Ecological Nutrition: Redefining Healthy Food in Health Care

Within what can be called the healthy food in health care (HFHC) movement, a growing coalition of actors are leveraging scientific data on the environmental health impacts of the conventional, industrial food system to inspire and legitimize a range of health care initiatives aligned with alternative agrifood ideals. They are shifting the definition of food-related health from a nutritionism model, eating the right balance of nutrients and food groups, to what I call an ecological nutrition model, examining the public health impacts of social, economic, and environmental factors related to the entire agrifood system. This represents potentially powerful new alliances between alternative agrifood movements and health care institutions with deep pockets and cultural clout./nUsing a commodity network approach, which combines evaluation of material and economic supply chain dynamics with analysis of the governing power of symbolic constructions of food, I explore social, political, and economic relationships shaping the HFHC movement with attention to scale, networks of power, meaning, and materiality. I analyze the significance of the HFHC movement from farm to hospital as it opens new markets for alternative foods and food system infrastructure, as well as from hospital to farm as a cadre of health experts find new interest in federal agrifood policy on issues including antibiotic use in livestock production, pesticides, and genetically modified organisms./nAs hospitals within the HFHC movement attempt to move from ecological nutrition ideals to the institutionalization of alternative procurement practices, they are struggling to navigate the tensions between their new food commitments and their reliance on the efficiency, affordability, and standardization provided by the conventional, industrial food system. By providing empirical data and analysis on this scale and values dilemma, I shed light on the question of whether the alternative agrifood movement can effectively scale up to meet institutional demand without losing sight of the social, health, and environmental values that brought it into being./nI contribute to emerging fields of farm to institution, agriculture of the middle, and values-based supply chain theory and practice focused on mid-scale food system interventions. My work is the first to examine the opportunities and obstacles a set of powerful supply chain players called Group Purchasing Organizations pose to alternative agrifood movements. I also examine the successes and challenges of a specific HFHC project that seeks to leverage conventional regional food distributors in order to meet both the scale-based requirements and values-based goals of HFHC farm to hospital initiatives./nFinally, I contribute to and call for more scholarly conversations that engage with both the discursive and corporeal nature of human bodies. In an ecological nutrition discourse, human bodies are both flesh and metaphor - beset by a growing assemblage of health woes attributed to the dominant agrifood system, as well as the portal through which we begin to tell a different story about our relationship to agrifood practices and policies. Ultimately, in the HFHC movement, the body and its disease or well-being are at the center of serious contestations over the food system, right use of the landscape, and appropriate use of agrifood technologies. Speaking for diseased bodies, HFHC advocates can be understood as seeking to re-embed the food system within its ecological context through transformation of food commodity networks, public health and agricultural policies, and cultural notions of what constitutes healthy food.

Advisor: Winickoff, David