Page:EB1911 - Volume 08.djvu/236

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DIETETICS
219

The heats of combustion of all the fats in an ordinary mixed diet would average about 9·40 calories per gram, but as only 95% of the fat would be available to the body, the fuel value per gram would be (9·40 × 0·95 =) 8·93 calories. Similarly, the average heat of combustion of carbohydrates of the diet would be about 4·15 calories per gram, and as 97% of the total quantity is available to the body, the fuel value per gram would be 4·03. (It is commonly assumed that the resorbed fats and carbohydrates are completely oxidized in the body.) The heats of combustion of all the kinds of protein in the diet would average about 5·65 calories per gram. Since about 92% of the total protein would be available to the body, the potential energy of the available protein would be equivalent to (5·65 × 0·92 =) 5·20 calories; but as the available protein is not completely oxidized allowance must be made for the potential energy of the incompletely oxidized residue. This is estimated as equivalent to 1·15 calories for the 0·92 gram of available protein; hence, the fuel value of the total protein is (5·20 − 1·15 =) 4·05 calories per gram. Nutrients of the same class, but from different food materials, vary both in digestibility and in heat of combustion, and hence in fuel value. These factors are therefore not so applicable to the nutrients of the separate articles in a diet as to those of the diet as a whole.

6. Food Consumption.—Much information regarding the food consumption of people in various circumstances in different parts of the world has accumulated during the past twenty years, as a result of studies of actual dietaries in England, Germany, Italy, Russia, Sweden and elsewhere in Europe, in Japan and other oriental countries, and especially in the United States. These studies commonly consist in ascertaining the kinds, amounts and composition of the different food materials consumed by a group of persons during a given period and the number of meals taken by each member of the group, and computing the quantities of the different nutrients in the food on the basis of one man for one day. When the members of the group are of different age, sex, occupation, &c., account must be taken of the effect of these factors on consumption in estimating the value “per man.” Men as a rule eat more than women under similar conditions, women more than children, and persons at active work more than those at sedentary occupation. The navvy, for example, who is constantly using up more nutritive material or body tissue to supply the energy required for his muscular work needs more protein and energy in his food than a bookkeeper who sits at his desk all day.

In making allowance for these differences, the various individuals are commonly compared with a man at moderately active muscular work, who is taken as unity. A man at hard muscular work is reckoned at 1·2 times such an individual; a man with light muscular work or a boy 15-16 years old, ·9; a man at sedentary occupation, woman at moderately active muscular work, boy 13-14 or girl 15-16 years old, ·8; woman at light work, boy 12 or girl 13-14 years old, ·7; boy 10-11 or girl 10-12 years old, ·6; child 6-9 years old, ·5; child 2-5 years old, ·4; child under 2 years, ·3. These factors are by no means absolute or final, but are based in part upon experimental data and in part upon arbitrary assumption.

The total number of dietary studies on record is very large, but not all of them are complete enough to furnish reliable data. Upwards of 1000 are sufficiently accurate to be included in statistical averages of food consumed by people in different circumstances, nearly half of which have been made in the United States in the past decade. The number of persons in the individual studies has ranged from one to several hundred. Some typical results are shown in Table IV.

7. Quantities of Nutrients needed.—For the proper nourishment of the body, the important problem is how much protein, fats and carbohydrates, or more simply, what amounts of protein and potential energy are needed under varying circumstances, to build and repair muscular and other tissues and to supply energy for muscular work, heat and other forms of energy. The answer to the problem is sought in the data obtained in dietary studies with considerable numbers of people, and in metabolism experiments with individuals in which the income and expenditure of the body are measured. From the information thus derived, different investigators have proposed so-called dietary standards, such as are shown in the table below, but unfortunately the experimental data are still insufficient for entirely trustworthy figures of this sort; hence the term “standard” as here used is misleading. The figures given are not to be considered as exact and final as that would suggest; they are merely tentative estimates of the average daily amounts of nutrients and energy required. (It is to be especially noted that these are available nutrients and fuel value rather than total nutrients and energy.) Some of the values proposed by other investigators are slightly larger than these, and others are decidedly smaller, but these are the ones that have hitherto been most commonly accepted in Europe and America.

Table V.Standards for Dietaries. Available Nutrients and Energy per Man per Day.
Protein. Fat. Carbo-
hydrates.
Fuel
Value.
Voit’s Standards. Grams.[1] Grams. Grams. Calories.
Man at hard work 133 95 437 3270
Man at moderate work 109 53 485 2965
Atwater’s Standards.    
Man at very hard muscular work 161 · ·[2] · ·[2] 5500
Man at hard muscular work 138 · · · · 4150
Man at moderately active muscular work 115 · · · · 3400
Man at light to moderate muscular work 103 · · · · 3050
Man at “sedentary” or woman at moderately active work  92 · · · · 2700
Woman at light muscular work, or man without muscular exercise  83 · · · · 2450

8. Hygienic Economy of Food.—For people in good health, there are two important rules to be observed in the regulation of the diet. One is to choose the foods that “agree” with them, and to avoid those which they cannot digest and assimilate without harm; and the other is to use such sorts and quantities of foods as will supply the kinds and amounts of nutrients needed by the body and yet to avoid burdening it with superfluous material to be disposed of at the cost of health and strength.

As for the first-mentioned rule, it is practically impossible to give information that may be of more than general application. There are people who, because of some individual peculiarity, cannot use foods which for people in general are wholesome and nutritious. Some persons cannot endure milk, others suffer if they eat eggs, others have to eschew certain kinds of meat, or are made uncomfortable by fruit; but such cases are exceptions. Very little is known regarding the cause of these conditions. It is possible that in the metabolic processes to which the ingredients of the food are subjected in the body, or even during digestion before the substances are actually taken into the body, compounds may be formed that are in one way or another injurious. Whatever the cause may be, it is literally true in this sense that “what is one man’s meat is another man’s poison,” and each must learn for himself what foods “agree” with him and what ones do not. But for the great majority of people in health,

  1. One ounce equals 28·35 grams.
  2. 2.0 2.1 As the chief function of both fats and carbohydrates is to furnish energy, their exact proportion in the diet is of small account. The amount of either may vary largely according to taste, available supply, or other condition, as long as the total amount of both is sufficient, together with the protein to furnish the required energy.