The 1999 Jo Rogers Memorial Oration of the Australian Nutrition Foundation

Nutrition Education for a Sustainable Future

Mark L. Wahlqvist

Josephine Frances Rogers (1925-1996)

As the fourth Chair of the Australian Nutrition Foundation, it is a privilege to give the 3^rd annual oration in recognition of the Foundation’s 2^nd Chair, Josephine Frances Rogers, a practising dietitian and outstanding nutrition educator for her entire professional life. She mentored many of today’s Australian nutrition leaders and stimulated intersectoral linkages from which we continue to benefit. Her predecessor, Professor Basil Hetzel, the inaugural Chair of the Australian Nutrition Foundation from, 1979 to 1984 happened to be my Professor of Medicine and an important role model for me in nutrition and public health at Adelaide University.

This tradition of combining approaches to individual nutritional well-being with those for public health nutrition is one well-established in the Australian Nutrition Foundation and one I seek to continue. The challenge presently before us is to ensure, through nutrition education and other means, that there is a sustainable food supply from which we can continue to choose healthfully. I know and am confident that my predecessors and successors in the Australian Nutrition Foundation have had and will share this vision. In this way and so many others, the Australian Nutrition Foundation continues its role as Australia’s peak nutrition education body, now presented as "Nutrition Australia".

Ecosystem Integrity

Few would now doubt that one of the greatest threats to human survival is the increasingly fragile nature of the many ecosystems which humans inhabit. Homo Sapiens sapiens has been remarkable in colonising habitats from temperate climates to desert and tundra, and from coast to mountain. With increasing technological sophistication, beginning with tool-making and fire for warmth and cooking and, now, with the tools of information technology and biotechnology, the perturbation of ecosystems has been relentless and increasingly extensive¹. It has not always been evident how these events would eventually manifest². At the same time, technological sophistication, with good governance may ultimately provide for ecosystem rescue.

When ecosystems are enjoyed, as well as understood, people are more likely to respect and protect them, and, in turn, be personally fulfilled. Edward Wilson (Kellert)³ developed the concept of "biophilia" for "a deep biological need for affiliating with life and nature". In turn, Kellert has propounded nine values of nature that have to do with human development (Table 1). Although in America and it may be surprising to many, the humanistic value is dominant, the values are undergoing a temporal and demographic shift, with a decline in the utilitarian and a rise in the ecologistic-scientific values. This may provide some optimism for an arrest in the decline in biodiversity, although population pressures for a while and political factors may supervene. But it may represent a return to traditional ecological knowledge and wisdom⁴.

Table 1. Values of nature related to human development

It is being appreciated slowly that food, and the environment form which it comes contributes to health through its appearance, especially colour, its aroma and its texture. In this sense the eco-system is an extension of our own biology. Phyto-hormones, like phytoestrogens, alongside endogenous hormones are a good example of this^5.

The link between physical activity, food, the environment and health is underscored by how different it is to walk in the bush, woods or forest, compared with working out on a treadmill between 4 walls. Our eco-health and eco-nutrition awareness and commitment requires a new generation of eco-science, eco-economics and eco-policy.

Perhaps at once an encouraging and a disturbing trend is that 77% of all Australian children aged 7 to 13 (interviewed in the Roy Morgan kids survey of September 1998) thought "that products which are bad for the environment should be banned", but only 57% of these that watched the TV programme South Park ("where the cool kids hang out") thought the same way. Thus a powerful trend towards eco-consciousness among the young may yet be countered (or encouraged) by certain media activities.

Ecosystems and Health

The principal feature of an ecosystem which contributes to health is its biodiversity. This is for several reasons^1,6.

1. A varied food supply is essential to maintain the health of the omnivorous human species.
2. A range of diverse food sources is necessary to safe-guard against climatic and pestilent disasters which may affect one or more of the food sources.
3. A diversity of plants and animals may provide a rich source of medicinal material, essential for the extraction of undiscovered therapeutic compounds.
4. Intact ecosystems of indigenous plants and animals appear to act as a buffer to the spread of invasive plants and animals, and of pathogens and toxins, thus contributing to the health of populations nearby.
5. The ‘spiritual’ values of exploring the diversity of plants, animals and ecosystems in an area appear to have a beneficial effect on mental health, strengthening the feeling of ‘belonging to the landscape’.

Biodiversity allows food variety which is the most internationally agreed dietary guideline apart from the promotion of breast feeding. At the beginning of extra-uterine existence we can depend on one food alone, from one’s mother, ideally eating a variety of foods herself, and, thereafter, we explore a widening array of foods, if they are available, and achieve food variety.

Simple ways of expressing food variety mathematically (number of biologically distinct foods eaten over a nominated time frame) are now current^7-12. Greater food variety in the human diet predicts survivorship and reduced morbidity, across ethnic groups^13,14. More socially active people are more likely to achieve food variety¹⁵.

The combination of social activity, physical activity and food variety is the most likely lifestyle profile to optimise health, reflected in longevity and healthy ageing¹⁶. It is an approach which is also likely to reduce substance abuse. But it is predicated on biodiversity for food variety and environments in which it is a pleasure to be active, socially and physical.

A Sustainable Food Supply

Food security remains one of the most important global nutrition challenges. It is not only predicated on pestilence, famine and conflict, but on agricultural practice, post-harvest management, trade, food processing, retailing, demographic change with massive migration and ageing populations, human behaviours and food choice. It is expected that population growth will place strain on the world food supply until at least 2050 AD. The challenge is to steer a course, in the next 50 years, of environmental sustainability and optimal health.

Virtually every food commodity, cereals, fruit, vegetables, legumes (notably soy), meat, fish and other seafood, milk and dairy products, herbs and spices will need careful management.

Water may be the most limiting factor of all in sustainability, with whole waterways undergoing degradation. Bottled water is now more expensive than gasoline! Water availability and safety is a measure of environmental integrity and of sustainability of the food supply.

New Directions in Nutrition Education

The tasks for nutrition education in the past have been principally:

• To make the best of the available food supply
• To ensure adequate energy intake (food groups with an emphasis on staples)
• To avoid deficiencies of essential nutrients (RDAs)
• To minimise the development of so-called chronic non-communicable diseases (dietary guidelines)

This education has usually been surrounded by a nutrition policy which encourages agricultural production and food processing to generate safe and nutritious food¹⁷.

In future, the sustainability of the food supply will be a feature of nutrition education. Eco-labelling of food stuffs is a part of this process, particularly evident in Europe¹⁸. When consumers peak of quality food, they are thinking not only of its immediate nutritional value, but also of its palatability and the cuisine it represents, and of the ecological circumstances in which it has been produced. Information systems will progressively have these considerations into account by way of certification at the point of purchase, and away from the product, with planned purchased.

The advent of FBDGs (Food Based Dietary Guidelines), promoted by the WHO (World Health Organisation) and FAO (Food and Agriculture Organization) recognize traditional cuisine and constraints on food choice, as well as the opportunity to evolve cuisine in relation to emerging nutrition science¹⁹.

The development of novel food to address convenience, fashion and health will also create greater demands on nutritional literacy.

Above all, nutrition education will need to encourage a sense of the limits of evidence alongside the value of scientific evidence, an analytic and discriminating capacity in relation to food choice, drawing on risk analysis, and, finally, a preparedness to live with uncertainty whilst engaging in advocacy.

"Nutrition Australia" for a global future

The Australian Nutrition Foundation has decided to represent itself as "Nutrition Australia", to state more clearly its mission and purpose as the peak community nutrition education body in Australia. This will be evident in its programmes in schools, with families and communities, in relation to maternal and child health, adolescent health, and aged care; and through initiatives with government, the corporate sector and other non-government organizations. Since its information technology strategy (formerly www. monash.edu.au/ANF; and now www.NutritionAustralia.org) and linkages to similar organizations abroad give it an internationalist outlook, Nutrition Australia should also contribute globally to the future of nutrition education.

References

1. McMichael AJ. Planetary overload. Cambridge: Cambridge University Press, 1993.
2. Wahlqvist ML. Critical Nutrition Events in Human History. Asia Pacific Journal of Clinical Nutrition, 1(2): 101-105, 1992.
3. Kellert SR. The value of life. Washington DC: Island Press, 1996.
4. Williams NM, Baines G, eds. Traditional ecological knowledge: Wisdom for sustainable development. Canberra: Australian National University, CRES, 1993.
5. Wilcox G, Wahlqvist ML, Burger HG & Medley G. Oestrogenic effects of plant-derived foods in postmenopausal women. British Medical Journal 1990; 301: 905-906.
6. Wahlqvist ML & Specht RL. Food variety and biodiversity: Econutrition. Asia Pacific Journal of Clinical Nutrition 1998; 7(3/4):314-319.
7. Hodgson JM, Hsu-Hage BH-H & Wahlqvist ML. Food variety as a quantitative descriptor of food intake. Ecology of food and nutrition 1994; 32:137-148.
8. Hodgson JM, Hage B, Wahlqvist ML, Kouris-Blazos A., Lo CS. Development of two food variety scores as measures for the prediction of health outcomes. Proc Nut Soc Aust., 16:62-65, l991.
9. Kant AK, Schatzkin A, Harris TB, Ziegler RG and Block G. Dietary diversity and subsequent mortality in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Am J Clin Nutr 1993; 57:434-440.
10. Kant AK, Schatzkin A, Ziegler RG. Dietary diversity and subsequent cause-specific mortality in the NHANES I epidemiologic follow-up study. J Am Coll Nutr 1995; 14:233-238.
11. Savige GS, Hsu-Hage B & Wahlqvist ML. Food variety as nutritional therapy. Current Therapeutics March 1997; 57-67.
12. Wahlqvist ML, Lo CS, Myers KA. Food variety is associated with less macrovascular disease in those with Type II diabetes and their healthy controls. J Am Coll Nutr 1989; 8:515-523.
13. Hsu-Hage B & Wahlqvist ML. Food variety of adult Melbourne Chinese: A case study of a population in transition. IN: Dietary patterns of selected countries, tea and coffee: Metabolic consequences. World Review of Nutrition and Dietetics, Basel, Karger, 1996, vol 79, 53-69.
14. Wahlqvist ML, Kouris-Blazos A & Wattanapenpaiboon N. The significance of eating patterns: A elderly Greek case study. Appetite. (in press)
15. Horwath CC. A random population study of the dietary habits of elderly people. PhD thesis. Department of Community Medicine, Adelaide, 1987.
16. Wahlqvist. Health Ageing: A nutritional perspective. Pp-138-143. Proceedings of the Vietnam-Australia Conference on Health Promotion. Hanoi, 18-20 February 1998.
17. Tansey G, Worsley T. The Food System. London: Earthscan Publications Ltd., 1995.
18. European Community. Products that speak for themselves sell well. Euro RSCG Vitesse.
19. World Health Organization (Member: ML Wahlqvist). Preparation and use of food-based dietary guidelines. Report of a Joint FAO/WHO Consultation (1995: Nicosia, Cyprus). World Health Organization, Geneva 1998.

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