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In this chapter the aim is to analyse the way the relationship between health and food has been changing at the same time as Spanish society itself. From the beginnings of the consumer society until the present day the modernization process has made its imprint on the guidelines public bodies have issued to the public on caring for their health and diet. Beginning in the 1960s with a welfare idea of a healthy diet, very typical of the decade, and meant for a population with nutritional problems, today we have guidelines for an overfed population. The social trends dominant in each historical moment are shown throughout this transformation process and the dietary recommendations have been part of the social change. However, the perceptions of the administration itself on what constitutes a healthy diet have also made their mark on the criteria. The modernizing nature of the paternalistic administration of the 1960s can be easily seen in contrast with the public bodies of the 1980s competing with the messages from the food and agricultural businesses. As the 20th century drew to a close, dietary advice was in keeping with a background dominated by considerations on the nature of social change and in which both public bodies and citizens trusted in the truths of science as a reference point for correct action. At the beginning of the 21st century, reflexivity and questioning of scientific power appear and also an increase in public preoccupation with food risks. Each stage is analysed relating historical background and dietary recommendations.

We examine the joint demand for components of a household’s diet diversity and its relationship with household and regional characteristics that embody diverse food access and utilization constraints within the framework of the dietary patterns of rice producers in Peru.

We use multivariate probit regression to account for the simultaneous nature of the choice of different dietary group components.

There are diverse food intake patterns for households, depending on their wealth, education, demographic structure, market access and geographic location, as well as past shocks. There are also several obesogenic foods that are complements to consumption, with milk being a strong substitute for some of them. Of particular concern is the high vulnerability of female-headed households to low consumption of micronutrient-rich foods as well as the high vulnerability of households with children to high consumption of beverages with added sugars. Climate shocks are also highly associated with poor diet quality.

Results show the important influence of trade on household nutrition and food security. They indicate that policy and program recommendations should focus on nutrition information (such as labeling requirements) and education so that consumers can make informed decisions. They also suggest that policy makers should focus on how to make healthy foods available during crises to prevent health issues after economic and climatic shocks.

Improving the nutritious quality of diets for individuals and populations is a central goal of many public health advocates and intergovernmental organizations. Yet the outcome of healthy eating has been shown to systematically vary across individual-level socioeconomic lines, and across countries in different locations of the food system. We therefore assess variation in the association between eating nutritionally dense fresh fruits and vegetables and both self-rated health (SRH) and body mass index (BMI) across individual income and country locations in the food system.

We use nationally representative survey data from 31 countries drawn from the International Social Survey Programme’s 2011 Health module. We estimate the effect of the frequency of eating fresh fruits and vegetables using random-intercept, random-coefficient multilevel mixed-effects regression models.

We confirm that eating nutritionally dense fresh fruits and vegetables frequently associates with more positive health outcomes. However, this general conclusion masks substantial individual- and country-level heterogeneity. For both SRH and BMI, the largest beneficial associations are concentrated among the most affluent individuals in the most affluent countries. Moving away from either reduces the positive association of healthy eating.

Our results provide an important wrinkle for policies aimed at changing the nutritional quality of diets. Adjustments to diets without taking into account fundamental causes of socioeconomic status will likely be met with attenuated results.

We compare two important health outcomes across a wide variety of types of countries. We demonstrate that our main conclusions are only detectable when employing a flexible multilevel methodological design.

Celiac disease is an auto-immune disorder that requires strict lifelong adherence to a gluten-free diet. I explore how a celiac diagnosis affects gendered feeding work within families.

This chapter is based on a grounded theory analysis of field research with five celiac support groups and 80 in-depth interviews. I interviewed 15 adult men and 56 adult women with celiac, plus nine additional family members.

Gendered care work norms place the onus of responsibility for gluten-free feeding work on women, multiplying time spent planning, shopping, and preparing meals. Women employ distinct gendered strategies to accommodate the gluten-free diet. Following a strategy of integration, women tailor family meals to meet other diagnosed family members’ dietary needs and the entire family’s taste preferences. However, when women themselves have celiac, they follow a pattern of deferential subordination, not allowing their own dietary needs to alter family meals. Thus, women continue to prepare family meals as a form of care for others, even when their medical needs justify putting themselves first.

Social support is a key determinant of compliance with necessary lifestyle and dietary changes in chronic illness. However, little research explores the gendered dynamics within families accounting for the link between social support and dietary compliance. I show how gendered care work norms benefit husbands and children with celiac, while simultaneously disadvantaging women with celiac.

In this chapter, we draw on health lifestyle, human capital, and health commodity theories to examine the effects of educational attainment on a wide range of individual dietary behaviors and dietary lifestyles.

Using data from the 2005-2006 iteration of the National Health and Nutrition Examination Survey (n = 2,135), we employ negative binomial regression and binary logistic regression to model three dietary lifestyle indices and thirteen healthy dietary behaviors.

We find that having a college degree or higher is associated with seven of the thirteen healthy dietary behaviors, including greater attention to nutrition information (general nutrition, serving size, calories, and total fat) and consumption of vegetables, protein, and dairy products. For the most part, education is unrelated to the inspection of cholesterol and sodium information and consumption of fruits/grains/sweets, and daily caloric intake. We observe that having a college degree is associated with healthier dietary lifestyles, the contemporaneous practice of multiple healthy dietary behaviors (label checking and eating behaviors). Remarkably, household income and the poverty-to-income ratio are unrelated to dietary lifestyles and have virtually no impact on the magnitude of the association between education and dietary lifestyles.

Our findings are consistent with predictions derived from health lifestyle and human capital theories. We find no support for health commodity theory, the idea that people who are advantaged in terms of education live healthier lifestyles because they tend to have the financial resources to purchase the elements of a healthy lifestyle.

This paper is the first to use the individual level, longitudinal catch-up growth of boys and girls in a historical population to measure their relative deprivation. The data is drawn from two government schools, the Marcella Street Home (MSH) in Boston, MA (1889–1898), and the Ashford School of the West London School District (1908–1917). The paper provides an extensive discussion of the two schools including the characteristics of the children, their representativeness, selection bias and the conditions in each school. It also provides a methodological introduction to measuring children’s longitudinal catch-up growth. After analysing the catch-up growth of boys and girls in the schools, it finds that there were no substantial differences between the catch-up growth by gender. Thus, these data suggest that there were not major health disparities between boys and girls in late-nineteenth-century America and early-twentieth-century Britain.

This chapter explores policy implications of deliberately targeted interventions aimed at closing the gap between nutrition baseline trends and desirable levels of nutrition intake according to World Health Organization/Food and Agriculture Organization of the United Nations guidelines. Special attention is paid to the implications for those at the bottom of the nutrition achievement range (Bottom Billion).

We conduct a forward looking evaluation with a global multimarket model for agriculture within the context of key drivers of change. We observe the effect of interventions on nutrition intake for the most food-insecure regions as transmitted through food prices, changes in country-level food trade, and other market-driven outcomes. We demonstrate the nutrition-enhancing effects that occur when animal-sourced protein consumption, livestock production, and livestock feed demand decrease in developed countries. We also show the effect of a significant growth in agricultural productivity and household incomes.

Our analysis shows that the most effective intervention boosts household income to facilitate adequate intake of food and key nutrients. Diet changes have notable effects but are harder to implement on a practical level. Enhancing agricultural productivity (especially in regions with historically low yields) is also effective in improving nutrition outcomes.

Short of social protection and direct assistance programs, the ability of policy to effect short-term changes in nutritional status is limited. We highlight the effectiveness of pathways that promote longer-term socioeconomic growth and productivity gains as ways of improving the nutrition and health status of consumers.

The chapter is an auto-ethnographic account of the self-management of a chronic illness within the context of a participatory research project on Mediterranean Diet (MD). A group of Italian women with type 2 diabetes is following a non-medical, personal interpretation of the Mediterranean-style diet. The research account is preceded by a critical appraisal of the scientific narratives of the MD.

Analysis of epidemiological research on MD examines some methodological aspects of gender blindness in its scientific approach. The ethnography concerns self-management of MD diet and redefinition of gender relations.

MD is analyzed as a case of transplantation of yesterday’s cultural and social capitals of the peasant classes, to today’s discourses on food considered as appropriate for affluent people suffering from satiety diseases. The ethnography highlights gender aspects of biographical work, examining in particular a “conversion” dietary model.

The ethnography must be amplified to include women and men from different social classes with various Mediterranean cooking habits, and family and gender patterns.

The chapter highlights cultural processes for women’s empowerment in self-managing type 2 diabetes.

This chapter may represent a seminal sociological work on chronic illness, gender and food studies in one of the “native” contexts of the Mediterranean-style diet.

The treatment and care of persons with a disability should and must be all encompassing. With the expansion of the knowledge that proper dieting can make a difference in the individual’s development and quality of life, attention must be focused on using proper food intake to remediate the negative impact of a disability. Food is related to proper healthcare; therefore, we must include proper nutrition in working with learners with exceptionalities. We must add to the list of treatments not only educational intervention, social interaction, and independent living, but also food intake. This chapter looks at the dietary needs of several disabling conditions, and addresses how particular dietary food selections help in their development and their ability to learn integration, playing skills with others, and working independently when called on to do so. Therefore, for the purposes of this chapter, we focus on exceptionalities such as cognitive disability, autism spectrum disorder (ASD), Down syndrome, attention deficit hyperactivity disorder (ADHD), muscular dystrophy, and cystic fibrosis.