usually not – adequate for these needs. By systems, we mean the institutionalised arrangements that go on behind people's backs. In systems terms, look at the entire set of mutually adjusting and reinforcing relationships which explain how any particular society feeds itself, giving particular attention to the role of the actors which shape the system.

Think about the questions that shape the uses to which nutrition science is put. Do you share the dominant framing assumptions of the current system? And if not, work out how these can be changed.

When you are optimistic, what is your vision?

Actually having a vision is the thing; even better when it leads somewhere! When people are told merely to 'get on with the job' it is so important to have a personal sense of direction for the future, and to share that sense with others. Our own vision is based on the general idea that people working in public health nutrition can share common goals. These may concern sustainability, the adequacy of diets, the importance of sustainable diets, and the learning about and sharing of food. Food is culture and culture is food. We should be generous with both.

When you are pessimistic, what do you foresee?

We have already seen it, but it made us more angry than pessimistic. In a children's museum in Houston, Texas, when one of us visited there, the only food available were burgers and pizzas, both from big-name chains. That was child abuse.

Remember, it really is possible to change things, to shame such places, to raise the matter with schools before they take children on school visits, and to shake up policy. What matters to these places is money, and reputation. Plan a campaign. Don't personalise it to anyone but use your nutritional skills to make the argument. Ask the question: Are you putting the health of children first?

Our most highly recommended writer

We can have one each? [Ed: yes, you can] My choice (Tim) is James Vernon's Hunger: A Modern History. It tells of the power politics that shaped nutrition science. See: http://books.google.co.uk/books/about/Hunger.html?id=ZPtV4cGU4LIC&redir_esc=y

My choice (Geof) is The Autobiography of John Stuart Mill. It is a shortish read and free to download. Mill wanted to change to the world for the better. We should all aim to do enough in the world, so as to be able to write such a book. Also see: http://en.wikipedia.org/wiki/On_Liberty. Actually not a wonderful summary of Mill's ideas, but a starting place

Vernon J. Hunger: A Modern History. Cambridge, Mass: Belknap Press, 2007.
Mill JS. Autobiography. First published 1873. Obtainable free at: www2.hn.psu.edu/faculty/jmanis/jsmill/autobiography.pdf

One choice of my own publications

Our book together, just published. Our commentary in this month's World Nutrition is all new stuff and also is developed from it. The book encompasses our thoughts, outlook and experience. In the word of a song by the English rock and roll singer, Ian Dury, it gives our 'reasons to be cheerful'.

Rayner G, Lang T. Ecological Public Health: Reshaping the Conditions of Health. London: Routledge/Earthscan, 2012.
http://www.routledge.com/books/details/9781844078325/

Tim Lang is professor of food policy at City University, London.
Geof Rayner is former, and first, chair of the UK Public Health Association.
They both are former members of the expert group advising the UK government on obesity, until their services were 'no longer required', and they were nudged aside.

Acknowledgement and request

Readers may make use of the material in these short communications if acknowledgement is given to the Association, and WN is cited

Please cite as: Nestle M, James WPT, Annan R, Margetts B, Geissler C, Kuhnlein H, Schuftan C, Cannon G, Yngve A, Popkin B, Uauy R, Jonsson U, Rayner G, Lang T. Looking into the future, what do we see? [Short communications] World Nutrition, April 2012, 3, 4: 119-163. Obtainable at www.wphna.org

The opinions expressed in all contributions to the website of the World Public Health Nutrition Association (the Association) including its journal World Nutrition, are those of their authors. They should not be taken to be the view or policy of the Association, or of any of its affiliated or associated bodies, unless this is explicitly stated.

WN contributions are subject to internal review by members of the editorial team.


2012 April. WN4. Communucations
Looking into the future, what do we see?

Respond below please

security code
Enter Security Code:



March

World Nutrition


WN

Fortification

Folic acid and
spina bifida


Mark Lawrence
Access cover, contents here
Access editorial here


WN

The Food System



Big Food bitten


Geoffrey Cannon
Access commentary here


March
COLUMNS

Philip James

From Cairo

Moving on to 2015-2025
How to work with industry

Click here


Geoffrey Cannon

From São Paulo

The five dimensions of nutrition
It is best to be small

Click here


Claudio Schuftan

From Bangkok

A tale of three meetings
How nice to meet Dr Nabarro

Click here


Reggie Annan

From Kumasi

Cancer in Africa:
Prevention and control

Click here


April issue
Out on 1 April


WN

New book

Cooking




Michael Pollan

Available on 1 April