I grew up in Australia. My first job, in 1975, was working as a physical anthropologist on an archeological excavation in South Australia. I was struck by the contrast of what seemed like the ideal life led by aboriginals for many thousands of years in harmony with their environment and seemingly healthy. This contrasted with aboriginals then living in Adelaide who were in very poor health and with clear signs of social breakdown.
It seemed to me at the time that poor nutrition must be an issue. I knew nothing about this so paid for myself to go to the UK to learn some more. In England I met colleagues from around the world and afterwards visited Kerala, India, and stayed at the Centre for Development Studies. I realised that equity, social justice and women’s empowerment could really make a difference to the effective use of scarce resources. Initial naïve efforts to solve the problem of malnourished aboriginal children made me realize that the causes, and thus what needed to be addressed, were often far removed from the obvious and immediate apparent cause. Improvement (aboriginal infant mortality is still ten times the national average) was more to do with politics than food.
After completing my MSc in London in 1978, I returned to Australia and worked on a project looking at dietary change in Italian migrants to Perth with a brilliant man called Bruce Armstrong. This work made me think more about how we assess diet in epidemiological studies. I organized a national workshop and we subsequently published a short guide on suitable dietary methods for use in various epidemiological studies, for me the beginning of nutritional epidemiology.
In 1985 David Barker invited me to come and work with him in Southampton. David was an inspiration and very supportive and allowed me, with support from Jo Hautvast, to set up a summer school in nutritional epidemiology. This course ran for about 13 years and developed into an MSc in Public Health Nutrition. Michael Nelson and I published a book based on the nutritional epidemiology course.
In order to improve things we thought that we needed better quality information and to support this we established the journal Public Health Nutrition. We also though that too many quacks projected themselves as nutrition experts so we worked with The Nutrition Society to establish a set of standards and set up a professional register. Working with colleagues (Agneta Yngve leading) across Europe we tried to strengthen workforce skills in Europe, and today the Association is taking up this challenge globally.
My early experiences shaped the way I think about how nutrition, as a biological science, also fits within a wider social and ecological context. Studying epidemiology and public health then made me realize that to make things better, or to keep them well, we need to address the underlying causes and not just treat the symptoms: in other words we must use a preventive population approach. Traveling the world has reinforced my conviction that we need to improve the system and structure within which nutrition operates to make it more effective in all countries. This is what motivates me to do public health nutrition.