244. Object of Dietary Studies.—The quantity of food which different families purchase varies between wide limits; a portion being lost mechanically in preparation and a still larger and more variable amount in the refuse and non-edible parts. If a record is made of all foods purchased and the waste and non-edible portions are deducted, the nutrients consumed by a family may be calculated by multiplying the weight of each food by the average composition. If such calculations be made, it will be found that in some families nearly a half pound per day of both protein and fat is consumed by adults, while in other families less than half of this amount is used. The object of dietary studies is to determine the source, cost, composition, and nutritive value of the foods consumed by different families; they also enable comparisons to be made of the amounts of nutrients purchased. Extensive dietary studies have been made by the United States Department of Agriculture, and the results have been published in various bulletins.^[76]

245. Wide and Narrow Rations.—When the amount of carbohydrates in a ration is small in comparison with the protein, it is called a narrow ration, while a wide ration is one in which the carbohydrates are much in excess of the protein. When a ration contains 0.40 of a pound of protein, 0.40 of a pound of fat, and 1 pound of carbohydrates, it has a nutritive ratio of 1 to 4.8 and is a narrow ration. To calculate the nutritive ratio, the fat is multiplied by 2¼, the product added to the carbohydrates, and this sum divided by the protein. It is not possible to designate accurately the amount of protein and other nutrients that should be in the daily ration of all persons, because the needs of the body vary so with different individuals. Hard and fast rules governing the amounts of nutrients to be consumed cannot as yet be formulated, as our knowledge of the subject is too limited. It is known that both excessive and scant amounts are alike injurious. While the appetite may indicate either hunger or satiety, it alone cannot always be relied upon as a safe guide for determining the amount and kind of food to consume, although the demands of appetite should not be disregarded until it has been demonstrated beyond a doubt that it is not voicing the needs of nature. There has been a tendency which perhaps was a survival of the Puritanical ideas of the early days to stamp as hurtful whatever seemed desirable and pleasant; as examples might be cited the craving for water by fever patients, and for sugar by growing children, which have now been proven to be normal demands of nature.

246. Dietary Standards.—As a result of a large number of dietary studies and digestion experiments, dietary standards have been prepared. Atwater in this country and Voit in Germany have proposed such standards for men employed at different kinds of labor, as follows:

In the table it will be seen that the quantity of nutrients increases with the labor to be performed. In order to secure the necessary heat and energy, rations for men at heavy labor contain proportionally more fat and carbohydrates than are required for light work. All dietary standards, however, should be regarded as tentative only. Opinions differ greatly on different points; for example, as to the amount of protein a ration should contain. This is a matter that can be determined only from extended investigations under a variety of conditions, and as yet results are too meager to formulate other than tentative standards. Chittenden has found that the body can be sustained on very much less protein than is called for in the standard ration.^[77] The amount of protein in the ration should be ample to sustain the body weight and maintain a nitrogen equilibrium; that is, the income and outgo of nitrogen from the body should be practically equal.

Fig. 58.—Dietaries and Dietary Standards.

(From Office of Experiment Stations Bulletin.)

On the other hand, excessive and unnecessarily large amounts of protein are sometimes consumed, adding greatly to the cost of the ration and necessitating additional labor on the part of the body for its elimination.

247. Number of Meals per Day.—Some persons advocate two meals per day rather than three, but dietary studies show that the best results are secured when the food is divided among three rather than two meals, and with a two-meal system the tendency is to consume a larger total amount of food than when three meals are eaten. It is not essential that the food be equally divided among the three meals. Any one of them may be lighter or more substantial as the habits and inclinations of the individual dictate. If it is found necessary to reduce the total quantity of food consumed, this may be done by a proportional reduction of each of the meals, or of any one of them instead of decreasing the number of meals per day. The occasional missing of a meal is sometimes beneficial, in cases of digestion disorders, but the ordinary requirements of persons in normal health who have either mental or physical labor to perform are best met when three meals per day are consumed, as this insures an even supply of nutrients. For persons of sedentary habits, the kind and quantity of food at each meal must be regulated largely by the individual from knowledge based on personal experience.

If there is trouble in digesting the food, it is well to study the other habits of life along with the food question, for it may be the difficulty arises from some other cause, and would be remedied by more exercise and fresh air, avoiding rush immediately after meals, more thorough mastication, or less worry. It is a serious matter to shut off the supply of food from a person not suffering from some disease and who is working; as well cut off the supply of fuel from a furnace and then expect a full amount of energy and heat. But unlike the furnace, when the human body is deprived of needed nutrients it preys upon itself and uses up its reserve that should be drawn upon only in cases of illness or extreme nervous strain. Some persons live in such a way as to never have any reserve of strength and energy to call upon but use up each day all the body can produce and so become physical bankrupts when they should be in their prime. Food is required for the production of nerve energy as well as physical energy.^[78]

248. Mixed Dietary Desirable.—Experiments in the feeding of farm animals show that the best results come from the combination of a number of foods to form a mixed ration, rather than from the use of one food alone,^[79] for in this way the work of digestion is more evenly distributed, and a higher degree of efficiency is secured from the foods consumed. The same is true in human feeding; the best results are secured from a mixed diet. Ordinarily, about two fifths of the nutrients of a ration are derived from animal and three fifths from vegetable sources.

249. Animal and Vegetable Foods; Economy of Production.—Animal foods can never compete in cheapness of the nutrients with cereals and vegetables, as it takes six to eight pounds or more of a cereal, together with forage crops, to make a pound of meat. Hence the returns in food value are very much larger from the direct use of the cereals as human food, than from the feeding of cereals to cattle and the use of the meat. As the population of a country increases, and foods necessarily become more expensive, cereals are destined to replace animal foods to a great extent, solely as a matter of economy.

250. Food Habits.—Long-established dietary habits and customs are not easily changed, and when the body becomes accustomed to certain foods, substitution of others, although equally valuable, may fail to give satisfactory results. For example, immigrants from southern Europe demand foods with which they are familiar, as macaroni, olive oil, and certain kinds of cheese, foods which are generally imported and more expensive than the staples produced in this country,^[80] and when they are compelled to live on other foods, even though they have as many nutrients, they complain of being underfed. Previously acquired food habits appear to affect materially the process of digestion and assimilation. Sudden and pronounced change in the feeding of farm animals is attended with unsatisfactory results, and whenever changes are made in the food of either humans or animals they should be gradual rather than radical.

251. Underfed Families.—As the purchasing of food is often done by inexperienced persons, palatability rather than nutritive value is made the basis of choice. Dietary studies show that because of lack of knowledge of the nutritive value of foods, whole families are often underfed. Particularly is this true where the means for purchasing foods are limited. In dietary studies among poor families in New York City,^[81] the United States Department of Agriculture notes: "It is quite evident that what is needed among these families more than anything else is instruction in the way to make the little they have go the farthest." Some classes of the rich too are equally liable to be underfed, as they are more prone to food notions and are able to indulge them. Among the children of the rich are found some as poorly nourished as among the poor.

252. Cheap and Expensive Foods.—Among the more expensive items of a ration are meats, butter, and canned fruits. The difference in composition and nutritive value between various cuts of meat is small, being largely physical, and affecting taste and flavor rather than nutritive value. Expensive cuts of meat, high-priced breakfast cereals, tropical fruits and foods which impart special flavors, add little in the way of nutritive value to the ration, but greatly enhance the cost of living. Ordinarily the cheapest foods are corn meal, wheat flour and bread, milk, beans, cheese, sugar, and potatoes.^[7] The amount of animal and vegetable foods to combine with these to form a balanced ration may be governed largely by personal preference or cost, as there is little difference in nutritive value. The selection of foods on the basis of cost and nutritive value is discussed in Chapter XVI.

253. Food Notions.—Many erroneous ideas exist as to the nutritive value of foods, and often wholesome and valuable foods are discriminated against because of prejudice. Skim milk is usually regarded as containing little if any nourishing material, when in reality it has a high protein content, and can be added to other foods to increase their nutritive value. The less expensive cuts of meat contain more total nutrients than many of the more expensive ones. Beef extracts have been erroneously said to contain more nutrients than beef,^[51] and mushrooms to be equal in value of beefsteak; chemical analyses fail to confirm either statement. The banana also has been overestimated as to food value, and while it contains more nutrients than many fruits, it is not the equal of cereals, as has been claimed.^[82] Cocoa, although a valuable beverage, adds but little in the way of nutrients to a ration unless it is made with milk. The value of a food should be based upon its composition as determined by chemical analysis, its digestibility as founded upon digestion experiments, and its palatability and mechanical structure. Food notions have, in many instances, been the cause of banishing from the dietary wholesome and nutritious foods, of greatly increasing the cost of living, as well as of promulgating incorrect ideas in regard to foods, so that individuals and in some cases entire families have suffered from improper or insufficient food.

254. Dietary of Two Families Compared.—A dietary study often reveals ways in which it is possible to improve the ration in kinds and amounts of food, and sometimes at less expense. The following dietaries of two families for the same period show that one family expends over twice as much in the purchase of foods as the other family, and yet the one whose food costs the less actually secures the larger amount of nutritive material and is better fed than the family where more money is expended for food.^[13]

Food Consumed, One Week

Fig. 59.—Cost and Nutritive Value of Rations.

In comparing the foods used by the two families, it will be observed that family No. 1 purchased their bread at the bakery at a cost of $ 1.00, while the bread of family No. 2 was home-made, skim milk being used in its preparation, the flour, milk, yeast, and shortening costing about 55 cents. Family No. 1 consumed 10 pounds of expensive steaks, family No. 2 consumed the same number of pounds, a portion being cheaper cuts. Instead of the 20 pounds of roast or similar beef used by family No. 1, only one half as much and cheaper cuts as boiling pieces, stew, rump roast, etc., were used by family No. 2; 5 pounds of beans and 5 pounds of cheese taking the place of some of the meat. Family No. 1 consumed 4 pounds of high-priced cereal breakfast foods, supposing they contained a larger amount of nutrients than were actually present. In place of the 4 pounds of high-priced cereal breakfast foods of family No. 1, family No. 2 used 5 pounds of oatmeal purchased in bulk. Family No. 1 bought their cake and pastry for $3.00, while those of family No. 2 were home made and cost $1.00. Family No. 2 used 2 pounds less butter per week because of the preparation and use of home-made shortening from beef suet and milk. They also purchased a smaller amount of tea, coffee, and spices than family No. 1. Family No. 2 consumed a larger quantity of less expensive fruits and vegetables than family No. 1, who ate 75 cents' worth of mushrooms with the idea that they contained as much protein as meat, but analyses show that mushrooms contain no more nutrients than potatoes and similar vegetables. In place of the celery and oranges, apples and prunes were used by family No. 2. The same amount of potatoes was used by each. Fifty cents was spent for milk by family No. 1 and $1.00 by family No. 2. The total amount expended for food by family No. 1 was $23.45, while family No. 2 purchased a greater variety of foods for $11.30, as well as foods containing more nutrients. The approximate amounts of nutrients in the foods purchased by the two families are given in the following table, from which it will be observed that family No. 2 obtained a much larger amount of total nutrients and was better fed at considerably less expense than family No. 1.

Nutrients in Foods Consumed.—Family No. 1

Family No. 2

255. Food in its Relation to Mental and Physical Vigor.—When the body is not properly supplied with food, the best results in the form of productive work cannot be secured. There is a close relationship between the nature of the food consumed and mental activity, also ability to satisfactorily perform physical labor. "The productive power of the individual as well as of the nation depends doubtless upon many factors other than food, such as race, climate, habit, etc., but there is no gainsaying the fact that diet has also a profound and direct influence upon it."^[83]

If the body is diseased, it cannot make the right uses of the food, and often the food is blamed when the trouble is due primarily to other causes. The fact that a diseased digestive tract is unable to utilize some foods is no valid reason why these foods should be discarded in the dietary of persons in normal health, particularly when the food is in no way responsible for the disease.

Some diseases are most prevalent in the case of a restricted diet. A change in the dietary of the Japanese navy greatly improved the health of the sailors.

256. Dietary Studies in Public Institutions.—Dietary studies in public institutions, as prisons, and asylums for the insane, show that it is possible to secure greater variety of food containing a larger amount of nutrients, and even at a reduction in cost.^[84] In such institutions it is important that the food should be not only ample in amount, but wholesome and nutritious, as many of the inmates respond both physically and mentally to an improved diet. For humanitarian as well as economic reasons institutional dietetics should more generally be placed under the supervision of skilled dietists.