The E. V.

McCollum International Lectureship in Nutrition

From Research to Global Reality: The Micronutrient Story1

Barbara A. Underwood
National Eye Institute, National Institutes of Health, Bethesda, MD 20814

ABSTRACT The professional life history of E. V. McCollum exemplifies how sound nutrition-related laboratory
research was translated into practical realities that influenced individual and national nutrition-related decisions.
Public health and educational programs emerging in the first third of this century improved health and nutritional
well-being in the United States. Characteristics that surrounded pioneering efforts early in the century are similar
to those that have reinvigorated global micronutrient concerns in the last third of the century. Sound community-
oriented scientific research revealed the true consequences of iodine, vitamin A and iron micronutrient malnutrition.
Repositioning the image of these three micronutrients from that of a clinical problem affecting relatively few to
one with consequences for individual, national and global development affecting many more, and disseminating
these facts through high-level political forums incited attention, commitment and actions. As in the early days of
McCollum and his contemporaries, current nutrition scientists played a significant role, interacting with politically

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oriented counterparts, in taking micronutrient research to reality for improving health and quality of life globally.
Lessons learned from the process, both past and present, should guide future nutrition-oriented endeavours in
moving research to reality for betterment of global community health. J. Nutr. 128: 145–151, 1998.

KEY WORDS: • vitamin A • iron • iodine • micronutrients • nutrition history

The Nutritional Science community is indebted to the fore-
sight of the founding committee of the Commemorative
McCollum International Lectureship. The program is intended
to encourage sound advancements in nutritional science and
their application for improving health and well-being on a
global scale and to commemorate the life of E. V. McCollum.
Our professional community is particularly indebted to Dr.
Harry Day whose insightful biographical writings have cap-
tured for the archives of nutrition Dr. McCollum’s personal
character as well as his scientific and public contributions to
the betterment of human health (Day 1974, 1979, 1987 and
1996). I found this record to be fascinating reading and recom-
mend it to both young and older nutrition scientists because
the personal qualities and professional principles recorded are
truly ones to emulate. In Dr. Day’s words, ‘‘No other nutri-
tional scientist probably rendered greater service in influencing
the dietary practices of the people and the thinking of scientific
bodies and public officials in matters concerning human nutri-
tion than did E. V. McCollum’’ (Day 1974).
The late Dr. Jean Mayer, who also knew Dr. McCollum
personally, presented the first McCollum lecture at the Na-
tional Academy of Sciences in 1979, a centennial celebration
of McCollum’s birth. In the printed record of the first McCol-
lum lecture Jean Mayer noted that ‘‘To McCollum application
of new knowledge and its dissemination to the policy-makers,
and to the general public, with the end result a more nutritious
diet, was as important as acquisition of knowledge itself’’
1
The eleventh E. V. McCollum International Lectureship in Nutrition presented
April 6, 1997 at the Experimental Biology ’97 meeting in New Orleans, LA. The
Lectureship is supported by the E. V. McCollum International Lectureship Endow-
ment Fund and is administered by the American Society for Nurtritional Sciences.
(Mayer 1982). A reading of Dr. McCollum’s autobiography
will make it obvious that this philosophy characterized his
lifetime professional journey from research to reality (McCol-
lum 1964).
Dr. McCollum’s life journey has influenced many nutrition
scientists, even those who did not know him, including myself.
First, I am privileged to be involved in the evolving micronu-
trient story, to the greatest extent with the vitamin-A tale,
whose scientific base began with Dr. McCollum’s seminal dis-
covery of ‘‘fat-soluble A’’ (McCollum and Davies 1913). Sec-
ond, I share his views that sound scientific knowledge acquired
by nutrition scientists should be applied practically and dissem-
inated widely to both private and public program and policy
decision makers. Third, as did McCollum, I believe that nutri-
tional programs that influence health and well-being should
be implemented in a manner that empowers individuals to
make informed practical decisions about daily nutrition-related
practices. Last, to achieve the goal of a more nutritious diet
and better health, McCollum believed—and so do I—that
sound scientific research should be the foundation for all subse-
quent steps to its realization in better human health and well-
being.
In January 1991, armed with this noble philosophy, I went
on assignment from the National Institutes of Health (NIH)—
the pinnacle for support of scientific research in the United
States—to the World Health Organization (WHO)—the
Mecca for global health-related public policy. I thought that
my experience as a nutritional research scientist and teacher
at four U.S. universities and the NIH, and as one involved
internationally over a 30-year period in both laboratory and
applied field research in Africa, Asia, Latin America and the
Middle East, qualified me to influence global nutrition-related

0022-3166/98 $3.00 q 1998 American Society for Nutritional Sciences.

Manuscript received 25 July 1997. Initial review completed 25 August 1997. Revision accepted 19 September 1997.

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146 UNDERWOOD
TABLE 1
Seminal highlights from the contributions of E. V. McCollum1
Biological methodology for evaluation of the nutritional value of foods
Discovery of fat-soluble vitamins A and D
Establishment of the first rat colony in the U.S. for nutritional
research
Elucidation of the nutritional importance of many other water-soluble
vitamins, minerals and amino acids
Concept of supplementary relations among dietary constituents, e.g.,
‘‘protective foods’’
1 Day 1974.
policy. I perceived that appropriate global policy and programs
would follow a well-documented critical review of the scien-
tific basis of the nutrition-related issue being presented to deci-
sion makers. This, I thought, would lead to an incremental
improvement in global nutrition, the goal of all politicians
and professionals in the health-related system. Obviously, I
had much to learn about taking research to global reality.
Before going to WHO, had I been more familiar with Dr
McCollum’s career progression—and his reflections recorded
in his autobiography (McCollum 1964)—perhaps my initial
baptism as a nutrition researcher into the political world would
have been less traumatic.
MCCOLLUM’S EARLY EXPERIENCES: PIVOTAL
POINTS IN MOVING NUTRITION RESEARCH
TO NATIONAL REALITY
Acquisition. The first three decades of the 20th century
were a most exciting period for nutritional research and an
enormously productive period for E. V. McCollum. Two thirds
of the more than 300 scientific journal and professional articles
McCollum published in his lifetime had appeared by 1935
(Day 1974). Seminal highlights from these many contributions
are noted in Table 1.
Application. The concept of the supplementary relation-
ship among dietary constituents was an especially important
contribution emerging from McCollum’s research in which he
fed animals restricted rations derived from single-plant sources.
He fed rats and other animal models cereal-based diets con-
taining lard or olive oil. These animals were deprived of what
McCollum first called ‘‘protective foods,’’ those containing fat-
soluble vitamin A, e.g., milk, butterfat or egg-yolk fat and
green leafy vegetables. The deprived animals grew poorly and
were in inferior nutritional condition. He showed that the
addition of the nonsaponifiable fraction of butterfat—or of
ether extracts of green leaves—to olive oil–containing cereal
diets, restored growth and protected against eye lesions that
Osborn and Mendel (1913) had identified as xerophthalmia
(McCollum 1957). Soon after, Stephenson and Clark (1920)
showed that rats deprived of McCollum’s fat-soluble A fre-
quently died even before they developed eye signs.
McCollum translated observations on the growth and
health emerging from laboratory animal feeding experiments
into their significance for human diets. He categorized foods
into five groups and conceptualized doable, self-empowering
guidelines for nutritionally sound food-choice decisions. This
basic concept formed the substance of McCollum’s presenta-
tion in 1917 at the prestigious Harvey Society Lecture in New
York—‘‘The Supplementary Relations Among our Common
Foodstuffs.’’ The concept was new and thought provoking for
the time, i.e., observations and knowledge acquired from ex-
perimental animal studies could be interpreted as guidance for
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daily-life eating experiences of humans. In 1918, the USDA
adapted McCollum’s five food groups into practical dietary
guidelines, a concept that the department has continued to
modify and use for public education even to the present.
Dissemination to decision makers. McCollum’s zeal for
widely disseminating the application of newer knowledge of
nutrition extended to household decision makers in 169 arti-
cles he published between 1922 and 1946 in McCall’s maga-
zine. Dr. McCollum advocated a rationale for eating that re-
flected his confidence in the supplementary relationship
among constituents of the diet. He stressed the health-related
merits of choosing from each food group in composing menus
to fill nutritional gaps left when sweets, cereals, breads and
muscular meats formed the bulk of the diet to the exclusion
of ‘‘protective foods.’’ His philosophy for enjoyment of eating
has been paraphrased as follows: ‘‘Eat what you want AFTER
you have eaten what you should.’’
McCollum’s educational zeal extended to many different
groups influential in guiding the American food supply, such
as decision makers on farms. For example, he published articles
in the well-established Hoard’s Dairyman in which he captured
the interest dairy farmers by addressing the then current situa-
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tion in animal nutrition as evolved through laboratory animal
feeding experiments. He applied the findings to their animal
husbandry concerns, which, of course, had economic implica-
tions for dairy farmers. He then linked these concerns to hu-
man nutrition in a final article entitled ‘‘The Relation of the
Dairy Industry to the Public Health.’’
McCollum disseminated newly acquired knowledge among
professional colleagues in overviews in five successive editions
of ‘‘The Newer Knowledge of Nutrition’’ and in six editions
of ‘‘Food, Nutrition and Health.’’ The publication we know
today as ‘‘Present Knowledge in Nutrition,’’ now authored by
many contributors, has continued this tradition of periodic
scientific updates.
McCollum played an active role throughout his lifetime in
influencing nutrition-related public policy, both nationally
and internationally. The United States in 1917 had entered
World War I, and soon thereafter a new entity, the U.S. Food
Administration, was created and headed by Herbert Hoover.
Its mission was to ensure the nutritional well being of our
nation, and to respond to the critical food shortages in Europe
(Day 1996). McCollum, who had just delivered the Harvey
Lecture based on the supplementary relationship of foods, was
brought to the attention of Hoover. Hoover, an astute politi-
cian, saw that this concept was ready made for the politics of
the time. The political climate in 1917 was patriotic and re-
ceptive to calls for conservation and physical fitness—an op-
portune time for McCollum to put nutrition concerns at the
forefront of national and global political agendas. For Hoover
it was a win/win situation with political, physiologic and eco-
nomic benefits to individuals, the nation and a war-torn world.
Hoover appointed McCollum to his Nutrition Advisory Group
and sent him around the country to disseminate his practical
guidelines for a nutritious diet.
Impact. Changes in U.S. food policy and in agricultural
and food-consumption practices occurred in the decade and a
half that followed, i.e., 1920–1935. Many attribute this success
largely to the pioneering effort of Dr. McCollum to move
sound nutritional research through political channels at an
opportune time to foster reliable nutrition policy and practices.
Furthermore, the programs implemented under the crisis con-
ditions of war that led to betterment of nutritional well-being
in the U.S. have had a sustained effect on maintaining a
healthier U.S. population. Some examples of public health
programs established by about 1935 include micronutrient for-
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 THE MICRONUTRIENT STORY
tification of flour, cereals and dairy products, iodization of salt
(Mertz 1997) and propagation of practical guidelines for sound
selection of food groups one should choose from daily while
still having the pleasure of eating what one wants.
PIVOTAL POINTS IN MOVING
MICRONUTRIENT RESEARCH
TO GLOBAL REALITY
Six decades after major acquisitions of knowledge provided
a sound scientific basis for public health actions to eliminate
micronutrient deficiencies in the U.S. a global micronutrient
renaissance is occurring. Elimination of micronutrient defi-
ciencies—particularly of iodine, vitamin A and iron—appears
to have suddenly leaped to the forefront of international politi-
cal agendas and into the plans for national nutrition strategies.
Since 1990, heads of state and government ministers, represen-
tatives of bilateral agencies and nongovernmental organiza-
tions and public health professionals around the world who
have attended international forums have pledged to purge or
substantially reduce populations of these deficiencies—both
overt and hidden—within the decade. Did this occur as sud-
denly as it might seem, or are there identifiable events that
facilitated incremental advancements in the last three decades
that are similar to those that charted McCollum’s successful
journey in the first three decades of the century? If such pivotal
milestones can be identified, the global community can be
encouraged that lofty goals are achievable, if not in the next
three years through crash programs internationally driven,
soon thereafter by well-planned, sustainable national pro-
grams.
[Parenthetically, the micronutrient renewal on the public
health side has paralleled a micronutrient revolution on the
molecular biology side, most notably for the retinoids (Bollag
1996) and iron (Beard et al. 1997)].
Knowledge acquired up to about 1980. As noted, the end
of the first third of the twentieth century had established link-
age between clinical signs of micronutrient deficiencies and
their nutrient-specific causes. Iodine deficiency was shown to
depress thyroid hormone production and result in cretinism
and goiter (Matovinovic 1983). Vitamin A deficiency (VAD)2
was demonstrated to disrupt epithelial tissue integrity and ocu-
lar health resulting in increased morbidity and blindness (Wolf
1996). Iron deficiency was shown to interfere with hemoglobin
synthesis that resulted in the well-recognized fatigue and pallor
of anemia (Beard et al. 1997).
The next half-century, 1930–1980, saw nutritional epide-
miologists focusing their efforts on determining how many
were affected by deficiencies of these three micronutrients,
who they were and where they lived. Population-based studies
are expensive, however, thus most of the studies conducted
during this period lacked the statistical power or the represen-
tative sampling required to chart the problem accurately. By
1980, however, ‘‘ball park’’ global prevalence estimates existed.
Dr. DeMaeyer and colleagues canvassed WHO member states
to obtain estimates of the prevalence of goiter and cretinism.
A prevalence of 20–60% was found, occurring mostly in devel-
oping countries; prevalence in the developed world where iodi-
zation programs had been instituted was as low as 5% (WHO
1993).
WHO was also instrumental in obtaining estimates of ane-
2
Abbreviations used: ICCIDD, International Council for Control of Iron Defi-
ciency Disorders; IDD, iodine deficiency disorders; INACG, International Nutri-
tional Anemia Consultative Group; IVACG, International Vitamin A Consultative
Group; VAD, vitamin A deficiency.
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147
TABLE 2
Seminal political events of last three decades leading to the
micronutrient renaissance of the 1990s
Year Event
1974 World Food Conference, Rome
1975 International Vitamin A Consultative Group (IACG)
established
1976 International Anemia Consultative Group (INACG)
established
1985 International Committee for Control of Iodine Deficiency
Disorders (ICCIDD) established
1985 Launching of the UN Agencies ten-year plan
1990 World Summit for Children, New York
1991 Policy conference on Ending Hidden Hunger, Montreal
1992 International Conference on Nutrition, Rome
1993 National Plans for Nutrition (ongoing)
1996 World Food Summit, Rome
mia prevalence, particularly in pregnant women among whom
30–75% prevalence was found in most of the developing
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world, with particularly high figures in South Asia (DeMaeyer
and Adiels-Tegman 1985). Globally, over a billion people
were projected to be afflicted by anemia, with prevalence being
much lower in developed countries where iron fortification
and supplementation programs targeted to pregnant women
were in effect.
The initial ‘‘guestimates’’ of the prevalence of VAD from
the mid-1960s WHO-sponsored global survey was 20,000–
100,000 affected children based on clinic records, anecdotal
reports and personal interviews (Oomen et al. 1964). That
this was an underestimate became obvious about a decade
later when results from the first carefully conducted national
representative survey in Indonesia revealed that about 60,000
corneal and 1.3 million noncorneal cases of xerophthalmia
occurred annually in this one country (Sommer 1982). This
statistic led to extrapolated estimates for four South and East
Asia countries of 500,000 corneal, and 4–8 million noncorneal
xerophthalmia cases annually (Sommer et al. 1981). The
global estimate was 13 million with xerophthalmia and 40–
80 million at risk of subclinical deficiency.
Partnerships for advocacy, technical and financial support
for interventions. The 1974 Rome-based World Food Con-
ference called for action to alleviate global food shortages
and micronutrient malnutrition, but follow-up activities on
a global scale were minimal. Between 1975 and 1985, as
data from scientifically sound epidemiologic surveys clearly
delineated the magnitude of clinically evident micronutri-
ent deficiencies, concern intensified. New alliances of pro-
fessional groups were formed — International Vitamin A
Consultative Group (IVACG), International Nutritional
Anemia Consultative Group (INACG) and the Interna-
tional Council for Control of Iodine Deficiency Disorders
(ICCIDD) — and some international and bilateral donor
agencies, national program managers and the private sector.
Muted alarm bells began to ring in international agencies
such as WHO, FAO and the World Food Programme
(WFP). In 1985, a 10-year UN agency plan for elimination
of iodine and vitamin A deficiencies and a reduction in
iron-deficiency anemia was launched (Table 2).
The UN call for actions, however, failed to generate suffi-
cient resources to mount a coordinated global attack, and few
countries gave high priority to micronutrients in allotment of
their own very limited health budgets. Although a clinically
evident health problem was acknowledged, it was not per-
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148 UNDERWOOD
ceived as a micronutrient deficiency crisis affecting global de-
velopment that was of sufficient magnitude to draw political
attention and action. Goiter was widely recognized as a lump
in the neck primarily of cosmetic concern, and nutritional
blindness was viewed as an unfortunate tragedy affecting rela-
tively few when compared with other blinding conditions such
as cataract and trachoma. Significant debilitating iron-defi-
ciency anemia concerned public health officials because of its
contribution to maternal mortality. Because severe anemia was
seen as limited to reproductive-age women, mainly during
pregnancy, the perception was that they could be treated
through existing maternal child services without need for new
population-based control measures. Hence, up to the 1980s,
the public and professional images associated with deficiency
of these three micronutrients were stereotyped and not of re-
source-capturing political concern. Obviously, there was need
for clarifying and repositioning the images of micronutrients
to demonstrate their true implications for economic and social
development.
Repositioning the micronutrient images to a development
perspective—1975–1990. Evidence needed to reposition
stereotyped micronutrient images was accumulated between
1975 and 1990 as a result of scientifically sound, community-
based studies that delineated the magnitude, consequences and
implication of micronutrient deficiencies.
Epidemiologic studies revealed that micronutrient defi-
ciencies, controllable by inexpensive practical interventions,
were issues not only of physiologic consequences to humans,
but issues that also had serious implications for economic and
social development of affected nations and the world. For ex-
ample, field studies demonstrated that iodine-deficient popula-
tions responded to simple iodine supplementation in the form
of concentrated oil or iodized salt by eliminating the incidence
of cretinism and reducing the prevalence and size of goiter
(Hetzel 1983, Pharoah et al. 1971). Beyond these clinically
obvious benefits of iodine prophylaxis to humans, there were
unexpected detrimental effects from not treating less obvious
deficiency on the viability and quality of animals produced for
domestic and export markets (Hetzel 1976) and on mental
performance of school-aged children (Bautista et al. 1982).
Iodine deficiency, therefore, had economic and social conse-
quences detrimental to national development that were far
greater than previously appreciated. To acknowledge expanded
consequences of less obvious deficiency, the term iodine defi-
ciency disorders (IDD) was coined (Hetzel 1983).
Community-based studies of vitamin A–deficient child
populations documented response to vitamin A given as con-
centrate in periodic high (Sommer et al. 1986) as well as
frequent low (Ramathullah et al. 1990) doses, or in fortified
foods (Muhilal et al. 1988), not only by decreased prevalence
of eye signs, but also by an average 23% reduced mortality
risk (Beaton et al. 1993). These findings had resource-saving
implications for institutional care because the severity of com-
mon childhood diseases such as diarrhea and measles was re-
duced by inexpensive vitamin A intervention (Ghana VAST
Study Team 1993, Underwood and Arthur 1996).
Studies also showed not only that anemic pregnant women
responded to iron supplementation, as expected, but unexpect-
edly, untreated moderately anemic Costa Rican (Lozoff et al.
1991) and Chilean (Walters 1995) infants, even after achiev-
ing adequate iron status after infancy, showed continued re-
tarded mental and psychomotor development deficits at 5–6
years of age. Also unexpected was improved worker productiv-
ity among iron-treated female Chinese cotton workers only
mildly or moderately anemic, which translated into increased
personal as well as corporate earnings (Li et al. 1994).
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Previously, underappreciated consequences for physiologic
development for all three micronutrients were shown by care-
fully designed scientific studies to have obvious associated con-
sequences for economic and social development of individuals,
nations and the world. Hence, sound epidemiologic research
provided the information needed to reposition the image of
micronutrients into one with obvious political appeal because
human, economic and social consequences could be averted
by low-cost available intervention programs (Hetzel 1996, Un-
derwood 1996, Yip 1994).
Hence, iodine deficiency was repositioned (Fig. 1A) from
a lump in the neck affecting 600–700 million to a range of
iodine-deficiency–related disorders (IDD; Hetzel 1983) with
a risk of loss of up to 10–13 IQ points affecting 1.5 billion
humans (WHO 1993) and innumerable potentially marketable
animals (Hetzel 1995); VAD was repositioned (Fig. 1B) from
a defect in the eye affecting 13–14 million children with an
additional 40–80 million at risk (Sommer 1981), to 250 mil-
lion at risk for their survival (WHO 1995); iron-deficiency
anemia was repositioned (Fig. 1C) from a life-threatening
problem for a half-billion pregnant women (WHO 1992) to
poor cognitive performance and work productivity affecting at
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least another one and a half billion children and adults (WHO
1997).
Logical thinking would lead to the conclusion that if impli-
cations from these findings known by the late 1980s became
broadly disseminated—and the public realized that the devas-
tating effects were preventable by available and affordable in-
tervention programs—it would be political suicide and unethi-
cal to allow continued inaction or muted preventive and con-
trol efforts on a global scale.
Politically receptive environment—1990 to present. Cre-
ating a receptive environment for this politically sensitive in-
formation required wide dissemination and strong advocacy.
Partnerships formed among scientists, program and policy mak-
ers and private sector representatives during 1975–1985 when
the critical epidemiologic studies were in progress, i.e.,
IVACG, INACG and ICCIDD, had the objective to provide
both scientifically sound advocacy and technical guidance to-
ward the control and elimination of micronutrient deficiencies.
These groups provided periodic forums for dissemination of
ongoing research findings and produced technical guidelines
for program development, implementation, monitoring and
evaluation. Their advocacy voices, however, had little effect
on high level politicians until late in the 1980s. From among
several competent spokespersons in each of the three groups,
three scientists are worthy of special note, Alfred Sommer of
IVACG (Sommer 1989), the late Edward DeMaeyer of
INACG and WHO (DeMaeyer and Adiels-Tegman 1985) and
Basel Hetzel of ICCIDD (Hetzel 1995). These three stepped
forward at a politically opportune time to carry the torch into
the political arena, as had McCollum and his contemporaries
(Markel 1987, Mastovinovic 1978) six decades earlier.
Fortunately, there was a counterpart champion for children
in the political world, the late James Grant, Executive Director
of UNICEF. His politically sensitive eyes and ears were re-
ceptive to the scientists’ message-bearers with their respective
repositioned micronutrient images, particularly for IDD and
VAD. Mr. Grant, like Herbert Hoover, saw the political impli-
cation of the micronutrient messages and envisioned how these
fit into the very high profile political milieu surrounding the
seminal UNICEF World Summit for Children, which was in
the planning stage. The issues were placed on the agenda of
the forum held in New York, and commitment to action was
pledged at the highest political level at the end of the 1990
conference (Table 2). This commitment was reinforced at lev-
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 THE MICRONUTRIENT STORY 149

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FIGURE 1 Repositioning of the images of micronutrient deficiencies—A) iodine, B) vitamin A, and C) iron—from an overt clinical problem
affecting relatively few to the veiled consequences for development of many individuals, nations and the world. Numbers are estimated prevalence
based largely on clinical signs and symptoms before 1990 (small triangles to left); after 1990, numbers are based on estimates of affected and ‘‘at
risk’’ of health consequences (larger triangles to right).

els progressively closer to the community in subsequent confer-
ences over the succeeding two years, i.e., Policy Conference
on Ending Hidden Hunger held in Montreal, Canada in 1991
and the International Conference on Nutrition held in Rome,
Italy in 1992, and national planning meetings that are ongo-
ing. These activities were reinforced by FAO convening the
World Food Summit in 1996 in Rome, Italy.
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Conventional wisdom is that when the bosses make com-
mitments, even if a bit ethereal, those answerable are more
likely to respond as requested. Hence, these conferences pro-
vided the hierarchical structure of commitment most favorable
to implementation of policies and programs, i.e., translation
of research into global realities. Micronutrients—iodine, vita-
min A and iron—were both scientifically and politically posi-
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150 UNDERWOOD
tioned for action. The yet unanswered crucial question, how-
ever, is whether in the next few years intended program recipi-
ents will partake, or more importantly will be empowered with
the information needed to become active participants in mak-
ing decisions necessary for the betterment of their own health.
Windows of opportunity for scientifically sound interven-
tion programs. Activities involved in preparation and follow-
up of the international conferences engaged a wide range of
individuals and groups. Their involvement has created unusual
opportunities to acquire, apply and disseminate nationally rele-
vant information for appropriate actions incorporating avail-
able, affordable interventions adaptable to local conditions
and sustainable resources. As of the end of 1996, national
follow-up plans of action for achieving improved nutrition-
related commitments have been developed in more than half
of WHO’s 192 member states (WHO 1997), and the interna-
tional political climate continues to be supportive. For exam-
ple, the First Lady of Bolivia placed micronutrients on the
agenda of the First Ladies Summit held in Bolivia in December
1996. To sustain this high level of commitment, however,
today’s recipients of intervention efforts have to be trans-
formed into knowledgeable consumers demanding from those
who make policy and program decisions continued access to
adequate micronutrients for their health. The strategies em-
braced, therefore, should have the critical components experi-
ence has shown to be essential to sustained progress, e.g.,
continued political and financial commitment from highest
ministerial to local implementing administrative units; com-
munity participation and program ownership; timely process
and impact monitoring; politically timely reporting of progress;
continued advocacy by international, national and local pro-
gram ‘‘champions’’; communication and education programs
to create informed clients.
Reflections on the role of the nutrition scientist in going
from research to reality. Policy and program decisions are
usually not made by scientists. Fortunately, however, decision
makers—at least in the developed world—normally decide
in partnership with the scientific community. In the U.S. we
are fortunate to have many advocacy bodies—American Soci-
ety for Nutritional Sciences (ASNS), American Society for
Clinical Nutrition (ASCN), Food and Nutrition Board (FNB),
Institute of Medicine (IOM), university groups and many oth-
ers. International groups such as UN-affiliated agencies, profes-
sional societies, such as the International Union Nutritional
Sciences (IUNS) and its adhering and affiliated bodies, and
others [e.g., Programme Against Micronutrient Malnutrition
(PAMM), Micronutrient Initiative (MI), Opportunities for
Micronutrient Interventions (OMNI), and other bilateral aid
programs] are also available to assist in-country nutrition scien-
tists and their partners.
Reflecting on my active participation with micronutrients
as a nutrition scientist involved in basic to community studies
for over 35 years, my relatively brief encounter with micronu-
trient politics representing WHO and my review of Dr. McCol-
lum’s remarkably successful life-journey from research to reality
leads me to share critical lessons learned from these interwoven
exposures. Nearly five years at WHO taught me patience but
not complacency in moving research to sustainable global real-
ity. Rarely does this transition occur by quantum leaps, but by
carefully orchestrated persistent, scientifically sound incremen-
tal steps. Nutrition scientists have a role in orchestrating those
steps as follows: 1) in the acquisition of scientifically sound
information; 2) in applying it in the appropriate politically
relevant terms in a development perspective; 3) in seeking
out and working with political counterparts to create receptive
climates for dissemination to decision makers from households
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to national planners; 4) in participating then in partnerships
for program design, implementation and monitoring; and 5)
in documenting incremental progress in politically expedient
time-frames.
Obviously, to mount each of those steps from research to
realizing a healthier global population requires many talents.
The nutritional sciences are most fortunate because of the
broad perspective and talents encompassed by our profession,
from the molecular biologist to the anthropologist to the nutri-
tion education and communication specialists. Few individuals
embrace all of the talents needed, but as teams under the
umbrella of professional groups we can and have a responsibil-
ity to contribute.
CONCLUSION
McCollum’s life journey exemplifies how sound nutrition-
related laboratory research can be translated into a realistic
perspective for those whose daily decisions affect both animal
and human health. His scientific contributions were imple-
mented in ways that empowered both politicians and people
with the knowledge needed to make nutritionally sound di-
etary decisions that carried personal benefits and improved the
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health of the nation. McCollum’s experiences, and those of
his contemporaries in micronutrient research, illustrate the
importance of politically opportune timing for science to in-
fluence national and global policy and the availability of effec-
tive, affordable and sustainable public health interventions.
Micronutrient concerns on a global scale experienced a
political renaissance less than a decade ago, and the story has
not ended. Micronutrients are on a path marked by signs that
would look familiar to Dr. McCollum, e.g., politically timely,
doable programs and commitments to action. Only well-timed
future assessments will reveal whether the course taken will
eliminate iodine and vitamin A malnutrition as public health
problems, and if iron deficiency will be substantially reduced,
and whether continued monitoring will assure that such
achievements are sustained.
The future will uncover many more journeys for nutrition
scientists in translating nutrition research into the reality of
more nutritious diets and improved global health. A reminder
from a reviewer of the IDD story is in order. It was noted
that ‘‘numerous announcements from scientific laboratories of
today sound like elaborate statements made by David Marine
long ago’’ (Matovinovic 1978). The same could be said for
E. V. McCollum and for many past giants and champions of
nutritional sciences. Too seldom do we look to seasoned expe-
riences for guidance in interpreting the present before launch-
ing journeys into the future.
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