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Sustainable food and health systems
4th edition

Mark L. Wahlqvist and
Danielle Gallegos

Janis Baines
David Borradale
Janeane Dart
Leisa McCarthy
Christina McKerchar
Claire Palermo
Gayle S. Savige
Jolieke C. van der Pols
Naiyana Wattanapenpaiboon

Food and Nutrition_4e.indb 3 9/9/19 1:15 pm

This edition published in 2020

First edition published in 1997

Second edition published in 2002
Third edition published in 2011

Editorial arrangement copyright © Mark L. Wahlqvist and Danielle Gallegos 2020

Copyright in individual chapters remains with the authors

Every effort has been made to contact the copyright holders of reproduced material.
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All rights reserved. No part of this book may be reproduced or transmitted in

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Mark L. Wahlqvist and Danielle Gallegos



t e

• Describe a scientific approach to food and nutrition


systems to underpin lifelong learning.

ch d
• Describe an ecological systems approach to health,

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human nutrition and food systems.

• Define the elements of human nutrition.


m be

al o


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o be possible if we can work within social, economic

and environmental frameworks that operate locally,
Nutrition is fundamentally a science. It is premised
nationally and globally.
on an understanding of human physiology and
This chapter provides an introduction to the
biochemistry and the action of nutrients and other
approach taken in this textbook. Most nutrition
food constituents. Nutrition scientists also need to textbooks emphasise the biological elements of
have an appreciation of food—its chemistry and nutrition.They tend to focus on body systems and the
structure, and how manipulating it can change biochemical and physiological aspects of nutritional
the availability, absorption and effectiveness of its intake or lack thereof. This book views the human
inherent constituents. body as part of a complex, dynamic, constantly
The fundamental science of nutrition emerged evolving system that integrates the environment with
in the 18th and 19th centuries, after the discovery social, economic and biological systems. Working
of oxygen in the 18th century laid the foundations with individuals, communities and populations
for nutritional biochemistry and an understanding to develop new solutions to optimise the world’s
of energy and nutrient metabolism. As a science, nutrition requires thinking about all these systems
nutrition is constantly evolving. As we learn more and how they interact. In this chapter, we define an
about the human body, the expression of certain ecological approach to food, human nutrition and
genes and general health and wellbeing as they food systems, the dimensions of human nutrition
relate to the environments we live in, we develop a and some of its historical origins. These concepts are
more sophisticated understanding of how food and further elaborated in following chapters, giving you
nutrition can be manipulated for improvements in a holistic but practical guide to the dimensions of
health. However, improvements in health will only human nutrition for the future.

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NUTRITION AS A SCIENCE being selective about what they believe. Sometimes

their reasons are based on personal beliefs and values,
Scientific methods and studies are vital in helping
or they may have a financial interest in proclaiming
us understand the interaction between food,
certain ‘facts’.
food systems, the environment and health. The
The importance of qualitative research in nutri­
basic principle of any scientific inquiry is that we
tion (see Chapter 3) is increasingly recognised as we
are uncertain about all we discover. Indeed, the
grapple with how people’s beliefs, values, experiences,
only certainty is that things are uncertain. Therefore,
perceptions and behaviours relate to putting food on
experiments and studies are constantly conducted
the table and into their mouths.This qualitative work
and the best recommendations, practices and policies
can provide valuable data that supplement statistical
are made based on what we currently know. There
analysis and increase our understanding of nutrition
is, and always should be, an expectation that our
in action.
understanding will be progressively modified as new
To ensure that individuals and populations have
evidence emerges. If we are unsure, or if there is no

access to the evidence, it is imperative that nutrition

evidence to support certain recommendations, it is

professionals understand how to critically evaluate

a professional responsibility to convey the limits of

the science as well as the ‘fake news’. Access to

what we know.

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information is no longer a problem; the more

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It is not possible to conduct experiments on

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difficult problem is sorting factual information

humans in the same way that rats or other animals
from that which is biased. To become expert

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are used in research, which makes the gathering

in this area, you will need to develop a range of

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of evidence challenging. As a result, information

professional skills (see Chapter 2) and to critically

on nutrition is drawn from two major sources.

evaluate and communicate the evidence as it comes

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The first is laboratory science, where experimental
to light (see Chapter 3). What this means is that, as
animals—and, to a lesser extent, human subjects—
an individual, for your own health and that of your
are used. The other main source of information is

family, and as a health professional keeping up-to-
epidemiology—the study of nutrition and disease
date, critically evaluating the science as it emerges
in populations (see Chapter 24). Epidemiology
is a lifelong task.
shows relationships such as an association between
heart disease and high intakes of certain saturated
fats, or between a higher incidence of the congenital
disease spina bifida and low intakes of the B-vitamin
folacin. Where such associations or predictions are The ecosystems approach to human health is a strategy
found, laboratory science takes over to determine designed to shift our thinking from traditional, one-
the nature of cause and effect. dimensional biomedical approaches towards a new
Statistical analysis must also be used to determine transdisciplinary and integrated approach (Heasman
whether a certain finding might have arisen by & Lang 2015). It makes use of the conceptual idea of
chance or not. Even so, knowledge that seemed an ecosystem to examine the complex and myriad
firmly established may change as continuing research factors influencing human health concerns and
uncovers new information. Assessing the significance seeks ways to improve human health and wellbeing
of new information can be complicated. Scientists through sustainable management of all components
do not necessarily agree and arguments may go on of the environment. The health of individuals, as
for years before finally being settled. This can lead well as that of communities, is inextricably linked
to a public perception that experts can never agree to the health of biophysical, social and economic
on what people should be eating. This is further environments, and all ought to be considered
compounded by some people in the nutrition field together.

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We can learn much from the concept of health as shift-work; the operational healthcare system;
and wellbeing as understood by Indigenous com­ communication and transport systems; and facilities
munities who have traditionally lived in a more for recreation (Wahlqvist 2014).
integrated way with their natural environment. For At the global level, the Millennium Ecosystem
many such communities, health encompasses not only Assess­­ment (, launched
physical health but also social, emotional and cultural in 2001 by a conglomerate of international organi­
wellbeing. This extends beyond the individual to the sations, involved a major assessment of human impact
community. We are ecological creatures, intimately on the environment designed to inform decision-
connected to our environment, not environmentally making and policy development. The results suggest
discrete individuals. We are connected with the that global ecosystems are losing their ability to
animate environment through the food and provide the services that are essential for human
beverages we ingest, our several microbiomes, health and wellbeing as a result of increasing human
our senses, our environmentally derived hormonal pressure. Given human dependence on ecosystems
profiles and more. We are connected with the inani­ for the necessities of life (food, water, shelter), this
mate environment—things not considered to be

t e r trend is likely to continue. The Millennium Eco­

alive, such as the weather—through the effects of system Assessment has triggered the development

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rain and drought on agriculture and our ability to

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of several ecosystem assessments, at global, regional

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live in comfort and safety from storms, fires and and national levels, in response not only to changes

other natural disasters. in scientific understanding, but also to a changing

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The linkages between human health and eco­ policy landscape (Allison & Brown 2017).

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systems are complex, dynamic and, in some respects, Food—how we produce, prepare, share and

political or dependent on governance; for example, consume it—is fundamental to our wellbeing. An

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a government may fail to adequately control the ecological approach to food and nutrition recognises
release of pollution into waterways. For thousands that food as a commodity is the conduit connecting

of years, ecosystems have provided humans with people and planet—highlighting our dependence on
essential services or benefits, such as food, water, environmental elements (Lang et al. 2009; Pirk et al.
shelter and medicine. On the one hand, human 2017). Humans are ecological creatures and, as such,
health has benefited by sacrificing the ‘health’ of we must see ourselves as intimately connected to
ecosystems. Examples of this include damming our ecosystems if we are to optimise our nutritional
wild rivers, destroying wetlands, diverting water status and health (Wahlqvist 2014).
for irrigation, converting wilderness to farmland, There is a new imperative to take an ecological
timber removal, local extinctions of wild animals approach to food and nutrition. In the last 100 years,
and loss of arable land for residential and commercial the global population has increased fourfold. While
development. On the other hand, archaeological world population growth has slowed, an increase in
evidence has shown that the destruction of eco­ longevity and the mobility of people has increased
systems has led to the downfall of civilisations the stress on the food system. Accelerating climate
(Ehrlich & Ehrlich 2013). At one and the same time, change is altering the available material resources,
ecosystems protect against and mediate health risk while local and global economic and political
and the transmission of disease. There are many developments (trade agreements, civil unrest)
settings in which ecosystems are vital for our health influence the availability of and access to food and
and need to be assessed. The most obvious are places health.The growing prevalence of nutrition-sensitive
where food is produced, processed and distributed to ill-health (obesity, diabetes, heart disease, allergy) and
consumers. Other settings include the home, school the inability to resolve micronutrient deficiencies
and education system; the workplace and workforce (such as iron, vitamin A and iodine deficiencies) are
with their specific characteristics and patterns, such a result of multiple ecosystems failure. As ecological

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creatures, we depend on our household, locality and from nutritional biochemistry to food products
community for our health status. Our genome is where the risk–benefit profile may be unacceptable.
influenced by our environment and our evolution For example, while vitamin A is important for
is ecological and intergenerational. For example, the health, there are serious risks associated with over-
emerging field of epigenetics indicates that what a supplementation or even unique ingestion in the
mother eats and does during pregnancy will impact absence of other food constituents. Generally, a
the genetics of her baby; because a female infant’s biodiverse diet should provide most people with
eggs are created in the womb, these impacts will in sufficient vitamin A (Wahlqvist et al. 1989) (see
turn affect these eggs and, potentially, the children Chapter 8). Insofar as possible, food or food patterns,
they eventually become. We cannot expect that our rather than food components, should be the basis
health will be optimal unless our biology, food system, of therapeutic strategies in order to maximise its
surroundings and social affairs are in harmony. For broader benefits and minimise the risk (Wahlqvist
these reasons alone, our priorities, livelihoods and 2016).

relationships must be environmentally attentive. With this in mind, nutrition for health is best

t e
Ecosystem damage and loss is the gravest threat to served by food-based guidelines. People eat food, not

a p
our health and survival. Consequently, health and

nutrients, and it is reasonable to look to food and

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nutrition professionals need to have an understanding food intake patterns as a way of optimising health, as

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of food systems and the dimensions of nutrition in long as other personal behaviours—physical activity,

order to optimise health now and into the future. sleep, stress management and substance abuse (as with

a m be w in alcohol, tobacco and drugs, legal and illegal)—are

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also addressed. Consequently, most countries have

t U established food-based guidelines to advise their

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Food is the primary source of nutrients needed to
populations on optimal dietary patterns for health
sustain life, promote health and optimal growth and
(see Chapter 19). However, the emergence of new
development, and assure human productivity. Foods

technologies is challenging our understanding of the
are produced by systems that are ecologically and
fundamental question ‘what is food?’. Meat grown
health relevant at every stage from production and
from stem cells (cultured meat) and food produced
harvest, through transport, processing, storage, sale,
and made via 3D-printing, which is extruded and
packaging, food preparation and to consumption
reconstructed to look like produce, are just two
(see Part 2). A safe food supply is essential for human
examples. Quite profound questions arise for food
life, and safety breaches of food systems result in
processors, consumers and regulators about these
loss of life (mortality) and ill-health (morbidity)
significant changes in food culture. If present environ­
(Chapter 5). Such systems therefore need to
mental pressures on the food supply increase, we may
be governed by increasingly complex policies,
find ourselves in much greater need of food and
procedures and regulations (chapters 6 and 7).
nutrition literacy to safely, sustainably and healthfully
Under­stand­ing food and its constituents is essential
manage our food supply (chapters 26 and 27).
in order to understand the contribution individual
foods and food combinations make to the dietary
intake of an individual and dietary patterns of
populations (Chapter 8). The concept of ‘econutrition’ is based on the
Neither nutrients nor other food components synergy between food and health through ecosystems,
have single functions or act alone. In other words, where the integrity of these is basic to food, human
foods affect the body in a number of ways and and planetary sustainability (Wahlqvist et al. 2012;
nutrients work together to create the desired impact. Wahlqvist & Specht 1998). The concept has been
Failure to understand this can lead to extrapolations used in developing interdisciplinary approaches that

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are critical to linking the basic sciences in multiple swallowing’ considerations can be divided into those
areas to address global ‘wicked’ problems such that deal with food production and supply, and those
as poverty, climate change and food insecurity concerning the anthropological and sociological
(Deckelbaum et al. 2006) (see also Chapter 2). influences that determine what we choose to eat.
An example would be the Millennium Villages The ‘post-swallowing’ aspects relate to the bio­
Project discussed in Chapter 29. The vicious cycles chemistry, genetics and physiology of nutrition.
that lead to loss of nutrients, soil erosion and In 2005, the International Union of Nutritional
decreasing biodiversity are linked to environmental Sciences recommended in its ‘Giessen Declaration’
degradation and result in decreased food production that nutrition science be inclusive of biomedical,
(refer to Chapter 26). Lack of food is associated societal, environmental and economic sciences
with malnutrition, illness and declining labour (Beauman et al. 2005). In this text, we use this as a
productivity, which exacerbates poor agricultural guiding framework and divide the study of human
management. An interdisciplinary approach is nutrition into four dimensions: biological, societal,
economic and environmental.These dimensions map

needed to break these kinds of vicious cycles.

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Econutrition conceptualises how we and other to the four components of ecosystems impacting on

public health that are connected in multiple ways

living things can acquire the nutrients we need to

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(Lang & Rayner 2012) (Figure 1.1):

optimise our wellbeing, health and lifespan in ways

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that are sustainable and respectful of the animate • environmental: includes the physical building

and inanimate environment. Wahlqvist and Specht blocks that are needed for life, such as soil, water,

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energy and food

(1998) identified ways in which biodiversity

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might contribute to successful econutrition, which • biological: the biophysiological processes of all

living things (animals, plants, microorganisms,

included an essential varied food supply for human

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health; a range of diverse food sources as security humans)
against natural disaster, climate change and pestilence; • societal: encompasses interpersonal relationships,
community, group and family traditions, and the

a rich source of medical compounds, many as yet
unknown; ecosystem buffers against invasive plants
and animals, and against pathogens and toxins;
and recognising a ‘spiritual’ value in diversity and
ecosystems with consequent mental health benefits
and the feeling of ‘belonging to the landscape’. Env
Seasonality—meaning growing and consuming l n m
foods according to their natural season rather than



attempting to have seasonal produce available all

year round—can add to the diversity (or variety) and
robustness of food sources. From an econutrition
perspective, health problems such as malnutrition
and some chronic diseases, including cardiovascular
disease, diabetes and some cancers, can be solved
or alleviated through local, ecologically sustainable,


biodiverse food systems (Chapter 31). og om

ic n
al Eco
Nutrition can be divided into ‘pre-swallowing’
and ‘post-swallowing’ aspects (Crotty 1995). ‘Pre- Figure 1.1: Dimensions of human nutrition

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institutions that frame daily living, including laws nutritious. The types and quality of the foods
and social arrangements consumed can be the result of several factors:
• economic: includes the role of nutrition in global • food-processing environments (see Chapter 5)
and national economic growth, as well as the role • government regulations regarding a safe food
of income and prices on food choice. supply (see chapters 6 and 7)
• what foods are supplied by farmers, food manu­
These dimensions will be highlighted for each facturers and supermarkets (see Chapter 8)
chapter. Remember, however, that it is usually rare • what foods we choose to buy and eat (see chapters
for only one dimension to be present. For example, 25 and 28)
the chapter on food systems may be identified as • the sustainability of the food system, particularly
‘environmental’, but as you read the chapter you given the escalation of climate change
will realise that farming practice is also a social (Chapter 26).
phenomenon, that economic power is one of the
main drivers and that foods are inherently biological

t e
in nature. The human and globe icons at the centre The biological dimension encompasses the ways in

which food contributes to all bodily functions, their

of Figure 1.1 remind us that the four dimensions—

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intergenerational transfer and their dependence on

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with food as the primary vehicle—are essential for

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personal behaviours, socio-environmental factors
human health, which is dependent on planetary

and homeostatic mechanisms, which allow a range


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of food patterns to provide for optimal health across
Environmental a
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post-swallowing mechanisms.

The importance of environmental health has been

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At its fundamental level the biological dimension
discussed above in the context of developing and
describes the:
maintaining healthy ecosystems. The locality in

• physiological bodily processes for extracting
which we are born and live is a major differentiator
nutrients from foods (Chapter 9)
of wellbeing and health across population groups.
• biochemical and physiological actions of nutrients
Our locality may, among other things, affect our
(chapters 10–18)
food system and our interaction with it in regard • consequences of too little or too much of these
to livelihood, recreation, the potential for growing nutrients (chapters 10–18)
food and plants (horticultural and animal welfare • nutritional requirements of the human body
and production, ornamental features, open space), at different life stages to optimise health
migration inwards and outwards, trade, degree of (chapters 20–22)
urbanisation, contamination and pollution. Within • assessment of the outward manifestation of
these localities, the macro-physical environment nutritional status in individuals (Chapter 23) and
encompasses climate, shelter, water, food supply and populations (Chapter 24).
conditions of hygiene. The micro-environments
include the settings in which people live, work and The biological dimensions of nutrition and their
play that influence what and how people eat. interaction with the environments in which we
Food is part of the human environment and, in live have continued to evolve. Nutritional biology
an ideal world, just the right amount of safe and explores the role of nutrition in the expression
nutritious food would be consumed so that each of certain genes and how diet can affect gene
person would have the best chance of achieving expression in future generations (epigenetics). These
optimum health and long life. However, it is not innovations are leading to nutrigenomics and
as simple as that. Not all available foods are equally personalised nutrition, or nutrigenetics. It may be

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that, in the future, a ‘reading’ of a child’s genome Food—what is chosen from the possibilities available,
will provide insight into the dietary requirements how it is presented, how it is eaten, with whom and
necessary to prevent the occurrence of particular when, and how much time is allocated to cooking and
diseases, although this will depend on a number of eating it—is one of the means by which a society creates
ethical and socioeconomic issues. itself and acts out its aims and fantasies. Changing (or
The biological environment in which individ­ unchanging) food choices and presentations are part
uals are conceived and develop in utero, followed by of every society’s tradition and character. Food shapes
early nurturing and breastfeeding as an infant is now us and expresses us even more definitively than our
recognised as vital to human health. It is now known furniture or houses or utensils do. (Visser 1986, p. 12)
that the health and nutrition of the mother (and
probably the father) can influence the health of the Food habits and nutritional outcomes are impacted
child many years later as an adult, particularly with by a range of social factors including where you live,
regard to diseases such as heart disease and diabetes how much money you earn and your education.
(Barker 2007) (see Chapter 20). The microbiome— These are called the social determinants of health

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that is, the microscopic (bacteria, archaea, fungi, (see Chapter 27). Food cultures, beliefs and cuisines

have emerged over time and, in some cases, have

viruses, algae) ecosystems and the combined

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genetic material in our body systems (the gut, on been codified as the rules of religion or as markers of

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the skin, in the respiratory and reproductive tracts national identity (Chapter 27). Fasting, for example,

and elsewhere)—is increasingly being recognised as is part of many religious and philosophical traditions,

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influential for overall health. The food we eat and but may have been a societal way of achieving equity

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how it is eaten, as well as the environments we live in food distribution or eking out limited supplies

in, all impact on the microbiota (see chapters 8, of certain commodities—for example, meat. Such

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30 and 31). intentions, overt or covert, may have had biological
justification in terms of preferred meal patterns, or

avoidance of over-consumption (propositions even
Food and eating are central to the human experience, now not fully tested), or respect for animal life.
not only providing fuel for bodies to work but also Food is culturally symbolic and distinctive food
providing means to make a living and to bring people habits (reflected as cuisines) persist in migrant groups
together socially.The foods we choose to grow, cook, longer than most characteristics. While they may
eat and share form our identity, and ensuring their undergo alignment with the host culture with time,
availability, access and safety is essential for human the reverse also takes place. This is especially evident
survival. We are the only species that cooks, so fuel in culturally pluralistic immigrant societies like
sources and food preparation skills have affected Australia, New Zealand, the USA and Canada (see
our survival. Our membership of families, groups Chapter 27). Indigenous populations are considered
and communities has also characterised our food and custodians of foodways and are instrumental in
social systems and, vice versa, our food consumption preserving biodiversity. Their health is linked to
defines our membership. The societal element of their ecosystems and the complexities of their social
nutrition science is instrumental in understanding and economic circumstances (Kuhnlein et al. 2006).
the historical influences on the way we eat, how Indigenous peoples around the world continue
policy and regulations can be enacted, the influence to suffer disproportionately from poverty, racism
of culture, the impact of class and poverty and the and poor health, but they have also demonstrated
role of family and community. Food as the delivery extraordinary resilience in maintaining a sense of
unit for nutrients is only part of the story; as Margaret identity (that includes dietary patterns) in the face
Visser notes, food has a key role in shaping and of significant, prolonged histories of colonialism and
expressing identity. genocide (Chapter 28).

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We are now creating new food cultures, although increasing recognition of the role trade agreements
we may be unaware of doing so. Shopping and cooking play internationally in the shaping of local food
confer survival advantages, but food dispensing or environments. Policies that emphasise greater market
vending machines are now commonplace in most access to food exports and the opening of domestic
urban settings.The new era of the ‘internet of things’ markets to foreign investment have created environ­
and ‘Uberisation’ allows the ordering, activation of ments that encourage the consumption of foods
cooking and food preparation, delivery and more that promote obesity and the development of non-
to be remote (Figure 1.2). Shopping, cooking and communicable diseases (see Chapter 25) (Ravuvu
commensality (eating and drinking at the same table) et al. 2017). A small number of transnational food
are fundamental social activities. Ongoing research companies peddle ultra-processed foods to a global
indicates that these activities reduce social isolation consumer market. ‘Big Food’ is forging new markets
and contribute to longevity (see Chapter 28). in low and middle income countries with profit and
economic gain as the primary driver (Williams &

Nestle 2017). Agri-food companies have a monopoly

t e
Nutrition as a science emerged from the under­ on the development and dissemination of seeds,

standing that well-nourished workers (and soldiers)

reducing biodiversity and limiting the ability of local

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were more productive and better able to contribute

farmers to build and maintain sustainable livelihoods

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to the economic development of not only their
i e (see Chapter 26). Global food prices are linked to the

immediate households but also the nation. Reducing prices of individual commodities, as well as global

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hunger has been a key United Nations development

fertiliser prices and oil prices, all of which impact on

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goal, in recognition of the fact that human potential the cost of food production. Food prices have been

and endeavour are restricted when nutritional health

extremely variable in the 21st century and are likely

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is sub-optimal. The relationship between economics to continue to be volatile as the impacts of climate
and nutrition is complex and multilayered, occurring change are felt.
at the macro or global level as well as at the micro or

Consumer food choices are greatly influenced
household level. by food price and household income. Families on
At the global level, consideration needs to be lower incomes tend to purchase foods that are low
given to the influence of trade agreements. There is
cost and maximise energy intake, resulting in poor
diet quality. Food prices also tend to be higher in
more remote areas due to difficulties associated with
transport and storage (see chapters 25 and 27).


This textbook will enable you to explore all the
dimensions of nutrition at individual, local and
global levels. It will enable you to develop a lifelong
appreciation of the dynamic and changing nature
of nutrition science that translate into practical
messages for human health. Finally, it will enable you
to understand the complexity of nutrition and its
Figure 1.2: The trend towards smart phone–managed
interactions between food and environmental, social
food systems: an unstaffed or ‘peopleless’ food and and economic systems, and how you can impact your
meal vending outlet in Taipei own health and the health of others as you develop
Source: Wahlqvist (2016) as a global citizen and as a health professional.

Food and Nutrition_4e.indb 8 9/9/19 1:15 pm


• Nutrition science is constantly evolving as we build a deeper understanding of the
human body and its dynamic interactions with environmental, social and economic
• Experiments, quantitative and qualitative studies, epidemiology and statistical analyses are all
tools used to build our understanding and knowledge of nutrition and its impact.
• An ecosystems approach understands that the health of individuals and communities is linked
to the health of the biophysical, social and economic environments. An ecological approach to
nutrition recognises that food as a commodity connects people and planet. Humans must see
themselves as an integral part of the ecosystem across space and time.
• Econutrition is defined as the interrelationship between nutrition and human health, agriculture
and food production, and environmental health, mediated by the economic and social

environments. It covers pre-swallowing and post-swallowing aspects.

pt e
• Econutrition encompasses four key elements embedded within a food system:

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— environmental: includes the physical building blocks that are needed for life, such as soil,

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water, energy and food

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— biological: the biophysiological processes of all living things (animals, plants, microorganisms,
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— societal: encompasses interpersonal relationships, community, group and family traditions,

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and the institutions that frame daily living, including laws and social arrangements

N llen &
— economic: includes the role of nutrition in global and national economic growth, as well as the

role of income and prices on food choice.

Animate: beings which have life, including animals and plants; inanimate refers to objects that are
not considered to be alive, such as rocks and buildings. The inanimate and animate are inextricably
linked, such that there is usually reproductive capacity or life in the most apparently lifeless places.
Biomedical: describes systems that focus on the physical and medical aspects of health.They promote
individual responsibility and tend to treat people in isolation from their environments.
Econutrition: the interrelationships between nutrition and human health, agriculture and food
production, and environmental health, mediated by social and economic systems (Blasbalg et al.
Ecosystem: a dynamic complex web of plant, animal (including humans) and microorganism
communities that interact with the non-living (material) environment and come together as a
functional unit (Millennium Ecosystem Assessment Board 2003).
Epidemiology: from the Greek words epi, meaning on or upon, demos, meaning people, and
logos, meaning the study of. Epidemiology therefore means ‘the study of the distribution
and determinants of health-related states or events in specified populations, and the
application of this study to the control of health problem’ (Last et al. 2000).

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Epigenetics: the study of changes in organisms due to modification in gene expression rather than
alteration of the genetic code itself.
Foodways: the cultural, social and economic practices relating to the production and consumption of
food of a group of people, a region or a historical period of time.
Genome: the complete set of genes or genetic material present in a cell or organism.
Homeostasis: from the Greek homos, meaning similar, and stasis, meaning standing still, is the ability
to achieve a state of equilibrium between different but interdependent groups of elements. Within
the body, regulating body temperature via shivering or sweating, and the regulation of blood
glucose levels, are examples of internal homeostasis.
Internet of things: the embedding of information technology into physical devices, cars, home
appliances and other objects to allow greater connectivity and create efficiencies.The ‘smart’ home
and ‘smart’ refrigerator would be examples.

Microbiome: the combined genetic material of microorganisms in a particular environment—for

t e
example, in the soil or in parts of the body (gut, lung, skin).

Morbidity: term used to describe a state of ill-health or diseases. For example, data may describe

ch d
mortality rates (i.e. death rates) or morbidity rates (i.e. rates of disease). In clinical practice a patient

i e
le cop
may be described as having multiple morbidities, indicating that they suffer from more than one


a m be in
Nutrigenetics: the effects of genetic variation on nutrient requirements.

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Nutrigenomics: the nutrient regulation of gene expression.

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Seasonal produce: describes foods that are readily cultivated and at their best, nutritionally and in

N llen &
terms of taste, at particular times of the year. Consuming foods out of season involves costs to the
environment in terms of cultivation, transportation and storage and is therefore not considered

Uberisation: within an economic system, the development of platforms to mobilise under-utilised
resources with low transaction costs. The term comes from ‘Uber’, a platform that matched those
in need of a ride with those with a car. It refers to the elimination of the ‘middle man’, putting the
provider and the customer of the service in direct contact.
Wicked problem: a social or cultural problem, such as poverty or obesity, that is difficult or impossible
to solve because of:
• root causes being difficult to recognise
• incomplete, contradictory or changing requirements or knowledge
• interconnection with other problems
• the large number of people and opinions involved
• the problem contributing a large economic burden. (Kolko, 2012)

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Allison, H. & Brown, C., 2017, ‘A review of recent developments in ecosystem assessment and its role in policy
evolution’, Current Opinion in Environmental Sustainability, 29: 57–62, doi:10.1016/j.cosust.2017.11.006
Barker, D.J., 2007, ‘The origins of the developmental origins theory’, Journal of Internal Medicine, 261(5): 412–17,
Beauman, C., Cannon, G., Elmadfa, I., Glasauer, P., Hoffmann, I. et al., 2005, ‘The principles, definition and
dimensions of the new nutrition science’, Public Health Nutrition, 8(6a): 695–8, doi:10.1079/PHN2005820
Blasbalg, T.L., Wispelwey, B. & Deckelbaum, R.J., 2011, ‘Econutrition and utilization of food-based approaches
for nutritional health’, Food and Nutrition Bulletin, 32(1_Suppl): S4–S13, doi:10.1177/15648265110321S102
Crotty, P., 1995, Good Nutrition? Fact and fashion in dietary advice, Sydney: Allen & Unwin
Deckelbaum, R.J., Palm, C., Mutuo, P. & DeClerck, F., 2006,‘Econutrition: Implementation models from the Millen­
nium Villages Project in Africa’, Food and Nutrition Bulletin, 27(4): 335–42, doi:10.1177/156482650602700408
Ehrlich, P.R. & Ehrlich, A.H., 2013, ‘Can a collapse of global civilization be avoided?’, Proceedings of the Royal Society
B: Biological Sciences, 280(1754), article 20122845, doi:10.1098/rspb.2012.2845
Heasman, M. & Lang, T., 2015, Food Wars: The global battle for mouths, minds and markets, London: Routledge

Kolko, J. 2012, ‘Wicked problems: Problems worth solving’, <>, accessed 14 June

pt e
Kuhnlein, H., Erasmus, B., Creed-Kanashiro, H., Englberger, L., Okeke, C. et al., 2006, ‘Indigenous peoples’ food

h d
systems for health: Finding interventions that work’, Public Health Nutrition, 9(8): 1013–19, doi:10.1017/
le cop i e
Lang, T., Barling, D. & Caraher, M., 2009, Food Policy: Integrating health, environment and society, Oxford: Oxford

m be in
University Press

a w
Lang, T. & Rayner, G., 2012, ‘Ecological public health: The 21st century’s big idea? An essay by Tim Lang and Geof

S to n
Rayner’, BMJ, 345: e5466, doi:10.1136/bmj.e5466

Last, J.M., Spasoff, R.A. & Harris, S.S. (eds), 2000, Dictionary of Epidemiology, New York, NY: Oxford University Press

N llen &
Millennium Ecosystem Assessment Board, 2003, Ecosystems and Human Well-being: A framework for assessment, <http://>, accessed 15 January 2019
Pirk, C.W., Crewe, R.M. & Moritz, R.F., 2017, ‘Risks and benefits of the biological interface between managed

and wild bee pollinators’, Functional Ecology, 31(1): 47–55, doi:10.1111/1365-2435.12768
Ravuvu, A., Friel, S., Thow, A.-M., Snowdon, W. & Wate, J., 2017, ‘Monitoring the impact of trade agreements on
national food environments: Trade imports and population nutrition risks in Fiji’, Globalization and Health,
13(1): 33, doi:10.1186/s12992-017-0257-1
Visser, M., 1986, Much Depends on Dinner, London: Penguin Books
Wahlqvist, M.L., 2014, ‘Ecosystem health disorders: Changing perspectives in clinical medicine and nutrition’, Asia
Pacific Journal of Clinical Nutrition, 23(1): 1–15, doi:10.6133/apjcn
—— 2016, ‘Future food’, Asia Pacific Journal of Clinical Nutrition, 25(4): 706–16, doi:10.6133/apjcn
Wahlqvist, M.L., Lo, C.S. & Myers, K.A., 1989, ‘Food variety is associated with less macrovascular disease in those
with type II diabetes and their healthy controls’, Journal of the American College of Nutrition, 8(6): 515–23, doi:
Wahlqvist, M.L., McKay, J., Chang,Y.-C. & Chiu,Y.-W., 2012, ‘Rethinking the food security debate in Asia: Some
missing ecological and health dimensions and solutions’, Food Security, 4(4): 657–70, doi:10.1007/s12571-
Wahlqvist, M.L. & Specht, R.L., 1998, ‘Food variety and biodiversity: Econutrition’, Asia Pacific Journal of Clinical
Nutrition, 7: 314–19
Williams, S.N. & Nestle, M., 2017, Big Food: Critical perspectives on the global growth of the food and beverage industry,
London: Routledge

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