In October 2019 the Australian Productivity Commission (APC) released a report stating that mental health cost employers $4.7 billion AUD in absenteeism. The report also highlighted significant government expenditure on health services as well as intangible costs on committees. Over the past decade there have also been a number of reports from federal and state governments on the economic and social costs of obesity in Australia (Mayes, 2016).
While there have been panicked responses to childhood obesity for almost two decades (Mayes, 2016; Gard, 2007), as well as a steady growth in concern about mental health, what is novel in recent interventions is the focus on diet as a dual solution for obesity and mental disorders. Indeed, these economic and public health crises can be thought of in terms of metabolism. That is, how individual bodies and populations absorb the environments they inhabit and inherit, and how these environments are expressed as states of health, disease or indeterminate futures. Along this metabolic line, some researchers claim that the “wicked problems” associated with obesity and mental health can be solved by looking at microbiomics (Jacka, 2016). Microbiomics is the study of the symbiotic relationship between colonies of microbial cells (bacteria, fungi, and viruses) living on or in a human host’s gut, oral cavity, skin, or hair. Specifically, there has been a focus on the human gut microbiome, which is the combination of the microbes living in our gastro-intestinal tract, their genes and their environment.
Research on the human gut microbiome links diet to “major depressive disorder and anxiety disorders’ as well as physical conditions such as obesity” (Logan et al. 2016: 131). As such, recent research has focused on how to maintain a healthy microbiota, leading to the emergence of the new field of nutritional psychiatry (Marx et al., 2017), which seeks to examine “the importance of whole diet in mental health” (Jacka 2016, 146).
While the media and popular books can over-hype the research by using the language of causality to link diet to mental health, most researchers recognize that the diet is situated in a “complex interplay” among “psychological stresses,” “environmental exposures such as pollutants” and other “lifestyle variables” (Logan et al. 2016, 132). Further, a child’s microbiome is shaped by the parental microbiome during pregnancy (Pentecost, 2018). Australian researchers have suggested that the findings of epigenetics and gut microbiome research could form the basis of public health dietary interventions aimed at what they identify as the key sites: pregnant bodies, the home, and the school (Davies et al., 2016; Jacka et al., 2011).
Although there are differences, this renewed focus on gut-brain interactions and the role of diet in mental health echoes a longer history governing metabolic processes that go back at least to the eugenics movement in Australia during the first half of the twentieth century.
Australian eugenics and public hygiene strategies, 1910s-1940s
A 1914 column illustrates the early interest in the connection between diet and mental health in Australia. The “According to Eve” column published in the Bendigo Independent ordinarily discussed social news, recipes, and mother-craft. However, on Saturday March 7, the pseudonymous “Eve” reported on new developments in eugenics that moved beyond the regulation of marriage and procreation to focus on the mother and child relationship. Eve praised compulsory education for children, but insisted that “if we want a fine, healthy race,” education must extend to nutrition and health education of mothers. Eve concluded by emphasizing it’s a mother’s responsibility to give her child “every chance of growing up healthy and happy” because a “sound mind in a sound baby is a child’s most blessed inheritance.”
Historians suggest the eugenics movement in Australia placed more emphasis on the role of the environment in shaping biology than on heredity (Anderson, 2002; Rodwell, 1998). There was general acceptance among Australian eugenicists that changes in environmental factors could improve physical and mental health. It was not just about regulating biological reproduction but understanding that environmental modifications could improve the biological future of those already born. This understanding of the interaction between biology and the environment grew out of anxieties about how the British race would metabolize a new environment. Would the white race degenerate or be able to thrive? As such, soil, air, diet and cultivation of the land were central to Australian colonial medical theory and practice. (Anderson 2002: 22-23).
Diet was not the only environmental intervention but it was crucial for prominent figures in the Australian eugenics movement, such as Harvey Sutton. Sutton was a Professor in Preventive Medicine at the University of Sydney, as well as President of the N.S.W. Council for Mental Hygiene. Sutton gave evidence at the 1925 Royal Commission on Health, suggesting that “hereditary mental defectives” should not be allowed to marry, should be segregated from the community, and, in certain cases, sterilized (Anderson 2002: 167). These recommendations reflect Sutton’s initial “hard” heredity view that some groups were “incurable.” However, he also suggested environmental interventions, reflecting a “soft” heredity perspective.
Sutton was concerned about the “quality of white school children” – a group who could be “cured” and improved. He believed “poor diet, unventilated rooms, and infectious disease had produced poor physical and mental specimens” (Ibid.). Sutton argued that these problems needed to be attacked “at the earliest possible moment” (Rodwell 1998: 166). He recommended to the commission that a national hygiene program examine, measure, swab, and classify every schoolchild in the country (Anderson 2002: 167). With more statistical information on the physical and mental health of children, more specific nutritional and environmental interventions could be made.
In 1933, as President of the N.S.W. Council for Mental Hygiene, Sutton gave a speech at the annual meeting in which he emphasized the importance of “organized control of mankind over his surrounding” (Sutton, 1934). In particular, Sutton was concerned by a “loss of efficiency…at school and industry, due to various forms of mental and physical incapacity” (ibid.). He particularly singled out “chronic fatigue and instability at school”, which “resulted from unhygienic modes of living including vitamin deficiency which…might still lower the resistance of the nervous system to various stresses” (ibid.).
To address these problems and test his theories, Sutton and his colleagues conducted an experiment at Blackfriars Infant Demonstration School (Sydney). Using his newly developed Australian Height-Weight Standard of Measurement, Sutton identified that nearly 25% of the students were under-weight (Rodwell, 1998: 173). These students were placed in a group and received “a daily health lunch,” which included: “grated chocolate and raisins, grated carrot, celery, marmite, steeped prunes, grated cheese, fruit salad and cream, and ice-cream” (Rodwell, 1998: 174). This became known as “Sutton’s Standard” and purportedly led to improvement in the mental and physical health of the children receiving this lunch.
Nutrition and its implication for mental and physical health was a key feature of the early twentieth eugenicists in Australia such as Sutton, as well as other prominent figures like Raphael and Phyllis Cilento. It was believed that early changes to diet could enhance, improve, and reverse the effects of biological inheritance. Although Sutton and the Cilentos leaned towards soft eugenics, there was certainly a hard dimension to some of their proposals, especially in relation to “inferior” non-white races.
The school and the home: spaces for intervention
The school and home were key sites for Sutton and Cilento’s interventions. The school continues to be a key site for Australian public health programs governing metabolic processes, particularly those in areas described as having a low socio-economic-status. In 2018, public health researchers proposed to an Australian Senate committee that every child in Australian primary schools should have their weight and height measured every two years in order to gain better data on childhood obesity and enable more targeted interventions. Critics of this proposal said it would stigmatize children, “increase the risk of disordered eating,” and have an overall “detrimental impact on these kids.” However, proponents argued the urgency of the situation required such interventions.
A 2010 Victorian government intervention aimed to use nutrition to promote physical and mental health, as well as cognitive capacities like memory and focus. The program was called It’s Your Move, which already implies a certain degree of responsibility. The aim of It’s Your Move was “to increase the capacity of schools to promote healthy eating and physical activity” (Jacka et al. 2011: 2). Researchers evaluating the program concluded that “the foods available and provided to adolescents need to be receive much greater attention” due to the influence of diet on “neurotrophic factors that are particularly salient to depressive illness.” Their report also recommended that attention be paid to “creating environments that promote healthy eating and engaging parents in supporting adolescents to main good nutrition during a difficult life stage” (Jacka et al. 2011: 7).
These proposals for increased screening of children’s bodies do not occur in a vacuum. Not only do they echo Sutton’s call in the 1925 to examine, measure, swab, and classify every child in the country, but they come at a time when there has been “a proliferation and intensification of food pedagogies” in schools, homes, early-child care settings, and pre-pregnancy discourses (Leahy et al. 2015: 1; Gard, 2007). The intense focus on food and nutrition as the locus for physical, mental, and environmental change has produced anxiety and an overwhelming sense of responsibility; this burden has fallen primarily on mothers (Lupton 2008).
Proponents of governmental interventions based on microbiomial research and nutritional psychiatry neglect, or perhaps are unaware of, the interaction between nutrition, mental hygiene, and eugenics in Australia during the early-twentieth century.
Biopolitical governance of crises and the reproduction of an improved (or resilient) population
So how does the history of an Australian eugenicist’s interest in nutrition speak to present developments in epigenetics and nutritional psychiatry? First, I do not wish to imply a simple guilt-by-association and suggest that nutritional psychiatrists or those conducting school-based interventions using gut-microbiome hypotheses are eugenicists in the same way Sutton or the Cilentos were. Second, I am not suggesting there is simple repetition of the past. It is worth asking: “what is new about this dual turn to the microbiome and epigenetics?”; “is there is anything to be learnt from their former manifestations?”; and “why now? Is there something similar or different about the crises and urgencies now to those of the 1910s-40s?”
A common thread worth considering is the biopolitical dimension. The eugenics of Sutton and Cilento were trying to produce a physically robust and mentally fit white population that would form the basis of efficient, productive and secure nation. Today, these objectives have been re-coded and are not explicitly racialized. Yet, there remains an emphasis on the need for young people to be economically efficient (i.e. not a burden), psychologically resilient (i.e. able to adapt to changing life circumstances), and happy. Those seeking to address the crises of obesity and mental health, contend that efficiency, resilience, and happiness can be secured via nutrition science and modifications to dietary practices.
This brings out further aspect of the biopolitical similarities – what lives can make these changes to diet in order to modify the human microbial system, which in turn improves mental health? Like Sutton’s belief that there are some groups that could be cured/improved via environmental changes, and others could not, today there is a similar dynamic that maps on to Michel Foucault’s notion of biopolitics that fosters the life of some, while disallowing the lives of others. That is, those who are able to make lifestyle changes or those who have access to “nutrition and psycho-pharmaceutical interventions that target the microbiome” are the ones whose lives can flourish (Logan et al., 2016), but those who cannot continue to suffer poor health, depression, anxiety and so on, all compounded by the knowledge that something could be done about it if their choices (or life circumstances) were different.
The emergence of research in nutritional psychology, gut-microbiome, and epigenetics does echo earlier environmental eugenics, but it also brings in new elements. Notably, a more precise but still vague way of reasoning about the interaction among genes, dietary-choices, environment, and gut-microbes in the production of physical and mental health. The production of this knowledge serves to broaden the perspective of health beyond the individual body and individual choices.
However, I have concerns that this broadened perspective will ultimately result in a doubling-down on the individual as central locus of responsibility and site of intervention. For instance, researchers intent of proving their thesis that diet and gut microbiome are causative intentionally abstract or “control for” social and political determinants of health like race, class, gender, or socio-economic status. As such they ignore or minimize the (bio)political dimension to these interventions.
No doubt, there is something new and important about epigenetic and microbiomic understandings of the interaction among genes, the individual and environment. But the way these understandings are enacted and enfolded in broader understanding of morality, health, responsibility, and blame is very old. The same populations are targeted by similar interventions, with similar results.
For all the talk of a broader perspective of metabolism and the ways in which the biological, psychological, social and environmental influences the individual, there is a real danger of that these complex interactions will be reduced to the gut, what goes into it, and the individual who chose it.
Anderson, W (2002) The cultivation of whiteness: science, health and racial destiny in Australia. Melbourne: Melbourne University Press.
Davies, P, Funder J, Palmer D et al. (2016) Early life nutrition and the opportunity to influence long-term health: an Australasian perspective.” Journal of Developmental Origins of Health and Disease 7 (5):440-448. doi: 10.1017/S2040174415007989.
Gard, (2007) Is the War on Obesity Also a War on Children? Childrenz Issues: Journal of the Children’s Issues Centre 11 (2):20-24.
Jacka, F (2016) Global and epidemiological perspectives on diet and mood. In The Gut-Brain Axis, 141-158. Elsevier.
Jacka, F, Kremer, M. Berk, et al. (2011) A Prospective Study of Diet Quality and Mental Health in Adolescents. PLOS ONE 6 (9):e24805. doi: 10.1371/journal.pone.0024805.
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Marx, W, Moseley, G, Berk, M and Jacka F (2017) Nutritional psychiatry: the present state of the evidence. Proceedings of the Nutrition Society 76 (4):427-436.
Mayes, C (2016) The Biopolitics of Lifestyle: Foucault, Ethics and Healthy Choices. London: Routledge.
Pentecost, M (2018) The first thousand days: Epigenetics in the age of global health.” In Meloni, M, Cromby J, Fitzgerald, D and Lloyd S (Eds.) The Palgrave handbook of biology and society, 269-294. Springer.
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Christopher Mayes is a DECRA Research Fellow in the Alfred Deakin Institute at Deakin University. He is an interdisciplinary scholar with disciplinary backgrounds in sociology, history and philosophy. His research interests include sociology of food and health, bioethics, and political theory. He is the author of The Biopolitics of Lifestyle: Foucault, Ethics, and Healthy Choices (Routledge, 2016) and Unsettling Food Politics: agriculture, dispossession, and sovereignty in Australia (Rowman & Littlefield International, 2018).