Access pdf of this month's WN commentary here
Access pdf of this editorial here

Diego Velázquez's 1618 painting 'An old woman frying eggs' . These eggs
are nutritious - as is the melon – and there is also nourishment in them

This month World Nutrition publishes a commentary which is unusual, in a nutrition journal. Enrique Jacoby of the Pan American Health Organization writes about the food culture and cuisine of Peru, his own country; and, as you also can see, the cover of the journal features a celebrity chef. Why the topic of the commentary, and why the subject of our cover? This editorial inverts the question and in effect asks, why not? To put the question another way, why has nutrition, as a relatively precise discipline, split away from nourishment, a much broader subject and indeed aspect of the good life well led, of which nutrition in the usual modern sense of the word is a part?

In 1988 the WHO European Office in Copenhagen published Healthy Nutrition: Preventing Nutrition-Related Diseases in Europe. The chief authors were Association Council member Philip James, together with Anna-Ferro-Luzzi, a mother of the Mediterranean Diet concept. The report was remarkable as a work of scholarship whose analysis of different food supplies and their impact on patterns of diet was compelling, combined with far-reaching proposals for agriculture and food policies. It was remarkable for another and charming reason. Its cover reproduced a photograph of a Tuscan family outside their small hillside home, enjoying a meal.

It wouldn't be true to say that food being prepared or eaten as a meal is never shown in nutrition reports and journals. But it's unusual. The reason why is first, because nobody eats nutrients as such, except in the forms of capsules or powders, and is second – wait for it – because the meal is overlooked in nutrition. This may seem to be going too far. True, meal patterns and frequency are occasional research topics, as is research on topics such as whether it matters if schoolchildren skip breakfast. School meals are also a common topic. But that's not what's meant here. By 'meal' is meant the repast typically eaten in company, as in the Tuscan picture, with its implication of fresh local produce prepared at home and enjoyed at the family table. Food eaten alone, even when there is enough or more than enough to eat, is not exactly a meal.

Nutrition, food, and meals

Now please turn to the picture that introduces this editorial. It is 'The old woman frying eggs' by Diego Velázquez, painted in 1618. It shows the culinary instruments of the time: everyday plates, cutlery, pans, pestles, jugs and mortars, the shine on a glass surface, the light's play on the melon carried by the boy, and the boiling pan with its spitting oil and the whites of the eggs. It was used in 1989 as the cover of the first issue of the journal of the British Guild of Food Writers (2). In the same way as the cover of Healthy Nutrition, what it shows is not nutrients (naturally enough, because nobody knew about nutrients in those days), and not individual foods, but a meal, here in the course of preparation.

Again like the cover of the WHO report, its power is in what the picture implies. This is of everyday food culture, the sources of the food, such as the chickens that surely will be in a yard near the house, the relationships centred on meals shared by members of a household, and what's known by sociologists as commensality – everything that is and can be shared by people sitting at table.

On this, the natural scientist and gastronome Jean Anthelme Brillat-Savarin(3) makes a telling observation which almost holds true now. 'The fate of whole peoples is decided at a banquet… Let one open any book of history, from Herodotus to our own days, and he will see that, without even excepting conspiracies, not a single great event has occurred which has not been conceived, prepared, and carried out at a feast'.

This prompts a question. Why is there now such a divide between study of and scholarship and writing on food, and study of and scholarship and writing on nutrition? Why is it evident that few food writers know or care much about nutrition, although they may privately have a stock of books on dieting, and that few nutritionists study meals, or even food, although in their private lives they may be gourmets and wine buffs? It's possible to think of several reasons why this is so, but it's difficult to think of a good reason.

When modern nutrition began

Brillat-Savarin himself, writing in the 1820s, in the generation after Antoine-Laurent de Lavoisier lay down the foundations of chemistry and biochemistry, without knowing it practically pin-points the time when nutrition separated from food. Writing of 'the intelligent knowledge of whatever concerns man's nourishment' (which he calls 'gastronomy') he says that it 'is part of natural history, by its classification of alimentary substances; physics, because of the examination of the composition and quality of these substances; chemistry, by the various analyses and catalyses to which it subjects them' and then also, on the other side of the divide 'cookery, because of the art of adapting dishes and making them pleasant to the taste; business, by the seeking out of methods of buying as cheaply as possible what is needed, and selling most advantageously what can be produced for sale; finally, political economy, because of the sources of revenue which gastronomy creates and the means of exchange which it establishes between nations'.

He concludes with a charming observation. 'It concerns every state of society, for just as it directs the banquets of assembled kings, it dictates the number of minutes needed to make a perfectly boiled egg'.

In a way every student of nutrition science knows the answers to the questions posed so far here. In its modern form, nutrition originated as a biochemical discipline in the 1830s, more or less simultaneously in Germany, France and Britain, and the rise of nutrition science – and the use of the term 'scientist' to identify scholars previously known as natural philosophers – is part of the story of the rise of the great European industrial powers. Nutrition science worked. From its origins to after the Second World War, its triumph was the engineering of big tall strong young people, and the virtual conquest of gross deficiency diseases among impoverished populations and communities within industrialised countries. Since then, as we all know, the story shifted. Malnutrition took the shape of obesity and diseases caused in part by deranged dietary patterns, while undernutrition, deficiency and starvation persisted and quite often became more prevalent within the impoverished countries of the global South. This is where we are now.

Nutrition in the usual modern scientific sense is important, no question. But the more we learn and reflect on the underlying and basic social, economic and environmental determinants of well-being, health and disease, the more we should be thinking of making nutrition part of a greater whole. This is what Enrique Jacoby's commentary implies.

Part of a greater whole

This thought can be expressed in terms of the proposal that properly understood, nutrition, the precise discipline, is part of nourishment, a very much broader concept. In these months following the Rio+20 environmental summit, we may even feel that nutrition, which conventionally is mostly of the body, aches to become part of nourishment, which is of the senses and also of the mind, heart and spirit. Doesn't it seem rather strange that we should by and large focus on the one aspect of nourishment that makes us no more than animals – indeed in some ways seems to make us hardly more than machines – while we neglect its other aspects that are to do with what is unique about us as humans?

During his recent secondment as Peru's deputy minister of health, Enrique Jacoby invited a group of people to consider how best to promote food and nutrition in Peru. They came up with the slogan Eat Tasty, Eat Healthy, Eat Peruvian. He observes that this was 'after identifying Peruvian foods as having valuable characteristics, some of which are commonly overlooked by nutritionists. A wide variety of natural (whole) foods are the basic ingredients of traditional dishes loaded with superb taste. Peruvian food culture and cuisine is based on locally grown food and also an intense regional exchange. It involves an active participation in food preparation... Peruvian food ways are commensal: food is shared round tables, and so has a symbolic and cultural dimension. They give health in many ways in addition to protecting against diseases'.

These issues may be better understood in Latin countries, and less so in English-speaking countries. This thought is suggested by language. Here are the words for 'nutrition' and for food as eaten, in some Latin languages:

---

	Nutrition	Food as eaten
French	La nutrition	L'alimentation
Spanish	Nutrición	Alimentación
Italian	Nutrizione	Alimentazione
Portuguese	Nutrição	Alimentação
English	Nutrition	Alimentation

---

So it seems that all these languages effectively have the same words. But there is a difference. The English word 'alimentation', referring to food rather than nutrients, a central concept in textbooks of dietetics until the middle of the last century, is now almost obsolete.

In his commentary Enrique Jacoby proposes that we will get a handle on nutrition and public health, when and only when we focus on the whole context of food as it is consumed. Taken out of its behavioural, social, economic, environmental – and political – contexts, nutrition will teach us what happens in the body as a result of consuming nutrients, and will certainly remain crucial in clinical settings. But for population health, which includes understanding and mastering epidemic disease, we need to be thinking in terms of nourishment.

References

1. World Health Organization. James WPT, Ferro Luzzi A, Isaksson B, Szostak WB. (eds.). Healthy Nutrition: Preventing Nutrition Related Diseases in Europe. WHO European series 24. Copenhagen: WHO, 1988.
2. News. Journal of the Guild of Food Writers 1, Spring 1989.
3. Brillat-Savarin, JA. The Physiology of Taste. Or, Meditations on Transcendental Gastronomy. Fisher MFK (ed). Washington DC: Counterpoint, 1999. Originally published in French, 1825.

Acknowledgement and request

Readers may make use of the material in this editorial if acknowledgement is given to the Association, and WN is cited. Please cite as: Anon. Nutrition and nourishment. [Editorial] World Nutrition, July 2012,3, 7: 289-293. 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.

2012 June. WN2. Editorial. The best food on earth
Nutrition and nourishment

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