[Hygiene and health diffusion and the prevention of obesity in Spain: the work of Jesús Noguer Moré (1903-1983)]. / Divulgación higiénica-sanitaria y prevención de la obesidad en España: la obra de Jesús Noguer Moré (1903-1983).

Introduction: Introduction: among the epidemiological challenges facing Spanish society in the first half of the 20th century, the problem of malnutrition stood out. Although hunger and malnutrition were the most prevalent forms, overweight and obesity were beginning to emerge, particularly among the wealthier classes. In all cases, and especially in the overnutrition situation, the issue was not so much economic as one of lack of knowledge. For this reason, for the hygienists, dissemination and education in food and nutrition was fundamental. In this field, the contribution of the Catalan endocrinologist Jesús Noguer Moré (1903-1983) stands out. The aim is to analyze the work he devoted to obesity. Material and methods: bibliographic analysis of the works of Jesús Noguer Moré. Results and conclusion: he considered obesity as a pathology of multifactorial etiology with serious consequences for morbidity and mortality. It would involve everything from genetics to previous pathologies, as well as inadequate dietary and lifestyle habits. Its therapeutic approach should be based on calorie restriction and physical activity. He underlined the role of certain types of family or professional activities in promoting overweight and obesity. In terms of prevention, he emphasized the importance of culinary and gastronomic practices, while at the same time placing the responsibility for these practices on housewives. A gender discourse that led Noguer to place women as the target group for his dissemination activities and where the ideal of feminine beauty in force in the inter-war period was very much present.

Introducción: Introducción: entre los retos epidemiológicos de la sociedad española de la primera mitad del siglo XX, destacaba el problema de la malnutrición. Aunque eran el hambre y la desnutrición las formas más prevalentes, el sobrepeso y la obesidad empezaban a emerger entre las clases acomodadas. En todos los casos y, sobre todo, en el escenario de la sobrealimentación, la cuestión no era tanto económica como de falta de conocimientos. Por esta razón, para los higienistas eran fundamentales la divulgación y la educación en alimentación y nutrición. En este ámbito, destaca la aportación del endocrinólogo catalán Jesús Noguer Moré (1903-1983). El objetivo es analizar los trabajos que dedicó a la obesidad. Material y método: análisis bibliográfico de las obras de Jesús Noguer Moré. Resultados y conclusión: consideraba la obesidad una patología de etiología multifactorial con graves consecuencias para la morbimortalidad. Intervendrían desde la genética hasta patologías previas, pasando por hábitos alimentarios y de vida inadecuados. Su abordaje terapéutico debía basarse en restricciones calóricas y actividad física. Subrayaba el papel de determinados tipos de actividades familiares o profesionales en el fomento del sobrepeso y la obesidad. En materia preventiva, resaltaba la importancia de las prácticas culinarias y gastronómicas, al mismo tiempo que hacía recaer la responsabilidad de las mismas en las amas de casa, un discurso de género que llevó a Noguer a situar a las mujeres como colectivo diana de su acción divulgadora y donde estuvo muy presente el ideal de belleza femenina vigente en el periodo de entreguerras.

Culinary and Gastronomic Practices during the Periods of Restrictions on Movement Caused by the COVID-19 Pandemic in the Province of Alicante (Spain).

INTRODUCTION: The third wave of COVID-19 had a large impact on the autonomous Region of Valencia, which gave rise to restrictions on movement and access to collective eating establishments. The objective of this study is to analyse the culinary and gastronomic behaviour exhibited by the population of the province of Alicante during the period of restrictions, in early 2021, in order to compare the results with an identical survey carried out during the first lockdown of 2020. METHODS: observational and repeated cross-sectional study. RESULTS: The frequency and time dedicated to cooking were similar, as was the tendency to cook as a family, although the percentage of meals ate alone increased and the presence of audiovisual devices during meals persisted. Recipes, cookbooks, websites and online courses became the principal sources of learning and the self-perception of improvements in culinary skills was greater. The cooking of traditional dishes of the Mediterranean diet predominated to the detriment of ready meals, but 41.6% of those surveyed preferred to improvise. The recipes most consulted were those for main courses. CONCLUSIONS: In spite of certain changes and setbacks, which in many cases led to a regression to the situation prior to the pandemic, many of the improvements made during the lockdown of 2020 persisted. Changes were made in culinary and gastronomic practices that can help to achieve a more conscious, healthy and sustainable diet but which require educational policies and actions to reinforce and consolidate them.

Food Education, Cookery Books and School Canteens in the Fight against Malnutrition: The Case of the Spanish Edalnu Programme (1961-1986).

The Spanish population completed its nutritional transition in the 1960s and 1970s, when it overcame the problems of malnutrition. Among the initiatives that made this possible, the Food and Nutrition Education Programme (Edalnu) (1961-1986) stands out. In addition to correcting the negative influence exerted by ignorance to nourish oneself correctly, it was intended to prevent the problems of overfeeding that most developed countries showed. The objective of this research addresses, in this context and from the parameters of applied history, the condition of the complementary pedagogical instrument that the Edalnu awarded to the school canteen in the fight against malnutrition, as well as the nutritional, dietetic, culinary and gastronomic criteria used for its operation. The results show that the school canteens sought to reinforce the food knowledge acquired in the classroom. Based on the dialogue between chefs and experts in nutrition and dietetics, balanced meals adapted to regional gastronomic diversity were prepared, which helped to promote, in line with current criteria, healthy and sustainable eating habits through traditional plant-based recipes, with a predominance of seasonal and local products, and with a complementary contribution of ingredients of animal origin.

A theory-based randomized controlled trial in promoting fruit and vegetable intake among schoolchildren: PROFRUVE study.

PURPOSE: The main objective of the PROFRUVE study was to evaluate the effectiveness of a TPB-based intervention program at increasing fruit and vegetable (FV) consumption in schoolchildren aged 7-10. METHODS: Eight eligible classrooms were randomly assigned to the intervention (classrooms n = 4; children n = 90) or control group (classrooms n = 4; children n = 95). The intervention group received 14 sessions of 1 h during an academic year (from October to June) but the control group did not. Sessions were based on the Theory of Planned Behavior (TPB) and focused on modifying FV intake. FV consumption was evaluated before, shortly after and 1 year after intervention ended using validated 7-day food records. RESULTS: FV intake increased significantly in the intervention group (+ 0.45 servings/day; 95% CI 0.17-0.74; p = 0.001) but not in the control group (+ 0.01 servings/day; 95% CI -0.20-0.22; p = 0.409) shortly after the intervention. Long-term measurement showed that 1 year after intervention finished, the intervention group maintained the effect (+ 0.52 servings/day from baseline; 95% CI 0.22-0.78; p = 0.003). Linear mixed model also showed that nested groups by classrooms differ from intervention and control groups regarding FV intake change (p = 0.002). Multiple linear regression showed that receiving the intervention (B = 0.345, p = 0.045) and FV baseline intake (B = - 0.383, p = 0.000) were associated with FV intake change after adjusting the model by age, gender and family social economic status (SES) (R2 = 0.196). CONCLUSIONS: The intervention program based on TPB seemed to be moderately effective in increasing FV intake and successful in maintaining the effect of the reached increase. Moreover, baseline FV intake determined the effect size of the intervention. TRIAL REGISTRATION: This study was registered at ClinicalTrials.gov. Identifier: NCT03400891. Data registered 17/01/2018.

La perspectiva histórica y el análisis crítico en el abordaje del desafío alimentario y social del hambre oculta / The historical perspective and critical analysis in addressing the food and social challenge of hidden hunger

El trabajo plantea la necesidad de abordar el hambre oculta a partir de los retos alimentarios y la casuística socioeconómica que la explican. Se analizan los usos que ha recibido desde la historia de la población y su asociación con los síndromes de miseria, atraso social y pauperización, Así como la nueva dimensión que ha adquirido con la emergencia de la pandemia de obesidad y la doble carga de la malnutrición y el sobrepeso. Tanto las lecciones de la historia, como el reto que representan los más de 2.000 millones de seres humanos afectados por el hambre oculta, muestran que para superarla, más allá de suplementar el déficit de micronutrientes, hay que corregir las desigualdades sociales ante la disponibilidad de alimentos y otras necesidades básicas(AU)

The work raises the need to address hidden hunger based on food challenges and the socioeconomic casuistry that explain it. Are analysed the uses it has received from the history of the population and its association with the syndromes of misery, social backwardness and pauperization. As well as the new dimension that it has acquired with the emergence of the obesity pandemic and the double burden of malnutrition and overweight. Both the lessons of history, and the challenge posed by the more than 2 billion human beings affected by hidden hunger, show that to overcome it, beyond supplementing the deficit of micronutrients, it is necessary to correct social inequalities regarding the availability of food and other basic necessities(AU)

[Nutrition and gastronomy in the region of Valencia]. / Nutrición y gastronomía en la Comunitat Valenciana.

INTRODUCTION: Objectives: to analyze the historical development of the Valencian dietary model, establish the relationship between gastronomy and nutrition and explore the role that reclaiming and adapting culinary and gastronomic traditions could play in the promotion of healthy eating. Methods: literature search and content analysis of studies on the subjects under study. Results: traditional Valencian cuisine is characterized by its variety and diversity at local and regional level; however, the extensive use of vegetables in its dishes and recipes renders it unique and was a crucial aspect of the Valencian population's successful food and nutrition transition in the 1960s. Westernization of the Valencian diet and loss of the heritage of the Mediterranean diet in the late 20th century led to a deterioration in the population's nutritional status and the emergence of problems such as overweight and obesity. Faced with this scenario, the modern cuisine spearheaded by the food sector in the Region of Valencia offers an opportunity to reverse this situation, reclaim the region's gastronomic heritage through dialogue between tradition and innovation and help restore healthier eating habits. Conclusions: the culinary grammar of traditional Valencian gastronomy can improve the population's nutrition by providing a healthy, attractive and tasty diet, besides offering a sustainable alternative for production and consumption through its commitment to regional produce.

INTRODUCCIÓN: Objetivos: analizar la evolución histórica que ha experimentado el modelo alimentario valenciano, la relación que cabe establecer entre gastronomía y nutrición y el papel que pueden jugar la recuperación y la adaptación de las tradiciones culinarias y gastronómicas en la promoción de una alimentación saludable. Metodología: búsqueda bibliográfica de trabajos que se han ocupado de los temas objeto de estudio y análisis de sus contenidos. Resultados: la cocina tradicional valenciana se caracteriza por su heterogeneidad y su diversidad comarcal y local, pero la base vegetal de sus platos y recetas le otorga una idiosincrasia gastronómica propia, que resultó clave para completar, en la década de los sesenta, la transición alimentaria y nutricional de la población valenciana. La occidentalización de los regímenes alimentarios de los valencianos y la pérdida de los referentes patrimoniales de la dieta mediterránea que tuvo lugar en las últimas décadas del siglo xx conllevaron un deterioro de su estado nutricional y la emergencia de problemas como el sobrepeso y la obesidad. Frente a semejante panorama, la actualidad y el protagonismo alcanzando por el sector de la gastronomía en la Comunitat Valenciana puede ofrecer una oportunidad para revertir esta situación y, desde el diálogo entre la tradición y la innovación, poner en valor un patrimonio gastronómico que ayude a recuperar hábitos alimentarios más saludables. Conclusiones: la gramática culinaria de la gastronomía valenciana tradicional puede mejorar la forma de nutrirnos al aportar una alimentación saludable, atractiva y sabrosa, además de ofrecer, por su compromiso con el territorio, una alternativa sostenible de producción y consumo.

[Malnutrition and inequalities in developmentalist Spain: rural food and nutrition surveys]. / Malnutrición y desigualdades en la España del desarrollismo: las encuestas rurales de alimentación y nutrición.

INTRODUCTION: the stage of autarky and early years of developmentalism was one of the periods in the contemporary history of Spain when inequalities in food and nutrition became more pronounced. OBJECTIVES: to examine malnutrition among the rural population (municipalities with fewer than 2000 inhabitants), including territorial inequalities and the delayed onset of a rural food and nutrition transition. METHODS: we analysed the rural food and nutrition surveys carried out by the General Commission for Supplies and Transport (Spanish initials: CAT) and the Food and Nutrition Education Programme (Spanish initials: EDALNU) between 1964 and 1972. RESULTS: the rural population presented a deficit of animal proteins, calcium and vitamins A and B2, due to scant consumption of protective foods. Andalucía and inland Spain were the regions with the highest percentage of people whose diet did not meet nutritional requirements. These deficiencies were not only responsible for the prevalence of caries and skin, mucous membrane and eye lesions, but were also behind delayed growth (height and weight). This was not the result so much of poverty as of the persistence of poor eating habits. CONCLUSIONS: besides evidencing the delayed onset of a food and nutritional transition in the Spanish rural population, our findings document policies that sought to encourage the consumption of protective foods in rural areas and empower the population with regard to food and nutrition.

Introducción: la etapa de la autarquía y los primeros años del desarrollismo fue uno de los periodos de la historia contemporánea de España en el que las desigualdades en materia alimentaria y nutricional se hicieron más evidentes.Objetivos: abordar la malnutrición que afectaba a la población rural (municipios de menos de 2000 habitantes), sus desigualdades territoriales y el retraso que mostraba su transición alimentaria y nutricional.Métodos: se han analizado las encuestas rurales de alimentación y nutrición que llevaron a cabo la Comisaría General de Abastecimientos y Transportes (CAT) y el Programa de Educación en Alimentación y Nutrición (Edalnu) entre 1964 y 1972.Resultados: la población rural mostraba un déficit de proteínas animales, de calcio, de vitamina A y de vitamina B2, justificado por el escaso consumo que realizaba de alimentos protectores. Andalucía y la España interior eran las regiones que mostraban mayores porcentajes de personas que no alcanzaban los requerimientos nutricionales. Dichas carencias, que explicaban la prevalencia de caries, así como de lesiones en la piel, en mucosas y oculares, también estaban detrás del retraso en la talla y el peso. No respondían tanto a la escasez de recursos económicos como a la persistencia de hábitos alimentarios inadecuados.Conclusiones: los resultados, además de mostrar el retraso de la población rural española en términos de transición alimentaria y nutricional, avalan las políticas que buscaban estimular en el ámbito rural el consumo de alimentos protectores y empoderar a la población en materia de alimentación y nutrición.

The health educator network as a nutrition education strategy: the example of the EDALNU programme (1963-1994) / La red de promotores de salud como estrategia de educación alimentaria: el ejemplo del Programa EDALNU (1963-1994).

Food and nutrition education is an essential tool to ensure public health. The year 1961 saw the launch of the Food and Nutrition Education Programme (EDALNU), which helped Spanish population to complete their nutrition transition. The aim of this study was to analyze the characteristics of the health education network which was created as part of the program. A total of 46,752 people, 94% of whom were women, received training on food and nutrition. Of these, 89.54% obtained the basic certificate, and 8.80% were awarded the diploma. Some 1,407 courses were given, reaching a peak in 1979 with 131 courses and 4,029 students. The most active provinces were Madrid, with 26.65% of the courses; Valencia, with 7.60%; Murcia, with 7.53%, and Malaga, with 6.75%. The Spanish Ministry of Culture and Education organized the largest number of courses (26.23%), followed by the Women's Section (11.16%) and Catholic Action (5.12%). Diploma courses were taught for 160 hours, while basic courses lasted 40 hours. The training delivered was affected by changes in the EDALNU program and the Spanish administrative and political structure. Our research revealed that the development and gender balance of the network of trainers presented regional inequalities, and that a wide range of institutions were involved in delivering the courses

La educación en alimentación y nutrición es una herramienta fundamental para garantizar la salud. En 1961, se puso en marcha el Programa de Educación en Alimentación y Nutrición (EDALNU), que ayudó a la población española a completar su transición alimentaria y nutricional. El objetivo de este trabajo es analizar las características de la red de promotores de salud que se desarrolló en el marco del programa. Recibieron formación relacionada con alimentación y nutrición 46.752 personas, el 94% de ellas mujeres. El 89,54% obtuvo el título de iniciado y el 8,80%, el de diplomado. Se realizaron 1.407 acciones y en 1979 se alcanzó el momento más álgido, con 131 cursos y 4.029 alumnos. Madrid, con el 26,65% de cursos; Valencia, con el 7,60%; Murcia, con el 7,53%, y Málaga, con el 6,75%, fueron las provincias más activas. El Ministerio de Cultura y Educación fue el encargado de organizar el mayor número de cursos (26,23%), seguido de Sección Femenina (11,16%) y Acción Católica (5,12%). La duración y los contenidos formativos de los cursos eran de 160 horas para los diplomados y 40 para los iniciados. La acción formativa desarrollada estuvo sometida a los cambios que experimentó el Programa y a los que afectaron a la estructura administrativa y política española. La investigación ha mostrado las desigualdades territoriales que acompañaron el desarrollo de la red de formadores, su componente de género y el carácter plural de las instituciones que organizaron los cursos.