Reassessments

By the 1960s the status of nutrition could be summa­rized as follows:

1. Apparently all of the chemical nutrients had been identified, so that it was possible to define an adequate diet in completely chemical terms.

2. There was still a great deal of malnutrition among the poorest people on the earth, mainly because of a lack of quantity of food. And the coarsest foods were too bulky for the small stom­ach capacities of newly weaned infants. The main problem was therefore one of economic distribu­tion of purchasing power and of the organization of food production rather than programs aimed at supplying specific nutrients.

3. The main exceptions to this were the deficiency of vitamin A in children in developing countries and the large pockets of goiter and cretinism, also mainly in developing countries. Again, there were scientifically tested procedures for dealing with these deficiencies, and their execution was a matter for government programs of education and public health, with technical support.

4. The populations of the most affluent countries had diets that in general provided most of the recom­mended levels of nutrients. Yet life expectancy at age 5 in a country such as Cuba or Panama was greater than that for corresponding children in a country like the United States or Sweden, with a much greater average income per head and far more sophisticated sanitary and medical re­sources. The major cause of the shorter life expec­tancy in the richer countries was the greater risk of cardiovascular heart disease resulting in a “heart attack.” It also appeared that individuals in affluent communities were more subject to certain types of cancer.