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December 2, 2012

The Great Malnutrition Scare vs the Obesity Epidemic

Filed under: Health,Historical Fats — Twistie @ 1:32 pm

This is Wilbur Olin Atwater. He was a pioneer in human nutrition, back in the day. He was also one of the major causes of the Great Malnutrition Scare of 1907-21.

You see, Atwater was one of the first people to try to figure out how much of what nutrients people need to function. And like many who are among the first to quantify something… he got a lot of stuff wrong. The amount of protein he decided the average person needs is today known to lead to kidney failure, just as a f”rinstance.

And between his miscalculations, misinterpretation of both his data and poorly gathered information, racially skewed height and weight charts, along with a great big ol’ dollop of cultural aesthetic preferences and prejudice over evidence, the Great Malnutrition Scare of 1907 – 21 began.

In 1907 a variety of economic and food distribution issues I’m not going into for a blog entry I hope to keep reasonably brief resulted in widespread food shortages. People took to the streets to protest for potatoes. No, seriously, I mean that literally.

And about this time, the first major study comparing what people actually ate to Atwater’s ideal for what they ought to be eating was published. People were horrified to discover how few people ate the way Atwater said they ought to in order to be healthy.

To perfect the storm, a New York reporter named Robert Chapin asked chemist Frank Underhill to calculate the amount of money a poor family would have to spend per day to have a nutritionally adequate diet. Underhill used Atwater’s figures and came up with the startling news that a poor family would have to spend $0.22 a day per adult male. Compared to wages, there was no way a poor family could feed itself adequately at that expensive rate.

Chapin used the figures Underhill gave him to argue for wage reform so that poor laborers could have the money they needed to feed themselves reasonably. But other writers latched onto the same figures to argue that the United States was in the midst of a malnutrition epidemic. By 1911, the Underhill figures were used in a study that claimed that despite the fact that higher paid steelworkers appeared healthy enough, didn’t have ailments associated with poverty, and seemed to have plenty of food on their tables… nearly all were malnourished.

In short, when the figures did not fit the facts, people assumed the facts were wrong.

Something, clearly, had to be done. There was much ballyhooing and wringing of hands. And then came the clarion cry of ‘won’t somebody think of the children?’ in all its glory.

Remember those height and weight charts I mentioned earlier? Yes, those were hastily compiled using mostly native-born children of Anglo-centric origin attending private schools their parents had to be relatively wealthy to send them to  in order to determine the ‘correct’ height and weight of an average healthy child.

In short order by comparing inner city New York immigrant children to this standard, it was quickly determined that thousands upon thousands of them were seriously malnourished.

Massaging the figures by removing age from the calculations didn’t help much. It did reduce the overall rate of ‘malnutriton’ but suddenly showed that a high percentage of tall but thin native-born Anglo-based children were the worst nourished of the lot. And then a study of students at two private prep schools indicated there was a higher rate of malnourishment there than at an East Side inner city public school.

Clearly height and weight couldn’t be the whole story. Could it?

In 1915 a new standard emerged for determining which children were and were not malnourished: the Dumferline Scale. This one included not only height and weight, but eyesight, breathing, muscularity, mental alertness and rosiness of complexion into account. Can you see a couple big problems with this list already?

Once the data for each child was taken, they were divided into four categories:

1) excellent

2) adequate

3) needs attention and supervision

4) requires immediate hospitalization

Not only were many of the criteria for determining nutritional health woefully skewed to an Anglo-centric scale, they were also poorly defined. The choice of what category to place a particular child in, too, was vague and open to broad interpretation. Under pressure to identify more cases of malnutrition, doctors and nurses often played it safe by putting children they considered on the cusp into the more dire category available.

Despite all these obvious deficiencies, the Dumferline Scale was adopted by New York City’s Health Department in December 1915. Other large cities quickly followed suit.

The results were sadly predictable. Malnutrition rates skyrocketed. In fact, they more than doubled nearly overnight.

Clearly the epidemic was too severe and too widespread to be handled by individual – and often expensive – nutrition clinics. No, this would have to be handled in the school lunch programs nutritionists and reformers all over the country had been clamoring for. With well over 800,000 New York schoolchildren identified as ‘below the normal standard’ of nutrition – nearly a quarter million of whom were significantly malnourished (aka: category three), clearly this was a necessary step.

Of course, these programs were still controversial and claims of malnutrition which ranged dramatically depending on which expert was consulted didn’t help get the idea across. School lunch would have to wait until it became more economically attractive and less controversial in the 1920’s.

So parents who believed the hype and feared for their children’s health because of their short stature, tendency to be thin, or lack of ‘rosy’ cheeks – and who could afford to do so – sent their children to nutrition clinics and listened to quack ‘experts’ in the subject. For instance, Dr. William R.P. Emerson who worked solely off the height/weight charts and championed a method called ‘measured feeding’ combined with assuring little girls they would never be beautiful and boys they would never be athletic if they didn’t gain weight. He further recommended automatic removal of tonsils and adenoids, as well as prescribing that ‘underweight’ children attend school only half time and avoid all outside activities… particularly music.

In short, the Great Malnutrition Scare mostly caused a lot of panic and hand-wringing. It caused a lot of frightened parents to try anything they half heard or read to get their children healthy. It encouraged the ‘clean your plate at all costs’ mentality that has screwed up so many relationships with food since. It poured public monies down a rabbit hole with no public payoff in improved nutritional standards, better understanding of the causes, consequences, or cures of malnutrition, or even programs to help feed those at risk. All of those programs came long after the initial panic died down and because of other fears.

Is anyone here seeing some scary parallels?

I know I am.


  1. This was one of the most fascinating bits of history I’ve read in a quite a while. Now I’m wondering if there good online resources for nutritional history? If not: someone please write a book! I’ll buy the hell out of it.

    Comment by Khris — December 2, 2012 @ 2:13 pm

  2. Great post, Twistie. The parallels to what is happening today with the “childhood obesity crisis” and your post are fascinating. I have had friends who have had teachers take away snacks they packed for their children’s lunches because they were “unhealthy.” A local school district put mandatory calorie restrictions on all school lunches, leaving many of the larger althletic kids starving at the end of the day. When will the government learn to stop doing stuff “for my own good?”

    Comment by Nique — December 2, 2012 @ 7:34 pm

  3. I’m trying to envision someone taking food away from my niece at school, Nique. All that comes to me is the headline “Local teacher viciously attacked by 2nd grader.”

    Comment by Gryph — December 2, 2012 @ 7:57 pm

  4. Interesting– I didn’t know much about any of this! I may have to do some digging and find out more.

    Comment by barbara — December 2, 2012 @ 8:25 pm

  5. You know, what I don’t get is that people look back at stories like this and shake their heads at the gullibility and foolishness, but can’t see the equivalent parallels of today.

    Did you know there has been NO increase in net global temperature since 1997 or 1998?

    Have you read about how fat was labelled the “bad” nutrient, while sugar is “non-hazardous”, in the 1970’s (see Gary Taubes), when in fact it may be sugar driving the increase in metabolic syndrome, and not fat?

    Did you know that tax revenues went UP after the 2001-2002 tax rate cuts?

    I don’t believe half of what I read in the newspaper. These crises, they come and go, and I can’t deal with the manufactured drama.

    Comment by marvel — December 3, 2012 @ 11:23 am

  6. I was going to say – the CLOSEST parallel I see is to the “global warming” scare (start with one kernel of partially founded science, magnify enormously with minimal verification and zero robust debate, project absolutely disastrous consequences, ignore contrary data, shout into silence anyone who questions the dominant paradigm, and embrace “solutions” that are likely to be ineffective at solving the defined problem AND infringe massively on people’s well-being).

    But I also see parallels to pretty much every dietary health movement out there today (most of them just operate on a smaller scale). Every eighteen months I am told something different I am eating will kill me, which previously was thought essential to my health. Delightfully, many people I know blame any health problem I have on my selfish, undisciplined failure to remove from my diet a food source that provides me with a substantial portion of my nourishment, but which the pundit of the hour has rigorously removed from HIS diet, thereby endowing him with infinite moral superiority (and, I can’t help but hope, rickets).

    First we hear that we oughtn’t consume dairy (regardless of whether we are personally allergic) because adult humans didn’t “historically” drink cow’s milk. (Was this studied for animals other than cows, or locations outside Europe?) But then we’re supposed to eschew gluten, too (regardless of whether we’re personally allergic), and no mention is made of the fact that this has been a primary food source for humans, historically. Then it turns out that we should have lots of yogurt, but it’s OK that that’s dairy, because it’s “probiotic.” Apparently now we’re into incantations – magic words make our food OK to eat.

    You know what? Pass the baguette and the chevre over here, and enjoy a heaping helping of sanctimoniousness and a side of STFU.

    Comment by the misfit — December 3, 2012 @ 7:07 pm

  7. Here’s the book that tells it all:

    “Revolution at the Table” (The Transformation of the American Diet)
    – Harvey Levenstein

    I’m nearly finished this book and will probably re-read portions of it.

    Comment by annie — December 4, 2012 @ 1:28 pm

  8. @misfit: Do you remember when everyone was supposed to avoid eggs and shrimp because of the cholesterol? And then they figured out that the biochemical test for cholesterol they’d used on shrimp and eggs couldn’t differentiate between various forms of cholesterol, and when they refined the tests, the cholesterol in eggs and shrimp wasn’t the bad kind after all.

    I think it’s the whole apocryphal GKChesterton quote — those who cease to believe in something will then believe in ANYTHING.

    Comment by marvel — December 4, 2012 @ 6:36 pm

  9. Generally, all “discoveries” and “reports” on nutrition and nutritional health have one thing in common: they all drive a campaign to sell specific corporate food products, and force other formerly desirable food products that would be competition to become unprofitable.

    That’s why milk is supposed to be so bad; and butter; and eggs; and red meat; and animal fats; etc. etc. etc. Then the “healthy” products being promoted make us sick, and you can sell a bunch of pharmaceutical treatments (and yes, those companies all own “food” companies as well, and vice versa. Oh, sure, this is a big conspiracy theory, but find out about the “ins” a “food” company like Nestle has with medicine, and how they get to determine that their products restore health outside of as well as inside of all hospitals and treatment facilities the world over. It’s not a conspiracy, it’s just business as usual).

    Anyway, follow the money. Somebody’s making big bucks and getting healthy financially. And it is never you. Don’t think for a minute the childhood obesity brouhaha isn’t going to fill up somebody’s coffers (for a hint, check out which boards of directors Shelley O graced before she became the First Lady).

    Good intentions and roads to hell always come with cash register noises.

    Comment by Aurumgirl — December 5, 2012 @ 9:58 am

  10. This paragraph made me laugh:

    “Remember those height and weight charts I mentioned earlier? Yes, those were hastily compiled using mostly native-born children of Anglo-centric origin attending private schools their parents had to be relatively wealthy to send them to in order to determine the ‘correct’ height and weight of an average healthy child.”

    It’s amazing how many people allow their views to be formed by warped premises.

    Comment by Susan Plus Size — December 6, 2012 @ 5:08 pm

  11. @Susan Plus Size … I have to agree. That paragraph stood out for me too. I also am bothered by ppl judgement. Hoping for change in 2013!

    Comment by Big Girls Rock — December 29, 2012 @ 3:41 am

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