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RESEARCH IN THE FIELD OF FOOD HABITS * MAY 23-24, I 94 I Reports on significant developments in food habits throughout the country with special emphasis on the South and Southeast. Dr. I. H. Moore (Director Child Health Demonstration, Sparta, Gag.: I am Health Officer Hancock County: strictly rural county; population ~2,764 (~o,ooo Negro); ~570 employed in lumber industry; solo live in Sparta; remainder farmers-75% tenants with about 3570 on share crop basis. Child Health Demonstration begun July ~g36. To improve economic, social, and health standards, worked out ~ ~ plans and objectives, 2) minimum ~en 1 ~ ' ~ Cat . ~ ~ ~- ~ ~ ~ or ~ . eral pUbllC health program, 3) special emphasis on cn1lo Health and applied nutrition. Typical meals of tenant farmers: breakfast corn pone, fried pork, syrup on biscuits, flour gravy; dinned fried dinner same as breakfast; boiled dinner, one vegetable long cooked with fatback, corn bread, syrup; supper leftovers from dinner. Few fruits; poor milk, if any. Post partum diet of mother rice, grits, light bread and butter, coffee. Vegetables, fresh meat, eggs, fish, and milk were thought dangerous. Geophagy widespread. Cash income $~5o.oo, kind $350.oo per annum. Objectives of program: to teach funda- mentals of good nutritional practices within economic paeans. Techniques: garden project under care of expert gardener for ~6 families; canning ser- vice; cooking and menu planning service; nutrition education-moving pic- tures, posters, newspaper articles, form letters, public talks and lectures, nutri- tion literature, personal conferences, nutrition classes held in prenatal and well-baby clinics; school lunch project expected to expand so every school in county will serve adequate lunch for nominal cost, produce or work, school garden. Cooperating Agencies: U. S. Children's Bureau, University System of Georgia, Agricultural Extension Service; county agents, Home Demonstra- tion agents, Vocational Agriculture teachers; Georgia Experiment Station; WPA and NYA. Results: i) Significant health improvement, especially of infants and school children. ~) Food habits definitely in~pr~ved prenatal diets show distinct improvement in use of milk, eggs, and vegetables but not in kind or amount of neat from ~936-4~. During ~942-43 fatback meat food habit easily changed by food demonstrations in meat cookery. 3) Program based upon 7 years experience which should produce rapid and significant improvement in nutri- tional status of rural communities outlined. Conclusions: ~) There is great and urgent need for widespread use of similar programs in the rural Southeast. 2) The success of such programs depends fundamentally upon the effectiveness of educational techniques used * See minutes of the conference of Committee on Food Habits, May 23-24, Ago, under sane title. 127

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I28 The Problem of Changing Food Habits to convey scientific knowledge to average citizen. 3) Rapidity of i1nprove- ment in nutritional status of rural population group is largely dependent upon coordination of effort and unity of purpose of local personnel of all community betterment agencies. Dr. Harold F. Clark (Teacher's College, Columbia University): An Ex- periment in Applied Economics; financed by Sloan Foundation. One ex- periment in Southern Appalachian Mountains. Measure food available, teach community how to improve conditions, measure again. Attempt to dis- cover whether education without economic change can change diet. Worked through schools. Found farmers in bottom third of group could not read ex- periment station bulletins. Adapted material for use in second grade of school. Problem of food storage of vast importance. Dr. Muriel W. Brown (United States Office of Education): Experiment in Obion County, Tenn. Population about 30,ooo (io,ooo in county seat); wide variety in living conditions. People on committees felt need for nutri- tion education, but people themselves did not know they had problems. De- cided to slant education so people would find out for themselves. Worked through schools, interested agencies, and lay committees working in each small population center. Plan: reach families through conferences in schools and nutritional clinics in each center; follow up in community through clinic; integrated program of nutritional education, all through schools. Teachers visited homes informally to get cooperation; children brought parents to clinics; older children helped in clinics. Teachers discovered own need for nutrition education; need for clinics felt in communities. Council of county agencies formed to coordinate services to needy families Red Cross in charge of emergency programs. Garden project, hot lunch program, increased use of whole grain cereals, summer study project for teachers, youth council (high school students) write history and keep records. Tried not to let teachers diagnose children. Malnutrition not found definitely related to eco- nomic status. Lack of mobility made check of foods relatively easy in com- munity; used local people to check amount of food in houses from time to time. Dr. Clark: Important changes are in process. Storage and preservation definitely improved. Expected changes to be much slower than they are. Why so rapid ? Dr. Ruth Benedict: Prestige groups could be used to erect changes. Dr. Clark: We are looking for a technique that will work anywhere rather than trying to improve community. Have stayed away frotn minority groups because of difficulty of transfer. Changes can be nude in almost any economic situation; if you can teach children, they will teach parents. New books pre- pared were taken out of schools and read in hones though previously text- books never were taken out. Dr. T. J. Woofter: Obion County preparation of food in schools-crucial point to transfer between generations. New diet must be liked, to stick. Dr. Moore: Do not yet have techniques for measuring spread from prestige groups. Dr. Clark: Almost universally, bottom third not touched by county agents. Dr. Charles Johnson: Shows need for change of method. Know people can

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Research in Food Habits ~29 not change even when they have information due to prestige value of certain foods, also health beliefs. Dr. Rensis Likert: There is need for more data on values placed on foods within the community. Must also get data on knowledge and attitudes to see what causes changes. Dr. Johnson: Might get better results with trained Negro investigators. Standard English textbooks may be too difficult for lower third; better write idiomatically. Hot lunch program another way of reaching group. Dr. Brown: Especially when the program is a cooperative one parents and children. Dr. Russell Wilder: Some difficulties may be due to diet deficiencies. Dr. Dorothy Dickins: Necessary to teach people that new ways are not temporary, but here to stay. Must look for reasons for geophagy, etc.-meet biological needs. Dr. Likert: Since we cannot teach perfect diet' what is first step that should be taken? Need to know ways in which patterns can be corrected within economic limits. Dr. Wilder: Main problem is knowing what are minimum standards of food and nutrition; coupled with that, the level to which that standard is now set. Possible danger in setting standard higher than people can reach. Dr. Hazel K. Stiebeling: Have set up three satisfactory but less than ideal diets, one emergency diet. One-fourth of people in United States could not afford even cheaper forms of adequate diet. Standards excellent, but practically unattainable for most of lower third. Dr. Wilder: Best we can offer is a kind of yardstick by which diet can be measured-get as near to as possible. Harder to determine minimums than satisfactory diet. People in France manage to stay more or less alive depend- ing on what is meant by alive. Should not set up standard as something every- one must achieve but rather as something to work toward. Therefore should put the goal as high as we can and explain meaning. Dr. H. D. Kr?tse (Milbank Memorial Fund): Exact number of people malnourished not known. Past methods for detection discredited and aban- doned. Evidence shows that much unsatisfactory nutrition in population is in latent or subclinical state. Some new methods for detection evolved. United States Public Health Service, Department of Preventive Medicine and Pedi- atrics of Cornell University Medical College, New York City Department of Health, and Milbank Memorial :Fund joined in setting up a project to apply and evaluate a series of these methods Worked with 2~50 boys and girls in public high schools, 350 pupils in private high school, i30 WPA people. Can now report (after 21 years) on prevalence of three deficiencies iron, ascor- bic acid, and riboflavin. Of high income group, Ho had low hemoglobin values, 67ot had low plasma ascorbic acid levels, 2~ showed definite signs of ariboflavinosis. Of low income group, 4% had low hemoglobin values, 47~ had unsatisfactory plasma ascorbic acid concentrations, 75%0 (of 5~2) showed signs of ariboflavinosis. Among WPA personnel, i3~ had low hemoglobin values, to had low plasma ascorbic acid levels, 35%0 showed ocular manifestations of ariboflavinosis less prevalent but more severe than

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30 The Problem of Changing Food Habits among low income group children. Indicates statements based on dietary surveys have not overstated actual nutritional conditions. Tests ought to be used more widely- only way to assess malnutrition problem and make plans for correction. Difficult to recognize deficiencies in people without examinations. Gave WPA people therapeutic treatment. Later gave dietary advice. But generally desirable to improve diet as soon as possible. Dr. Moore: Must find malnourished; but also must make population really want proper diet. Dr. Benedict: Important question is hold not ~why. Must find out how one thing is correlated to other factors and how changes can be made. Dr. ~ilhjalv%ur Stefansson: Grew up on frontier, lived partly by hunting. On exploration trips often lived exclusively on animal tissue several months at a time, the various periods adding up to about five years. Dieticians were sceptical and expected bad results if reports were true. Examinations by a number of doctors (results published in J. Amer. Med. Assoc.) showed none of expected bad results. American Meat Institute wished to reprint articles; permission refused. Suggested that instead an experiment be carried out for one year at Russell Sage Institute. Together with colleague agreed to live for year, It328-29, on an exclusively carnivorous diet. During first sev- eral weeks all meat weighed in advance; thereafter ate as pleased. During first months meat fried, roasted, or boiled; thereafter usually boiled, medium, or well done. During experiment never ate whole animal and always had meat cooked, not raw. Results have been published by Dr. Eugene F. Du Bois and other supervising scientists in various technical journals; popular account by Stefansson in Harper's Magazine. Ten years later persuaded American Meat Institute to found three dietetic fellowships, one for study of anthropoid diet by Lasker under Hooton at Harvard, two for studies of hunting peoples at Columbia by JofFe and Posnanski under Benedict, Linton, and Strong. Research being continued in own library. Dr. Benedict: Fellowships were surveys of literature. Many problems arising must be studied in field. Problem of clay eating. Some tribes always eat. Some say prelude to insanity and it is; some say will kill pregnant women and they die at childbirth. Question whether a matter of mental states or chemical effect. Mr. Meredith C. Tl~i15071 (Extension Service, Dept. of Agriculture): Function of extension education to teach those who have desire for informa- tion and to create desire for information on part of those who do not have it. Too often neglect second part. Possible to influence 96-97% of farmers; usu- ally touch about 7570. Two studies bearing on food habits; measurement of growth in knowledge resulting from 4-5 months' participation in 4-H Club work-showed where changes needed; survey of home food production and consumption habits of farm families in two Ohio counties sample areas represented good and bad land; about ~ tenant families with cash expenditure per year under $400. Study showed 4670 adults, 6~% children consumed 3 or more cups milk daily; 8%o adults, 2~ children no milk; practically all families used butter; 4~7o adults, 43~o children ate raw fruit or vitamin rich food 5-7 days a week; additional 4070 adults, 34~ children ate same 3-4 days .

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Research in Food Habits Hi week; 34/ adults, 3770 children ate one green or yellow vegetable daily; 5~7o adults, 53~ children ate one or more servings whole grain or lightly milled cereal or bread, or bread made from enriched flour daily; g7~0 families canned home produced fruit and/or vegetables average ~ 76 quarts per family. Green, leafy or yellow vegetables grown by 98/ families. (Three- fourths of the families reported that all family members disliked an average of four different kinds of green, leafy, arid yellow vegetables. In ~5 to 40~ of the homes, all members of the family disliked turnip greens, mustard greens, kale, Swiss chard, asparagus, spinach, and broccoli. In lo to ~5~ of the families, all members disliked winter squash, wild greens, peppers, and carrots. ~ Miss Gladys Gallup (Extension Service): Significant part of study was actually getting into hones. But need to perfect ways of evaluating success of projects and teaching methods. Mr. Wilson: Portion of funds for e~nerimental nrniect ought to he ear- marked for use in evaluation. ~ r--J--- _~O Dr. Ethel Waring (Cornell University): Can new food habits be learned? Can old food habits be changed? Yes, at pre-school age under guidance of parents as well as of specialists. Based on studies New York State College of Home Economics, Cornell U. Studies of the learning of ~o best and lo poor- est eaters, judged by measures taken first month in nursery school for 66 children (Genetic Psych. Monogr.~. Intensive individual studies by means of motion picture film and stenographic record; analyzed established techniques of observing, recording, analyzing. Basis for investigating was question: What does the adult do to get the child to take over for himself the new goals the adult has for him? Adult practices classified according to outcome; gen- eralizations made in form of working principles-stated in terms meaningful to parents. Three adult relationships of adult to child in changing food habits possible: neutral, opposed, cooperative (see Cornell U. Bull. 420, Working Principles in Child Guidance). One film demonstrates how mother can change guidance by getting cooperative relation. Question: Do same relationships prevail among adults, so home visiting teacher or worker can get family or family November to take over new goals ? Study made in rural community with special emphasis on techniques whereby rapport was developed which estab- lished cooperative relationship (submitted for bulletin, E. l. Freeman: Family Education through House Visiting). (Orwell studies show new food habits can be learned and old ones changed with minimum of strain and evidence of pleasure in acquired [earnings. Depends on skillful Guidance based on general principles, not on specific practices. O ~ Mr. Ernest E. Maes (Office of Indian Affairs, Dept. of Interior): Inter- American Indian Institute organized as result of first Inter-American Con- ference on Indian Life. Dr. M. L. Wilson member of policy-making com- mittee for part of project. One field representative to go to Central America, another to South America. I am going to South America to see what is being done for Indian populations. Diet information part of survey. Expect to find people interested in improvement of health habits of Indian population, who 9

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I32 The Problems of Changing Food Habits will want to know what is being done here. Would like suggestions for making surveys of food habits in each country. Dr. Benedict: Tied up with land problems whether Indians have retained land or not. Detailed studies of food intake depend upon knowledge of how much land is available. Great contrast in this item; difficult to get any idea. Can tell whether people eat enough, but not what governments can do, with- out detailed study of land ownership and availability. Miss Genoeffa Nizzardi~:i (Formerly, Advisory Commission to the Council on National Defense): ~930 Census showed United States population ~22,775,o46, of which 4,54~6,877 (3.76370) Italian stock ~,790,425 (3770) born in Italy, 2,756,453 (6370 ) native born American with one or both parents Italian born. Live in every state including District of Columbia, per- centage of Italian stock to total state population varies from less than .570, .~43~ in Oklahoma, to To in Connecticut. Six eastern states (New York, New Jersey, Pennsylvania, Rhode Island, Connecticut, Massachusetts) have 72.g~o of entire Italian stock. In 92 cities Italian population 5,ooo or more; percentage of Italians to total population of cities varies from ~.o3 5 (Seattle, Wash.) to 5g.77to (Loci, N. J.), 40.870 (Milford, Pa.), 33.8~ (Port Chester, N. Y.~. Three cities with largest number Italians are: New York City (~,o70,355), Philadelphia (~82,368) and Chicago (~8~,86~. Diet one phase of Italian culture which has yielded least to outside pressure. "Little Italys" support own green grocers, bakeries (decade ago served pri- marily as community ovens), latticini (soft cheeses and handmade macaroni), Italian-American grocery stores (do not patronize chain stores), pizzerias. Because so many items of diet supplied within group, diet plays important role in contacts with outside groups: hospitals, convalescent care, fresh air care for children, school lunch program, "Y" suppers, CCC boys, Army diet. Diet has definite characteristics. Need to know how people combine foods, what characteristic tastes are preferred in order to suggest modifications. No existing study of Italian diet. Families receiving aid not in position to ex- plain preferences. No Italian background nutritionists. Position of Italians as minority group has made them protective about customs and habits. Need analysis of the diet pattern in operation in the kitchens of millions of Ameri- can housewives of Italian descent. What forces have played on group, caus- ing what changes ? Are changes consistent with dietary standards we want to achieve ? Study of second generation girl would give information on childhood and neighbors, on swapping of recipes from different sections of Italy. Girl should be elementary school graduate because then would have had lessons in American cooking. Study would give picture of kind and extent of changes. Directions of changes could be evaluated in light of present-day dietetic standards. Could work out acceptable methods for bringing diet habits closer to accepted dietetic practice. Preserve good features and blend in additions. Would give local groups all over country working with Italians essential information. Preliminary study suggests need for study of cooking methods- capitalize on preferences. Definition of portions in Italian anneals portions ~.^ .

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Research in Food Habits ~33 are actually courses. Development of vocabulary regarding dietary and re- lated areas English names of foods, cooking terms, table service, etc. Should evaluate changes beginning to operate and then hasten some and stop others, such as reluctance to admit using "peasant" dishes, substitution of soft bread for hard, crusty bread, adoption of sweet desserts, adoption of blanched celery, etc. Dr. M. L. Wilson: (Extension Service, United States Dept. of Agricul- ture): Object to get reports of research and work having to do with food habits. Research falls into two categories: ~) biological and physiochemical and ~) psychological and cultural. Must find how much failure of people to meet standards due to economic causes, how much due to culture and habit patterns. Calls for closer cooperation of sciences. Social sciences must try to catch up to biological sciences. Dr. Richard Osborn Cummings (Formerly, Division of Statistical and Historical Research. Bureau of Agricultural Economics. United States Dent. O ~ ~ A 1. ~ TO- . 11 1 1 , 1 . . , 1 ~ 1 OI f~grlcullure): ~lstorlcallv mucn evidence lo substantiate chances in IOO(] , ~ habits. Studies show loss of appreciation of certain foods (acorns in Europe) and survival of prejudices regarding others (fresh fruits and vegetables as- sociated with fevers, malaria, etc.~. Why-how losses in appreciation of diets tal;e place are fundamental considerations in discussion of social aspects of nutrition. Must take into consideration variety of individual, en- vironmental, and social factors. Must consider heredity, differences and changes of taste with age, natural environment. For example, differences of soil and correlations with nutritional deficiencies thyroid deficiencies and use of iodized salt in Michigan. Changes in ways of living occasioned by re- forms and technology important lath century interest in rickets in Eng- land may be identified with enclosure movement. Miserable living condi- tions due to industrial revolution-see Charles Dickens' works. Effect of modern methods of food processing. Must study diets at different economic levels. Liar may effect changes in any one or all levels England at present time. But must take into account existing prejudices (Englishman's dislike of goat neat, horse meat, etch. Must also consider racial, religious, and moral prejudices (game birds and work of Audubon Society). Must consider factor of education are concerned not only with what child eats, but how he eats it. Pleasure. Children in cafeterias in Hawaii. Pleasure used in advertising ~ Castoria, "Force" campaign) . Importance of psychological factors and symbols attached to food should be investigated further association of blood with tomatoes made boy in Polish village like them, orthodox Jews dislike them; association of color of bread with social status-one reason for eating white breads. Earliest American survey of food habits recorded was state survey made in 870's concentrating primarily on rural population. First really scientific surveys made by Atwater in Massachusetts in late i880's. Came to Washington to work with Bureau of Labor. Earliest surveys with aid of agricultural stations started in Who's; available in experiment station reports. Whole series made in different parts of country; diets of Negroes, lumbermen, college men, etc., separately treated.

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I34 The Problems of Changing Food Habits Dr. Douglas Oliver (Formerly, Prooklyn College, Brooklyn, N. Y.*: Will make a community study of a small Iowa town to learn something about agricultural economics. Led to undertake study because of experience of previous field study of the Sinai culture and neighboring cultures in southern Bougainville. Began with study of totemism, clan history, etc., but found little local interest in these. Study of leadership showed that leader was a successful social climber who gained political status through prestige won bit control of food resources. }based on accumulation and distribution of large quantities of vegetables and pigs. Man who gave largest feast won most prestige. Leadership had nothing to do with inherited status; was matter of controlling production, exchange, and consumption of food. Led to study of techniques of production arid effect of exchange upon social interactions. Comparative data from closely related neighboring culture showed far-reach- ing effects of slight changes in food habits. In neighboring culture no in- terest in pig raising; main crop tare which cannot be conspicuously con- sumed at lavish feasts. Here descent matrilineal, residence matrilocal no emphasis upon social climbing and leadership. Whereas in Sinai pork was important food, pig raising a vital enterprise. Pigs, in hands of men traders, formed capital goods used to accumulate wealth and prestige. From this developed male-dominated political institutions; residence became patrilocal change over from matrilineal to patrilineal descent in progress. All made possible by different food habits. Study of land tenure also led back to con- sideration of food habits; land tenure principles derived from patterns of utilization and farming techniques-ultimately depended upon diet standards. When writing up data looked for usefully comparative material works of Richards, Malinowski, Birth, and Forde helpful but not detailed enough. Turned to agricultural economics found raw material but not in sociological framework. Came across some points suggestive of institutions found in Melanesian communities and so decided to undertake study of an American rural community. Got financial support of Social Science Research Council and in September will begin study. Chose Iowa because more chance of finding a community not a cultural island and not complicated by racial antagonisms and extreme poverty. Some basic problems are ~) what effect type of production has upon interaction of people, and how that results in social stratification and leadership; s) how men climb the agricultural ladder and become leaders; 3) what effects the production techniques have upon land utilization and tenure. Later hope to reconstruct local history, see effect of introduction of new techniques of food production on social stratification leadership, and land tenure. Intend to keep food habits central to investiga- tion. Hope to explore possibilities of working with agricultural administra- tors find out what they know and want to know, how to present results to them. Will work parallel with officials rather than convergently. Bureau of Agricultural Economics has prepared maps of rural cultural areas based on data such as "plane of living," "land use," etc. A food habits map, based on above type of research, might be useful to historian and administrator. *There was no opportunity for Dr. Oliver to review the summary of his remarks at the time of publication of this current report.

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Research in Food Habits ~35 Dr. Herbert Passin ~ Formerly, University of Chicago, Chicago, Ill. ): Based on a study already carried out in L7nionville, Illinois, hope to provide a detailed cultural picture of dietary habits there to be w orked out with special reference to established cultural divisions within the area Unionville, "the hills," the Negro bottoms, the "river-rat" communities and neighboring small towns. Unionville is cross-roads town of about 300 persons in Massac County, Ill.; has a school, three general stores and halfway between town and "the hills" two churches with associated cemeteries. Dominant topographical feature is Ohio River 2 miles to south; floods its valley every spring, destroy- ing crops, homes, barns. Flood plain alluvial bottom land very fertile and is the chief locus of agricultural activities of the people. Once heavily timbered; still is to some extent a factor in migration of large number of southern Negroes to area. Only small number of families, who have pre-empted mounds and ridges, live in bottom lands; most live on uplands and come down to work fields. "River-rats" transient population of fishermen live on banks of river or in houseboats; sometimes work as hired held during . . . . . . . . . .. ... .. ~ . harvest but have no regular social relations with natives. To east on section road is New Liberty, town similar to Unionville. Hamletsburg, older but similar, lies to north and east. North of Unionville lie "the hills" which con- stitute both physical and social boundary. Scotch-Irish element there re- placed by German element. Contrast with Unionville and other whiskey towns because of differential rate and character of acculturation. In Union- ville two-thirds of families have lost land and depend upon sharecropping, day labor and WPA; in hills two-thirds remain small independent farm owners. In Unionville civilization accelerated by whiskey making; "the hills," opposing whiskey, have slower, more resistant type of contact. Hill people generally more conservative; consider Unionville lower class, slightly un- couth, and disapprove of ways of town youth. To east and west lie Negro settlements-Black Bottoms and Shady Grove. Greatest migration came after Civil War. Were farmers and timber workers. Sharp racial lines maintained. For majority, standards of living of Whites and Negroes are approximately the same. Negroes also depend on WPA, relief, sharecropping, and day labor. Now propose to make study of diet habits of area establishing gen- eral character of diet, daily consumption,'recipes, materials (to be turned over to Department of Agriculture for analysis). Will consider buying habits, attitudes toward "store foods," trading practices, availability of resources. ~. ~ . . . .. . . . , . ~ ~ . . . ownership, production, cash income, use to which domestic animals are put. Subiect of drinking as important for area as clav-~atin~ .~nrrilv ~n`1 , abundance (except as altered by WPA), hunting and gathering of wild foods, age and sex differences in food habits all important aspects. Broad statistical mean of food habits fails within any given area because of cultural divisions. Will try to separate out the differential cultural elements that are ~,jO _ _ ,, _ ~ usually merged In a statistical average ot dietary habits-will be advance to- ward a more significant and richly suggestive type of study. Dr. Ruth Tolman (Formerly, Bureau of Agricultural Economics, United States Dept. of Agriculture): Interviews on food habits in 5 urban communi- ties; 440 individuals interviewed on nutritional knowledge and food practices

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36 The Problem of Changing Food acme informal interviews used. ~) Quality of diet very crudely evaluated; used terms "high point" (~.67o), "intermediate" (5~.~9fo), and "low point" (27.370) (384 responding, rather than Dr. Stiebeling's "good," "fair," and "bad." Only rough approximation because quantities were disregarded and data often inadequate. ~) Reasons given for diet choices. Question of "why" people choose particular foods not a profitable one; replies often rationaliza- tions. Significant that people do not know Ally they eat as they do. Reason- able to conclude that cultural and unconscious factors enter more into food choices than conscious ones. 3) If you had a little more Morley each week would you spend it on food ~ Replies th question significant because of number of people (67.970) who said would spend extra money on things other than food-in particular on clothes. Tables 4 (Which foods do you think people are not getting enough of 7), 6 (Does anything happen to people who don't get enough vitaw~insi), 8 (What foods are richest in vitamins we need)), IO (Character of nutrition information indicated by responses to three above questions), and ~z (Factors considered important in choosing knees) show that quantity and amount of information revealed is actually very good. Only about 12~ of responses conspicuously stupid or fantastic. Suggests dis- crepancy between information and practice. Both general and specific knowledge of what happens to people who do not get enough vitamins is fairly good. Courses in school or college, then personal contacts given as chief sources of information in regard to vitamins. Health and "doctor's orders" main reasons given for changes in food habits. Later tables concerned with views of the government's efforts and responsibility in regard to providing an adequate diet for those in need; 6870 (of 440) believe in giving help of this kind. Breakdowns and cross-tabulations not complete. Table 24 (quality of diet in relation to age) shows more high-point diets for people under 30 years. Little difference in quality of diet in relation to sex. Table 27 shows more low-point diets at lower income levels. Differences corresponding to educational level are marked. Dr. Stiebeling: Table 4, order of importance of food needs, suggests people will not get very far without further information and a change of attitude. Both education and quality of diet in part a function of income. Taking upper and lower groups spending same money for food, advantage of upper side will not be so striking as table suggests. Dr. Cu~r~in~s: What would be differences in this kind of survey between large and small cities? Much more publicity in large cities. Dr. Esther F. Phipard (Bureau of Human Nutrition and Home Economics, United States Dept. of Agriculture) on a report prepared together with Dr. Hazil K. Stiebelir~g, also of the Bureau of Human Nutrition and Home Economics, on the magnitude of poor-diet groups: Report based on 2 large- scale dietary studies made by Bureau of Home Economics * in cooperation with other Federal agencies. i) Study of diets of employed wage earners and clerical workers living in cities in 8 major geographical regions (data col- lected as part of an investigation made by Bureau of Labor Statistics to re *The Bureau of Home Economics was merged into the Bureau of Human Nutrition an-d Home Economics February 2~, ~943.

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Research in Food Habits ~37 vise Cost of Living Index); did not include families that had received relief or that had incomes under $500. Over 4,ooo weekly records of family food consumption included. Comparisons were made of quantities of food con- sumed and its nutritive value by region, season, and level of expenditure for food. ~) Conducted as part of Consumer Purchases Study (cooperative work of 5 Federal agencies to study consumption in relation to income and family composition), survey included non-relief. native-born families living on farms, in villages and cities. , O Included Negro families in Southeast. Analysis oasect on more than s,ooo records of food consumption for one week. Nutritive value of diets studied in relation to income, family composi- tion, region and size of community. Findings of surveys reinforced by many smaller studies. Facts about poor diets: More than a third of the families in the United: States probably have diets that have to be classed as poor; only one-fourth have good diets; remainder have fair diets. Some families spend too little to obtain an adequate diet. None of village or city families in North or West got good diets when spending less than $~.oo per adult unit per week for food. In Southeast a small proportion of white families got good diets for slightly less than this amount. Probably one-fourth of non- relief non-farm families included in Consumer Purchases Study spent too little for food to get excellent diet. No data on this point available for entire population, but proportion undoubtedly considerably more than one-fourth. Many families spend enough but do not obtain an adequate diet: three- fourths of non-relief families in villages and cities included in Consumer Purchases Study spent enough to get adequate diets. With expenditures above a certain minimum, diet depends on how food dollar is invested. There are more poor diets among large than among stroll families: among village and city families in North and West proportion that had good diets decreased as family size increased. Large families spend less for food of each person than small. at given income the large families are less well off than small families. But at any given ir~co~ne level there is a wide range in food expenditures even among families of the same size and composition. Helps explain difference of quality of diets among families similar as to income and family composition. Poor diets are more prevalent among the lower income groups than among the higher. But more liberal expenditures for food do not guarantee good diets. Diets ctre better in the North and West than in the South because incomes and expenditures for food are higher in North and West. Where food expenditures are same, diet in South as good as elsewhere true of both Negro and White families. Poor diets are Store likely to be found irt villages and cities than on farms. Among non-relief families included in Consumer Purchases Study, 3570 of those in cities and villages, 25f7o on farms had poor diets. Superiority of many farm diets may be ascribed to large share (an average of about two- thirds) of food supply which is farm furnished-chiefly milk, eggs, vegetables. Question frequently asked: What income will-support the level of food ex- penditures needed for an adequate dried No simple answer to this. At ~938 price levels, families of two persons with incomes of $500-$~000 could pur- chase either low cost or moderate cost good diets described in "Planning for Good Nutrition," Yearbook of Agriculture, ~939. Families of 5-8 probably

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38 The Problem of Changing Food Habits would require incomes of $~500-$~000 for same diet. An~ong farm families as much depends on success in home food production and food purchases as upon cash income. Summary: In general, quality of diet is determined not only by economic resources in relation to family size but also by the wisdom and economy with which resources are used with reference to nutrition. Discussion: It was pointed out that better diet on farms may in part be due to work of Farm Security Administration and Extension Service and that there should be corresponding help given to people in towns. Dr. Stiebeling: Not all farm diets good only\the average. Fully three- fourths of Negro families on farms had incomes under $~ooo a year (in cash and in kind). Dietary standards used for measuring adequacy comparatively low and no deductions were made for kitchen or plate waste or for cooking losses. Dr. Phipard, in a report prepared together with Dr. Stiebeling on technical material on which to base practical educational program for the homemaker in the low-income level: Large quantity and variety of material available, each piece adapted to particular group for particular purpose. Food budgets for village and city families materials prepared to help homemakers plan eco- nomical and adequate diets. Diets to f t the family income a 38 page bulletin giving diet plans at four levels of cost and nutritive value; work for maxi- mum flexibility. Getting the most for your food mone~a 4 page leaflet with illustrations to help in food selections; designed for low income families- weekly market lists for adequate diet at minimum cost and another for emer- gency use. Family food budgets for the use of relief agencies leaflet pre- oared in Aqua to aid welfare agencies in working out relief allowances; two cost levels-minimum cost adequate diet and emergency diet. Similar ma- terial worked out by relief agencies with special emphasis on low cost foods available in locality; follow through with market orders, menus, recipes; often translated into Italian, Spanish, etc. Food budgets for farm families in nearly every state Extension Service together with State Agricultural Col- lege promoting "live at home" programs designed to help farm families get as much of food supply as possible from farm; integral part of Farm Security Administration. When disaster cuts down hone-grown food leaflet pre- pared jointly by Bureau Home Economics, Extension Service, and Children's Bureau, to help families adjust to devastation caused by droughts or floods. Nutrition education some contained in all above publications; other material in Good Food Habits for Children, Food for Children, Milk for the Family, and in publications on food buying and preparation; also in Consumers' Guide which goes to ~zo,ooo families and family agencies; also the Market Basket, a 2-3 page leaflet issued weekly by Office of Information, Bureau of Human Nutrition and Home Economics. Movies; Tim strips prepared by Extension Service, Public Health Service, private agencies, and business groups. Dr. Clark brought up discussion of ways of providing a cheap diet contain- ing adequate vitamins, particularly education to new forms of food Dr. Stiebeling: Possible to work out synthetic diets, but new and strange things cause definite reactions against them. Dr. Clark: One job of scientific group is to lay out cheap but optimal diet. . . .

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Research in Food Habits ~39 Actual sore spots ire diet ought to be cleaned up. Should raise issue of prices of vitamin C, calcium, and vitamin ]3 and map out low cost diet with enough of these elements. Dr. Benedict: At Massachusetts Institute of Technology they say they can provide a year's food for $~.65, but in small competitive package you pay 35 for small amount. fob for economists. Dr. Likert: Mark-up in prices a problem. Must discover ways of meet- ing need, then matter of preparation, then how to get people to use it this last is our job. Dr. Stiebeling: If very low cost and monotonous diet worked out, would you get people to eat it ? Dr. Likert: If worked out with alternate choices to suit neighborhood, should be tried. Dr. Cummings: Must also take seasonal changes into account. But must educate people to use acceptable foods. Dr. Clark: Soy bean meal has been tried. Spread through a county and a state in 6 months. Committee should try to get press behind such campaigns. Dr. Wilson: Opportunity for research on phenomena on national scale- attitude of people to enriched bread. Millers said people would not eat whole wheat bread. Millers surprised to note increasing demand for whole wheat bread or long extraction bread- attribute this to commotion about vitamins. Would be interesting to study consumption. Don't know how much increase exists, but could find out. Dr. Benedict: Might be tied up with good, going concern for nutritional education. Might give general information useful elsewhere. Dr. Cummings: With knowledge of results of certain methods, could employ them in other directions. Dr. Likert: Outlines an increasing responsibility for this Committee. Dr. Stiebeling: Some changes are considerably more difficult than just changing from white to enriched white bread. Dr. Clark: Against even experimental work on subject if there was any possibility of harm in any of suggested diets. Dr. Stiebeling: We are now engaged in making a study of spending and saving in rural families in wartime. This will provide data on incomes, sav- ings, and expenditures for living in the year ~94~ and for the first quarter of ~942. In addition to information on expenditures for food there will be esti- mates of the quantities of food consumed in the spring of ~4~ by different income classes and information on home food production programs both in the spring of ~94~ and for the year ~94~. Report of comparison of milk con- sumption of families participating in the 5 milk program with consumption of families not participating. Tried to study same loo families before and after campaign, but at time of second survey only 624 families of original loo families still at same address. Original group included all families of two or more persons eligible for relief; did not include one-person families, aged or blind. Before program went into effect White families bought ~.63 quarts per person per week at ~ per quart; Negro families bought o.8~ quarts per person per week. Half of eligible families included in sample par

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I40 The Problems of Changing Food Habits ticipated in program. Found consumption of fluid milk in White families doubled, actual expenditures went up ~470; in Negro families consumption tripled and actual money outlay went up some. During August one-fourth of all eligible families in District participated; about half of eligible families of ~ or more participated. Washington Post suggests any loci income family should be allowed to participate, including all WPA.* * Available reports: U. S. D. A. 45~ MP. Family food consumption and dietary levels. Urban and village series. 30 cents. U. S. D.-A. Leaflet. 3 market lists for low cost meals. Single copy free; $~.~5 per loo. U. S. D. A. Leaflet. Market lists for moderate-cost and liberal meals. Single copy free $~.25 per loo. U. S. D. A. Cir. 645. .Low priced milk and the consumption of dairy products among low income families, Washington, D. C., ~940. lo cents. U. S. D.-A., AWING. Food for growth. All above bulletins are obtainable from Superintendent of Documents of the Govern- ment Printing Office, Washington, D. C.