Malnutrition and "nutrition engineering" in low-income countries: a comment on Alan Berg's vision of the nutrition track record.

Alan Berg, senior nutrition advisor at the World Bank, recently asserted that Western nutritionists have engaged in "nutrition malpractice" with respect to undernutrition in developing countries. This "malpractice" results from both an underemphasis on applied research and an education of nutritionists that leaves them unprepared for practical, "how-to" aspects of applying technologies effectively to nutritional deficiency problems. The author criticizes Berg's conceptualization of undernutrition as a technical or "engineering" problem and highlights the need for a better understanding of structural determinants of malnutrition. A critique is also offered of Berg's assertion that political commitment of governments of developing countries and levels of research funding are not important constraints to combatting malnutrition. The author recommends that research and training in applied nutrition should include education of nutritionists from the regions in which the deficiency problems are found.