Hidden Hunger

Gender and the Politics of Smarter Foods

Aya Hirata Kimura

• Publisher: Cornell University Press
• Year: 2013
• ISBN:
  9780801467684
• Topic: Technology & Engineering
• Subtopic: Food Science
• Index: Technology & Engineering

For decades, NGOs targeting world hunger focused on ensuring that adequate quantities of food were being sent to those in need. In the 1990s, the international food policy community turned its focus to the "hidden hunger" of micronutrient deficiencies, a problem that resulted in two scientific solutions: fortification, the addition of nutrients to processed foods, and biofortification, the modification of crops to produce more nutritious yields. This hidden hunger was presented as a scientific problem to be solved by "experts" and scientifically engineered smart foods rather than through local knowledge, which was deemed unscientific and, hence, irrelevant.In Hidden Hunger, Aya Hirata Kimura explores this recent emphasis on micronutrients and smart foods within the international development community and, in particular, how the voices of women were silenced despite their expertise in food purchasing and preparation. Kimura grounds her analysis in case studies of attempts to enrich and market three basic foods—rice, wheat flour, and baby food—in Indonesia. She shows the power of nutritionism and how its technical focus enhanced the power of corporations as a government partner while restricting public participation in the making of policy for public health and food. She also analyzes the role of advertising to promote fortified foodstuffs and traces the history of Golden Rice, a crop genetically engineered to alleviate vitamin A deficiencies. Situating the recent turn to smart food in Indonesia and elsewhere as part of a long history of technical attempts to solve the Third World food problem, Kimura deftly analyzes the intersection of scientific expertise, market forces, and gendered knowledge to illuminate how hidden hunger ultimately defined women as victims rather than as active agents.

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UNCOVERING HIDDEN HUNGER

Obviously, what hungry people need first and foremost is more food. But they also need better food.

—Economist, July 31, 2004

One of the great Western misconceptions is that severe malnutrition is simply about not getting enough to eat. Often it’s about not getting the right micronutrients—iron, zinc, vitamin A, iodine—and one of the most cost-effective ways outsiders can combat poverty is to fight this “hidden hunger.”

—Nicholas Kristof, New York Times, May 24, 2009

Shiny red and blue packages of cookies and instant noodles replete with appetizing photos and fancy logos arrived at a cluster of small shacks that constitute a tiny portion of the vast Jakarta slums. Mothers took the noodles for themselves and the cookies for their children. Although they resemble common junk food, these products are actually healthy foods according to the UN World Food Programme. They are fortified with iron, zinc, calcium, magnesium, phosphorus, potassium, vitamins A, D, E, K, B₁, B₂, B₆, and B₁₂, and folic acid. The WFP’s enthusiasm for fortified foods is shared by the government of Indonesia, which decided on mandatory wheat flour fortification in 1998 and began distributing fortified baby food to low-income families in 2001. The baby food was fortified with iron, zinc, calcium, magnesium, potassium, vitamins A, D, K, B₁, B₂, and B₁₂, and folic acid.

In the 1990s, the lack of proper micronutrients—or “micronutrient deficiency”—became a hot topic in the international food policy community to describe the “food problem” in the developing world. A previously hidden, yet deadly, aspect of the condition of Third World people, micronutrient deficiency, or “hidden hunger,” became the focus of many development projects. The term “micronutrients” refers to vitamins and minerals that are vital for the proper functioning of the body; examples of micronutrient deficiencies include vitamin A deficiency, iron deficiency anemia, and iodine deficiency disorder. These disorders are often not apparent to the people with a deficiency, hence it is called hidden hunger. In the 1990s, many international conferences, from the World Summit for Children to the World Food Summit, urged governments to recognize the importance of micronutrient deficiencies, and many international and philanthropic donors started to commit resources to combating hidden hunger. The degree to which concern with micronutrient deficiencies became established within the development discourse could be seen, for instance, in the 2008 Copenhagen Consensus conference of leading international economists and specialists, who chose micronutrient remediation as one of the most cost-effective development interventions. In another example from around the same time, a well-known pioneer in microfinance, the Grameen Bank, formed a joint venture with the French multinational corporation Danone/Dannon to produce fortified yogurt in Bangladesh in 2006.1

There are various policies to address hidden hunger, but fortification and biofortification, not supplements or nutrition education, became the most celebrated instruments for addressing it in the final decade of the twentieth century. “Fortification” refers to the process of adding micronutrients to food products during the manufacturing process, as when vitamins are added to baby food, wheat flour, sugar, cooking oil, or butter. Indonesian fortified cookies and instant noodles are examples. “Biofortification” alters crops biologically so that the plants themselves contain more micronutrients; the prime example of this is genetically engineered Golden Rice, which has enhanced beta-carotene, a vitamin A precursor. Both fortification and biofortification are responses to concerns about the micronutrient intake of the poor.

In this book I explore the politics of the recent turn to micronutrients by examining international projects and agreements on hidden hunger as well as by using case studies from Indonesia. The Indonesian cases illustrate how micronutrient deficiencies gained prominence in expert discourse in the 1990s and interest in fortification and biofortification increased, despite hunger and limited access to sufficient quantity of food still being rampant in some communities. I will show, for instance, how mandatory fortification was started with wheat flour, and how Golden Rice was promoted by biofortification proponents to Indonesia’s policymakers in the 1990s. It is tempting to portray this interest in “quality” and hidden hunger as driven solely by the latest advances in nutritional science. The increased attention to hidden hunger might be viewed as the result of scientific progress uncovering previously hidden human needs, now revealed as micronutrient deficiencies. This might be seen as the logical extension of how the hunger problem is viewed since the impressive increase in global food production through the application of modern technologies.

This view creates several puzzles, however. First, why was it that the 1990s saw the micronutrient turn, even though scientists had known about micronutrients and their health implications for over half a century? Since the early twentieth century, the functions of micronutrients have been recognized, and fortification has been implemented in developed countries.2 Furthermore, the preferred solution to the problem—fortification and biofortification—substantially diverges from what many activists and scholars have advocated as the best way to achieve a sustainable, secure, and stable food system. Biofortification uses controversial genetically engineered crops. Fortification, by its very nature, depends on processed foods, which some have criticized for distorting traditional dietary patterns and increasing the potential for chronic diseases. The emphasis on fortification also leads to a lucrative business opportunity for multinational companies. In this book I explore how and why fortification and biofortification became the preferred “solutions” to the Third World food problem. Tracing trends in the international development discourse and through detailed cases of three categories of standard micronutrient-oriented programs (mandatory fortification, voluntary fortification, and biofortification), I show how activities related to fortification and biofortification of micronutrients increased. I believe that this micronutrient turn was driven by “nutritionism” and that it ought to be understood as a manifestation of a scientized view of food insecurity in developing countries.

Nutritionism

While attention to the nutritional quality of food might be considered a welcome change from an earlier focus on food quantity, I suggest that when it is driven by “nutritionism,” it has serious political and gendered implications. Nutritionism refers to an increasingly prevalent view that food is primarily a vehicle for delivering nutrients. Gyorgy Scrinis (2008, 39) defines it as “nutritionally reductive approach to food” that “has come to dominate, to undermine, and to replace other ways of engaging with food and of contextualizing the relationship between food and the body.” The goodness of food depends on the type and amount of nutrients. Health improvement becomes the foremost purpose of food and of the act of eating.3

Nutritionism is so pervasive that it is often hard to notice how peculiar it is. But it is highly reductionist. Food and eating have layered meanings and values that go well beyond nutritional properties and contributions to physical well-being.4 A list of nutrients, however comprehensive, cannot capture the richness of the cultural, social, and historical meanings of food that are intimately tied to family, community, and ethnicity and, as well, to social status and power. Additionally, pleasure, not only wellness, can be the objective of eating. People eat for various reasons, and the discourse of health and nutrition captures only one dimension of the act of eating.

Nutritionism is often understood as a kind of marketing gimmick in the sophisticated consumer market of the global North. Michael Pollan, who has written several popular books on US food politics, has explained how the concept of nutritionism enabled food companies to market processed foods as “healthy” food, resulting in an increase in obesity in the United States (2008). With so many “functional foods” and “nutraceuticals” flooding the supermarket shelves, it is not difficult to see why nutritionism’s theorization has so far been focused on industrial nations. But nutritionism has become influential globally. “Smart foods,” or food fortified with added vitamins and minerals for enhancing functional benefits, are no longer the monopoly of health-conscious shoppers in developed countries. They are now a part of antihunger and antimalnutrition strategies in developing countries.

Furthermore—and here I follow anthropologists of international development who locate projects to improve the welfare of people in the global South in the field of governmentality—I situate nutritionism as a technique of power.5 There is no doubt that nutritionism creates profitable marketing opportunities for food companies. But nutritionism is also tied to new modes of governance and consciousness and subjectivity of individuals that are particularly compatible with the neoliberal age. Placing nutritionism within the complex relations of power-knowledge (Foucault 1980), I argue that nutritionism is part and parcel of the long history of problematizing people’s food and bodies in the developing world, particularly through the deployment of modern scientific and technical expertise. In her analysis of projects driven by the “will to improve” in Indonesia, Tania Li (2007) discusses how such projects require “the practice of ‘rendering technical’” that makes contentious issues a delimited technical matter. The result is depoliticization as well as a boundary between those “with the capacity to diagnose deficiencies in others and those who are subject to expert direction” (7–21). Nutritionism follows this long-standing practice of improvement schemes by “benevolent and stubborn trustees” who “claim to know how others should live, to know what is best for them, to know what they need” (4).

I chart four important dimensions of nutritionism in the context of Third World food politics. First is the rise of what I term charismatic nutrient and corresponding nutritional fixes, technical attempts to solve the Third World food problem that target only its nutritional aspect.6 Because nutritionism marks the problem of Third World food as chemical and individual, it follows that the Third World food problem is essentially the problem of “inferior” food. The poorness of particular diets is calculated based on the discrepancy between an individual’s intake of nutrients and scientifically set standards. The way to correct a bad diet is to provide the essential missing nutrients in the most efficient form for delivery, be it a pill, fortified cookies, or a biofortified crop. As we will see, different charismatic nutrients have been celebrated as the key to combating the Third World food problem at different historical periods, and various “solutions”—nutritional fixes in a different guise—have been proposed based on this reductionist understanding of the food problem.

A second dimension of nutritionism is that it effectively depoliticizes the food problem by recasting it as a technical matter. Nutritionism tends to individualize the Third World food problem by adopting chemically analyzable nutrient makeup and biochemical parameters as standards for measuring the health of food and bodies. By creating a discursive field of identifiable missing nutrients, nutritionism refashions the food problem. Food problems become a matter of individual self-discipline, of “awareness” and “behavior,” with corresponding market-based solutions. One critical consequence of such framing is that it fits the food problem inside increasingly precise nutritional parameters, removing other ways of discussing it. Nutritional composition of food and bad eating habits of individuals come to be considered the problem, rather than living conditions, low wages, lack of land and other productive resources, or rising food prices. By profoundly limiting the frame of analysis and the usable vocabulary, nutritionism critically shapes the construction of the food problem and limits the range of possible conversations.

Third, nutritionism in food security policies is shaped by larger development discourses, and the micronutrient turn in the 1990s was inseparable from overall neoliberalization. Unlike other mechanisms to address micronutrient deficiencies, such as nutrition education and supplement distribution, typically done by governments and/or international organizations, fortification and biofortification are more market driven and efficient alternatives. Although governmental agencies could implement programs, often the expertise necessary (such as intellectual property rights, manufacturing and marketing know-how, and so on) is held by private industry, and vitamins are added to existing food products made by private companies, so that fortification and biofortification are celebrated as instances of public-private partnership.7 On another level, the interest in micronutrients coincided with a decrease in public funding for international agricultural research. In the 1980s, the productivist paradigm that had dominated international development started to fall out of favor. Green Revolution programs were funded and supported by governments and dependent on subsidized seeds, fertilizer, water, and other agricultural infrastructure.8 But after the 1980s, governments increasingly disengaged from international agricultural projects, and international agricultural research centers also suffered from major funding cuts. The proportion of agricultural research done by the private sector increased, with an emphasis on inventions that were amenable to patent protection (Alston, Dehmer, and Pardey 2006). In this way, the micronutrient turn of the 1990s was profoundly shaped by neoliberalization, which, on the one hand, propelled the retreat of government from agricultural policy and, on the other, saw fortification and biofortification as market-based programs.9

Fourth, nutritionism critically shifts who can speak authoritatively about the food problem and who is listened to. In emphasizing the technical nature of the problem and solution, nutritionism privileges experts over lay people. This is particularly evident with “hidden hunger,” where “patients” may not be aware that they have a problem. By legitimizing the domination of experts, nutritionism circumvents democratic processes in contemporary food politics. Nutritionism closes rather than expands avenues for citizen dialogue and participation in the making of better food systems. In the world of nutritionism, people credentialed as experts—not the poor women who are mainly responsible for feeding families and who also suffer from micronutrient deficiencies—are the ones who “know” the problem and hence can prescribe solutions for the malnourished. Conversations about food and food security in the Third World are filled with the claims and counterclaims of experts, but the silence of women who make food every day is a serious issue. It is precisely the voices of these women, who can describe the lived realities of malnutrition and hunger, that we need to make audible if we are to understand food’s political and social, not simply its nutritional and medical, meanings.

Nutritionism systematically organizes knowledge about food and bodies, privileging an expert view while silencing other views. Nutritional science not only provides new knowledge and insight into the relationships between health and nutrients, it also fashions vocabularies for talking about food. By privileging academic credentials and public health contributions, nutritionism sets the parameters of acceptable debate. As we will see in Indonesia, nutritionism profoundly shapes how experts actually act on food and bodies in the Third World.

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Table of contents

• List of Tables and Figures
• Acknowledgments
• List of Abbreviations
• 1. Uncovering Hidden Hunger
• 2. Charismatic Nutrients
• 3. Solving Hidden Hunger with Fortified Food
• 4. Bound by the Global and National: Indonesia’s Changing Food Policies
• 5. Building a Healthy Indonesia with Flour, MSG, and Instant Noodles
• 6. Smart Baby Food: Participating in the Market from the Cradle
• 7. Creating Needs for Golden Rice
• 8. Conclusion
• Notes
• References