Feeding the colonial subject: nutrition and public health in Puerto Rico, 1926-1952.
--ASENJO 1947: 225
"The policy of supplying skim milk to our people, through the government and private commerce, is not an issue to be discussed by the public opinion or a mere recommendation of the Nutrition Committee; it is a decision that I took as Governor of Puerto Rico"
--MUNOZ TO PONS, MARCH 7, 1949 (1)
AMONG ITS MANY EFFECTS, THE POLITICAL AND SOCIAL TURBULENCE OF THE 1930S INCREASED THE VISIBILITY OF PUERTO RICO'S PUBLIC HEALTH AND MEDICAL PROBLEMS.
The creation of special New Deal reconstruction programs for the island was in part a response to the severity of Puerto Rico's public health issues and lack of medical infrastructure. These programs also promoted the expansion of biomedical research to investigate prevalent infectious diseases and nutrition disorders. Biochemist Conrado Asenjo was among those scientists who tried to devise strategies to combat malnutrition, considered one of Puerto Rico's major health scourges during this critical period. Trained under leading biochemists in the United States and in the recently opened Puerto Rico School of Tropical Medicine, Asenjo started his career investigating the potential of foodstuffs native to the island to nutritionally complement the traditional rice, beans, and root crops diet. His most celebrated discovery occurred as part of a series of studies sponsored by Puerto Rico's Department of Agriculture and Commerce during the early 1940s. In collaboration with chemistry technicians from the Agricultural Experiment Station in Rio Piedras, Asenjo proved that the vitamin C content of a little known fruit called acerola surpassed that of any other foodstuff known at the time (Asenjo 1946; Asenjo and Freire de Guzman 1946). Biochemists and agricultural scientists further studied the potential of the West Indian Cherry, as acerola was known in the scientific literature, to treat nutritional deficiencies and the possibilities for its mass cultivation (Asenjo and Moscoso 1950; Arostegui et al. 1955). Home economists and extension workers conducted educational campaigns to popularize the consumption of this and other native fruits and to correct "fallacies" and "superstitious beliefs" people had about them (Roberts and Stefani 1949; Roberts 1952, 1957; Seijo de Zayas 1952).
Before and after becoming Governor, Luis Munoz Marin was also actively involved in public health efforts to attend to Puerto Rico's nutrition problem. These efforts were greatly aided by improvements in dairy technologies after World War II, which made possible the creation of a palatable beverage with skim milk solids. This product gave new alternatives for public health experts in their fight against malnutrition and served the new Munoz government in fulfilling the promise of "better nutrition for Puerto Ricans" (Seijo de Zayas 1955; Ortiz Cuadra 2005). During the 1948 elections, this promise was "one plank in the Governor's campaign platform" and he later worked "actively behind various aspects of the nutrition program" (Roberts 1950: 324).
This article examines the scientific, public health, and political efforts to define and address Puerto Rico's nutrition problem from the late 1920s to the early 1950s and the relationship between these initiatives and the sociopolitical changes of the period. It considers how the criteria and paradigms used to measure and solve malnutrition responded to technological and social changes at both local and international levels. The article investigates how these biomedical and public health understandings of malnutrition interacted with the emerging "techno-agrarian discourse" that during the 1930s called attention to the detrimental effects of Puerto Rico's monocrops agriculture over the local food supply (Alvarez-Curbelo 1993). It then examines the significance of this interaction for the consolidation of the Popular Democratic Party (PPD), founded in 1938 by Munoz with an agenda focused on the "plight of the poorer classes" and their victimization by absentee landowners and that later advocated for the Commonwealth (or Estado Libre Asociado in Spanish) as the pragmatic solution to Puerto Rico's colonial state (Cordova 20 0 5: 173).
The present study will illustrate how the biomedical and sociological measurement of Puerto Ricans' malnutrition and its association with dietary scarcity were central to debates about the island's colonial political economy during the interwar years. In this period, nutrition experts from various disciplinary backgrounds focused on malnutrition as a problem of monotonous diets deficient in protective and high protein foods such as green and yellow vegetables, meat, eggs, and dairy products. This segment of the local intelligentsia--biomedical researchers, experts in tropical agriculture, and public health professionals--"re-conceptualized the land problem" seeking "the rationalization and redistribution of the wealth" produced by absentee landownership and the increase of food crops agriculture as ways of reforming society and promoting better nutrition (Alvarez-Curbelo 1993: 26). In this context, nutrition sciences offered "objective definitions of poverty" that bolstered the social welfare discourse of the PPD (Worboys 1988: 209; Cordova 2007).
However, the potential of enhanced food enrichment technologies and supplementary feeding to deliver large-scale public health improvements after WWII fostered malnutrition's reconceptualization from a problem of monotonous diets, rooted in structural factors, to a technical issue to be approached biomedically (Worboys 1988). This recasting of malnutrition converged in Puerto Rico with the introduction of a development project that prioritized industrial manufacture and incentivized migration of surplus labor while gradually abandoning plans for agricultural expansion and diversification (Dietz 1989; Duany 2002; Fernandez 2010). The establishment of the Commonwealth as Puerto Rico's own kind of decolonization framed these economic policies' implementation. In this context, enrichment and supplementation technologies facilitated a shift in the local public health approach to malnutrition from a focus on diversifying people's diets through the expansion of local food production to an emphasis on technical interventions and nutrition education.
This article is primarily interested in understanding how local agendas, influenced by U.S. politico-economic interests and international scientific trends, shaped the design and implementation of public health strategies against malnutrition. It focuses on how Puerto Rican technocrats and politicians used the language of nutrition to mobilize and model citizen-subjects through the application of biomedical expertise and technologies (Cordova 2005). Nick Cullather argues that in the post-WWII period, awareness of the "world food problem" and its significance for the international order transformed peoples who had been colonial subjects into "development subjects, mobilized, sterilized, and enlightened by foreign experts" (2010: 8). Studies of Asia and Africa's transition from one state of subjection to another dominate the historiography of development in general and of international public health in particular (Amrith 2006; McVety 2012).
However, the case of Puerto Rico blurs the line between colonial and developmental governance and challenges the dichotomy between foreign and local expertise. This context offers a unique opportunity to explore public health's transformation from a project seeking to convert populations to the principles of biomedicine during the interwar years to a practice based on "bringing about change" through technology facilitated policies after WWII (Amrith 2006: 16). In Puerto Rico, local scientists, intellectuals, and professionals assumed instrumental roles in that transition. They shared U.S. policymakers' anxieties about the island's putative overpopulation and backwardness (Briggs 2002).
In order to consider the case of nutrition policies in Puerto Rico and to illustrate the role played by local governing and scientific elites in the transformation of this particular aspect of public health, the article first describes the international development of nutrition sciences during the first decades of the twentieth century. It then examines the work of nutritional biochemists on the island and analyzes how this scientific activity produced particular images of Puerto Rican malnutrition during the 1930s. Next it investigates the collaboration between experimental nutritionists, agricultural scientists, and home economists, as well the public health applications and political economy implications of their research. Finally, it examines the exchange of knowledge between nutrition experts and the PPD government in the design of two particular public health interventions: powdered skim milk's distribution and the rice enrichment program.
Nutrition Science and Tropical Medicine in Puerto Rico
Inaugurated in 1926, the Puerto Rico School of Tropical Medicine assumed an important role in the public health work conducted by relief and reconstruction agencies during the 1930s (Amador 2008; Rodriguez 2011). The School's Department of Chemistry and Nutrition opened its doors at a time when nutrition as a professional and scientific field was undergoing significant changes that altered its disciplinary organization and practices. Specifically, food rationing during World War I "fostered an international network of nutrition experts and laboratories pushing research in new directions." The "discovery" and isolation of vitamins and their linking to pathologies "revolutionized the field" in the 1920s giving clinical significance to this newer science of nutrition (Vernon 2005; Cullather 2007: 354). The subsequent transition from an emphasis on calories as metrics of energy value to a greater focus on the quality of foodstuffs and their composition turned biochemistry into the most authoritative discipline within the field. This new knowledge of nutrition equipped dietary specialists and health officials with more specialized tools with which to assess food supplies and populations' eating habits (Kamminga and Cunningham 1995).
Thus, the interwar years were characterized by a renewed impulse to survey and characterize the nutritional status of both national and colonial populations (Brantley 2002; Arnold 2010). Under the leadership of the League of Nations this movement expanded debates about "how hunger and malnutrition should be defined and measured" (Vernon 2005: 705). Technical debates continued throughout the 1930s in efforts to establish diadnostic methods and minimum dietary requirements to assess populations' nutritional status and the nutritive value of foods, as well as to increase the availability of foodstuffs through better agricultural planning (Barona 2010). The League's 1937 report Relation of Nutrition to Health, Agriculture, and Economic Policy represented the culmination of this decade's efforts towards setting international nutrition standards and planning a new world agricultural to improve people's health (League of Nations 1937). This social and scientific language of nutrition influenced local and international experts "who became principal agents for the development of public health and welfare policies" (Barona 2008: 88). These processes assumed special significance for Puerto Rico during the interwar years.
As international institutions directed their attention to the biochemical and sociological study of nutrition, the work of U.S. military doctor Bailey Ashford in Puerto Rico reflected the gradual transition from understanding malnutrition using the infectious disease model, which emphasized episodic events such as famines, to approaching it as a chronic condition characterized by persistent deficiencies. Ashford is widely known for hookworm research, prevention, and treatment and for his role in the establishment of the Institute of Tropical Medicine (Feliu 2002; Trigo 2002; Trujillo-Pagan 2003; Amador 2008). His interest in deficiency diseases such as beriberi, pellagra, and sprue was the product of his clinical and bacteriological investigations of peasants' notorious "indolence" (Ashford 1921, 1922, 1923, 1930). As Puerto Rican biochemist Conrado Asenjo noted, "nutrition attracted public attention since the first decades of the century as a result of the campaigns waged against the anemia of our jibaros" (Asenjo 1962a: 31). The more Ashford and his colleagues studied the clinical picture of this disease the more they realized that the acute conditions observed were not only due to parasitic infestation but also to extreme undernourishment (Ansejo 1962a: 32).
The research conducted by scientists at the Department of Chemistry of the new School of Tropical Medicine built upon Ashford's pioneering studies. There, Conrado Asenjo started his career working alongside senior biochemists during the early 1930s as part of the project "Nutritional Studies of the Foodstuffs used in the Porto Rican Dietary." This series of studies, supported by a grant from the Rockefeller Foundation, were conducted from 1931 to 1941 under the direction of Donald Cook and Joseph Axtmayer. Cook was a Columbia University graduate and disciple of renowned biochemist Henry Sherman. Axtmayer had also been Sherman's student and co-directed with Cook the Department's nutritional research program. Both Cook and Axtmayer had experience studying the Puerto Rican diet, particularly the polished rice and red kidney beans dish, as well as the food problems of an island "nutritionally dependent on her imports" (Cook 1927-28: 66; Cook and Rivera 1929-30; Axtmayer 1930).
The Rockefeller-sponsored studies applied the rat-growth method developed by Sherman at Columbia and produced a considerable amount of data about the nutritive content of the foodstuffs most widely consumed by Puerto Ricans (Axtmayer and Cook 1932; Axtmayer and Silva 1932; Cook and Axtmayer 1934; Cook et al. 1940-41). (2) Investigators also studied the biochemical composition of Puerto Rico's typical dietary to determine its nutritional value relative to other diets. These results were to be used to "reinforce the native diet" by promoting the incorporation of foods of better nutritional quality "into the universal rice and beans dish" (Asenjo 1962a: 40). For these biochemical analyses, researchers selected "the diets of three representative groups in order to obtain a composite picture of the dietary habits of the average Puerto Rican" (Cook et al. 1940-41).
This study had "as an object instruction the correction of fallacies, comparison, and determination of food values" in each of these diets (Axtmayer 1937a: 3). For this, Axtmayer and colleagues studied a continental diet as eaten by residents and visitors from the U.S., a caterer's diet supplied by hotels and restaurants, and the jibaro or country diet composed of the food consumed by poor rural families. In contrast to the country family diet, both the continental and caterer's contained bread, potatoes, butter, and eggs. The price of each meal was 85 cents for the continental diet, 15 cents for the caterer's, and 8 cents for the jibaro's (Cook, Axtmayer, and Dalmau 1940).
Since their interest was mainly the diet of the jibaro, Axtmayer and colleagues analyzed "his range of food stuffs: polished rice, red kidney beans, pork, onion, chick peas, salted cod fish, olive oil, annatto seeds, lard, salt, garlic, black pepper, sweet potatoes, tomatoes, and pigeon peas." Although, they were surprised to find in this diet the highest iron content, they concluded that it was conspicuously low in vitamin A, calcium, and "good quality proteins." On the basis of this data, these biochemists encouraged "social service and public health workers to promote the benefits of a more judicious selection and combination of foods" (Axtmayer 1937: 3).
Asenjo, who had recently obtained his undergraduate degree in upstate New York, worked at the School of Tropical Medicine as part of this project from 1933 to 1937 when he returned to the U.S. for doctoral training at the University of Wisconsin. After completing doctoral and postdoctoral studies, Asenjo joined the School's Chemistry Department where, similar to his mentors, he studied Puerto Rico's nutrition problems from a biochemical perspective. However, different from his mentors Asenjo applied "chemical, microbiological, and biological methods" to evaluate the potential of foodstuffs native to the island but little used by the population to correct the typical diet's deficiencies and serve in the fight against malnutrition (Asenjo 1962a: 45).
These scientific elucidations of Puerto Ricans' dietary scarcity and its presentation as the cause of their chronic malnutrition made increasingly visible the effects of monocrops agriculture over the island's food supply and public health status. The activity of agricultural scientists and their collaboration with nutritional biochemists from the School of Tropical Medicine reflected these increasing concerns.
Tropical Agriculture, Rural Reconstruction, and Puerto Rico's Food Problem
One of Asenjo's mentors, Henry Sherman, summarized his impressions on the connection between the island's food supply and the nutritional condition of the people in an essay titled "A Glimpse of Social Economics in Porto Rico." He noted that while "the fertile lands of the coastal plains are practically monopolized by sugar cane, the eastern part of the interior is chiefly devoted to the growing of tobacco, and the western interior is the coffee country," the area available for the growing of food for home consumption decreased significantly during the previous decades. Sherman also asserted with dismay how "we have had no previous experience of a situation in which agricultural land values are so high while wages are so low" (Sherman 1930-31: 221-4).
In a 1934 essay, Pablo Morales Otero, President of the Puerto Rico Medical Association, included Sherman's impressions as part of his analysis of the island's most important public health problems. Quoting Sherman's phrase "agriculture is not only an industry, it is a vital regime," Morales associated the "decrease in the number of agrarian farms and small landowners" during the first decades of the twentieth century with the nutritional problems measured "from a biological point of view by scientists at the School of Tropical Medicine." These "demonstrated qualitatively and quantitatively the undernourished status in which the majority of Puerto Ricans live diminishing their efficiency and endurance and being, perhaps, the most important predisposing cause for some pathological states such as anemia and uncinariasis" (Morales Otero 1934: 102).
These discussions of Puerto Rico's malnutrition problem in relation to land tenure patterns became central elements of the "techno-agrarian discourse" that legitimized Luis Munoz Marin's populism (Pantojas-Garcia 1989; Alvarez-Curbelo 1993: 26). The PPD slogan "pan, tierra y libertad" ("bread, land, and liberty") reflects the significance of nutrition ideas for these agendas (Cordova 2005). An exploration of the professional and institutional collaboration between the School of Tropical Medicine, the Department of Agriculture and Commerce, and the Agricultural Experiment Station shows how analyses of the malnutrition problem in relation to food production issues contributed to making the land question a crucial part of this emerging political discourse.
Similar to other colonial settings, the collaboration between private business and government was crucial for the development of agricultural sciences in Puerto Rico (Aso 2009). Responding to the needs of sugar and coffee planters, the Spanish government established the first agricultural experiment stations (AES) at Mayaguez and Rio Piedras in 1888. These stations closed by 1890 but laid the foundations for future research in tropical agriculture (McCook 2002). In 1901, the United States Department of Agriculture (USDA) reopened the Mayaguez's station, renaming it The Porto Rico Agricultural Experiment Station. In 1910, the local government organized the Insular Experiment Station at the Rio Piedras' facility. This station's incorporation into the University of Puerto Rico (UPR) in 1933 promoted the diversification of its research and a closer collaboration with scientists from related disciplines (McCook 2002).
The work of botanist Carlos Chardon reflected this new impetus in tropical agriculture research and highlighted the association between the island's food problem and its land tenure patterns. Chardon's activities while Commissioner of Agriculture in the 1920s and later as Chancellor of the UPR are located within the international rural reconstruction movement that during the interwar years focused on modernizing agriculture, advocated for measures to improve the lot of small farmers, and called for reforms to food production systems (League of Nations 1937; McCook 2002). Appointed by President Roosevelt in 1934 "to study and draw the necessary policies for economic reconstruction" as part of the Puerto Rican Policy Commission, Chardon came up with a plan that "articulated the basis and premises" of Puerto Rico's restructuring (Rodriguez 2011: 128; Garcia-Colon 2009: 39).
The Chardon Plan, the title of the Commission's report, held that "a policy of fundamental reconstruction should contemplate the definite reduction of unemployment ... the achievement of this largely by restoration of the land to the people who cultivate it, and by the fullest development of the industrial possibilities of the Island" (Chardon 1934: 1). The Plan's focus on reorganizing agricultural production reflected current preoccupations with the island's food supply and the population's nutritional status. Scholars also consider it "the archetype of the PPD's reformist program" (Pantojas-Garcia 1989: 523). Chardon's promotion of science-based agricultural development translated into proposals for the relocation of farmers who, having access to more productive lands, "would be able to grow foodstuffs for their own consumption as well as to contribute to the local food production" (Dietz 1989: 170).
This increased attention on food production issues also gave rise to collaboration between biochemists from the School of Tropical Medicine, chemists and agricultural economists from the AES, and the Department of Agriculture and Commerce (DOA). While the interests of the sugar industry shaped the research conducted at the two AES during the first decades of the century, the work of the UPR station gradually diversified in the 1930s to include more studies related to food crops agriculture and small farming. In this way, the contemporary international movement stressing "the necessity for marrying agriculture and public health in the interest of the latter" was echoed in Puerto Rico by an interest in the nutritional potential of native foodstuffs and in the relation between agricultural production and food consumption tendencies (Barona 2010: 33).
Articles by Axtmayer, Asenjo, and Cook appearing in publications by the UPR AES and the DOA reflect this trend (Axtmayer 1938, 1939; Axtmayer, Asenjo, and Cook 1938; Axtmayer, Rivera, and Cook 1940). The DOA provided samples for biochemical analyses and financed Asenjo and botanical chemist Jose Goyco's studies on the properties of oils expressed from papaya, tropical almond, avocado, guandbana, and molinillo, among other fruits and seeds (Asenjo and Goyco 1942, 1943a, 1943b, 1944-45; Asenjo et al. 1945). Between 1937 and 1940, agricultural economists from the UPR AES also directed three studies about food consumption tendencies in relation to supply and distribution in San Juan, twenty-two cities and towns, and various rural areas of the island (Descartes and Diaz Pacheco 1938; Diaz Pacheco 1940, 1941; Descartes et al. 1941). When comparing the data obtained in these different regions, Diaz Pacheco found that the rural families surveyed consumed more foodstuffs harvested at home plots although their consumption of protective foods was lower and their diet less diverse than that of the urban populations studied (Diaz Pacheco 1941).
In the context of these investigations into Puerto Ricans' consumption patterns and the nutritional potential of native foodstuffs, Asenjo and botanical chemists from the AES began to study the biochemical characteristics of a little known fruit called acerola, or the West Indian Cherry. These studies led to the discovery of acerola's high ascorbic acid, or vitamin C, content. Further analyses conducted on acerolas harvested at the AES confirmed their original observation (Asenjo 1951, 1953). When comparing this fruit with other known rich sources of this micronutrient, researchers determined that acerola was the richest source of vitamin C, showing that its juice was 50 to 100 times more potent in this compound than orange juice (Asenjo and Freire de Guzman 1946; Asenjo and Moscoso 1950; Roberts 1957).
As a result of this discovery, the AES began in 1947 an extensive study of the potential of the West Indian Cherry as an economic crop through the plantation of 400 trees at the main Rio Piedras station (Asenjo and Moscoso 1950; Moscoso 1956). These studies' findings were quickly publicized in U.S. medical and lay media (Derse and Elvehjem 1954; Meade 1956). "A West Indian cherry a day keeps scurvy away," declared The Science News Letter (Society for Science and the Public 1954). Clinicians in the U.S. also began to develop and test the nutritional potential of juice blends with acerola (Clein 1956).
The story of the acerola highlighted the importance of promoting the production and consumption of local food crops as part of public health nutrition programs. At the same time that biochemists and agricultural scientists were involved in these experimental research collaborations, public health workers and home economists conducted nutrition surveys to investigate people's eating habits, promote the incorporation of fruits like acerolas to the traditional diet, and analyze the socioeconomic causes and manifestations of malnutrition.
From the Laboratory to the Field: The Political Economy of Food and Nutrition
"Porto Rico and its distressing health conditions," declared an American Journal of Public Health editorial in 1931, "may seem remote to most of us, but this West Indian island has been part of the United States for a third of a century, and its million and a half inhabitants are as much American citizens as the Mayflower descendants of Massachusetts" (Editorial Section 1931). Those distressing health conditions were well known to Governor Theodore Roosevelt, who, according to physician Luis Salivia, was "greatly interested in bettering the condition of the inhabitants of our island" (Salivia 1930: 68). These observations reflect the extent to which the effects of the Depression increased scientific and political attention to the island's health problems.
In efforts to intervene with this precarious public health situation, the Puerto Rico Emergency Relief Administration (PRERA) allocated funds for food distribution and medical training (Rodriguez 2011). Following the PRERA, the Puerto Rico Reconstruction Administration (PRRA) partially implemented the Chardon Plan's recommendations and also included provisions to "try to correct the existing health conditions in the rural areas of Puerto Rico in so far as it was compatible with the economic program" (Morales Otero and Perez 1939: 47). The PRRA Health Division, directed by Pablo Morales Otero, then Professor of Bacteriology at the School of Tropical Medicine, centralized the provision of these services creating various sections in charge of a particular medical aspect. These included the Rural Medical Service Section, the Rural Sanitation Section, the Camps Medical Section, the Social Service Section, the Dietetic Unit, and the Statistics Section (Morales Otero et al. 1937).
This agency employed medical and social workers to conduct various public health and socioeconomic studies in agricultural regions of the island served by the PRRA. The data obtained through these was intended to help authorities "to cope with the health and sanitary problems involved in the several PRRA projects and to take care of the physical examination of its workers." According to Morales Otero, "the facts brought out by the surveys may be considered as truly representative of the life conditions of the large group of ill-nourished, poorly clad, ill-housed, and diseased people in this class, which forms the bulk of the population of Puerto Rico" (1937: 241). (3)
The PRRA also sponsored one of the first comprehensive nutrition surveys conducted by Puerto Rican experts. Here, investigators used questionnaires to record in detail the amount and type of food consumed in every meal by 800 families from the coffee, tobacco, fruits, and sugar cane zones where the PRRA was active. The surveyors consistently noted that the average composition of workers' meals lacked diversity and protective foods. Breakfast almost always consisted of black coffee only, sometimes with a little milk. A typical lunch was made of rice and beans or boiled root vegetables with flakes of salted codfish. Whatever "was left from lunch was served at dinner hour" (Lang 1939: 121). Among the 800 families studied by the Dietetic Unit between 1937 and 1938, 99.6 percent used rice daily, 99 percent used beans, and 93.5 percent used cod fish "while only 24.6 percent consumed meat and 60 percent milk" (Morales Otero 1958: 95).
These nutritional surveys documented great deficiencies in all regions, which were associated with monotonous diets that did not provide the minimum calories, proteins, fats, vitamins, and minerals requirements. Researchers also recorded the weekly income of PRRA laborers in each agricultural zone. Most families spent more money for food than what they received as weekly income, forcing them to buy on credit. This degree of poverty, combined with lack of knowledge about "what a balanced diet means or what the nutritive values of the most common foods are," led to a situation in which people's "only aim is to eat whenever they are hungry using whatever vegetables they can get or buy the most economical foods they are able to purchase with their small income" (Lang 1939: 121).
Measuring malnutrition's causes and manifestations at the population level, these health and dietary studies produced compelling biosocial depictions of Puerto Rico's poverty. The language of nutrition connected the island's biomedical and public health problems with its agricultural and economic reality. It also helped cement the land question as a central element in Munoz's populist discourse and the reform of sugar corporations' landowning patterns as a defining part of his party's agenda (Rodriguez Castro 1993). In this way, the techno-agrarian discourse of the 1930s was further consolidated in the party's platform through its association with Puerto Rico's malnutrition and sanitary problems.
The opportunity to institutionalize that agenda, initially laid out by the Chardon Plan, materialized with the appointment of agricultural economist Rexford Tugwell as Governor of the island, the victory of the PPD in the 1940 elections, and the rise of Munoz as President of the Senate. After a decade of scientific and political activity linking Puerto Rican's biological injuries with the island's agrarian problem, a new effort to enforce the 500-acre limitation in land ownership was codified with the Land Law of 1941 (Descartes 1943). Title V of this law attempted to "assist in the creation of new landowners" by providing individual plots to small farmers and their families, who had tax-free usufruct rights over them (Morales Otero 1946: 235). Although WWII made difficult the purchase of land and the enforcement of this policy, it highlighted even more the need to increase subsistence farming and local food production.
The war compelled the island's government to mobilize to ameliorate the effects of food shortages. The General Supplies Administration (GSA) was created to regulate foodstuffs' distribution, stabilize prices of basic necessities, and control inflation. The Tugwell government also convened an expert committee to deal with the food and nutrition situation during the war. The Puerto Rico Nutrition Committee (PRNC) was organized in 1940 with "the object of assisting in the Program for National Defense" and included representatives from various agencies like the Departments of Health and Education, the Department of Home Economics of the UPR, and the Agricultural Extension Service (Coll de Velazquez et al. 1965).
Lydia Roberts, a home economist with an established reputation in the U.S., was one of the most influential members of the PRNC. Roberts trained in Home Economics at the University of Chicago, where she taught courses on infant and child feeding during the 1920s. In that same institution she obtained a doctorate degree, worked as associate professor and later as chair of the Department of Home Economics (Bing 1967; Jack 2009). In 1942, at 61 years old, Roberts was invited to Puerto Rico to study the food and nutrition problem. Once on the island, she also became actively involved in home economics training at the UPR (Ortiz Cuadra 1996).
One of Roberts' first projects in Puerto Rico was a dietary and sociological survey to collect updated data about the general living conditions on the island. This information was intended to serve as a guide for the revision of the Department of Home Economics' curriculum and adapt it to the needs of Puerto Rican homes and families (Roberts and Stefani 1949). Conducted during the second half of 1946 among 1,045 families, this was a "fact-finding diagnostic study" whose results were "intended primarily for Puerto Rican workers concerned with the problem of raising the standard of living in Puerto Rico" (Roberts and Stefani 1949: v). Analyses performed to test the sample's validity showed that it was representative of the island's population as whole and that "the findings reported can be regarded as reasonably typical of Puerto Rican families in general" (Roberts and Stefani 1949: xxii).
Similar to the PRRA studies, this survey found that "rice and beans forms the backbone of the classic Puerto Rican diet." Different from those, Roberts' study also included data from urban families. An analysis of people's diets according to both region and income showed that "it is income what largely determines even the use of rice and beans. In the lowest rural income group, 79.7 percent of the families had rice and beans at least once in the day's meals and 14.5 percent had them twice." However, "in the highest income group in the urban zone these foods were served at least in 95.5 percent of the homes, and in 57.6 percent they were used in both the noon and evening meals" (Roberts and Stefani 1949: 160-1). When analyzing data related to home food production, which the researchers expected to be of some significance "in a country in which the chief industry is agriculture," Roberts and Stefani found that although 66.9 percent of rural families had fruit trees available, this was on average "a negligible factor in the nutrition of the large majority of the families," especially in urban areas (Roberts and Stefani 1949: 193-9).
Although the Land Law of 1941 had the indirect purpose of increasing local food production, nutrition studies conducted among resettled communities concluded that it had a "limited effect at improving population's health and standards of living" (Robinson and Suarez 1947: 100). Ramon Suarez, clinical nutritionist responsible for one of these studies, noted in 1947 that "the diets of subjects were monotonous," milk consumption was still conspicuously low, fresh fruits and vegetables were lacking, and "all of the other dietary essentials failed to measure up to the recommendations of either the National Research Council or to a more conservative standard elaborated for Puerto Ricans" (Robinson and Suarez 1947: 105, 132).
Plans "to improve the economy, raise the standard of living, and promote better nutrition" through a more diversified agriculture continued to appear after the inauguration of the Commonwealth of Puerto Rico in 1952 (Pico 1953a: 73; Trias Monge 1997). With the island's colonial dilemma seemingly resolved, Rafael Pico, chairman of the Puerto Rico Planning Board, described "the objectives of the Commonwealth agricultural program," which included maximizing the utilization of the island's agricultural resources, increasing milk production, and improving farmers' access to credit (Pico 1953b: 92). Nonetheless, at the same time, the PPD government embarked on an economic development project that prioritized industrial manufacture and labor migration over agricultural expansion and diversification.
This industrialization model was based on offering tax breaks, utilities subsidies, and low labor and operating costs to attract U.S. factories to the island (Caban 1989; Duchesne 2000). Under the new policies, efforts to expand food crops' agriculture were reorganized and transformed according to the labor and land needs of the industrialization program (Carro-Figueroa, 2002; Garcia-Colon 2009). Meanwhile, improved technologies were developed to add synthetic vitamins as replacement for nutrients lost in food processing and enhanced manufacture techniques allowed the expansion of supplementary feeding programs. This conjecture locally facilitated a significant shift in public health approaches to the problem of nutrition.
Improving the Lot of the Underprivileged and the Undernourished
By the time Luis Munoz Marin became Puerto Rico's first popularly elected Governor in 1948 nutritionists, agricultural scientists, and health officials agreed that the island's poverty was at the root of the malnutrition problem. They also recognized that an increase in local food production, especially fruits, vegetables, and dairy products, was the most effective way to eradicate it. However, the new emphasis on industrialization relegated the promotion of food crops agriculture to second place. Simultaneously, the enhancement of enrichment technologies and supplementation products during the late 1940s fostered a redefinition of malnutrition from a sociomedical problem of deficient diets to a technical issue to be addressed biomedically (Worboys 1988).
This recasting of malnutrition reflected a broader shift in international public health approaches after WWII marked by the reliance on "techno-centric campaigns" and targeted interventions that "engendered much optimism and a great sense of ambition" (Amrith 2006: 3). In the case of nutrition policy, enrichment technologies and supplementary feeding offered seemingly efficient and low cost strategies to "broaden public health interventions' scope" (Packard 1997: 96). In Puerto Rico, this shift in international public health in general and in nutrition practices in particular coincided with the beginnings of an economic development project that promoted industrialization and labor migration as the most effective ways of raising people's standards of living. In this context, public health strategies gradually moved from a focus on people's diets and their relation with the island's food production system to measures that relied on technical interventions and educational campaigns.
Thus, the PPD government implementation of supplementary feeding programs, food enrichment projects, and nutrition education campaigns during the late 1940s and early 1950s are part of these new "techno-politics of public health" (Amrith 2006). The scientific, political, and policy debates around these measures are particularly illustrative of the role public health played in the construction of the PPD's political discourse and in the legitimization of its government. One of these strategies involved the importation, distribution, and sale of powdered skim milk. Another made compulsory the enrichment with thiamine, niacin, and iron of all rice sold to the public. Home economists and agricultural extension workers organized educational campaigns and demonstrations to promote the purchase and use of these products throughout the island.
For home economists and extension workers assessing the nutrition situation, the limited availability and consumption of protective foods were of particular concern. The persistently low consumption of milk especially worried nutritionists and public health officials. Therefore, the PRNC and the DOH explored various strategies to secure a stable supply and increase the availability of fresh milk through the expansion of the local dairy industry. However, although this industry represented the second most important agricultural sector on the island during the 1940s, the possibilities for its expansion were severely constrained after the war (Duran Novoa 2008).
In 1948, the Assistant Manager of the Puerto Rico Agricultural Corporation (PRACO) Dairy Industrial Plant noted that "fresh milk production is at its lowest point due to the discontinuation of high producing cattle's importation, the abnormal amount of rain and its effects in the condition of the grass, the small number of bona fide dairy owners who are really an asset to the community," and "the fact that most of the plants are owned by speculators who control at will the price paid to farmers for their milk." Therefore, "the supply of fresh milk is inadequate in some localities," and considerably out of reach for the average consumer throughout the island. "Due to these facts and many others," he continued, "the milk situation has been getting more critical every day and is rapidly reaching its climax" (Diaz Cataldo to Munoz, December 13, 1948; c. (caja) 1825, f. (folder) 215.1).
Given the limitations of the island's dairy industry, it became increasingly clear for public health workers that there was need for a more affordable and accessible product with comparable protein content. In this context, powdered skim milk emerged as an ideal tool to correct some of the nutritional deficiencies prevalent among the Puerto Rican population. Initially a dairy byproduct used as animal feed, powdered milk had to "overcome the stigma that it had carried in the mind of the consumers" before it could be successfully marketed in the U.S. (Smith-Howard 2007: 152). This occurred when improved drying and packaging technologies allowed the transformation of powdered milk into a palatable beverage and increased its storage life (Gillespie 2003). Because it did not have to be refrigerated, powdered skim milk provided a source of high quality protein for U.S. troops during WWII. Postwar mass relief and rehabilitation efforts in Europe, directed by agencies such as the United Nations International Children Emergency Fund (UNICEF), also relied heavily on cheap supplies of this product for their supplementary feeding programs (Gillespie 2003).
With powdered skim milk's reputation as an effective food supplement established, its production increased from a 428 million annual average before the war to 559 million after the war (Gillespie 2003: 127). It did not take long before U.S. dairy industries realized the possibilities offered by the poorest territory under the American flag as a consumer of this product. In June of 1949, Bartel Sanna of Sanna Dairy Engineers wrote to Governor Munoz informing that he had "taken the privilege of airmailing six sample packages of our Sanalac brand nonfat milk solids" to his office in San Juan. Sanna explained the instructions to turn the milk solids into a liquid beverage noting the higher solubility and flavor of their product, which, he believed, made it "equal to fresh milk." He also mentioned to Munoz his visit to the island and his meeting with "Lydia Roberts at the University and with Antonio Vicens of the General Supplies Administration" with whom he "spent considerable time going over several aspects of such a product" (Sanna to Munoz, June 4, 1949; c. 1825; f. 215.1). (4) In his reply to Sanna, Munoz acknowledged receipt of the samples and emphasized the need for such products. Given that "the price of fresh milk is rather prohibitive for low income families" and "a large number of our population goes without any milk in their diet, nonfat dry milk solids might provide a solution for this deficiency in the Puerto Rican diet" (Munoz to Sanna, June 16, 1949; c. 1825, f. 215.1).
Having identified interested industries in the U.S. and importers on the island, representatives from the PRNC, the DOH, and PRACO met throughout 1949 to discuss the possibility of "allowing and facilitating the sale of powdered skim milk and its derivatives to the people of Puerto Rico" (Memorandum Leche Desnatada. February 9, 1949; c. 1825, f. 215.1). The sale of powdered skim milk was prohibited according to Law Number 38 of the Sanitary Code, which regulated the production, importation, and distribution of dairy products. According to Commissioner of Health Juan Pons, allowing its distribution through an amendment to the Code "would put within the reach of our great low income population a type of lower cost milk which, even if incomplete in its nutritional value when compared with fresh milk, provides additional nourishment to those who are now unable to consume this product" (Circular Num. 187 Departamento de Salud. February 23, 1949; c. 1825, f. 215.1).
After studying various aspects related to the project, especially concerns regarding the sanitary control of skim milk sale, health officials at the DOH and the PRNC concluded in favor of the project. The plan finally submitted by these agencies' representatives to amend the Sanitary Code and allow the "free importation of skim milk" went into effect in August of 1949 as Regulation 14 of the DOH. This regulation "ruled the importation, storage, sale, transportation, and consumption of powdered skim milk" (Bigles to Cancio, July 26, 1949; c. 1825, f. 215.1). Home economists organized community demonstrations and educational campaigns to "emphasize the high nutritive value of milk in all forms" and to dispute the "erroneous belief that fat is milk's best part" (?Cudl es el valor nutritivo de la leche sin grasa? c. 1825, f. 215.1; Roberts 1950: 322). (5)
Although there was opposition from some importers who argued that the canning requirements and selling restrictions of Regulation 14 were "commercially absurd and were destined to favor whole powdered milk traffickers," local and U.S. nutritionists praised the Puerto Rican government for its enactment (Gomez to Mendoza de Munoz Marin, September 22, 1949; c. 1824, f. 215). In May of 1950, the Nutrition Newsletter, published by the USDA, congratulated the Puerto Rican government for "providing a cheap milk supply for Puerto Rican families," and for "encouraging people to purchase and use nonfat dry milk through an educational campaign carried out with the cooperation of all agencies within the Committee [PRNC] and of Governor Munoz Marin." "The product was given prestige," the newsletter noted, "because these campaigns have been carried out by professionals such as nutritionists, home economists, and extension workers" (USDA 1950).
Apart from this initiative, the PPD government promoted other anti-malnutrition strategies that promised to correct the deficiencies of Puerto Rico's traditional rice and beans diet, which continued to be under scientific and public health scrutiny after the war. However, discussions around its biochemical content gradually replaced concerns with its inadequate components. According to the most recent biochemical studies, a diet based exclusively on polished rice and red kidney beans lacked a great deal of essential micronutrients like riboflavin, niacin, and thiamine (Asenjo 1948, 1950). Attempting to encourage people to substitute red kidney beans for what were considered more nutritive grains, the PRNC had launched various campaigns during the 1940s promoting the use of chickpeas or, preferably, soybeans (Axtmayer 1946; Roberts 1950). The limited success of these campaigns prompted committee members to explore other measures to add essential nutrients to people's diet.
This scientific and public health emphasis on Puerto Ricans' rice and beans dish reflected trends in international nutrition research. The poor nutritional status and high incidence of deficiency diseases among "rice eaters," when compared to countries where wheat was the principal grain, was well documented, especially throughout Asia and the Philippines (Aykroyd 1948; Williams 1961; Arnold 2010; Cullather 2010). Although beriberi, the main deficiency disease associated with rice diets, was not as prevalent in Puerto Rico, rice enrichment became a central part in the PPD government's efforts to solve the malnutrition problem (Ashford 1921, 1922; Asenjo 1962a). Clinical nutritionists, biochemists, home economists, and representatives from the DOA and the GSA were all involved in conversations around the potential of rice enriched with thiamine, niacin, and iron as a public health tool in the fight against malnutrition.
In February 1948, U.S. biochemist Robert Williams wrote to Pablo Morales Otero, now Director of the School of Tropical Medicine, and to Lydia Roberts to inform them "about the situation with respect to enriched rice in the United States." In his correspondence, he noted that there were better methods of enriching foodstuffs with synthetic micronutrients, and inquired "whether Puerto Rico may not be interested in securing the importation of such rice" (Williams to Morales Otero, February 2, 1949; c. 1825, f. 215). Williams was a veteran nutritional biochemist who had worked in the Philippines during the 1910s investigating the etiology and clinical manifestations of beriberi (Williams 1961). Upon his return to the U.S., he embarked on his "real life work," "the epic hunt for the beriberi factor" through the isolation and synthesis of the micronutrient whose deficiency provoked this disease (Williams 1956: 72-3; Williams 1961: xviii; Parman 1962; Gratzer 2005: 173). In 1936, this search culminated with the final synthesis of vitamin B1 or thiamine, one of the vitamins lost in the process of milling and polishing rice (Major 1942; Swazey and Reeds 1987: 38-40).
In his correspondence with Morales Otero and Roberts, Williams noted how "a large scale experiment involving some 80,000 people" in the Philippines proved the benefits of fortified rice which was "favorably received by the Philippine government and the Filipino people." However, he worried that since "the demand for rice in any form has been so keen and the millers have grown indifferent to its nutritional improvement, there is a danger that the whole undertaking of fortified rice in the United States may be abandoned or postponed indefinitely" (Williams to Morales Otero, February 2, 1949; c. 1825, f. 215). Although synthetic thiamine was added as part of the wheat flour enrichment process, there was no regulation in the U.S. making this compulsory (Institute of Medicine 2003: 46-7).
In his response to Williams, Morales Otero agreed that "as rice is our most popular diet, it would be the most effective means of supplying protective factors to the mass of our people." He also highlighted the importance of the new technology for enrichment described by Williams, which "does not alter either the appearance or the taste of the grain" as "other forms of enriched rice have been unpopular because of a musty taste and unattractive appearance after cooking." Although Morales expressed concern regarding to the potential rise in price, he believed that "enrichment of the type you offer will gain government support, since the fundamental philosophy of the party in power is one of improving the lot of the underprivileged, which is, of course, synonymous with the undernourished." Considering that "enrichment of rice will benefit the population greatly, provided, of course, that the consumers' price is not raised significantly," Morales Otero promised "to take up the matter with Governor Munoz" (Morales Otero to Williams, March 18, 1949; c. 1825, f. 215).
Morales Otero concluded his letter encouraging Williams to communicate with Conrado Asenjo to discuss the details of the proposed project and arrange a visit to the island. Williams replied favorably to this proposed encounter, noting that he "shall look forward to seeing Dr. Asenjo in New York or at Detroit in the Federation meetings" (Williams to Morales Otero, April 1, 1949; c. 1825, f. 215.1). (6) However, in spite of Williams' assurance that enriched rice "was favorably received by the Filipino people" and that "the layman will not be able to distinguish it from ordinary white rice," Commissioner of Health Juan Pons had doubts about the possibility of introducing it to the Puerto Rican consumer. In a letter to the Executive Secretary Roberto Sanchez Vilella regarding Williams' proposal, Pons noted that "having made sincere efforts to use enriched rice in my own home, even I cannot get used to its grayish appearance and its taste so markedly different from what we are accustomed to." Therefore, he continued, "any legislation requiring the exclusive importation of enriched rice would only be viable if the new procedures were truly effective in maintaining the general aspect and taste favored by Puerto Ricans" (Pons to Sanchez Vilella, April 19, 1949; c. 1825, f. 215).
Once it was determined that the rice produced with the new enrichment technology remained white after the process, Pons decided to endorse the proposal. Although concerns over possible price rises remained, Governor Munoz favorably considered the project and in June of 1949 convened various specialists to form the Comite del Arroz (Committee on Rice), appointing Lydia Roberts as its director (Vicens to Sanchez Vilella, April 19, 1949; c. 1825, f. 215). This committee was responsible for studying the possibility of requiring the enrichment of all rice imported to the island and for making recommendations regarding the specific form of that legislation (Munoz Marin to Roberts, June 2, 1949; c. 1824, f. 215). Most of the members were part of the PRNC whom Governor Munoz "directed to work in harmony with the people representing the rice interests in Puerto Rico" (Munoz Marin to Williams, June 8, 1949; c. 1824, f. 215).
As chairwoman, Roberts regularly updated the Governor on the activities of the various members of the committee and on the progress made toward the goal of producing final recommendations. One of these communications is particularly informative as it reflects the range of actors and activities associated with the rice enrichment project. In a letter of September 1949, Roberts detailed the information collected by committee members about the quality of Puerto Ricans' diets in relation to the nutrients enriched rice was intended to provide, as well as the results of surveys conducted among physicians regarding the prevalence and incidence of deficiency diseases. She also explained the results of Asenjo's analyses "of samples of enriched rice, cooked as Puerto Ricans prepare it" and of "simple rat feeding experiments" conducted at the School of Tropical Medicine and at the Department of Home Economics. According to Roberts, these analyses "well authenticated the value of enriched rice." In face of these results, "one of the first actions of the committee was to write to Dr. Pons, suggesting that he consider the possibility of using enriched rice in government institutions" like hospitals and welfare agencies (Roberts to Munoz Marin, September 27, 1949; c. 1824, f. 215).
The committee spent almost two years analyzing similar studies and negotiating various aspects of the proposed legislation, especially those related to strategies for securing a stable supply of enriched rice. During this process, conflicts emerged between nutritionists and the representatives of rice importers and distributors. Records of these appear in the correspondence between committee members and the Governor, as well as in the popular press. The main issue of contention between rice importers, represented by the Chamber of Commerce, and those favoring the proposed legislation was related to the increased cost of this type of rice. According to the Chamber of Commerce "the additional nutritional value that fortified rice would have, as required by the project, does not justify the imposition of this new burden on the consumer." This price increase was due, they argued, to the higher production cost of enriched rice and, because "Puerto Rico would be the only market where enrichment is required by law," to the limited amount of rice millers in the U.S that could supply this variety (El Mundo 1951).
In reaction to these declarations, Antonio Colorado, representative of the GSA in the Committee on Rice, sent a lengthy response to the editors of El Mundo disputing the Chamber of Commerce's claims and emphasizing the public health role of the legislation. Accusing it of inflating prices, Colorado dismissed the impact of the fact that Puerto Rico would be the only market requiring rice enrichment by law noting that the island was the only place where people demanded arroz brillado (polished rice) "which, although it does not add but removes nutritional value, increases production cost at a rate of 10 cents for each 100 pounds." "If we already pay for the rice polishing process," Colorado noted, "which is perfectly useless and only serves the purpose of satisfying el sentimiento estetico de la cocinera (the cook's aesthetic sensitivity), is it not justified to pay 25 cents to add nutrients to it?" Colorado concluded emphasizing that the goal of "feeding our people better" is a cause worthy enough, and as such any new cost resulting from enrichment "should be assumed by merchants, not by consumers" (Colorado to Vargas, April 26, 1951; c. 1824, f. 215).
In efforts to further dispute the Chamber of Commerce's claims, Colorado provided Munoz with a detailed summary of the results obtained in the Philippines where a trial was conducted to determine the public health effects of enriched rice and analyze the cost-benefit ratio of this intervention. Here Colorado emphasized that the cost of the enrichment program "was covered with an increase of around 1/10 cents per pound in the sale price of rice which totals 35 cents per person per year" (Colorado to Munoz Marin, May 10, 1951; c. 1825, f. 215). With this and similar data, Colorado aimed to prove that rice enrichment was a simple and affordable procedure, the costs of which were minimal when compared with its public health benefits.
Therefore, and in spite of the Chamber of Commerce's opposition, Munoz's interest and direct involvement with this project ensured its speedy approval in May 13, 1951, when the legislature converted it into Law Number 430. According to the text of this law, its purpose was "to fix and prescribe the nutritional qualities that all rice imported and sold to the public for human consumption in Puerto Rico must possess and the nutritive elements it must contain" (Reglamento Sanitario Num. 22; c.1824, f. 215). (7) Regulation 22 of the Sanitary Code, signed by the Governor in August of that year, put into effect the legislation requiring that all rice imported to the island be enriched with thiamine, niacin, and iron. In the Governor's words, this effort further contributed to the "big strides that have been made during the last ten years in our fight to overcome poverty, disease, and hunger" (New York Herald Tribune 1952).
During the rest of the decade, the PPD government continued the full-fledged implementation of Operation Bootstrap, the name given to its industrialization strategy based on incentivizing the relocation of U.S. factories to the island and promoting the migration of "excess laborers" to the U.S. In his address to the 8th Convention of Social Orientation, the then Secretary of Health Juan Pons evaluated the implications of "Puerto Rico's rapid industrialization" for the "physical, social, and psychological health problems" of the island's population. Although "the changes brought by industrialization will improve some symptoms and worsen others," Pons concluded that "the sick will notably improve in the balance ... because I know we have good physical, economic, and social physicians" (Pons 1954). Among the greatest foreseen improvements was the eradication of malnutrition, which, according to Pons, "occupies a preponderant place among all the abnormal states affecting Puerto Rico's inhabitants." (8)
Conclusion: Dieta y Democracia
Two years before Governor Munoz created the Comite del Arroz, the PRNC together with the Puerto Rican chapter of the 4-H program published the pamphlet Dieta y Democracia (Diet and Democracy). A youth organization administered by the USDA, 4-H stands for "four personal development areas:" head, heart, hands, and health. In Puerto Rico, 4-H groups focused especially on promoting good health through the cultivation of high nutritional value crops. This education pamphlet noted that "democracy needs healthy citizens," encouraged people to "preserve good health with a proper diet," and offered advice regarding the foods they should eat, how much, and why (Seijo Tizol 1947). Soon after its publication, Puerto Ricans elected their Governor for the first time, a Constitutional Convention was convened, and the Commonwealth's proclamation inaugurated a seemingly new era of democratic government for the island.
The content and timing of this health promotion pamphlet reflects the crucial role played by ideas about diet and nutrition in the construction of Puerto Rico's social and political projects during this period. Nutrition sciences' findings evocatively acknowledged Puerto Ricans' biological injuries and sanctioned specific methods to redress them. During the 1930s and 1940s, biochemical, clinical, and public health analyses of Puerto Rico's nutrition problem identified deficient diets, which lacked protective and high protein foods, as the underlying cause of the island's malnutrition crisis. Through biomedical, agrarian, and sociological investigations, nutrition sciences offered "objective definitions" of Puerto Ricans' poverty that helped mobilize the island's intelligentsia around a critique of the colonial political economy. In this way, nutrition's scientific apparatuses mediated the emerging relationship between the Puerto Rican state, as envisioned by the PPD, and its newly constituted citizen-subjects.
The availability of enhanced food enrichment technologies and feeding supplements cruciallyreshaped nutrition practices afterWWII. The potential ofthese new technologies to deliver large-scale public health improvements depoliticized malnutrition and turned it into a technical issue (Worboys 1988; Gillespie 2003). In Puerto Rico, this recasting of malnutrition converged with the beginnings of an economic development project that prioritized industrial manufacture and labor migration over agricultural expansion and diversification. In the context of the government's dwindling commitment to food crops agriculture, enrichment and supplementation schemes obscured an earlier public health approach emphasizing dietary improvement through agricultural diversification. Simultaneous with this shift, the need to "provide cheap foodstuffs for the expanding industrial work force" provoked a "general "revolutionizing of Puerto Rico's food marketing system" through the introduction of the supermarket model during the mid 1950s (Carro-Figueroa 2002: 94; Ortiz Cuadra 2005).
By the end of the 1960s, nutrition experts from the UPR School of Medicine carried out various island-wide surveys to investigate the effects of the rapid socioeconomic changes brought about by industrialization on Puerto Ricans' nutritional status. After analyzing the dietary, clinical, serological, and socioeconomic data obtained through these surveys, researchers admitted that the picture disclosed exceeded all their expectations. Although serological analyses revealed a lower prevalence of nutritional anemia and protein deficiencies among rural people, clinical assessments showed a higher prevalence of deficiency signs in upper income groups and "an elevated prevalence of obesity in adults," among which "28 and 12 percent, respectively, of the women and men were above 20 percent overweight" (Fernandez et al. 1971: 956-8).
Today, more than half of the island's population is classified by the Center for Disease Control and Prevention as overweight or obese and the island is the U.S. jurisdiction with the highest incidence of diabetes (Center for Disease Control and Prevention 2011; Disdier Flores 2011). While scientific and policy activity in Puerto Rico predominantly frames obesity and diabetes as the result of lifestyle choices and metabolic disorders, the history traced here highlights the need, once again, to address the state of the island's food system and its relation to local agricultural patterns as part of strategies to attend to these public health problems.
This research was partially supported by a Pre-Dissertation Field Research Travel Grant from the Institute of Latin American Studies at Columbia University. I would like to thank Kavita Sivaramakrishnan, David Rosner, Ismael Garcia-Colon, Cruz M. Ortiz Cuadra, and CENTRO Journal's anonymous reviewers for their guidance and helpful comments.
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(1) AGPR: Archivo General de Puerto Rico, Fondo: Oficina del Gobernador, Materia: Departamento de Salud, Tarea 96-20, c. (caja) 1825, f. (folder) 215.
(2) With this method, investigators placed albino rats, raised under equal conditions until the time of the experiment, in different cages. Some were fed with the experimental diets and others with a control. The rats' growth was measured after a period of time. The findings obtained in these studies were compiled and published by the Pan-American Sanitary Office in 1942 (Axtmayer and Cook 1942).
(3) Morales Otero probably borrowed this phrase from President Roosevelt's second inaugural address in 1937, where he spoke of "one third of the nation as ill-housed, ill-clad, and ill-nourished" (Grey 1999: 4).
(4) Vicens directed the General Supplies Administration since its creation in 1942.
(5) It is interesting to note that, while most studies concluded that Puerto Rico's traditional dietary was particularly deficient in vitamin A, powdered skim milk did not provide a significant amount of this nutrient, which was removed with the elimination of the fat (Suarez 1943-44; Asenjo 1947). The nutrition committee explained to attendees at nutrition education events and home demonstrations that vitamin A could be recuperated through the consumption of locally available fruits and vegetables such as pumpkin, batata mameya (yellow sweet potato), mango, and mamey (Seijo de Zayas 1952; Roberts 1954).
(6) The meeting mentioned in this correspondence is the annual meeting of the Federation of American Societies for Experimental Biology, held in Detroit, Michigan, April 18-22, 1949.
(7) In January 13, 2011, the Puerto Rican Legislature derogated Law Num. 430 with the P. de la C. 3777.
(8) Juan Pons, "Desnutricion." Biblioteca Conrado Asenjo-Recinto de Ciencias Medicas, Sala Ashford, Fondo Juan Pons Gil, seccion #5, caja 2, cartapacio 35, documento 1.
The author (firstname.lastname@example.org) is a Ph.D. candidate at the Center for the History and Ethics of Public Health, Department of Sociomedical Sciences, Columbia University. Her research interests include the politics of health and disease in Latin America and the Caribbean, the role of public health in economic development efforts after WWII, and the relationship between nutrition sciences, food policies, and agriculture in mid-twentieth century Puerto Rico.
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|Author:||Gonzalez, Elisa M.|
|Publication:||CENTRO: Journal of the Center for Puerto Rican Studies|
|Date:||Sep 22, 2013|
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