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Scrimshaw et al (1) were the first to describe the paradigm of the interaction of nutrition and infection as an interactive and 2-way phenomenon. It is appropriate that this dean of public health thinking for developing countries provides the Foreword for the recent volume of Nutrition and Health in Developing Countries, the fourth in the Nutrition and Health Series of Humana Press edited by Adrianne Bendich. Scrimshaw et al's notion of nutrition's influencing and being influenced by infection has been deepened and other environmental and social phenomena in developing societies have been added, giving it a third millennium context and dimension.
Twenty-nine authors of distinct national origins—ranging from Australia, Brazil, the United Kingdom, Canada, China, the Netherlands, India, Peru, South Africa, Spain, and the United States—and with extensive experience in clinical, epidemiologic, or policy investigation in developing countries, contributed the 22 chapters of this volume. Eight chapters were written by authors residing in developing countries: 1 from Brazil, 1 from China, 1 from Indonesia, 1 from Nigeria, 2 from Peru, and 2 from South Africa. It is impressive that the editors mobilized such a diverse and distinguished cadre of contributors to write the extensive and abundantly referenced chapters.
Basically, the book covers 3 topic areas: infectious diseases and health conditions, micronutrient deficiencies, and nutrition and development. Ten chapters cover infectious diseases and health conditions: child growth and development, pregnancy and peri-partum health and mortality, low birth weight, diarrheal diseases, respiratory infections, measles, malaria, tuberculosis, HIV, and, surprisingly, obesity. Four chapters discuss specific nutrient deficiencies of public health interest in the tropics (eg, vitamin A, iron, iodine, and zinc), whereas 2 chapters discuss issues related to a combination of multiple micronutrient deficiencies and protein-energy or general malnutrition. The remaining 6 chapters focus on nutrition and development and cover topics of historical perspective, nutrition transition, urbanization, social communication, economics of interventions, and research and policy directions. Impressive is the consistency of the bidirectional and interactive view (1), in which the disease or developmental issue affects nutriture, and nutrition and diet affect health and social and economic development.
Nutrition and Health in Developing Countries has its limitations. The composition and writing is uneven, with some masterful and some pedestrian efforts. The reproduction of some illustrations lacks adequate resolution and clarity. Given the scope of the volume, duplication and redundancy could hardly have been avoided, and it was not. Fortunately, there is general agreement among the different contributors who covered the same topic areas.
This book is truly unique in the literature and I especially recommend savoring the "bookend" chapters: chapter 1 ("Nutrition and Development: A Historical Perspective") by Richard Semba and chapter 22 ("Research and Policy Directions") by David Pelletier. Both chapters reflect an understanding of the intricate and complex multidirectional and multidimensional interactions of nutrition in developing societies and look back and forward along an evolving continuum.
Despite the blending of biological, clinical, and public health issues with demography, sociology, and economics, most readers will find all topics to be accessible and complementary. For some time now, at least for deprived, developing societies, the luxury of segregating basic from applied issues in nutritional biology—and nutrition from the social sciences—has been replaced by a convergence of all of these concerns with one another. In fact, in recent years, advocacy for nutrition and health has emerged under the term "public nutrition" (2–4). I have critiqued and criticized this discipline for the inherent breadth and overextension of fields that would be predicted to produce superficiality and attenuation in their trainees (5). However, this book has such depth and richness across the topic areas that generally comprise public nutrition that I recommend it as the "holy book" for graduate-degree programs in community health, public health, and public nutrition. The book is also of value to research nutritionists whose interest is the macro- or micronutrients cited above, to clinicians and health workers in developing countries, and to professionals in agencies involved with international programmatic and policy endeavors. There is little in the volume, however, for the dietitian or food technologist.
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