ABSTRACT HITE, ADELE H. a Material-Discursive Exploration Of
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ABSTRACT HITE, ADELE H. A Material-Discursive Exploration of “Healthy Food” and the Dietary Guidelines for Americans. (Under the direction of Carolyn R. Miller and Stephen B. Crofts Wiley). Americans seem caught in a paradox involving nutrition guidance, nutrition science, and health: Scientists and public health experts continue to produce information and advice about the connections between diet, obesity, and chronic disease, and many Americans have apparently taken up dietary regimes with this information in mind. At the same time, over the past few decades, the health of Americans appears to have worsened. In this study, I examine this paradox, as well as other contradictory elements of dietary health discourses in America, from the perspective that nutrition science and dietary guidance are shaped by historical and cultural contexts, as well as the values and social norms of the professionals engaged in nutrition knowledge production. My specific focus is the shift from defining a “healthy diet” as one that prevents diseases of deficiencies to one that prevents chronic disease. This shift was a reflection of and reinforced by corresponding shifts in nutrition science, public health, health policy, and economics that emphasized individual responsibility for health outcomes and marketplace solutions for social problems. My investigation challenges familiar narratives about dietary health by examining the socio-cultural, economic, political, and historical factors in 20th century America that have shaped beliefs about relationships between diet and chronic disease and how, in turn, these beliefs have shaped thinking about bodies, agency, and moral imperatives related to health behaviors. I begin with a critical examination of how, in mid-20th century America, concerns about avoiding specific food components in order to prevent chronic disease became part of popular, scientific, and public health discourses. Using Foucauldian concepts of “history of the present,” the dispositif, biopower, and governmentality and perspectives from science studies and rhetorics of science, I examine historical and scientific sources to investigate the establishment of dietary guidance for the prevention of chronic disease and the development of power-knowledge relations around this guidance. Next, I investigate how and why U.S. federal nutrition guidance shifted from a focus on adequate nutrition to a focus on chronic disease prevention. My study uses methods from rhetorical analysis and genre studies to explore the controversy that took place in 1980, when two conflicting sets of dietary guidelines positioned themselves as authoritative government advice on how to eat a “healthy diet.” I use these texts—Nutrition and Your Health: Dietary Guidelines for Americans, produced by an ad hoc committee of officials from the U.S. Departments of Agriculture and Health and Human Services, and Toward Healthful Diets, written by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences—along with government hearings and media accounts contemporaneous to the debate, to examine why views presented in the Dietary Guidelines persisted over those in Toward Healthful Diets, an outcome that was neither self-evident at the time, nor inevitable. My investigation continues with an exploration of how the assumptions that undergird the concept of diet as a means of controlling chronic disease are represented in the material features of diet-related fitness apps. I use theoretical frameworks from feminist new materialism to examine how “healthy diet” discourses are manifested differently within different apps and how the constraints and affordances of a given app makes “the body” visible to its community of users in the digital space during the work of disciplining their bodies with regard to weight and health. This investigation may help shed light on the 21st century American paradox of “more information and less health.” Furthermore, by positioning “healthy diet” discourses within a situated, contingent historical context, I hope to engage scholars across the academy in problematizing current notions of what it means to “eat right.” © Copyright 2019 by Adele H. Hite All Rights Reserved A Material-Discursive Exploration of “Healthy Food” and the Dietary Guidelines for Americans by Adele H. Hite A dissertation submitted to the Graduate Faculty of North Carolina State University in partial fulfillment of the requirements for the degree of Doctor of Philosophy Communication, Rhetoric, and Digital Media Raleigh, North Carolina 2019 APPROVED BY: _______________________________ _______________________________ Carolyn R. Miller Stephen B. Crofts Wiley Co-Chair of Advisory Committee Co-Chair of Advisory Committee _______________________________ _______________________________ William J. Kinsella Emily Winderman _______________________________ Charlotte Biltekoff External Member ii DEDICATION To my father, Bohdan Huryn, and to my husband, Greg Bower—for your unflagging support iii BIOGRAPHY Adele Hite is a registered dietitian who has completed graduate studies in nutritional epidemiology and holds master’s degrees in public health nutrition and English. She has worked as a high school English teacher, a health educator at the Duke Lifestyle Medicine Clinic, and a certified yoga instructor. She is the co-author of a mix-and-match meal planning cookbook, Dinner Plans: Easy Vintage Meals and the keeper of an oft-neglected blog, www.eathropology.com. Her work encompasses rhetorical and cultural studies of food politics, nutrition science, and public health; critical health studies; science-based policy controversies; science and technology studies; and the science-policy-publics interface—among other things. She lives in Durham, North Carolina, with her husband and lots of books. iv ACKNOWLEDGMENTS I think most, if not every, dissertation is a team effort, and mine is no exception. However, the number of years of graduate training that it has taken me to get to this point may be somewhat exceptional. As a result, the list of those whose have played a significant role in this effort is extensive, and yet I feel that there are many others, unnamed, who have contributed. I hope they know who they are and accept my thanks for their support and assistance. I owe a significant debt of gratitude to my co-chairs and to my committee, for their guidance, inspiration, and patience: Carolyn R. Miller and Stephen B. Crofts Wiley have my deepest gratitude for the many hours they have put into this project. Their confidence in the merits of this work have sustained me during some very difficult times on this journey, and their incredible talents as editors and compassion as mentors have played an enormous role in making this work into something that is, I hope, worthy of that confidence. Steve Wiley has been challenging me to think harder, deeper, and more creatively about my work ever since my first semester in the CRDM program. I am particularly indebted to him for his insights into the ways in which critical cultural theory could help me sort through the confusion around discourses of food and health without recapitulating mistakes of past efforts to “fix” dietary guidance. His thoughts on this will be a source of inspiration for me as long as I work on these issues. The one lesson that I will always remember from Steve is to think less about “either/or” and more about “both/and.” My CRDM colleagues insisted that I take a class with Carolyn Miller and following their advice is one of the smartest moves I’ve made in my life. I gathered some of the most useful tools in my analytical toolbox from Carolyn, and by being a student of hers, learned much about how to teach. But far more than that, it was her engagement with and genuine intellectual curiosity about my work that kept me headed in the right direction. The one lesson that I will always remember from Carolyn is that I write better when I write less. Having Steve Wiley and Carolyn Miller both (!) read and respond to my work has been one v of the greatest gifts that I have been given during my graduate school years. As generous, perceptive readers, they have provided hundreds of comments and insights, both written and shared over coffee, that made connections I had missed and found organization in places that had none. I can’t thank them enough for all of the time and effort they have put into helping me grow as a scholar. I have Charlotte Biltekoff to thank for introducing me to the world of critical nutrition. I think it is safe to say that my ability to identify “critical nutrition” as my area of scholarly interest rests largely on the work she did to create that space. Her deep knowledge of the history of nutrition in America as a means of social management has been an invaluable guide, and her generosity in sharing her insights is an inspiration and reminder to me to “pay it forward” as a scholar. I am so fortunate to have caught Emily Winderman on her whirlwind tour of North Carolina. I met her during her interview for a faculty position at N.C. State University and snagged her as soon as I could for my dissertation committee. Every conversation with her brings fresh perspective to my work. She has been an expert guide to scholarship in the rhetorics of health and medicine, as well as a counselor and friend. Bill Kinsella is one of the first people I met when visiting the CRDM program. I am grateful for his warm welcome and, even at that first encounter, his enthusiasm for my topic. The sheer volume of additional compelling questions that he generated from my initial tentative forays into the paradoxes and conundrums surrounding the Dietary Guidelines assured me that the CRDM curriculum would provide some really useful tools for dissecting these issues. This has been true to an extent I could not have envisioned, but that he certainly did. In addition to my co-chairs and committee members, there are many scholars who have provided inspiration, guidance, and direction as I’ve worked on this project: I owe special thanks to Christopher Mayes, Craig Hassel, Julie Guthman, and Garrett Broad for the work they have done in this area and their early interest in my work.