CHAPTER V.

DIET.

The importance of a duly proportioned and sufficient dietary is shown

by its great influence on health and constitution. An ill-proportioned

or deficient diet is certain to lead to failure of health. The anatomy

of an animal may be modified in the course of generations by altered

diet, as well as its character; thus, the alimentary canal of the cat

has increased in length to adapt it to its omnivorous habits. In the

case of the bee we have a still more remarkable instance. If by any

accident the queen bee dies, or is lost, the working bees (which are

sexually undeveloped) select two or three eggs, which they hatch in

large cells, and then feed the maggot on a stimulating jelly, different

from that supplied to the other maggots, thus producing a queen bee.

The food of mankind varies naturally with—

I.—_Climate._ A cold climate leads to increased metabolism, and

consequently a large amount of fatty matter can be eaten without

producing nausea. Witness the difference between a Laplander’s and a

Hindoo’s diet.

The _season_ of the year has likewise some influence. Vital processes

are more active in spring than autumn, and more food is consequently

required in the former season.

II.—_Occupation._ Although muscular exercise is not associated with

an immediate increase of elimination of urea, yet as a matter of

experience more nitrogenous food is required and can be metabolised

by hard workers than by idlers. The trappers on the North American

prairies can live for weeks together on meat alone, accompanied

by copious draughts of tea. They are constantly in the open air,

undergoing fatiguing exercises, in a dry and rare atmosphere. For

brain workers no special food is required. Foods containing phosphorus

have no special value, so far as is known, for mental work. Such work,

however, is apt to affect digestion; consequently the digestibility of

food is more important for those engaged in sedentary occupations than

its chemical composition.

III.—_Sex._ As a rule, women require about one-tenth less food than

men, but probably this rule hardly holds good in the case of women

engaged in laborious work.

IV.—_Age._ Infants require only milk, and the less they have of any

other food before a year old the better. Atwater has calculated that——

A child under 2 requires 3∕10 the food of a man doing moderate work.

„ of 3 to 5 „ 4∕10 „ „ „ „

„ of 6 to 9 „ 5∕10 „ „ „ „

„ of 10 to 13 „ 6∕10 „ „ „ „

A girl of 14 to 16 „ 7∕10 „ „ „ „

A boy of 14 to 16 „ 8∕10 „ „ „ „

Vital processes are more active in early life, and food is required

not only to carry on the functions of the body, but also to furnish

the materials for growth. Hence, while the proportion of proteids to

carbohydrates and fats should be—

As 1:5.3 in adults, it should be about as 1:4.3 in children.

After the age of thirty-five or forty, the tendency is to take too much

food. All the tissues of the body are established, and excess of food

(especially nitrogenous food) is liable to produce tissue degeneration

by loading the system with partially metabolised matter, and may lead

to gouty diseases. It is much safer to take what may be regarded as too

little than too much food after this period.

=Times for Eating.=—The best arrangement seems to be to have three

meals, each fairly nutritious, and containing all the constituents

required. The Romans only had two meals daily, prandium and cœna. This

is common among the French at present, but it tends to overloading the

digestive organs at these meals.

An ordinary full meal has usually passed from the stomach in four

hours. Fresh food ought never to be introduced before this period; it

is advisable to allow an interval of five hours between meals for the

healthy, so as to give time for the digestive organs to rest, and for

the absorption of food. The practice of taking tea with the chief meal,

or a “meat tea,” is bad. Tea is better taken an hour or two after food.

Regularity in the time of taking meals is important, as the digestive

organs acquire habits like other parts of the body. Work ought not, if

possible, to be resumed immediately after meals, nor active exercise of

any kind. These tend to abstract blood from the digestive organs, and

so diminish the efficiency of digestion.

=Vegetable and Animal Foods.=—The fact that the food we require can

be obtained from the vegetable world has led to the proposition that

vegetable food should be taken alone. It is urged in favour of this

plan, that a large amount of suffering to animals would be prevented.

Also that animal food is not so economical as vegetable, land being

more economically employed in producing corn than in feeding cattle.

Thirdly, there is the indubitable fact that health can be maintained

for prolonged periods on vegetable food (including nuts, cereals,

fruits, etc.)

On the other hand, the chief objections to a purely vegetable diet are

that the undigested refuse is greater than with an equal quantity of

animal food; that a longer time and more exertion than for animal foods

are required in digesting the most nutritious vegetable foods, such

as legumens, while other vegetable foods do not contain a sufficient

proportion of nitrogenous material. Also, if one lived entirely on

vegetable food, a greater bulk would be required, and owing to the fact

that such food is less easily absorbed, satisfaction to the appetite

would not so soon be produced. Animal food has a great advantage as

regards convenience. Man is not an eating machine; he requires food

which is easily converted into the body substance, and this is supplied

by the flesh of animals, milk and eggs, with a due proportion of

non-nitrogenous food; sheep and oxen work up indigestible vegetable

materials into easily assimilable mutton and beef. The greater

convenience of animal food as a supply of proteid is shown by the

following examples of foods _after the removal of water_:—

100 parts of rice contain 7 parts of proteid.

„ wheat „ 16 „ „

„ pea flour „ 27 „ „

„ fat beef „ 51 „ „

„ dried lean beef „ 89 „ „

On the other hand, vegetable foods are a cheaper source, not only

of carbohydrates and fats, but also of proteids as well. Thus the

approximate cost of—

1 lb. of proteid in beef is 2s. 8d.

„ „ milk is 2s. 2d.

„ „ bread is 1s. 6d.

„ „ oatmeal is 7½d.

„ „ peas is 7d.

Under the ordinary conditions of town life, there is considerable

danger of indulging in an excess of nitrogenous food, and vegetarians

may therefore do good by showing that meat is not absolutely necessary,

and can often with advantage be largely replaced by vegetable food.

If we include milk, cheese, and eggs in the vegetarian diet, the

objections to it partially disappear; and it would be well if it were

much more widely known, especially among the poor, that on these,

together with vegetables, health can be maintained with the addition of

little or no meat.

=The Determination of Diet.=—The first principle in making a dietary

is that it =must be mixed=, containing all the necessary constituents,

proteids, hydrocarbons, carbohydrates, water, and salts. No one

of these alone will support life for any considerable period.

Carbohydrates (sugar and starch) can be most easily dispensed with;

fats, on the other hand, are essential for the maintenance of health.

The next point is to ascertain =the proportion= in which these

different foods are required. _Salts_ are commonly taken with other

foods, common salt being the only one taken alone. The amount required

is given on p. 7. The amount of _water_ required varies with the

season of the year, the amount of exercise and perspiration, and other

factors. As a rule, not more than two pints of water are required per

day, and still less if fruit is freely taken. We may therefore confine

our attention to the carbonaceous and nitrogenous foods, and try to

ascertain the amount of each of these required. Every diet must be

subjected to the following tests, to fully ascertain its value:—

1. =The Chemical Test.=—The metabolism undergone by food in the body

being essentially a process of oxidation (though partially modified

and incomplete), the amount of heat yielded on complete combustion of

a food may be taken as a measure of its value as a source of energy,

of which heat and work are convertible forms. The standard of heat

production is the =calorie=, the amount of heat required to raise the

temperature of one gramme of water 1° C. This is the small calorie.

The kilo-calorie (called the =Calorie=) is the amount of heat required

to raise 1 kilo (1 litre) of water 1° C., or 1 lb. of water 4° F. In

calculations on this basis, allowance must be made for foods which are

incompletely oxidised in the body. Rubner has shown that the heat value

of 1 gramme (=15½ grains) of each of the chief food stuffs is as

follows:—

Proteid 4.1 Calories.

Carbohydrates 4.1 „

Fat 9.3 „

The method of applying this standard to a food is as follows: the

percentage of proteid or carbohydrate given in the following table is

multiplied by 4.1, and the percentage of fat by 9.3:—

┌────────────────────────────┬──────────────────────────────────────────┐

│ │ IN 100 PARTS. │

│ ├──────┬────────────┬─────┬────────┬───────┤

│ │WATER.│ALBUMINATES │FATS.│ CARBO─ │ SALTS.│

│ │ │OR PROTEIDS.│ │HYDRATES│ │

├────────────────────────────┼──────┼────────────┼─────┼────────┼───────┤

│_Uncooked meat with little │ │ │ │ │ │

│ fat_ │ 74.4 │ 20.5 │ 3.5 │ ─ │ 1.6 │

│_Cooked meat─without loss_ │ 54 │ 27.6 │15.45│ ─ │ 2.95 │

│_Salt beef_ │ 49.1 │ 29.6 │ 0.2 │ ─ │ 21.0 │

│_White fish_ │ 78.0 │ 18.1 │ 2.9 │ ─ │ 1.0 │

│_Bread, white wheaten_ │ 40. │ 8. │ 1.5 │ 49.2 │ 1.3 │

│_Wheat flour_ │ 15. │ 11. │ 2. │ 70.3 │ 1.7 │

│_Rice_ │ 10 │ 5 │ .8 │ 83.2 │ 0.5 │

│_Oatmeal_ │ 15 │ 12.6 │ 5.6 │ 63.0 │ 3. │

│_Peas (dry)_ │ 15 │ 22 │ 2. │ 53. │ 2.4 │

│_Potatoes_ │ 74 │ 1.5 │ .1 │ 23.4 │ 1. │

│_Butter_ │ 8 │ 2. │88 │ ─ │variable│

│_Eggs (including shell, for │ │ │ │ │ │

│ which deduct 10 per cent.)_│ 73.5 │ 13.5 │11.6 │ │ 1 │

│_Cheese_ │ 36.8 │ 33.5 │24.3 │ ─ │ 5.4 │

│_Milk_ │ 87.0 │ 4. │ 3.5 │ 4.8 │ .7 │

└────────────────────────────┴──────┴────────────┴─────┴───────┴────────┘

Thus for bread—

Proteid 8 × 4.1 = 32.8

Fat 1.5 × 9.3 = 13.95

Carbohydrate 49.2 × 4.1 = 201.72

——————

Total Caloric value of 100 grammes of bread = 248.47

The total fuel value in Calories of one pound of certain typical foods

is given by Hutchison as follows:—Butter 3,577, peas 1,473, cheese

1,303, bread 1,128, eggs 739, beef 623, potatoes 369, milk 322, fish

(cod) 315, apples 238.

2. =The Physiological Test.=—Not only is a proper proportion of

proteid, fat, and carbohydrates required, but these must be capable

of digestion and absorption and of oxidation in the body. Cheese is a

highly concentrated food, but its value is less than its percentage

composition would indicate, because of the difficulty of digesting

considerable quantities of it. Green vegetables consist largely of

cellulose, which is only imperfectly capable of absorption into the

blood, although it can experimentally be oxidised by combustion. The

proportion between absorbed food and food rejected in the fæces can

be ascertained by analysis. Many experiments made on these lines show

that on a purely animal diet (meat, eggs, milk) but little nitrogen is

lost, while with vegetable foods (carrots, potatoes, peas, etc.) the

waste of nitrogen is considerable. Fats are very completely absorbed

from the alimentary canal. The amount remaining unabsorbed is greatest

with mutton fat (10 per cent.), least with butter (2½ per cent.).

Experimentally it has been found that an amount up to 150 grammes

(about 5½ oz.) of fat can be absorbed without appreciable loss.

Carbohydrates are very completely absorbed, even starchy foods rarely

escaping digestion. Completeness of absorption from the alimentary

canal is not desirable for all foods; a certain amount of unabsorbed

residue is required to stimulate peristalsis. With a purely vegetable

diet this amount is excessive, and there is physiological waste of

effort.

3. In practical dietetics =the Economic test= is important.

Carbohydrate is by far the cheapest food, and generally vegetable

are cheaper than animal foods. Thus a shilling’s-worth of bread

yields 10,764 Calories, while the same sum spent on milk would only

yield 1∕3, and on beef 1∕10 this number of heat units. Similarly a

shilling’s-worth of peas contains 572 grammes of proteid, about double

as much as the same money’s-worth of cheese; while to obtain the same

amount of proteid from eggs would cost more than eight, and from beef

more than five times as much as from peas (Hutchison). The market

price of foods is no certain indication of their nutritive value. Thus

haddock will supply as much nutriment as sole at a fourth of the cost;

Dutch as much nutriment as Stilton cheese at less than half the cost.

Similarly the most economical fats are margarine and dripping.

4. =An Examination of Actual Dietaries= under various conditions has

strikingly confirmed the results obtained by other methods. It has

been found that (_a_) the _potential energy_ required by a healthy man

weighing 11 stones, and doing a moderate amount of muscular work is

3,000 to 3,500 Calories (=310 grains); and that (_b_) about 20 grammes

of nitrogen and 320 grammes (=4,960 grains) of carbon are excreted

by such a man. (_c_) Expressing the 3,000 Calories required in terms

of grammes of food, it is found that 125 grammes of proteid, 500 of

carbohydrate and 50 of fat are necessary. These facts are expressed in

the following table (Hutchison):—

┌──────────────┬──────────────────┬───────────────────┬───────────────┐

│ │STANDARD AMOUNT OF│ SAME AMOUNT OF │ │

│ │FOOD CONSTITUENTS │ FOOD IN TERMS OF │YIELDING ENERGY│

│ │REQUIRED ├─────────┬─────────┤ IN CALORIES. │

│ │(IN GRAMMES). │ CARBON. │NITROGEN.│ │

│ ├──────────────────┼─────────┼─────────┼───────────────┤

│_Proteid_ │ 125 │ 62 │ 20 │ 512·5 │

│_Fat_ │ 500 │ 200 │ ── │ 2050· │

│_Carbohydrate_│ 50 │ 38 │ ── │ 465· │

│ ├──────────────────┼─────────┼─────────┼───────────────┤

│ │ 675 │ 300 │ 20 │ 3027·5 │

└──────────────┴──────────────────┴─────────┴─────────┴───────────────┘

Three of the best known standard dietaries give the amounts in grammes

of each food constituent as follows:──

┌──────────────┬─────────────┬─────────────┬─────────────┬────────────┐

│ │ PLAYFAIR. │ MOLESCHOTT. │ ATWATER. │ AVERAGE. │

│ ├─────────────┼─────────────┼─────────────┼────────────┤

│_Proteid_ │ 119 │ 130 │ 125 │ 125 │

│_Fat_ │ 51 │ 40 │ 125 │ 72 │

│_Carbohydrate_│ 531 │ 550 │ 450 │ 510 │

├──────────────├─────────────┼─────────────┼─────────────┼────────────┤

│Calories │ 3140 │ 3160 │ 3520 │ 3273 │

└──────────────┴─────────────┴─────────────┴─────────────┴────────────┘

Expressing the same facts in English ounces instead of grammes, 4-2∕5

oz. of proteid, 2½ oz. of fat, and 18 oz. of carbohydrate, would

represent the ounces of each constituent required according to

(1) (2)

┌────────────────────┬────────────────┬────────────────┐

│ │AVERAGE OF ABOVE│ HUTCHISON. │

│ │THREE DIETARIES.│ │

│ ├────────────────┼────────────────┤

│_Proteid_ │ 4-2∕5 │ 4-2∕5 │

│_Fat_ │ 2-1∕2 │ 1-4∕5 │

│_Carbohydrate_ │ 18 │ 17-3∕5 │

├────────────────────├────────────────┼────────────────┤

│_Ounces of dry food_│ 24-9∕10 │ 23-4∕5 │

└────────────────────┴────────────────┴────────────────┘

The chief point of divergence in the above standard dietaries is in

the relative proportion of carbohydrate and fat. Probably the correct

proportion between these is as 1 to 10; but it will vary according to

climate and other circumstances. Detailed examination of a large number

of dietaries shows that the amount of daily proteid should be about

125 grammes, or 4-2∕5 ozs. This is contained in 20 eggs, or in 18 oz.

_i.e._ about 4½ ordinary platesful of cooked meat.

It must be noted that the 23-24 oz. of food given above as the standard

daily amount represents dry food. This represents 40 oz. or nearly 3

lbs. of ordinary food.

The following example by Waller, gives a rather liberal standard

English diet, for a man doing a moderate amount of muscular work.

CARBON. NITROGEN.

_Foundation_: 1 lb. bread 117 5.5

1∕2 lb. meat 34 7.5

1∕4 lb. meat 84 —

_Accessories_: 1 lb. potatoes 45 1.3

1∕2 pint milk 20 1.7

1∕4 lb. eggs 15 2.0

1∕8 lb. cheese 20 3.0

——— ————

Total 335 21 grammes.

This divided up into meals works out roughly as follows (Hutchison):—

{Two slices of thick bread and butter.

Breakfast {Two eggs.

{One plateful of potato soup.

Dinner {A large helping of meat with some fat.

{Four moderate sized potatoes.

{One slice of thick bread and butter.

Tea A glass of milk and two slices of thick bread and butter.

Supper Two slices of thick bread and butter and 2 oz. of cheese.

From the preceding data, practical problems as to dietaries are easily

solved. Thus if it be required to find

_how much oatmeal, milk, and butter would be required to give a

sufficient quantity of albuminoids, fats, and carbohydrates to an

adult male_,

the calculation may be based on the figures in the table on p. 32, or

the following figures may, for the sake of convenient calculation, be

taken as representing the percentage amount of each of these chief food

principles contained in the foods named:—

ALBUMINOIDS. FATS. CARBOHYDRATES.

Oatmeal 12 6 60

Milk 4 3 5

Butter 2 88 —

Let o = number of ounces of oatmeal required.

m = „ „ milk „

b = „ „ butter „

Then (12o + 4m + 2b)∕100 = 4.5 ozs. of albuminoid

(6o + 3m + 88b)∕100 = 3 ozs. of fat

(60o + 5m)/100 = 14.25 ozs. of carbohydrate,

according to Moleschott’s diet.

When these equations are worked out by substitution and transference—

o = 19.2 ounces.

m = 55.4 „

b = 0.24 „

_Similarly if it is required to find how much meat, bread, and butter

of the following percentage composition will be required to give a man

a sufficient amount of albuminoids, fats, and carbohydrates._

ALBUMINOIDS. FATS. CARBOHYDRATES.

Meat 25 15 0

Bread 8 1.5 50

Butter 2 88 0

Let m = number of ounces of meat required.

b = „ „ bread „

B = „ „ butter „

Then 12m + 8b + 2B/100 = 4.5 ozs. of albuminoid

(15m + 1.5b + 88B)/100 = 3 ozs. of fat

50b/100 = 14.25 ozs. of carbohydrates

When these equations are worked out—

m = 6.28 ounces.

b = 28.5 „

B = 1.15 „

=Relation of Food to Mechanical Work.=—In the body the movements of

every part are constant sources of heat. It is evident therefore that

the potential energy of food can be expressed by (_a_) the amount of

heat obtained by its complete combustion, or (_b_) by the amount of

work capable of being obtained from it. Joule discovered by exact

experiment that the mechanical power obtainable from a given amount

of fuel is directly proportional to the amount of fuel used, being

in fact due to the oxidation of this fuel, the heat produced being

transformed into mechanical power. The _heat unit_ or calorie has been

already given (p. 32). The gram-metre is the _work unit_. The heat unit

corresponds to 425.5 units of work. Thus the same energy required to

heat one gramme of water 1° C. will raise a weight of 425.5 grammes to

the height of 1 metre. Conversely a weight of 425 grammes if allowed

to fall from a height of 1 metre, will by its concussion produce heat

sufficing to raise the temperature of 1 gramme of water 1° C. In

England the amount of work done is commonly expressed as foot tons,

_i.e._ tons lifted one foot; while in France it is similarly expressed

as kilogrammetres. Gramme-metres can be converted into foot-pounds

by multiplying them by .007233, and kilogrammetres into foot-tons by

dividing by 311.

Frankland estimated that—

1 oz. dry albumin yields 174 foot-tons of potential energy.

1 oz. fat „ 378 „ „

1 oz. starch „ 135 „ „

1 oz. cane sugar „ 129 „ „

1 oz. glucose or lactose „ 122 „ „

In practical dietetics digestibility of food as well as chemical

composition is an important factor. Furthermore metabolism in the body

is not in every instance so complete as oxidation outside it. Hence

estimates of potential energy can only be regarded as theoretically

correct. Examination questions like the following are occasionally

asked:—

A man does work equal to 176.8 foot-tons in a day. Supposing that he

eats only bread, how much will he require to give the amount of energy

required, if bread contains 8 per cent. proteid, 1.5 per cent. fat,

and 49.2 per cent. carbohydrate?

On the above basis, from 100 ounces of bread the amount of potential

energy obtainable is:—

8 × 174 = 1,392 foot-tons

1.5 × 378 = 567 „

49.2 × 135 = 6,642 „

——-——

Total energy = 8,601 „ obtained from 100 ozs. bread.

Let _b_ = number of ounces of bread required to develop 176.8

foot-tons of energy.

Then 8,601: 100:: 176.8: _b_.

Therefore _b_ = +2.05 ounces+.

Hygiene: a manual of personal and public health (New Edition) · 第 5 / 48 章