Demography and Nutrition: Evidence from Historical and Contemporary Populations (review)

"Daunting" is a good word to describe this study. As with its predecessor, Human Demography and Disease,¹ the authors employ an array of quantitative techniques (the results presented in scores of tables and figures), such as time series and aggregative analysis, computer modeling, and family reconstitution, to which they add an interdisciplinary knowledge of nutrition, biochemistry, and epidemiology—the whole intended to provide an overview of the impact of human nutrition on population dynamics. The central thesis is that the transformation from foraging to farming, beginning some 10,000 years ago, meant nutritional deterioration that has affected human demography ever since. Most of the focus of the work is on revealing the consequences of that deterioration in preindustrial England. The reader is alerted to these arguments in an introductory discussion of the diet of hunter-gatherers, and the decline in human health (and stature) that accompanied plant and animal domestication. The chapter concludes with the diet of the working classes in preindustrial England.

Succeeding chapters present data that reveal the following: (1) The rural English population grew very slowly from 1550 to 1750, due in no small part to epidemic disease, yet rose sharply after 1750. (2) But there was something more than disease at work to slow population growth between 1550 and 1750: fluctuating wheat prices (as well as those of oats and barley) would have meant malnutrition for many. (3) But not famine. Famines have punished populations from Roman times to the developing world of the twenty-first century, but judging from burial data they had only limited demographic consequences for preindustrial England. (4) Rather, the problem was chronic malnutrition, which has had a dramatic impact on fertility in many locales over time and across the globe. By contrast, improved nutrition after 1750 in northern England brought a substantial rise in fertility, presumably because women had more of an opportunity to build up fat reserves. (5) Even seasonal malnutrition, especially among people on a suboptimal diet, can have severe demographic consequences. Low-birthweight females grow up to bear low-birthweight infants at risk of neonatal mortality, and malnutrition in utero predisposes to hypertension, diabetes, and coronary heart disease in later life. (6) Malnourished mothers, although producing an excessive number of low-birthweight babies, may not be able to produce enough good-quality milk to nourish those babies (a breast-feeding mother needs a minimum of 300 to 400 extra calories to properly nurse an infant early in life, and close to 600 as the baby gets older). Moreover, until the end of the seventeenth century medical authorities contributed to neonatal mortality by advising that infants not be nursed during their first few days of life; some suggested delaying breast-feeding for up to a month after birth. (7) An analysis of burial records and grain prices in the parish of Penrith in the Eden Valley, Cumbria, shows that high infant and child mortality rates were correlated with high grain prices. (8) There was a gradual amelioration in infant mortality beginning around 1600, and it was this ongoing reduction of infant and child mortality that brought about the population boom after 1750. (9) Endemic goiter, at one time widespread in England among those not living in coastal areas, was also a factor in high infant mortality rates and was probably the cause of a significant number of stillbirths and abortions. (10) Seasonality played a significant role in infant mortality; stamina, height, weight, longevity, and even the incidence of mental illnesses have been related to birth months. In England, the summer months (before the crops were harvested) were hungry ones. The most successful pregnancy outcomes (based on baptismal records) were those managed by women who had the opportunity to build up their fat stores immediately before the hungry season. (11) Malnutrition predisposes the individual to infectious diseases, and children with a poor nutritional status endured more severe cases of childhood ailments and had...