ABSTRACT
There has been a remarkable change in the scientic approach to the quality of food and the determinants of the total amount eaten over the past 30 years. Young investigators may not realize when the rst major national reports on obesity were published. In 1976, in the United States1 and United Kingdom,2 the nutritional aspects of health from a global perspective were still dominated by the issue of nutritional inadequacy. The international epidemiological studies of Keys3 and the metabolic feeding studies of Hegsted,4 Keys,5 and Ahrens6 led in 1950s to the concept that an excess
of a specic nutrient, namely saturated fatty acids, could alter a selective aspect of metabolism, in this case blood cholesterol levels, and that changes in circulating and cellular lipids were the underlying causes of the new epidemic of coronary heart disease. This set in train Keys’ campaign to reduce saturated fat intake, which was then taken up by the American Heart Association in the late 1950s7 but was still barely recognized as important by governments. The problem of obesity was usually considered as simply an issue of individual overindulgence in food, and the nutritional community was still focused, even in the United States, on nutritional deprivation. This was emphasized in the third edition of this handbook where there was a clear exposition of the early history of the U.S. government’s recognition of the importance of nutrition in terms of ensuring an adequacy of food for children and vulnerable adults.8 To this day, there are complex legal arrangements for food stamps and special measures for the poor in the United States, which are not yet entirely matched by measures to deal with the current major burdens of disease such as cardiovascular disease and obesity.
