PARLOUS PLENTY INTO THE TWENTY-FIRST CENTURY

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285 CHAPTER 26 PARLOUS PLENTY INTO THE TWENTY-FIRST CENTURY The custom and fashion of today will be the awkwardness and outrage of tomorrow. So arbitrary are these transient laws. Alexandre Dumas LOOKING BACKWARD from this start of a new century (and new millen- nium for that matter), just a tad more than 600 years have gone by since the Old and New Worlds were united. These are but a small fraction of the ten to twelve thousand years that have elapsed since the beginning of agriculture, but in that short time span the foods of the world have been astonishingly rearranged so that potatoes grow in such diverse climates as those of Siberia and Indonesia, sugar in equally diverse places like Pakistan and Mexico, and pistachios have been transplanted from Iran to California – now the world’s second largest producer. In the Old World, China is now the most important producer of wheat, originally domesticated in the Middle East; China and India dominate the production of rice, which likely began as a Southeast Asian crop; India is the biggest producer of tea, fi rst cultivated in China, and peanuts, fi rst cultivated in South America; tropical Asia produces most of the world’s manioc – an American plant that Brazil claims as a native; and China is also the leading producer of white and sweet potatoes, a half-world away from their native Andes. In the New World, Brazil has become the world’s 286 A Movable Feast most important producer of coffee, originally from Africa, sugar from New Guinea, a big producer of pepper from India’s Malabar coast, and the second largest producer of soybeans, which originated in China. North America is a major grower of wheat, the biggest producer of Mesoamerican maize, and leads Brazil in soybean production. Save for the United States, however, the nations that cultivate the most important of these (now thoroughly shuffl ed) crops are generally thought of as situated in the developing world. And while residents of the West, and especially the people of the United States, are battling obesity, much of the world lives under the threat of famine – and has for at least the past 6,000 years. 1 China has suffered as many as ninety famines per century over the last 2,000 years, including a recent one between 1958 and 1961; most estimates of the number of dead were at between 14 and 26 million – although some said as many as 40 million. In India at least ninety major famines have occurred over the past 2,500 years. Russia continued to be ravaged by famine – mostly man-made after the Bolshevik Revolution – that claimed millions of lives until the mid-twentieth century; and in Brazil’s northeast, climatic and political circumstances have made famine a regular occur- rence since these disasters fi rst entered the historical record in 1584. 2 Of course, famines are not just limited to big food producing nations; during the twentieth century they made catastrophic appearances in developing countries in the Horn of Africa, sub-Sahara Africa, and Asia. 3 The terrible irony is that the ravages of famine are phenomena that globalization – which has precipitated a tremendous expansion of agricultural productivity, a sophisticated system of transport, and globally interlinked markets – could easily prevent. 4 Or it could if the nations of the world would agree that every one of its citizens is entitled to food security as a basic human right. 5 Until that agreement is reached, famines and chronic malnutrition will mar the future as they have the past. And there is something very wrong when some 800 million people in the world are classifi ed as chronically undernourished yet U.S. farmers collect money for not growing food, and northern European farmers produce such an excess of food that the Common Market of the European Union has ordered cut- backs on the production of such items as pork and butter. Yet, even more devastating than famine-generated hunger is the chronic malnutrition that affl icts some 800 million individuals as we begin the twenty-fi rst century, even though food globalization has helped to narrow the dietary gap between some of the developed and developing countries. 6 Parlous Plenty into the Twenty-First Century 287 Nonetheless, it seems that the world is losing its war on hunger because the narrowing excludes almost a billion persons for whom even the cost of cooking fuel can be a major expense. 7 In the early 1990s, it was estimated that some 500 million children and adults experienced continuous hunger (and even more were vulnerable to it); that one in three children in the developing world was seriously malnourished; and that over a billion people suffered from nutritional defi ciencies. Ironically, these estimates were made at a time when Americans were spending a sum greater than the entire economy of Medieval Europe on their dogs and cats. 8 In the agrarian societies of developing countries, a sole cereal crop may supply as much as 80 percent of the total caloric intake, and meat is seldom if ever tasted – a situation that has not changed for many over the course of some 10,000 years. 9 Even in Mexico, during a recent recession it was calculated that fully one-half of its estimated 92 million people were getting less than the minimum daily requirement of 1,300 calories. 10 It is generally acknowledged that adequate infant nutrition is bedrock for the optimal health of a people; yet in under-nourished populations malnutrition begins in the womb. Too often the result is a low birth-weight (LBW) infant, and LBW is the most important determinant of neonatal and infant mortality as well as physical growth until age seven. 11 Although there is a high correlation between maternal weight gain during pregnancy and normal birth weight, many developing country mothers register low, or even negative, weight gains during pregnancy. And together, low maternal weight and LBW continue to be among the leading causes of the world’s disease burden. 12 LBW is not easily corrected after birth, in no small part because of the diffi culty of educating developing country mothers who comprise the majority of some 870 million illiterate adults living in those countries. 13 Busy mothers have curtailed breast-feeding since Neolithic women began working in the fi elds, and substitute infant-feeding methods have left much to be desired ever since. The use of a pap has led straight to protein energy malnutrition, often because the mother’s immunological defenses are not transmitted in her milk to the baby. Wet-nursing has proven equally disas- trous, 14 and bovine milk is not only hard to digest for human infants but, because iron availability from milk is species-specifi c, they get less than half the iron from bovine milk than they would from breast milk. 15 Yet, formula foods – originally developed as low-cost milk substitutes such as INCAPARINA made from corn and cottonseed fl our or CSM 288 A Movable Feast (corn-soya-milk), 16 also present deadly problems. Practically everybody can recall hearing or reading about multinational corporations aggressively marketing infant formulas to replace mother’s milk in Third World nations. Those mothers were defl ected from breast-feeding by formulas they could not afford (and thus they over diluted them) and the mother’s badly needed antibodies in hostile disease environments did not reach their babies. Per- haps most lethal of all, unhygienic living conditions meant that formulas were prepared with fouled water and there was little understanding of the importance of bottle sterilization. For all of these reasons, countless babies died amid erupting scandal. 17 Moreover, infancy is just the beginning of the nutritional trials that face Third World youngsters. Those that survive this one and move into childhood, are confronted by another set of hurdles. In many societies men and boys eat fi rst, and females are last in line at the food pot, with female children just ahead of the family dog. 18 Like infants, children are also beset with a high frequency of diarrheal and respiratory diseases that contribute to malnutrition and stem from it because malnutrition lowers resistance to pathogens. 19 It is a synergistic interaction in which each condition worsens the other, and nutritional defi ciencies – especially those of protein, vitamin A, and iron – make the child increasingly vulnerable to diseases like measles (a major killer of the Third World young) and nutritional syndromes like PEM. 20 PEM or protein energy malnutrition consists of a group of nutritional diseases related to an inadequate intake of protein and energy (calories) that chiefl y attack infants and young children in poor countries. Its symp- tomatic poles are kwashiorkor, characterized by edema and skin lesions (a rich variety of colloquial names indicates a wide prevalence historically) and marasmus, with the victim presenting a “skin and bones” appearance. In the past the swollen bellies of kwashiorkor were sometimes interpreted to signal over-nutrition, but the signs of frank starvation characteristic of marasmus have never fooled anybody. 21 PEM impairs immunities to infections, produces a fatty and sometimes permanently damaged liver, and, as is the case with severe vitamin defi ciencies, has been linked with mental decrement in later life. 22 The illness generally develops when a child is weaned from the protein in mother’s milk and placed on a pap. It is prevented by the inclusion of some good quality protein in the weanling’s diet. However, this is sometimes not easy to include in places where population growth exceeds Parlous Plenty into the Twenty-First Century 289 food production – making yet another argument for global food entitle- ments as a part of food globalization. 23 On a more upbeat note, the globalization of foodstuffs has helped to make enough “extra” protein available to increase the average height for many in the world and to help them start catching up to the stature of our Paleolithic ancestors. 24 This is because of a close association between the average height of a population and its nutritional status, so that height can actually serve as a proxy for protein intake. 25 Protein intake is also important to the age of menarche. In seventeenth- century Germany, for example, it was noted that peasant girls menstru- ated later than the daughters of townspeople or the aristocracy. 26 Over the last century there has been a decline in the age of female sexual maturity throughout most of the world 27 although, signifi cantly, the greatest height increases and age of menarche reductions have taken place in the United States and Europe – those regions of the world where improving nutrition and the end of chronic malnutrition have produced declining mortality over the past three centuries or so. 28 But the less affl uent countries are now closing the protein intake gap. In the developed world, diets are comprised of ever more sugar, fats, and alcohol, which supply calories yet no protein. By contrast, beans, high in protein, fi gure heavily in the diets of many in developing countries. 29 It goes without saying, however, that a lowered age of menarche can mean increased fertility, and more mouths to feed makes escape from Third World status just that more diffi cult. Moving from food-related health problems in the developing world to others in the developed world, we have already observed that food processing was given a considerable fi llip by the onset of industrialization, and it has made incredible progress ever since especially during the last half- century. 30 But government and consumer uneasiness has kept pace with that progress – uneasiness about the use of additives in food processing such as, to single out just one, the venerable preservative nitrate that turns meat red. After all, additives are chemicals, and chemicals can be dangerous. Unquestionably, many of these were in the past, and surely many more will prove to be in the future. So long as there are convenience and processed foods there will be additives. The problem becomes one of when their potential for harm outweighs their usefulness. Salt is a good example. It is used in near mega-doses by almost all food processors because it makes foods tastier, improves their appearance, increases shelf life, and, not incidentally, adds to profi ts by adding weight 290 A Movable Feast to products because salt promotes water retention. 31 Because of the inten- sive use of salt as an additive, however, Americans consume some two teaspoons of the mineral daily even if they do not touch the saltshaker – from which Americans get only about one twentieth of their sodium. But, those two teaspoons are about twice the upper limit of sodium recommended for good health and are pointed to as a major cause of the high blood pressure affl icting some 50 million Americans. Yet, most Americans fi nd salt tasty, and in the wake of the low sodium craze that peaked in the early 1990s, no longer view it as particularly hazardous, and might even insist that salt as well as other additives are vital to the appearance, texture, fl avor, and keeping-quality of foods. Moreover, the use of additives is monitored by governmental authorities and new additives are subjected to rigorous testing, so that the risks they pose may seem acceptable ones. 32 Regardless of the merits and demerits of food additives, they are unquestionably less dangerous than a number of other constituents of our food supply. Pathogens, for example, ignite food-borne infections, and there are a lot of them about in the form of cestodes, nematodes, trema- todes, protozoa, fungi, bacteria, viruses, and at least one prion (the agent that causes bovine spongiform encephalopathy or “mad-cow” disease). 33 In fact, some food- and water-borne infections rank among history’s greatest “killer” diseases like cholera, typhoid, and tuberculosis (from infected bovine milk). Less severe are the diarrheal disorders such as shigellosis (bacillary dys- entery) and Escherichia coli that have rueful, but rollicking monikers like “Montezuma’s revenge,” “Rangoon runs,” “Delhi belly,” and “Tokyo trots” – amusing to everyone but the victims of the moment. Other names for these gastro-intestinal ailments like la tourista, suggest that they prey mostly on visitors, whereas locals have built immunities to them since early childhood. 34 Yet, North Americans have learned from recent outbreaks of E. coli that some strains of the disease are diffi cult for the body to combat and, therefore, are far from funny. Other dangers just below the surface of our twenty-fi rst century dietary minefi eld have to do with food allergies, which children are more likely to suffer from than adults, although they can develop at any age. 35 Among the most common allergy triggers are bovine milk, crustacea (crab, lobster, shrimp), eggs, fi sh, legumes (especially peanuts and soybeans), shelfi sh (clams, oysters, scallops), nuts, and wheat. 36 Those who Parlous Plenty into the Twenty-First Century 291 experience allergic reactions to such foods, ranging from the mild (itching and redness) to the severe or even deadly (anaphylactic shock) learn to leave them alone. 37 A problem, however, is that food processors often use terms that conceal rather than reveal the presence of allergenic proteins such as “natural fl avorings,” which might include soybean or milk proteins. And peanuts, when pressed, defl avored, then refl avored, are sold as other types of nuts, such as almonds. Nonetheless, they retain their allergenic qualities and, therefore, constitute a serious threat to unsuspecting peanut- allergy sufferers. 38 Careful label reading can help in dodging food allergy hazards (although this is no help when eating out), but globalization has created a situation whereby people may not know they are allergic to a food. So long as famil- iar foods are eaten, consumers learn what foods should be taboo. But what about the new, unfamiliar foods abruptly made available by globalization? For example, what about the introduction of soybeans to the French diet – soybeans which (despite containing highly touted heart-healthy proteins) now rank third among the most common cause of food allergies in France? Or the kiwi fruit, whose introduction to the United States set off a rash of kiwi fruit allergies? 39 With new and exotic foods increasingly on the market, allergic reaction promises to be an increasing health problem in our new century. Another unintended consequence of globalization – food intolerances – is already a problem. This can be especially serious when governments act as if they are not a problem as, for example, when a picture of Donna Shalala (then Secretary of Health and Human Services) appeared with a milk mustache in an advertisement for milk in the New York Times. 40 Did she even know that millions of Americans are lactose intolerant or realize that her milk mustache was tantamount to a federal endorsement of milk? Lactose intolerance (as distinct from allergy to milk proteins) has a genetic cause 41 and affects the vast majority of the world’s peoples. It has been estimated that although 96 percent of northern Europeans are able to digest milk, some 50 to 75 percent of Africans, Indians, and Eastern Europeans cannot, along with virtually all East Asians and Native Americans. 42 Genetics probably lay at the root of other food intolerances as well, although the line drawn between food intolerances (the result of nonimmunologic mechanisms) and allergies (that stem from immunologic abnormalities) can be fuzzy. 292 A Movable Feast Celiac disease, for example, seems to have familial associations and is thought to be genetic in origin. Those with the condition cannot tolerate a component of gluten, which is a protein present in the grains of the grass family (Gramineae), and especially in wheat. 43 It predominates among people whose ancestry lies in Europe or northern India – both major cen- ters of late wheat cultivation which has suggested a number of things to researchers. Perhaps celiac disease is an artifact of earlier times when the body evolved mechanisms to discourage the consumption of toxic wild grains. 44 Or maybe breeding for better gluten (which forms the tough, elastic framework of wheat breads) in the distant past meant a trait selec- tion that accidentally ordained gluten intolerance for a small minority of wheat bread consumers? Or could it be that the gluten intolerant simply lack a particular enzyme? 45 Celiac disease patients are advised to seek out “gluten-free” products (not always an easy thing) so as to avoid the diarrhea their affl iction produces, which can lead to iron defi ciency and a wasting condition, even altered mental capacity. 46 It seems likely that in the past individuals with celiac disease born into societies sustained by wheat would not have lived long enough to reproduce and pass on the disorder, in which case it probably had a signifi cantly greater prevalence in the past than it does today. There is also a dermatological form of gluten intolerance, but most other food intolerances are provoked by additives such as aspartame, sulfi tes, tartrazine, (a widely used food dye), and monosodium glutamate ( MSG), which fi rst caught public attention in 1968, when the Chinese Restaurant Syndrome (Kwok’s disease) was traced to MSG overuse. 47 These are classifi ed as food intolerances because they have not been linked to any immune mechanism and perhaps, like lactose intolerance or celiac disease, were brought to the surface by (in this case a relatively recent) dietary change. Salt sensitivity, although not classifi ed as a food intolerance, might well be placed under that rubric because past intakes could not have condi- tioned most humans for the quantities of sodium chloride now consumed daily. Even our ancient ancestors on a fairly salty diet that was 80 percent meat would have taken in less than half – perhaps only a third – of today’s average per capita intake in the United States, and to some immeasurable extent such heavy salt consumption bears responsibility for today’s mortality generated by kidney disease, stroke, and especially, hypertension (a major cause of heart attacks) in the West, and stomach cancer in developing regions. 48 Parlous Plenty into the Twenty-First Century 293 Contemporary hunter-gatherer populations consume roughly the same amount of sodium as our foraging forefathers and suffer no hypertension – not even the age-related increase in blood pressure that medicine has resignedly come to call “normal.” 49 Part of the reason for the lack of hypertension in hunter-gatherers is that, as a rule, mammals consume more potassium than sodium, and potassium helps the body retain sodium (salt is, after all, crucial to life itself). Contemporary hunter-gatherers take in 10 times more potassium than sodium and, presumably, our hunter- gatherer ancestors did the same. 50 But beginning around 1,000 years ago, salt became more available and less expensive (despite various taxes on the mineral), and the Europeans doggedly began reversing this ratio. It had been understood for a long time that salt was a preservative (the Egyptians used it to mummify bodies) and now cod, herring, salmon, mackerel, sardines, and eels were all preserved with it. So was Irish beef (Irish corned beef that became a staple of the British navy) along with bacon, ham, cheese, cabbage (sauerkraut), cucum- bers, capers, olives, and countless other foods. Much cooking was done in salted water, and salt was again liberally applied at the table. 51 In fact, so much salt was consumed in eighteenth-century England that it has been calculated that the average person was taking in a lethal dose of salt every day. 52 That this did not kill off an entire nation was because of a sodium tolerance that the English (and presumably other northern Europeans) developed. Their bodies adapted by learning to rid themselves of excess salt through urine and perspiration. 53 By contrast, for other peoples such as sub-Sahara Africans, salt was always a precious commodity. Some, produced locally by evaporating seawater or by exploiting plant resources, could often provide what little salt was used in African cooking. But the salt mined in the desert and carried south in the caravans was the most highly prized – so much so that it was money – a currency – that, in many places, was traded for West African gold and slaves. 54 As a consequence of this historical experience with salt, people of Afri- can origin have bodies that treat the mineral much differently from those of European descent – as something to be conserved and, consequently, they excrete considerably less sodium in urine and perspiration. 55 It is suspected, that this is at least part of the explanation for why African Americans have much higher rates of hypertension and heart disease than European Ameri- cans, which, once again, brings up the question of RDA s for whom? 56 294 A Movable Feast It is diffi cult to avoid salt in the United States because – as we saw – the food processing industry adds enormous amounts to foods with the result that Americans have turned the 10:1 potassium to sodium ratio consumed by our ancient ancestors upside down. For the fi rst time people are now taking in more sodium than potassium – and at a time when it is beginning to appear that potassium in proper amounts can reduce hypertension. 57 Iron presents another kind of problem. It is an essential mineral, important for mental development, and a key component of hemoglobin – around 70 percent of the body’s iron is in hemoglobin. 58 The rest, which resides in the liver and spleen and especially in bone marrow, is generally on call when needed. Iron balance is crucial. Too much is toxic, too little can precipitate iron defi ciency anemia. This – the most common form of anemia – is especially prevalent in developing countries where diets provide little meat (from which iron is effi ciently absorbed) but much in the way of vegetable foods (from which iron is poorly absorbed). And some of the vegetable foods contain oxalic or tannic acids that interfere with iron absorption. 59 Moreover, pathogenic presence has a considerable infl uence on iron lev- els. Helminthic parasites, for example (like hookworms that live off of blood), can prosper to the point where they create anemia in the host. 60 Yet, smaller parasites – viruses and bacteria – also need iron to multiply, and these pose a tricky problem. The body tries to deny iron to these parasites by removing it from the blood and putting more of it into storage. The idea is to starve the parasites and forestall their multiplication, which means that iron administration to treat anemia in developing countries may actually work against the patients while benefi ting the parasites. Another kind of problem arises in developed countries. Since most iron is recycled in humans, iron supplementation and food fortifi cation may not be such a good idea after all. In the case of the United States, where the RDA for iron is high and plenty of it is available in foods, iron supplementation has, nonetheless, been carried out on a massive scale since the 1940s. Some feel that it is foolish, even hazardous, to nurture viruses and bacteria in this fashion – pathogens that may lie behind those chronic diseases of ours now on the rise. 61 . CHAPTER 26 PARLOUS PLENTY INTO THE TWENTY-FIRST CENTURY The custom and fashion of today will be the awkwardness and outrage of tomorrow. So arbitrary are these. helped to narrow the dietary gap between some of the developed and developing countries. 6 Parlous Plenty into the Twenty-First Century 287 Nonetheless, it

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