Tag Archives: health

‘Let thy food become thy medicine’: healthy diets and supplements in English language self-help books 1950-2000

 

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In this post, Nicos Kefalas (a PhD student with the Balance project) discusses his doctoral research into healthy eating and supplementation. Here he considers why self-help books about diet became so popular in the post-war period, and examines the ways in which this literature deployed linguistic devices to construct readers as “empowered” agents of healthy-lifestyles.

In recent years, it seems that not a day passes by without public debate about healthy eating and supplements. Thousands of magazines, newspapers, websites, YouTube videos and blogs are dedicated to issues revolving around food, diet, exercise, supplementation and health. Popular discussants of healthy diets even make use of data from randomized-control trials (RCTs) and population studies, metastudies and large trials, and translate such knowledge into easily digestible graphics on various foods and supplements to demonstrate whether or not they are truly good for overall good health. (Or to weed out products that could be considered as ‘snake oils’).[1]

 

My PhD examines the historical emergence and development of healthy eating, dietary advice and supplements to provide a better understanding of when, how, why and by whom ‘Healthmania’ was promoted. [2] ‘Healthmania’ is the fascination of various institutions of the West with healthy diets, foods and supplements, and the concomitant production of advice and products to help individuals attain better lifestyles, both independently and collectively. From the 1950s onwards, self-help literature, lifestyle magazines, newspapers, advertisers, science and the state accepted and promoted certain foods, diets and supplements for a number of reasons. Building upon a widespread valorisation of science on the one hand, and fascination of the media and public with slim bodies and healthy lifestyles on another, leading scientists, public figures and state bodies were all motivated by a mixture of personal ambition and broader political aims to promote healthy eating and supplementation.

 

Following historical work on Galenic medicine, food and health that has centred on early-modern herbals, manuals and cookery books, I am currently examining English language self-help books published between 1950-2000 which concentrate on nutrition, diets, food and health.

 

‘HEALTHMANIA’ IN SELF-HELP BOOKS’

Self-help authors made individual agency central to their efforts to popularise ‘optimal’ and ‘ideal’ diets. It is clear that the language and advice in self-help books emphasize and promote the notion that readers have the power to manage their own health and a moral obligation to do so. The books heavily imply that the proactive, educated, well-read and well-informed individual can promote their own good health. The readers are initiated into a self-narrative in which they do not need or want the help of doctors and expensive or ineffective treatments. This newfound agency over their own health is reinforced by the growth of capitalism to provide the foods and supplements necessary to sustain a mentality of ‘buying a better body’. Indeed, not only does the self-help literature direct its readers to the nearest health food stores, pharmacies and juice bars, but it also urges readers to consume specific foods (often exotic fruit), drinks and supplements. Some authors of self-help guides even take a further step. For example, Dr Atkins urges his readers to monitor their progress using a home urine-chemistry kit, encouraging the purchase of sophisticated surveillance technology, alongside expensive dietary consumables and further literature.

One of the reasons behind the popularity of the self-help industry lies in the fact that it stood out from mainstream science and advice for better health, which often consisted of the mantra to ‘eat less, exercise more’. By contrast, whilst self-help books sought to empower readers to make positive changes in the present and future, self-help books nonetheless removed the blame for ill-health and obesity from their readers and instead attributed responsibility for past failures to the food industry, ‘modern foods’, fast foods, mainstream science, and modern lifestyles. Each reader is thus given the chance to feel like a revolutionary and an ‘enlightened’ consumer. This narrative was facilitated through the consistent use of motivational language, tone, expressions and symbolism. Taking Atkins’ book as an example once more, one can see how phraseology and capitalisation of sentences urged his readers to stop being bystanders to the damage done to their bodies by modern foods (namely carbohydrates in this case) and start defending their health. Such phrases were ‘A REVOLUTION IN OUR DIET THINKING IS LONG OVERDUE’ and ‘WE ARE THE VICTIMS OF CARBOHYDRATE POISONING’.[3]

 

People turned to self-help books because they addressed contemporary anxieties of the everyday individual. The fear of hunger, for instance, is explicitly addressed by the genre as a whole. These authors knew that people fear hunger, because when they are hungry they lose their control of their bodies, and compromise their diets with filling – though not necessarily healthy – foods. In the short-term, authors reassured readers, this was not necessarily an issue. As Robert Haas advised his readers: ‘There is no point in worrying about cheating occasionally’. He noted, however, that such infidelities to his rules were only acceptable if ‘you stick to the Peak Performance Programme in the long run’.[4]

 

Yet, alongside questions of deprivation, self-help authors had another, seemingly paradoxical, problem to think about, – luxury and efficiency. No one wants to start a boring diet that does not bring the desired results fast enough.  Produced at a time when instant gratification of nearly all desires, cravings and wants can be quite simply achieved, self-help books had to portray eating healthily as an easy process coming from filling, varied, tasty and luxurious foods. For example, Atkins argued that people could lose weight on: ‘Bacon and eggs for breakfast, on heavy cream in their coffee, on mayonnaise on their salads, butter sauce on their lobster; on spareribs, roast duck, on pastrami; on my special cheesecake for dessert’.

 

These and many more themes in the self-help genre play a big part in the popularisation of science and the growth of ‘Healthmania’. The readers of these books are given the knowledge to become active agents of their own health. Change towards better health is elevated to an individualistic and stoic process by which the readers refused to be ill, overweight or obese. The process of becoming healthier offered by the self-help genre is easier with less hunger and more ‘exotic’ and luxurious foods than the average diet recommended by the state and doctors. The advice in these books offers readers a way to avoid the dreaded visits to doctors’ practices, and thus on the surface at least, serves in part to undermine the authority of orthodox medicine. However, even though these books seem to have been against modern scientific theories/practices, self-help authors were using contemporary scientific ideas. These authors offered a self-criticism of the various food and health-related professions they wrote from.  They did so by using widely accepted scientific tools and perspectives to criticise orthodox medicine and dietetics from a marginal perspective.  Indeed self-help books promoted their advice by using the same tools and analytics (macronutrients, micronutrients, calories, specific foods and supplements, the culture of quantification, and often their authors underwent the same training as their ‘mainstream’ counterparts). By following the advice offered by these books, the readers break out of the complacency to ill-health imposed on them by ‘modernity’ and became part of a reactionary kinship. In these works, health itself became a rational, measurable and quantifiable endeavour. More significantly, though, it became a commodity, leading to the explosion of the supplement industry and ‘Healthmania’ in general.

 

 

[1] For instance: http://www.informationisbeautiful.net/visualizations/snake-oil-supplements/

[2] This notion goes beyond the 1980s term coined by Robert Crawford, called healthism which is: ‘the preoccupation with personal health as a primary – often the primary – focus for the definition and achievement of well-being; a goal which is to be attained primarily through the modification of life styles’.

[3] R.C. Atkins, Dr Atkins’ Diet Revolution (New York, Bantam, 1972), pp. 3-5.

[4] R. Haas, (British adaptation by A. Cochrane), Eat To Win (Middlesex, Penguin, 1985), p. 157.

The Health of Pilots: Burnout, Fatigue, and Stress in Past and Present

Natasha Feiner

On 24 March 2015 a Germanwings Airbus crashed 100 kilometres northwest of Nice in the French Alps after a constant descent that began one minute after the last routine contact with air traffic control. All 144 passengers and six aircrew members were killed.

The crash, tragic as it was, attracted significant media attention and it was not long before attention turned to co-pilot Andreas Lubitz. German prosecutors said that they found indications that Lubitz had concealed an illness from his employer, hiding a sick note on the day of the crash. Whilst some media coverage looked to Lubitz’s history of depression, others investigated ‘burnout’. Der Spiegel reporter Matthias Gebauer tweeted in March that Lubitz was suffering with ‘burnout-syndrome’ when he took time out of pilot training in 2009.[1]

The term ‘burnout’ was coined by Herbert Freudenberger in 1974 and is still widely used in Germany (and to a lesser extent, the UK and America) today. Symptoms include long-term exhaustion and diminished interest in work, which is often assumed to be the result of chronic occupational stress.

The recent media discussion of burnout among pilots as a result of the Germanwings crash has brought the issue of pilot health into sharp relief. Several countries have implemented new cockpit regulations and there has been significant discussion of how pilots (and the airlines that employ them) should best deal with stress, personal problems, and exhaustion. These issues have their historical antecedent in late-twentieth century discussions of ‘pilot fatigue’.

It is widely acknowledged today that commercial airline pilots are employed in one of the most stressful occupations of the modern age. Before the Second World War this issue was rarely discussed outside academic circles. Traditionally conceived by the public as heroic and superhuman, early pilots were held up as paragons of masculine strength and vigour, able to manage great responsibilities with little (if any) impact on their physical or mental health.

Although fatigue was first recognised as a potential problem in the 1950s, it was not until the 1960s that the relationship between flying, fatigue, and the health of pilots was first discussed in the mainstream media. A number of newspaper articles highlighted the stressful nature of the pilot’s job and (from the early 1970s) a number of alarmist articles reported incidents of pilots falling asleep at their controls. In one report a pilot flying over Japan was said to have “nodded off” and then woken to find the rest of his flight crew asleep:

‘In the report… the BOAC captain said that when he felt himself dozing he shook himself, looked around the flight deck and found his two co-pilots and flight engineer asleep. “I immediately called for black coffee to bring everyone round” [he said]’.[2]

The increased media interest in ‘pilot fatigue’ coincided with a period of industrial strife amongst pilots who were experiencing radical changes not only in the type of aircraft they were asked to fly, but also in terms of management and working conditions. These issues came to the fore in 1961 when airline BEA released their summer flying schedules. The proposed schedules were intensive and many BEA pilots questioned the implications for safety. Long duty periods and inadequate rest breaks would, it was argued, cause dangerous fatigue that may increase the likelihood of accidents.

BEA relented and allowed an investigation of ‘pilot fatigue’. Carried out by physician of aeronautics H. P. Ruffell Smith, the investigation used a system of points for measuring flight time limitations, replacing the traditional hours system. The subsequent report suggested that BEA pilots should not fly more than 18 points per day, and extra points were awarded for especially stressful or fatiguing operations, such as take-off and landing. Ruffell-Smith’s report was never published and BEA did not enforce his recommendations. The problem of ‘pilot fatigue’ was not solved.

In the years that followed a number of high profile air disasters occurred, many of which were later attributed to ‘pilot fatigue’. In 1966 a Britannia plane crashed in Ljubljana, Yugoslavia, killing 98 people. One year later another plane crashed, this time in Stockport, killing 72 people. Then, in 1972 a BEA Trident plane crashed in Staines, killing 118 people. The Trident crash, in particular, caught media attention as the pilot in charge of the plane, Stanley Key, had made ‘numerous complaints’ about the length of the working day prior to his death.[3]

As a result of this, in 1972 pilots’ union BALPA revived its campaign to reduce working hours, shifting their focus to the dangers ‘pilot fatigue’ posed to passengers. By emphasising the potential dangers of fatigue, BALPA was able to convince airlines to carry out a further investigation into flight time limitations and pilot workload. Based on the results of the investigation, in 1975 the Civil Aviation Authority published strict regulations on flight times with the aim of avoiding ‘excessive fatigue’[4].

Whilst the problem of ‘pilot fatigue’ did not come to a neat conclusion in 1975 (BALPA continues to campaign on the issue to this day) the working conditions of pilots were drastically improved by the introduction of strict flight time limitations.[5] Such drastic changes would not, arguably, have taken place without the support of the British media. The alarmist nature of newspaper reports on the subject of ‘pilot fatigue’ forced airlines to take the health of pilots seriously, for fear of further frightening (and consequently losing) customers.

One would hope that the British media could play a similarly positive role today, following the Germanwings tragedy, by encouraging a re-evaluation of mental health policy by airlines (as well as by employers more generally). Although many initial newspaper reports about Lubitz were (sadly) insensitive and stigmatising, several recent articles have used a of discussion the Germanwings crash as a platform for encouraging greater awareness and understanding of mental health.[6] The tragedy may yet engender a re-evaluation of mental health and stress in the workplace, as the Trident crash did for ‘pilot fatigue’ in 1972.

 

[1] Gebauer is quoted in this news report: http://www.independent.co.uk/news/world/europe/germanwings-crash-copilot-andreas-lubitz-who-crashed-plane-suffered-burnout-says-friend-10137076.html [last accessed 23/06/15]

[2] The Times, Dec 13 1972, page 1.

[3] The Times, Nov 29 1972, page 4.

[4] The Avoidance of Excessive Fatigue in Aircrews: Requirements Document, (London, 1975), p. 1.

[5] For more information on BALPA’s current ‘Focus on Fatigue’ campaign see: http://www.balpa.org/Campaigns/Focus-on-Fatigue.aspx [last accessed 23/06/15].

[6] Alastair Campbell (‘Time to Change’ ambassador) on the stigma and taboo surrounding mental health: http://www.huffingtonpost.co.uk/alastair-campbell/andreas-lubitz-would-we-be-blaming-cancer_b_6961386.html [last accessed 23/06/15].