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December 15, 1962


JAMA. 1962;182(11):1115. doi:10.1001/jama.1962.03050500047013

Nutritional diseases, according to Moises Behar and Nevin Scrimshaw,1 should be considered on the same basis as other diseases: interaction between host and agent. The lack of an essential ingredient as the agent in causing nutritional disease is only part of the story. The production of the disease depends also upon host factors, such as age, sex, activity, genetic variation, growth, pregnancy, lactation, neoplasms, infections, trauma, and metabolic abnormalities. Further, agent and host factors are influenced by a wide range of environmental factors, each of which involves host or agent or both, and which will, in turn, be conditioned by physical, biological, and socioeconomic factors.

This epidemiological concept of multiple causation of nutritional disease adds up to a fairly complicated interrelationship between host and agent and environment. From it all we learn that: (1) the requirements of the host depend chiefly on physical factors which are principally climatic variables,

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