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Books received

Analysis of adverse reactions to monosodium glutamate (MSG). Edited by Daniel J. Raiten, John M. Talbot, and Kenneth D. Fisher. American Institute of Nutrition, Bethesda, Md., USA, 1995. (ISBN 0943029-03-1) 293 pages, paperback. US$65.00 plus shipping and handling.

Monosodium glutamate is extensively used as a food ingredient throughout the world and has even been used as a vehicle for nutrient fortification in Indonesia. Yet it has been linked to the "Chinese restaurant syndrome" that many people claim to experience after consuming food heavily seasoned with MSG. However, this has not been confirmed in double-blind feeding studies. It is appropriate that the Life Sciences Research Office of the US Federation of American Societies for Experimental Biology has carried out a study of reactions to MSG, commissioned by the US Food and Drug Administration.

This book summarizes evidence available from over 200 reports and publications. After analysing the nature and quality of these studies, the study rejected many of the claims based on anecdotal evidence. However, there does appear to be a small subgroup of healthy persons who respond within one hour of exposure. Included are discussions of glutamate chemistry, consumer exposure data, metabolism of glutamate and related compounds, neurophysiology of glutamine, biological effects in animal studies, human studies, and problems with experimental design. The data from individual reports are well summarized and evaluated in a series of tables. This volume meets an important informational need of regulatory agencies in all countries and of nutritionists who must advise on the use of MSG. It is indispensable for evaluating the use of MSG as a vehicle for fortification.


Community-based longitudinal nutrition and health studies: Classical examples from Guatemala, Haiti, and Mexico. Edited by Nevin S. Scrimshaw. International Nutrition Foundation for Developing Countries, Boston, Mass., USA, 1995 (ISBN 0-9635522-60) 178 pages, paperback. US$5.00 plus postage.

There is no substitute for longitudinal community-based studies to identify the multiple causative factors and the functional consequences of disease in a population. Unlike clinical trials, they probe for the host, agent, and environmental factors responsible for disease and suggest health-related behaviour that can reduce or eliminate the disease burden studied. Yet such studies are so difficult and costly to organize and sustain that relatively few are carried out. Moreover, their publication as monographs or multiple articles limits their accessibility to policy makers and to medical and public health professionals. This low-priced paperback describes relatively concisely five classical nutrition-oriented field studies, one in Mexico, three in Guatemala, and one in Haiti. For students they illustrate the steps involved in designing, implementing, and interpreting longitudinal community-based health studies. Health professionals at all levels will benefit from the insights into developing preventive measures and evaluating their effectiveness.


Food habits in later life. A cross cultural study. Mark L. Wahlqvist, Louise Davies, Bridget H.-H. Hsu-Hage, Antigone Kouris-Blazos, Nevin S. Scrimshaw, Bertil Steen, and Wija A. Van Staveren. Jointly published by the United Nations University Press and the Asia Pacific Journal of Clinical Nutrition, 1996. Available on INFODISK CD-ROM from the Asia Pacific Journal of Clinical Nutrition, Department of Medicine, Monash University, Monash Medical Centre, 246 Clayton Rd., Clayton, Victoria, Australia 3168. US$65.00 (in developing countries, US$39.50).

The steady increase in the numbers of older people in all societies, particularly in the less-developed parts of the world, has been variously attributed to clean water supplies. improved sanitation, availability of life-saving drugs, and better food supplies. Very little seems to be known about the effects of the lifetime eating pattern on health in older age. A cross-sectional study of the present generation of older people in a variety of countries with differing food habits offers opportunities to study health and well-being related to both food intake and lifestyle. A WHO workshop in Hyderabad, India, in 1986 included a group of professionals interested in nutrition and the study of ageing. The outcome was the project in this book. Time and much discussion were needed to decide the practicalities of a study to be carried out involving distinctive groups of elderly people speaking various languages and not likely to agree to any invasive procedures. The flood of geriatric texts now available is singularly deficient in reviews of long-term nutrition outcomes. Although diseases due to malnutrition are adequately covered, it is clear that there are many populations with lifestyles, food habits, and food beliefs that vary significantly. The health status of these elderly people now may give some indication for adjustments for future generations. The practical aspects of investigating the lifestyle and dietary history of elderly people depend very much on establishing rapport and require infinite patience. This book is the outcome of studies of the first groups of elderly who were investigated. Further studies will depend on funding by the countries concerned. The influence of nutrition on ageing demands continued investigation along the lines described in this volume. This CD-ROM is the equivalent of more than one thousand printed pages, reporting on major studies of the food habits, health, body composition, and lifestyle of more than two thousand elderly people in 18 countries. The disk contains more than two thousand tables and charts of original data. The volume is divided into six sections, each of which contains chapters written by experts in their fields.


Lost crops of Africa: Volume 1. Grains. National Research Council. National Academy Press, Washington, DC, USA, 1996. (ISBN 0-309-04990-3) 383 pages, paperback. US$24.95 plus shipping and handling.

The purpose of this book is to draw worldwide attention to the potential of traditional African cereals for expanding and diversifying both African and world food supplies. It points out that the more than 2,000 native grains, roots, fruits, and other food plants in Africa that have been feeding people for thousands of years mostly receive no attention at all by agronomists and agricultural researchers. Their contribution and potential is grossly unappreciated and neglected. Colonial authorities, missionaries, traders, and agricultural researchers introduced and supported the cultivation of rice and maize, leaving the native grains as foods for rural and poor populations. This occurred despite the fact that the native grains were often more nutritious and better yielding under African conditions.

For each crop, the prospects, species, genetics, uses, nutritional value, environmental requirements and other agronomic characteristics, crop management, harvesting, handling, processing, and food use are described succinctly. This book also documents and hopes to accelerate changing social attitudes and practices. African sorghums are a booming new food crop in Central America, and pearl millet is seen as a promising new food crop for the United States. Nutritionists see these two crops as the key to solving African nutrition problems. Food technologists and engineers are showing how traditional grains can be processed locally without the time and drudgery of daily grinding in the household. Wheat, rice, and maize have had nearly miraculous advances in productivity and buffered much of humanity from nutritional disasters. However, the book points out that feeding the population of the next century cannot be based on a redoubling of these three grains. The distinguished panel responsible for this book, headed by the Nobel Prize winner Norman Borlaug, and the dozens of contributors worldwide foresee a new green revolution based on the exploitation of the "lost" food crops of Africa and other developing regions.

Copies of this book are available without charge for those in Africa who can document a need for the volume in their work and for classroom use throughout Africa. The next volume in this series on "Cultivated Fruits" will be eagerly awaited.


Mothers, babies and disease in later life. D. J. P. Barker. British Medical Journal Publishing Group, London, 1994. (ISBN 0-7279-0835-9) 180 pages, hardcover.

The book Fetal and infant origins of adult disease was reviewed in the Food and Nutrition Bulletin, Volume 16, Number 3, September 1995. This book by the same author provides further evidence that the nourishment a baby receives from its mother and its exposure to infections determines its susceptibility to disease in later life. It follows that improving the health of girls and young women, and of mothers during pregnancy, will improve the health of their children throughout life. The first nine chapters present evidence on the relationship between early nutrition and a variety of specific diseases. A chapter is devoted to the argument that the poor health of people in lower socio-economic groups is directly related to poor nutrition of mothers and infants. The final two chapters deal with prevention. This volume adds further powerful arguments for the importance of improving nutrition and health status during pregnancy and infancy in all underprivileged populations.


Nutrition action analysis: Going beyond good people and adequate resources. Suttilak Smitasiri. Institute of Nutrition, Mahidol University, Thailand, 1994. (ISBN 974-587-9037) 200 pages, hardback.

This book analyses behavioural change as an outcome of education and communication. It is based on experience convincing communities in rural north-eastern Thailand to produce and consume ivy gourd, a vegetable rich in beta-carotene. This book illustrates the nutrition communication process through a case study in developing, implementing, and planning an intervention to change nutrition-related behaviour. Its value lies also in its critical analysis of all stages and aspects of the process and outcomes. It offers a clear, well-documented methodology to bring about improved nutrition behaviour in other populations as well. The book is well written and makes a valuable contribution to the literature on nutrition education and communication.


The nutrition and health transition of democratic Costa Rica. Edited by Carlos Muņoz and Nevin S. Scrimshaw. International Nutrition Foundation for Developing Countries, Boston, Mass., USA, 1995. (ISBN 0-0635522-4-4) 221 pages, paperback. US$5.00 plus postage.

The remarkable improvement in health and nutrition statistics in Costa Rica from those of a developing country to a rate characteristic of industrialized countries during the single decade of the 1970s is without precedent. In 1970 the infant mortality rate in Costa Rica of 68 per 1,000 did not differ markedly from that of other Central American countries, and as in these countries, less than 10% of the health budget was allocated to preventive health measures. At the end of the decade the infant mortality rate had dropped to ]9.], and health posts emphasizing prevention of communicable disease, mother and child activities, environmental sanitation, and health education covered 84% of the population. Moreover, these changes were accomplished with social harmony by the democratic government of a poor agricultural country that abolished its army in order to devote more adequate resources to the social contract. Today, despite the structural adjustment crisis of the 1980s, its infant mortality rate of 3.7 per 1,000 is among the lowest in the world.

This book, which was written mainly by Costa Rican health officials intimately involved in this health revolution, explores what was accomplished, how it was done, and why it was done. It describes the astonishingly wide range of social initiatives taken by the governments of the 1970s, not only in the health sector but also in the development of primary and secondary education, technical colleges, the national university, and distance learning; cooperatives; consumer protection measures; and major physical infrastructure improvement. It is intended as a reference text for students of public health and social medicine and as a stimulus to persons everywhere responsible for health and policy planning. It is a uniquely authoritative and readable summary of a successful health and demographic transition by a poor developing country in advance of and contributing to its economic development.


Nutrition and national development. An evaluation of nutrition planning in Malawi from 1936 to 1990. Victoria J. Quinn. Kooninkluke Biblitheek, The Hague, Netherlands, 1994. (ISBN 90-5485-334-4) 401 pages, paperback.

This book documents and explores critically the unsuccessful nutrition planning efforts of the small central African country of Malawi from 1936 to 1990. Child nutrition levels did not improve substantially over this period. It stands in marked contrast to the study of the successful nutrition and health transition of the small Central American country of Costa Rica in the same period reviewed above (The nutrition and health transition of democratic Costa Rica, edited by Carlos Muņoz and Nevin S. Scrimshaw). Political will was the major factor in Costa Rica and was lacking in Malawi, but the author identifies other important weaknesses in the Malawi effort, including lack of adequate assessment and analysis of the nutrition situation in the country and inappropriate actions, such as the importation of irrelevant nutrition activities by donors. There was also not sufficient understanding that improvement in nutrition status requires action in a variety of sectors. For example, in the 1980s, when at an international level nutrition was seen as a structural problem related to poverty, the Government of Malawi continued to consider it a technical problem of the health and education sectors.

The author emphasizes that an important lesson from the study is the important role of research and evaluation in providing the empirical basis on which to plan actions and assess past efforts. The situation analysis strategy of UNICEF in the 1980s contributed importantly to introducing assessment and analysis into government policy. Among the recommendations are a long-term planning horizon on the pan of donors and emphasis on advocacy, annual high-level nutrition symposiums to monitor progress, nutrition in national development as a theme in university training in relevant disciplines, and nutrition planning officers in the different ministries.

It is concluded that the horizon for improvement in Malawi "should realistically be framed in terms of decades." This is in such striking contrast to the remarkable health changes in Costa Rica in the decade after the key political decisions were made that it must be viewed not as a statement of the inevitable, but only as a political projection. The Malawi experience is so meticulously and sympathetically documented that the reader has much to learn from the failures, always remembering that with appropriate political decisions the outcome could have been quite different.


Physical status: The use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO technical report series 854. World Health Organization, Geneva, 1995. (ISBN 924120854-6) 452 pages, paperback. SwF 71 (in developing countries, SwF 49.70).

This is the report of a 1993 WHO Expert Committee that was the culmination of two years of preparation involving 100 experts worldwide. Anthropometry is the single most universally applicable, inexpensive, and non-invasive method that is available to assess the size and proportions of the human body and its growth and development, and that reflects overall nutrition and health status. It offers recommendations for the appropriate use and interpretation of anthropometry in individuals and populations in various operational settings and provides reference data for the appropriate use of anthropometric indicators and guidelines on how these reference data should be used. It also identifies a number of unresolved issues that require further research. This report should be available to everyone responsible for nutrition and health surveys in developing countries.

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