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Good Health and Bad Medicine:
 Diet - Part 2

 Diet - Part 3

 Diet - Part 4

 Diet - Part 5

 Some Common Food Fallacies

 Teeth - Part 1

 Teeth - Part 2

 Teeth - Part 3

 Obesity - Part 1

 Obesity - Part 2

 Read More Articles About: Good Health and Bad Medicine

Diet - Part 4

( Originally Published 1940 )


People have always assumed that instinct and appetite could be relied upon to guide them in the proper choice of foods. Unfortunately this is not the case, for while many have learned to reject what is harmful, too few know the essentials of good nutrition. And good nutrition does not mean only the traditional three square meals a day. It is true that enough food to satisfy hunger will supply the body's energy needs (too much will result in obesity). But not enough attention is given to the nutritional quality of foods.

Starvation is reported only occasionally in the United States. Much more common, however, are the deficiency diseases—rickets, scurvy, pellagra, beri-beri and goiter—all of them attributable to the fact that too little of certain essential foodstuffs or materials are obtained. More prevalent than the gross deficiency disorders are mild or moderate states of ill health or poor efficiency not characterized by the obvious signs of the major deficiency diseases but by ill-defined symptoms and signs such as loss of "pep," easy fatigue, listlessness and indigestion. While very little is yet known about these border-line nutritional disorders, there is enough evidence to indicate that they are due to food deficiencies of one kind or another.

A large part of the population is not getting the optimum returns from food expenditure. Too much money is spent on breads and other cereals and not enough on the protective foods—particularly dairy products, fruits and vegetables. Of course, the indigent—and that means about 40,000,000 people—cannot afford to buy adequate amounts of eggs, milk, cheese, meats, fruits and vegetables. Until the struggle for the economic right to buy these necessities is won, the indigent have to depend upon the grains, cereals and cheap vegetables such as potatoes as the mainstay of their diet.

To get the most out of the little that they can buy, the breads and grains should be bought unrefined, i.e., as whole wheat or graham bread and whole-grain unmilled cereals (usually sold in muslin or cellophane bags). Corn Flakes, Puffed Rice and Rice Krispies, advertising notwithstanding, will bring no dividends in good health. They are relatively expensive luxury foods that have little more than energy value.

Even when more money can be spent for food, there should be less emphasis on cereals and white bread and more on dark, whole-grain breads and cereals. Of course, persons with sensitive digestive tracts can't tolerate over-loading with whole-grain foods, but whenever possible, at least one-half of the total intake of breads and cereals should be in the form of whole-grain products.

Equal consideration should be given to dairy products, fruits and vegetables. Many food authorities assert that of money spent for food, as much should go for milk products (including cream, butter and cheese) and for fruits and vegetables as for meats, poultry and fish.

Drs. McCollum and Becker—two well-known nutrition authorities—have proposed the slogan: "Eat what you want after you have eaten what you should." The following "shoulds" will made good the shortages in vitamins and minerals that frequently characterize the ordinary diet.

1. Every child, and every childbearing and nursing mother should get daily at least 1 gram of calcium. The best food source of calcium is milk, and one quart of milk daily will satisfy the calcium requirements of children and pregnant and nursing mothers. Adults require about .6 gram of calcium, which may be obtained from about a pint of milk a day. Many children and adults, however, are sensitive to milk; but if it can be tolerated, it should always be a part of the diet. Buttermilk or skim milk may be enjoyed more than whole milk. Either is an adequate substitute for whole milk with respect to calcium content.

The following foods will furnish 1 gram of calcium:

Cheese—1/4 lb. Lettuce—5 lbs.

Dry beans—11/2 lbs. Bread, whole wheat—4 lbs.

Watercress—1 lb. Bread, white—8 lbs.

Dandelion greens-2 lbs. Corn meal--12 lbs.

Eggs-31 eggs or 31/3 lbs. Beef—22 lbs.

Cabbage-5 lbs.

Obviously the most economical way for an adult to get an adequate calcium intake is not to eat pounds of bread, meat or vegetables but to have daily milk or cheese or both. The milk may be taken in part as cocoa, milk shakes, creamed soup, creamed vegetables, custard, ice cream, junket and puddings. A League of Nations' report on nutrition stated that the Swiss eat more than three times as much cheese as we do, and the Danes and French twice as much. These foreign nations show good nutritional sense in eating large amounts of cheese.

2. Once a day take a liberal serving of greens or potherbs and a large salad. Vegetables are a rich source of vitamins and minerals. The best way to get the most out of vegetables is to buy vegetables with colors—green, yellow and red. These vegetables are richest in essential vitamins and minerals. A vegetable plate and salad should have as many colors on it as possible, and green should be the prevailing one.

3. Meat, fish and poultry and eggs should also be eaten regularly. An average serving (about 1/4 pound of meat and at least 1 egg) five times weekly will be an adequate supplement to the proteins supplied by milk products. More of the animal organs should be eaten—liver, heart and kidney are valuable not only as protein but they are richer in minerals and vitamins than meat muscle itself, and often cheaper.

4. Fruit should be eaten daily. If oranges or citrus fruits are expensive, the cheaper apples and tomatoes will provide for vitamin C needs. More for the money can also be obtained from tomatoes canned with the juice than from tomato juice. More fruits—fresh or stewed—should be used for desserts and less pastries and cakes.

These are the minimum requirements for healthful eating. The rest of the diet can be made up with the cheaper foods such as refined breads and cereals, fats, jams, etc. The adult who would obtain the maximum value from his diet should follow this diet scheme. He should keep in mind the difference between the average American diet and an adequate diet. The average diet contains enough calories and enough proteins, but not enough vitamins and minerals. An adequate diet contains all. If an adequate diet is obtained, the consumer will be able to pass by advertisements for vitamin compounds with the confidence that he is getting more from his food than any vitamin preparation can supply. He would require neither foods "fortified" with vitamins nor vitamin concentrates. The latter should be resorted to only upon a physician's advice.

As important as proper choice of diet are proper cooking methods. Thiamin, ascorbic acid, riboflavin, and nicotinic acid all dissolve readily in water. To get the most out of foods rich in these vitamins, cook them in the smallest amount of water possible, and then serve the liquid in sauces, gravies or soups. Foods rich in thiamin and ascorbic acid (easily destroyed by cooking) should be cooked as quickly as possible; in no case should soda be added to vegetables well supplied with these vitamins, or, for that matter, to any vegetables.

Many people will concede all that has been said about the wisdom of wise selection and preparation of foods, but flinch at the time and attention required. Why not, they say, eat what you like and make up for a possible deficiency by taking vitamins and minerals conveniently packed in a capsule? And many go further and insist that it is probably cheaper to buy a vitamin capsule than the equivalent amount of vitamins in the form of milk, butter, eggs, etc. This line of thought is, of course, encouraged by vitamin manufacturers.

Vi-Syneral, a vitamin and mineral preparation, is an ex-ample of the kind of preparation encouraging such beliefs. On the back of a Vi-Syneral carton it is stated that "Each Vitamin Capsule (dark color) contains not less than:

"Vitamin A—8000 units—equivalent to Vitamin A potency of 3.6 teaspoonfuls of cod liver oil, which conforms to U.S.P. XI standards or 8 ozs. butter or i6 ozs. eggs or 120 ozs. milk."

The impression is thus indirectly gained that if one capsule of Vi-Syneral is taken it is not necessary to eat butter, eggs or milk. What the carton does not state is that 8,000 units may be twice the amount of vitamin A required by a normal person; that the taking of a vitamin capsule containing 8000 units of vitamin A is no guarantee that all or most of these units will be absorbed from the digestive tract, whereas there is a much greater likelihood that vitamin A from food sources will be absorbed; and that more than the average requirements of an adult or child would be met by one pint of milk, one serving of carrots, squash or greens, one serving of tomatoes or a yellow fruit and a sandwich filling of egg, cheese or liver—foods that also supply other vitamins, many more minerals as well as food energy; and in a form readily absorbable from the digestive tract. One-half cup of cooked spinach, broccoli or chard alone would furnish about 15,000 units of vitamin A.

Consider also the statement about the content of vitamin B1: "Vitamin B1—2oo international units equivalent to Vitamin B1 potency of 20 ozs. spinach or 48 ozs. carrots or 44 ozs. oranges or 44 ozs. milk."

The requirements of an adult for B1 is apparently dependent upon the caloric intake. The more energy that is used, the greater the amount of vitamin B1 that is required.

Furthermore, 20o international units is decidedly not an adequate intake of B1. Assuming an average degree of activity and energy intake, according to Dr. Cowgill a person weighing too pounds requires about 135 international units, a person weighing 154 pounds needs approximately 280 international units, and a person weighing 198 pounds needs about 55o international units—more than two and one-half times as many as is present in a daily dose of Vi-Syneral.

Furthermore, the statement on the carton is misleading, because neither spinach, carrots, oranges or milk are the best sources of B1.

Thus an adequate amount of B1 will be obtained if a wide variety of vegetables and fruits and whole grain breads and cereals are included daily in the diet.

Again it must be said that many people, particularly those with spastic constipation, cannot tolerate much of fruits, vegetables and cereals. For them, a vitamin B1 supplement may be desirable and physicians can prescribe a more potent thiamin preparation than Vi-Syneral.

Vi-Syneral also contains vitamin C. There is no rational basis for the insertion of this vitamin in a capsule, particularly since half a tumbler of a fresh fruit juice will furnish more than the minimum number of units of vitamin C required by a child or adult.

As for vitamin D, the needs of adults for this vitamin have not yet been demonstrated. Babies and mothers will get their vitamin D more cheaply from fish-liver oils or concentrates and from exposure to sunlight in season.

The mineral (light color) capsules of Vi-Syneral contain among other minerals' .05o gram of calcium. Since a child and mother require i gram and an adult about .6 gram of calcium daily for optimum health, the mineral capsule will furnish only one-twentieth of daily needs even if we were to assume that all of the calcium were absorbed (which is probably not true). The other minerals in the capsule are also obtained in larger quantities and in more absorbable form from an adequate diet.

It is evident then that not much of a case can be made out for preparations such as Vi Syneral for the average normal person who has an adequate diet. In instances where the diet has been one-sided for some time, so that a relative shortage of vitamin intake can be assumed, the inclusion in the diet of appropriate foods will correct the deficiency. The experience of doctors in the treatment of pellagra shows that an adequate diet is more essential to permanent recovery from a dietary deficiency than the administration of one or more vitamins.

It must also be remembered that medical science has only scratched the surface of vitamin and food research, and that many other nutritional or vitamin factors may yet be discovered and isolated from foods. Until much more knowledge is available, a large amount of respect should be shown for the nutritional potentialities of good foods. The use of vitamin and mineral mixtures by the consumer is no assurance of "good health"; their daily use is no guarantee that all of the vitamins and minerals which a person must secure will be provided. Moreover, doctors know little about the long-time effects of vitamin preparations. Some of these effects will undoubtedly be good, but it is possible that other effects will not. Good foods, however, can only have good results. The only vitamin which appears to be lacking in an abundant, adequate diet is vitamin D. In infancy, childhood and during pregnancy, therefore, a supplement of vitamin D is desirable or necessary.

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