Education and Training in Nutrition

In December 1959 a symposium on education and training in nutrition in Europe organised by the FAO and the WHO was held in Bad Homburg (German Federal Republic). European experts in nutrition presented a series of papers on complementary aspects of the general subject. C. de Hartog, director of the Nutrition Bureau in The Hague, and A.M. Copping, senior lecturer in nutrition at the Queen Elizabeth College, University of London, presented a paper on “The nutritional state of Europe and the need for education and training in nutrition”.[1] They emphasised that, although the relationships between nutrition and health were widely recognised, reports from different countries to the FAO Nutrition Meeting for Europe in June 1958 indicated that varying degrees of malnutrition still existed in European countries in 1959.

Over a long period of increasing industrial development, changes in traditional food patterns were taking place in Europe in many population groups, related to changes in agricultural and economic conditions. New foodstuffs had been introduced, which were cheaper and more easily prepared, but sometimes “of unknown quality” from a nutritional point of view. The upheaval of the war and post-war conditions influenced eating habits in areas where tradition was previously prevalent. One issue of the Bulletin of Agricultural and Food Statistics (1959) published by the OEEC showed that a meaningful change had occurred from 1948-49 in the general pattern of European food consumption.[2] The most notable trends were increased consumption of fruit and protein-rich foods such as meat, eggs, cheese and milk, and a simultaneous decrease in the consumption of potatoes and cereals. An increase in the consumption of sugar and fats was noted and a decrease in that of fish. These trends arose from social and economic changes in post-war Europe. “While on the one hand they have led to increase in the consumption of valuable foods, on the other they have been associated with over-nutrition and its probably harmful results. Examples of this tendency will be found in the reports of Denmark, Norway, Sweden, the Netherlands, the United Kingdom, Belgium, Austria, Switzerland”.[3]

The overall European consumption records and average food consumption figures for specific countries did not give a picture of family and individual consumption, which varied widely within countries according to income groups, the urban/rural divide and cultural traditions. The Bad Homburg conference aimed to analyse how the available food was used, and the participants were concerned with the question of whether those responsible for food policy fully appreciated the need for education in nutrition. Unbalanced diets and their harmful effects upon health were frequently attributed to lack of nutritional knowledge and to ignorance of the special needs of vulnerable groups such as pregnant women and young children. It was often observed that in families that had only a limited budget available for the purchase of food, a better diet could have been chosen if the housewife had had more knowledge of nutrition and correct feeding. Once again, the experts insisted on the fact that ill-balanced diets were consumed not only by lower income groups, but also by higher ones in which ignorance might affect the choice. Therefore, nutrition education was called upon to do more than teach good eating habits - it was also expected to develop public awareness of the importance of good nutrition and food policies for health and social stability. Employers were to appreciate how good nutrition increased work efficiency and cut down on absenteeism, and taxpayers were expected to realise that good nutrition decreased public expenditure for medical care. Through proper education and training of public health officers, doctors, teachers and social workers in nutrition, greater awareness of the need for knowledge of good food in the whole population was able to be created. This started with the instruction of pregnant and nursing women.

While rickets was no longer a serious problem in most European countries, reports from Norway, Finland and Denmark indicated that it still existed in advanced countries where preventive programmes were in operation and it was common in Poland. Improving the diets of mothers and their children led to a positive change, and if knowledge of the relationship between diet and rickets were to be spread, rickets would disappear completely in Europe. The same could be said of other deficiency diseases and malnutrition cases. Nutritional training of those responsible for the care of young children from weaning to school age was essential; this age-group was particularly vulnerable as this is a period of rapid growth and mental development, an age at which good or bad habits might be learned and the nutritional pattern for their entire life set. Physicians, public health nurses, social workers and teachers were expected to have solid training in nutrition.

In many countries measures are now taken to protect the health and nutrition of the school children. There is increasingly well-organized medical inspection and knowledge of the relation between good feeding and mental ability and general well-being has been put into practice. Effective school feeding programs benefiting large numbers of children are in operation in a number of European countries. School feeding is particularly valuable in schools in which there are long morning school hours and free afternoon hours. Children often do not have a good breakfast before coming to school in the morning. Teachers are sometimes unaware that their pupils would be less tired and uninterested and would learn better and perhaps behave better, if they were allowed a short break during which food was provided. More knowledge of nutrition on the part of educational authorities and the teachers themselves would favor the development and expansion of school feeding programs.32

The school meal was considered to have a direct value from a health and nutritional point of view, but was also of great value for educational purposes. School feeding programmes could become an excellent means of providing education in nutrition as well as of supplying additional nutritious food to scholars. Adolescents were also an important target group, since it was demonstrated that failure of normal physical development and susceptibility to disease in adolescents might be related to an unbalanced diet. Physical examination and biological tests indicated that the whole biological stability might be disturbed if the diet was inadequate. The experts proposed educating housewives in nutrition through information given by public services. It was even more important to provide education in nutrition at an earlier stage in life, by teaching the future housewives in school the value of food, so that when feeding her family she would have the ability to choose and prepare food efficiently.

Hartog and Copping denounced the fact that people were continually bombarded with publicity, advertisements, manufacturers’ recommend- dations and other people’s opinion, lacking any reference about the legitimacy and reliability of nutritional information. Therefore, the housewife had to be helped to develop her power of discrimination about the information she received on food and nutrition.

The problem of malnutrition in the elderly required greater attention. Malnutrition frequently occurred as the result of low protein intake and vitamin deficiency. Long-term and continual poor nutrition might be cumulative and find clinical expression because the older body adapts less easily to injury and infection, and poor nutrition contributed to this negative situation. The need for changing food habits was seldom recognised by old people or those taking care of them. Education in nutrition was called to find a place among gerontologists, making an important contribution to community welfare.33

In view of reports from European countries indicating that unsatisfactory nutrition still exists, the problem arises of finding a solution for nutritional inadequacies. The problem differs from that in developing countries in that most European countries have a good educational system, though education in the principles of nutrition may be lacking. We must investigate the extent and nature of the teaching of nutrition to members of those professions who may in turn pass on their knowledge to the whole population. We must

consider not only formal training in the science and application of nutrition, but also training in connection with food policies, food supplies, cultural backgrounds and food habits. In general when the existence of nutritional inadequacy is established it must be attacked by improvement in food supplies to the needy groups as well as by nutrition education based on the principle of modifying nutritionally unsound customs or habits. The social and economic condition must be fully understood in order to attack the nutrition problem effectively. Thus, in the training of any specialist in nutrition, social science is an important subject. Without the appreciation of the influence of socio-economic factors on food habits and dietary patterns it is impossible to teach the use of food to the best advantage or to train nutritionists who can assist the community by passing on their knowledge.34

Professional groups meant to have responsibility for teaching nutrition and influencing people as part of their professional activities included nutritionists and dieticians, medical doctors, health workers, nurses, midwives, home economists, agricultural extension workers, social workers and school teachers. These groups all required specific education and training in nutrition in order to serve as a bridge to the general population. The Bad Homburg conference concentrated on the training of professional workers at universities in applied nutrition and dietetics, medicine and public health, home economics, agronomy and school teaching. Nutrition education programmes were in action in some European countries, but criticism was expressed at the results obtained before 1960:

Some countries have fairly developed programs of training. For instance, in the United Kingdom, there are at present an undergraduate university course in nutrition, graduate courses in dietetics, special training courses in public health and tropical nutrition and a diversity of contributions to teaching nutrition in medical studies and in courses in physiology or in biochemistry. Outside the universities there are various courses in dietetics providing for full qualification in the profession of therapeutic dietitian and courses in nutrition in colleges of domestic science where training is given to teachers of domestic subjects. Refresher courses are provided from time to time both for dietitians and for teachers of domestic science.

In other countries such as Poland and Turkey the problem is beginning to be tackled by the institution of new courses in nutrition in training of public health officers. In the Netherlands and in Finland more fully developed training up to university level is available. In Denmark, Norway and Sweden, studies in household science and in nursing provide good background work in nutrition. In some countries almost no general instruction in nutrition comes into the picture. It is probably true of all countries in Europe that the extent of training and education in nutrition is limited by availability of suitable teachers. Recommended reading and study courses are an essential part of keeping teachers up-to-date in their knowledge and unless these are provided work can soon fall below a desirable standard.35

The main concern was to investigate how the education and training programmes available in European countries could be designed to be fully effective in training the types of workers for whom they were intended, and whether trained nutritionists were employed to the best advantage in the health and welfare, agriculture and education services.

Gino Bergami, professor of human physiology at the University of Naples, presented a paper on “The Problems of Nutrition in Europe from the Public Health Standpoint”.36 He started by classifying the factors that influenced adequacy of diet, since from the public health standpoint, this was the main problem in preventing malnutrition and deficiency diseases. Two main factors were said to determine the individual choice of foods: availability and dietary habits. According to Bergami, these could be summarised as follows: availability depended on seasonal variations in agricultural production, food imports, existence of subsidised foods and taxes; dietary habits were related to national traditions, religious norms, climatic conditions, taste and nutritional information. The latter was based on knowledge of the nutritional properties of foods, knowledge of some principles of nutrition, nutritional advice obtained from the media and specific nutritional advice given by competent experts. Both factors could be influenced differently; while dietary habits could be directly influenced by physicians, nurses, health staff, home economists, schoolteachers and social workers, the availability of food was outside the range of intervention of nutrition experts.37 Availability depended upon agricultural planning, government economic decisions and national and international trade.

The problem is one of increasing magnitude, because food technology today is introducing so many new chemical entities, is modifying so deeply the physical and chemical properties of natural foods, and so easily transforms inedible food into apparently attractive food, that a great effort is needed, at [4] [5] [3]

a high level, to ensure that the nutritional properties of these kinds of semiartificial food are scientifically determined.38

Bergami considered the existence of two different types of nutrition problems in Europe. One was quantitative (calorie intake) and the second was qualitative, linked to the composition of the diet. The quantitative problem, following the economic recovery of European countries and the gradual extension of the production of foodstuffs, was regarded as minimal and restricted to the extent that poverty still existed in some countries. However, he also testified to the growing risk of obesity derived from the nutritional transition. He stressed the wide differences in dietary habits existing among northern European and Mediterranean countries, and the risk of industrialisation in impairing the nutritional quality of food.

A more pedagogical approach was taken by B. Markovic, chief of the Department of Health Education at the Central Institute of Hygiene in Zagreb. He described his experience working with group methods as a useful approach for nutrition education. The principles of the group decision method were to avoid any criticism and to present the problem to the group so that its members realised that they were invited to express their own viewpoint. Field trips were another option that increased understanding and knowledge of food processing and distribution, leading to the establishment of good human relations with those experts and professional groups working on food and nutrition. Lectures were another option, although their impact was considered to be temporary and superficial, limitations that the author remarked upon, since the training systems at many European universities were based on this method of teaching.

Markovic recommended opening the doors to small group discussions and role-playing as a spontaneous acting out of a situation. Feeding experiments and audiovisual materials were also mentioned. As nutrition was an essential element for the population, he recommended that prominent persons - respectable people who had a marked influence on the community - were contacted to participate in planning nutrition education. In any case, nutrition education programmes had to be evaluated and the progress assessed in order to determine the effectiveness of teaching methods, the extent of the improvement and the changes in attitudes and behaviour they had brought about. Questionnaires were the most common method of evaluation, complemented by clinical examination, surveys on food consumption, analysis of epidemiological changes and other modifications in food intake and eating habits.

Joachim Ktihnau, professor of biochemistry at the University of Hamburg, presented a paper on the problems of nutrition in Europe from a medical viewpoint.[7] He considered that the basic character of the nutritional situation in the highly industrialised European countries in 1959 was determined by the fact that, although a general food shortage no longer existed and the requirements of all essential nutrients could be met without difficulties, as the statistics showed, people were looking with suspicion and distrust at their food, which had undergone transformations due to industrial and technological processing. This general feeling of uncertainty about the quality and health risk of many foodstuffs that had undergone extensive changes from their natural origin to consumption was likely to have been intensified by alarming articles in journals, magazines and newspapers. Sensationalist information was not a good element to challenge the threat. This probably influenced the housewife’s fear of being poisoned by ordinary food. The worst consequence of this widespread apprehension was the fact that people became attracted to food reformers and faddists who had no scientific training, which could lead to pathogenic food patterns. Ktihnau demanded public information and education by any possible means such as lectures, radio and television, giving details on food additives and their legislative control, contamination of food by pesticides and residues, insecticides, antibiotics and fertilisers.

Action will have to be based on studies and experience in social psychology and in traditional food patterns as well as on an exact and objective analysis of the numerous forms of food faddism. Much work has to be done in this respect in order to avoid the failure of efforts to improve knowledge of nutrition among the public. These efforts must also be extended to inmates of hospitals, children’s and maternity homes, and old pensioners institutions.

The basic fact of industrialization and rationalization of food production is an unavoidable step in the irreversible process of modern civilization and has created new patterns of nutrition, which have to be accepted as part of present-day life. If the average man is harassed by the fear of being poisoned by his food, he must be in a position to obtain reliable evidence that his fear is unjustified, and that modern trends in nutrition cannot be arrested by any unrealistic attempt to “return to Nature” or by other

sectarian programs.40

Nutritional disorders of childhood might be avoided by proper instruction and training of mothers, nurses, school teachers and managers in nursing homes. Catering staff also had to be trained in order to ensure the sound nutrition of workmen in large industrial plants, employees in public services, soldiers and prison inmates. However, Khhnau considered that the most urgent need was the education of physicians in nutritional sciences. Doctors represented the ultimate authority in questions of nutrition, and had to take over full responsibility for educating all personnel required to disseminate practical nutritional knowledge among the public.

Education in nutrition could not be separated from food policy directed at the most vulnerable groups, such as pregnant and nursing women, children and convalescents, while the specific requirements of the increasing number of elderly people in the community had to be considered. Food policy meant finding a balance between the diet most desirable under existing conditions and the economically justified or practicable diet. This applied to the government when it concerned a population, and it equally applied to the individual when it concerned personal nutrition. To a great extent the success of a food policy was dependent upon the cooperation of the people.41

Undoubtedly, social and cultural factors influenced diets and the state of nutrition of the European population. “It is most important that a nutritionist should bear continuously in mind the concept that the diet of man is determined, not only by economics, but also by a non-finite set of factors, described under the general and rather vague term of food habits’”.[8] [9] [10]

J. Claudian, a member of the nutrition department at the Institut National d’Hygiene in Paris, reviewed cultural and social factors influencing the state of nutrition in Europe. He defined human behaviour with regard to food not as an individual function, but bound to the social environment: an organised body of individuals following a given way of life. Nutrition has to be considered as an integral part of the set of rules that govern the way in which a human group sharing a long common history lives and thinks, that is to say, as an essential part of culture. Tastes and preferences in choosing food, cooking techniques, rules governing the rhythm and make-up of meals are to a very large extent shared by the community. “A food pattern, a term commonly used to designate this whole attitude to food, is therefore seen to be the expression of a culture or a given social environment”.[11] Food consumption and the level of nutrition could be expressed numerically and correspond with exact biological and economic criteria; on the contrary, the food pattern represented a very complex concept determined by factors connected with the way of life, habits and psychological factors.

The concept of way of life was proposed by ethnologists and geographers to express all the human activities focused on providing for people’s needs. Claudian considered that it was essentially concerned with job, profession and working activities, which determine the nutritional needs according to their more or less strenuous nature. In this sense, the division of work among the sexes and the role of women in society and in the different branches of housekeeping should be taken into account, “determined as it is by technical and economic standards, the way of life represents the particular method of a human group of adapting itself to the material environment; it is therefore clearly oriented towards the satisfaction of physiological needs”.[3]

Habits represent the automatic behaviour, of a partly ritual kind, which a social and cultural group has adopted and follows implicitly. Habits are the result of collective experience transmitted from generation to generation, constituting a sort of implicit norm controlling all aspects of human life: the way the population thinks, ways of acting, and, obviously, also of eating. Traditional customs, the legacy of the past, but also recently acquired habits are involved, and Claudian considered that habits do not necessarily have an adaptive character.[13]

Anthropologists tend to assume that at the root of each mode of behaviour there is always a sense, a mode of thought, which can be considered as determining or guiding it. However, regarding nutrition and dietary habits, it is not what man knows, thinks or believes that determines what he eats, but more particularly what he likes, and the

emotional attitude to food is far from being simple. Cultural studies have shown that in addition to the sensory value of food, there is also a symbolic value, subconsciously determined, complex and full of many nuances. Certain foodstuffs, like meat, white bread, sweets, pastries and certain fats have a long-standing prestige value in most cultural areas of Europe, while other products have a negative perception associated with poverty and scarcity.

The act of eating is intimately bound up with cultural habits and a collective way of organising community life. It is not the same in Northern, Central and Mediterranean countries in Europe. The pleasure of eating is not only the satisfaction of a basic instinct or simple enjoyment, but also a pleasure derived from common fruition. Meals taken in company also represent a social function that no one neglects, and the act of drinking in a group occupies an important place in the rituals of friendship and hospitality. The feast, in its nutritional connotations, plays an important role in human behaviour. Side by side with rational behaviour, and more or less subconscious attitudes, food habits include an amount of automatic behaviour and reactions such as taste or disgust, which are rarely a matter of conscious thought.

Claudian demanded a certain distance and prevention when interpreting the results of psychological surveys, taking into consideration the opinions of people on the benefits obtained from eating different foods, or on the food preferences of social groups, stating that “the motivation which we obtain by this type of research often represents an attempt of justification of a rationalistic king, of affective or purely automatic behaviour”.46 A complete dichotomy usually takes place between theoretical knowledge of food values and normal behaviour. As an example, Claudian cited research carried out by the Institut National d’Hygiene of Paris that showed that some people who drank minimal quantities of milk were nevertheless fully aware of the value of this foodstuff.

The ideas which the average European has about food are an incongruous mixture of subjective “impressions”, of ancestral beliefs and of scientific notions which have been more or less well understood. Their relative proportions naturally vary with the amount of education, which makes a man more or less receptive to scientific ideas (or ideas considered to be scientific), and also to the ideas disseminated by commercial publicity.47

Depending on the way of life, food habits, mode of thought, and also collective and individual emotional attitudes to food, each human being

  • 46
  • 47

Ibidem, p. 3. Ibidem.

and each human group has a more or less specific food pattern. Claudian noted that the concept of food pattern, which stresses the diversity of human behaviour in the realm of food, and on what might be called the different food habits of human groups, is not a part of the science of nutrition. It is indeed a concept shared by a whole range of disciplines that study humans in their social environment from slightly different perspectives. By considering data from the anthropological sciences, human geography, ethnology, cultural sciences and sociology, the nutritionist is prompted to take into consideration the plurality of food patterns in Europe, putting them in relation to a few main human environments: cultural and historical traditions; the two big ecological divisions: towns and countryside (the rural/urban divide); and the social and professional groups, a specificity characteristic of the urban environment.

When bearing these contexts in mind in order to understand the influence of social and cultural factors on the food habits of the various groups, according to Claudian, a major difficulty arose: the instability of European food patterns, which had been changing continuously throughout the previous century. Under the pressure of the technical and industrial revolution, the social, economic and demographic structure of Europe, nutrition patterns and food habits had been extensively transformed. The raising of standards of living and lifestyle changes had brought about considerable modifications in eating habits. Anthropological research had shown that the very unequal spread of the benefits of the new era on the whole continent resulted in a new geography of food in accordance with differences in economic and technical levels of development. This new geography of food was superimposed on the traditional cultural geography.

In the western countries where the industrial revolution had expanded strongly, traditional food habits were disappearing or were being relegated to the folklore of the culture. The differences between the urban food pattern and the rural food pattern were also in the process of being swept away. In a modern town, which is the off-shoot of an industrial civilisation, new social classes tended to build up new eating habits and new food patterns. While nutritionists, nutritional physiologists and public health authorities talked about a more or less standard European food pattern, corresponding to a European or Western civilisation, already foreseen by certain sociologists, Claudian expressed his scepticism. He noted that in 1960 there were only transitional food patterns in Europe, which were considerably influenced by developments in technical and economic conditions. The point that differentiated food patterns in particular was the proportion of traditional social and cultural factors and new components that went into their respective structures.

He considered it relevant in this respect that the factors that determined human feeding behaviour did not reach the same dynamic values. Closely linked to economic and technical conditions - as the way of life itself - it undergoes the first changes, whilst the psychological factors undergo a slower and more incomplete transformation and therefore food habits are most resistant to change. A traditional food pattern represents an adaptation to a given environment; a new food pattern requires a re-adaptation involving a new apprenticeship. This involves a transitional phase, which is always critical, so that certainly some of the nutritional problems observed in Europe after the post-war years, according to Claudian, were the consequence of the rapid development of European society.48

Claudian discussed a few examples, as case studies, to show the role of social and cultural factors in the genesis of certain food patterns, as well as their influence on the nutritional state of certain European populations. The first case discussed relates to the tradition of cereal porridge and the occurrence of pellagra in Central Europe. It was in the central and eastern areas of Europe where Claudian found the clearest survival of certain long-standing food habits. Indeed, in vast areas of the Danubian countries, porridge with flour or semolina made from cereals unsuitable for breadmaking, and no longer used on the rest of the continent, was still the basic foodstuff. Even if maize, the cereal used in those days, was a recent innovation, the consumption of porridge was a long-standing tradition in those countries. In the 17th century cereals from America merely replaced another cereal unsuitable for breadmaking which had been cultivated in those regions traditionally: millet.

Compared with the old panicium milliaceum, maize presented clear advantages in yield, but the fact that it was accepted without hesitation by populations that did not easily change their habits also had another explanation: the new plant did not change the traditional cooking methods to which the population was particularly attached in any way. This attachment of Danubian peasants to their polenta was very special. Besides bread, which was a food for festive occasions, maize porridge was the main item of daily food and all cooking was based on it. Replacing porridge with bread would have required a complete remodelling of their food techniques and even to some extent the whole economic system. However, if the substitution of maize had some evident economic advantages for the population, it also concealed a serious danger, which the Danubian peasants could not foresee: pellagra.

In Romania, pellagra appeared around a century after maize came into general use, at the exact time when the amount of milk available to the rural population was drastically reduced as a consequence of a change in economic policy. Cheese and milk represented the traditional supplement of these age-old cereal preparations, and without these supplements maize porridge turned out to be apellagrogenic food.[13]

The Italian pellagra endemic that had already been overcome was particularly instructive, furnishing a double example: a deficiency disease with a long-standing food behaviour that did not keep pace with the economic conditions of that time as its basis, and the danger that the introduction of a new food that had not been tested previously might present for a traditional food pattern.

The second case discussed by Claudian regarded the geography of fats in Western Europe, closely connected with the survival of old food patterns. Fairly well-defined boundaries separated the zone of Nordic countries where butter is eaten and the Mediterranean countries where the consumption of vegetable oil is prevalent. The geography of lard and other fats of animal origin were lot as well defined, with lard being the main fat used in cooking in Central and Eastern Europe, but also playing an important role in certain Mediterranean and Nordic areas. Therefore, a clear contrast could be established between two civilisations that had been opposed to each other since ancient times, in spite of the economic changes: the butter civilisation and the olive oil civilization. “This contrast of tastes, of cravings and of exclusive feelings of repulsion for fats which the European has more than for other foods is easy to explain. Fats play a very special part in man’s food behavior: they are intimately linked with the ways of preparing food. The type of fat used is characteristic of the type of cooking”.[15]

During the war and post-war years the traditional fats of Europe were replaced by less expensive synthetic substitutes made from foreign fats of vegetable or animal origin. In the Nordic countries, margarine increasingly replaced butter; in the Southern countries arachis oil gradually replaced olive oil. These substitute fats were accepted insofar as they reproduced the physical and sensory qualities of the traditional fats. Anthropologists noticed that the replacement of a new food product was accepted when offering economic advantages, but only on condition that the new food fitted in with food preparation habits and previous experience.

Habits connected with the choice of fats brought Claudian to an important and much debated subject: the role of food in increasing the incidence of degenerative vascular diseases observed in Northern European countries.[13] Statistical and clinical research indicated that in general the Mediterranean food pattern produced less cholesterol and was less liable to generate infarcts than the butter-margarine type of the Northern countries. This statement was discussed in the early 1960s, required qualification and was the origin of the prestige obtained by the so-called Mediterranean diet, a concept proposed initially and defended by Ancel Keys. However, Claudian recognised that the consumption of lipids is closely linked with the availability of food and the living standards of the population. Surveys on food consumption indicated that as soon as economic conditions evolved, the European citizen increases the total consumption of fats, particularly fats of animal origin such as meat, milk, eggs and fish. As the butter- and margarine-consuming countries are also rich countries, the population easily consumed large quantities of fats and animal products. Consequently, the geographical distribution of heart and vascular diseases in Europe were conditioned by a cultural factor: traditional habits connected with the type of fat and an economic factor related to the standard of living.[17]

The third case discussed by Claudian regarded the different food patterns in the rural environments in France. In contrast to the trend towards uniformity, which urban districts seemed to impose on eating habits, in rural areas large regional differences were preserved. “The food patterns which we find today in France in the countryside are not completely explicable by the natural or economic conditions and clearly show the survival of traditional cultural factors”.[13]

Indeed, from the perspective of fat consumption, several fairly well- defined zones could be distinguished in France. The north-western regions represented the butter zone, with butter the only fat used in cooking; in the south-western area the traditional fat was lard and melted goose fat; the south, which had always been the traditional olive oil area, still used vegetable oils; and finally, in the central and eastern areas, the population was less selective, and different fats were consumed in varying proportions. This geography of fats also corresponds with regional food patterns and helped determine them to a great extent.

In the overall nutrition picture, surveys showed difficulties in these regions in meeting the animal protein, calcium and vitamin B2 needs, despite the fairly high consumption of meat in urban areas. In the less rich regions in the south and south-west, where butter was practically non-existent, deficiencies in fat-soluble vitamins were sometimes found as well as a shortage of animal products and calcium. On the contrary, in the areas where mixed fats were eaten and a satisfactory balance between milk, cheese and butter was struck, nutritional problems did not arise.

The fourth case study regarded the nature of urban life and its effect on eating. The time the housewife had available for preparing food, and the time given to meals, undoubtedly represented a determining factor in the food pattern of social groups. In this respect, conditions were very different in the rural and urban areas. In towns, a housewife working outside the home had to very considerably reduce the time she could spend on cooking and preparing meals. In French towns, the average duration of activities related to food procedures in families of workers and minor staff per 24 hours, calculated by Claudian after some studies carried out by the Nutrition Section of the Institut National d'Hygiene in Paris, were as follows:54

Housewife only in the home

Housewife working outside

Shopping time

1 hour

45 minutes

Preparation of food

3 hours 30 minutes

2 hours 30 minutes

Duration of meal

1 hour 15 minutes

45 minutes

Washing up

2 hours

1 hour 30 minutes

This time distribution implies a tendency to prepare simple dishes that require less work and a shorter cooking time instead of timeconsuming cooked dishes. Therefore, the use of manufactured foods, more or less “ready to serve”, was rising. In addition, the accelerated tempo of the urban way of life cut down the time available for the midday meal. These two factors, imposed by the way of life in modern towns, were partly responsible for giving the urban food pattern its particular trend and shape.

The last case discussed by Claudian related to food trends of different professional groups in the town. In a series of studies carried out in several large French towns by the Nutrition Section of the Institut National d'Hygiene in Paris, staff and industrial workers showed rather different tendencies in their food habits. Considering the consumption of certain foodstuffs among professional groups spending the same amount of money on food, around 200 Francs per person per day, in 1950-51 the distribution of food consumption was as follows:55

Type of foodstuff

Office workers (in grammes)

Industrial workers (in grammes)
















Drink during meals (wine & beer)



These differences enabled Claudian to distinguish two food patterns, one followed by the sedentary citizen, the other by the urban manual worker. These two patterns could only be explained by the way of life, mentality and specific lifestyle habits of the two groups of workers. The higher consumption of bread among manual workers could be related to the greater calorific output required by their work. The greater tendency of workers to drink alcoholic beverages, a phenomenon found in all countries of the world, was related by anthropologists to the monotonous and depressing nature of work in the factories. On the other hand, psychological factors presumably explain the peculiar craving of workers for meat, as well as their relative indifference to fruit.

Opinion surveys carried out in the same environment show that among certain groups of workers, red meat has a special nutritional prestige (not shared by fruit and milk) and that manual workers consider alcoholic drinks to be far more stimulating than coffee (which on the contrary is appreciated by workers in sedentary professions).

These factors, which are undoubtedly important, should not make us forget the important role of food habits which a social group preserves and consolidates over many generations. A recent survey on the consumption of alcoholic drinks in France shows that the “highest consumption is found in manual workers, who are sons of manual workers, and who have not changed their environment”.56

Nevertheless, differences in consumption between manual and office workers with equal incomes considerably diminished as the standard of living increased, and above a certain level the food pattern of the manual workers disappeared. Claudian considered this was due to a phenomenon of imitation. Humans show a tendency to imitate the behaviour of social groups that have a certain prestige. Country dwellers forsook their food and other customs to conform to those of the town. In an urban environment the workers adopted the bourgeois food habits as soon as they could. This double tendency was found at every stage of human behaviour regarding food: zealously maintaining their own tradition and the constant need for change, something that Claudian considered was not the only paradox of human culture.

  • [1] Hartog, C. den, Copping, A.M., “The nutritional state of Europe and the need foreducation and training in nutrition”, FAO/WHO Symposium on Education andTraining in Nutrition in Europe, Bad Homburg, December 2-11, 1959, FAO D. LubinMem. Library, 060275, NU, FAO/59/10/7588.
  • [2] Hartog, C. den, Copping, A.M., “The nutritional state of Europe”, 1959, p. 1.
  • [3] Ibidem, p. 2.
  • [4] Ibidem, p. 7-8.
  • [5] Bergami, G., “The Problems of Nutrition in Europe from the Public HealthStandpoint”, FAO/WHO Symposium on Education and Training in Nutrition inEurope, Bad Homburg, 2-11 December, 1959, FAO D. Lubin Mem. Library, 060275,NU, FAO/59/10/7588.
  • [6] Ibidem, p. 2.
  • [7] Ktihnau, J., “The Problems of Nutrition in Europe from a medical standpoint”,FAO/WHO Symposium on Education and Training in Nutrition in Europe, BadHomburg, December 2-11, 1959, FAO D. Lubin Mem. Library, 060275, NU;FAO/59/10/7588.
  • [8] Ibidem, p. 4.
  • [9] Dols, M.J.L., “Food policy, its application and impact on nutrition in Europe”,FAO/WHO Symposium on Education and Training in Nutrition in Europe, BadHomburg, 2-11 December, 1959, FAO D. Lubin Mem. Library, 060275, NU,FAO/59/10/7588.
  • [10] Claudian, J., “A review of the cultural and social factors which influence diets andthe state of nutrition in Europe, FAO/WHO Symposium on Education and Trainingin Nutrition in Europe, Bad Homburg, 2-11 December, 1959, FAO D. Lubin Mem.Library, 060275, NU, FAO/59/10/7588.
  • [11] Ibidem, p. 1.
  • [12] Ibidem, p. 2.
  • [13] Ibidem.
  • [14] Ibidem.
  • [15] Ibidem, p. 6.
  • [16] Ibidem.
  • [17] Ibidem, p. 7
  • [18] Ibidem.
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