"Malnutrition": An Intellectual Odyssey David Seckler When President Young asked me to "malnutrition". Under one criterion proper address this meeting of the Western Agricul- nutrition is defined as sufficient intake of tural Economics Association on my work in nutrients to reach the full genetic growth nutrition policy I gladly accepted for I have potential of the individual defined by various been spending most of my time talking to anthropometric and nutritional standards. nutritionists about these problems and Malnutrition then becomes abnormally low perhaps not enough time talking to my fellow size and/or consumption. Under the second agricultural economists. I say this not only criterion, malnutrition is defined in terms of because of the obvious connection between certain clinical signs of nutritional inadequa- nutrition, food policy and agriculture but cy and/or indices of functional impairment, because of a discovery, in my opinion, of such as the inability to work productively. considerable consequence. This discovery is Proper nutrition then presumably becomes that the concept of "malnutrition" cannot be the absence of these clinical-functional signs comprehended except in terms of the eco- of malnutrition. The problem is that most of nomic theory of optimality. the people who are not "properly nourished" In order to understand what I mean by this under the first criterion are also not "mal- statement it is first necessary to understand nourished" under the second criterion! "malnutrition" is an extremely ambiguous There exists a considerable "grey area", word. The Random House Dictionary, for consisting of perhaps as much as 80% or more example, defines "malnutrition" as "lack of of the conventionally estimated world of proper nutrition." Since "proper nutrition" is malnutrition, who are neither "properly not defined, one must simply assume that it nourished" nor "malnourished". They are is "lack of malnutrition". As Ford observes, simply "Small but Healthy" people who have "The term 'malnutrition' has been in use for a very attaind an optimum size with respect to their long time and appears to be self-explanatory but environment. even the briefest perusal of the vast literature on In the course of the following discussion I nutrition raises grave doubt about that. There is no would like to describe how I arrived at this has the same signifi- way of knowing if the word - my "Intellectual Odyssey," as I cance in all parts of the world or if its interpreta- conclusion tion lies, like beauty, in the eyes of the behol- have called it. I have chosen this mode of der ..... Anything less scientific than this chaotic presentation primarily because it appears to inexactitude would be difficult to imagine." me to present the most convenient format for The problem is that there are two quite reducing a rather lengthy research effort to a different criteria of "proper nutrition" and short discussion; but also, because I am interested in the philosophy of science, and I David Seckler is Professor in the Department of Eco- have personally found the process of"conjec- nomics at Colorado State University on assignment to ture and refutation", as Karl R. Popper Ford Foundation in New Delhi, India. describes it, over these past three years one of the most exciting intellectual episodes of Appreciation is expressed to P. V. Sukhatme and Shel- don Margen for their gracious help and encouragement my life. Thus I will speak some of my in this odyssey although they are not, of course, personal experience and to those who think responsible for any of the views expressed here. this has no place in academe I can do no 219 December 1980 Western Journal of Agricultural Economics better than cite our colleague William Foltz still in this most fascinating field of nutrition. who once said in introducing his remarks on a I estimated that a representative house- paper he was about to review, "Gentlemen, I hold of Indian agricultural laborers consisting apologize for citing my personal experience of 5.33 people would generate about 776 days - but, Gentlemen, it is the only experience of work per year under full employment I have had." [Seckler]. In order to meet their energy requirements at this level of work they would require about 4,245,000 kcal. per year - or, Nutritional "Requirements" at 3,150 kcal. per kg. of wheat, about 1,350 My interest in nutrition began in the kg. of wheat per year. The poor Indian summer of 1977 when I was in India on a household spends about 60% of its income on short-term consulting assignment to the Cen- foodgrains, 20% on other food items, and tral Soil and Water Research Conservation 20% on non-food necessities such as clothing, and Training Institute, Dehra Dun. The shelter and fuel. Thus to meet all necessities or assignment, I thought, was quite simple: to it must earn about 2,000 kg. of wheat the do economic evaluations of various projects equivalent per year. At full employment, of the Institute in rather remote and isolated daily minimum foodgrain wage would be 2.6 areas of India, particularly in the "hill areas" kg. Assuming men earn 20% more than would of the Himalayas. women, the minimum male wage rate The specific problem I encountered was be 2.9 kg. of foodgrain. I later found that this to that in the highly underemployed and pover- estimate corresponds remarkably close ty stricken area of the hills - and, I later Clarke and Haswell's survey of agricultural economies. They found, generally throughout India - people wage rates in subsistence that, would not work for less than about Rs.5 (or observed, "... the strange fact... times and places for which we 60¢) per day. I thought it peculiar that people throughout all appeared to be willing to starve rather than have information, the rural laborer, however less than work for this, under Indian conditions, not poor, will not do a day's work for inconsiderable wage. The fact of this wage three kilograms grain equivalent." floor was of course of considerable impor- It is difficult to convert this minimum tance to my evaluations because while it is foodgrain wage to monetary terms without conventionally assumed that the shadow detailed knowledge of local diets and costs of price of labor under conditions of unemploy- foodgrains and other necessities. However, ment is zero, or near zero, this fact seemed to following Dandekar and Rath's estimates for me to indicate that there was a real cost of rural India 1969-1970 and adjusting for infla- labor keeping this wage floor in place. Let tion to 1977 I found that the Rs.5 figure was me say at the outset that I do not believe that perhaps as close as one could conceivably "culture" or "work-leisure" preferences are get. I concluded that the energy-work con- very relevant in this domain of abject pover- nection is indeed decisive in setting such ty. Something more fundamental, I suspect- floors as I had observed. ed, was going on. The one snag in this conclusion was that It is clear that the physical energy expend- the Rs.5 figure was based on the assumption ed in physical work must be provided by the of a fully employed household. If unemploy- physical energy provided by food. Thus there ment existed in the extent of 20%, with only must be a fundamental connection between 600 days of work per year, the minimum earnings, which are used mainly to purchase daily wage would have to be about Rs.5.8 or food, and the energy requirements of the 16% more than the observed floor (the rela- work required to obtain earnings. I thought I tion is non-liner due to savings of calories and would spend a few days working this little other necessities in unemployment).l For problem out and here I am, three years later, reasons explained below, I later discovered 220 Seckler Malnutrition that I had overestimated kcal. requirements cle must soon end because the laborer "gets and thus, the Rs.5 figure was probably about sick". The body throws out a complex variety right with 20% unemployment. of defensive mechanisms: slowness, drow- From this point I naturally became inter- siness, lethargy, stumbling, and fainting ested in the mechanism through which this (quite a common sight in Indian fields)- apparently universal minimum foodgrain which causes the laborer to be dismissed. As wage would be established. The classical more of the laboring class is disabled by low theory of the subsistence wage immediately wages a labor shortage develops and wages comes to mind. But this theory is a long-run are restored to their energy equilibrium theory depending on the regulation of the level. Of course there is nothing above aggregate supply curve for labor through equilibrium in this model to stimulate a attrition of children and, while obviously true higher wage because once the laborer can as a long-run phenomena, it did not appear to purchase enough energy to do the work, the me to be adequate for the essentially short- marginal product of the energy-wage is zero. run, nearly day-to-day equilibrium which I This analysis seems to me to be perfectly seemed to detect in the case even of the satisfactory but it depends on one crucially individual household. important and, I find, entrancing assump- The answer to this problem is quite specif- tion. This assumption is that the wage- ic and direct in the nutritional literature. In earners in a household love their dependents the classic starvation studies of Keyes, there to the extent that they will, in a sense, is shown a very clear production function "irrationally" share their scarce food supplies between energy intake and work ability and with their dependents in proportion to their work performance.