Abstract
We propose the use of the analytic frame of “nutrition justice” to reconcile the separate imperatives of Global Health for nutritional sufficiency for all, the requirement to eradicate childhood malnutrition, and the need for strategies to check the emerging pandemic of the double burden of malnutrition in the Global South. Malnutrition and its consequences of growth stunting are the result of disruption to the nutritional ecology of childhood from structural violence. This is mediated through loss of food security and perturbation to the cultural status of food, and on the prerequisites for nurture during infancy and early childhood. These socio-political factors obscure the role of biological adaptation to nutritional constraint on growth and hence the causal pathway to the double burden of malnutrition. In this paper we describe how the effects of historical and contemporary structural violence on the nutritional ecology of childhood are mediated using the examples of remote Aboriginal Australia and the Lao PDR. Both populations live by force of circumstance in a “metabolic ghetto” that has disrupted the prerequisites for parental nurturing through loss of food security and of traditional sources of transitional staple foods for weaning. Growth faltering and stunting of stature are markers of adaptation to nutritional constraint yet are also the first steps on the track to the double burden. We discuss the implications of these observations for strategies for global food sufficiency by mean of a thought-experiment of the effect of food and nutrient sufficiency for growth on future health and metabolic adaptation.
Highlights
The ability of our speciesto adapt to almost all of Earth’s environmental niches is the hallmark of the success of our survival strategies, but contains the seeds of its demise in the face of the inexorable increase in the global population, the persistent wastage of food, and from the impending effects on climate change on water and food security
In this paper we argue that these apparently categorically separate problems are inextricably linked when viewed from the perspective of what we call “nutrition justice.”
In this paper we propose that the concept of childhood adaptation to nutritional constraint with a change in the tempo of growth at a critical period, expressed as phenotypic plasticity, could be used as a model beyond the niche of evolutionary developmental biology, and that it could provide an explanatory model for the contemporary challenges of global nutrition
Summary
The ability of our speciesto adapt to almost all of Earth’s environmental niches is the hallmark of the success of our survival strategies, but contains the seeds of its demise in the face of the inexorable increase in the global population, the persistent wastage of food, and from the impending effects on climate change on water and food security. The humanitarian approach to intervention for childhood malnutrition in nations in which malnutrition is endemic [61, 62], contains an internal paradox: that if all children were to be provided with sufficient food to achieve their genetic potential for height there would not be sufficient food available within that nation This highlights the gap between the clinician’s short-term strategy of nutritional rehabilitation and the need to consider the structural and cultural consequences for children in countries (such as Laos which is the focus of the thought experiment that illustrates this point), in which the phenotypic adaptation of short stature allows homeostasis with the available food supply within a self-sufficient subsistence economy [63]. East Asia, which are food sufficient but at the cost of transgenerational metabolic adaptation to a nutritional plane provided by a lowprotein rice or vegetarian-based diet
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