FEEDING THE FAMILY THE MACMILLAN COMPANY NEW YORK • BOSTON • CHICAGO • DALLAS ATLANTA • SAN FRANCISCO MACMILLAN & CO., Limited LONDON • BOMBAY • CALCUTTA MELBOURNE THE MACMILLAN CO. OF CANADA, Ltd. TORONTO The Welfare of the Family is Largely in the Hands of the One who Provides the "Three Meals a Day" FEEDING THE FAMILY BY MARY SWARTZ ROSE,' Ph.D. PROFESSOR OF NUTRITION, TEACHERS COLLEGE COLUMBIA UNIVERSITY REVISED EDITION Neto gork THE MACMILLAN COMPANY 1924 All rights reserved PRINTED IN THE UNITED STATES OF AMERICA Copyright, 1916 and 1924. / By THE MACMILLAN COMPANY. Set up and electrotyped. Published October, 1916. Revised edition. Published June, 1924. Nortoooh iPreas J. S. Cushing Co. - Berwick & Smith Co. Norwood, Mass., U.S.A. PREFACE TO THE SECOND EDITION Since the publication of the first edition there has been a continuous stream of contributions to our knowl- edge of the vitamins which has emphasized their im- portance in raising the diet from the "subsistence level" to an actively health-promoting one. These researches have added greatly to our knowledge of the nutri- tional role of many different food materials, and especially of the fruits and vegetables. We have also more infor- mation as to the importance of calcium and phosphorus and as to quantitative requirements of both children and adults for these; as to the nutritive value of individual proteins and of various protein mixtures, as well as the maintenance requirement of adults; and on the whole a fuller conception of what constitutes a well- balanced diet. All these advancements lend additional emphasis to the programs for family dietaries previously outlined in this book, and the task in revision has been one of inter- pretation rather than of alteration so far as these are concerned. The most radical changes have been in the chapters on Food for the Baby and Food for the Sick and Con- valescent. Feeding in infancy has been improved through our increased knowledge of growth and the relation of food to it. Feeding in tuberculosis appears V VI PREFACE TO THE SECOND EDITION to be on a firmer scientific basis and modifications in the general feeding plan have been made in accordance with recent investigations. While the discovery of insulin is epoch-making in the treatment of diabetes mellitus it has not decreased but on the contrary increased the need for scientifically accurate dieting, and the researches of the past decade in this field have greatly improved feed- ing programs for diabetics. Changes in cost have been made, bringing the data up to the present level. For this part of the revision the author gratefully acknowledges her indebtedness to Miss Margaret Hessler. A table showing the vitamin content of various food materials has been added. M. S. R. April, 1924. PREFACE TO THE FIRST EDITION While many things contribute to health, - sleep, fresh air, and exercise, for instance, - the foremost consideration is food. This is recognized to-day as never before, and those who regard their own welfare and desire to give their children the best possible equipment for the stress of modern life are asking how to choose food wisely. So many kinds of food are displayed in our markets, and so many placards offer warning or advice about what to eat, that a guidebook to good nutrition would seem quite essential for the twentieth century family. The purpose of the author has been to provide such a little book for the numerous housewives who pre- pare something like a thousand meals a year for their families and who wish to know how the science of nutri- tion can be made to function most successfully in their daily lives. Much literature has been published in regard to food and diet, but it is not a simple matter to collect and organize it for one's own use in the midst of all the cares of a household. In the present volume separate chapters are devoted to the special food needs of the different members of a typical family group - babies, growing children, adult men and women, aged persons - after which some space is devoted to a consideration of the food problems related to the family group as a whole. VII VIII PREFACE TO THE FIRST EDITION Among the latter are such points as the construction of daily menus on a rational basis, the wise expenditure of money for food, and reasonable control of the amount and kinds of food consumed. Since it is an unfortunate fact that the housewife is often called upon to feed the sick, a chapter upon this topic has been included. There has been no attempt to make this comprehensive or detailed, because the sick should be fed under a phy- sician's guidance. The writer believes, however, that the home feeding of the sick will be more successful if intelligently done, and that a few printed suggestions will be helpful in carrying out the physician's orders. Detailed calculations of the amount of food to be consumed each day are neither necessary nor practicable in the home, but some information in regard to the rela- tive nutritive value of food materials is a great help in keeping the diet well balanced. For the sake of those who wish to study this phase of feeding, illustrative dietaries have been placed in each chapter, and in the Appendix tables given for quick estimation of the food values of a number of familiar kinds of food. These are expressed in terms of ordinary household measures (cups, tablespoons, teaspoons) and are as accurate as possible with such units of measurement applied to materials tending to vary considerably in their com- position. The housewife does not need to do careful weighing so much as to train her eye to judge approximate food values, for which measures are usually sufficient, though weights are of course more accurate. The "dietary recipes" have been given because recipes vary PREFACE TO THE FIRST EDITION IX so much that the name of a dish does not always give a clue to its exact composition. Often several recipes for the same type of dish have been given, to show how the food value will vary with changes in the ingredients. The author wishes to acknowledge with thanks the valuable advice and criticism given by Professor Henry C. Sherman of Columbia University and the assistance of Miss Esther Swartz in the preparation of the manu- script. Teachers College, Columbia University, February 16, 1916. TABLE OF CONTENTS PAGE Preface v List of Food Plans and Dietaries xv List of Illustrations xix CHAPTER I. The Significance of Food i Introduction i The body a working machine 4 Fuel for the human machine 5 Sources of body fuel 6 Measurement of the fuel value of foods .... 8 Measurement of the fuel requirements of the body . . 14 The body a builder of its own tissues . . . .17 How food supplies the material for body building . . 18 Balance wheels for the human machine .... 26 The ash constituents 27 Water 28 The vitamins 28 Vitamin A 29 Vitamin B 31 Vitamin C 32 Other possible vitamins 33 II. Care of the Digestive Mechanism 35 The part of the mouth in good digestion . . . .37 The part of the stomach in good digestion ... 40 Good digestion in the small intestine .... 44 Good digestion in the large intestine 46 Diet for constipation 48 III. Food for the Adult Man 52 Energy requirements of the adult man • • • • 53 The sedentary man 53 The muscularly active man 57 Thin and fat men 63 XI XII TABLE OF CONTENTS CHAPTER PAGE Building material for the adult man .... 69 The protein or nitrogen requirement .... 70 The ash requirement 77 The vitamin requirement 80 IV. Food for the Adult Woman 82 Energy requirements 82 Thin and fat women 91 The protein, ash, and vitamin requirements ... 95 Food for the prospective mother 97 Food for the nursing mother 103 V. Food for the Baby 109 Preparation for weaning 114 Care of the baby's milk 117 Daily food program for breast-fed baby . . .119 Artificial feeding 121 Energy requirements of the baby 122 The protein requirement of the baby . . . .123 The ash and vitamin requirements of the baby . .124 Use of proprietary infant foods 129 VI. Food for the Two-year-old Child . . . .133 VII. Food for Children Three and Four Years Old . 144 VIII. Food for Children Five to Seven Years Old . . 153 IX. Food for Children Eight to Twelve Years Old . 166 X. Food in Adolescence and Youth . . . .185 XI. Food after Fifty 207 XII. Food for the Family Group: Menus . . . 218 The construction of the menu 220 Types of meal plans 221 Food combinations from the scientific standpoint . . 224 Food combinations from the esthetic standpoint . . 229 Summer and winter menus 235 XIII. Food for the Family Group: Cost of Food . . 244 Factors in market cost 245 Market cost and fuel value 249 Cost of proteins, ash constituents, and vitamins . . 253 TABLE OF CONTENTS XIII CHAPTER PAGE XIV. Food for the Family Group : Food Plans and Dietaries 268 Planning a family dietary 269 Essentials in the family dietary 271 Planning the menu 273 Calculation of the dietary 276 Cost of the family dietary 283 Reducing the cost of the dietary 284 Dietaries costing less than one and three-fourths cents per 100 Calories 291 Family dietaries at the lowest cost .... 297 XV. Food for the Sick and Convalescent . . .317 Energy requirements in sickness 319 Fluid diet 320 Soft or semi-solid diet 326 Light or convalescent diet 327 Diet in minor illness 329 Acute indigestion 330 Intestinal putrefaction 331 Food in fevers 333 Diet in typhoid fever 335 Diet in tuberculosis 341 Diet in diabetes 348 Diet in gout 356 APPENDIX TABLE I. ioo-Calorie Portions of Foods as We Eat Them . 362 II. Food Values in Terms of Common Measures . . 379 III. Dietary Recipes 385 IV. Fuel Value in Relation to Cost .... 456 V. Height and Weight of Men at Different Ages . 460 VI. Height and Weight of Women at Different Ages 461 VII. Height and Weight of Boys at Different Ages . 462 VIII. Height and Weight of Girls at Different Ages . 464 IX. Height and Weight of Boys from Birth to School Age 466 X. Height and Weight of Girls from Birth to School Age 467 XI. Amounts of Vitamins in Food Materials . . . 468 LIST OF FOOD PLANS AND DIETARIES PAGE i. For a Sedentary Man: A day's food plan 56 A dietary costing 25 to 3 cents per 100 Calories ... 58 A dietary costing i| to 2 cents per 100 Calories ... 59 2. For a Muscularly Active Man : A day's food plan 62 A dietary costing 1 cent per 100 Calories .... 64 3. For a Thin Man: A fattening dietary yielding 3450 Calories .... 66 4. For a Fat Man : A reducing dietary yielding 1400 Calories .... 68 5. For an Active Woman: A day's food plan 85 A dietary7 costing a| to 3 cents per 100 Calories ... 87 6. For a Sedentary Woman : A day's food plan 88 A dietary costing 2g to 3g cents per 100 Calories . . 89 A dietary costing ij to 2 g cents per 100 Calories . . 90 7. For a Fat Woman: A reducing dietary yielding 1052 Calories .... 92 8. For a Thin Woman : A fattening dietary yielding 3000 Calories . . . .96 9. For a Nursing Mother Doing Moderate Muscular Work : A dietary costing ig to 2 cents per 100 Calories . . 107 10. For a Child 1J to 2 Years Old : A day's food plan ........ 142 A dietary costing 2j cents per 100 Calories . . . 143 11. For a Child 3 to 4 Years Old: A day's food plan 150 A dietary costing 2 cents per 100 Calories . . . .151 XV XVI LIST OF FOOD PLANS AND DIETARIES PAGE i2. For a Child 5 to 7 Years Old: A day's food plan 163 A dietary costing 2 to 2j cents per 100 Calories . . . 165 13. For a Child 8 to io Years Old: A day's food plan 182 A dietary for a child 8 years old costing i| to 2j cents per 100 Calories 183 A dietary for a child 10 years old costing if to 2| cents per 100 Calories 184 14. For Boys and Girls 14 to 16 Years Old: A day's food plan 193 A dietary for a 16-year-old boy costing if to 2| cents per 100 Calories 195 A dietary for a 16-year-old girl costing 2 to 2| cents per 100 Calories 196 15. For an Elderly Person: A day's food plan 214 16. For an Aged Person: A day's food plan 215 A dietary 216 17. For the Family Group: A dietary costing 2 to 2| cents per 100 Calories . . . 278 A dietary costing if to 2 cents per 100 Calories . . . 287 A dietary costing 1J cents per 100 Calories . . . 300 A dietary costing i| cents per 100 Calories .... 306 18. For a Convalescent: A general food plan 328 19. For Typhoid Fever: Modified milk diets 337 A mixed fluid diet 338 A soft diet 339 20. For Tuberculosis: A day's food plan for a moderate-priced diet . . . 343 A moderate-priced dietary 345 A low-priced dietary 346 A plan for low-priced diets 347 LIST OF FOOD PLANS AND DIETARIES XVII 2i. For Diabetes: page A series of diets for testing tolerance of diabetics . . 350 22. For Chronic Gout: A dietary yielding 2275 Calories 358 LIST OF ILLUSTRATIONS "The welfare of the family is largely in the hands of the one who provides the three meals a day " .... Frontispiece PAGE A bomb calorimeter - a device used for measuring the fuel value of foods 8 A respiration calorimeter for measuring the energy requirement of babies facing 15 Sources of Vitamin A facing 29 Sources of Vitamin B facing 31 Sources of Vitamin C facing 32 100-Calorie portions of fruit ...... facing 59 roo-Calorie portion of vegetables facing 87 " The well nourished baby gains steadily in weight " . facing 109 " A quart of milk a day " ...... facing 133 "Suitable food is the most fundamental thing in the physical prog- ress of the child " ....... facing 147 A mid-morning lunch . . . ... . . facing 155 4 Charts of normal growth of boys and girls from birth to the six- teenth year ......... 167-170 "Always hungry" facing 173 roo-Calorie portions of salads and salad accessories . facing 187 roo-Calorie portions of desserts facing 225 Differences in the nutritive value of proteins 256 roo-Calorie portions of beverages facing 325 A convenient food scale 349 A comparison of the distribution of calories in normal and severe diabetic diets 353 XIX FEEDING THE FAMILY CHAPTER I THE SIGNIFICANCE OF FOOD Introduction "What shall we have for dinner?" This is the constant cry of the housewife, who often feels that house- keeping would be relieved of one of its greatest bugbears if some one else would undertake the planning of the meals. And yet this is a burden not so easily shifted to another's shoulders. Menus may be written, but they seldom fulfill requirements exactly as they stand. The foods designated are not in the market, or the family does not like them, or there are leftovers to be disposed of, and the problem remains unsolved. In fact, the one who is entrusted with the feeding of the family has a responsibility not lightly escaped. Of the three neces- sities of life which the home must provide, - food, clothing, and shelter, - food is the most important. Without it, life is impossible. With scanty provision of it, growth is stunted and power declines. With abun- dance, one may stuff the furnace until the fires of life are dulled by sheer surplus of good fuel. By indiscreet choice, precious days of life may be lost on account of 1 2 FEEDING THE FAMILY headache or other acute, though minor, ills, and by con- tinued bad feeding the way paved for serious impairment of health. For food most people spend the largest part of their incomes. What a pity if they buy sickness instead of health! While it is true indeed that "the life is more than meat," it is equally true that there is no life of the spirit without sustenance for the body. The welfare of the family, both physical and spiritual, is largely in the hands of the one who provides the "three meals a day" which often seem so appalling in their inevitability. The only way of relief is through mastery of the principles which underlie the daily choice of meals. "What shall we have for dinner?" does not imply choice between nothing and something, as under the precarious condi- tions of primitive life or the equally uncertain chances of extreme poverty. It indicates, rather, bewilderment amidst a wealth of materials for man's delectation such as the world has never seen before. If only half a dozen foods were available, the matter would be quickly settled. The question is apt to mean, What new foods can be found to delight the palate or charm the eye of those who are never really hungry ? Eating is a social custom as well as a physiological necessity, and the hostess, even at a table of two, is disturbed, votes her dinner a failure and her efforts wasted if her partner does not partake freely. What she may really need is more skill in divin- ing his physiological requirements, rather than in pre- paring dainty dishes to pamper his appetite. Many traditions have grown up about foods, rooted in THE SIGNIFICANCE OF FOOD 3 ancient tribal or religious taboos, or the result of mis- interpreted experiences. There are people to-day who solemnly affirm that fish and milk are a dangerous combination, based on who knows what unhappy coincidence! If an unusual food has been eaten at the same time as an onset of acute illness, the food often gets the blame, though the evidence is wholly circum- stantial. The coincidence of the brain and fish both having rather high percentages of phosphorus has at least given us the pungent advice addressed to the young man who wanted some quantitative dietetic instruction as to the amount of fish needed to develop his brain - "Eat a whale1" In the light of modern scientific research these tradi- tions and false impressions give way to exact knowledge of what food does for the body and how it does it. By patient steps, through Lavoisier's brilliant insight into the relation between the intake of oxygen in respiration, the output of carbon dioxide from the lungs, and the evolution of heat and work in the body; Liebig's study of the composition of foods and body materials; Rub- ner's accurate researches establishing definite relation- ship between food consumption and body activity; Eijkmann's demonstration that a specific disease may be produced by one diet and cured by another; Hopkins's brilliant conception of subtle elements in food regulating nutritional processes; Osborne and Mendel's control of growth through changes in the quality of a single chemi- cal component of the dietary; McCollum's demonstra- tion that old age may be deferred through a well-assorted 4 FEEDING THE FAMILY diet - through the work of these and other able investi- gators, we have come to the realization that nutrition is science rather than a bundle of old wives' rules; that foods, though so numerous and so varied in form, can be reduced to rather simple terms; that the amount re- quired by a man for a day's work can be determined with amazing accuracy, and that even the factors which govern the power to develop can be analyzed and a young animal made to grow or be stunted at will by the control of its food. Scientists in many laboratories are studying the laws which govern nutrition, and as they progress in knowl- edge the housewife is given new standards by which to choose the food for the family, and greatly increased power to secure physical welfare for the group in her care. She is also relieved of old and foolish fears about the baleful influence of this or that particular food, and turns a deaf ear to alarmists and faddists, who by juggling with technical terms often bring good foods into dis- repute. Meals of many kinds are found to be good, and simplicity may be cultivated without fear of dietary deficiency when one knows the A, B, C of good nutri- tion. The Body a Working Machine In considering the part which food plays in human life, one of the most important conceptions which modern science has given us is that of the body as a working machine, whose output we can measure as accurately as that of any steam, gasoline, or electric engine. Unlike THE SIGNIFICANCE OF FOOD 5 other machines, this living one must work to exist. Man is to be compared to a clock, going all the time, rather than to an automobile engine, working only at in- tervals. When one is lying asleep or perfectly quiet, the heart goes on with its work, which, counted for a whole day, will amount to as much as lifting an average man some 2500 feet into the air; the chest moves in respiration ; the muscles are under tension ready for any sudden call to further work; the digestive tract is busy caring for the last meal, or if that is gone, possibly by vigorous movement calling like Oliver Twist for "more." Every movement, voluntary or involuntary, even to winking an eye, is work in the mechanical sense; and exercise which brings many muscles into play, whether in digging a ditch or playing football, sweeping a room or flitting over a tennis court, adds to the energy expended in proportion to its severity. Fuel for the Human Machine In order to have energy to spend as outlined above, we must first acquire it. But how? The earth's great bank of energy is the sun ; its currency is light and heat. These man cannot "cash in" directly. They have to go through a great clearing house, the plant world, before they become available for the human economy. Plant cells transmute light and heat into chemical energy and bind this with elements from the air and soil to make three great classes of energy-bearing substances, which man can use for his activities, known as protein, fat, and carbohydrate. These are the "fuels" which 6 FEEDING THE FAMILY supply energy for the human machine. This energy of food may be converted into useful work - inside the body in keeping up the life processes, outside in per- forming all sorts of muscular movement - and also into heat to maintain body temperature. In fact, heat is a by-product of all bodily activities, which is turned to good account in keeping warm. If not enough is obtain- able in this way, the transformation of more energy into heat can be brought about by doing more work (shiver- ing, clapping the hands, stamping about, running, etc.); or if this is not done, by the automatic response of in- ternal processes to the stimulus of cold, increasing some- what the rate at which body fuel is burned. Since the three fuel foodstuffs are so essential to man's well-being, it behooves us to inquire how they may be obtained. The three kinds of material which serve as body fuel, protein, fat, and carbohydrate, are found variously dis- tributed in all sorts of vegetable food. From the juice of the beet and sugar cane we refine a pure carbohy- drate, sugar, which is also found in the juice of sweet fruits and vegetables, such as oranges, grapes, apples, corn, peas, etc. From wheat, oats, corn, and other grains, potato tubers, manioc roots (tapioca), we secure another form of pure carbohydrate, starch, which is also found in lesser amounts in many kinds of fruit and vege- tables, as bananas, peas, beans, nuts (especially chest- nuts). From olives, cottonseed, peanuts, cocoa beans, and Sources of Body Fuel THE SIGNIFICANCE OF FOOD 7 other seeds we can obtain pure fat, which we find plenti- ful in nuts, but only in small amounts in other kinds of vegetable food. The vegetable foods which have the largest amounts of protein.are the legumes, - peas, beans, lentils, and peanuts. Nuts such as almonds, filberts, walnuts, pe- cans, have also a considerable store. Next in impor- tance come the cereals, with oats, wheat, and corn head- ing the list. Other vegetable foods contribute compara- tively small amounts of this sort of fuel. Plant foods may be called the original source of human energy. But animals, eating the plants, may work over the protein, fat, and carbohydrate of their plant food in their internal laboratories, the living cells, and produce animal proteins from the vegetable proteins, animal fat from the vegetable carbohydrate or fat, and animal car- bohydrates from any one of these three, but especially from the carbohydrates. These new forms, elaborated in the animal body, also serve man for fuel. In animal food as he eats it there is little carbohydrate, except in milk, though scallops, oysters, and clams are perhaps worthy of mention. Fat is found more or less inti- mately associated with lean in all kinds of meat, about the leanest animal food being codfish. Milk is often prized most for its fat, in the form of cream or butter, and bacon also offers fat in a very acceptable form. Strictly lean meat affords fuel in the form of protein, whatever the animal from which it is derived. From bones we get gelatin, also pure protein, though not in all respects equivalent to that of meat. Milk and eggs 8 FEEDING THE FAMILY are particularly valuable for their protein content. Cheese consists chiefly of the protein from milk, with or without the fat, according to variety. Egg white has all its fuel in the form of protein, while the yolk has it partly as protein and partly as fat.1 Measurement of the Fuel Value of Food Food materials differ greatly in the amount of pro- tein, fat, and carbohydrate which they may contain. Some, as has been noted, have only one kind of fuel, A Bomb Calorimeter- a Device used for Measuring the Fuel Value of Foods some two, and some all three, and these in varying pro- portions. It is, nevertheless, a comparatively simple 1 For further information on the kind and relative amounts of protein, fat, and carbohydrate in different food materials, the reader is referred to Tables I, II, and III, of the Appendix, to Sherman's Food Products, Rose's Laboratory Handbook for Dietetics, or to Chemical Composition of American Food Materials, Bulletin 28, Office of Experiment Stations, U. S. Dept, of Agriculture. THE SIGNIFICANCE OF FOOD 9 matter to find out how much energy (or working power) a given kind of food is capable of yielding in the body. The chemical processes by which energy is liberated are of the same nature as burning outside the body. If we take some kind of food, then, as a lump of sugar, and burn it under such conditions as to make the process complete and to measure all the heat generated, we can express this heat in terms of a standard unit of measure- ment, called the calorie.1 A special piece of apparatus is used in food laboratories which fulfills all the require- ments for measuring the fuel value of food; it is called a calorimeter. The food is burned in an atmosphere of pure oxygen in a gas-tight chamber or "bomb," and the heat is taken up in water surrounding the bomb, the change in temperature of the water showing the amount of heat liberated. In reckoning the fuel value of food, we have to consider whether it will be burned as completely in the body as in the calorimeter and one of the tasks of the nutrition laboratories has been to discover the losses due to in- complete utilization of food materials. From hundreds of digestion experiments we have learned how to correct the calorimeter returns for the healthy person on a mixed diet and can say in general that an ounce of pure carbo- hydrate or pure protein will yield 113 calories to the body; an ounce of fat, 255 calories. But, as we have seen,2 most of our foods are mixtures 1 The amount of heat required to raise i kilogram of water i° Centi- grade or i pound of water 40 Fahrenheit. 2 Pp. 6 and 7. 10 FEEDING THE FAMILY of these substances in varying proportions, and almost always we find associated with the energy-yielding sub- stances water and salts, very valuable in the diet for other reasons, but not sources of energy; also plant fiber or cellulose, a form of carbohydrate which the body cannot use for fuel but which makes valuable ballast for the digestive tract. We may say, then, that the more water and cellulose a given food contains the lower its fuel value for a given weight will be. Thus the fuel value of pure sugar is 1814 calories per pound; that of grape juice, which as regards fuel is practically a dilute solution of sugar, is only 454 calories per pound; while that of tomatoes, composed largely of water and cellu- lose, is but 103 calories per pound. Pure proteins and carbohydrates have the same fuel value per pound in the body, but pure fat has two and one-fourth times as high an energy value per pound; hence the more fat a food contains, the higher its energy value in proportion to its weight. Some differences in fuel values of various foods, when compared by weight, are brought out in the following tables, in which the foods are grouped according to the fuel foodstuff which predominates in them: I. Foods Rich in Protein Calories per Pound of Edible Uncooked Material Beef, dried, lean 817 Beef, fresh, lean 709 Beef, tongue, fresh 718 Cheese, cottage 498 Cod, fresh, steaks 329 Cod, salt 473 Egg whites 231 THE SIGNIFICANCE OF FOOD 11 II. Foods Rich in Fat Calories per Pound of Edible Uncooked Material Bacon 2836 Butter 3488 Cream, thick 1727 Lard ... 4082 Oleomargarine 3410 Olive oil or Cottonseed oil 4082 Salt pork 3S55 Suet 3425 Walnuts, English 3199 III. Foods Rich in Carbohydrate Calories per Pound of Edible Uncooked Material Apples 285 Bananas 447 Cornstarch 1632 Dates 1575 Honey 1480 Molasses 1301 Potatoes, white 378 Rice 1591 Sugar, granulated 1814 Tapioca 1608 IV. Foods Rich in Both Protein and Fat Calories per Pound of Edible Uncooked Material Almonds 2936 Beef, fat 1357 Cheese, American 1994 Eggs 672 Egg yolks 1643 Milk, whole 3U Peanut butter 2741 Peanuts 2487 Sardines 1221 12 FEEDING THE FAMILY V. Foods Rich in Protein and Carbohydrate Calories per Pound of Edible Uncooked Material Beans, dried 1564 Bread 1174 Buttermilk 162 Farina 1641 Lentils 1581 Macaroni 1624 Milk, skim 166 Oatmeal 1810 Oysters 222 Peas, dried 1612 Calories per Pound of Edible Uncooked Material Cabbage 143 Celery 84 Cucumbers 79 Lettuce 87 Spinach 108 Squash i°3 Tomatoes 103 Watermelon 137 VI. Foods Rich in Cellulose and Water From such tables it is easy to see that we could scarcely depend upon celery or lettuce for our daily fuel supply, as it would be hard to eat even a single pound in one day and a man would require over 25 pounds. It is also evi- dent that some foods are cheaper fuel than others, bread at 10 cents a pound being nearly 12 times as cheap fuel as oysters at 25 cents a pound. In everyday life, how- ever, we do not eat foods by the pound, but by the serv- ing. When we sit down to the table and the host serves the meat, we should like to be able to tell how much THE SIGNIFICANCE OF FOOD 13 energy he is passing us. When the dessert comes in, we should need mental agility, indeed, to translate pounds of eggs, flour, sugar, and cream into ice cream and cake. A better unit for this purpose is the amount of food re- quired to yield 100 calories, which corresponds quite closely to the ordinary serving of a number of foods. The following table shows how convenient a unit this is for practical purposes.1 Cooked or flaked breakfast foods . f-i| cups Milk f cup, whole; i| cups, skim Cream J cup, thin; if tablespoons, very thick Butter, olive oil, or any other kind of fat i tablespoon Bread i slice 3 in. X 35 in. X 1 in. Uneeda biscuit 4 crackers Fresh fruit 1 large orange or apple; 1 medium banana or bunch of grapes; 2 medium peaches or pears Dried fruit 4 or 5 prunes or dates; 2 dozen raisins; if large fig Eggs 1 exceptionally large; if medium Meat (beef, lamb, mutton, veal, chicken) About 2 ounces of cooked lean meat Bacon (cooked crisp) About J ounce (4 small thin slices) Potatoes 1 medium Sugar 2 tablespoons granulated; 35 "full- size" lumps Cocoa (made with milk) . ... I cup Cream of bean soup | cup Macaroni and cheese | cup Rice pudding j cup Ice cream (made with thin cream) | cup Milk sherbet f cup Sponge cake if in.cube Nuts (shelled almonds, peanuts, pecans) About f ounce Sweet chocolate About f ounce Approximate Amounts of Food to Yield ioo Calories 1 For fuller details see Tables I and III of the Appendix. 14 FEEDING THE FAMILY Measurement of the Fuel Requirements of the Body Food is fuel for the human machine, but how shall we know how much to supply? Ordinarily we trust to appetite, and an unperverted appetite is a very useful guide to rational eating. If an adult year in and year out maintains a uniform normal weight, we may assume that his food supply is adjusted to his needs. If a child makes healthy, steady gains in weight throughout the period of growth, a study of the food which he con- sumes will give us a good clue as to his actual needs. But all adults do not maintain normal weight; some are too thin and many are too fat; all children do not make normal gains in weight; appetite is too great or too little or too pampered, and we need accurate meas- urement by scientific methods of the real fuel needs of the body to serve as a check on appetite or as a guide when appetite fails. Before it was realized that the energy in food must be proportioned to the body's energy expenditure, it was the custom to feed invalids very largely on beef tea and other broths with little fuel value. No matter how quietly they lay in bed, the internal work of their bodies had to go on, which means that fuel was still being burned; only in this case little of it came from food, and most of it from stores of fat held in the body for just such emergencies, and some of it from the proteins of the body itself, such as the pro- teins of muscle. Now it is clearly understood that a man lying quietly in bed throughout the twenty-four hours of the day burns at least twelve calories for every Courtesy of Professor John R. Murlin. A Respiration Chamber for Measuring the Energy Requirement of Babies THE SIGNIFICANCE OF FOOD 15 pound of body weight, which means for an average man a daily total of from 1600 to 1800 calories. So far as conditions permit, care is taken to see that the energy supply comes from food, rather than that the body be permitted to burn itself up. A general starving policy for the sick is as obsolete as blood-letting. The most satisfactory way to study any person's fuel requirements is to measure directly the amount of energy given off from his body hour by hour in the forms of work and heat. To do this, a closed chamber with walls impervious to heat is required, and devices for supplying fresh air and food, so that the person may remain within for some time. Such a device is called a respiration calorimeter. In its present state of perfection (the re- sult of many years of experimentation) it is very elabo- rate and expensive to build and operate; hence simpler devices, measuring the energy output indirectly, through determination of the amount of oxygen consumed or of carbon dioxide given off by the lungs, are now widely used. The illustration opposite shows a calorimeter with its door open and a baby's bed inside. The ad- vantage of such a chamber is that here a person may remain under normal conditions while his energy out- put is measured during sleep, awake but lying quietly, sitting up at rest, reading, writing, riding a bicycle, or doing anything which the size of the chamber permits. The energy expenditures of men, women, and children have been studied in this way, and no matter what pre- conceived notions a person may have had about his own food requirements, the calorimeter measures his actual 16 FEEDING THE FAMILY energy expenditure, which there is no way to meet except by food. Hundreds of observations show that men under the same conditions of age, weight, and occu- pation expend practically the same amount of energy. This is further verified by studies of food consumed by men of the same class, doing the same kind of work, in different parts of the world, as the table below strik- ingly illustrates.1 Farmers in Connecticut 3410 Calories Farmers in Vermont 3635 Calories Farmers in New York 3785 Calories Farmers in Mexico 3435 Calories Farmers in Italy 3565 Calories Farmers in Finland 3474 Calories Average 3551 Calories As far as energy requirement is concerned, nutrition is an exact science; a definite amount of work calls for a definite amount of energy in the form of food. The only reason why we are not forced to stop working as soon as food is withheld is that we are able to carry stores of fat (and a little carbohydrate) as reserve fuel, and also to draw if necessary on our own body protein. So men have fasted thirty and forty days ; but the body becomes more and more impoverished, and when the reserves are exhausted there must come fuel in the form of food, or all work stops and death is the result. On the other hand, if more fuel is supplied than can be used, the fires do not burn the brighter, but the surplus is stored up for emergencies and we say the person is get- 1 Lusk, Fundamental Basis of Nutrition. THE SIGNIFICANCE OF FOOD 17 ting fat. In later chapters the fuel requirements of the different members of the family will be discussed in detail. The Body a Builder of its Own Substance The body is not only an active, working machine, spending energy in the form of work and heat, and de- manding that the expenditure be made good by fresh supplies of fuel in the form of food; it is also a busy contractor, sending goods hither and yon along a net- work of traffic lines, to add to parts already built, or to replace or repair parts lost through ordinary wear and tear or through accident. The materials handled are of various kinds, made up from 16 or 17 different elements, among which may be mentioned carbon, hydrogen, oxygen, nitrogen, sulphur, phosphorus, iron, calcium, magnesium, potassium, sodium, chlorine, and iodine. By means of these substances a seven-pound baby grows until he becomes a man weighing perhaps 200 pounds; and the man, though daily losing small portions as the price of his very existence, may still maintain a uniform weight through many years of adult life, by taking in enough to replace what has been lost. The relative amounts of these different elements in the adult body are shown in the following table: Average Elementary Composition of the Human Body 1 Oxygen, about 65.0 per cent Carbon, about 18.0 per cent Hydrogen, about 10.0 per cent Nitrogen, about 3.0 per cent 1 Sherman, Chemistry of Food and Nutrition, p. 234. 18 FEEDING THE FAMILY Calcium, about 2.0 per cent Phosphorus, about 1.0 per cent Potassium, about 0.35 per cent Sulphur, about 0.25 per cent Sodium, about 0.15 per cent Chlorine, about 0.15 per cent Magnesium, about 0.05 per cent Iron, about 0.004 per cent Iodine Fluorine Silicon Very minute quantities How Food Supplies the Material for Body Building The fuel foods all contain carbon, hydrogen, and oxygen, so that no special attention need be paid to these elements. Protein food has an absolute monopoly of the nitrogen supply for the body, and so occupies a distinguished place in the human economy, for nitrogen enters into the construction of body proteins, which are essential to the life of every cell and constitute the most prominent part of muscle tissue. A child cannot grow and form strong muscles without it; a full-grown adult cannot keep in health without it, for throughout life the cells discard small amounts of nitrogen hour by hour, as a waste product of their internal life ; furthermore, some old cells die are disintegrated and their nitrogen thrown out, so that altogether there is a certain daily loss which must be made good by protein food. Hence, in choosing the day's fuel we cannot confine ourselves to carbohy- drate and fat, but must include some protein. The pro- portion of fuel best taken in this form will be discussed in connection with the food requirements of the different individuals in the family group. THE SIGNIFICANCE OF FOOD 19 Protein is a term standing for a large number of re- lated substances, all made by the chemical union of simpler substances containing nitrogen, called amino acids. There are 18 or more of these entering into the structure of common proteins, and, as has been aptly suggested, these are used like the letters of the alphabet to build up different kinds of protein. It is estimated that these 18 units may be joined together to make 350 million times a million different combinations, using only a single representative of each. Hence we have milk, meat, fish, egg, cereal, and vegetable proteins, all built from the same "building stones," or the same "letters of the protein alphabet," containing therefore all the essentials for constructing different kinds of body protein, as circumstances may require. Such proteins are called "complete." There are certain proteins, such as gelatin and some kinds found in vegetable foods, in which important amino acids are lacking. If these "incomplete" proteins were used as the sole kind of protein in the diet of children they could not grow, be- cause some of the constituents for building body pro- tein would be lacking. It would be like taking the word legume apart and trying to make the word muscle. We should have a superfluous g and e, but no 5 nor c, and be forced to break up another word, such as casein, to get the extra letters. The effect of incomplete proteins has been most interestingly shown in the feeding of young rats. When given milk food or a mixed diet they grew up in the normal way, but on a diet in which the only protein food was a single kind of incomplete protein, 20 FEEDING THE FAMILY called gliadin, separated for the purpose from all the other proteins of the wheat kernel, they seemed per- fectly well but could not grow; as long as they were kept on the gliadin diet they remained dwarfs, but as soon as fed with the milk food or mixed diet they began to grow again. In one classic experiment a rat fed the gliadin diet weighed, when 140 days old, just what it should have weighed when 36 days old ! Fortunately, most protein foods contain a goodly assortment of amino acids, and on an ordinary mixed diet, in which milk, eggs, meat, fish, and various vege- tables rich in protein are used, an adult need have little concern as to the particular kind of protein which he is taking. If he confines himself to vegetable food, in which incomplete proteins are more frequent, there is more danger of lack of sufficient amounts of some amino acid, and the combination with such a diet of some milk, cheese, or other food known to be rich in "complete" proteins is wise. In the diet of growing children this is a matter of more importance, and emphasis must be laid on the best proteins for growth, as will be brought out in the chapters on feeding of children. The total amount of protein in the food is measured according to its weight, usually in grams,1 according to its fuel value, in calories, or according to the amount of nitrogen which it yields. The following table shows these protein and nitrogen values for a number of foods rich in protein: 1 One gram equals about of a pound. THE SIGNIFICANCE OF FOOD 21 Amounts of Protein in ioo-Calorie Portions of Some Common Food Materials Food Material Measure of Portion Pro- tein Calo- ries Pro- tein Grams Nitro- gen Grams Gelatin, dry .... 2f tablespoons 99-8 24-9 3-98 Cod, fresh steaks . . 5 ounces (uncooked) 93-7 23-4 3-90 Chicken, lean meat . . 2| ounces (roasted) 79-6 19-9 3-i9 Halibut, steaks . . . 3 ounces (uncooked) 61.3 15-3 2-45 Beef, lean round . . . 21 ounces (uncooked) 54-5 13-6 2.18 Salmon, canned . . . 1 cup 53-6 13-4 2.14 Oysters, solids . . . t cup 49-o 12.3 i-95 Milk, skim .... 11 cups 37-o 9-3 i-49 Eggs ii eggs 36.4 9-i 1-47 Buttermilk r| cups 33-6 8-4 i-34 Sausage, Frankfort . . i sausage 3i-3 7-8 1-25 Peas, dried .... 2 tablespoons (uncooked) 27-7 6.9 1.10 Beans, navy .... | cup (uncooked) 26.1 6-5 1.04 Cheese, American . . i|-inch cube 26.0 6-5 1.04 Beans, baked (canned) i cup 21-5 5-4 0.86 Milk, whole .... f cup 19.0 4-8 0-77 Peanuts, shelled . . . 2 dozen singles 18.8 4-7 0-75 Oatmeal i cup (cooked) 16.8 4.2 0.67 Macaroni i cup 14.8 3-7 0-59 Bread, white .... 2 small slices 14.4 3-6 0.58 Almonds, shelled . . 12-15 nuts 12.9 3-2 0.51 Wheat, flaked . . . f cup (cooked) 12.7 3-2 o-5i Cornmeal 1 cup (cooked) 10.4 2.6 0.42 Walnuts, shelled. . . 8-16 meats 10.4 2.6 0.42 Chocolate, bitter . . | square 8.4 2.1 o-33 Sulphur needed for the building of body proteins is found mostly in two closely related amino acids - cys- teine and cystine. These are not evenly distributed in all proteins. Some have little or none and some have a great deal. Often one protein present in a food will have but little and another in the same food will be rich in sulphur. This is the case with milk. One of its 22 FEEDING THE FAMILY proteins (casein) has very little; another (lactalbumin) has a great deal. The result is that milk will supply enough sulphur for growth. In the main, we feel that if the diet is diversified the various proteins will yield the body sufficient sulphur when its nitrogen require- ment is met. Amounts of Phosphorus in i 00-Calorie Portions of Some Common Food Materials Food Material Measure of Portion Phos- phorus Grams Spinach 2 J cups (cooked) 0.285 Buttermilk i| cups 0.271 Haddock 5 ounces (uncooked) 0.259 Codfish, fresh 5 ounces (uncooked) 0.252 Lettuce 2 large heads 0.224 Celery 4 cups of |-inch pieces 0.201 Cauliflower | medium head 0.200 Asparagus 20 stalks 0.177 Cheese, cottage 5 j tablespoons 0.175 Beef, lean 2j ounces (uncooked) 0.147 Beans, dried I cup (uncooked) 0.137 Milk t cup 0.134 Rhubarb 4 cups of i-inch pieces 0.134 String beans 2j cups of i-inch pieces 0.126 Peas, dried 2 tablespoons (uncooked) 0.120 Egg yolk 2 yolks 0.118 Turnips 2 cups of i-inch cubes 0.117 Tomatoes if cups (cooked) 0.113 Corn, green i cup 0.102 Oatmeal i cup (cooked) 0.099 Eggs il eggs 0.122 Onions 3-4 medium 0.093 Cabbage 5 cups (shredded) 0.092 Bread, graham 2 slices 0.084 Peanuts 2 dozen singles 0.073 Potatoes 1 medium 0.069 THE SIGNIFICANCE OF FOOD 23 Phosphorus is equally important with nitrogen, though required in smaller amounts. It forms a part of every active cell of the body and, along with calcium, helps to give rigidity to the bones and teeth. It is not limited like nitrogen and sulphur to the protein of food, but is found sometimes associated with protein, as in the pro- tein of the yolks of eggs (called vitellin), or one of the proteins of milk (casein); sometimes associated with fat, as in the yolks of eggs (in the lecithin); and some- times in simpler forms in grains, fruits, and vegetables. Iron is another element essential to body structure. It enters into the composition of the red corpuscles of the blood (essential to the conveyance of oxygen to the cells and hence to the burning of the fuel foods) and also is an element in the structure of all active cells, so play- ing a part in secretion and growth. While not needed in very large amounts, it is so important that the new- born child is not left to the chances of getting it in his food, but comes into the world with a special supply to tide him over the first few months, while he is becoming adjusted to the outer world. It is found in a variety of foods, among the most valuable being egg yolks and green vegetables, especially spinach. Calcium is essential for strong bones and teeth. In combination with phosphorus it is the chief mineral element of these tissues. By far the most valuable source of calcium is milk, 100 calories of milk yielding as much as could be got from about 2400 calories of white bread and meat. Considerable calcium can be obtained from the grains if the outer coats are included, but very little 24 FEEDING THE FAMILY Amounts of Iron in i 00-Calorie Portions of Some Common Food Materials Food Materials Measure of Portion Iron Grams Spinach 2 f cups (cooked) 0.0151 Cabbage 5 cups (shredded) 0.0035 Beans, string 2J cups of i-inch pieces 0.0027 Celery 4 cups of J-inch pieces 0.0027 Egg yolk 2 yolks 0.0023 Beef, lean 2 j ounces (uncooked) O.OO2I Strawberries i f cups 0.0021 Eggs I i eggs 0.0021 Beans, dried | cup (uncooked) 0.0020 Tomatoes if cups (cooked) O.OOl8 Peas, dried 2 tablespoons (uncooked) 0.0017 Potatoes i medium O.OOl6 Raisins 1 cup 0.0014 Carrots 3-4 medium O.OOI3 Beets 2-4 medium O.OOI3 Turnips 2 cups of j-inch cubes O.OOI3 Bread, graham 2 slices 0.0010 Onions 3-4 medium 0.0010 Figs 15 large 0.0010 Oatmeal 1 cup (cooked) 0.0010 Prunes 4-5 0.0010 Milk i cup 0.0004 Bread, white 2 slices 0.0004 from cereal preparations made without them, as a com- parison of whole wheat and white flour will show. Vege- tables, though less striking a source of calcium than milk, yield enough to be of some importance. Recent investi- gations have shown that they are more useful to the adult than to the growing child. Milk should be the chief reliance for calcium all through the period of growth. THE SIGNIFICANCE OF FOOD 25 Amounts of Calcium in i 00-Calorie Portions of Some Common Food Materials Food Material Measure of Portion Calcium Grams Celery 4 cups of J-inch pieces 0.421 Cauliflower | medium head 0.403 Buttermilk 11 cups 0.294 Spinach 2| cups (cooked) 0.281 Cheese, American ij-inch cube 0.212 Milk, whole t cup 0.174 Cabbage 5 cups (shredded) 0.143 Carrots 3-4 medium 0.124 Asparagus 20 stalks 8 inches long 0.122 Beans, string 2 cups of i-inch pieces O.IIO Onions 3-4 medium 0.069 Beets 2-4 medium 0.064 Figs 1 j large 0.051 Tomatoes if cups (cooked) 0.050 Beans, dried I cup (uncooked) 0.047 Eggs ii eggs 0.045 Peas, fresh . * 1 cup 0.026 Bread, whole wheat 2 slices 0.020 Raisins I cup 0.019 Prunes 4~5 O.Ol8 Oatmeal 1 cup (cooked) 0.017 Potatoes 1 medium O.Ol6 Bread, white 2 slices O.OII Beef, lean 2j ounces (uncooked) 0.008 Cracker, soda 4 crackers 0.006 Cornmeal 1 cup (cooked) 0.005 The other elements which go to make up the body- structure are not only required in comparatively small amounts, but are almost sure to be provided if the diet contains the range of foods which will insure the four already mentioned. A possible exception is iodine. This substance is 26 FEEDING THE FAMILY essential to the normal functioning of the thyroid gland. When the iodine supply is deficient the gland tends to enlarge, simple goiter being the result. The ocean is the source of iodine, and consequently goiter is of rare occurrence near the seacoast. But in various parts of the world there are great inland areas where it is preva- lent. In the United States, for example, the Great Lakes region and portions of the Northwest are dis- tinctly goitrous. Goiter tends to appear at adolescence, especially in girls, and its eradication depends upon the administra- tion of iodine. Very little is contained in ordinary foods, rich supplies being found only in sea foods, in sea salt which has not been highly purified, and in drinking water which has its origin near the ocean or has derived iodine from the soil through which it passes. In goitrous regions boys and girls should be safe- guarded by vigilant school health officers who will watch for the first signs of thyroid enlargement and provide for the suitable administration of iodine. It is to be hoped that scientific research will eventually give us some gen- eral preventive measure both simple and practical. Balance Wheels for the Human Machine A man with locomotor ataxia is a pitiable sight. He can move about, but he has lost the power to control his movements at will. He makes us realize what fine coordination of nerves and muscles ordinary people enjoy. Now the body is composed of many units, each with activities of its own, but subservient to the welfare THE SIGNIFICANCE OF FOOD 27 of the whole; there are glands, like the pancreas and the thyroid, which play a wonderful part in this coordi- nation. If the pancreas becomes seriously deranged, the body loses the power to burn carbohydrate and this most valuable of fuel foods is lost to the economy; if the thyroid gets excessively active, the body may burn fuel faster than it can be supplied, and the victim grows emaciated. The Ash Constituents The chemical elements which make up the body sub- stance must be nicely balanced, or trouble ensues. The blood maintains its neutrality, the heart its regular beat, nerves and muscles their ready response to every im- pulse, largely through the presence of phosphorus, cal- cium, magnesium, sodium, and potassium in suitable amounts in the tissues and fluids. These and all the other chemical elements in the body except carbon, hydrogen, oxygen, and nitrogen are grouped together under the term ash constituents, because they constitute the part left behind as ash when food materials are burned. They are sometimes styled "salts" or "min- eral matter." When any one of these elements is with- held or is insufficient in amount a young animal's growth is interfered with. Moreover, the efficiency of each ele- ment is enhanced by proper amounts of the others. As in the case of the Three Musketeers it is "each for all and all for each" - none functions at its best except as part of a well-balanced diet. Iron builds good red blood more efficiently when plenty of calcium is pro- vided. Phosphorus and calcium, both essential to sound 28 FEEDING THE FAMILY teeth and strong bones, function at their best only when they bear a certain relationship to each other. Rickets, that disease of early childhood characterized by failure of the bones to deposit lime properly, may be produced experimentally in animals by diets low in phosphorus but high in calcium, and conversely, by diets low in cal- cium but high in phosphorus. The balance between the two seems to be more important than the precise quan- tity of either one. It behooves us, therefore, to have a good general representation of the ash constituents in the diet all the time. Water Water helps to regulate the concentration of the min- eral elements, to make possible the transportation of materials to the tissues by holding them in solution in the body fluids, and to facilitate the removal of waste through the kidney drainage system. It also plays an important role in the regulation of body temperature. A liberal daily supply is essential to the best health and should be regularly provided for in the scheme of living of every person young or old. Four to six glasses a day in addition to what is obtained in food is usually sufficient. The Vitamins Besides the fuel foodstuffs, water, and ash constitu- ents or mineral matter, there are substances existing in minute quantities in foods which exercise a profound in- fluence upon nutrition. These are known as vitamins. They are the most elusive and yet the most spectacular 9- Cheese io. Milk 7. Cabbage 8. Tomato (N.B. The cabbage leaves must be green to be rich in vitamin A). Important Sources of Vitamin A 5. Butter 6. Carrot 3- Eggs 4. Lettuce 1. Cream 2. Spinach THE SIGNIFICANCE OF FOOD 29 of all dietary constituents. They exist in such small quantities in food materials, and lose their identity so easily when the chemist tries to isolate them, that none have as yet been chemically identified. We know them only by their works! In this way three have been defi- nitely recognized, known for the present as A, B, and C.1 Vitamin A Vitamin A is often referred to as the fat-soluble vita- min. Important sources are milk, cream, butter, cheese, eggs, liver, fish oils (especially cod-liver oil), thin green leaves of plants, yellow vegetables, germ of seeds, and tomatoes.2 If we wish to determine whether this vitamin is pres- ent in any food we take a suitable laboratory animal (the white rat, for instance) and place it on a diet known to contain every dietary essential except this one vitamin. On such a diet a young rat will soon show a decline in the rate of growth, finally cease to grow, and develop such signs of physical unfitness as rough and falling hair, poor appetite, disturbed digestion, and eventually a very characteristic disease of the eye called xerophthalmia. If now we add to the diet some food containing the A vitamin the animal will promptly recover, the eyes will cease to be inflamed, the hair will become smoother and glossier and begin to come in again if it has fallen out, 1 For a full discussion of the vitamins consult Sherman and Smith's The Vitamins, Eddy's Vitamine Manual, and McCollum's Newer Knowl- edge of Nutrition, 2d Edition. 2 See Appendix, Table XI for full list of sources of the various vita- mins. 30 FEEDING THE FAMILY the appetite and digestion will return to normal, and growth will be resumed. Striking as is the influence of the A vitamin upon the growing animal, its effects on the reproductive capacity of the adult are equally impressive. Two pairs of well- fed adult animals, one pair on the diet devoid of vitamin A, the other on a diet containing it, will not show any bad effect of the diet on themselves for a long time, because reserves of this vitamin may be stored in the body, and tide over periods of temporary shortage. But the pair deprived of the A vitamin will have very few, if any, offspring, and what few they may have will be weak if not still-born. The mother will be unable to suckle the young properly, and that family will die out unless the young are put upon a better diet. These effects on animals are confirmed in various ways for the human race. A physician of Copenhagen, Dr. Bloch, has reported a large number of cases of eye disease among poor children in Denmark, whose diet had no whole milk - only separator skim milk, and whose eye disease was cured by giving them whole milk with its greater supply of the A vitamin. Similarly a Japanese physician, Dr. Mori, has reported cases of eye disease in children on a diet largely rice, cured by the addition of chicken livers. In Roumania, during the war, Dr. Gideon Wells, a distinguished American scientist, ob- served among children cases of eye disease which he was able to cure by diet. In India, Dr. McCarrison, of the British Medical Corps, has had wide opportunity 0. Peas 10. Milk 7. Cabbage 8. Tomato Important Sources of Vitamin B 5. Apple 6. Dried beans 3. Potato 4. Lettuce I. Orange 3. Spinach 31 THE SIGNIFICANCE OF FOOD to study the effect of very limited diets, and he adds his testimony that lack of the A vitamin is detrimental to human welfare. Vitamin B The B vitamin is more widely distributed in food ma- terials than the A vitamin. It is found in many vege- tables and fruits, in milk, eggs, whole grains, legume seeds, liver, kidney, and pancreas. Beriberi, one of the scourges of the oriental world, has been proved to be due to lack of this vitamin. A similar disease is produced in the pigeon by feeding food devoid of the B vitamin, so the pigeon may be used to test whether or not a given food contains it. Since in two or three weeks there develops a characteristic disturbance of the nervous system causing paralysis, and since on administration of the B vitamin the disease is cured in a few hours, the evidence as to the curative role of the vitamin is clear. Partial deprivation may not result in acute disease for a long time, yet there will be evidence of faulty nutri- tion ; for example, marked loss of appetite and failure to digest food which has been eaten are characteristic symptoms of shortage. This vitamin also is a factor in growth. Since it is not stored in the animal body to any extent, depriva- tion is quickly felt. The rate of growth becomes slower and slower and finally growth stops altogether. Im- provement quickly follows administration of the vita- min. In the adult withholding it also interferes with reproduction and lactation. 32 FEEDING THE FAMILY Vitamin C The C vitamin is rather irregularly distributed in food materials and is more easily destroyed than A or B by heating, drying, or aging of food. It is for this reason that emphasis is laid on having some strictly fresh food in the diet. The vitamin stands heating or drying under certain circumstances, however, as for example in to- matoes, which retain a high potency when canned. As a general rule, if foods to be depended on for the C vita- min are cooked they should be cooked for as short a time as possible, and one should be informed as to whether the food so treated will retain any considera- ble amount of its efficiency or not. Excellent sources of the C vitamin are lemons, oranges and other citrus fruits, tomatoes, potatoes, cabbage and turnips (especially yellow) ? The body does not store the C vitamin, hence daily supplies are needed. When the human body is de- prived of it for any considerable length of time, scurvy results. Among lower animals the guinea pig is most susceptible to scurvy and is therefore used in testing foods to see whether they contain the C vitamin. But a diet not entirely devoid of this vitamin may be too poor in it for the best health and yet yield enough to prevent acute scurvy. This is one of the dangers in the restricted diets of young children. Cow's milk is a variable source when fresh, and when pasteurized it loses part of its original supply. So it is important not 1 See Table XI for details. 9. Apple io. Tomato 7. Cabbage 8. Fresh peas Important Sources of Vitamin C 5. Lettuce 6. Yellow turnip 3. Spinach 4. Potato I. Lemon 2. Orange THE SIGNIFICANCE OF FOOD 33 to depend upon milk for this vitamin but to have some rich source in the diet of the child every day. Shortage of vitamins and perhaps especially of the C vitamin is detrimental to the development of the teeth. It is important that every mother and every growing child be liberally supplied with all three of these vitamins. Other Possible Vitamins That there are others seems probable. One of the prevalent forms of malnutrition in infancy is rickets, characterized as already stated on page 28 by a failure of the bones to take up calcium from the blood and harden properly. In children, it has been cured most success- fully by treatment with sunlight, or ultra-violet rays, or by giving cod-liver oil. There has been secured from cod-liver oil a concentrated preparation which is many times more effective than cod-liver oil itself and thought by some to contain an anti-rachitic vitamin. At least there seems to be some substance distinct from the A vitamin which is also found in remarkable amounts (100 or 200 times as much as butter) in this oil. It thus appears that there are several ways in which favorable conditions for bone development and avoidance of rickets may be brought about. Rickets needs to be eradicated because even if not dangerous in itself it may make the child more susceptible to other diseases, especially those of the respiratory tract, and because it may mean poor development of the teeth, if not of other parts of the skeleton. Studies of the reproductive capacity of rats have sug- 34 FEEDING THE FAMILY gested the possibility of another vitamin markedly in- fluencing reproduction. It has been found that rats growing and maturing on certain diets do not reproduce well, and that the addition of some particular food seems to stimulate reproduction. These observations need to be followed by further work to determine whether there are really new vitamins, and if so, to bring their functions and their distribution clearly to light. CHAPTER II THE CARE OF THE DIGESTIVE MECHANISM The first requirement for good nutrition is an ade- quate supply of fuel for all body activities. This must be accompanied by or include those substances which serve to build up the organism and keep it functioning well, constituting a so-called "balanced diet." Many se- lections of food will theoretically accomplish these re- sults, but not all of them are equally successful in prac- tice. It is possible to make a balanced ration from two or three foods, if carefully selected, and eat these to the exclusion of all others. One may take the whole day's supply of protein in the form of cottage cheese, or of beans; may divide the total day's food in two meals or six; serve molasses on meat, as truly a combination of protein and carbohydrate as bread and meat. But we must ask whether these practices represent the highest art in caring for the human machine. It makes a great deal of difference in an engine whether the coal for the day is put in all at once or at intervals, whether in large lumps or fine dust. We may lose valuable fuel through imperfect combustion if the fires are choked. Coal may fall through the grate and be lost with the ashes if not of suitable size. The walls of the fire chamber may be 35 36 FEEDING THE FAMILY burned out by bad packing which prevents circulation of air. So in the case of the human furnace a great deal depends upon the way in which the fuel is introduced. We gather food materials from the four quarters of the globe, prepare them in factory and kitchen for the table, and yet when the products come to the table they are mostly crude material so far as the body is concerned. Food must be subjected to many processes in that long and tortuous tract which we call the alimentary canal before it can enter upon its real functions in the living cells where energy is liberated and new material built. And the way it behaves in that canal is of great import for good nutrition. If it irritates the sensitive walls of stomach or intestines, the whole body is depressed, and the cells may be unable to make use of good material when finally brought to them. If it is crowded along too fast, with no time allowed between meals for rest of the digestive organs, a strike may be inaugurated against such bad working conditions and the poor body left to starve in the midst of plenty. Before discussing in detail, therefore, the food needs of individual members of the family, it will be worth while to give some attention to those principles in the choice and manner of taking food which in general tend to con- serve or promote good digestion and are more or less applicable to all. The final purposes in digestion are (i) to bring all foods into fluid form, (2) to separate all proteins into their amino acid fragments, (3) to divide all fats into two components (fatty acids and glycerol), soluble in the digestive fluids, and (4) to divide all car- THE CARE OF THE DIGESTIVE MECHANISM 37 bohydrates into their component parts (simple sugars). In such simplified forms foods pass into the blood stream and thence to the tissues. The processes by which these objects are attained are partly mechanical and partly chemical. They begin when food is taken into the mouth and continue in orderly fashion until the products indicated above pass through the intestinal walls into the blood and lymph, and the waste material is eliminated in the feces. The Part of the Mouth in Good Digestion On guard at the beginning of the alimentary tract stands the mouth, whose first duty is to grind up coarse foods and soften or possibly dissolve them. Fluid foods relieve the mouth of this duty and are therefore selected when the teeth are missing or when for some other reason chewing is not likely to be well done. Fine minc- ing will to a large extent accomplish the same purpose; so beef is sometimes scraped free of all tough fibers, or vegetables and hard-cooked eggs put through a fine sieve when great ease of digestion is desired. On the other hand, when chewing is possible, similar fineness and softness may be attained by giving foods which must be chewed in order to swallow them, such as crisp toast, zwieback, and hard crackers, which tend to break up in fine pieces and are not only softened but actually dissolved by the saliva, which has the power of acting chemically upon carbohydrate material. The agents in the alimentary tract which split up proteins, fats, and carbohydrates into the fragments which can pass through 38 FEEDING THE FAMILY the intestinal walls (amino acids, fatty acids and glycerol, and simple sugars) are technically called enzymes. They have been likened to keys, each fitting a single kind of lock, and setting free a simpler substance, as if one had a nest of boxes and a key to each by which the next smaller could be released. Thus in the saliva of the mouth we find an enzyme called ptyalin. It will un- lock a starch unit, producing what we may call a "double sugar "1 (maltose); this in turn must be unlocked by another enzyme which will set free from it a simple sugar, - the kind which the blood can take to the mus- cles to burn for fuel. By means of nicely adjusted se- ries of enzymes the body is kept from being overwhelmed with the kind of material which it is trying to use. If we take at one time a large quantity of glucose, es- pecially when the stomach contains no food which might help to dilute it, we are liable to irritation of the stomach and possibly of the small intestines, although glucose is a simple sugar and requires only to pass into the blood to be available to the body. This trouble is simply due to the fact that the body has too much of it to take care of at once. If it is greatly diluted with water be- fore taking, it will cause no trouble ; or if taken in small enough quantities to be diluted by the saliva, or mixed with other foods so that it is thoroughly diluted by them. This is illustrated by the eating of hard and soft candy. If the hard candy is sucked it becomes greatly diluted by the saliva, while the soft candy, quickly swallowed, is diluted but little. When starch is taken, 1 Technically known as a disaccharid. THE CARE OF THE DIGESTIVE MECHANISM 39 it is gradually changed to sugar, and this is one great reason why it is better to have most of our carbohy- drate food in the form of starch rather than of sugar. But starch needs to be cooked so that the enzymes can readily attack it and large masses of starchy food broken up so that the digestive juices can reach every particle. Foods which become pasty in the mouth, such as hot breads of many kinds, soggy potatoes, or unripe, raw bananas, tend to slip down the throat in lumpy masses little affected by the saliva and hard for the other juices to penetrate. Th s is another reason why baked po- tatoes, baked bananas, and hard, dry breadstuffs are better for steady diet than the pasty foods just men- tioned. Pure starches, like cornstarch and tapioca, may be cooked rather quickly, but cereal foods, especially such forms as breakfast preparations of oats, corn, bar- ley, and wheat, have their starch grains sealed within pockets of cellulose, which the body enzymes cannot soften and which are not usually well broken by chewing. Hence without long, slow cooking to loosen up these cellulose walls, much of the starch will fail to digest quickly. Besides helping to grind and soften all hard, coarse food and to digest starch, chewing is one of the signals to the stomach to prepare for its duty. The alimentary canal is operated like a complex railway system. Signals are sent ahead and the way prepared for the oncoming load. Hence, while we cannot add to or take away from the energy which a food may contain by the care with which we chew it, we can make it easier for the rest 40 FEEDING THE FAMILY of the digestive work to be carried on smoothly. We may thus save ourselves from some of the dangers of "indigestion," which often seems to be the chief topic when people discuss their food. The Part of the Stomach in Good Digestion The stomach is the great reservoir into which food from the mouth quietly settles. The receiving end holds it in such a way that the gastric juice penetrates it slowly; and the digestion of starchy food, begun in the mouth if the food has been thoroughly chewed and mixed with saliva, may continue here for some time, till contact with the acid gastric juice stops the action of the salivary enzyme and ends one chapter in the story of digestion. A good flow of healthy gastric juice depends upon many factors Regularity in time of meals is one. Habit is a powerful force in digestion as elsewhere, and the habit of responding to food at regular times and those only will do much to keep the stomach healthy. Most people are exceedingly careless in this respect, and good food is often blamed for bad results, when the broken schedule was really what upset the system. Efficient mastication has already been mentioned as a factor in putting the stomach in good humor to receive food, and in sending the food down in such shape that it can be taken care of with ease. The pleasurable sen- sations from the sight, smell, and taste of food not only "make the mouth water," but the stomach also. Some foods stimulate a flow of gastric juice aside from any THE CARE OF THE DIGESTIVE MECHANISM 41 pleasant sensations they may produce, and are of great value when appetite fails or when for some other reason the stomach's responses to food in general are weak. Water is such a substance and can be taken a few minutes before or at the beginning of a meal with positive stimu- lating effect. The most efficient gastric stimulants are those substances which give flavor to meats; hence the advantage of meat early in the meal when it is served, and the value of beginning a meal with soups contain- ing the extracts of meat, such as bouillon, consomme, and other kinds with meat stock as the foundation, when the stomach responses are feeble. Herein lies the chief value of beef broth for invalids; but, since beef broth itself has little if any fuel value, it should be ac- companied by some "real food," which it will help to digest. The general nervous state of the person is very quickly reflected in the stomach. "Laugh and grow fat" is a wise saw. Attention to the appearance of food on the table and other devices which tend to put the prospec- tive eater in a happy frame of mind are worth while from this point of view. Excitement, worry, anger, chill, fatigue, all tend to retard the digestive processes and the greatest skill in the choice of easily digested food may be of no avail while these unfavorable states persist. If food must be taken under such conditions, it is best taken in some warm, rather dilute fluid form, such as soup, cocoa, malted milk, gruel, or a raw egg beaten up in milk. Next best is some very dry food which has to be moistened and softened in the mouth and reaches 42 FEEDING THE FAMILY the stomach nearly fluid, such as toast crisp throughout, which may be accompanied by some finely minced, lightly cooked lean meat. Concentrated foods of various kinds are apt to prove irritating, especially to a sensitive stomach. Among such foods are cheese, candy, nuts, strongly acid fruits. These should be used in small amounts at a time, and in combination with bland foods which will dilute them, - crackers, bread or macaroni with cheese, candy only at the end of a meal (never on an empty stomach, as concentrated sugar is particularly irritating), nuts in small quantities along with other food less rich in fat and less concentrated, acid fruits very much diluted, as in lemonade or cherry tapioca. The rate, and hence often the comfort, of digestion is further influenced by the proportions of the protein, fat, and carbohydrate eaten. Water passes through the stomach very quickly. Carbohydrates tend to pass out faster than proteins and proteins faster than fats. Mixtures of protein and carbohydrates go faster than proteins alone, but more slowly than carbohydrates. Mixtures of fat and protein, on the other hand, go more slowly than either alone. This retarding effect of fat is an advantage or disadvantage according to circum- stances. The healthy empty stomach tends to contract rhythmically, with more or less insistence, producing the "pangs of hunger." Its possessor, therefore, may find himself very uncomfortable between meals, com- plaining that his food does not "stay by him." He does not need a diet that relieves the stomach, but rather one THE CARE OF THE DIGESTIVE MECHANISM 43 which tends to require some time for digestion, and this can be accomplished by the use of more fat. Such a person can eat pork and beans, sausage, suet pudding, mince pie, and the like without discomfort, especially if leading an out-of-door life. A less vigorous person would find such foods delaying digestion unduly; hence they are usually, and very properly, considered hard to digest. The same is true of other foods where a con- siderable amount of fat is intimately mixed with proteins or even with carbohydrates, such as fat meats, rich sauces, pastries, cakes. A good cook is not always the safest provider of the family food because of her tendency to load up all kinds of dishes with cream and butter. The taking of fat is less likely to be overdone if it is served by itself as butter for bread, or as thin cream for bever- ages and cereals, than when it is used liberally in the kitchen. Most people can eat large amounts of carbohydrate food with ease. Thus bread, in which eight-tenths of the calories are in the form of carbohydrate, is the ''staff of life." But there are persons in whose stomachs carbohydrates tend to ferment very easily, usually be- cause of bad mastication, little gastric acid, or poor mus- cular activity of the stomach. These need to eat less carbohydrate food than others and to rely more upon protein and simple forms of fat for fuel. As already pointed out, sugars ferment more readily and are liable to be more irritating than starchy foods, so that good results are often obtained merely by ruling out sugars and very sweet foods. At other times foods containing 44 FEEDING THE FAMILY much cellulose, such as green vegetables, must be ex- cluded because the cellulose tends to retard carbohy- drate digestion, unless it is removed through a strainer. Usually it is wise to enforce good mastication by the use of hard, dry breadstuffs. Good stomach digestion depends, in general, upon keeping the whole body in good condition by breathing fresh pure air, taking suitable exercise, cultivating cheer- ful mental habits; observing regular mealtimes, and refraining from food at all other times; avoiding food when greatly overwrought or exhausted, or limiting it to simple, warm, fluid foods; masticating thoroughly so that food never goes down in large lumps; paying some regard to the retarding effect of fat on digestion; and avoiding large amounts of very concentrated or irritating foods. Good Digestion in the Small Intestine Into the small intestine by spurts from the stomach comes material in various stages of digestion, mostly fluid, with small particles of insoluble or still undissolved substances floating in it. Here are enzymes greater in number and more powerful in action than anywhere else in the alimentary canal. The acid gastric juice sends a call to the pancreas through a special " chemical messen- ger" and out pours a fluid with enzymes for starch, pro- tein, and fat. From the walls of the intestine itself numbers of tiny glands supply a secretion containing enzymes for breaking up the last combinations, setting free amino acids from the larger protein fragments left THE CARE OF THE DIGESTIVE MECHANISM 45 by the other enzymes, and also dividing all the remain- ing double sugars into simple sugars. The bile flows into the intestine and makes conditions more favorable for these changes, especially helping in the digestion of fat. In the small intestine we find two systems of move- ments. By one the food is very thoroughly mixed with the digestive juices containing the enzymes, and brought into contact with the tiny fingerlike projections on the intestinal walls which absorb the digested materials and start them on their journey to the tissues that need them. By the other, the material is moved along from part to part, meeting fresh surfaces for absorption, and leaving less and less to be pushed into the large intestine. Good health in the small intestine is very quickly affected by conditions in the stomach. Hence it is for- tunate that the stomach is very sensitive to bad feeding and gives us warning of what we may be doing to the more important intestinal tube. Any nervous disturb- ance affecting the stomach is likely to be shared sym- pathetically by its neighbor. Anger, fear, and other painful emotions tend to stop digestion in all parts. Bacteria of various kinds thrive in the small intestine, and when food is not digested at the normal rate, are likely to seize it and devote it to their own nourishment. Thus carbohydrates tend to ferment, producing trouble- some gases and irritating acids; and proteins to undergo putrefaction, with the formation of products which are more harmful than those formed by carbohydrates, producing, when absorbed into the system, the con- dition called "auto-intoxication." Fermentation can be 46 FEEDING THE FAMILY lessened by limiting carbohydrate food, and putrefaction reduced by limiting protein food; the dangers of both can be avoided in part by care in mastication and choice of the form in which the food is taken, and in part by stimulating normal peristalsis in the intestine - the movement which carries the food downward into the large intestine. This will be discussed in detail after a few words in regard to the large intestine. Good Digestion in the Large Intestine The large intestine serves in great measure as a recep- tacle in which the last portions of digested material may be sorted out from the waste which is to be eliminated as of no further use to the body. No digestive enzymes are furnished in its fluids; no such vigorous mixing of food and digestive juices occurs as in the small intestine, though a slow backward movement in the part adjacent to the small intestine forces the material in this part back and forth to insure absorption of all that is useful. At intervals a vigorous downward push forces the waste onward and finally out of the body altogether. It is very important that these movements of large and small intestine, conveying material along the tract, be normal. If they are too rapid, digestion is left in- complete and the body loses valuable food material, as in diarrhea. If they are too slow, waste accumulates, mechanically irritating to the intestinal walls and to adjacent parts; bacteria prey upon the retained ma- terial, and ample opportunity is afforded for the absorp- tion of any poisons which they may produce, thus laying THE CARE OF THE DIGESTIVE MECHANISM 47 the foundations for bad complexions, headaches, sensa- tions of fatigue, irritation of the appendix, and other unpleasant conditions. The peristaltic movement of the large intestine tends to be hindered by many of the habits of civilized life. In the first place, the abdominal muscles are likely to have less exercise and hence to be less vigorous, partly because of less general physical activity and partly be- cause of more confining dress, particularly for women. In the second place, food is likely to be too highly refined. Some bulk is necessary for intestinal muscles to exer- cise against, and this is obtainable only by taking some indigestible material as part of the diet. Animals get ballast in the form of sand, or bones, or the woody parts of plants, and many of the natural foods of man contain considerable woody fiber, seeds, and other forms of cellulose. But by our modern milling processes we remove the bran from grains; in our market gardens we force vegetables so that their fiber is very delicate; we discard seeds and rind of fruits, and thus make pos- sible a diet almost free from ballast. Furthermore, modern transportation makes possible a very free choice of food. We are not dependent on a problematic catch of game or fish for meat; we can have it every day and three times a day so long as we have money to buy it. Therefore we may unconsciously eliminate from the dietary or relegate to an insignificant place foods which have chemically a stimulating in- fluence upon the movements of the intestines, such as most fruits and acid vegetables. 48 FEEDING THE FAMILY Finally, habit plays a large part in normal intestinal movement, as in other digestive processes. If the normal warning is disregarded, it soon becomes ineffective and recalling it becomes increasingly difficult. The greatest stimulus to intestinal movement comes immediately after taking food into the stomach and particularly after breakfast. Thus the omission of breakfast, common with some persons, may mean the loss of a much needed impulse. From these various causes, constipation is one of the recognized ills of modern life. One has only to notice advertisement of drugs in street cars and on billboards to realize this. But the taking of drugs is a poor sub- stitute for the normal control of the alimentary tract by diet and regularity, and is to be countenanced only when more hygienic measures fail. Diet for Constipation In endeavors to remedy or avoid constipation through diet, we may choose then : (i) Foods rich in cellulose, such as celery, cabbage, string beans, dried beans and lentils with their hulls, as- paragus, lettuce, spinach, onions, raisins, figs, prunes, and other fruits eaten with their skins, cereals from which the bran has not been removed, such as rolled or cut oats and wheat. When still more ballast is required, bran itself can be used in various ways, the pleasantest being as bran bread, muffins, or crackers. Another plant product which serves the same purpose is agar-agar or "vegetable gelatin." This is eaten simply cut into THE CARE OF THE DIGESTIVE MECHANISM 49 small pieces, along with or instead of some breakfast food, or it can be obtained in the form of wafers. It may also be made into biscuits; boiled in water, flavored and cooled, it makes an edible jelly.1 Successful results from the use of such foods depend largely upon taking a sufficient quantity and constantly including them in the diet. (2) Foods yielding vegetable acids, such as lemons, oranges, tomatoes, rhubarb, apples, cider, and other fruits and fruit juices (except blackberries, which are constipating). The acids are mild stimulants to intes- tinal movement and most people find fruit pleasant to take. The desired results are often gained by taking fruit or fruit juice the first thing in the morning. For persons of sensitive stomach, very mild fruit should be selected, or fruit juice diluted with water. Hot lemon- ade, prunes, or figs may be tried at bed time, if they do not cause discomfort. Liberal serving of fruit at meals has much to recommend it as a means of counteracting constipation. (3) Foods producing slight gas formation, such as honey, molasses, spinach, onions, cauliflower, and some others. These tend to ferment slightly; the gas gener- ated breaks up hard masses in the intestine and also acts as a slight stimulant to movement. Carbonated waters may bring about the same result through the gas with which they are charged. Honey and molasses are best taken with coarse breads. They must not be used too freely or they will disturb digestion. The vegetables 1 One-fourth ounce of agar-agar will solidify one quart of liquid. 50 FEEDING THE FAMILY may be as effectively served as salads with an olive oil dressing, or simply cooked and seasoned with salt and butter. (4) A lubricant. For people whose digestion of fat is rather imperfect, fat in liberal quantities is often laxa- tive and such may be benefited by a tablespoonful or two of olive oil before breakfast and the last thing at night. For most people, however, the lubricating effect is lost through digestion of the fat and can only be secured by taking an indigestible mineral oil. Such substances do not actually stimulate intestinal movement, and only aid in the elimination of waste by making it softer and allowing it to pass along the tract more readily. If movement is very sluggish, the oil may slip through without carrying feces with it, in which case foods of the two types indicated above must also be used, or recourse had to exercise or, under the guidance of a physician, to drugs which specifically stimulate peristalsis. A large volume of water, two glasses or more, if taken on an empty stomach, will sometimes start intestinal peristalsis, but since water tends to be absorbed before it reaches the large intestine its action is rather uncertain, differing greatly with individuals. However, the drink- ing of water freely is desirable, as it helps to flush out the system and carry waste products off through the kidneys. THE CARE OF THE DIGESTIVE MECHANISM 51 Some Anti-Constipation Menus1 (for Healthy Adults) Breakfast An orange Cut oats, cream Bran muffins and honey Bacon I Luncheon : Scalloped corn Triscuit Baked apple Dinner: Vegetable soup Roast beef Spinach (large serving) Baked potatoes (skins eaten) Cabbage salad Graham bread Steamed fig pudding, lemon sauce II Breakfast Stewed prunes Shredded wheat, cream Tomato omelet Graham toast Luncheon: Pork and baked beans Boston brown bread Sliced pineapple Oatmeal macaroons Dinner : Boiled mutton, caper sauce Stewed onions Lettuce salad, French dressing Bran wafers Lemon jelly, whipped cream 1 Two glasses of water or a glass of diluted lemon, orange, or other fruit juice should be taken each day, on arising. CHAPTER HI FOOD FOR THE ADULT MAN A human being requires about twenty-five years to complete his growth. During this time he adds to his stature, gains in weight, and changes in physiological and mental habits. Then he enters upon a period, last- ing perhaps from a quarter to a third of a century, during which his body may maintain a fairly constant weight, and no marked changes occur in the nature of any of his body processes. He is now the fully built "working machine" and his largest food requirement is adequate fuel for his varied activities. Some of the general principles governing choice of fuel have already been discussed in Chapter II. We are now concerned with the amount of fuel which will maintain the best working conditions. Underfeeding will weaken the body by causing it to draw upon its own substance for fuel; overfeeding will result in the storage of an overload of fat, interfering with normal muscle action and making unnecessary weight to carry, or else it will tax the digestive and excretory systems to the point of injury. Ideal conditions exist when a man carries a normal weight for his height,1 and his daily intake of food corresponds closely to his daily expenditure of energy. 1 See Appendix, Table V, Height and Weight for Men at Different Ages. 52 FOOD FOR THE ADULT MAN 53 Energy Requirements of the Adult Man In the long run, one must gain weight with a surplus of fuel and lose weight with a shortage. Hence the sim- plest way to tell whether one's energy intake is appropri- ate is by keeping track of body weight. But if it be found that the person is gaining or losing, changes in the diet can be more intelligently effected and the de- sired results more speedily attained if we know both his energy requirement and the energy content of his food. It is not assumed that many people will need to "count their calories" every meal or every day, but that each may use such knowledge to work out for himself a prac- tical food program and to make such changes from time to time as circumstances require. The nature of these changes for the sedentary and active, the thin and fat, are briefly outlined in the following pages. The Sedentary Man Studies of healthy adult men lying at rest in a respira- tion calorimeter,1 after fifteen hours without food, show that in the work of maintaining their internal body processes (circulation, respiration, muscle tension, etc.) they expend about 0.45 calories per pound per hour; that is, a man weighing 154 pounds and lying quietly in bed without food for twenty-four hours would draw upon the tissues of his body for fuel to the extent of about 1665 calories. From this fundamental or "basal" re- quirement there is no escape while normal life processes 1 See page 15. 54 FEEDING THE FAMILY go on. If food be taken to make good this loss, the in- fluence of food itself (which somewhat increases energy expenditure, the effect varying with kind and amount of food) must be taken into account in making up the balance. This will add about io per cent to the total heat production, so that his expenditure will be about one-half calorie per pound per hour, or 1850 calories for the whole day. Every movement of hand or foot, all the muscular work involved in raising and keeping the body in a sitting or standing position, or in perform- ing the varied activities of daily life, will make definite increases in the energy output, all of which have been carefully measured in scientific laboratories. Sitting quietly in a chair, with only the movements usually incident to sedentary living, such as changes of posture, movements in reading, writing, or talking, will make the total fuel cost per hour about three-fifths of a calorie per pound. Hence a man of average weight, spending eight hours in bed and sixteen hours in a chair, will need a daily total food supply of approximately 2100 calories. Standing involves more energy than sitting, raising the energy expenditure to about three-fourths of a cal- orie per pound per hour, while walking on a level road at a rate of some three miles an hour, or other light exer- cise incident to ordinary life, calls for about one calorie per pound per hour. The day's energy requirement of a man of sedentary habits may then be estimated as follows: FOOD FOR THE ADULT MAN 55 Calculated Energy Expenditure for Twenty-four Hours for a Sedentary Man Weighing 154 Pounds Activity Pounds Hours Calories per Pound Per Hour Total Calories Sleeping 154 8 1 2 616 Sitting 154 8 3 5 739 Standing 154 4 3 4 462 Walking and other light exercise 154 4 I 616 Total 24 2433 Studies of food requirements of sedentary men of various occupations, as, for instance, writers, draughts- men, teachers, bookkeepers, shoemakers, tailors, phy- sicians, and others who sit at their desks or watch ma- chinery show that they tend to require from 2200 to 2800 calories per day, as they vary somewhat in weight and activity. It is possible to supply this amount of fuel in the form of cereals, beans, pork, bread and but- terine, with hot coffee and milk, for from 17 to 22 cents a day, or from three-fourths to four-fifths of a cent per 100 calories. Reference to Table IV, showing costs per 100 calories of some common foods, will make it clear, however, that the range of foods which can be used in a dietary costing less than one cent per 100 calories is quite limited. Men prefer a more varied diet, and it is easier to secure all the elements for good nutrition, with good digestion, if it is possible to spend somewhat more for food. The following food plan is suggested as a work- ing basis for the selection of the diet of a sedentary man, when the money allowance is liberal. The cost estimate 56 FEEDING THE FAMILY is based on New York City prices, and in many regions, where meats, milk, fresh fruits, and vegetables are cheaper, the food could be obtained for less. Such a plan will give a diet adequate in proteins, ash constitu- ents and vitamins and sufficiently easy of digestion for the ordinary sedentary person. The dietaries worked out from this food plan (pp. 58 and 59) show in detail how the following of such a scheme will insure a well-balanced ration.1 A Day's Food Plan for a Sedentary Man Fuel Requirement: 2200-2800 Calories Cost: 2^-3 p per 100 Calories Breakfast: Fruit 100 Calories Cereal 50-100 Calories Eggs or Liver and bacon or Creamed dried beef on toast Toast . 100-200 Calories or Rolls (hard and crisp) or Muffins (occasionally) . loo-zoo Calories Butter 100 Calories Coffee with cream 100-150 Calories Top milk for cereal . 100 Calories Sugar for cereal and coffee 50-100 Calories 700-900 Calories Luncheon : Thick vegetable soup or Broiled fish or Cheese dish 100-200 Calories 1 Many of the recipes used in the menu in this and following dietaries are given in the Appendix, Table III. Rolls or bread 100-200 Calories FOOD FOR THE ADULT MAN 57 Butter 50-100 Calories Fruit or Pudding (pie occasionally) . . 200-400 Calories Coffee with cream and sugar .... 100-150 Calories 600-800 Calories Dinner Roast beef (rump) or Stuffed steak or Meat loaf or Baked fish Clear soup and crackers 50-75 Calories 100-300 Calories Potatoes or Rice or Macaroni 100-150 Calories Bread 50-100 Calories Green vegetable (cooked) 100-150 Calories Lettuce, celery, or other crisp vegetable 50-150 Calories Pudding (made with milk) or Stewed fruit or Ice cream (occasionally) . . . . 200-300 Calories 900-1200 Calories The Muscularly Active Man Muscular activity greatly increases an individual's total energy requirement. The sedentary occupations demand little more food than would be needed if the person were sitting at rest, though it w'ould be better for sedentary persons to take some vigorous exercise each day for the sake of their general health and increase their food intake accordingly. This is particularly true of brain workers and all whose work involves nervous rather than muscular tension. 58 FEEDING THE FAMILY A Dietary for a Sedentary Man, Based on the Preceding Plan Fuel Value: 2400 Calories Cost: 2^-^ per 100 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast : Grapefruit (C, B) . . . medium 7.6 7 100 Shredded wheat biscuit (B) i biscuit 0.9 13 100 Scrambled egg (A, B) . . t cup 2-5 24 IIO Bacon 2 small pieces °-3 7 50 Graham toast (B) . . . 3 small pieces 1.2 14 100 Butter (A) 2 tsp. o-3 - 67 Top milk (io oz.) (A, B) . icup 2.1 9 100 Whole milk (A, B) . . . f cup 5-i 19 100 Sugar i tbsp.(scant) o-5 - 50 Coffee i cup - - - Luncheon: 777 Cream of baked bean soup (B, A) | cup 3-9 22 150 French rolls i roll i-3 12 100 Butter (A) £ tbsp. 0.2 - 50 Apple pie i piece (3 in.) 4-8 9 300 Cream, thin (A, B) . . 2 tbsp. 0.9 2 50 Sugar 2 tsp. o-3 - 40 Coffee 1 cup - - - Dinner : 690 Clear tomato soup(C,B,A) I cup 3-7 4 50 Saltines 2 crackers o-3 3 33 Roast veal (shoulder) . . small serving 2.1 66 100 with stuffing .... | cup 0.8 9 100 Gravy (brown sauce) . . 3 tbsp. i-7 7 50 Boiled potatoes (C, B) 1 medium 3-6 11 100 Green peas, buttered (B, A, C) | cup 3° 21 100 Lettuce (C, A, B) French dressing 1 serving 0.6 - 5° Snow pudding .... 1 cup 3-3 15 150 Boiled custard (A, B) . . i cup 2.2 13 100 Macaroons 2 macaroons 0.8 6 100 933 Total for day .... 293 2400 In this and succeeding dietaries the most important sources of the A, B, and C Vitamins will be indicated by these letters in parenthesis after the food. When more than one letter is placed after any food, the one for which the food is most significant will be placed first. Food Material Weight (oz.) Measure Food Material Weight (oz.) Measure i. Banana 5-5 1 large 6. Stewed prunes 2.8 2 prunes and juice 2. Grapes 4-9 1 large bunch 7. Canned peaches 7-5 3 medium halves and juice 3. Grape fruit 7.6 1 medium 8. Baked apple ' 2-3 1 large 4. Orange 9-5 1 large 9. Canned pears 4-7 3 halves and juice 5. Pineapple 8.2 2 slices 1 in. thick 10. Apple sauce 3-5 s cup ioo-Calorie Portions of Fruit 1 1 Cf. Appendix, Tables I and III. FOOD FOR THE ADULT MAN 59 A Dietary for a Sedentary Man, Based on the Preceding Plan Fuel Value: 2400 Calories Cost: ij-2^ per 100 Calories Measure Weight Protein Total Oz. Calories Calories Breakfast: Apple (C, B) Cornmeal and cream of 1 medium 5-6 2 75 wheat (half and half) (B) i cup 6.8 12 100 Milk (A, B) 1 cup 8-5 34 170 Sugar i| tbsp. 0.7 - 75 French toast (B, A) . . . 2 slices 2.8 20 200 Coffee - - - 620 Luncheon: Scalloped potatoes with cheese (j oz.) (A, B, C) 1 cup 6-3 23 200 Graham bread (B) . . . 3 slices i-4 14 TOO Butter (A) 1 tbsp. 0-5 I TOO Stewed apricots (B) . . . s cup 4-o 6 150 Cocoa 11 1 cup 9-0 22 l6o 710 Dinner : Swiss steak with gravy2 slice 4 in. 2.2 / X 2 in. X (meat 73 325 t in. only) Baked potatoes (C, B) . . 2 medium 6.0 22 200 Mashed turnips (C, B) . . i cup 4-5 6 75 Graham bread (B) . . . 3 slices i-4 14 100 Butter (A) r tbsp. o.S I 100 Cranberry jelly (C> B) . . 1 tbsp. 0.7 - 5° Bread custard pudding i cup 4-3 34 220 (A, B) 1070 Total for day .... 284 2400 II 1 See Table III, Appendix, p. 388. 2 2 tbsp, drippings and 1 tbsp, flour added for gravy. 60 FEEDING THE FAMILY Muscular work is usually graded as "light," "moder- ate," "active," or "severe," light exercise being such as that incident to sedentary occupations and not much more vigorous than walking at a moderate pace along a level road, and requiring about one calorie per pound of body weight per hour. "Moderate" exercise is typical of occupations which involve active use of some parts of the body while sitting, standing, or walking, as in the case of carpenters, mail carriers, house workers, and others. Such exercise means an expenditure of from one and one-fourth to one and one-half calories per pound per hour during working hours, and a daily total for men of average size in such occupations of from 2700 to 3000 calories. "Active" exercise is sufficiently great to develop muscular strength, as in farmers, masons, and black- smiths, and requires during active working hours an expenditure of from one and three-fourths to two cal- ories per pound per hour, or approximately 3 500 calories per day. "Severe" exercise indicates very heavy mus- cular work, such as that done by lumbermen, exca- vators, and stevedores, and calls for fuel equal to as much as three calories per pound per hour during work, so that the total day's food requirement for such men often reaches 4000 and may reach 6000 calories. The changes in energy requirement due to differences in activity may be summarized as follows: FOOD FOR THE ADULT MAN 61 I Kind of Activity Calories per Pound per Hour 1 2 Sitting quietly 3 5 3 4 Light exercise I Moderate exercise ij-ii Active exercise 11-2 Severe exercise 3 or more II Occupation Calories per Man per Day In bed twenty-four hours 1600-1800 At rest, but sitting most of day 2000-2300 Work chiefly done sitting 2200-2800 Work chiefly done standing or walking . . . 2700-3000 Work developing muscular strength .... 3000-3500 Work requiring very severe effort 4000-6000 A day's food plan at minimum cost for a man doing severe work is given below. Such work usually insures good appetite and digestion, if the work be done under generally hygienic conditions. Hence more foods rich in fat, such as fried cereal foods, sausage, pork and beans, suet pudding, and pie, may be taken without detriment. These have the advantage, too, of raising the total fuel value of the diet without greatly increasing the volume of food to be consumed. Bread made from whole wheat flour will help to insure ash constituents without add- 62 FEEDING THE FAMILY ing to the cost. At least a pint of milk should be found in the day's food, and whenever they can be secured with little or no additional cost, green vegetables should be used freely. Cabbage and canned tomatoes will take the place of more expensive vegetables in the winter. Cabbage should be eaten raw or cooked only a few minutes. Fuel Requirement: 3500-4000 Calories Cost: i-ii^ per 100 Calories Breakfast: Cereal (oatmeal, cornmeal, etc.) . . . 150-300 Calories (fried occasionally) A Day's Food Plan For a Working Man Sausage or Salt fish or Liver and bacon 200-300 Calories Toast or Muffins or Corn bread 300-400 Calories Oleomargarine 150-300 Calories Milk for cereal and coffee 100 Calories Sugar for cereal and coffee 100 Calories 1000-1200 Calories Luncheon : Beans, peas, or lentils (baked, or in soup or stew) or Macaroni and cheese or Cheese . . . 200-400 Calories Bread (rye, graham, white, etc.) . . . 200-400 Calories Fruit, fresh or as sauce (bananas, apples, apricots, prunes) 100-150 Calories Cake or pie 200-400 Calories Milk and sugar for coffee 200 Calories 1000-1400 Calories FOOD FOR THE ADULT MAN 63 Dinner : Meat pie or Stuffed meat and potatoes or Meat stew with dumplings . . . . 300-400 Calories Savory vegetable (onions, tomatoes, or cabbage) 100-200 Calories Bread 200-400 Calories Suet pudding or Bread pudding or Creamy rice pudding 250-400 Calories Milk and sugar for coffee 200 Calories 1400-1800 Calories On the following page is an example of a dietary based on this plan. Thin and Fat Men THIN MEN In case men are extremely thin or fat, some variation from the general rule of feeding according to age and weight is necessary. Thin men usually have more muscle in proportion to weight than fat men, and they also have more surface exposed, both of which facts increase their need for fuel somewhat. A store of body fat is de- sirable as reserve fuel for emergencies, as evidence of a well-nourished body which is more resistant to dis- ease, and as protection against jars and bruises. This reserve can only be gained by taking food in excess of daily fuel needs. Tables showing what normal men of different ages and height should weigh may be con- sulted with profit and are for convenience included in the Appendix. Since food is the only source of body 64 FEEDING THE FAMILY A Dietary for a Working Man, Based on the Preceding Plan Fuel Value: 3945 Calories Cost: 1^ per 100 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast : Oatmeal mush (B) . . . ij cups 12.0 25 150 Creamed dried beef (A, B)1 t cup 6.0 4° 250 Old New England corn bread . large slice 4.0 32 400 Oleomargarine 2 tbsp. 0.9 - 200 Milk for cereal and coffee (A, B) i cup 5-i i9 100 Sugar for cereal and coffee 2 tbsp.(scant) 0.9 - IOO Coffee I cup - - - 1200 Luncheon: Kidney bean stew (B, C, A) i| cups 18.0 IOO 355 Rye bread (B) 1 loaf 2.8 28 200 Oleomargarine 2 tbsp. 0.9 - 200 Banana (B, C) i large 5:5 5 IOO Molasses cookies I 2 . . . 2 large i-5 12 200 Milk for coffee (A, B) . . 3 tbsp. 2.0 8 40 Sugar for coffee .... i tbsp.(scant) o-5 - 50 Coffee i cup - - - 1145 Dinner : Stuffed beef heart . . . i serving 4.0 84 400 Potatoes, boiled (C, B) . . 2 small 5-4 16 150 Carrots (A, B) 2 small 5-0 5 50 White bread I loaf 3-9 42 300 Oleomargarine 2 tbsp. 0.9 - 200 Date pudding II 2 (B) . . i serving 3-5 22 310 Brown sugar for clear sauce 2 tbsp.(scant) o.8 - IOO Milk for coffee (A, B) . . 3 tbsp. 2.0 8 40 Sugar for coffee .... i tbsp.(scant) 0-5 - 50 Coffee i cup - - - 1600 Total for day . . . 446 3945 1 Vitamins from milk. 2 See Table III, Appendix, pp. 401 and 411 FOOD FOR THE ADULT MAN 65 substance, persistent overfeeding without indigestion, of a well-balanced diet is the only way to gain in weight. Change of climate, outdoor living, and other devices which increase appetite are aids in taking sufficient food, but much can be accomplished under ordinary living conditions by conscious systematic effort to take more fuel. Adequate rest is important, since fatigue is often a contributory cause of undernutrition. A health ex- amination should be sought, to be sure there is no dis- ease responsible for the emaciation. Simple foods which do not upset digestion are best. Liberal use of butter, cream, and bacon, and the taking of from one to two tablespoons of olive oil after each meal, are practical ways of increasing the fuel value of the diet. Vegetables can be served with cream sauces, or as salads with may- onnaise, French, or cream dressings; milk enriched with cream, cocoa and chocolate made with milk, or tea and coffee with cream and sugar liberally used are compara- tively easy to take. Custards and creams of various kinds are valuable means of adding to the fuel value of the meal. Meat is best used in moderation. FAT MEN A fat man requires less fuel in proportion to his weight than an ordinary man. Fat represents "dead weight." The actual amount of muscle may be no more (even less) than in another man who tips the scales at a lower figure. As men grow older they tend to less and less muscular exertion and yet their appetites often continue keen, so that they keep up eating habits formed in more active 66 FEEDING THE FAMILY A Fattening Dietary Suggested eor a Sedentary Man Fuel Value: 3450 Calories Ordinary Requirement: 2500 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast: Grape juice (B) .... 1 cup 7-o - 200 Farina with 4 dates (B) . . I cup 7-o 14 200 Scrambled egg (A, B) . . i cup 4.2 40 200 Toast i slice o-5 7 50 Butter (A) i tbsp. 0.2 - 5° Cream, thin (A, B) . . . 1 cup 6-3 18 350 Sugar 2 tbsp.(scant) 0.9 - 100 Coffee 1 cup - - - 1150 Luncheon: Creamed chicken (A, B) 1 i cup 3-2 32 200 on Toast 1 slice o-5 7 50 Lettuce salad (C, A, B). . 1 serving 1.2 1 IOO Saltines 3 saltines 0.4 5 5° Vanilla ice cream II (A, B)2 1 cup 4-o 12 200 Chocolate II (A, B)2 . . t cup 7-8 33 250 850 Dinner : Cream of corn soup (A, B) 1 cup 8.0 24 200 Roast beef 2 J slices 4-0 250 Baked potato (C, B). . . 1 medium 3-o 11 IOO Buttered Lima beans (B, A) i cup 2-5 24 150 Whole wheat bread (B) . . 2 slices 1.4 16 IOO Butter (A) 2 tbsp. 0.9 - 200 Baked apple (C, B) . . . 1 large 4-6 2 200 Cream, thin (A, B) . . . 2 cup 3-6 IO 200 Sugar 1 tbsp, (scant) o-5 - 5° 1450 Total for day .... 371 3450 1 From milk and butter. 2 See Table III, Appendix, pp. 388 and 415 FOOD FOR THE ADULT MAN 67 years, with the result that they steadily take in more fuel than they use up, and gradually increase in weight. It is now thought most favorable to health to carry no more weight after thirty than what is normal for the height at thirty.1 Too much fat is a disadvantage, as it is apt to interfere with the healthy play of the muscles, causing them to deteriorate, and laying the foundation for troubles with the heart. Excessively fat people also seem predisposed toward gout and obesity. It is usu- ally much easier to keep the weight from becoming ex- cessive than to reduce it after it has gone up. Hence it should be borne in mind that persistent gain in weight in a healthy person means that he has been overeating and he should make consistent efforts to lower his food intake. Increasing exercise will help to burn off fat, but is likely to stimulate the appetite, so that accurate meas- urement and systematic limitation of the fuel value of the diet is necessary. Foods very high in fuel value, i.e., fats and dishes containing much fat, should be avoided and bulky foods of low fuel value used to satisfy the eager appetite. Even then considerable self-denial is usually necessary to achieve success. Clear soups should take the place of cream soups, butter and cream be almost eliminated, sugar used very sparingly, and confectionery avoided. Green vegetables of all kinds, raw or plainly cooked, such as cabbage, celery, lettuce, spinach, asparagus, cauliflower, can be freely eaten. Bread, cereals, pota- 1 See Appendix, Table V, Height and Weight for Men at Different Ages. 68 FEEDING THE FAMILY A Reducing Dietary Suggested for an Overfat Man Fuel Value: 1400 Calories Ordinary Requirement: 2500 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast: Orange (C, B, A) . . . . i large 9-5 7 100 Eggs (A, B) 2 eggs 4-8 54 150 Graham bread (B) ... 2 thin slices o-7 7 50 Coffee (clear) i cup - - - 300 Luncheon: Bouillon i cup 8-5 21 25 Soda cracker .... i cracker 0.2 3 25 Halibut steak, broiled, with large lemon serving 6.o 122 200 Asparagus, plain (B) . . . io stalks 8.o l6 50 Potato, boiled (C, B) . . Butter (for potato and i medium 3-6 11 IOO asparagus) (A) .... J tbsp. o-3 - 50 Apple, raw (C, B) ... i medium 4-9 2 65 515 Dinner : Raw oysters 12 oysters 7.2 49 IOO Roast beef, strictly lean large serving 5-8 162 250 String beans, plain boiled (A, B, C) i cup 2.0 5 25 Potato, boiled (C, B). . . Tomatoes, sliced, with vine- i medium 3-6 11 IOO gar, salt and pepper (C, B, A) i medium 7-7 8 50 Cheese, pineapple 1 (A, B) . 0.4 12 50 Water cracker i cracker 0.1 1 10 Coffee (clear) i cup - - - 585 Total for day .... 491 1400 1 Roquefort, Swiss, Brie, or American may be substituted. FOOD FOR THE ADULT MAN 69 toes, and other starchy foods should be taken in small quantities and can often be omitted. Fresh fruits should be substituted for puddings, cakes, and pies. Lean meats, simply cooked, may be used liberally if plenty of green vegetables be also included in the diet. Building Material for the Adult Man When a steam engine transforms the energy of coal into useful work, about nine-tenths of the total amount of energy present in the fuel will be unavoidably con- verted into heat and dissipated into the surrounding atmosphere, and only one-tenth actually transformed into useful work. In the finest motors the skill of the designer has succeeded in reducing this inevitable loss of potential working power to about seven-tenths. Man is a much more efficient machine than the ordinary engine, being able to convert up to a third of his energy into muscular activity when well trained to his work (very commonly as much as one-fifth) and also utilizing the heat which is a by-product of his activities to keep up his body temperature. Man can also do his work with comparatively little wear and tear on the body itself, provided he treats it with the same care that would be given to any other high-grade machine - supplies fuel in suitable forms and amounts, keeps within the limits of its work capacity, and sees that it is well oiled (furnished with regulating materials) and clear of waste. Nevertheless, as we have seen in Chapter I, it is a law of life that some old material shall constantly be replaced by new, and we must take into account a daily 70 FEEDING THE FAMILY loss from the body of substances entering into its inti- mate structure or serving to modify and control its processes, such as nitrogen, phosphorus, iron, and cal- cium. We must find out how the diet is to compensate for such depletions. THE PROTEIN OR NITROGEN REQUIREMENT During much of the nineteenth century biological chemistry was dominated by the ideas of the great organic chemist, Liebig. He thought muscular work to be performed at the expense of the muscle itself, and taught that the only way to maintain muscular strength was to eat protein food, and especially that as much like the body protein as possible, namely, meat. But near the middle of the century this idea was subjected to scientific investigation, and convincing, though crude, proof adduced to show that a man doing a day's work without protein food would by no means burn enough of his body protein to account for the work done; in fact, would burn scarcely more than if he had not been working at all. It became apparent, therefore, that fats and carbohydrates were the main source of muscular energy, a fact fully demonstrated before the opening of the twentieth century. If a diet be ample in fuel, chiefly as carbohydrate and fat, the loss of protein for each individual in health proceeds quite uniformly, whether his life be active or quiet. Muscles do not "break down" in exercise; rather they tend to "build up," or increase in size and strength, and thus to store protein in their own struc- FOOD FOR THE ADULT MAN 71 ture rather than to use up what they have. Accord- ingly, the actual requirement for protein in the diet is comparatively independent of the amount of physical exertion, and remains fairly constant whether the indi- vidual be leading the sedentary life of an office or the strenuous life of outdoor work on the farm or in the lumber camp. The requirement for fuel, on the other hand, will vary tremendously with the kind and amount of work, as previously shown. The fact that protein food is both a fuel and a build- ing material makes its place in the diet confusing. When burned for fuel, the nitrogen in its constitution is gotten rid of as speedily as possible, beginning to appear in the urine within an hour or two after a meal, and the non-nitrogenous fragments then burn like carbohydrate or fat. When protein is used for building material, the nitrogen is retained in the body to help form new body protein. There is, however, no provision for storing a surplus against a rainy day. What is not needed is excreted and that for future use must come from future food. It is possible to take the whole day's fuel in the form of protein food, lean beef, for instance. A man requiring 3000 calories would have to eat nearly five pounds and would get eight or nine times as much pro- tein as actually needed to keep up his body protein. Since protein food is expensive, this would be uneco- nomical, if not harmful. By substituting carbohydrate or fat and carbohydrate together, as potatoes, bread, butter, and the like, for part of the protein, a much more satisfactory diet can be arranged. 72 FEEDING THE FAMILY In scientific laboratories detailed experiments have been made to try to establish the ideal proportion of protein in the diet, and with plenty of fuel it is found that the protein will be used very economically. At the same time, protein is good fuel itself, and there is no reason for restricting one's intake to the minimum, under ordinary circumstances. For a man of average weight, from two to two and one-half protein calories per pound of body weight will adequately protect the body against protein starvation and leave some surplus to be burned as fuel. Where strict economy must be practiced, it is well to remember that adequate fuel is the first requisite for good nutrition, and the use of protein simply for fuel is extravagant. On the other hand, many protein foods are easy to digest, and when economic conditions do not forbid may be used more freely. There are limits, how- ever, beyond which it does not seem wise to go. When a very large proportion of the day's fuel is protein ma- terial there is produced in the body a kind of stimu- lation which results in an increased production of body heat. This is of no advantage so far as we know, except when a person is exposed to cold and can utilize this heat to maintain his body temperature instead of gener- ating more by shivering or more active muscular ac- tivity. In extremely cold climates or in severe winter weather in temperate regions, a liberal supply of protein in the diet may promote physical comfort. On the other hand, in hot weather, especially with much hu- midity, dissipation of heat which the body is inevitably FOOD FOR THE ADULT MAN 73 generating becomes difficult, and an extra supply of heat arising from a large amount of protein in the diet simply increases the difficulty of keeping comfortable, and may be a real menace to health. Furthermore, individuals differ in the ease with which they get rid of the surplus nitrogen. Sometimes large amounts of protein food, especially meats, tend to increase intestinal putrefaction and bring on a whole train of unfavorable symptoms; sometimes the kidneys' powers are overtaxed, and certain forms of nitrogen tend to accumulate in the body to its disadvantage. For such reasons, a moderate supply of protein, covering fully the needs for nitrogen, but not serv- ing as the chief source of fuel, will produce the best results. It is often convenient to express this in terms of the total day's fuel. An allowance of two calories per pound for a man of average weight means about 300 calories per day. If his total energy requirement is 3000 calories, this means approximately 10 per cent of his fuel in the form of protein; if the total is 2500 calo- ries, 12 per cent in the form of protein. Two and one- half calories per pound for a man consuming 3000 calories would mean about 15 per cent of his fuel as protein. A higher proportion results in more loss of heat from the stimulating power of protein, so that in general the body needs seem best met by supplying from 10 to 15 per cent of the total fuel in the form of protein, except when a man is in bed, in which case care should be taken that he has at least two protein calories per pound. By reference to the dietaries already given 1 it will be seen 1 See pages 58, 59, 64, 66, and 68. 74 FEEDING THE FAMILY that the protein supply falls within the limits suggested here. That proteins are composed of amino acids of different kinds, and that the nutritional efficiency of any particu- lar protein or mixture of proteins is really a matter of just what amino acids it is capable of yielding, has al- ready been pointed out (page 19). Fortunately, pro- teins are of many kinds, and usually several are asso- ciated in any single food. Cereal proteins alone do not yield a protein mixture which can be depended upon exclusively, but milk, eggs, and meat, each and all, make good any amino acid deficiencies in the cereal foods, even when used with them in rather small amounts. This is another reason why a pint of milk in the diet of an adult every day is a good rule. Liebig, the first great student of protein in nutrition, thought that meat, being most like man's muscle, would be most efficient in replacing it. He had no idea that all proteins are literally taken to pieces in the digestive tract and all the parts (amino acids) reassembled by the cells according to their needs. Liebig's notion has been slow in giving way to the newer conception of the place of protein in nutrition, and many spend money in main- taining a traditionally high amount of meat in the diet who might be using their money to better advantage and perhaps securing better health. The regard in which meat is held is probably largely due to its peculiar texture and to certain substances found in its juices which give it a pronounced and agreeable flavor and exert a stimulating effect upon appetite and digestion. FOOD FOR THE ADULT MAN 75 Meat agrees with the lazy eater who bolts his food, because it does not require mixing with saliva, being dissolved by the gastric juice of the stomach even if swallowed in comparatively large pieces. As regards satisfying real body needs, meat proteins are by no means superior to all others. In fact, the proteins provided by nature for building body protein, as in the growth of the young, are found in milk and eggs. The value of milk as a source of protein for growth cannot be disputed. Meat has certain disad- vantages as the sole or chief protein food of the diet. Associated more or less intimately with the protein of meat we find certain substances called "purins," to which, in part, the flavor is due. These purins are not nutritious, but are gradually transformed in the body to uric acid, to be carried off as waste in the urine. Per- sons inclined to gout have difficulty in getting rid of uric acid, and the more meat they eat the more uric acid tends to accumulate in the system, circulating in the blood and depositing in the joints. If protein is taken in moderation and chiefly from eggs, milk, cheese, bread, and nuts, which contain no purins, dangers of this diffi- culty may be reduced. Meat proteins are also particu- larly liable to intestinal putrefaction, while milk not only is less liable to this kind of decomposition, but actually helps to decrease the number of putrefactive bacteria in the intestines. For persons of indoor sedentary life a very liberal use of meat is certainly undesirable. Even athletes, for whom meat was once thought especially necessary, have demonstrated the possibility of reducing 76 FEEDING THE FAMILY their daily consumption to one-sixth the amount which the training table previously provided, with an actual increase in their capacity for endurance. Aside from questions of health the economic advantages of some other protein foods over meat are easily demonstrated. By reference to the table on page 21 1 it will be seen that 100 calories of lean round of beef will yield 54.5 protein calories. Six portions will, therefore, supply 327 protein calories, enough protein for an average-sized man for a day. But these 600 calories will cost 38 cents (with beef at 45 cents a pound in the market) and if his fuel requirement is 3000 calories, 2400 must still be bought to make up the day's total. If milk be se- lected, it will take 17 portions, costing 37.7 cents (with milk at 15 cents per quart), but leaving only 1300 calo- ries to be obtained from other sources. If eggs are chosen, 9 portions will be required, costing 36 cents (with eggs at 40 cents a dozen), but requiring only 2100 calories to supplement those from protein. Milk and eggs are not only adequate substitutes for meat, but they carry in addition a rich supply of ash constituents and vitamins which would have to be added to the meat ration to make it equally valuable with either of the other two. The housewife who provides a somewhat varied diet, ample in fuel value, including milk and eggs, need not feel that she is depriving her family of any essential if she furnishes a very small amount of meat or none at all. One-fourth of a pound a day as an aver- age for each adult man will provide approximately one- 1 Protein in loo-calorie portions. FOOD FOR THE ADULT MAN 77 third of his protein requirement; bread, cereals, fruit, and green vegetables will furnish another third; and the remainder can be obtained with little difficulty from a glass of milk, an egg, some cheese, beans, or nuts. Attention has already been called in Chapter 11 to the importance of the ash constituents of food - how they enter into the structure of the skeleton and the soft tissues, and take a prominent part in the maintenance of life and health through the regulation of body processes. The results of ash starvation would not be manifested so quickly as those of deprivation of vitamins, water, fuel, or protein (nitrogen) because the amounts lost daily are small and in an adult the reserves in the body are comparatively great. Nevertheless, the ash supply is worthy of consideration in any food. Studies of what men actually do eat reveal that the elements most likely to be taken in too small amounts for a good daily bal- ance are phosphorus, calcium, and iron. A comparison of a reasonable supply of these elements for an adult with the amounts furnished by several combinations of food otherwise very excellent will show how ash-bearing foods might be neglected (1 and 2 below), and how introducing a single change will improve such food combinations (3 and 4 below). The quantities per day believed to be adequate for an average healthy man are as follows: Phosphorus 1.32 grams Calcium 0.67 gram Iron 0.015 gram THE ASH REQUIREMENT 1 See pages 21-27. 78 FEEDING THE FAMILY (1) A ration of lean meat, white bread, and butter would be ample in protein and total fuel, but conspicu- ously deficient in calcium. Weight Oz. Protein Calories Total Calories Calcium Grams Phos- phorus Grams Iron Grams Bread, white (i| loaves) . . . 20.7 216 1500 0.165 0.525 0.0053 Beef, lean . . 9-0 216 400 0.029 0.556 0.0077 Butter . . . 2.8 4 600 0.012 0.012 - Total . . 436 2500 0.206 1.093 0.0130 (2) A diet of white bread and milk would be adequate in protein and total calories, high in calcium and phos- phorus, but poorly supplied with iron. Weight Oz. Protein Calories Total Calories Calcium Grams Phos- phorus Grams Iron Grams Milk (7I cups) . 61.2 228 1200 2.088 I.608 0.0042 Bread, white (1J loaves) . . . 17-9 187 1300 O-I43 0-455 0.0046 Total . . 415 2500 2.231 2.063 0.0088 (3) It is evident that the substitution of some milk in the bread-beef-butter diet will remedy its calcium shortage. Weight Oz. Protein Calories Total Calories Calcium Grams Phos- phorus Grams Iron Grams Bread, white (ij loaves) . . . 17-9 187 1300 0-143 0-455 0.0046 Beef .... 6.8 163 3°o 0.024 0.442 0.0062 Butter . . . 2-3 3 500 0.010 0.010 - Milk (25 cups) . 20.4 76 400 0.696 0.536 0.0014 Total . . 429 2500 0.873 1-443 O.OI22 FOOD FOR THE ADULT MAN 79 (4) The second diet could be liberally supplied with iron by the simple expedient of substituting graham bread for white. Weight Oz. Protein Calories Total Calories Calcium Grams Phos- phorus Grams Iron Grams Milk (7! cups) . Bread, graham 61.2 228 1200 2.088 I.608 0.0042 (i| loaves) 17.6 177 1300 0.260 I.092 0.0125 Total . . 4°5 2500 2.348 2.700 0.0167 In the probability of satisfying the ash requirement lies one advantage of a mixed diet. If some foods known to be rich in iron, calcium, and phosphorus are included each day, one may rest assured that the ash constituents will be adequately provided for, without detailed calculations like those just cited. Milk is the most valuable source of calcium; a single roo-calorie portion will supply one-third of the day's requirement. Other valuable sources are indicated in the table on page 25.1 One portion of milk will also supply one- ninth of the day's phosphorus requirement. Eggs (es- pecially the yolk), cereals from whole grains, lean meat, dried peas and beans, are desirable for their phosphorus content. (See table, page 22.)2 With the exception of milk, the foods just named, also fruits and green vege- tables, are rich sources of iron. (See table, page 24.)3 A 1 Calcium in 100-calorie portions. 2 Phosphorus in roo-calorie portions. 2 Iron in roo-calorie portions. 80 FEEDING THE FAMILY large serving of spinach will of itself supply one-third of the day's iron requirement. If one makes it a general rule to have a pint of milk (including that concealed in vari- ous foods by cookery) in the dietary program to insure the calcium and phosphorus supply, and adds some vege- table rich in iron daily, using eggs, meat, and cereals with the bran retained from time to time, but not necessarily all of them every day, there is little likelihood of the diet of the adult being deficient in ash constituents. The necessity for at least three different vitamins in the diet has already been pointed out. While the de- mand for these is not so great in the adult as in the grow- ing child, their presence in the diet is essential to the maintenance of health and resistance to disease. One may live on a higher plane of vitality when the diet is well-balanced in regard to these as well as all other fac- tors. Scientific investigation has not yet gone far enough to tell definitely how much is required, but it seems certain that with one or two first-class sources of each in the diet daily, there is no likelihood of deficiency for any grown man. With a little forethought, even a very economical diet (precluding the use of butter and generally of eggs) may still have its A vitamin supply in milk, liver, and such vegetables yielding the vitamin as may be available from time to time. At almost any season at least one may be had - cabbage, tomatoes, carrots, beet and dandelion greens, making almost the cycle of the seasons. The B vitamin is so widely dis- THE VITAMIN REQUIREMENT FOOD FOR THE ADULT MAN 81 tributed in fruits and vegetables, that a diet regularly containing almost any of these in addition to milk will be safeguarded against any shortage. The C vitamin is best insured by a fairly regular supply of fresh fruits and vegetables, being sure that choice is not confined to those least rich in the vitamin or that it has not been destroyed by heating, aging, or drying. Vegetables de- pended upon for the C vitamin should be cooked as short a time as possible, if cooked at all.1 With a little knowledge, it is not necessary to have elaborate cookery or many kinds of food to keep a man well nourished. So simple a ration as milk and graham bread (see page 79) will supply everything but the C vitamin. Add an orange or a tomato a day and one might subsist in health without further thought about food. The bread-butter-beef-milk diet shown to be adequate in calories, protein, and mineral constituents (page 78) needs also the addition of something for the C vitamin and for ballast. Spinach or cabbage would fulfill both requirements. Once a feasible plan has been worked out, variety may be secured by changes from one food to another of the same general character. Thus one cereal may generally be replaced by another or by bread; one kind of meat by another; one green vegetable by another, giving that variety which is con- venient and helps to maintain good appetite. Warm food usually adds to the ease with which a meal is di- gested, and often to its relish. 1 For full information as to the vitamin content of various foods, consult the Appendix, Table XI. CHAPTER IV FOOD FOR THE ADULT WOMAN Energy Requirement However much civilization may tend to empha- size certain physiological and psychological differences between men and women, when we come to study their essential food needs we find that the laws of energy exchange are practically the same for both sexes. Res- piration, circulation, digestion, and muscular tension,- all forms of internal body work, - demand their daily quota of fuel; the larger the body, the more fuel re- quired to run it; the more external work done by the human machine, the more fuei demanded for this purpose. In actual comparisons between Iv'ng men and women, we recognize that men as a class are larger and heavier than women; they also tend to have a higher muscular development and to carry on more severe muscular work; wherefore the common notion that men as a rule eat more than women is true. But when we compare men and women of the same height and weight, lying at rest so that differences in external activity are 82 FOOD FOR THE ADULT WOMAN 83 excluded, we find them requiring about the same number of calories, the differences being no greater than between athletically developed and ordinary men, or between tall and muscular men, as compared with short and fat men. Women as a class tend to have more body fat in proportion to their weight, which reduces the amount of active working muscle. If a man and a woman do the same kind and amount of work, the expenditure of energy to accomplish the task will be as great for the woman as for the man. We shall not fall into any serious error then in applying to women the same table already used for calculating the fuel require- ments of men. Kind of Activity Calories per Pound per Hour Sleeping 1 2 Sitting (reading, hand or power machine sewing, knit- ting, writing) 5 Standing Light exercise (dishwashing, cooking for 2-4 persons, bed making, sewing with foot power) I Moderate exercise (cooking for 6-12 persons, sweeping, ironing, scrubbing by hand) 4-4 Active exercise (cooking for large groups, ironing, scrub- bing with heavy implements, etc.) 4-2 Taking the weight of the average woman as 123 pounds, we may estimate the energy requirement of a house- keeper doing all but the washing and heavy cleaning for a family of five as follows : 84 FEEDING THE FAMILY Calculated Energy Requirement for Twenty-four Hours for a Moderately Active Woman Weighing 123 Pounds Activity Hours Calories Sleeping 8 492 Sitting 5 369 Standing 2 185 Light exercise 6 738 Moderate exercise 3 461 Total 24 2245 The daily requirement for the average woman in some of her common occupations will be approximately as follows: 1. At rest 1600-1800 Calories per day 2. Sedentary occupations 2000-2200 Calories per day Milliners Teachers Bookkeepers Seamstresses Stenographers Machine operatives 3. Occupations involving standing, walk- ing, or manual labor 2200-2500 Calories per day Cooks in family groups General housekeepers Chamber maids Waitresses 4. Occupations developing muscular strength 2500-3000 Calories per day Laundresses Cooks for large groups Women's appetites tend to be more fickle than men's, perhaps partly due to the fact that in the past they have not had very high ideals of health and have not made themselves lead such lives as to produce good steady FOOD FOR THE ADULT WOMAN 85 appetites. They have stayed too much indoors, taken too little systematic exercise and rest, and been confined too closely to one environment, to get that nervous and muscular poise which brings good tone to the alimentary tract and hence a healthy appetite. Eating is primarily a duty; nature has graciously made it also a physio- logical and social pleasure for most people; but whether she has or not, the duty remains, and science steps in to guide when the palate fails as a monitor of health. For women perhaps more than for men is appetite apt to be perverted and a knowledge of food values of con- stant practical use. The following food plans and dietaries are suggestive of ways of supplying suitable fuel for active and seden- tary women. They are also arranged with a view to insuring an adequate supply of proteins, ash constitu- ents, and vitamins. A Day's Food Plan for an Active Woman Fuel Requirement: 2600-3000 Calories Cost: 2^-3^ per 100 Calories Breakfast : Fresh or stewed fruit 50-100 Calories Cereal 50-150 Calories Milk 100-300 Calories Cream 100-200 Calories Creamed fish or Fish balls or Eggs loo-zoo Calories Toast or muffins 50-150 Calories Sugar 50-100 Calories Coffee - 600-800 Calories 86 FEEDING THE FAMILY Luncheon : Thick vegetable soup with crackers or Cheese or nut salad or Scalloped eggs and tomatoes or Cold meat and potatoes 250-400 Calories Bread 100-200 Calories Butter 100-200 Calories Canned, dried, or fresh fruit with cake 200-400 Calories 700-1200 Calories Dinner : Soup with rice, noodles, or vegetables . 25-100 Calories Roast rump of beef or Mutton or Pork chop 200-350 Calories Potatoes or macaroni 150-250 Calories Boiled onions or other seasonable vege- table 150-200 Calories Simple vegetable salad or Celery or Olives 50-150 Calories Bread 50-200 Calories Butter 50-200 Calories Fruit gelatin or tapioca or Brown Betty or Fruit pie . . . . 200-400 Calories 900-1400 Calories Food Material Corn a In Southern Weight (oz.) Measure Food Material Weight (oz.) Measure 2. 3- 4- 5- Creamed asparagus on toast Potato chips Baked potato Stuffed pepper (with ham) 3-4 4.6 o.6 3° 2-5 I cup Small serving io pieces i medium I pepper 6. 7. 8. 9- Buttered Lima beans Stuffed tomato Spinach with egg Scalloped onions t-7 4.0 7-6 2-5 1 cup i medium t cup 8 cup ioo-Calorie Portions of Cooked Vegetables 1 1 Cf. Appendix, Tables I and III. FOOD FOR THE ADULT WOMAN 87 A Dietary for an Active Woman, Based on the Preceding Plan Fuel Value: 2865 Calories Cost: 2^-3^ per 100 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast : Canned pineapple (B, A) . i slice 1.2 - 50 Cornflakes (B) t cup 0-5 3 50 Milk (A, B) I cup 8-5 34 170 Fish balls (B) 2 small 2.6 21 150 Toast 2 slices 1.1 14 100 Sugar i tbsp, (scant) o-5 - 50 Butter (A) i tsp. O.I - 30 Cream, thin (A, B) . . . 1 cup i.8 5 100 Coffee I cup - - - 700 Luncheon: Cheese souffle (A, B) . . 1 cup 2-5 27 150 Turkish pilaf (C, B, A) . . I cup 7-5 9 100 Corn muffins (B) .... 2 small 2.4 26 200 Butter (A) i tbsp. o-5 1 100 Canned apricots (B). . . | cup 4.8 5 100 Chocolate loaf cake . . . piece 2 j in. X 25 in. X ijin. i.8 10 200 Milk (A, B) i cup 8-5 34 170 1020 Dinner: Vegetable soup (B) . . . i cup 6.o 18 25 Pork chops i large 2.4 92 250 (Raw weight) Glazed sweet potatoes (A, B) 2 halves 5-2 10 250 Mashed turnips (C, B) . . 1 cup 4-5 7 50 Cole slaw (C, B, A) . . . 2 cup i-4 3 5° Rolls 2 small i-5 15 120 Butter (A) i tbsp. o-5 1 IOO Apple tapioca (C, B) . . t cup 5-4 2 150 Cream sauce (A, B) . . . I cup i-7 5 150 1145 Total for day 342 2863 88 FEEDING THE FAMILY A Day's Food Plan for a Sedentary Woman Fuel Requirement: 1800-2300 Calories Cost: 2^-^^ per 100 Calories Breakfast: Fruit 100 Calories Cereal or omelet or bacon . . . . . 50-100 Calories Toast or muffins 50-200 Calories Butter 33-100 Calories Cereal coffee with cream and sugar or milk or cafe au lait or cocoa 100-200 Calories 400-600 Calories Luncheon: Cream soup or creamed meat on toast or macaroni croquettes, cheese sauce or egg, fish, or cheese salad 150-250 Calories Rolls 100-150 Calories Butter 50-100 Calories Fruit 100-150 Calories Cocoa or milk 150-175 Calories 600-800 Calories Dinner : Soup 25-100 Calories Croutons or crackers 25-50 Calories Roast beef or Nut loaf or Meat pie 150-300 Calories Potatoes or Rice or Baked banana 100-150 Calories Spinach or other green vegetable . . 10-50 Calories Crackers or bread and butter .... 15-50 Calories Lettuce, tomato or other simple salad . 75-150 Calories Sherbet or Custard or Fruit jelly or whip 200-300 Calories 8oo-uoo Calories FOOD FOR THE ADULT WOMAN 89 A Dietary for a Sedentary Woman, Based on the Preceding Plan. I Fuel Value: 2000 Calories Cost: 25-3! £ per ioo Calories Measure' Weight Oz. Protein Calories Total Calories Breakfast : Orange (C, B, A) . . . i orange 9-5 7 ioo Omelet (A, B) .... i egg 2.0 28 IOO Toast i slice 0-5 7 50 Butter (A) i tsp. 0.1 - 3° Cocoa 11 1 cup 6.7 16 120 400 Luncheon: Corn a la Southern . . . Fruit salad (C, B) (mayon- J cup (scant) 4.2 20 125 naise) I cup 3-o 6 200 French rolls i roll i-3 12 IOO Butter (A) 2 tsp. 0-3 - 66 Milk (A, B) t cup 6-3 24 124 Sugar cookies 2 large 1.0 7 IOO 7i5 Dinner : Cream of pea soup (B, A) . s cup 5-2 16 IOO Croutons | doz. 0.4 3 50 Lean roast beef .... slice 5 in. X 6 in. X s in. i-5 42 150 Baked potato (C, B) . . Spinach a la creme (A, B, i medium 3-o ri IOO C) Tomato salad (C, B, A) | cup (scant) 1.8 4 45 (French dressing) . . . i serving 4-5 3 170 Saltines i saltine o.x i 15 Tapicoa cream (A, B) . . i cup 7-o 3° 255 885 Total for day . 237 2000 1 See Table III, Appendix, p. 388. 90 FEEDING THE FAMILY A Dietary for a Sedentary Woman, Based on the Preceding Plan. II Fuel Value: 2035 Calories Cost: 1^-2^ per 100 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast : Orange (C, B, A) . . . 2 orange 4-7 3 50 Cream of wheat (B) . . . i cup 3-o 6 50 Cornmeal muffins (B) . . 2 small 2.4 26 200 Butter (A) Top milk for cereal and 2 tsp. o-3 - 60 coffee (io oz.)(A, B) . . 1 cup 3-i 14 ISO Sugar i tbsp. o.6 - 60 Coffee i cup - - - 570 Luncheon: Creamed salmon on toast 1 cup and (A, B) 2 slices 7.0 77 350 Cole slaw (C, B, A) . . . i cup i-4 3 50 Bread i slice 0.7 7 50 Butter (A) J tbsp. 0.2 50 Apple sauce (C, B) . . . s cup 3-5 1 100 Sponge cake (A, B) . . . piece i| in. Xijin. X2 in. 0.9 11 100 Russian tea i cup - - - Sugar for tea i tbsp. o-3 - 30 730 Dinner : Stuffed steak slice 3 in. diam. 1 in. thick 2.2 78 200 Tomato sauce (C, B, A) I cup 2-5 5 1OO Browned potatoes (C, B) . i medium potato 3-5 11 125 Boiled onions (B, C) . . 2 onions 5-o 10 IOO Bread i slice o-7 7 50 Butter (A) | tbsp. 0.2 - 50 Coffee jelly Whipped cream (sweetened) 2 cup 4-0 4 40 (A, B) 11 tbsp. 0-7 1 70 735 Total for day 264 2035 FOOD FOR THE ADULT WOMAN 91 Thin and Fat Women FAT WOMEN To eat out of proportion to one's need, either on the side of meagerness or superfluity, is culpable. Tables of normal weight for age and height should be consulted and effort made to maintain an approximately normal weight. The normal weight at thirty is regarded as the most favorable to health in subsequent years.1 If ordinary eating habits result in this, as they should, we may rest assured that the diet is satisfactory as to quan- tity of fuel; if not, some attention should be given to the matter. The tendency to take on extra fat is ap- parently greater in women than men, and should be especially watched if hereditary. The only sure and healthful way to prevent it is to be abstemious in food. A pound of body fat means the storage of some 4000 calories. The time to adjust the diet is when the tend- ency to store fat begins to appear. Once a great excess has accumulated, the problem of its removal without harm becomes more complicated; and extensive "reduc- ing" should be carried on only under the supervision of a physician who can regulate the rate of fat loss accord- ing to the general health. But in the early stages of growing fat, careful weighing of food or "counting the calories" will prove effectual and safe, but must be persisted in, perhaps throughout life. Suggestions in re- gard to the choice of food have already been given in Chapter III, but a dietary whose total fuel value is more likely to meet a woman's requirements is given below. 1 See Appendix, Table IV, Height and Weight for Women at Dif- ferent Ages. 92 FEEDING THE FAMILY A Reducing Diet Suggested for an Overfat Woman Fuel Value: 1052 Calories Ordinary Requirement: 2400 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast : Apple (C, B) 1 medium 4-9 2 65 Egg (A, B) 1 egg 2.4 27 75 Toast 1 slice o-5 7 50 Coffee1 1 cup - - - Skim milk (B, A) . . . . i| tbsp. 1.0 3 10 10.30 a.m. : Bouillon 5 cup 4.0 10 12 Water cracker 1 cracker 0.1 1 IO Luncheon: Lean cold roast beef . . . medium 3-5 97 150 serving Rye bread (B) 2 thin slices o-7 7 50 Lettuce and cottage cheese salad Lettuce (C, A, B) . . . ad libitum 1 Cheese (A, B) . . . . tbsp. > - 40 85 French dressing . . . | tbsp. J 4.30 p.m. : Tea with lemon1 . . . . 1 cup - - - Water cracker 1 cracker 0.1 I 10 Dinner : Boiled cod with lemon . . large serving 8.2 209 225 Boiled potato (C, B) . . | medium 1.8 6 50 Cauliflower (plain) (B) . . large serving 3-o 6 25 Butter (A) 1 tsp. (scant) 0.1 - 30 Watercress and egg salad Watercress2 ad libitum 1 Egg (A, B) 1 egg y - 27 IIO French dressing . . . | tbsp. J Orange (C, B, A) . . . . i large 4-7 3 50 Black coffee demi-tasse - - - 10.30 p.m. : Hot skim milk (B, A) . . J cup 4-3 16 45 Total for day 462 1052 1 Saccharine may be used for sweetening if desired. 2 Not investigated, but all greens are probably rich in A, B, and C. FOOD FOR THE ADULT WOMAN 93 THIN WOMEN Women of nervous temperament are apt to be too thin. They expend much energy in heightened muscu- lar tension, while nervous disturbances quickly react on the alimentary tract, making it difficult to take or digest sufficient food. Only an intelligent persistence in taking regularly a supply of food in excess of immediate needs will result in a gain of weight. The removal, as far as possible, of nervous excitement or irritation and avoid- ance of great muscular exertion, limiting exercise to the lighter forms, are great helps in adjusting the balance between intake and outgo of energy. To be more than ten per cent under weight for one's height usually means lessened physical efficiency.1 This is not always realized by any means. Studies of under-weight college women have shown that they re- garded themselves as well, and were surprised at how much more buoyant they felt, and how much less easily fatigued, when they began to gain in weight. Food must be taken regardless of appetite, and often also regardless of minor digestive disturbances, for these do not necessarily signify that food is not going to be utilized finally. At the same time it is wise to choose food which can be taken without repugnance and which will digest with the greatest ease. Fluid foods are most easily taken when appetite fails, and make practical additions to the usual diet. Milk, which is so valuable 1 See Appendix, Table VI, Height and Weight for Women at Dif- ferent Ages. 94 FEEDING THE FAMILY a food, can be taken in many forms: hot, cold, with added cream or milk sugar, or both; in cocoa and choco- late ; in sherbets and ice creams; as buttermilk, zoolak or koumiss; so that it is one of the easiest foods to add to the diet. Fruit juices from sweet fruits, or with their fuel value artificially increased by the addition of milk sugar, make agreeable and nutritious beverages. Raw eggs are easily swallowed and give a good return for the effort made, whether taken plain or modified by being beaten up with milk, cream, or fruit juice. A little study of food values should make it possible to find ac- ceptable ways of increasing the fuel intake. Three glasses of milk, added to the regular diet, will mean an increase of 500 or more calories; an extra pat of butter taken at each meal will add 300 calories. From one to three tablespoons of olive oil may be taken after each meal, increasing the fuel intake from 300 to 900 calories. Very often the easiest way to increase the food intake is by one or two additional meals, e.g., mid-morning and mid-afternoon lunches, or a morning lunch and a glass of milk or other nourishing beverage just before going to bed. This is especially true for women whose work is exhausting, so that they come to their regular meals "too tired to eat." It is hard to fatten an overworked person, and rest should be sought - long hours of sleep at night and a short period of lying flat and relaxed (if only ten minutes) in the middle of the day; but even a slight surplus of food over immediate needs, if persist- ently taken, will in time have its favorable effect on the general health and especially on the nervous system. FOOD FOR THE ADULT WOMAN 95 To get the best results, considerable increases in the food intake should be maintained, with just enough exercise to promote a good appetite. One example of a fatten- ing diet has already been given;1 another, approximating a little more closely the average requirement of a woman, is presented on the next page. The Protein, Ash, and Vitamin Requirements Just as the laws which control energy requirement operate in the same way for women as for men, so the requirements for protein and ash differ little for the two sexes under ordinary conditions. A woman requiring eight-tenths as much fuel as a man will probably need eight-tenths as much calcium and phosphorus and from two to two and one-half protein calories per pound. She will probably need more iron because of the extra loss of this element in menstruation. Hence it is wise to see that the iron-bearing foods are supplied liberally. Fortunately salads of green vegetables and fruits are well liked by most women and constitute an easy way of introducing iron into the diet.2 No more is known about the quantitative vitamin requirements of women than of men, but from animal experimentation there would appear to be no difference in the needs of the sexes under ordinary conditions. Foods which insure a liberal ash supply will in the main carry vitamins, though there are exceptions, so that tables should be 1 See page 66. 2 See discussion of phosphorus, calcium, and iron contents of foods, pages 22-25. 96 FEEDING THE FAMILY A Fattening Dietary Suggested for a Thin Woman Fuel Value: 3000 Calories Ordinary Requirement: 2400 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast : Prunes (B) 4 medium 1 1.4 (dry) 3 100 Grapenuts (B) 3 tbsp. 1.0 12 100 Egg (A, B) 1 egg 2.4 25 70 Toast 2 slices 1.0 14 100 Butter (A) 1 tbsp. 0.5 1 100 Cream, thin (A, B) . . . 1 cup 5-4 15 3°o Sugar 1 tbsp, (scant) o-5 - 50 Coffee 1 cup - - - 10.30 a.m. : Cocoa III2 (A, B) ... f cup 7.6 32 250 Luncheon: Corn chowder (B) . . . f cup 4-4 18 150 Fruit salad (B, C) ... 1 serving 3-o 6 200 Roll 1 roll i-3 12 IOO Butter (A) 15 tbsp. 0-7 I 150 Chocolate blancmange with I cup 5-4 18 200 whipped cream (A, B) 2 tbsp. o-9 2 IOO 4 p.m. : Egg in orange juice (A, B, C) 1 egg 3 tbsp, juice > 2 tsp. sugar J 4.2 25 13° Dinner : Broiled steak piece 3 in. X i| in. X 1 in. 3° 70 150 Scalloped potatoes (C, B, A) 1 cup (scant) 5-2 13 150 Buttered beets (B, A) . . i cup 2.0 3 50 Lettuce and tomato salad (C, B, A) 1 serving 5-4 6 200 Salted almonds (B) . . . 12 nuts o-5 13 IOO Boiled custard (A, B) . . | cup 3-3 20 150 Macaroons 2 macaroons 0.8 6 IOO Total for day .... 3i5 3000 1 Soaked 24 hours, then allowed to stand 24 hours to dry. 2 Two tbsp, milk sugar instead of cane sugar. See Table III, Ap- pendix, page 389. FOOD FOR THE ADULT WOMAN 97 consulted if one wishes to know the vitamin content of any particular food.1 Food for the Prospective Mother Traditions in regard to food have a strong hold on the imagination in connection with those periods during which the unborn child or nursing infant derives its sustenance directly from its mother. Stuffing when food needs are not greatly increased, attributing mys- terious influences to specific food materials, and supply- ing inadequate fuel when food needs are really very much increased are common errors due to lack of knowledge of the fate and function of foods. It is reassuring for the prospective mother to remem- ber that all food is broken down in the chemical processes of digestion and reorganized in the body according to its needs. Meat helps to build muscle, not because it is already in that form, but because when digested it yields amino acids (page 19) which the body can recom- bine into its own kinds of protein; the proteins of milk and eggs, and many of the proteins of vegetables will yield exactly the same kind of amino acids and hence serve equally well for constructing new muscle. Nature tries to promote normal development of the offspring even under adverse conditions; if materials for the growth of the baby are lacking in the food they will be drawn as far as possible from the mother's body. Thus if the diet be deficient in calcium and phosphorus for bone formation, the mother's bones and teeth are likely 1 Appendix, Table XI. 98 FEEDING THE FAMILY to be the first to suffer loss, though, of course, a great scarcity is eventually likely to affect the baby. In cer- tain regions there is the possibility of insufficient iodine for the best functioning of the thyroid gland and the administration of a suitable preparation of iodine by a physician is desirable. Shortage of any one of the vitamins has been shown to have disastrous effects upon offspring. The body does not carry reserves of the B and C vitamin and must have new supplies constantly. While it does have the power of storing the A vitamin, often this has not been fed in sufficient amounts to allow much storage and in any case the demands of the unborn child for this vita- min are very great. Hence the A vitamin should be well represented in the mother's diet. In animal experiments it has been shown repeatedly that the offspring are born stronger and their mothers are able to nurse them better at less cost to themselves, when the A and B vitamins are both liberally supplied. The teeth of a child are largely determined before birth and shortages of ash constituents and vitamins affect them very unfavorably. The best way to equip a child with the best teeth his heritage allows is through atten- tion to the nutrition of the mother during pregnancy and lactation. At no time is a diet supplied with proteins adequate for growth, ash constituents of all kinds (especially calcium, phosphorus, and iron), and all of the known vitamins going to bring as big a return as when given to the mother upon whom an infant is depending for all its sustenance. FOOD FOR THE ADULT WOMAN 99 For the most part, the same kinds of food which con- stitute a well-balanced diet for the mother under ordi- nary conditions will serve for the mother and child. Simple dishes, prepared from easily digested foods, should be adhered to for the sake of good digestion, without which any food will fail of its purpose. When the digestive tract is particularly irritable, considerable care must be exercised in this respect, bearing in mind that fatigue, anxiety, and constipation may be large factors in indigestion. The majority of mothers suffer in the early stages of gestation from nutritional dis- turbances familiarly spoken of as "morning sickness." The cause of the nausea and vomiting at this time is not in the stomach itself, but is due to the fact that the connection between the mother and the embryo through the placenta is not yet perfectly established, and a mild form of poisoning results from substances produced in the process of placenta formation getting into the general circulation. The disappearance of the morning sick- ness is an indication that the connection between mother and child which secures nourishment for the embryo from the mother's blood has been fully established, and from this time on the mother's appetite should steadily improve. Any increases in the amount of food required on account of the developing child before the end of the fourth month of gestation have been shown to be prac- tically negligible. Beginning with the fifth month, growth is increasingly rapid up to the time of birth, but the actual amount of building material needed day by day is not very large, nor even in the last weeks will the 100 FEEDING THE FAMILY energy demands be increased more than 20 per cent, or one-fifth of the mother's usual daily supply before preg- nancy. They will be practically in proportion to her increase in body weight. A woman of sedentary habits will then need from 2400 to 2800 calories per day, while a woman who is usually active will probably be some- what less so, and is seldom likely to require over 2800 to 3000 calories. The increased requirements for building material and vitamins will be best met by the liberal use of milk and eggs, supplemented by fruit and green vege- tables. Frequent small meals are often utilized to better advantage than a few large meals in the last two or three months; in fact, most of the suggestions which have already been given in regard to a fattening diet will be helpful in adjusting the food intake at this time. The day's diet should include: 1. A cereal made from the whole grain, as rolled or cracked oats or wheat, wheatena, barley, puffed wheat; these to be served as breakfast cereals thoroughly cooked, or in simple puddings. 2. Milk, from a pint to a quart or more per day. This may be used as a beverage with meals, or between meals, or employed in making cocoa, custards, and other dishes. Sweet milk may be replaced by buttermilk, zoo- lak, malted milk, kumiss, etc., according to preference. 3. Fruit, as oranges, apples, prunes, raisins, figs, dates, or other easily digested kinds, fresh or dried, cooked or raw. Fruit juices may be substituted for the whole fruit, especially where digestion is disturbed. Some kind of fresh fruit once a day is desirable. FOOD FOR THE ADULT WOMAN 101 4. A green vegetable, as spinach, peas, beans, lettuce, celery, cabbage, brussels sprouts, chard, etc. These may be served as salads, buttered, creamed, or in soups. They should be cooked as short a time as possible, and steamed or otherwise prepared so as to conserve the juices which contain valuable ash constituents and vitamins. Pea and spinach soups made with milk are often useful when digestion is poor. 5. Meat, fish, or some substitute such as eggs or cheese, once a day. 6. Butter, olive oil, bacon, peanut butter, or oleo- margarine in moderate quantities to add to the fuel value of the diet. If whole milk is used freely there is not likely to be any shortage of the A vitamin, but if the milk fat is not used, butter is desirable to replace it. Peanut butter has proteins of excellent quality in addi- tion to its high caloric value. For the sake of ease of digestion, fats are best used in their simplest form, on bread, with potatoes, rice and the like, rather than in the making of rich sauces and gravies. The food plan already given for a sedentary woman can easily be modi- fied to yield 2700 to 2800 calories by adding a pint of milk, a couple of eggs, two small tablespoons of butter, and a piece of sweet chocolate. The food plan and dietary for an active woman will be suitable when di- gestion is good, and the fuel value can be easily increased by the use of milk or eggs, which, as already indicated, also give desirable increases in building and regulating material. In economical dietaries bread should be made with milk and preferably from whole wheat, rye, 102 FEEDING THE FAMILY or other dark flours. It will add then to the laxative quality of the diet, as well as to its ash content. Such bread is good for any one, but most needed when green vegetables and milk cannot be bought freely. Where cost must be carefully considered such menus as the following may prove useful: I Breakfast : Oatmeal, milk, and sugar Whole wheat bread and butter or butterine Cereal coffee or coffee, with an equal amount of hot milk added, or cocoa made with milk Stewed prunes Luncheon : Cream of tomato soup Cold corned beef Whole wheat bread and butter or butterine Tea or coffee (one-half milk), or cocoa Dinner : Lamb stew with vegetables (carrots, potatoes, onions) Cole slaw Whole wheat bread and butter or butterine Custard pie Tea or coffee (one-half milk), or cocoa II Breakfast : Wheatena, milk, sugar Dates, graham bread, and butterine Coffee (one-half milk), or cocoa Luncheon : Macaroni and cheese Stewed tomatoes Graham or rye bread and butterine Coffee (one-half milk), or cocoa Dinner : Baked split peas with bacon Boston brown bread Stewed onions Apple betty, milk and sugar Coffee (one-half milk), or cocoa FOOD FOR THE ADULT WOMAN 103 Ill Breakfast : Cracked wheat, milk and sugar Rye bread and butter or butterine Coffee (one-half milk) Apple Luncheon : Vegetable soup with crackers Whole wheat bread and peanut butter Figs (may be stewed) Cocoa or coffee Dinner : Corned beef hash Stewed cabbage Whole wheat bread and butter or butterine Rice or tapioca pudding (made with milk, molasses, and raisins) Coffee (one-half milk), or cocoa These menus may be supplemented by a cup of gruel or milk, with graham or whole wheat crackers, if an extra meal is desired. Food for the Nursing Mother It has been shown by calorimetric experiments that the total energy requirement of mother and child just after birth is almost exactly the same as the total re- quirement just before birth. But the normal healthy baby grows rapidly and makes increasing demands upon his commissary department. A baby a month old will take, on the average, two and one-third ounces of mother's milk per day for each pound of body weight, a twelve-pound child thus receiving about 28 ounces of milk in twenty-four hours. Since an ounce of mother's milk yields on the average 20 calories, the total day's fuel supply for such a child will be 560 calories. These 104 FEEDING THE FAMILY must certainly be added to the mother's diet or they will be drawn from her body reserves. It also seems reasonable that there should be some surplus (at least ten per cent) over the estimated re- quirement of the baby, since we do not know just how efficiently food calories are converted into milk calories. It has been shown in some studies of nursing mothers that the quantity and quality of milk produced depend on a diet of good quality, meeting the mother's energy requirement plus that of the baby, rather than on an exaggerated energy intake. The following estimates of the increased energy demands made by the nursing in- fant are calculated on the basis of a ten per cent increase over estimated requirements. Additional fuel requirements for nursing a baby: First 3 months 60 calories per pound of infant's weight Second 3 months .... 50 calories per pound of infant's weight Third and fourth 3 months . 40-45 calories per pound of infant's weight This means that a woman of average weight and sed- entary occupation will require while nursing a baby as much food as if she were doing hard muscular work, i.e., 2800 to 3000 calories per day; while a woman actively employed may need even more than 3000 calories. Not only is there this increase in the energy require- ment, but the construction of milk demands extra quan- tities of such important materials as protein, calcium, phosphorus, and vitamins. Studies with cows show that the efficiency of milk protein for the production of a new milk supply is about 60 per cent. Such data FOOD FOR THE ADULT WOMAN 105 indicate that the mixed diet ought to supply at least two protein calories for each one withdrawn in the mother's milk, and milk itself must be considered one of the most desirable foods for milk production. On this basis, from three to four protein calories should be allowed for every ounce of milk produced. For a woman supplying 28 ounces of milk per day, there should be an increase over the average consump- tion of 17 per cent in iron, 20 per cent in phosphorus, and 76 per cent in calcium. In other words, the most marked increase as regards ash is in the calcium re- quirement. This again is most easily met by milk, and also most economically, considering that milk sup- plies at the same time efficiently used protein. Two hundred calories of milk in addition to the ordinary mixed diet will cover the extra requirement for calcium and phosphorus for 28 ounces of human milk, while 50 calories of lean beef, 10 of spinach, or one egg yolk will meet the additional need for iron. This shows that with a little care in the selection of foods there need be no danger of shortage of these important elements. The milk, spinach, and egg yolk will add materially to the A and B vitamin supply; and care to have some fresh fruit or potatoes, cabbage, or tomatoes in the diet will insure enough of the C vitamin. A liberal supply of water is also necessary. The general plan of diet suggested for the prospective mother1 may be followed by the nursing mother, and the dietaries for thin men and women2 will be sug- 1 See page 100. 2 See pages 66 and 96. 106 FEEDING THE FAMILY gestive as to how to keep up the fuel value of the diet. Since foods are broken down in the digestive tract and made over in the body, it is absurd to think that par- ticular foods have specific effects upon the character of the milk. Any wholesome diet, ample in fuel and the other dietary essentials, is suitable for good milk production. At the same time it must be borne in mind that the mammary glands are very sensitive to nervous influences, and disturbances of digestion react very un- favorably upon the milk-secreting mechanism. There- fore any food which is known to disagree with the mother, or whose effect is doubtful, should be refrained from. And since the increased demands for food make the work of the digestive tract extraordinarily great, there is more danger than usual of an upset, and the diet should be correspondingly simpler and easier of digestion. Excitement, worry, fatigue, chill, constipation, all react quickly and unfavorably upon the milk secretion, and must be carefully guarded against. Successful nursing demands a quiet, contented life, in which food is intelli- gently chosen, and exercise, fresh air, and mental di- version are provided in due moderation. For the few months which are so critical in the life of the baby, less important interests must be set aside, even those of other members of the family who can better afford a little neglect. A very simple, inexpensive dietary, meeting the fuel requirements of the nursing mother also engaged in physical labor (from one of the menus on page 102), is given below: FOOD FOR THE ADULT WOMAN 107 A Day's Dietary for a Nursing Mother Also Doing Moderate Muscular Work Fuel Value: 3195 Calories Cost: i^-2$* per 100 Calories Measure Weight Protein Total Oz. Calories Calories Breakfast : Oatmeal (cooked) (B) . . 1 cup 8.0 17 100 Milk (A, B) I cup 5-i 19 100 Sugar i tbsp. o-5 - 50 (scant) Whole wheat bread (B) 2 slices 1.4 16 TOO Butterine i tbsp. 0.4 - 75 Cocoa II (A, B)1 . . . . 1 cup 7.6 32 200 Stewed prunes (B) . . . 5 prunes and 6.0 4 200 juice Luncheon: Cream of tomato soup (C, 1 cup 8.0 28 250 B, A) Cold corned beef (with fat) small serving 2.0 42 200 Whole wheat bread (B) . . 3 slices 2.1 24 150 Butterine 15 tbsp. 0.7 1 150 Milk for tea (A, B) . . . | cup 2.6 10 5° Sugar for tea 2 tsp. o-3 - 35 Gingerbread small piece 1.2 8 100 Tea Dinner: 1 cup - - - Lamb stew with vegetables 2 cups 17.0 67 350 Whole wheat bread (B) . . 3 slices 2.1 24 150 Butterine 1 tbsp. 0-5 - 100 Custard pie (A, B) . . . 1 large piece 7.6 36 400 Milk for tea (A, B) . . . i cup 2.6 10 50 Sugar for tea Lunch at Night: 2 tsp. o-3 - 35 Bread 2 slices i-3 14 100 Butterine | tbsp. o-3 - 5° Peanut butter (B, A) . . 2| tsp. 0.6 19 100 Milk (A. B.) t cup 5-i 19 100 Total for day 390 3195 1 See Table III, Appendix, page 388. 108 FEEDING THE FAMILY In addition to regular meals, a glass or bowl of hot milk, malted milk, gruel or eggnog taken just before nursing the baby in mid-morning or mid-afternoon is often beneficial, as it gives both extra food and extra water. The Well-nourished Baby Gains Steadily in Weight CHAPTER V FOOD FOR THE BABY Happy the baby who enjoys his inalienable right to Nature's food supply - his own mother's milk ! His chances of a long and healthy life are immensely greater than those of the poor child who has to be artificially fed. In case of misfortune depriving him of his natural food supply, the best substitute is the milk of some other healthy woman with a baby of approximately the same age, but unfortunately this kind of substitute is not readily commanded by the average family, and the faith- ful cow has usually to be relied upon when the normal supply is cut off. That such a substitute is far from ideal, statistics make perfectly clear. A study of nearly 50,000 babies born alive in Berlin in 1890 showed that about one-fourth of these were dead at the end of the first year, of whom one in two was bottle-fed and only one in 13 breast-fed. A similar study made by the Children's Bureau of the United States Department of Labor in 1915 in Johnstown, Pennsylvania, showed that at every month of the first year the mortality of the artificially-fed babies was from two to four times as great as for the breast-fed, while that of babies with mixed feeding lay between the other two. Of course 109 110 FEEDING THE FAMILY the highest mortality was among the youngest infants. The mortality of artificially-fed babies at 2 months of age being 237 per 1000, while at eight months it had fallen to 53 per 1000. On the other hand the mortality of breast-fed babies at two months was only 72, and at eight months 26 per 1000. That the baby not only has a better chance of sur- viving the perilous first year, but of growing to manhood as well, was made evident in a hygiene exhibition re- cently held in Dresden, in which it was shown that in 24 families with 109 children, all breast-fed, not one was dead at the end of five years; while in 33 families in which the babies were all bottle-fed one or more had been lost in each family in the same period. In another group of 79 families, in which 85 of the children were breast-fed and 109 bottle-fed, all the breast-fed children were alive at the end of eleven years, while more than half (57%) of the bottle-fed babies were dead. In a study made in New York City of the relative danger to babies of dirt, flies, and artificial feeding, it was quite evident that artificial feeding was, of the three, the worst enemy to baby life. Such evidence makes clear the importance of a mother's making every effort to start the baby right and give him a fair chance to live and thrive. Every month of breast-feeding is to be regarded as so much gain for the baby. Such evidence as that cited above, im- pressing the importance of breast-feeding, has stimulated effort to help mothers nurse their babies. With proper care throughout the period of pregnancy and regular supervision after birth, most mothers can do so success- FOOD FOR THE BABY 111 fully. If the milk supply is insufficient it can often be increased by mechanical stimulation of the breasts, and if it becomes necessary to give additional food the discarding of the natural food is not justified on this account. Only when it fails entirely, or there is some serious disturbance of the mother's health which makes nursing unwise, or when there is persistent failure on the part of the baby to digest the milk, should artificial feeding be adopted as the sole means of sus- tenance. Good breast-feeding cannot be done carelessly, how- ever. The mother must take the best possible care of herself, eating wholesome food in sufficient amounts, as outlined in Chapter IV; leading a regular, hygienic, peaceful life as far as she is able, in order to maintain a full and uniform milk supply. She must keep in mind that upon her rests the responsibility for the healthy development of her baby; must avoid indigesti- ble food, or food that spoils her appetite so as to prevent sufficient quantities of food being taken; must have regular hours for meals and rest; get fresh air and exer- cise, but avoid fatigue and overwork; keep her mind pleasurably occupied while avoiding excitement; and, finally, she must feed the baby according to a definite schedule. A healthy baby grows fast. During the first six months he should double his birth weight, and by the end of the year triple it. He must not only digest food for this rapid body building, but he must have energy for the daily maintenance of his internal and external 112 FEEDING THE FAMILY body activities besides, the result being that he has to take care of much more food in proportion to his weight than an adult does, and any upset in digestion is a very serious matter. Hence, anything in the mother's life which might disturb her steady production of whole- some milk must be avoided, and anything in the baby's life which might cause indigestion. He must have plenty of sleep and be allowed to lie quietly by himself when awake, have p'enty of fresh air to breathe and clothing which will give him a chance to exercise his arms and legs freely, so that he need not get all of his exercise by crying. Above all, he must get his meals regularly. With definite hours for feeding, the quality of the milk is more uniform, and the baby's alimentary tract responds better to the food. The stomach needs an interval of rest between meals, and the secretions of the alimentary tract are strongly influenced by habit, pouring out more freely under the stimulus of regular feeding. The appetite is less fickle, too, when meals come at definite times. "Meals by the clock" is one of the first rules of successful feeding. What the schedule shall be depends somewhat upon circumstances, but nowadays babies are fed much less frequently than they used to be, with benefit to their digestion and more freedom for their mothers. For the first three months it is customary to feed them six times in twenty-four hours, and after that only five times till the ninth or tenth month, then going on a four- meal schedule. Schedules are generally arranged as follows: FOOD FOR THE BABY 113 Suggested Schedule of Hours for Infant Feeding Number of Feedings per Day Hours for Feeding A.M. P.M. First three months 6 2, 6, IO 2, 6, IO Fourth to tenth month .... 5 6, io 2, 6, IO Eleventh and twelfth months . . 4 7, io 2, 6 If the baby is delicate, shorter intervals between feed- ings are sometimes prescribed, but never less than two hours; if very sturdy, four-hour intervals are sometimes adopted at the very start. Such schedules should be arranged under the advice of a competent physician. Strict observance of the schedule determined upon is more important than the exact interval between feedings or the number of feedings in the day, but in general long intervals promote good digestion better than do short ones. If the baby frets between meals he should be given cool (not cold) boiled water from a bottle or spoon - nothing else. Pacifiers are to be strictly avoided. They spoil the shape of the mouth and are bad carriers of germs; the constant sucking is undesirable for many reasons and swallowing air causes gastric discomfort. After meals the baby should be placed upright and patted very gently for a moment or two to bring up the "gas" (generally air) which he may have swallowed, then laid in his crib to rest quietly and soon go to sleep. His chief business in life is to grow. He is not to be considered a source of entertainment, nor should efforts 114 FEEDING THE FAMILY be made to amuse him. The healthy baby when awake will play quietly by himself and not get over-excited nor exhausted. We judge the feeding to be successful when he makes steady gains in weight, averaging about eight ounces a week in the early months, and falling gradually to about four ounces a week; and when by quiet sleep, absence of fretfulness, and other signs of health he shows that his diet agrees with him. The age at which a baby may be weaned depends upon the finding of other food which contains all the es- sentials for growth in a form in which the baby can digest them with ease. It is always difficult to feed a very young baby any food but his mother's milk. Each month it becomes increasingly easier and in enlightened communities where good clean cow's milk is available and mothers receive expert guidance in the care of their babies through local health stations, private physicians, or at least government publications such as those of the Children's Bureau of the United States Department of Labor,1 it is safe to wean babies sometime between the ninth and twelfth months. But preparation for weaning should begin some time before this, so that the baby will not have to get ad- justed to too many new foods all at once. We may start a program of gradual adjustment about the fifth month. This gives plenty of time to establish the foods that will compose the diet when the child is weaned, Preparation for Weaning 1 Prenatal Care, Infant Care, The Care of the Pre-School Child. FOOD FOR THE BABY 115 introducing one at a time, and allowing time to become accustomed to each before another is added. The easiest food to introduce first is orange juice, or its equivalent, which will be needed for the sake of its C ■vitamin as soon as cow's milk is one of the mainstays of the diet. It should be given in very small amount at first, and unless very mild should be diluted with at least an equal quantity of water. In the course of two or three weeks the orange juice can be gradually in- creased to i tablespoonful and by the early part of the seventh month to 2 tablespoonfuls, and this quantity continued throughout the first year or again increased to 3 tablespoonfuls. When orange juice is not practi- cal, raw carrot, cabbage, or turnip juice may be used - though not so convenient - or fresh or canned tomato juice, diluted like the orange juice. The next addition may be a small quantity of well- cooked cereal jelly. Cereals, being wholesome and economical, are very valuable in children's diets, and yet so many mothers seem to have difficulty in teaching older children to eat them that it has been found ad- visable to start this type of food very early and get the habit established before the child thinks much about his food. By beginning at the age of 6 months, the task seems to be greatly simplified. Hence from 1 to 2 teaspoonfuls of a cereal mush, thoroughly cooked and free from any large particles, should be given just be- fore one of the morning feedings and perhaps also one of the evening feedings. Cream of wheat or strained oatmeal is most convenient. 116 FEEDING THE FAMILY This cereal jelly should be given warm, not hot nor cold, and salted a little (the person giving it should al- ways know how it tastes and keep it the same, day after day). The amount should be slowly increased to i or 2 tablespoonfuls at io months, and a little milk should be poured over it when fed. The next addition at the seventh month should be a green vegetable. When the baby is weaned this will be needed for iron and other ash constituents, and perhaps for the B vitamin. In fact it has been found that nursing babies may benefit immediately from such an addition to their ash and vitamin supply. This is undoubtedly the case if the mother's diet has not been for some time (a year or more probably) of the best qual- ity. (In studies of dairy cows, no direct improvement of the milk supply came from changes in the diet after the calf was born comparable to that produced by a better diet in the previous dry period.) At first only the vegetable juice should be given. A few leaves of spinach or a few cubes of carrot may be steamed in just enough water to keep moist for fifteen or twenty min- utes, and one teaspoonful of the juice strained off for the baby. Soon this can be increased to i table- spoonful, and in the course of a month, the pulp may also be pressed through the sieve and given with the juice. A few grains of salt may be used to season, but this should not be overdone. A baby's simple foods need just the same care as any fancy delicacies for mother's parties. By the eighth month the baby should begin to use FOOD FOR THE BABY 117 his jaws and such teeth as he may have on a dry stale crust of bread. Once a day he should have this exercise, and gradually he will learn the important lesson of chew- ing. When the child is nine months old, he will be ready to learn to take cow's milk, the food around which his diet should be built throughout the remainder of his childhood. First one may discontinue the io p.m. feed- ing entirely, when the infant is nine months old. Then at the tenth month discontinue the 2 p.m. breast-feeding and give a soup made of milk and the daily portion of strained vegetable; two weeks later substitute 6 ounces of warm cow's milk for the breast-feeding at 10 a.m. By the eleventh month, cow's milk may be substituted for the 6 p.m. breast-feeding (if the baby has not by this time weaned himself) and finally the breast-feed- ing at 6 a.m. will be stopped. All suggestions regarding the time of weaning a baby may require revision according to the season of the year. It is much safer to postpone weaning than to attempt weaning or any other radical change in the baby's food during hot weather. The Care of the Baby's Milk Only clean milk should be bought. Fresh milk is good when one can be sure that every precaution has been taken to keep it clean and cold and free from harm- ful or excessive bacteria. "Laboratory" and "certi- fied" milk are guaranteed to be wholesome. In the country one should know the conditions under which the milk is produced, and buy only that which is clean 118 FEEDING THE FAMILY and kept cold from the time of milking. Pasteuriza- tion is the great safeguard against disease-producing bacteria. But it must be remembered that pasteurized milk needs exactly the same kind of care as fresh milk. It must be kept clean and cold and be used within a short time, for it is not " germ-proof," but even more capable of growing bacteria than before it was pasteurized, and there is not the warning that we have in fresh milk, i.e., souring. It must also be remembered that whatever supply of the C vitamin there may have been in the fresh milk may be reduced almost to nothing by the heating, hence a child's diet should always have some other source of this vitamin. Bringing milk quickly to a boil is as effective as pasteurization in destroying bacteria, and tends to make it easier to digest, so that either fresh or pasteurized milk may be boiled one minute and cooled again quickly if one wishes to be doubly sure of its safety. All milk must be protected from contamination at home as well as in transit. It should be put in a cold place and covered. Milk for the baby should be thor- oughly mixed so that the cream is evenly distributed, and each meal put in a clean sterile feeding bottle (washed with hot water containing washing soda, then boiled in clear water for 20 minutes), stoppered and kept cold till used. Just before feeding, it can be warmed to body temperature in hot water. Any food left over should be used some other way, not kept for the baby. A thermos bottle should never be used to keep milk warm; germs grow fast in milk when warm. FOOD FOR THE BABY 119 When good liquid milk cannot be procured recourse may be had to dried milk. This can now be obtained with all the original fat, and no more altered in its com- position than pasteurized milk (sometimes actually less, for dried milk can be obtained which has most if not all of the original vitamin C of the fresh milk). For emergency use, or where it is impossible to keep fresh milk cold, dried milk is invaluable. In purchasing one must distinguish between dried whole milk, which should be used for babies, and dried skim milk, which is also an excellent food, but will not give the baby the butter fat which he should have in his diet. Daily Feeding Program for the Breast-Fed Baby from the Fifth to the Twelfth Month The feeding program from the time supplements are added to the breast milk to the end of the first year may be briefly summarized as follows: Fifth month Breast-feedings at 6 and io a.m., 2, 6, and 10 p.m. At 9 a.m. give 1 teaspoonful of orange juice and increase gradually during month to 1 tablespoonful. (Raw cabbage juice, or tomato juice may be sub- stituted for the orange juice). Sixth month Breast-feedings at 6 and 10 a.m., 2, 6, and 10 p.m. 1 tablespoonful of orange juice at 9 a.m. and 6 p.m. Just before 10 a.m. breast-feeding give 1 teaspoon- ful of well-cooked cereal jelly. Increase gradually during month to 1 tablespoonful. Seventh month Breast-feedings at 6 and 10 a.m., 2, 6, and 10 p.m. 1 tablespoonful of orange juice at 9 a.m. Increase gradually during month to 2 tablespoonfuls. At 10 a.m. and 6 p.m. i tablespoonful of cereal jelly. At 2 p.m., just before breast-feeding, 1 teaspoonful of cooked vegetable juice (spinach or carrot). Increase during month to 1 tablespoonful. 120 FEEDING THE FAMILY Eighth month All items indicated for 7th month. In addition, a stale dry crust of bread after 2 p.m. breast-feeding. Ninth month Discontinue 10 p.m. feeding. Use pulp of vegetables put through fine sieve, with juice. Add one or two new vegetables to list (green peas, asparagus tips, very tender string beans). Tenth month Breast-feedings at 6 and 10 a.m. and 2 p.m. Sub- stitute 6 ounces warm cow's milk for 6 p.m. breast- feeding. Give 2 ounces of warm cow's milk over 1 or 2 tablespoonfuls of cereal jelly at 10 a.m. and 6 p.m. At 2 p.m. give j cup vegetable soup (| cup milk, and 1 or 2 tablespoonfuls of strained vege- table pulp, salted lightly), 1 tablespoonful of baked potato with a little butter, 1 tablespoonful lightly sweetened apple-sauce, a small piece of stale bread crust, toast, or zwieback. By middle of month substitute 6 ounces of warm cow's milk for the 10 a.m. breast-feeding. Eleventh month Substitute 6 ounces warm cow's milk for 6 p.m. breast- feeding in middle of month and discontinue 6 p.m. breast-feeding. Up to this time use schedule for tenth month. Then change to the following: 7 a.m. 8 ounces warm cow's milk. 9 A.M. 2 tablespoonfuls orange juice. 10 a.m. 2 tablespoonfuls cooked cereal jelly with 2 ounces of warm cow's milk over it, 6 ounces of milk to drink. A small piece of toast. 2 p.m. | cup vegetable soup (2 tablespoonfuls strained vegetable pulp and milk) or milk and vegetable given separately, i small baked potato with a little butter, 1 teaspoonful of egg yolk (may be served on bread crumbs or potato), 1 table- spoonful cooked pulp and juice of mild fruit (as apple sauce), 1 slice toast or zwieback. 6 p.m. 2 tablespoonfuls cooked cereal jelly with two ounces of warm milk over it, 6 ounces of warm cow's milk to drink, 1 slice of stale bread (2 to 4 days old) or toast, with a little butter. FOOD FOR THE BABY 121 Artificial Feeding Unfortunately there will always be some babies de- prived more or less completely of their natural food. Mothers having the best of intentions sometimes fail to produce milk, or furnish an inadequate supply, and other misfortunes may rob the baby of his birthright. For such children a substitute for the natural food must be provided. Nothing can take the place of milk for this purpose, even though it be milk from another species of animal, such as the cow. Milk contains everything needed for growth, and while the proportions of building materials vary with the natural rate of growth of the species - milk for the puppy that doubles its weight in nine days having more protein and ash per quart than milk for the calf that doubles its weight in 47 days, and this in turn having more building materials per quart than milk for the human baby that doubles his weight in 180 days - the main point is that these substances are present in forms which the human child can use better than any others, provided he can be made to di- gest the strange food. With plenty of fresh unheated milk from cows having fresh food there would even be enough of the C vitamin. But since these conditions cannot be constantly met, we no longer try to depend on milk for this in ordinary circumstances. The ordinary problem in artificial feeding is, there- fore, one of adapting cow's milk to the digestive tract of the baby and at the same time providing, as far as possible, a normal supply of all the essentials for nutri- 122 FEEDING THE FAMILY tion and growth. There are many special devices by which these objects can be attained, and the wise physi- cian adopts the one which seems best suited to the individual case. Much thought and care have been given by many pediatricians to the arrangement of nicely graded feeding schedules for the artificially fed infant, avoiding overfeeding on the one hand and under- feeding on the other and adjusted week by week to the increasing strength of the child. Such schedules must take into account the requirement of the baby for each of the essentials for nutrition and growth. Before con- sidering any program, then, it will be well to summarize these requirements briefly. The Energy Requirements of the Baby The energy requirements of babies of different ages have been investigated carefully, with the infants lying quietly asleep, and not having had any food for three or four hours. In the Carnegie Nutrition Laboratory in Boston alone, more than one hundred infants have been studied in the calorimeter. Newborn babies asleep be- side their mothers give off nearly two and one-half times as many calories per pound as the mothers. An allow- ance of from 30 to 35 calories per pound is necessary merely to keep a baby alive. Babies cannot lie quietly all the time, however. If they are to grow and acquire strong muscles they must have exercise, which they get by crying, kicking, pounding with their fists, and other movements. This means work, requiring a further supply of energy. A five-months-old baby has been FOOD FOR THE BABY 123 shown to double his energy expenditure by the effort of crying. Active children really work as hard as any adult manual laborer. Furthermore, a baby is constantly storing food ma- terials in his body in the process of growth. Every day as much as | to | of the calories represented in his food may be used in this way. All the energy demands of the baby - (i) for the maintenance of life processes, more rapid than in the adult, (2) for muscular activity, often great, and (3) for storage in growth - make the infant's total energy requirement during the first three months of his life about 50 calories per pound per day. As he grows older, the requirement for internal activities becomes gradually less in proportion to body weight, the rate of growth falls, and therefore the total requirement for the second three months is about 45 calories per pound per day; for the rest of the first year about 40 calories per pound per day. The Protein Requirement of the Baby During the period of most rapid growth there is a constant storage of protein as the various kinds of body- tissue increase in amount, and especially as the muscles grow. This protein must supply an amino acid assort- ment containing liberal quantities of certain of these acids which have been found to play a very significant role in growth, such as lysine and cystine, along with the ordinary supply of amino acids of other sorts required for human maintenance. These are guaranteed to the baby in milk. When the energy supply is properly 124 FEEDING THE FAMILY met and the proteins in the food are of such excellent quality as those of milk, an allowance of from twelve to fifteen calories of protein in every one hundred total calories may be regarded as most satisfactory. It has already been pointed out that liberal supplies of calcium and phosphorus are necessary for normal growth of bones and teeth and for the proper functioning of the body as a whole. Here again, we can depend largely on milk, since the amount of milk which guarantees sufficient protein will also yield sufficient calcium. It seems probable that the addition of vegetables, fruit, and egg yolk to the diet of the first year makes desirable increases in the phosphorus supply. We know that the growing child's need for iron is high, but just how far toward meeting his requirement the iron of cow's milk will go we do not know. Hence we make it a practice to supplement the baby's diet as early as the digestive situation permits with small quan- tities of iron-bearing food, such as spinach or other green vegetables, or egg yolk or both. The Ash Requirements of the Baby The Vitamin Requirements of the Baby As already stated, these have not yet been determined with any precision. We know from actual experiment that babies grow better, show less tendency to be anaemic and develop better teeth, if the C vitamin is made a regular part of their diet from the first. So also experi- ments on human babies have made it appear probable FOOD FOR THE BABY 125 that they grow at a better rate when they have more B vitamin than they ordinarily get in cow's milk diluted sufficiently to be easy to digest. Fortunately in supply- ing the C vitamin we usually increase also the amount of B vitamin in the diet. The need for the A vitamin for growth is so clear for animals of a number of species that we cannot but be- lieve that the human baby should have a liberal allow- ance. That any more is needed than is yielded by an amount of whole cow's milk, practical for a baby from other standpoints, seems unlikely, but it is well to remem- ber that the foods chosen to supply iron (i.e., spinach and other green vegetables and egg yolk) may at the same time increase the quantity of this vitamin considerably. The question of guarding against rickets must also be considered. With plenty of sunshine to which the baby is actually exposed, no special changes may be necessary in the diet, but in regions where sunlight is scanty a good precaution is a small amount of cod liver oil daily, especially if egg yolk is not being used. The egg yolk has been shown to protect babies against rickets. Daily Food Program for Artificial Feeding The schedule of hours for feeding artificially will on the whole be the same as for a breast-fed baby, but since babies bottle-fed from birth are apt to be more delicate, they are sometimes fed every three hours for two or three months longer than the breast-fed baby, i.e., till the end of the fifth or sixth month. As to the quantity of milk needed, it has been noted 126 FEEDING THE FAMILY that an ounce and one-half of milk per pound of the baby's weight will give the daily supply of protein, for which we depend upon milk. To this must be added some easily digested carbohydrate food which will dis- solve in the milk, preferably milk sugar or some form of so-called malt food (e.g., dextri-maltose). This will add to the fuel value of the diet and at the same time make it easier to digest. The amount to be added is determined by finding the calories yielded by the milk allowance of the day and deducting this from the total calories required. Thus an ounce and a half of milk per pound for a 14-pound baby would mean 21 ounces for the day, furnishing approximately 420 calories.1 A four- months-old baby of this weight, requiring perhaps 45 calories per pound, would need 630 calories per day. Deducting the milk calories, we have left 210 calories to be secured from about i| ounces of the carbohydrate food selected. Water must also be added to the diet, partly because of the high rate at which chemical processes go on in the baby's body and partly because it will make the diet easier to digest. It is estimated that a baby requires fluid food yielding about 3 ounces per pound of body weight through the first three months, 25-2! ounces per pound through the next three months, and 2 ounces through the next two months. We may estimate the water to be added to the milk by calculating the total amount of fluid required and deducting the amount of 1 20 calories per ounce is often used for approximating the energy yield of whole milk. FOOD FOR THE BABY 127 milk from this. The difference will be the water to add. Thus, a baby six months old, weighing 16 pounds and getting 21 ounces of fluid per pound would have al- together 36 ounces. Deducting 24 ounces of milk (i| ounces per pound), the water to be added would be 12 ounces. The following schedule has been worked out to illus- trate these principles. It should be adapted to the individual baby, preferably by conference with a physi- cian who will examine the baby frequently in order to know just what kind of progress is being made, and to correct any unsuitable measures before they have a chance to do harm. Only thus can ideal adjustments be made. Schedule for Artificial Feeding of Well Babies 1 1 st and 2d days 3 ounces of milk, 7 ounces of water; boil briskly 1 minute, add | teaspoonful of milk sugar,2 cool quickly and divide into 6 feedings. The baby may not take all of any feeding. Discard what is left each time. 3d and 4th days 4 ounces of milk, 8 ounces of water, 2 teaspoonfuls of milk sugar;2 boil i minute, cool and divide into 6 feedings. 5 th to 7th days 5 ounces of milk, io ounces of water, tablespoon- fuls of milk sugar; boil i minute, cool and divide into 6 feedings. 1 Arranged in the manner suggested by Holt and Shaw in Save the Babies, published by the American Medical Association. 2 Dextri-maltose may be substituted for the milk sugar. It agrees better with some babies. Being slightly lighter in weight than milk sugar, the amounts specified must be increased in proportion of one teaspoonful to each tablespoonful of milk sugar. 128 FEEDING THE FAMILY Beginning of 8th day to end of 1 st month Beginning with 5 ounces of milk, 10 ounces of water, and 1J tablespoonfuls of milk sugar, increase the milk by j ounce every 3 days, the water by 1 ounce every 4 days, and the milk sugar by J table- spoonful at the end of the 3d week. Beginning of 2d month to end of 4th month At the end of the 1st month the baby will be getting approximately 9 ounces of milk, 15 ounces of water, and 2 tablespoonfuls of milk sugar divided into 6 feedings. Now add 1 teaspoonful of orange juice daily midway between the 2 morning feedings. Increase the milk by | ounce every 4 days, the milk sugar by | tablespoonful every 2 weeks, and the orange juice by 1 teaspoonful every month; decrease the water by J ounce every 2 weeks. At the begin- ning of the 4th month the number of feedings may be decreased to 5 or the 6 feedings may be continued another month. Beginning of 5 th month to end of 7th month At the end of the 4th month the baby will be getting approximately 21 ounces of milk, 12 ounces of water, and 4I tablespoonfuls of milk sugar divided into 5 feedings; also 1 tablespoonful of orange juice between the two morning feedings. Now in- crease the milk by j ounce every 2 weeks, make no change in the milk sugar. Increase the orange juice by 1 teaspoonful every month. At the be- ginning of the 6th month give 2 teaspoonfuls of cereal jelly, 1 of these before the 10 a.m. feed- ing, the other before the 6 p.m. feeding. Increase this by 2 teaspoonfuls once a month. By the middle of the 6th month give a crust of bread to munch before the 10 a.m. feeding. At the be- ginning of the 7th month give 1 teaspoonful of strained green vegetable juice (preferably spinach, though carrot or slightly cooked cabbage will do) just before the 2 p.m. feeding. One teaspoonful of egg yolk may be mixed with the orange juice at this time (or 1 teaspoonful of cod liver oil may be administered instead). Beginning of 8th month to end of nth month At the end of the 7th month the baby will be getting approximately 26 ounces of milk, 9 ounces of water, and 4I tablespoonfuls of milk sugar, divided into 5 feedings; 2 tablespoonfuls of orange juice mid- FOOD FOR THE BABY 129 way between 2 morning feedings; 2 tablespoon- fuls of cereal jelly (half of this at the 10 a.m. feed- ing, the other half with the 6 p.m. feeding) each time with a little of the milk feeding poured over it; a stale crust of bread to munch once a day, and 1 teaspoonful of strained vegetable juice at the 2 p.m. feeding; 1 teaspoonful of egg yolk or cod liver oil. Now increase the milk by | ounce every 10 days, decrease the water by j ounce every 2 weeks; increase the orange juice by 1 teaspoonful every month, the cereal jelly by 2 teaspoonfuls every month; use the strained pulp as well as juice of the green vegetable and increase by 1 teaspoonful each month. At the 10th month begin to decrease the milk sugar by J tablespoonful every 2 weeks. By this time whole milk can be given and the schedule already outlined for the breast-fed baby can be adopted. Beginning of 12 th month It is hoped that the baby can be breast fed at least for a time. In starting to feed an older baby, select a for- mula for one several months younger and increase its strength gradually until the child is taking the full amount of food suggested for his age. Use of Proprietary Infant Foods In spite of all one may say about the value of clean, fresh cow's milk, properly prepared and supplemented, the mother's faith is often shaken by glowing advertise- ments of patent infant foods and she is tempted by their convenience to give credence to their flaunted virtues. In composition they differ widely, some of them con- sisting of dried milk mixed with a certain amount of sugar, or dextrin and maltose, to be used with water without cooking; others consisting of dried milk mixed with 130 FEEDING THE FAMILY sugar and baked wheat flour, to be used with water but requiring cooking; and a large group made chiefly from wheat or barley flour, sometimes simply baked and some- times more or less completely changed into dextrin and maltose; none of these last should be used as a steady diet without the addition of milk and an antiscorbutic such as orange juice. It becomes evident at once that such foods cannot be used intelligently without information as to their composition. It is impossible to make the necessary adaptation of food to the growth of the individual baby simply by following the directions on the label of a box of food. Those not requiring the addition of milk are to be criticized because they often contain but little fat and ash; may or may not yield proteins of suitable quality for growth; and yield a very inadequate or un- certain supply of vitamins. This means that the baby may have his fuel needs met without getting proper building and regulating material. The body stores water and fat instead of building muscle and bone, looks fat but succumbs quickly in case of illness, losing weight with great rapidity; and is liable to trouble from soft or weak bones which have to bear too much weight for their strength. The foods sold to be used with milk serve the same purpose as plain barley or other cereal flour made into gruel, provided sufficient quantities of milk are used. Those which are dextrinized are convenient because they go into solution readily, but barley can be easily dextrinized at home with any reliable preparation of FOOD FOR THE BABY 131 diastase and usually at much less expense, or plain dextri-maltose may be purchased with no more trouble. At the end of the first year, whether a baby be breast or bottle-fed, he should have reached the point where he drinks plain warm cow's milk from a bottle,1 taking in all about one quart a day, and in addition i to 3 tablespoon- fuls of strained, mild fruit juice, 1 to 2 tablespoonfuls of strained green vegetable pulp, from one-half to a whole yolk of an egg; 2 tablespoonfuls of thoroughly cooked, strained cereal (divided between two meals), and a piece of stale bread, crisp toast, or zwieback to chew. Noth- ing else is needed to keep a baby healthy and no risk of upsetting his digestive tract should be run by adding other foods. Because a baby is not made violently ill by tea, coffee, sugar, sweet crackers and what not, it does not follow that these are desirable. The perversion of his appetite, so that he does not desire the foods which are best for him, is a serious matter, though the results are not immediately apparent. The child's chief busi- ness in life is to grow strong and develop good habits. Regular hours for eating and sleeping, regular supplies of carefully chosen food, and plenty of fresh air mean not only the development of sturdy legs and rosy cheeks, but of good eating habits and a strong digestive tract able to stand the inevitable strains of later life. Good growth in this part of the body cannot be seen directly, but it counts tremendously when the whole life is in re- 1 The bottle is preferable to the cup, because the child will drink more slowly and the mother can tell more accurately just how much he has taken. 132 FEEDING THE FAMILY view. One year of good feeding at the beginning of life is more important than ten after forty, and a baby's needs are not to be judged by an adult's inclinations. Feeding must be a matter of principle and not of im- pulse ; the reward will be partly in the present - much more in the future. A Quart of Milk a Day CHAPTER VI FOOD FOR THE TWO-YEAR-OLD By following such a program as has been suggested for the first year, making every effort to maintain the supply of breast milk through the major part of the year, and cautiously yet systematically adding to the child's diet those foods which perhaps enhance its value and certainly prepare for the future, there should be no special difficulty in feeding during the second year. The woes of "the second summer" and "teething" are mostly the result of bad feeding. To boast that a fifteen- months-old baby "eats everything" is not a tribute to its precocity but to the ignorance or willful negligence of its mother. In these first two years the child must get the idea that it is his business to eat what is provided for him, and not to expect what is not offered to him. Training in good eating habits cannot begin too early. And training is necessary. No human being can safely eat according to his whims. Each must learn that eating is an important duty, to be faithfully performed day by day. In the healthy child, hunger usually makes it a pleasant duty, but not always. New foods do not al- 133 134 FEEDING THE FAMILY ways appeal, by any means. They must be "learned," sometimes by many repetitions. We make the condi- tions of learning as favorable as we can. For the very little child this means first of all that he shall have the appetite which comes from good health and freedom from physical or nervous fatigue; second, that there shall be a cheerful person who can heartily commend to him the food of which he is to partake; and third, that the food itself shall be of just the same flavor and texture and temperature that it was when he had it before. Thus the habit of eating that food becomes established. When he balks, it is well to try to discover the reason. If there seems to be none, he should not be pushed too far - not required to eat too much - but made to eat enough to realize that he is eating the food that he refused. As fast as possible such refusals should be suppressed. It often takes time and patience to establish essential foods in the child's diet, but the earlier one begins the easier it will be. The most important of these foods is milk. It should remain the chief staple throughout the second year, from three cups to a quart being incorporated into the diet daily. This generally means drinking two to three cups and using the rest in preparing various foods. Usually not more than a quart altogether, including that used in cooking, should be given, as there must be oppor- tunity to get in other foods too. Scientific study has year by year emphasized the importance of milk as a food for growth. In 1906 Hopkins of Cambridge Uni- versity showed that animals on diets made up from FOOD FOR THE TWO-YEAR-OLD 135 highly purified protein, fat, carbohydrate, and ash con- stituents, would not thrive, but immediately began to improve when a little milk was added to their diet. Since then numerous experimenters, both in this country and Europe, have piled up evidence: (i) that the pro- teins of milk are of the very best quality for growth, and when combined with the proteins of cereals and vege- tables improve their quality, too; (2) that milk is rich in the A vitamin, so that with a quart of whole milk per day in a child's diet, there is little occasion to fear shortage of this vitamin; (3) that the supply of the B vitamin, while not so liberal as that of the A vitamin, is still excellent, so that a little supplementing with vege- tables and fruits makes the diet satisfactory in this re- spect; (4) that milk is the most important source of calcium for the child's bones and teeth, and that children have a high capacity for storing calcium, best met by a quart of milk a day; (5) that milk is also a rich source of phosphorus, but that this may be supplemented to advantage by phosphorus in egg yolk and many kinds of vegetables and cereals from whole grain; (6) that besides calcium and phosphorus, milk has a rich and varied assortment of other mineral elements essential to health and growth; even its iron, though not large in amount, is utilized to the full and should not be disre- garded, though it should be supplemented by other iron- bearing foods, principally green vegetables, egg yolk, and the cereals that are eaten with their bran coats unre- moved. To cut down the supply of milk after the first year is a grievous mistake. 136 FEEDING THE FAMILY The Food Program for the Second Year Before birth and during the first year, the quality of the teeth is largely determined, but for several years longer the permanent set will be developing, and the only way we know by which to grow good teeth is by attention to diet. We may keep them 11 as good as new" by cleanliness and dental care, but we make them from what we eat. So the greatest advance in the eating pro- gram is in the direction of more exercise for the teeth and jaws through the systematic use of food to chew. The program outlined for the last month of the first year needs comparatively little modification for the second year. There should be four meals a day; the first not earlier than 6 a.m. nor later than 7.30 a.m. ; the second at 10 or 10.30, depending on the hour for the first; the third at 2 or 2.30 p.m. ; and the fourth at 5, 5.30, or 6 p.m., depending on the sleeping schedule. Adequate rest is necessary to enable a child to utilize his food. Many children are undernourished primarily from lack of rest. Thirteen hours should be allowed for the night's sleep, and at 7 p.m. no two-year-old should be out of bed. If he can be in bed at 6, so much the better. Cereals can still be used to advantage twice a day. For variety two kinds may be given the same day in the second half of the year, instead of using the same one morning and evening. Any kind selected should be cooked till thoroughly softened, and for the first part of the year put through a strainer if coarse (like rolled oats or wheat). In the latter part of the year the cereals FOOD FOR THE TWO-YEAR-OLD 137 may be given unstrained. From one-half an ounce to one ounce of dry cereal cooked thoroughly can usually be fed daily. Preference should be given to cereals made from the whole grains. Oatmeal is one of the richest in ash constituents, and is very economical be- sides. Unless there is a tendency to looseness of the bowels, it can well be used at least three or four times a week. The cereal foods should be served warm with milk or thin cream (top milk) but not sugar. The less sugar as such in the two-year-old's diet the better. It should be used only where necessary to make certain foods, such as stewed fruits or simple desserts palatable. It affords fuel only and tends to crowd out foods carry- ing building and regulating material by its enticing flavor. It also tends to blunt and pervert the appetite. The less the little child knows of it the better. All candy, cake, or other highly sweetened food should be abso- lutely withheld. The use of egg yolk in little children's diets is desir- able because it furnishes proteins of excellent quality, a rich supply of phosphorus and iron, and A and B vita- mins, besides having been shown to be a safeguard against rickets. It should be introduced cautiously, as some very young children are disturbed by it. If the quan- tity is not too large, there is less likelihood of trouble. It can be combined without cooking with the orange juice, or mixed with soft crumbs of bread; or it can be boiled till mealy, mashed to a paste, and spread on a piece of bread. From one-half to one yolk daily is as much as should be given. Once in a while the whole 138 FEEDING THE FAMILY egg may be given for a change, but for children of this age who are getting a quart of milk a day the white is superfluous. Every day some fruit juice or strained pulp should be given. Orange juice remains the staple, but gradually other kinds mild in flavor may be tried, as prune juice or pulp, cooked apple juice or pulp (from stewed or baked apples), pineapple or fresh peach juice carefully strained. Not more than two or three tablespoonfuls should be given at one time. If a new kind is being tried, only half the usual quantity should be given, diluted with half as much water. The best time to give the fruit is between two morning meals. Fruit is im- portant because it helps to counteract constipation and adds ash and vitamins for growth. With the 2 p.m. feeding some cooked and sifted fruit pulp lightly sweet- ened (apple-sauce, fresh ripe pear sauce) is desirable unless it makes the diet too laxative, in which case it should be postponed for a while. There may be some additions to the number of vege- tables eaten, but spinach, carrots, string beans, and green peas are good staples, and can be used both singly and in combination with one another. A wider range is merely for the sake of convenience. Any vegetable chosen should be mild in flavor, strained through a fine sieve, and given in moderate amounts (1 to 2 tablespoon- fuls). It must always be remembered that green vege- tables are given for their ash constituents and vitamins, and care must be taken that the cooking process is one which will conserve these. Care that the vegetable is of FOOD FOR THE TWO-YEAR-OLD 139 good quality and carefully seasoned is also important. During this year the vegetable soup made with milk and a little flour for thickening is exceedingly practical. The potato should not be regarded as taking the place of green vegetables, but as occupying a little dietary niche all its own. It is so generally available, so easy to prepare and digest, so good a source of calories and the C vitamin to say nothing of iron and other mineral constituents, that it may well appear in the diet once a day after the first year. At first only one or two table- spoonfuls of a baked potato fresh from the oven (or its equivalent, one freshly boiled in its jacket) should be mashed and moistened with a little cream, or else be seasoned with a very little butter. One of the commonest mistakes in feeding in the second year is to give too many kinds of food. The older members of the family must rigidly refrain from offering "tastes" of their food, or in any way suggesting the thought of the child eating the food provided for adults. It is very important for him to learn early that adults' and children's food are not the same, any more than their clothing. What mother would put French-heeled slip- pers on an eighteen-months-old baby? Yet the same mother will offer her little child a twenty-five-year-old's food, quite content with the fact that he swallows it. If he is subsequently fretful and restless - that is "bad temper " ! While personal traits develop early, and manifest likes and dislikes have to be met as best one can, it is a foolish notion that any whim should be allowed to con- 140 FEEDING THE FAMILY trol the selection of food. What if a person disliked all foods containing protein? Should he be permitted to die of nitrogen starvation ? Food needs of the body are governed by scientific laws, and the more the mind is trained to recognize and respect these laws, the simpler the feeding problem becomes. The adult who is re- sponsible for the welfare of the child is the authority as to what he shall eat, and not the baby who is as yet but a little animal with no knowledge of his own needs. The early inculcation of good eating habits is one of the most fundamental things in his training. He may, like Darwin, become world famous in spite of forty-three years of dyspepsia, but what might not Darwin have accomplished if he had been able to work a whole day at a time, instead of only half a day ! People who offer to children, for whose feeding they are not responsible, anything to eat without express permission are vandals, guilty of a greater outrage than if they should tear or ruin their clothes. An attack of indigestion has far- reaching consequences in a little child; it may retard the healthy development of the digestive tract itself; it may help to stunt growth in general; or it may so lower the resistance of the body to bacteria that harmful organisms gain a foothold and acute illness results. It pays to take the best of care in the feeding of little children; to give them the few simple foods that are best for them in an atmosphere which promotes content- ment, to prepare these foods with care, so that appetite and digestion may be fostered, and to serve them with unfailing regularity. FOOD FOR THE TWO-YEAR-OLD 141 The results of good feeding are cumulative. Each succeeding year means chances of greater strength and, what is more important in life to-day, greater endurance of strain and resistance to disease. If a child does not make good weight gains1 and show other signs of health, he should be given a thorough health examination so that any handicap may be removed at the earliest pos- sible moment. The food plan given on page 142 illustrates the arrange- ment of a schedule for meals, and the dietary worked out on this plan is suited to the food needs of the average child of eighteen months. The average weight of a normal child one year old is from 20 to 21 pounds; of a child two years old, 29 to 30 pounds. An allowance of about 40 calories per pound will cover the energy needs of the second year. Four protein calories per pound will meet the need for nitrogen, and the selection of foods indicated will afford an abun- dance of ash constituents and vitamins. 1 See Appendix, Tables IX and X. 142 FEEDING THE FAMILY A Day's Food Plan for a Child One and One-Half to Two Years Old Fuel Requirement: 900-1200 Calories Cost: 2-2^ per 100 Calories 6 a.m.: Warm milk, 1 cup 170 Calories 8 a.m. : Orange juice or Prune pulp or Baked apple pulp ► 2-3 tbsp 10-25 Calories 10 A.M.: Strained cereal jelly, 2-3 tbsp 25-50 Calories Top milk for cereal, 2-4 tbsp 50-100 Calories Warm milk to drink, 1-1 cup .... 125-170 Calories Stale bread or Dry toast or Plain zwieback • 1-2 slices 50-100 Calories 2 P.M. : Yolk of egg 50 Calories Baked potato, 1-2 tbsp 10-20 Calories Stale bread or Dry toast i-2 slices 50-100 Calories Sifted spinach or Sifted green peas 1-2 tbsp 5-15 Calories Warm milk to drink, i cup 170 Calories Cooked and sifted fruit pulp, 1-2 tbsp. . 10-25 Calories 5 : 30 p.m. : Cereal jelly, 2-3 tbsp 25-50 Calories Top milk, 2-4 tbsp 50-75 Calories Stale bread, 1-2 slices 50-100 Calories Warm milk to drink, 1 cup 170 Calories FOOD FOR THE TWO-YEAR-OLD 143 A Day's Dietary for a Child One and One-Half Years Old Fuel Value: 1100 Calories Cost: 2^ per 100 Calories Measure Weight Oz. Protein Calories Total Calories 6 a.m. : Warm milk (A, B) . 8 a.m. : i cup 8-5 34 170 170 Orange juice (C, B, A) IO a.m. : Strained oatmeal jelly 2 tbsp. 1.0 12 12 (B) Top milk (10 oz.) (A, 3 tbsp. i-5 5 30 B) 2 tbsp. 1.0 5 50 Warm milk (A, B) . i cup 8-5 34 170 Stale bread .... 2 p.m. : i slice 0-7 7 50 300 Yolk of egg (A, B) . i yolk o.6 ii 56 Baked potato (C, B) 2 tbsp. i-5 6 50 Toast Sifted spinach i slice 0-5 7 50 (A, B, C) ... 2 tsp. 0-5 - 2 Warm milk (A, B) . 5 : 30 p m- : Strained oatmeal jelly I cup 8-5 34 170 328 (B) Top milk (io oz.) 2 tbsp. 1.0 3 20 (A, B) . . . . 2 tbsp. 1.0 5 50 Stale bread . . . i slice 0-7 7 50 Warm milk (A, B) . i cup 8-5 34 170 290 Total for day . . . . . 192 1100 CHAPTER VII FOOD FOR CHILDREN THREE AND FOUR YEARS OLD Adhering to the principle of gradual increase in the complexity of the diet, there will be no striking changes in the character of the food during this period. As children grow older they take an increasing interest in the appear- ance and flavor of food, and enjoy occasional changes in the form in which it is served, and even in the dishes used. Milk is still the basis of the diet, one quart a day being a suitable amount for most children. Some of the cream from the top of the bottle may be removed and used for the cereal, and a portion of the remaining milk used in making a vegetable soup; another portion for some very simple dessert, as junket, plain baked or boiled custard, cornstarch or gelatin blancmange, bread, tapioca, rice, or other cereal pudding (without raisins). Such a dessert can now be served once a day. The rest of the milk will usually be drunk (slightly warmed); but, again, part of it may be used for supper in a dish of bread and milk; or of milk toast; or with rice or some other cereal taking up milk readily (such as crisp corn flakes). In this way adaptations can be made to 144 FOOD FOR CHILDREN THREE AND FOUR 145 the tastes of individual children without any real change in the character of the diet. Milk is milk whether drunk from a cup or eaten with a spoon as rice pudding or delicate pink junket.1 A well-cooked cereal should appear in the menu at least once a day. Straining being no longer necessary, the choice is practically unlimited, though cereals from the whole grains (especially oatmeal) should have the preference. The most important point is thoroughness of cooking, so that the cellulose is softened in the highest degree, and the flavor of the grain is developed. The fireless cooker is a valuable aid in the preparation of cereals, but care must be observed to maintain a cooking temperature long enough to accomplish the purpose. Cut oats and cornmeal in particular need more than one night's cooking to develop their best texture and flavor. And since these bland dishes are a very important part of the little child's diet, too much emphasis cannot be laid upon care in their preparation. A cereal of different character from that usually served for breakfast can often be made the main dish for supper, rice, cornmeal, and occasionally cornflakes lending themselves well to this purpose. Milk or cream may be used freely with the cereal foods, but not sugar; this should be reserved for desserts and not depended on to flavor plain foods like cereals and bread, because sugar blunts the appetite so that less is likely to be eaten 1 Excellent suggestions in the way of menus and recipes for young children may be found in Food for Young Children, Farmers' Bulletin No. 717, U. S. Department of Agriculture. 146 FEEDING THE FAMILY and children are apt to tire of them sooner. Nothing is really gained by cultivating a perverted appetite for the sake of getting a particular food eaten. To allow a child to eat ice cream and oatmeal, mouthful about, is not establishing the oatmeal habit. Persistent feeding of a small amount, properly prepared, temporarily making up the deficiency in some other way (as by more plain bread and milk) seems to be the best method. Some form of dry, rather hard bread should be included in each meal, and for the sake of tooth and jaw develop- ment should never be neglected. Most crackers are too easily softened to serve the purpose well, and tend to cling to the teeth, though hard, whole wheat crackers may be given now and then for variety. As long as milk is the staple in the diet, and eggs and fruit and vegetables can be given daily, it is not of great moment whether the bread be white or brown. When there is danger of lack of iron, whole wheat preparations should be used. Fruit should be given at least once a day, twice if it can be afforded. If digestion is feeble, only the fruit juices and pulp previously allowed and in about the same quantity (one to three tablespoonfuls) should be given. If the child is sturdy, mild fruits of delicate texture, thoroughly cooked, such as baked apples (pulp only), freshly stewed Bartlett pears, baked or steamed banana, may be gradually introduced into the diet. All of these should be cooked with little or no sugar and only two to four tablespoonfuls given at one time, according to the age and the strength of the child. Courtesy of Professor Flora Rose. Suitable Food is the Most Fundamental Thing in the Physical Progress of the Child FOOD FOR CHILDREN THREE AND FOUR 147 A fresh vegetable (green as often as possible) of mild flavor and delicate texture should be made a regular part of the daily diet; it may be mashed or finely chopped instead of sifted, as earlier. String beans, squash, and stewed celery are good additions to the former list. Raw vegetables should not be used, nor cooked ones of strong flavor or coarse texture. Delicate cabbage is possible, when other green vege- tables are hard to obtain. It should be shredded ex- ceedingly fine and steamed in an open vessel in a very little water about twenty minutes, when the water should have mostly evaporated. A seasoning of salt and a teaspoonful of cream can then be added. Tomatoes, being rich in all three vitamins, are a valuable resource especially in winter, on account of not losing their C vitamin by canning. They should not be used undi- luted or unstrained, but some of the strained juice may be incorporated into a white sauce and this poured over a crisp soda cracker or a slice of toast. Where great economy is necessary, dried peas and beans may be used in soups, being digestible in this form and valuable for mineral constituents and vitamin B. A little tomato can be combined with either from time to time. As with cereals, care in cooking is necessary to make vege- tables wholesome and attractive, and since in later life these become more and more a source of the indispen- sable ash constituents and vitamins, pains should be taken to teach children to like them. At this period, however, they only supplement milk, eggs, and fruit, and it is often better to be content if the child tastes a vegetable than 148 FEEDING THE FAMILY to have a pitched battle over eating a larger amount. New foods are often unpopular simply because of their strangeness; with familiarity, the impression always being given that they are desirable, one can in time over- come many seeming aversions. Whole eggs can now be used at least three or four times a week. With plenty of milk and green vegetables we may safely economize somewhat on eggs when they are dear, but they are too valuable a food to be omitted entirely. One may be served as a dish by itself at the mid-day meal, in any way in which it is kept soft - "boiled," poached, coddled, or shirred; in an omelet or cooked with milk as creamy egg, egg timbale, etc.; but never hardened by high temperatures or coated with fat as in frying. Often it will be incorporated into the dessert, and sometimes instead of the cooked desserts children relish an "egg pudding," which is really an egg- nog, the egg beaten up in milk and moderately sweetened. The diet for the child from two to four is to be built around milk, vegetables, fruit, cereals, and hard or at least stale bread. Potato once a day and butter in moderation, on bread and potatoes and in small amounts in cooked vegetables, help to make up a liberal energy supply. No other foods are needed to keep a normal child in healthy condition up to the beginning of the fifth year. The great temptation is to enlarge the range of foods too fast, and to feed the little children at the family table too soon. If they must be served there, they should be taught to pay no regard whatever to the food FOOD FOR CHILDREN THREE AND FOUR 149 eaten by the other members of the family. The best meal schedules generally insure their being fed by them- selves, however, which is more satisfactory in all re- spects; they are not tempted to cry for things they should not have; adults are not tempted to give them "tastes"; and exclusive attention can be given to their manner of eating, which is also important if they are to become civilized members of society. The average weight of healthy girls and boys for the third and fourth years is in round numbers 35 and 37I pounds respectively. An allowance of from 37 to 40 calories per pound will cover the energy needs of these years, and three or four protein calories per pound will meet the nitrogen requirement. The food intake of indi- vidual children will vary considerably from any standard because the rate of growth differs much and so does the muscular activity. Quite early, little boys exhibit a higher degree of muscular tension than little girls, so that even if they seem to play in much the same way the boy may give evidence of a larger amount of energy expended by a more pronounced demand for food. Throughout the growing period, the best way to meet this situation is to supply food according to the stand- ards developed by the study of many children, to watch weight and appetite, and to guard against possible under- feeding by supplying as extra fuel as much plain bread, milk, and cereals as the child desires. If a child is really in need of food, he will eat plain bread, dry grapenuts or cornflakes cheerfully; if not, such food will not tempt him to overeat merely to please the palate. In no case 150 FEEDING THE FAMILY A Day's Food Plan for a Child Three to Four Years Old Fuel Requirement: 1100-1400 Calories Cost: 2-2^ per 100 Calories 7 a.m. : Orange juice or prune pulp 1 . ' b r > 3-4 tbsp. 25-50 Calories or apple sauce J Well-cooked cereal 50-75 Calories Top milk, 2-4 tbsp 50-100 Calories Milk to drink, 1 cup 170 Calories Toast or > 1-3 slices 50-150 Calories Dry bread] 10:30 A.M.: Milk, 1 cup 170 Calories Bread and butter, 1 slice 50-75 Calories 2 p.m. : Milk or Milk soup with 1 1 • > 150-200 Calories vegetable juice or pulp J J Egg, soft cooked 60-80 Calories Baked potato, 1 small 50-75 Calories Sifted green vegetable, as spinach, asparagus tips, peas, 1-2 tbsp. . . . 5-15 Calories Buttered stale bread, 1-2 slices ] or ( • • 75~i5o Calories Zwieback J Plain custard or junket 1 , , 1 • , > 1-4 cup . . 100-200 Calones or cereal pudding J 5: 30 p.m. Bread and milk or Milk toast 200-300 Calories or Cereal and milk Mild cooked fruit, as baked apple, stewed pears, steamed (and warm) mashed banana 25-150 Calories FOOD FOR CHILDREN THREE AND FOUR 151 A Day's Dietary for a Child Three to Four Years Old Fuel Value: 1350 Calories Cost: 2per 100 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast: 7 A.M. Orange juice (C, B, A) . 3 tbsp. i-5 - 18 Wheatena (B) .... f cup 3-o 6 5° Top milk (io oz.) (A,B) . 2 tbsp. 1.0 5 50 Toast 1 slice 0.5 7 50 Butter (A) 1 tsp. 0.1 - 32 Milk to drink (A, B) . . I cup 6.4 24 125 325 Lunch: io: 30 A.M. Milk (A, B) I cup 6.4 24 125 Soda cracker .... 1 cracker 0.2 2 25 ISO Dinner : 2 P.M. Cream of pea soup (B, A). 3 cup 5-2 l6 IOO Poached egg (A, B) . . 1 egg 1.8 25 70 Baked Potato (C, B) . . 1 small i-5 3 5° Toast 1 slice 0.5 7 5° Bread 1 slice o-7 7 50 Butter (A) 1 tsp. 0.1 - 32 Tapioca cream (A, B) I cup 2.8 12 IOO 452 Supper: 5:30 p.m. Steamed rice .... i cup 2.6 6 66 Top milk (10 oz.) (A, B) . 4 cup 2.1 9 IOO Milk to drink (A, B) . . 1 cup 6.4 24 125 Bread 1 slice 0.7 7 5° Butter (A) 1 tsp. . 0.1 32 Date marmalade . . . 1 tbsp. o-5 1 5° 423 Total for day .... .... 182 1350 152 FEEDING THE FAMILY should food be offered except at mealtime, but the drink- ing of water between meals should be encouraged. The meal schedule now includes three "regular" meals, i.e., breakfast, dinner, and supper, and some chil- dren do well with these only. Many children, however, do not eat a hearty breakfast, and need a supplementary meal between breakfast and dinner, or else between dinner and supper. When this meal is given it should be just as regularly planned for as the other meals, but it should be very simple, as one does not wish the bad habit of indiscriminate eating between meals to come out of it. The food plan and dietary given on pages 150 and 151 illustrate the practical working out of the principles discussed above. CHAPTER VIII FOOD FOR CHILDREN FIVE TO SEVEN YEARS OLD One day the writer sat in a restaurant for luncheon beside a little girl apparently about six years old. She was just finishing a plate of hot griddle cakes and a double portion of syrup, and her mother was pouring half of her cup of coffee into a cup for the child. As the meal was finished and they rose to depart, the mother remarked to a friend accompanying them that she was taking the little girl to see a doctor - "she had seemed languid lately." Poor child! With such a luncheon even a robust adult might feel "languid." Unfortu- nately the retribution for dietetic sins comes slowly and insidiously, as a rule, instead of swiftly and strikingly, and the connection between an abused stomach and "bad nerves" or "temper," or other manifestations of a physical constitution below par is not impressed, if it is even suspected. One of the interesting developments of the babies' health contests which have been held with such success in the past few years is the chagrin of par- ents who dreamed they were bringing normal if not prize babies to the examining experts and were startled into new vigilance by discovering that they did not 153 154 FEEDING THE FAMILY even know what a normal child really is. And one of the most encouraging features of such contests is that, with knowledge of how a baby ought to be cared for put into practice, the babies low of grade one year have been able to capture prizes a second year. Such endeavors to improve children physically must not be limited to the first three or four years, however. Each stage of development calls for watchful care. Good health habits must be fixed, and even adults are known to lapse from good habits started in early life. How much more the irresponsible child from five to seven! We must not only help him to remember to drink water, to attend to his bowels at a stated time, to go to bed and eat meals by the clock, to keep clean, to maintain a good posture, but we must impress the de- sirability of all these things upon his mind. More and more we must teach him that the building of a strong body is governed by laws which he must respect. Es- pecially in these years must we inculcate the idea that food is to be chosen for what it will do for our bodies, and that as a general proposition we must learn to like what we ought to eat. An interesting study of child health has been made in a mountain county of Kentucky. The children were between two and eleven years of age. Of a total of 149 children only 7 per cent were reported "excellent" in nutrition, and only 18 per cent even "good." What is the hope for the future if the oncoming generation is so manifestly unfit? Only about one-fourth of these children were having a diet which included all the con- A Mid-morning Lunch FOOD FOR CHILDREN FIVE TO SEVEN 155 stituents necessary to nourish their bodies. Four-fifths of these little children were estimated to be harming themselves by eating between meals, more than half by indulgence in tea or coffee. Their only salvation (so far as they can be considered "saved") lay in the fact that in this community milk was a staple article of food, three-fourths of the children having at least a pint daily. A strong contrast is seen in another com- munity, where an equally large number of children with all sorts of background and heredity, but with an in- telligently controlled environment, constitute a group with a percentage of underweight strikingly low, show- ing that we have it largely within our power to de- termine whether our children are below par in this respect or not. In communities where the general level of living is better than in the mountain district cited above, we still find an amazing number of children with defective teeth. It is now thought that the character of children's teeth is almost wholly determined before they are six years old, and as has been already stated, it is diet more than any other one thing which seems to determine the qual- ity of teeth. Sunshine and rest are important aids to the utilization of food by children. We must not be content merely with supplying good food. We must see that fatigue, interference with normal breathing, poisons from dis- eased throat or teeth, or other physical defects do not interfere with nutrition. All through childhood weigh- ing should be done at regular intervals and tables of 156 FEEDING THE FAMILY weight and height of normal children consulted1 as an aid in judging of progress. Feeding during the fifth, sixth, and seventh years differs little from that for the fourth year, except in the increasing quantity required to meet the needs of the larger child. All the kinds of nutritive material essen- tial to growth have already been introduced into the dietary - milk, eggs, cereals, fruit, green vegetables, stale bread; supplemented by butter, cream, potatoes, and, in certain dishes, a little sugar for flavor. All food should still be served as simply as possible. Much of the quart of milk which ought to be the foundation of the diet can be drunk; the rest used in simple soups, desserts, or plain cream sauces for vegetables. For variety, especially on cold days, the appearance of milk as a beverage may be changed by heating with a little malted milk; by cooking with just enough cocoa to give color and flavor; or by coloring with a cereal coffee. The addition of a spoonful of whipped cream to one of these modified forms may glorify it into a very special treat for some birthday or holiday. No tea, coffee, or strong cocoa should ever be given to children. A wel- come addition to the simple desserts during this period will be various homemade frozen dishes, such as milk sherbets and plain ice cream. These should not be served oftener than once a week, being too sweet for staple desserts; and in very moderate quantities on account of their coldness. Unless one is absolutely cer- tain of the quality, ice cream purchased outside the home 1 See Appendix, Tables VII and VIII. FOOD FOR CHILDREN FIVE TO SEVEN 157 should not be given to young children. Very often it is made under unsanitary conditions, or kept unduly long, and is badly contaminated by bacteria. Ice creams made from thick cream are too rich for little children. The frozen dish should be regarded chiefly as another means of making milk acceptable in the dietary by a simple change in its form. Lemon or orange milk sherbet, cocoa or junket ice cream, or a plain frozen custard of milk and eggs are the most suitable to choose. Cereals should still be served without sugar, but with plenty of milk. The warm cooked cereal should always be the staple breakfast dish, oatmeal being given the preference. The ready-to-eat cereals should be reserved for supper or for especially hot days in summer; eaten dry and crisp instead of bread, they make a suitable lunch if the child is hungry in the middle of the after- noon ; he is not likely to fail to chew such fare or to overeat of it. Raw fruits, except in the form of juice, should be in- troduced into the diet cautiously. Perfectly ripe pears, peaches, and scraped ripe apples, are the best to experi- ment with, but for the most part the fruit should be cooked, and especially any given for supper. Dried fruits, such as apples, peaches, and prunes, are very valuable, especially when the cost must be limited. They all need long, slow cooking and little or no added sugar. Dates may be stewed in a little water and put through a sieve to remove the coarse outer skin, then flavored with a little sugar and lemon juice. Bananas should always be cooked for young children, baked in 158 FEEDING THE FAMILY their skins or steamed in a covered vessel in a very little water. They do not require sugar. Preserves of all kinds and very sweet canned fruits must be avoided. With potato once a day, orange juice several times a week, tomato juice once or twice a week, and some variety in the other fruits and vegetables, there need be no con- cern about shortage of the C vitamin. Green vege- tables should still be cooked, and mashed or sifted because they are likely to be poorly masticated. The addition of a plain cream sauce now and then will give variety to the menu and add to the fuel value of the vegetable dish. A cream sauce to which a little tomato juice has been added poured over crisp toast or soda crackers makes an attractive supper dish. Potatoes should always be mealy. Baking is the safest method of cooking, but after the fifth year, plain boiled and mashed potatoes are not objectionable. Fried ones must never be offered. The temptation to add hot breads, biscuits, rolls, griddle cakes, and the like must be steadily resisted. Only bread stale enough or hard enough to offer exer- cise in mastication should be given. Breadsticks, crisp to the center, or sippets, made by toasting narrow strips of bread in the oven, will be welcome for variety. Butter, cream, and bacon fat in moderation are valu- able in the child's diet. But the butter should be spread on bread rather than used in cooking; cream should be thin and used preferably over cereals, toast, and simple desserts. Bacon fat may be added to baked potatoes or spread on bread. FOOD FOR CHILDREN FIVE TO SEVEN 159 Occasionally a small serving of plain cookies, stale sponge cake, graham, whole wheat, or other crackers may be given at the end of the meal. Soft cake should not be given at all. With milk freely supplied and an average of one egg a day, there is no special call for the introduction of meat regularly into the diet until after a child is seven years old, and, on the other hand, there are several good rea- sons for using little or none during these early years. In the first place, as has been already shown in Chapter II, meat is of all protein foods most liable to putrefac- tion in the intestine; and experiments indicate that the younger the child the more speedily these products of putrefaction develop when meat is fed. A somewhat analogous case among animals is often cited. Adult cats thrive on a rich meat diet, while kittens fed largely on meat are liable to convulsions. So children of three show more signs of putrefaction when meat is made a part of their diet than do children of six; and these in turn are more liable to it than children of eight. Since milk feeding will cause the signs of putrefaction to dis- appear and meat protein is no better for growth than milk protein, the advantage is decidedly with the milk rather than the meat. Another reason for withholding meat is that it natu- rally tends to displace milk on account of its higher flavor, and meat is much poorer in ash constituents and vitamins than milk, being totally deficient in calcium, of which milk is the most important source, while muscle, which is what is most commonly meant by meat, has 160 FEEDING THE FAMILY little of any known vitamin. A third reason is that the stimulating extractives in meat, which may be quite useful to a jaded adult, should not be used to whip up the sensitive growing organism, which when healthy is far better off without stimulants of any kind. The two chief advantages of meat are that it requires mastica- tion and exercises the chewing apparatus and that it is a useful source of iron. But, as already shown, dry bread makes excellent chewing material, with none of the disadvantages of meat; and eggs and green vege- tables will supply iron in forms believed to be more useful to the child, aside from the fact that the intestinal putrefaction of meat may seriously interfere with the utilization of its iron. Excepting the point in regard to mastication, what is true of meat is true of beef juice. Its use is best restricted to babies who for some reason cannot have an adequate supply of milk, egg yolk, and fruit juice, or who are sick enough to need a stimulant. The chief merit of meat broths seems to be to induce the eating of cereals or vegetables which may be cooked in them, and this can usually be accomplished in some other way. Broths almost inevitably limit the amount of milk taken, and do not seem to justify the regard in which they have been held in the past as a food for chil- dren. It appears foolish to put a busy housewife to the trouble and expense of making them when milk-and- vegetable soups seem so much more desirable. The average weight of normal children for the fifth, sixth, and seventh years and the energy requirement per pound of body weight per day are, in round numbers: FOOD FOR CHILDREN FIVE TO SEVEN 161 Energy Requirements for Fifth, Sixth, and Seventh Years Year Weight in Pounds (for Medium Height) Calories per Pound Fifth 41 36-38 Sixth 45 35-37 Seventh 50 34-36 It seems advisable in these years of comparatively rapid growth to allow from three to four protein calories per pound per day; though probably somewhat in ex- cess of the actual requirement, it is well to have a liberal supply for periods of rapid development. The same scrupulous care in regard to regularity of meals must be continued. Usually breakfast will now be given at 7 or 7 : 30; a very simple lunch at 10 : 30 or 11 ; a substantial dinner at 1 or 1 : 30; and a plain supper at 5:30 or 6. During this period many children begin going to school, and the meal schedules must be ad- justed to the school schedule. Especial care needs to be taken that breakfast be provided in time to be eaten without haste or fear of being late to school, and with time for a bowel movement afterwards. No child should be permitted to go to school without breakfast. The pangs of an empty stomach will cause him to feel fagged out long before the noon meal, which is often the next one. He will then be likely either to be over- hungry and eat hurriedly to the upset of his digestion, or to have lost the feeling of hunger and refuse a rational meal. In any case, considering the amount of fuel a child must take to keep his machinery going and to have 162 FEEDING THE FAMILY a surplus for growth, he cannot afford to miss breakfast with the hope of making good the loss later in the day. Numerous studies of school children show that no break- fast and malnutrition are commonly found together. The young child is fortunate if his school provides a mid- morning lunch, to take the place of the one which he has formerly enjoyed at home. This should be of the sim- plest character; a slice of bread and butter, a glass of milk and a cracker, or a bowl of cereal and milk being quite sufficient. Such good results have followed the introduction of these school lunches - gains in weight, improved general health, and better school behavior - that they are now a part of the regular school program in many places, and mothers may find that they can render useful public service in extending the practice where it is not in vogue.1 When there is no opportunity for a morning lunch, the dinner must be served earlier in the day - prefer- ably at noon - and then a light lunch may be given in the afternoon, similar to that suggested for morning, at 3 or 3 :30. During the first school years the child has many new conditions to meet, such as the excite- ment of going away from home and mingling with a large number of persons, and the change to a schedule involving hours of confinement, and no extra strain should be put upon him in the way of caring for diffi- cult food. He needs more than ever to be safeguarded 1 For information on the school feeding movement, see School Feeding: Its History and Practice at Home and Abroad, by Louise Stevens Bryant, and Malnutrition and School Feeding, by John C. Gebhart (published by the United States Bureau of Education). FOOD FOR CHILDREN FIVE TO SEVEN 163 against unsuitable food, or food at unsuitable times, to which his school companions and surroundings may tempt him, and against eating when exhausted or greatly excited by his work or play. Regularity, simplicity, and serenity are good dietetic watchwords; good health has economic and social as well as personal value, and in these early years the foundations for it should be most carefully laid. A Day's Food Plan for a Child Five to Seven Years Old Fuel Requirement: 1400-1700 Calories Cost: 2-2|^ per 100 Calories Breakeast : Orange 7-7 : 30 a.m. or Baked apple or Prunes 50-100 Calories Well-cooked cereal 50-100 Calories Milk 150-200 Calories Dry toast or stale bread .... 50-100 Calories Butter or Cream or Bacon fat 25-50 Calories io-io :30 A.M. Milk 125-175 Calories Bread 50-75 Calories Butter 25-50 Calories Dinner : Soft cooked egg (occasionally lean 1-1: 30 p.m. beef or lamb or chicken) . . . 50-75 Calories Mashed or sifted vegetable, as spinach, peas, string beans, car- rots 5-15 Calories . Baked potato or boiled rice . . . 50-100 Calories Bread 50-100 Calories Butter 50-100 Calories Milk (may be combined with veg- etable in soup) 100-150 Calories Stewed fruit or plain pudding . . 100-200 Calories 164 FEEDING THE FAMILY Supper : Cereal with milk 5: 30-6 p.m. or Creamed vegetable on toast or Milk toast or Bread and milk . . . . 150-300 Calories Stewed fruit, custard, or junket, with or without stale sponge cake or plain cookies .... 100-200 Calories FOOD FOR CHILDREN FIVE TO SEVEN 165 A Day's Dietary for a Child Five to Six Years Old Fuel Value: 1608 Calories Cost: 2-2%t per 100 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast: 7: 30 a.m. Baked apple (C, B) . . 1 apple 4-o I 100 Oatmeal (B) .... i cup 4-o 8 50 Milk to drink (A, B) . . I cup 6.4 24 125 Milk for cereal (A, B) . 7 CUp 1.2 5 25 Toast 2 slices 1.0 14 100 Butter (A) | tbsp. 0.2 50 45° 10: 30 A.M. Milk (A, B) .... s cup 5-i 19 100 Soda crackers .... 2 crackers 0.4 5 50 150 Dinner : 12:30 p.m. Split pea soup (B, A) 5 cup 6.0 26 100 Croutons (toasted) . . 27 croutons i-4 14 100 Spinach (A, B, C) . . 1 cup 4.2 4 33 Bread 2 slices i-3 14 100 Butter (A) | tbsp. 0.2 - So Stewed prunes (B) . . 6 small 2.8 2 100 483 Supper: 5:3° pm. Baked potato (C, B) . . 1 medium 3-o II 100 Bread 2 slices i-3. 14 100 Milk (A, B) 1 cup 6.4 24 125 Creamy rice pudding (A, B) | cup 4-4 24 200 525 Total for day . . . .... 209 1608 CHAPTER IX FOOD FOR CHILDREN EIGHT TO TWELVE YEARS OLD By the time most children are eight years old they are established in the school-going habit. Some of the problems of nutrition which arise when they first change from a life of comparative freedom and of much time out of doors to one of restraint and too often, alas, of little fresh air, have been mentioned in the preceding chapter. The years when the rate of growth is most rapid and the digestive tract most sensitive now are past, and errors in diet are followed by less swift retri- bution, so that there is a temptation to relax the vigilant care of the child's food and leave him to his own devices. But this is a great mistake. The period of physical de- velopment in a human being covers nearly a quarter of a century, and the seven-year-old child has climbed less than a third of the hill of growth. We attend to his clothing and shelter - how much more important to see that he has proper food ! Fortunately we now have some communities which maintain (either through public or private agencies), for conserving and developing child health, a school physi- cian for periodic health examinations and general super- 166 FOOD FOR CHILDREN EIGHT TO TWELVE 167 vision, a school nurse to assist the physician and attend to the correction of hampering physical defects, a dentist to care for the teeth, and a nutrition expert to supervise the childrens' food, assist the teachers in giving instruc- tion in regard to food and its relation to health and en- list cooperation of the homes in a good health program. Increase in height of boys from birth to the eighteenth year With increasing care of the pre-school and kindergarten children, there should be less to do in succeeding years, nevertheless children between eight and twelve carry little reserve material in their bodies and their food must literally meal by meal yield liberal amounts of fuel and body-building material if they are to grow rapidly taller without becoming so far underweight as to menace health and future growth. They need to be interested 168 FEEDING THE FAMILY in taking care of themselves and learning to choose their own food intelligently. There is probably no school period in which the returns on such instruction are greater. Weekly weighing and charting of each child's progress have proven a valuable stimulus to effort on the part of many children. Whether food education be carried on in the school or not, it certainly should be in the home. There are now Increase in weight of boys by years from birth to the eighteenth year available many helps for fathers and mothers whereby they may interest and instruct their children in regard to food in addition to training them by precept and example in good eating habits.1 If a child has a per- sistently poor appetite which cannot be cured by plenty of rest and sleep and a suitable feeding schedule, he 1 See Publications of the American Child Health Association, The Bureau of Education, U. S. Department of the Interior, The Chil- dren's Bureau, U. S. Department of Labor. FOOD FOR CHILDREN EIGHT TO TWELVE 169 should have a thorough physical examination to deter- mine the cause. According to the principle already laid down, the comparatively simple diet of the seventh year is to be gradually extended. Only a few well-chosen dishes need be offered at any one meal, but a tendency to Increase in height of girls from birth to the eighteenth year choose a single dish for a meal and refuse everything else should be discouraged. In adult life a well-balanced diet demands more kinds of food than in childhood, when such a variety of elements is supplied by milk alone, and it is a great advantage to have been so trained as to be able to take these in all sorts of forms. Most adults eat in groups and pronounced individual likes and dislikes have great economic and social, if not always physiological, disadvantages. Half the problems of the 170 FEEDING THE FAMILY food provider arise, not from the difficulty of securing wholesome food to make a well-balanced ration, but from the necessity of remembering that Mr. Jones will not touch fish, Mrs. Smith never eats cabbage, and Mr. Brown must always have apple pie for supper I Youth is the time to cultivate respect for all natural foods as a means to physical and mental efficiency, and not merely as ticklers of the palate. Disparaging remarks about Increase in weight of girls by years from birth to the eighteenth year wholesome food should never be permitted, for it must always be borne in mind that eating has psychological as well as physiological aspects, and children are quick to catch the notions of those with whom they associate. If mother plainly turns up her nose at milk and cereals and bread and butter, how can she expect the children to relish them? Most food aversions are acquired in early life when the sensibilities are keenest. An acci- dent at the table with humiliating consequences, an un- FOOD FOR CHILDREN EIGHT TO TWELVE 171 pleasant association of a food with illness, a comparison with something disagreeable, may cause repugnance lasting for years. Such aversions, once acquired, call for patience and tact and may never be completely overcome. It is a part of the feeding problem of child- hood to prevent such misfortunes. Table conversation should deal with topics other than food, and when dis- turbances arise at the table eating should be stopped until tranquillity is restored. Food taken in grief or anger has a poor chance of fulfilling its proper mission. If a child refuses a food really essential to his welfare, hunger will often do more to reestablish his taste for it than commands or threats. New dishes or appeals to the imagination are often helpful in holding children to their proper diet. A glass measuring cup for milk has often inspired interest in the quantity drunk. One mother set her two little children to running " calorie races" when they were below normal weight, with de- cided improvement in the quantity of food taken. It is worth while to take thought as to how to keep chil- dren's attitude toward their food rational. Feeding from the Eighth to the Twelfth Year A quart of milk, continued as the basis of the diet, will give relief from much concern as to whether it is well-balanced or not. Cooked cereals for breakfast should be given the preference, the ready-to-eat varie- ties being reserved for occasional use because the warm, full-flavored porridge is less likely to be tired of. By the eighth year, raw fruits can be used more freely, only 172 FEEDING THE FAMILY the strongly acid ones being forbidden. For the even- ing meal preference should be given to cooked fruits, moderately sweetened. Jellies may be spread lightly on bread now and then, but preserves should be withheld entirely. Dates, figs, and raisins are valuable additions to the diet now. Dates and figs should be thoroughly washed and drained, after which they may be heated in an oven to dry and sterilize them, then cooled and packed in jars for future use. Figs are best stewed in a little water and require no sugar. With cream, they make an acceptable dessert. Raisins should always be cooked. They may be simply stewed and served as a sauce, or used to vary the flavor of other fruits, especially of dried peaches and apricots, added to bread, rice, and other cereal puddings, or baked in raisin bread. Their high fuel value, rich ash content, and sweet flavor make them very valuable in children's dietaries. Dates are often used to vary the appearance of the breakfast cereal, being cut up and stirred in a few minutes before serving. They can also be used in puddings and bread like raisins, and make a popular sandwich filling. The child may now be expected to eat any mild, thor- oughly cooked, green vegetable, and one should be pro- vided, if possible, every day. Pains should be taken to cook vegetables so as to develop their best flavor, much of their unpopularity being due to bad cooking. Chil- dren's sense of taste is keen in the early school years. Raw vegetables should now be made a regular part of the diet, beginning with a little tender lettuce, or cabbage very finely shredded, or grated carrot. A little Always Hungry FOOD FOR CHILDREN EIGHT TO TWELVE 173 orange juice makes a good dressing for such a "salad." A little later finely cut celery, apple, and other fruits can be added. The habit of eating some crisp raw vegetable daily is a good one to establish, but care must be taken to see that such food is properly masticated; and highly seasoned salad dressings of all kinds should be absolutely avoided. By the time a child is eight or nine years old, meat may be more regularly introduced into the diet. It should not be allowed to displace milk, but used to supplement it. Lean beef, mutton, lamb, chicken, lean fish, such as halibut and cod, or oysters are most suitable for this period. Fat meats or meats cooked in fat or served with rich gravies or sauces should be avoided, a too difficult of digestion. Only a small portion (not over an ounce) should be allowed and that not oftener than once a day. Children are generally fond of sweets but their im- portance is commonly exaggerated. Children in whom the taste for sugar has not been cultivated do not ex- hibit a marked craving for sweets. They may even object, like a fine big boy of eight who took exception to a mid-morning lunch of zwieback of a common sweetened variety, complaining, "It's too sweet! It's too sweet!" In any case sweets should never be given between meals. Not only candy, but the delectables of the soda fountain and ice cream parlor, are out of place for anybody except at the end of a regular meal, and even then are not desirable for children. The less they know about such sweets the better. 174 FEEDING THE FAMILY Sugar is a valuable fuel food, but with its high flavor and rapid diffusibility it is likely to satisfy the appetite before body needs are really met, if given at the begin- ning of a meal; and it is not only likely to disturb the normal appetite, but seriously to upset digestion if taken between meals; while in large quantities at any time it irritates the stomach and displaces foods which serve for building material as well as fuel. Candy is too con- centrated to be an ideal food. If greatly desired a very small amount may be given at the end of a meal, when it will be diluted by the other food and do no particular harm. Only plain candies made from pure ingredients should ever be allowed. Rich confections from choco- late and nuts are too difficult of digestion. Plain sweet chocolate is a good substitute for candy if used in small amounts and if it does not keep the child awake at night, and so are the sweet fresh and dried fruits. Gingerbread and plain cookies also satisfy the taste for sweets, and ice creams and ices can be used now and then for the same purpose. Nuts are not easy to masticate, and on account of their high fat content are rather slow of digestion. Hence they do not enter into the dietary of little children, and cannot be freely permitted even during this period. When ground to a paste, however, the first objection is removed and peanut and other nut butters are an accept- able addition at this time. No fried food, pastries, tea or coffee, rich sauces, or meat salads with mayonnaise dressing should ever be permitted. Three regular meals a day will now suffice for many FOOD FOR CHILDREN EIGHT TO TWELVE 175 children, but if breakfast is light or the child is very hungry between meals, a simple mid-morning or mid- afternoon luncheon may still be provided. It should not be given if it interferes with zest for the regular meals, and it should never be sweet, so as to tempt the child to eat when not really hungry. Dry bread, crack- ers, or milk are best. Mild fresh fruits are allowable if the child is well and strong. This extra mid-morning or mid-afternoon lunch is often served at school, where it generally consists of a half pint of milk and a cracker or two. Orange juice has been found a beneficial school lunch in an orange-growing district. Such feeding should not supplant the home breakfast or noonday meal, but it may be a valuable supplement to either of these. It is particularly valuable for the children in the early years of school life, and is often a great aid in bringing underweight children into better condition. Teachers report not merely gains in weight but better behavior and better school progress after the institution of milk feeding. Incidentally, it is of value in teaching children to drink milk. The desire to do like the rest overcomes prejudices which may fill the child's whole horizon at home. Dinner should be served at noon rather than at night, to insure early and peaceful slumber. Many children have to take the noon meal at school, however; in the country because they live too far away to go home at noon; in the city among the poor because the mother goes away to work and there is no one to prepare a noon meal, or among the well-to-do because the single school 176 FEEDING THE FAMILY session often extends beyond what should be the dinner hour. The luncheon of the school child, therefore, de- serves special consideration. Where the school au- thorities give it no attention, the children usually take their food from home. In this case they lose the ad- vantage of warm food in promoting easy and rapid di- gestion, and their minds are not so clear for the after- noon work. They are also more likely to bolt their food when not eating at a table with other people. If then a lunch box must be carried from home, special thought should be given to the selection of food, so that it may be suitable in kind and amount, and appetizing when the box is opened. Three or four kinds of food are quite enough to provide at a time, for at best the busy house- wife usually finds her wits taxed to furnish wholesome lunches with much variety. PLAN FOR THE SCHOOL LUNCH BOX i. Sandwiches are the great staple, easily portable and generally liked. The bread should never be less than twenty-four hours old, lightly buttered and filled with finely chopped boiled eggs carefully but mildly seasoned; a nut paste, such as peanut butter, preferably softened by working in a little milk or cream; a dried fruit paste, made of chopped dates, figs, or raisins, or a mixture of these. For the older children, chopped meat, cheese of various kinds and especially cottage cheese, and jellies are also desirable. Sandwiches of raisin or date bread without other filling than butter will help to give variety. FOOD FOR CHILDREN EIGHT TO TWELVE 177 2. Fruit is appetizing and carries well. Its succulent qualities make it especially acceptable with the rather dry sandwich. Not only fresh ripe fruit, but also apple sauce, stewed raisins, figs, pears, peaches, etc., can often be carried by a little forethought in securing small jars with tight-fitting covers. Paper cups designed for jelly with close-fitting tops are practicable for this purpose. Ripe tomatoes are juicy enough to take the place of other fruit for the older children and their richness in vitamins makes them as valuable as oranges. 3. A sweet of some kind should be included, such as plain cookies of various sorts, gingerbread or sponge cake, baked custard, a piece of sweet chocolate, or a few dates rolled in sugar. 4. Some fluid to drink with the meal aids digestion and should always be taken. Water will serve, of course, but milk will add to the food value and so will fruit juices, if they can be carried. Plenty of waxed paper to wrap the different kinds of food and keep them from flavoring each other should be kept on hand; this is one of the big secrets of a tasty lunch box. At its best, however, the lunch box must be regarded as a makeshift. A regular school luncheon, shared by teachers and pupils, has tremendous advantages. If only one hot dish - perhaps soup or cocoa - can be provided at school to supplement what the children bring from home, it draws the pupils together socially, so that the meal is taken in a more orderly fashion, and experience in hundreds of rural schools shows that it 178 FEEDING THE FAMILY results in improved physical condition of teachers and pupils. When they leave home early in the morning, travel a considerable distance in the cold, and return only in time for supper, the cold food carried in their boxes would often be really insufficient for their body needs, even if it were in the best form. Recent studies of rural conditions have shown that country children tend more than city children to be below par physically; and this is certainly not because country life does not offer opportunity for good development, but because country dwellers often fail to realize that they must take advantage of the fresh air and wholesome food which are theirs to command. The realization of what good feeding means for physical and mental develop- ment results not only in careful provision of food for the meals at home, but cooperation with school authorities in securing protection from bad feeding at the noon hour. In many of our large cities and industrial centers the elementary school luncheon has long since passed the experimental stage and is regarded as a valuable part of the school training as well as a safeguard for the health of the child. Very often the pioneer work has been done by women's clubs or philanthropic organiza- tions which have assumed the task of demonstrating to school authorities the practicability and value of such feeding. The expensive machinery of education is wasted when it operates on a mind listless from hunger or befogged by indigestible food. Whether the cause be poverty, ignorance, or carelessness, the child is the sufferer, and the painstaking work of the school lunch FOOD FOR CHILDREN EIGHT TO TWELVE 179 supervisors to secure wholesome and adequate noon meals for the school children at a minimum cost not only brings immediate benefit to the children, but exerts a widespread influence upon homes and parents, as the children carry to them reports of these concrete lessons in the science of proper selection, preparation, and hygiene of food. All school lunch work should be con- sidered educational and should be an important factor in reducing malnutrition. The school luncheon must be simple, easily served, and economical. It may consist of a hot dish, with some form of bread, and a choice of about two other dishes; milk or cocoa should always be obtainable. In the New York City Elementary Schools the food is cooked in central kitchens and distributed by auto trucks to the different schools, where it is served by pupils of the cooking classes or by those appointed by the prin- cipal in schools having no cooking. "Milk is the food around which menus are built" says a recent report of this work.1 " Each day it is introduced by means of a cream soup or a milk dessert. Graham or whole wheat bread is always used, except when the crumbs of dried white bread are needed for a certain recipe. . . . Vege- tables, cereals and fruits make up the balance of foods served." A sample week's menu is given on next page. 1 School Lunches, New York City Elementary Schools, 1923. This contains the recipes of the dishes used in the lunches. For further suggestions regarding school luncheons see School Lunches, Farmers' Bulletin No. 712, U. S. Department of Agriculture, and The Lunch Hour at School, Bureau of Education, U. S. Department of the Interior. 180 FEEDING THE FAMILY MENU Calories per Monday: Serving *Cocoa 268 Graham bread and butter sandwich 130 Fresh fruit - two kinds ] Stewed fruit-1 kind ) ^rage portion 9S Tuesday: Lima beans and barley soup 177 Buttered roll (white) 275 *Stewed tomatoes, thickened with bread crumbs 50 Chocolate cornstarch pudding 235 Wednesday: Cocoa 268 *Lima beans with tomato sauce 125 Buttered graham roll 250 Baked apple, or fresh fruit, average portion 95 Thursday: Vegetable soup with barley 185 *Baked beans 182 Rye bread and butter sandwich 250 Rice custard 165 Friday: Cream of Lima bean soup 172 Peanut butter sandwich 250 Scalloped corn 85 Gingerbread or molasses cookies 208 All dishes marked * cost two cents; all others three cents. In addition to the regular menu there are offered daily for 1 cent each: 1 glass of whole milk (124 Calories) 1 bar sweetened chocolate or 1 wrapped stick of candy (125 Calories) 1 sweetened cracker 1 2 to 4 sweetened crackers j 1 0 a ories A study of the food actually purchased by the children shows that the average tray carries about 1150 Calories. If the noon meal is served at home, it may be somewhat more elaborate, provided the child has time to eat it in a leisurely fashion. When he has to hurry back to school this fact must be taken into account, and no extra tax FOOD FOR CHILDREN EIGHT TO TWELVE 181 put on his digestive powers. The food plan following will show the general type of food to be chosen. If a warm, substantial dinner is served at noon, the evening meal may be comparatively simple, especially through the tenth year, as also indicated in the food plan below. Children of eleven and twelve will relish a night meal about as substantial as the noon meal, though they will be perfectly nourished with the simpler supper. If the noon meal has been a cold or light lunch, then the dinner may be given at night. In any case, the evening meal should be served by six o'clock, so as not to interfere with an early bedtime. A healthy child of eight years may be anywhere from 43 to 51 inches in height and weigh from 39 to 75 pounds, and in later years even more individual variation is possible.1 The energy requirement will vary, not only with the body weight, but with the degree of physical activity, and boys with their higher muscular tension and tendency to vigorous sport will usually demand somewhat more food than girls of corresponding size; hence an absolute standard cannot be set. The following figures, however, deduced from the observations of many persons on the food needs of school children, will serve as a general guide as to suitable amounts of food to provide. Age in Years Protein Calories per Pound Total Calories per Pound 8-9 10-12 3-4 32-35 30-34 1 See Appendix, Tables VII and VIII. 182 FEEDING THE FAMILY A Day's Food Plan for a Child Eight to Ten Years Old Fuel Requirement: 1700-2000 Calories Cost: if-2|fS per 100 Calories Breakfast : Mild fruit, raw, stewed, or baked . 50-100 Calories 7-7:30 A.M. Well-cooked cereal 75-100 Calories Dry toast or stale bread .... 50-100 Calories Butter 5O-75 Calories Milk, plain or flavored with cocoa . 100-150 Calories Dinner : Soft cooked egg or very small 12-12: 30 p.m. portion of baked or broiled fish, lamb, chicken, or bacon . . . 50-75 Calories Potatoes or Rice or Baked banana 75-100 Calories Spinach, carrots, onions, or other mild vegetable, simply cooked . 10-25 Calories Milk (may be combined with vege- table in soup) 100-150 Calories Bread 75-100 Calories Butter or jelly 50-100 Calories A little shredded raw cabbage or other crisp salad vegetable with fruit juice or salt Calories negligible Bread, rice or other nutritious pudding or Stewed fruit, with cookies 150-200 Calories Supper : Cream soup 5 : 30-6 p.m. or Milk toast or Scalloped vegetable or Baked potato with milk to drink 200-300 Calories Bread 50-100 Calories Nutritious pudding or stewed fruit, as figs, raisins, dates, apples . . 100-200 Calories FOOD FOR CHILDREN EIGHT TO TWELVE 183 Fuel Value: 1783 Calories A Day's Dietary for a Child Eight Years Old Measure Weight Oz. Protein Calories Total Calories Breakfast : 7-7: 30 a.m. Orange (large) (C, B, A) J orange 4-7 3 50 Oatmeal (B) .... I cup 6.0 12 75 Cream, thin (A, B) . . 2 tbsp. 0.9 2 50 Milk (A, B) 5 cup 6.8 25 133 Toast 1 slice o-5 7 50 Butter (A) 2 tsp. o-3 - 66 424 Dinner : 12 : 30 p.m. Egg timbale (A, B) . . 2 cup 5-6 32 125 Baked potato (C, B) . . 1 medium 3-o II 100 Asparagus tips (B, A) 5 stalks 1.9 2 11 Bread 2 slices 1-3 14 100 Butter (A) 2 tsp. 0-3 - 66 Peanut butter (B, A). . if tsp. 0.4 12 66 Stewed pears (B) . . . i cup 4-0 I 100 Sugar cookies .... 2 cookies o-9 6 100 Milk (A, B) t cup 6.8 25 133 801 Supper: 5:30-6 p.m. Cream of bean soup (B) . 4 cup 3-9 22 150 Bread sticks Cornstarch blancmange 12 sticks 0.4 10 75 (A, B) J cup 5-4 18 200 Milk (A, B) 5 cup 6.8 25 i33 558 Total for day . . . 227 1783 Cost: if-2j^ per 100 Calories 184 FEEDING THE FAMILY Fuel Value: 2000 Calories A Day's Dietary for a Child Ten Years Old Cost: per 100 Calories Measure Weight Oz. Protein Calories Total J Calories Breakfast : Orange (C, B, A) . . . . i large 9-5 7 IOO Flaked wheat (B) . . . i cup 6.o 13 100 Top milk (io oz.). (A, B) . i cup 2.1 9 IOO Milk (A, B) 1 cup 6.4 24 125 Toast 2 slices 1.0 14 IOO Butter (A) | tbsp. o-3 - 50 ' 575 Dinner : Hamburg steak .... i ball i-3 4i 75 Baked sweet potato (A, B) i potato 4-5 9 150 Bread 2 slices i-3 14 IOO Butter (A) Creamed peas and carrots i tbsp. o-5 - IOO (A, B, C) Shredded lettuce with a cup 5-o 14 75 orange juice (C, B, A) . Bread pudding (with 2 leaves 0.4 - - raisins) (A, B) . . . . i cup 6.o 18 200 Milk (A, B) 1 cup 6.4 24 125 825 Supper: Potato soup (A, B, C) . . t cup 6-3 22 150 Saltines 6 crackers o.8 IO IOO Whole wheat bread (B) 2 slices 1.4 l6 IOO Butter (A) i tbsp. o-3 - 50 Stewed apples (B, C) . . 1 cup 5-o I IOO Molasses cookies .... 6 very small 0-7 6 IOO 600 Total for day . . . 242 2000 CHAPTER X FOOD IN ADOLESCENCE AND YOUTH During adolescence development is again in some respects very rapid; boys grow suddenly tall and have the task of covering their long body frames with muscle; girls grow less fast, usually, but must meet demands for more blood, and take on the supply of muscle and fat which gives them the contours of womanhood. In- adequate and unsuitable food at this time hinders normal development just as truly as in infancy, and many a healthy child fails to make the strong man or woman of which he gave promise because of malnutrition in these critical times. Careful training from birth will, of course, help a great deal in tiding over the adolescent years, but in the storm and stress of the period certain vagaries of appetite may develop, such as the desire on the part of girls to avoid all plain food and live on sweets or other highly flavored food; the insistent craving for food on the part of boys, that leads to the consumption of unduly large quantities at one time, - so that wise guidance in feeding is still essential. In addition to keeping out of the menu dishes which are decidedly difficult of digestion, or limiting them to occasional use under the most favor- 185 186 FEEDING THE FAMILY able circumstances for taking care of them, there should be such supervision of the food eaten that drifting into the habit of a very one-sided or insufficient diet is im- possible. The drinking of milk should be encouraged, and tea and coffee absolutely forbidden. Cocoa or cereal coffee in which milk and not water is the foundation fluid provide an acceptable warm drink for breakfast or supper. Cereals for breakfast are perhaps accepted more unquestioningly by boys with their keener appe- tites than by girls, but their use by both should be per- sistently encouraged. The addition of dates or of chopped nuts often increases their attractiveness. For girls of small appetite, toast made from whole wheat or graham bread, served with hot milk or cream, may take the place of the porridge. Fruit, fortunately, is usually well liked, and while this may be an expensive item in the diet, it is too important a source of body building and regulating material to be neglected. People who will buy porterhouse steak and lamb chops for themselves should not begrudge money for fresh fruit in the diet of their children. Those who must economize closely will have to depend more upon dried and less upon fresh fruit, except as the latter can be obtained cheaply in the height of the season. In the country, of course, fruit may be canned and so saved for use when out of season. Green vegetables should be used as freely as possible, especially in the dietary of growing girls who need a rich supply of iron and A vitamin. Salads are usually popular if daintily prepared, and become a very Food Material Weight (oz.) Measure Food Material Weight (oz.) i Measure I. Saltines o.8 6 saltines 6. Tomato and cucumber salad 2.0 Very small serving 2. Soda crackers 0.9 4 crackers 7- Chicken salad r.6 Very small serving 3. Mayonnaise dressing 0.5 i tablespoon 8. Cheese straws o.8 2 j straws 4. French dressing o.6 i} tablespoon 9- Graham crackers 0.8 3 crackers 5- Fruit salad 1-5 Very small serving ioo-Calorie Portions of Salads and Salad Accessories 1 1 Cf. Appendix, Tables I and III. FOOD IN ADOLESCENCE AND YOUTH 187 useful part of the high school girl's menu. They should consist of crisp fresh or cooked vegetables, fresh fruit, or eggs, served with a simple cream or oil dressing with- out high seasoning. Strong condiments have no place in the dietary of youth, and rich salads of meat or fish with a heavy load of mayonnaise dressing are a severe tax even on the sturdy adult stomach. Although cooked vegetables seem more substantial to voracious boys, they should be taught the value of lettuce, celery, and the like, as sources of ash and vitamins. Meat should be provided in moderate amounts, two to four ounces a day. It is generally liked, and if wisely used, adds to the palatability of an otherwise adequate diet. As an addition to the protein content of the diet, cheese may be used in such dishes as cheese fondue, macaroni or hominy baked with cheese, combinations of rice, cheese, and tomatoes, or as a filling for sandwiches. These are good meat substitutes, and much less expen- sive than meat. A variety of breadstuffs will increase the attractive- ness of the menu and help to keep up the fuel value of the diet without great expense. The use of different kinds of flour; the incorporation into the loaf not only of the raisins and dates already mentioned, but now of nuts, especially walnuts or filberts; the sprinkling of cinna- mon and sugar over the top of the loaf, - are some of the ways of varying this staple food. Warm breads of all kinds should be used sparingly, if at all. When provided, they should be so baked as to have plenty of crust and a little soft center, and served for breakfast or 188 FEEDING THE FAMILY luncheon rather than the evening meal. Rolls made from raised dough should be baked with a crisp crust and served cold or reheated on the second day. Small graham or cornmeal muffins, or cornbread or muffin batter baked in a thin sheet, are permissible occasionally, and so is Boston brown bread if served cold. Griddle- cakes, waffles, and baking powder biscuit should not appear in the dietary of the child under fourteen and very seldom after that. The habit of eating syrups on hot breads should not be fostered. The temptation to use them to excess is difficult to control, and the appetite for more wholesome food is vitiated. In no case should a hot soft bread constitute the main dish at a meal. On those rare occasions when waffles or griddlecakes are provided, they should follow a cereal or some other plain substantial dish. This insures a smaller consumption of the indigestible food and protects the body by that much. Bread and cereal puddings, custards, and blancmanges are still the most desirable forms of dessert, since they combine high food value with ease of digestion. They are particularly useful in the dietary of boys whose demand for food is so great as to tax their stomach capa- city severely. It is possible to overstrain the stomach muscles by too great distention and thus lay the foun- dation for gastric trouble when the nervous strains of middle life begin to be felt. For hearty boys a fairly concentrated diet is therefore desirable, and large volumes of fluid should not be permitted with meals. Desserts like baked Indian meal or poor man's pudding, FOOD IN ADOLESCENCE AND YOUTH 189 where milk is concentrated with the cereal in baking, are ideal for growing boys. Pastry should be used very sparingly. Custard or prune pie, having but one crust and conveying valuable milk, eggs, and fruit, with the minimum of pie crust, are examples of the best kinds of pie. Cake if provided should be served as a dessert and should never be rich. Cookies, sponge or plain cup cake are the best types. These can be varied by chocolate, nuts, or raisins very easily. Regularity of meals becomes increasingly difficult to secure, but needs to be emphasized as much as ever. Three regular meals a day should be sufficient, but for the rapidly growing child of keen appetite it is often wise to provide access to some very plain food, such as bread, crackers, or milk, between meals. Girls, especially of high school age, frequently wish to omit breakfast, but they should not be permitted to go to school with- out any food. "Nerves" are often the direct result of undernutrition, and in this period the welfare of the woman's nervous system is largely determined. Many high school children do not go home for the noon meal. In fact, the custom of providing meals at school began in America with the high school, and most city schools have lunch rooms. Sometimes these are let by contract and there is no skilled supervision of the food supply. But with the spread of the carefully supervised elemen- tary school luncheon attention has been directed to the real needs of the high school youth and the opportunities for education in good eating habits. An interesting attempt to help the pupil to choose wisely is shown in 190 FEEDING THE FAMILY the Menu Bulletin of the Julia Richman High School in New York City.1 Julia Richman High School LUNCH SERVICE Menu Bulletin No. 37 N.B. You require 800 balanced Calories for lunch. Purchase the items which give you this quantity. „ Calories Price Soup: Split pea, bread and butter 310 $0.05 Hot dish: Veal stew with vegetables, bread and butter . . . 350 .10 Vegetables: Lima beans 125 .03 Sandwiches: Date, nut on graham bread 245 .04 Chopped egg 200 .04 Desserts: Raisin layer cake 300 .05 Horton's ice cream 200 .05 Bread pudding, chocolate sauce 275 .04 Baked apple and cream 120 .03 Apple 50 .01 Crackers: Cecilias 100 3 for .01 Fireside peanut jumbles no 2 for .01 Candy: Sweet milk chocolate, large bars 500 .05 Almond bars 600 .05 Assorted penny candy 100 .01 1 The School Lunch Service, Department of Education, The City of New York. Division of Reference and Research. Bulletin No. 3, 1914. Hot dish: Desserts: Crackers: FOOD IN ADOLESCENCE AND YOUTH 191 Beverages: Milk 140 .03 Cocoa no .03 Breads: White or graham, with butter 185 .02 "The result of the educational work done here is clearly demonstrated in the change of demand for food. The first few days of the service, the candy and pastry tables were the chief points of purchase, more than half the receipts coming from that source. About 30 bowls of soup were sold and 15 to 20 other hot dishes. Within four weeks from the commencement of the service we were selling an average of 80 to 90 bowls of soup and 40 to 60 other hot dishes." The high school luncheon will usually offer a greater variety of foods than the elementary school meal, but these should always be presented with the fact in mind that the young people are going back to brain work, and heavy dishes are out of place. The daily menu list may well include such dishes as the following: 1. Soup, as tomato, green pea, split pea, white and black bean. 2. Two or three hot dishes, as spaghetti with tomato sauce, mashed potatoes with green peas, baked beans, corn pudding, a stew with vegetables or a hot roast beef sandwich. 3. Salads, as potato, egg, fruit, or green vegetable. 4. Sandwiches, one or two varieties each day. 5. Fruit, as apples, bananas, stewed fruits of various kinds. 6. Milk and cocoa. 7. Plain cake or sweet wafers offered only in combination with milk or other plain food. 8. Ice cream, charlotte russe, simple baked pudding, sweet chocolate. The evening meal needs to be more substantial than for the younger children. In the city this will be the time for the regular dinner; in the country it is more likely to be supper. Here we must guard against ex- 192 FEEDING THE FAMILY tremes - too heavy a meal on the one hand and too light on the other. Supper should include one substan- tial warm dish as a rule. This may be a thick soup, as suggested for the younger children, macaroni and cheese, a stew or chowder, or a loaf of beans or lentils with a cream or tomato sauce. This with plenty of bread and butter, some stewed fruit and cookies, or a wholesome pudding, and milk to drink will make a sufficiently nourishing repast. Suggestions for dinner are given on the food plan below. The energy requirements of this period are approxi- mately : Age in Years Protein Calories per Pound Total Calories per Pound 12-13 3 27-34 14-17 3 22-30 This means that the total daily requirement for girls from fourteen to seventeen will be from 2200 to 2600 calories; for boys of the same age from 2800 to 4000 calories. Very often by this time the full height will have been attained and the parents are surprised at the large consumption of food, thinking that growth has ceased. But growth is not merely a question of height. As already said, it involves laying on of muscle and fat, development of internal organs and a vigorous nervous system, and these demand food. Furthermore, muscular activity, especially out of doors, is a great aid in muscle and nerve development, and the extra fuel required to FOOD IN ADOLESCENCE AND YOUTH 193 support this activity should never be begrudged young people. For five or ten years after full height is reached their food consumption will be considerably higher than that of adults of the same size. As long as they confine themselves to simple, nourishing foods they are not likely to overeat. Sometimes their expenditures in growth and activity exceed their assimilative powers. Especially is this true of those who grow very tall with great rapidity and indulge freely in active sports and dancing. To leave a balance in favor of the body it may be for a time necessary to curtail the activity some- what - to insist on longer hours for rest and less violent exercise until substantial gains in weight and other signs of physical welfare show that the energy demands are not greater than the energy supply. A Day's Food Plan - Age Fourteen to Sixteen Years Fuel Requirement: 2200-4000 Calories Cost: 15-2! per 100 Calories Breakfast : Fruit 50-100 Calories Cereal 100-250 Calories Milk 200-300 Calories Bread 100-300 Calories Butter 100-200 Calories 600-1000 Calories Luncheon: Macaroni and cheese or Hot roast beef sandwich or Bean soup and crackers . . . 200-300 Calories Cocoa or milk 150-250 Calories Bread 100-300 Calories Butter 100-300 Calories FEEDING THE FAMILY 194 Luncheon - Continued: Baked custard or Rice pudding or Baked apple 150-300 Calories Dinner: 700-1200 Calories Meat or Bean or lentil loaf and potatoes or Scalloped eggs . 200-300 Calories Potatoes or Macaroni or Rice or Baked banana 100-200 Calories Green vegetable, cooked 25-150 Calories Fresh fruit or vegetable salad . . . 100-200 Calories Bread 100-300 Calories Butter 100-300 Calories Ice cream or Tapioca cream or Charlotte russe 150-300 Calories Milk or cereal cafe au lait 150-250 Calories 900-1500 Calories FOOD IN ADOLESCENCE AND YOUTH 195 A Day's Dietary for a Boy Aged Sixteen Years Fuel Value: 3840 Calories Cost: 13-2^ per 100 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast: Banana (B, C) .... i large 5-5 5 100 Oatmeal (B) . . . . . 2 cups 15-8 34 200 Milk (A, B) 11 cups 12.7 48 250 Cornmeal muffins (B) . . 2 small muffins 3-2 36 275 Butter (A) i tbsp. o-5 - 100 Sugar i tbsp. (scant) o-5 - 50 Luncheon : 975 Macaroni and cheese (A, B) i cup 4.2 34 200 Graham bread (B) . . . 3 slices 1.4 14 100 Butter (A) i tbsp. o-5 100 Cocoa II (A, B)1. . . . t cup 7.6 32 200 Stewed rhubarb (C, B) . . 1 cup 2-5 1 150 Gingerbread 11 .... 2 small pieces 2.2 14 200 Afternoon Lunch : 950 Graham bread (B) . . . 3 slices 1.4 14 100 Butter (A) i tbsp. o-5 100 200 400 Dinner : Swiss steak 2 slices 2.2 70 200 Mashed potatoes (C, B) I cup 6.2 14 200 Stewed tomatoes (C, B, A) f cup 6.7 9 120 Cole slaw (C, B, A) . . . t cup 2.1 5 75 Bread 4 slices 2.7 28 200 Butter (A) . 2 tbsp. 1.0 - 200 Brown Betty (B, C) . . . i cup 6.i 9 3°O Milk (A, B) i cup 8.4 34 170 Sugar i tbsp. o-5 - 50 1515 Total for day .... 401 3840 1 See Table III, Appendix, pp. 338 and 400. 196 FEEDING THE FAMILY A Day's Dietary for a Girl Aged Sixteen Years Fuel Value: 2350 Calories Cost: 2-2%$. per 100 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast : Orange (C, B, A) . . . . I large 4-7 3 5° Oatmeal (B) i cup 7-9 17 100 Top milk (12 oz.) (A, B) . s cup 3-o IO ICO Whole milk (A, B) . . . t cup 5-i iQ 100 Toast 2 slices 1.0 14 100 Butter (A) i tbsp. o-S I 100 Sugar i tbsp. (scant) i cup 0-5 - 50 Cereal coffee - - 600 Luncheon: Com chowder s cup 6.6 24 200 Date and cheese sandwich . 3 triangles 3in.X3iin. X 4 in. 3-0 27 29O Cocoa 11 with whipped cream (A, B) . . . . t cup 7-o 16 155 Baked apple (B, C) . . . i small 3-2 i I40 785 Dinner: Broiled Hamburg steak i large cake 2.6 82 *5° Brown sauce 3 tbsp. i-7 7 50 Baked potatoes (C, B) . . i medium 3° 11 100 Stuffed peppers1 . . . . i small 2.6 9 50 Banana salad (A, B, C) i serving 3° 13 IIO French rolls 2 small 1.9 18 150 Butter (A) i tbsp. o-5 - 100 Washington pie (A, B) . . piece 3 in. X3 in.Xi in. 2.1 21 200 Cereal coffee (J milk) . . i cup 8.0 5 25 Sugar 2 tsp. o-3 - 3° 965 Total for day .... 298 2350 1 See Table III, Appendix, pp. 388 and 454 FOOD IN ADOLESCENCE AND YOUTH 197 Food for Boys and Girls from the Seventeenth to the Twenty-fifth Year "A little thought, a little self-control, and then forget that there is such a thing as digestion." By the end of the sixteenth year good habits in eating ought to be well established, and the digestive system should be strong enough to care for all reasonably whole- some food, if offered at suitable times. The food require- ments of the next few years depend very largely upon the nature of the youth's occupation. Up to this time the majority have been held in school by choice or law, but now some engage in vigorous muscular labor, some go into sedentary trades, and some continue to go to school. Nearly all continue to increase in body weight, and many in height, for four or five years, if not longer. The pro- cesses initiated, sometimes with such vigor, in the period of adolescence are now more slowly completed. Muscle is added, internal organs perfect their structure, the nerv- ous system grows stronger, and that fine working ma- chine - the adult man or woman - comes upon the scene. The influence of active and sedentary life upon the choice of food has already been discussed in the chap- ters dealing with the adult man and woman. The active youth engaged in outdoor labor can thrive on the simple rations of pork and beans, cabbage and potatoes, corn bread, milk, and apple pie, provided they are suffi- cient in amounts to cover his fuel needs and in such pro- portions as to insure adequate protein, ash constituents, 198 FEEDING THE FAMILY and vitamins. Outdoor life and fresh air are sauce to his appetite and tonic to his digestion. On the other hand, the young bank clerk, sitting in a hot, close room, with no more exercise than a short walk or two, would find his brain utterly befogged by such a diet because conditions are not favorable for digesting it. He must have the simple fare of the sedentary man, in quantities not exceeding his daily needs, and daintily prepared, since his living conditions foster neither keen appetite nor vigorous digestion. Girls at sedentary occupations are more liable to suffer from the blunting effect on appe- tite than boys, and are tempted to eat foods of high flavor, like pickles and candy, with little regard to after- effects. But the simple, nourishing food already sug- gested for sixteen-year-old girls and sedentary women indicates the type of diet which they should have. Young people entering the commercial world are fre- quently confronted with the luncheon problem. If they take food from home, there must be careful selection, just as in the case of the school child, and a warm bever- age should be added if possible. More and more are factories and other commercial concerns realizing the relationship between good feeding and efficiency in their employees, and establishing their own lunch rooms, with experts in charge to provide good food at a moderate price. Very often, however, the boy or girl must patron- ize some public restaurant, and here we have as yet little guarantee as to quality of food and no guidance as to what to choose. Those lunch rooms which provide plain, clean food under sanitary conditions, but without FOOD IN ADOLESCENCE AND YOUTH 199 expensive frills in the way of table decoration and service, are doing a real service to the young man and woman of small means forced to lunch away from home. But the individual must still decide for himself what shall con- stitute his meal. A serving of wheat cakes and maple syrup will give approximately the same fuel value as one of milk crackers and milk, but the latter is much less liable to cause digestive disturbances and is richer in building material for the still growing organism. Simi- larly, a serving of baked macaroni and cheese, with its accompanying bread and butter, as the main part of the luncheon would be preferable to one of mince pie, though the cost of calories may be the same. While the importance of fruit and vegetables is not to be lost sight of their purchase as a part of a restaurant meal is not always good economy. The cost of an orange in a restaurant is not only the purchase price of the fruit, but a necessary charge for service, for rent and all the other things that go into "overhead" in a business. Now a boy or girl, if living at home can usually purchase fruit himself outside at less cost, and make it a part of the home meal. The same is true of raw vegetables and salads. One gets a better return on one's money in a restaurant on the cooked vegetables. And if one can have these at home, it is better economy to stick to potatoes, beans, macaroni, and the like in the restaurant and make up the deficiency of this meal at home later. Most young people need from 750 to 1200 calories for luncheon, the exact amount depending, of course, upon many factors - the kind of breakfast, the size and 200 FEEDING THE FAMILY activity of the individual, and so forth. But even when growth has slowed down to these last stages, the welfare of the young person is usually promoted by three regular meals, each fairly substantial. Some examples of simple luncheons in which the cost of the food materials at retail is from i| to 2j cents per 100 calories are given below. Inexpensive Luncheons I. Cream of tomato soup i cup 225 Calories Toast 2 slices 100 Calories Butter 1 tbsp. 100 Calories Rice pudding 5 cup 325 Calories 750 Calories II. Potato soup 1 cup 200 Calories Croutons 15 cubes 50 Calories Cornmeal and raisin pud- ding 3 cup 300 Calories Sugar cookies 2 large 200 Calories 750 Calories III. Bean soup 1J cups 150 Calories Corn bread 2 in. X 4 in. X 4 in. 200 Calories Butter 1 tbsp. 100 Calories Chocolate blancmange | cup 200 Calories with cream (thin) | cup 100 Calories 750 Calories IV. Cheese and nut sand- wiches 2 large 415 Calories Dates 10 200 Calories Buttermilk i| cups 135 Calories 750 Calories V. Milk 1 cup 175 Calories Date sandwiches 2 large 375 Calories Sliced orange (1) and banana (1) with 175 Calories Sugar 5 tbsp. 25 Colories 750 Calories FOOD IN ADOLESCENCE AND YOUTH 201 VI. Grape nuts 75 tbsp. 250 Calories Sugar 2 tbsp. 100 Calories Milk 11 cups 300 Calories Banana 1 large 100 Calories Salted peanuts 12 nuts 50 Calories 800 Calories VII. Macaroni and cheese 1 cup 200 Calories Lettuce salad, French dressing small serving 100 Calories Graham bread 2 slices 100 Calories Butter 1 tbsp. 100 Calories Gingerbread 2 in. X 2 in. X 2 in. 200 Calories Whipped cream 2 tbsp. 100 Calories 800 Calories VIII. Nut loaf, tomato sauce 2 cup 200 Calories Graham muffins 2 small 200 Calories Butter 1 tbsp. 100 Calories Lemon milk sherbet t cup 300 Calories 800 Calories IX. Creamed dried beef J cup 175 Calories Baked potato 1 large 150 Calories Baking powder biscuit 3 small 125 Calories Butter 2 tbsp. 200 Calories Sliced banana (1) with sugar (1 tsp.) and thin cream (3 tbsp.) 175 Calories 825 Calories X. Cheese fondue 3 cup 200 Calories Brown bread 3 slices 150 Calories Butter 1 tbsp. 100 Calories Cocoa f cup 200 Calories Rice pudding (creamy) 5 cup 200 Calories Whipped cream 1 tbsp. 50 Calories 900 Calories 202 FEEDING THE FAMILY For the college youth the feeding problem is one of adaptation to a life partly active and partly sedentary, with some allowance of surplus for growth throughout most if not all of the four years. Within the period from the eighteenth to the twenty-third year most young people complete their college education, and this is the time when they should be laying the final stones in that foundation of physical health and strength which is to make their active working years most effective. It is not always realized that these are years for storing capital physically as well as mentally. Too often young people are released from the safe-guarding routine of home life and left to their own devices as regards food in the college community, when their eating ought to be carefully supervised. The existence of the train- ing table shows some recognition of the fact that un- wholesome living and physical fitness are incompatible, and what we need is to extend this idea in a modified form to every student in college - to make every college table a training table for high physical resistance in future years. Many institutions have their own dining halls, where the food can be properly prepared and served; small excuse for these if it is not adequate for the students' needs ! And yet, all too often, the selection is left to some one with no real knowledge of the principles of good feeding, whose work is judged by the size of the bills and not at all by the well-being of the young people. With trained dietitians available, this is no longer ex- cusable. On the other hand, college students do not need expensive and elaborate fare; and even the expert FOOD IN ADOLESCENCE AND YOUTH 203 college dietitian is likely to suffer many and severe criticisms from the members of her group, because of the different standards of living which they bring with them, the bad eating habits which they may have acquired in their own homes, and the utter separation in their minds of the price which they pay for board from the kind of fare that a given sum of money will buy. At one time Mrs. Richards made an investigation of a college dining hall in the University of Chicago where there were com- plaints of the food. The students were asked to make out some bills of fare which would please them, and it was found that to give them what they wished would cost about $10 per week, whereas they were paying $3.50! It is only by education and establishing confidence in the dietitian that such problems can be satisfactorily met. Schools which do not provide dining halls of their own have a responsibility for the kind of eating houses patronized by their students, and should at least be able to warn against those which are unsanitary. Young people of limited means are in danger, if left to them- selves, of economizing on food to the detriment of their health, and will naturally pick out those restaurants where they can seemingly get the most food for the least money. This is perfectly legitimate till we come to the type of eating house which buys adulterated, spoiled, or otherwise inferior food and skimps on dishwashing, refrigerator cleaning, and other necessary sanitary pre- cautions, in order to sell at a low price. From such the college student needs to be strictly guarded. For- 204 FEEDING THE FAMILY tunately the habit of "boarding oneself," which was fairly common half a century ago, is not so prevalent to-day, and students in general are probably better fed. This is as it should be, for it is a sad thing to see a young man or woman of promise break down at thirty-five or forty, unable to stand the strain of existence because of malnutrition in the critical years of development. With proper nutrition and rational division of work, rest, and play, the college student should emerge from his four- year course stronger physically as well as mentally. To achieve this is a part of his education. Specifically, the college youth needs an ample diet of plain food, fairly rich in building materials and "ballast." During periods of more intense study the food should be specially easy of digestion, without being too concen- trated. Such fare as already outlined for the boy and girl of sixteen should in the main be provided. In the institution, one of the great dangers is monotonous routine. A weekly program is made out and followed month after month. This is never advisable, as variety seems to be essential to the appetite of the human being, and the custom is most disastrous for the brain worker, whose less keen appetite makes him more sensitive to monotony. There should be variation from week to week, as well as from day to day, and still more marked variation with the seasons. Milk should be served freely as a beverage, and will often be found to cut down the amount of more expensive food. At any rate, it is food which the young people should be encouraged to take, and may be the means of providing individuals FOOD IN ADOLESCENCE AND YOUTH 205 with high food requirements with a full quota of nourish- ment when the following of the conventional menu would scarcely satisfy them. Fruits and vegetables are sometimes conspicuously lacking in the dietaries for students, partly on account of expense and partly on account of a failure to appre- ciate their value, both on the part of the students and the dining-room managers. The only remedy is knowl- edge of the part which the various vitamins and mineral constituents play in nutrition and a determination to live up to the best practice known to modern science. Fruits and vegetables must be provided, and college boys and girls must have a "will to eat them." If they have been carefully trained in ea^i^from their early years, this will be comparatively easy, but there will be some who need constant encouragement to develop rational eating habits. It is well to bear in mind, too, that nothing interferes with clear thinking more than constipation, and the sed- entary student on a diet chiefly composed of meat and potatoes, eggs, milk, and white bread is particularly liable to this malady. Those who have young people to care for should insist on a food allowance liberal enough to include plenty of fruit and vegetables, and should encourage also the use of whole wheat bread and cereals from whole grains. Advantage may be taken of holidays and other times when physical and outdoor activity is increased to vary the menu by the introduction of some foods which are too slow of digestion for the person at brain work. If 206 FEEDING THE FAMILY afternoons are given over to athletics and little study is done early in the evening, baked beans and brown bread will make an acceptable supper. On a cold Saturday, after hours out of doors, mince pie or suet pudding will be a satisfying dessert. But no student should be set to his evening task on a meal of hot biscuits and honey or molasses. To satisfy his youthful needs for energy he will have to eat more of them than will be good for his digestion. A thick soup, and a cereal pudding with fruit, along with plenty of bread and butter, will fulfill his requirements much better. The food of growing children and youth is relatively more expensive than that for adults, because of their higher expenditure of energy in proportion to size and the greater need for building materials and vitamins, which are more costly than simple fuel. While we in- sist on economy in the use of food materials, it must be a wise economy avoiding waste, but recognizing the necessity of an adequate food supply, even through the college years. If rigid economy must be practiced, let it be as far as possible on the seasoned adult who can best bear it, and not upon developing young people whose right it is not only to be well born, but also well reared. Twenty-five years serve to round out the period of growth. Then follows a span of a quarter of a century or more which constitutes the period of adult life, whose food needs have been discussed in chapters III and IV. After fifty one must consider the modifications for ad- vancing age, which are treated in the next chapter. CHAPTER XI FOOD AFTER FIFTY Old age is a physiological condition rather than an accumulation of years. Some men are older at fifty than others at eighty. After the first quarter of a cen- tury, roughly the period of growth, there follows a second quarter of a century, possibly a third, in which the body tends to maintain a fairly constant weight, sometimes not varying more than a few pounds in twenty-five or thirty years. With the fuel intake regulated to the muscular activities of the individual, and the load of work adapted to the capacity of the human machine, we have ideal conditions for constant productivity for years, provided the stoking of the furnace is sensibly attended to. "Overwork" in the active adult period is in most cases the mask behind which dwell sins against nutrition and other simple laws of hygiene. It has been shown that the rate at which animals de- cline in vigor can be greatly modified by diet, those having liberal supplies of the various dietary essentials retaining their youthful vigor much longer than their brothers and sisters and cousins living in the same en- vironment, but having a diet deficient in some health- promoting constituent. Many people pass their whole 207 208 FEEDING THE FAMILY lives on a low nutritional plane. They are not sick, they go about their work and carry on the functions of human beings, but they never feel as well as they might. They never have "health positive" as the modern saying is. They never realize what it is to live "abun- dantly." To do this there must be a regular health program - physical examinations from time to time (every birthday), correction of any physical defects which may develop, suitable amounts of rest and rec- reation, and a diet which is known to be definitely con- tributing to health and not merely keeping the person alive. Many of the characteristic diseases of later life are the cumulative result of infection somewhere in the body, and immunity to infection is largely determined by the defenses against microorganisms which the body makes for itself. It has been shown repeatedly that a diet poor in vitamins, and especially vitamin A, makes the individual liable to infection. It has also been shown that a diet poor in the quality of its proteins predisposes to disease, pellagra being the striking instance. It is equally certain that a diet poor in mineral elements makes the whole organism function at a disadvantage. On the other hand there is evidence that education in re- gard to health and opportunities for health examina- tions have during the past decade actually increased the working span of human life. Though a man may not be "old" at fifty - may still be vigorous in mind and body - it is likely that his muscular activity has decreased from what it was at thirty. He is more content to watch a ball game than FOOD AFTER FIFTY 209 to participate in it; he takes his game of tennis more as a duty than as a means of working off surplus animal spirits; he walks where formerly he might have run and too often rides when he might walk. This tendency to lessened muscular activity is accompanied by a gradual slowing up of the internal processes demanding fuel for their maintenance and, so, with advancing years the need for food diminishes. Appetite, however, may be as keen as ever; the eating habits acquired in more active years are unconsciously followed; or the increase of wealth results in the setting of a more luxurious table, and the palate leads far from the path of necessity - often into danger. The tendency to increase in weight is a sure indication that the fuel intake is greater than the energy expenditure. Watching the scales and ob- serving whether one is growing more than io to 15 per cent heavier than the normal weight for his height1 is the best way for one to discover whether or not his calorie intake should be cut down. If the diet has been up to this time a well-balanced one, with meat in moderation, milk, fruit, and vegetables freely used, and few rich foods, condiments, or stimulants, reduction is a matter of quantity chiefly. Eating smaller portions of the foods served and chewing them thoroughly so as to appease the appetite without excess, at the same time drinking water freely so as to facilitate the elimination of waste, should keep the body in good condition. Up to the age of sixty reductions in food are necessi- tated chiefly by lessened external muscular activity, and 1 See Appendix, Tables V and VI. 210 FEEDING THE FAMILY excess of food is stored as body fat. These phenomena cannot be considered as particularly characteristic of "old age" as a physiological condition. In the truly aged, there is a decided retardation of the internal pro- cesses, and caring for excess food becomes more difficult. There is a tendency to lose rather than to gain body weight, as the following figures show: Age in Years Men Pounds Women Pounds 6o 144 125 70 139 125 80 135 U3 9° 127 109 Average Weight of Old Men and Women 1 It is roughly estimated that the decrease in food re- quirement due to old age, from the total fuel which would be required by an adult of the same degree of activity, is about 10 per cent between the ages of sixty and seventy; about 20 per cent between seventy and eighty; and about 30 per cent after that. In other words a man who at thirty requires per day 2000 calories simply sitting at rest, will require under the same circumstances only about 1800 at seventy and only 1600 at eighty. The ordinary activities of a man of thirty may raise his energy output to 3500 calories per day, but few men of eighty could do sufficient muscular work to transform so much additional fuel. Their lives are likely to be decidedly 1 From Bulletin No. 223, Office of Experiment Stations, U. S. Depart- ment of Agriculture (calculated to pounds). FOOD AFTER FIFTY 211 sedentary; hence 1600 to 1800 calories will probably closely approximate their total daily expenditure, though no absolute rule can be laid down. In general, there is safety in abstemiousness ; dangers of excess are greater than dangers of undernutrition. One of the difficulties in true old age is loss of the power of mastication. When the teeth become useless, it is necessary to provide food which does not require chewing, or digestion will be interfered with. Instead of the steaks and roasts which furnish much protein in middle life, we must substitute milk and soft-cooked eggs; finely scraped or minced meats, or easily flaked fish. If the gums cannot effect the mastication of breadstuffs, fermentation is likely to result. The sub- stitution of thoroughly crisp toast or zwieback, softened in milk, tea, coffee, soup, and the like, usually gives good results, the change in texture making the food break up readily into small pieces so that it will digest more rapidly. Very thoroughly cooked cereals and baked potatoes are other useful sources of carbohydrate food. If sugars can be taken without fermentation, they are valuable. Many old people are fond of sweets and can eat considerable amounts without indigestion. On account of the slowing of digestive processes, and the tendency for the digestive juices to flow less readily, fats should be used rather sparingly. Rich sauces, cakes and puddings, pastries, and fried foods should be discarded. Cream, bacon, butter, and olive oil, all forms which can be very simply used, with bread, cereals, and the like, are much to be preferred, and then in mod- 212 FEEDING THE FAMILY eration. Stimulants to gastric secretion may very properly be used to aid digestion in the aged. Warm food is desirable for the same reason. Instead, then, of a glass of cold water before a meal to start the gastric juice, a warm beverage such as tea or coffee or a clear soup of some kind will be advisable. Unless there is difficulty in the elimination of uric acid, the potent influence of meat extracts as gastric stimu- lants may be exerted in the form of beef and other kinds of broth. With the lowering of metabolism characteristic of senility, coupled with sedentary living, there is more difficulty in keeping the body comfortably warm, and more care must be taken to conserve the heat naturally generated. This is another reason for giving warm rather than cold food. Even between meals a hot drink of broth, tea, or coffee will often prove most acceptable instead of plain water, and will counteract the tendency to drink too little which interferes with free elimina- tion of waste products. With constructive processes at a standstill, or destruc- tive actually in ascendance, the need for building ma- terials is reduced to a minimum. As long as Efe persists there is necessarily some exchange of materials in the processes of cell activity, and none of the elements already seen to be essential to a well-balanced dietary can be entirely dispensed with. But the total amount required is less than ever before. In the case of pro- tein, there is usually more danger of difficulty in getting rid of a surplus than in the more active years, so that a FOOD AFTER FIFTY 213 very moderate supply is best. An allowance in the day's diet of one and one-half protein calories per pound should fully protect the body against nitrogen deficiency. Milk, gelatin, and cereal proteins-forms which do not readily undergo putrefaction - are more desirable than meat. How freely fruits and green vegetables may be used depends much upon the individual. If mastication is possible and fermentation does not develop, they may make up a considerable part of the dietary. But with decreased powers of caring for them, they must be given in such ways as one would give them to little children, i.e., fruits as juice or stewed pulp of mild varieties; vegetables well cooked and mashed or put through a sieve and served as puree or soup. Many old people sleep better with some form of nourishment late in the evening or when they waken in the night. Hot milk, plain or modified with a cereal gruel or warm water, hot malted milk, or hot bouillon with one or two crackers may be given at such a time. If the person wakes early in the morning, food is often desired before the regular breakfast. Sometimes a few plain crackers may be left by the bedside, some choice ripe fruit, fruit juice, or a glass of milk. By such additions to the menu, it is likely to come about that the number of meals is increased in extreme old age to five or six instead of three a day. In many ways the diet gradually approximates that fed to chil- dren in the first five or six years - fruit juices, well- cooked cereals, milk, eggs, strained vegetables, and 214 FEEDING THE FAMILY cereal puddings making a large part of the ration, with simple meals coming at frequent intervals. The em- phasis on building materials is less, and hot and stimu- lating foods not permissible in early life (such as tea and coffee) are usually a part of the aged person's menu. Moderation and simplicity are the passwords to health. A Day's Food Plan for an Elderly Person Age: 70-80 Fuel Requirement: 1500-1800 Calories 7 : 30 a.m. Soft, sweet fruit or mild, diluted fruit juice (grape, pineapple, or apple) . . 75-100 Calories Well-cooked cereal with thin cream and a little sugar 100-200 Calories Toast or zwieback with butter . . . 100-200 Calories Bacon or soft-cooked eggs 75-150 Calories Tea or coffee with cream and sugar . . 100-200 Calories 12 : 30 P.M. Cream soup 100-150 Calories Fish or oysters, cheese souffle or fondue 100-200 Calories A cooked green vegetable finely chopped 10-25 Calories Rice, or baked or riced potato . . . 75-100 Calories Toast or zwieback with butter . . . 100-200 Calories Stewed fruit or fruit jelly with gelatin or tapioca 100-200 Calories 4 p.m. Tea or coffee, or bouillon, or malted milk, toast or crackers 75-100 Calories 6 p.m. Chicken, or lamb chop, or broiled beef balls . 100-150 Calories Riced, or baked, or mashed potato . . 75-100 Calories One other cooked vegetable (soft enough to mash with a fork) 25-100 Calories Toast or zwieback, or dinner biscuit . . 75-100 Calories Custard, or cereal pudding, or gelatin dessert 100-200 Calories Tea or coffee with cream and sugar . . 100-200 Calories FOOD AFTER FIFTY 215 A Day's Food Plan for an Aged Person Age: 80 or over Fuel Requirement: 1200-1500 Calories 6 a.m. Weak tea or coffee with hot milk or cream or hot milk or malted milk . . 75-100 Calories 8 a.m. Soft-cooked egg or omelet or well-cooked cereal with cream 75-150 Calories Zwieback or toast 75-150 Calories Weak tea or coffee with hot milk or cream 75-100 Calories 12:30 p.m. Cream soup or vegetable puree with croutons 100-200 Calories Broiled, baked, or boiled fish, small serv- ing or Cheese souffle or egg timbale loo-zoo Calories Baked, riced, or mashed potato . . . 50-100 Calories Stewed or baked fruit1 ...... 100-150 Calories Weak tea or coffee with hot milk or cream 75-100 Calories 4 p.m. Tea or coffee with hot milk or cream . 75-100 Calories 6 p.m. Broth 10-15 Calories Minced chicken, lamb, mutton, or beef, small serving 100-150 Calories Zwieback or toast lightly buttered and moistened with hot, salted water . . 75-150 Calories A cooked vegetable, mashed or sifted (as peas, squash, asparagus tips) . . . 25-100 Calories Cereal pudding or custard 100-200 Calories 10 p.m. Broth 10-15 Calories Toast 25-50 Calories 1 If sugar causes gastric disturbance, saccharine may be used in place of part or all of it. If the fruit acid is irritating, a very little bicarbonate of soda may be used to neutralize it. 216 FEEDING THE FAMILY A Day's Dietary for an Aged Person, Based on the Preceding Plan Fuel Value: 1614 Calories Measure Weight Oz. Protein Calories Total Calories 6 A.M. Buttermilk (B, A) . . . t cup 7-4 25 75 75 8 A.M. Grape juice (B) .... I cup 3-5 - 100 Cream of wheat (B) . . . 1 cup 3° 6 50 Milk (top io oz.) (A, B) . 1 cup 2.1 9 100 Sugar 1 tsp. (scant) O.I - 16 Bread (toasted) .... 2 thin slices 0-5 7 50 Butter (A) Bacon i tbsp. 4-5 small 0-3 - 5° pieces 0-5 13 100 Coffee with J cup milk and i tsp. sugar (A, B) . . 1 cup - 9 60 526 12:30 P.M. Bouillon 5 cup 5-o 13 15 Croutons (toasted) . . . 1 doz. 0.7 7 50 Minced lamb with gravy (2 tsp. flour) .... - 2.4 (roast meat) 43 120 Baked potato (C, B) . . i small 2-3 9 75 Butter (A) i tbsp. o-3 - 5° Tapioca cream (A, B) . . 1 cup 2.8 12 100 410 4 P.M. Tea with 1 tsp. sugar . . 1 cup - - 16 Bread (toasted) .... 2 thin slices o-5 7 50 66 FOOD AFTER FIFTY 217 Measure Weight Oz. Protein Calories Total Calories 6 P.M. Omelet (i egg, i tsp. butter) (A, B) . . . . - - 25 100 Rice steamed with green peppers and tomato (C, B, A) i cup 3-5 7 70 Baked squash (i tsp. butter) (A) i cup 3-o 5 50 Pulled bread i slice 0-5 7 50 Orange jelly (C, B, A) . . i cup 4-o 4 40 Whipped cream (A) . . . Cereal coffee with | cup hot 2 tbsp. 0-9 2 100 milk and i tsp. sugar (A, B) i cup - 9 60 470 IO P.M. Hot malted milk (A, B) 2 tbsp, in | cup water o.6 9 67 67 Total for day .... 228 1614 CHAPTER XII FOOD FOR THE FAMILY GROUP: MENUS Diversity of age I Diversity of need ! Diversity of taste! How shall the individual requirements set forth in the preceding chapters be harmonized so that one table may serve all? How shall one pair of hands, if need be, prepare the food required? And how may there be time and energy left for house and clothes and for that "higher life" of the family to which food, cloth- ing, and shelter are after all only the means? Our grandmothers have brought up families without any knowledge of food requirements save tradition - why not do likewise; spend what we can, take what the market affords, and trust in Providence for the results? Alas, science has at least made us aware that "mys- terious dispensations of Providence" which robbed families of health and strength could have been averted by a little knowledge and care; that bad feeding kills more babies than any other kind of negligence; "that man's efficiency in this world, if not his happiness in the next, is mainly due to the precautions he takes to use suitable food." To-day the profession of housewife demands knowledge of the needs of each member of her group and ability to supply them under all sorts of 218 FOOD FOR THE FAMILY GROUP: MENUS 219 circumstances. Happy is he who sits down to the dinner provided for him without thought of what he must leave out, with a mind free for social pleasure, secure in the skill and knowledge of his cook. Happier still the children brought up under the watchful eye of a mother who understands the laws of health and holds them in the highest regard. Patient mastery of the A B C's of nutrition will be repaid a hundred fold. And some of the rewards will be immediate. One grand- mother remarked the other day: "The modern way of bringing up does seem to make good babies." Nutrition as a science is not very old, but it has begun to illumine the page of tradition; and mastery of its principles will enable us to proceed with confidence instead of un- certainty. We have to cope to-day with many new conditions upon which tradition throws no light. Pack- age goods, ready-to-eat foods, hothouse products, strange wares from the ends of the earth - we must learn in these to recognize the old familiar foodstuffs (or to note their absence) and adapt ourselves to the new order. Then when we find that a new food product at $4 a pound contains the same nutritive sub- stances as milk at eight cents a pound, we shall be able to choose intelligently between them. Knowing that milk and egg yolk, which are no trouble to prepare, are better for little children than beef juice, shall we not save ourselves labor and often expense ? Realizing that the energy value of a food is the same whether served simply or elaborately, shall we not be better able to decide how much elaboration is worth while ? 220 FEEDING THE FAMILY "I shouldn't mind housekeeping if it were not for planning the meals" - how often have we heard this? There is a sort of inevitableness about meals which makes them seem truly awful at times. A hungry family and nothing on the table is terrible to contemplate. But routine (drudgery if you will) loses much of its de- pressing power when our work gains significance. To see the children rosy, the family accounts free from doctor's bills, and an atmosphere of serenity in the home are surely compensations for time and thought given to family meals. There is a steady demand for menus, and they are always suggestive. But they seldom fit the case exactly. They depend on times and seasons, localities and pocket- books, community customs and individual notions, as well as the states of health and size of families and ages of their members. Hence menus cannot be made whole- sale and slavishly followed. The examples which have been given in this book in discussing the food of the different types which one may find in a family group are designed to illustrate principles and may be greatly modified without any sacrifice of nutritive value. A meal may be reduced to a single kind of food material or it may contain many kinds of food and many dishes. If there is only one kind of food used, the menu is no problem. So the baby, each of whose meals is alike, is not the one the mother has in mind when she worries about "planning meals." Nor are normal young chil- The Construction of the Menu FOOD FOR THE FAMILY GROUP: MENUS 221 dren up to at least four or five years of age much cause of concern on this account; their food is limited in variety and their meals vary little from day to day. It is when the choice of food materials becomes practically unlimited, when selecting for the older children and adults, that the menu looms large, and from this point of view it will be first discussed. Types of Meal Plans One great help in the daily task is the standardization of the meals to be served at different times in the day. This will have to be determined for each family group according to its food needs. If the adults are all seden- tary, and have ample noon meals, breakfast may be very light: fruit, some kind of breadstuff, as toast or rolls, and a beverage, as coffee, cocoa, or milk. Or it may be light: fruit, cereal, breadstuff, beverage. If, however, the workers take little food at midday, it may be wise to increase it to medium: fruit, cereal, eggs or meat, breadstuff, beverage. If the workers are engaged actively in muscular pursuits, and their total intake for the day must be high, the breakfast may be medium or heavy: fruit, cereal, eggs or meat, one other hot dish, breadstuff, beverage. For the mixed family group, where the adults are not very active muscularly, the "light" breakfast is the most convenient type, as it provides at the same time the essentials of the children's break- fast. For one person demanding more variety, an egg or serving of bacon can be added without much extra labor. On the other hand, the sedentary person eating 222 FEEDING THE FAMILY in a group of active muscular workers can pass by the extra dishes and confine himself to the "light" or "medium" breakfast, the "heavy" type being quite unsuited to his needs. Similarly, various plans present themselves for lunch- eon and dinner, or for dinner and supper, as the case may be. As a general rule, digestion is better when there is at least one hot dish at a meal. This may be a beverage, and luncheon consist of a beverage and sandwiches. Thus peanut butter sandwiches and cocoa are perfectly practical for a luncheon yielding 700 to 800 calories per capita. Or the hot dish may be a soup, and again sandwiches used to supplement it. Or the hot dish may be a chowder, macaroni and cheese, some creamed dish on toast, and the like, served with bread and butter and a beverage. The inclusion of a vegetable rich in vita- mins, such as lettuce or other greens, is always desir- able. These simple types of luncheon are suited to the sedentary worker, but can be made more pleasing to the palate by the addition of a simple dessert - stewed or fresh fruit, charlotte russe, blancmange. Another type of luncheon, still suitable for the sedentary, con- sists of soup, some other hot dish, such as mentioned above, bread and butter and dessert, to which a beverage may or may not be added. This can be easily varied by substituting a salad for the hot dish - giving a type of luncheon especially wholesome and attractive to seden- tary women. For the active worker, especially if en- gaged out of doors, for whom food must be liberally FOOD FOR THE FAMILY GROUP: MENUS 223 provided, one or two hot dishes, a substantial dessert (as pie) and a hot beverage, with bread and butter, will give as satisfactory results as a greater variety, if the dishes are high in fuel value. More formal luncheons resemble dinners in type. A very simple dinner will consist of two hot dishes (as meat and a vegetable), which may be combined and served as one at times, bread and butter, and a dessert, with or without any beverage but water. The addition of another vegetable will make this more pleasing and almost always better balanced. Where it does not in- volve too much labor, dinner is very happily begun with soup. As already said, this stimulates gastric secretion, the warmth is refreshing, and one is in better condition to enjoy the rest of the dinner with the edge taken off hunger without blunting the appetite. A soup, three hot dishes, a salad, dessert, and beverage, with bread and butter, make a meal elaborate enough for any family. In fact, one of the reasons for difficulty in menu making is the tendency to put too many dishes into one meal. We may apply to foods as well as to house furnish- ings William Morris's dictum, "Nothing is beautiful which is not also useful." An added dish should serve a real purpose in a meal, artistic or physiological. A green vegetable is a desirable part of any dinner menu, but two green vegetables unless one is raw and the other cooked offer no enhancement to each other and rarely add anything to the effect not already accomplished by one, and one might just as well eat two servings of one as one serving of each of two kinds. Every duplication 224 FEEDING THE FAMILY of this kind makes it so much the more difficult to pro- vide the sauce of variety for the next time. Foods of mild flavor and the same general texture and color, such as potatoes, rice, macaroni, samp or hominy, and other cereals, serve as "fillers-in" or carriers of calories, whereas other foods of more striking charac- teristics give piquancy to the meal. There is no par- ticular advantage in multiplying such fillers-in. Served one at a time, they produce a better effect than when several are used together. When these are multiplied, there is always the likelihood that green vegetables, cooked or raw, will be omitted because there are al- ready a sufficient number of dishes. Potatoes are not quite in the same class with the cereals because of their richness in the B and C vitamins, iron and some other ash constituents, but while they may well be used at least once a day, it seems more artistic not to serve them in the same course with rice or macaroni. Often the dessert furnishes the most energy of any single dish, amounting to as much as 300 or 400 calories per serving. When the first part of the meal is not very high in fuel value, this is all very well; but when "heavy" desserts are not needed to bring up the total fuel value of the meal, a salad or fruit will leave a pleasant impression upon the diners, at the same time relieving the cook of work and making the meal better balanced. Food Combinations from the Scientific Standpoint "What foods go well together?" Many housewives seem to think that there are laws on this point as un- Food Material Weight (oz.) Measure Food Material Weight (oz.) Measure I. Date pudding 1.1 Slice 3 in. diam., | in. thick T. Vanilla ice cream 1.6 2| tablespoons 2. Cottage pudding 1.1 Slice 2 in. X 2| in. X ij in. 8. Hard sauce 0.6 1 tablespoon 3- Rice pudding 3-i i cup 9. Cornstarch blanc mange 2.7 1 cup 4. Lemon milk sherbet i-9 1 cup 10. Baked custard 3-3 i cup 5- Lemon sauce i-5 i cup 11. Lemon jelly 3-8 i cup 6. Boiled custard 2.2 | cup ioo-Calorie Portions of Desserts 1 1 Cf. Appendix, Tables I and III. FOOD FOR THE FAMILY GROUP: MENUS 225 alterable as those of the Medes and Persians. As a matter of fact, the answer depends very much upon whether one is an Englishman or an Esquimaux, a Bostonian or a Bengali. Reverend S. Hall Young, re- counting his experiences with John Muir in Alaska, tells what difficulty they had, when they were entertained by the Indians, to keep their food from being drenched with a sauce of seal oil - a special delicacy to their hosts, which tasted very disagreeable to them. A Chinaman does not put sugar on his rice nor in his tea, but what American housewife would omit to offer sugar with both, unless she were serving rice as a "vegetable" - a habit too little in vogue ? The study of food combinations is like the old defini- tion of arithmetic, "both a science and an art." As a science it relates chiefly to the promotion of digestibility and the representation of the different food elements in the diet. It has been pointed out in Chapter II that digestion is more likely to be satisfactory for the adult when the meal is not limited to a single food material. Thus bread and milk is to be preferred to milk alone. A meal composed mainly of carbohydrate material leaves the stomach too quickly to suit ordinary meal schedules, and so does one entirely fluid. A meal of fat alone would offer a staggering proposition to an ordinary appetite, and if eaten would digest slowly, giving no zest for another meal soon. A meal of protein alone might have some advantages in an Arctic climate, since it would stimulate heat production and help to give feel- ings of warmth, but this would be most disadvantageous 226 FEEDING THE FAMILY in warmer regions. All together, man finds himself more comfortable with proteins, fats, and carbohydrates well represented in each meal, starch predominating. Since we need such a variety of substances and our everyday method of getting these is somewhat hit-or- miss, we shall insure hitting oftener than missing by the general plan of adding fruit at least once a day, a green vegetable at least once a day, and milk totaling at least a pint a day. It is desirable to keep the fuel value of any regular meal essentially the same from day to day, but we should go a step further and see that some foods furnishing iron, phosphorus, and calcium, the A, B, and C vitamins and "ballast" in the form of cellulose are regularly provided for. Let us not have a feast and upset our digestions by overeating to-day, and have a famine to-morrow, but stoke the furnace regularly, according to its needs. Herein lies the advantage of knowing the relative fuel value of different foods and different dishes. It will keep us from serving to-day a cream soup, a fat meat, sweet potatoes (perhaps glazed, with increase in fuel value), a vegetable with Hollandaise sauce, a salad with mayonnaise dressing, and ice cream with a chocolate sauce - all dishes very high in fuel; and to-morrow a bouillon, a lean fish, riced potatoes, sliced tomatoes without dressing, and fruit for dessert - a meal which may have only half the fuel value of the first one - unless we have good reason for making such a change.1 1 By means of the tables in the Appendix, a rough check can easily be kept on the fuel value of a meal, without any detailed computation. FOOD FOR THE FAMILY GROUP: MENUS 227 Foods which are known to be difficult of digestion should not be massed in the same day, or, more particu- larly, in the same meal. Even though the family en- joys griddle cakes, pork chops, fried potatoes, and plum pudding, do not provide them all on the same day, but spread them over four days in combination with other foods easier to digest. Thus, we might have cantaloupe, grape nuts, and griddle cakes for breakfast one day; tomato soup, cold roast beef, fried potatoes, apple float, and cookies for luncheon another day; and pork chops, mashed potatoes, string beans, orange salad, and caramel custard for dinner another day, thus giving the enjoy- ment of these more difficult foods under circumstances favorable to their digestion, and making it possible, where there are children, to provide for them without an entirely different menu ; for of course these dishes, so hard to digest, would be withheld from children entirely. Dishes which contain large amounts of fat and protein are always slow of digestion and should be eaten with simple carbohydrate food. Thus, chicken salad with mayonnaise dressing, eaten with bread and butter (the butter in moderation), may make an acceptable luncheon, but if we add a cup of rich chocolate with whipped cream, the chances of a good appetite for dinner are de- creased ; unless the person is active and out of doors, the effect is apt to be bad in the long run, if a headache does not immediately follow. Foods which are fried in small pieces, so as to be well loaded with fat, are to be used sparingly and in combination with those having little or no fat. Thus, fried potatoes "go with" lean meat 228 FEEDING THE FAMILY like beef or mutton, and not with fat pork or bacon. Foods fried in large pieces are not necessarily loaded with fat, but their texture is often objectionable. This is the case with fritters, hot doughnuts, and the like. They form pasty masses like other hot breads, and should not be used in the same meal with such breads, pastry, or rich cake. Concentrated foods should be served with something which will serve to dilute them. Thus cheese, a con- centrated protein food, is served with crackers, or com- bined with a white sauce and served on toast; or mixed with macaroni, rice, hominy, bread, etc., in various dishes. Eaten in this way, it loses its reputation for being indigestible. Butter, a concentrated fat food, is eaten with bread or potatoes; foods mildly sweetened with sugar are more wholesome than rich preserves, cake, or candy. Small portions of many foods can be well borne where larger ones would do harm, because they are diluted by the rest of the meal. Foods which stimulate digestive juices should precede those which are negative or tend to retard the flow. Thus, soup precedes other foods; meat is also served near the beginning of the meal. Foods which promote appetite are placed early in the meal, as fresh fruit for breakfast. Sweets, which dull appetite, should be reserved till the last. Some people are sensitive to certain combinations which others eat with ease. This can be explained only by some peculiarity of the individual. Impressions that certain combinations do not agree are often based on FOOD FOR THE FAMILY GROUP: MENUS 229 very little evidence; but if repeated and unprejudiced experiments give always the same result, the trouble- some combination should, of course, be avoided by that person. Sometimes the trouble comes from putting together too concentrated foods. Acids taken with much sweet milk to drink tend to make the milk form hard curds in the stomach, which of course interferes with digestion, but when a little acid is combined with the milk and the curd kept from forming a mass, as in lemon milk sherbet or cream of tomato soup, the product is easy to digest. Catsups, pickles, and highly spiced or very sweet foods of all sorts are irritating to the delicate walls of the alimentary tract and should be used sparingly by the robust, never by invalids, children, or any of delicate digestion. Food Combinations from the Esthetic Standpoint A balanced meal does not necessarily mean an artistic one. Graham bread and perfectly fresh, unheated summer milk will sustain a man for months, but most people would find it uninteresting in a few days and actually palling on the appetite in a week or two. The human being exhibits two psychological tendencies in his diet - one, to stand by the old favorites; the other, to demand variety from day to day. A very radical change in diet is apt to upset digestion. Foreigners suffer from the strange food in a new country as much as from lack of other familiar associations. Some one has said that acclimatization is largely a matter of get- 230 FEEDING THE FAMILY ting used to the food, and certainly this is an important part. So we find a diet made up of certain staples, like bread and butter, milk and potatoes, welcomed daily, along with variables of all sorts, which help to keep up the appetite as well as to insure the presence of the differ- ent food elements required by the body. The menu maker needs to steer a medium course ; to recognize this love of variety and yet not to cater to it to an unnecessary extent. A well-balanced diet, even if monotonous, will be more satisfying in the long run than an ill-balanced one. The first thing to see to, then, as already indicated, is that the different food elements are represented each day in some form. Then attention may be turned to that variety which comes from differences in form, color, flavor, and texture of foods, so prized by the expert in gastronomies. The aim of the artist is to arrange a meal not only wholesome, but a joy to all the senses. So long as beauty is a part of life, and the spirit more than meat, the housewife will take pride in assembling her family about a board which delights the eye and "makes the mouth water." Her great care must be, if this spirit is strong in her, to see that she does not sacrifice real body welfare to the eye and the palate. Not all have a natural gift for making artistic or novel food combinations, and many have little opportunity to study the achievements of others. A visit to a good hotel, restaurant, or tea room, with careful study of the table d'hote menus, will often furnish new ideas for the home table. So to exchange meals with a neighbor and to compare notes on menus is interesting and instructive. FOOD FOR THE FAMILY GROUP: MENUS 231 Most home magazines furnish menus, and these may well be kept as an aid when one's own ingenuity fails. But there are a few working principles which may at least keep one from committing great gastronomic blunders, and really help in securing a well-balanced diet from day to day. In the first place, take the day as a unit in planning rather than the single meal; or, better still, plan for the week or the month; at least remember that there should be some variation from week to week and month to month. In the country, the natural procession of the seasons helps to secure this wider variety. In the city, where hothouse products or those from other districts press close on the heels of those from near-by territory, season is more apt to be lost sight of. But here one should learn to use the maximum amount for the year in the height of a given food's season. We may, for instance, serve cantaloupe in New York from April to November, but it is better for artistic as well as economic reasons to limit our freest use of the melon to August and September, when it is likely to be at its best. Impressions carry over strongly from one meal to the next and from one day to the next. So, with the excep- tion of certain staples (usually mild in character), such as bread, butter, milk, and the like, try to avoid serving any food in the same form twice in the same day, and, better still, avoid repeating it the same day in any form. When storage facilities are poor and perishable food has to be used up quickly, of course such a rule cannot be rigidly adhered to. And in the country, where a crop 232 FEEDING THE FAMILY like strawberries must be enjoyed to the full in its short season, the effect of variety is gotten chiefly by varying the form in which the food is served. Thus, we may have plain, unhulled berries surrounding a mound of sugar for breakfast, a berry float for luncheon, and a sherbet for dinner, and get a very different impression from each meal. So the country housewife welcomes the little book of Apples in One Hundred Ways and others of its kind, whereas the city housekeeper, who has perhaps ten or fifteen kinds of fruit at her command at one time, may get her variety simply by changing the species, and is less concerned with different ways of preparing each kind. In fact, she is foolish to spend time in mak- ing elaborate dishes when she can get her variety so largely by careful marketing. Another good rule is to avoid serving a food which gives its pronounced character to a dish twice in the same meal, even in different forms. How often we see tomato soup, tomato catsup, and tomato salad on the same dinner table! Or find soup, meat, and salad fla- vored with onions, and perhaps onions served as a vege- table also. Care should be taken in cookery to develop the natural flavor of each kind of food, and to add extra flavors sparingly, so that they may be fully enjoyed when they are used. Serving meals in courses helps to heighten artistic effect, and is often easier than getting everything on the table at once. Courses should contrast with one an- other ; a bland one, then a more highly flavored one; a hot one and then a cold one; a fluid one and then a FOOD FOR THE FAMILY GROUP: MENUS 233 solid one. The last course should have a pleasant after- taste. This is especially emphasized in a formal meal like dinner. Some people prefer a sweet dessert, others cheese, still others coffee or fruit. Individual courses may consist of one or more dishes. In general, the larger the number of courses, the simpler each one should be. A meal may consist of a single course and still be artistic in effect, exhibiting contrasts and harmonies within itself. Broiled steak, potato balls, watercress, bread and butter, coffee, and fruit not only make a satisfying meal, but show contrasts of form, as between the potato balls and the steak; of color, em- phasized by the cress and the fruit; of texture, part being good to chew, part soft, part crisp, and part succulent. On the other hand, a meal composed of cheese fondue, sweet potatoes, creamed carrots, baked bananas, and bread and butter would be equally good from the nutritive point of view, but would weary the eye by sameness of color and the palate by sameness of texture and, to some extent, of flavor. Many popular combinations offer sharp contrasts in texture - crackers and cheese, tea and toast, ice cream and cake; in fact, this kind of contrast seems to play almost as important a part in creating a pleasing effect as good combinations of flavor. Of the latter, there are many familiar ex- amples ; cranberry or other acid fruit sauce with fowl and game, mint or peas with lamb, apples with pork, tomatoes with cheese or beef. But it is a mistake to adhere too closely to conventional combinations. Goose- berries are quite as pleasing with chicken as are cran- 234 FEEDING THE FAMILY berries; apples are good with beef, and delicious with sweet potatoes; many combinations may be devised which give pleasing effects and make the often used foods seem "different." One secret in the happy use of leftovers is to place them in entirely different surround- ings from those in which they were first served; in an- other meal, perhaps, or at least with other kinds of food. Thus, macaroni served creamed with roast beef for dinner, if not all used, may be made into croquettes and served for luncheon with a cheese sauce. Allowing a considerable interval of time between repetitions of the same dish is another help in creating a sense of novelty. If possible, keep to-day's leftovers till day after to- morrow ; repeat a favorite food once in ten days or two weeks, instead of regularly every week. Even changing the dish in which the food is served will often have an evident effect on the appetites of the family. Mrs. Richards, in one of her numerous "dietary surveys," found the girls of a certain school refusing en masse a dessert served in a large baking dish. It was put away till next day, turned out in a fine mold, and the girls not only ate it, but demanded more! A consideration of the menu - the selection and service of foods in a meal - is worth while because it will help the housewife to make her family eat the foods which they ought to have. Skill in cookery and genius in food combination are only means to this end. The ideal meal is a simple one - whether of one or several courses - in which the different types of food are harmoniously represented, but not repeated, and in which food accessories, such as FOOD FOR THE FAMILY GROUP: MENUS 235 pickles, spices, preserves, and the like, are little needed because the foods themselves are well cooked and each contributes its own characteristic flavor, texture, form, and color to the making of a well-blended whole. Spells of hot weather have always been accounted disastrous to babies. The well-organized infant welfare work of some of our larger cities has taken account of the fact that more babies die in July and August than in other months of the year and makes preparation for a regular summer campaign for the purpose of remedy- ing this sad condition. While its activities include all kinds of hygienic measures - cleanliness, protection from flies, suitable clothing, etc. - the matter which receives most attention, as most important, is that of food. With this properly supplied, illness and death both decrease strikingly. In the case of older children and adults, hot weather does not work such havoc, but it does render every one more susceptible to nutritional disturbances and it is well to recognize this in planning the family meals. Sudden and extreme changes in the weather are especially trying and often go unsuspected as the cause of digestive difficulties. When the temperature suddenly drops after a few days of intense heat (especially with high humidity), one often notes in the newspapers that several prominent men have been stricken about the same time with acute indigestion, and remarks on the coincidence, especially if a number of one's own acquaintances are Summer and Winter Menus 236 FEEDING THE FAMILY having the same experience. It is quite likely that the weather is at least in part to blame, and one should be particularly cautious about dietary indiscretions and chill when the thermometer is falling rapidly in the summer time. Before the days of canning and cold storage it was often quite difficult to have much variety in the winter diet, especially towards spring, when the supply of home preserved fruits and vegetables began to give out. Salt meats and potatoes many times formed the bulk of the ration, and undoubtedly some of the ash constituents and vitamins were not very well represented, the value of milk as a supplement to such a diet being quite un- realized. So it came about that a low nutritional state was expected with the warm days of spring, and dosing with "treacle and sulphur" was not limited to Mrs. Squeers of Dotheboys' Hall. To-day, with our vastly improved facilities for a rational diet throughout the year, fruits and green vegetables, canned if not actually fresh, take the place of "blood medicines," and one may expect to be as healthy in the spring as at any other time of year. But warm days do bring a muscular relaxation which reacts on the digestive tract as well as the rest of the body, and it needs to have its task lightened somewhat, if we do not wish to run the risk of an upset. While increases in atmospheric temperature do not affect the activities which go on internally, the amount of energy transformed in muscular work is apt to be more or less unconsciously reduced, and it is well to diminish the energy intake somewhat. Even if muscular work goes FOOD FOR THE FAMILY GROUP: MENUS 237 on as in cold weather, there is apt to be a lessened muscu- lar tension in sleep, or when resting, and even if there were not, it would be wise to eat a little less for a few days till the body had adapted itself to the weather. With lessened amount of food there should go care to choose those things which are most likely to prove easy of digestion - simple dishes and not too many kinds in any one meal. Foods rich in fat, which, as we have seen, is of all the foodstuffs the most likely to retard digestion, should be withheld - pastries, cakes, sauces, and gravies. Hot breads, particularly with syrups or honey, are especially liable to fermentation at such a time. Protein foods, which, as already pointed out, most deserve the term "heating foods," should be used in moderation. The diet should consist of a very moder- ate allowance of lean meat, or its equivalent in eggs, cheese, milk, or other meat substitute; vegetables very simply cooked, as baked potatoes, boiled onions, quickly cooked cabbage; or served as crisp salads dressed with French dressing, cream dressing (cream and vinegar), or merely a little vinegar and seasonings; fruits, cooked when there is any doubt as to perfect ripeness or in the person any tendency for them to disagree, and eaten in moderation. Cold desserts, of gelatin, cornstarch, tapi- oca, or frozen custard or fruit juices, are not only easy of digestion, but refreshing. If taken slowly at the end of a meal, frozen dishes will not chill the stomach unduly. This is much better than icing the stomach at the soda fountain between meals. If it is impossible to resist its temptations, it is much better to take a plain soda or 238 FEEDING THE FAMILY phosphate, lemonade, iced tea, or grape juice, than to indulge in ice cream sodas or sundaes. In any case, care should be taken not to drink cold beverages rapidly when warm. The shock to the nerves of the stomach is never good, and may be very severe. Since the body goes on generating heat at the same rate internally whether the weather be hot or not, the problem of physical comfort in the summer time is one of getting rid of the heat generated. Any physical activity, of course, increases the amount to be dissipated into the surrounding atmosphere. We may facilitate this heat loss by lighter clothing, by fanning, by cooling baths, or by inducing perspiration if conditions are favor- able for its speedy evaporation. This is the reason hot beverages prove cooling to some. On days when the humidity is high this method will not work. The warm beverage will only add to the tota discomfort. Cold beverages will take body heat to warm them in the stomach and will carry away body heat when their water is eliminated, and therefore they are very valuable if not taken too cold or too fast. Another factor in nutrition in warm weather is the fact that bacteria flourish at an amazing rate, and extra care must be taken to guard against spoiled food. Even in the refrigerator there is not always safety. Many ice boxes are so poorly constructed that their temperature rises with that of the surrounding air, and food is poorly protected. Especial care should be taken of protein foods, such as meat and milk. In planning a menu for a hot day, it must be remem- FOOD FOR THE FAMILY GROUP: MENUS 239 bered that eating habits cannot be radically changed on short notice, without danger of a digestive upset. It is not well to give a person accustomed to hot food entirely cold meals. One hot dish can be provided without much difficulty - a beverage if nothing else. The following are suggested as illustrating good types of summer menus: Summer Menus I Breakfast Raspberries Cooked cereal with cream Toast Coffee Dinner Veal cutlet, brown sauce Buttered beets Mashed potatoes Lettuce salad Wafers with cream cheese Currant jelly Supper Creamed macaroni on toast Sliced tomatoes Rolls Tapioca fruit jelly with whipped cream Lady fingers II Breakfast Fresh fruit Cornflakes with cream Toasted muffins Coffee Dinner Stewed chicken String beans Rice Red cabbage salad Shortcake Supper Scalloped corn Baked potatoes Stewed fruit Gingerbread Breakfast Fresh fruit Cooked cereal with cream Toast Coffee Luncheon Potato salad, may- onnaise dressing Graham bread sandwiches Fresh sponge cake Chocolate III Dinner Tomato soup Sal tines Jellied tongue New potatoes with parsley Vegetable salad Junket ice cream, fruit sauce 240 FEEDING THE FAMILY IV Breakfast Fresh fruit Cooked cereal and cream Popovers Coffee Luncheon Minced chicken on toast Bread and butter Jelly Cocoa Marguerites Dinner Vegetable soup Bread sticks Salmon loaf, cream sauce Peas Boiled potatoes Sliced cucumbers Fruit sponge with creamy sauce V Breakfast Stewed rhubarb Cooked cereal with cream Muffins Coffee Luncheon Broiled sardines on toast Tomato and chive salad Brown bread and butter Fresh fruit Cocoa or tea Dinner Julienne soup Cold roast lamb Currant mint sauce Scalloped potatoes Cottage pudding with berry sauce VI Breakfast Fresh berries Puffed rice Frizzled ham Graham toast Coffee Luncheon Omelet with aspara- gus tips Creamed potatoes French rolls, twice baked Macedoine of fruit Cocoa or tea Dinner Cream of spinach soup Croutons Nut loaf, cream sauce Stuffed peppers Caramel custard Vanilla wafers In cold weather any excess of food beyond immediate needs is apt to be taken care of with greater ease than in summer, and energy requirements often are slightly higher, as cold stimulates to higher muscular tension and greater physical activity. This does not apply, of course, FOOD FOR THE FAMILY GROUP: MENUS 241 to one who lives in hot, close rooms at summer tempera- ture during the winter months. Most people get enough stimulus from the cold to have a little better appetite and a little higher food requirement in winter than in summer. But the most marked difference is usually in digestive power. Dishes may safely appear in the winter menu which would be out of place in warm weather. Buckwheat cakes, sausage, doughnuts, baked beans, and mince pie are commonly recognized as winter foods, though it is well to remember that even then they have little place in the dietary of sedentary per- sons. The man who goes to work out of doors on an icy morning will find a breakfast of fried mush and sausage well suited to his needs. He can digest fat meats and other kinds of food rich in fat without any trouble. A liberal supply of protein will help to give him a feeling of warmth, and the conditions of outdoor life usually insure him against harm from an excess of nitrogenous waste products, though in special cases an excess of meat may cause trouble. Esquimaux thrive on a diet in which protein may contribute 40 per cent of the total energy value of the diet, and turn the heating properties of the protein to good account in the severe cold, whereas in a warmer climate such high protein would be at least a waste of good fuel, if not actually harmful. But the sedentary person needs at all times to be careful neither to overtax his digestive system nor to overeat, and children must be protected in winter as well as summer against rich and heavy food. 242 FEEDING THE FAMILY Some Winter Menus I Breakfast Stewed figs Oatmeal with cream Scrambled eggs Golden corncake Coffee Dinner Baked ham, brown sauce Southern sweet potatoes Spinach Apple pie Coffee Supper Corn chowder Toasted crackers Orange and date salad Bread and butter pudding II Breakfast Stewed dried peaches and raisins Hominy with cream Bacon Graham muffins Coffee Dinner Cream of corn soup Hamburg steak with onions Mashed potatoes Dried Lima beans, stewed Steamed fig pudding, foamy sauce Supper Cheese souffle Baked rice and tomatoes Hermits Tea or cocoa Breakfast Oranges Cornmeal and cream of wheat, with cream Baked sausages Toast Coffee Luncheon Scalloped oysters Parkerhouse rolls Celery Stewed apricots Ginger cookies Tea III Dinner Noodle soup Boiled mutton, jelly sauce Baked potatoes Creamed onions Cole slaw Chocolate bread pudding, creamy sauce IV Breakfast Stewed prunes Wheatena and cream Boiled eggs Toast Coffee Luncheon Minced lamb on toast Apple and nut salad Cream cheese Crackers Cocoa or tea Dinner Tomato bisque Boiled tongue, vin- aigrette sauce Savory potatoes Buttered parsnips Mince pie FOOD FOR THE FAMILY GROUP: MENUS 243 V Breakfast Cream of wheat with dates Omelet with bacon Toast Coffee Luncheon Macaroni and cheese Apple sauce Baking powder bis- cuit Cocoa or tea Dinner Potato soup Braised beef with vegetables Scalloped tomatoes Pineapple salad Pumpkin pie VI Breakfast Sliced bananas Shredded wheat bis- cuit Griddle cakes Coffee Luncheon Creamed oysters on toast Pickles or olives Jellied fruit with whipped cream Cup cakes Tea Dinner Chicken soup with rice Beef loaf, brown sauce Mashed potatoes Creamed carrots and peas Apple sauce Baked Indian pudding, lemon sauce CHAPTER XIII FOOD FOR THE FAMILY GROUP: COST OF FOOD It is comparatively easy to plan attractive menus if one does not have to count the cost of materials nor of the labor required in preparation and service, though, of course, it can never be done without some time and thought. With plenty of money, the great danger is in the line of over-elaboration, which is not only in- artistic, but tempts to overeating and waste of food. It is better to gratify one's esthetic taste by excellence of quality in food and service than by a multiplicity of dishes. Especially to be shunned are dishes made over- rich with cream and butter, which are not only expensive but upset digestion. For most people, cost is a large factor in the feeding problem; from one-half to one-fourth of the family income has to be devoted to buying food, and the smaller the income the larger the percentage which must be so spent. Fortunately beyond a certain minimum there is no vital connection between nutritive value and cost. Nutritious and expensive are not synonymous; in fact, some of the most nutritious foods are the cheapest. Cost alone is, therefore, a poor guide for the housewife 244 FOOD, FOR THE FAMILY GROUP: COST OF FOOD 245 in determining what she will feed her family. She needs to know some of the factors which influence the cost of food in order to make wise selection, especially if she has to try continually to make one dollar do the work of two. Factors in the Market Cost of Food One of the factors in the cost of food is the amount of labor and price of material required to produce it. A potato is cheap, and one will produce several dozen with very little work on the part of the planter. Hence potatoes rank as cheap food. Fish, which forage for themselves and have only to be caught and brought to market, make cheap meat. Under pioneer conditions meat is, in general, cheap, since it comes from wild ani- mals. But when grain has to be raised to feed cattle for beef, the cost of the animal's food and care makes meat dear. In this country the passing of the great western grazing fields increased the cost of beef, and our present hope of keeping this kind of food within reach of our pocketbooks lies in the utilization of the vast plains of South America, where food for the animals may still be had for nothing. Meat from Argentine cannot, how- ever, be as cheap as that caught near one's own door, because of the cost of transportation. Cost of transportation played a small part in domestic economy before the days of express or fast freight and refrigerator cars. But to-day we bring together in one market apples from Oregon, melons from California, olive oil from Spain - food products from almost every 246 FEEDING THE FAMILY quarter of the globe - and the expense of this trans- portation must be added to the original cost of produc- tion. The cost of foods out of season is very largely due to their having been brought from a distance. With the best of facilities for transportation, many foods deteriorate in transit, and any percentage of loss must also be added to their cost. So perishability be- comes another factor to be reckoned with. If a carload of peaches goes to market, and half of them spoil before they reach the retail buyer, she will have to pay twice as much for what she gets as she would if they had all kept perfectly. Cereal products, dried foods of various kinds, potatoes, onions, and other foods which keep very well are always cheap as compared with strawberries, raspberries, lettuce, and the like, which require careful handling and will not keep long under the most favor- able conditions. With the development of cold storage, perishability is not so great a factor as formerly, but we still have to add the storage charge, and to take into account the fact that foods taken out of cold storage deteriorate with extra speed, so that the cost cannot be as low as for fresh goods delivered to a near-by market. Canning reduces the loss due to perishability and makes transportation of food products simpler, but one must pay for the labor involved in the process as well as the materials, so that canned goods are to be ranked as intermediate in price between dried foods and fresh ones, at least under city conditions. The way in which goods are put up for the market will affect the cost. Package goods are more expensive FOOD FOR THE FAMILY GROUP: COST OF FOOD 247 than the same material in bulk; small packages cost more in proportion than large ones; fancy wrappers often bring a fancy price. Elegant shops and immediate delivery add materially to the original cost. The extra charge for package goods is often worth paying, because greater cleanliness is assured, and sealing keeps the material in better condition, to say nothing of the greater ease of storage at home. A small package is a better investment than a large one, if part of the large one would spoil before it could be used up. But these things should be realized by the purchaser. Twenty-five cents invested in two jars of peanut butter, one costing 15 cents, the other 10, will yield 10 ounces of food, while a single 25 cent jar will contain 12 ounces, so that one saves over four cents (a gain of 20 per cent) on the larger purchase. Each housekeeper must decide for herself where the danger of loss and inconvenience of storage counterbalance the gain from large quantity buying, but the tendency in cities is to buy in unnecessarily small quantities, not only because storage space is precious, but because it is so easy to replenish one's larder quickly. In the country, where space is available, there may be the opposite danger of buying in such large quantities that the food either deteriorates before it is used up, or a great deal of extra care must be given to keep it in proper condition. Many foods bring high prices because of the esthetic appeal which they make to the consumer. Size and shape, color, flavor, and texture all play their parts in this appeal. Tender beef is preferred to tough, and, 248 FEEDING THE FAMILY since a comparatively small part of each creature is tender, the law of supply and demand sends up the price. Large red apples are more attractive than small green ones, though the latter may actually have a better flavor. Olive oil is preferred to cottonseed on account of the difference in flavor, though the nutritive value is the same. In some markets white eggs are preferred to brown. It is hard to separate this idea of esthetic appeal from nutritive value. We are all inclined to think the foods which we like are good for us, and ap- pearance and flavor attract or repel very quickly; but so far as real nourishment goes, these things are second- ary, and the household provider must be able to dis- criminate between real nutritive value and other factors, in order to spend her money to the best advantage. Just as the finest-looking food of a given kind may not give the best return in nutritive value for the money spent, the cheapest form of the same goods may be an equally bad investment. A peck of apples so small and gnarled that more than the average amount of waste is produced in paring and coring may be dearer than larger ones at a little higher price. A pound of prunes in which there is little flesh and much skin and stone may be bought for eight or ten cents, but will be satisfactory neither as regards nutritive value nor flavor; one will get a better return on one's money by spending for this fruit at least 12 or 15, or preferably 20, cents a pound. A piece of corned beef at 18 cents a pound may have so much bone and fat that the lean cooked meat will have cost fully 50 cents per pound, while a rump roast of beef at FOOD FOR THE FAMILY GROUP : COST OF FOOD 249 25 cents a pound will yield lean cooked meat costing only 35 cents per pound. Unless the fat of the corned beef is eaten, it ■wall not be as economical a purchase as the roast, though the first cost is less and the total number of calories per pound is greater. Fat meat is never profitable unless the fat is used for food. Market Cost and Fuel Value One cannot say, then, that either the dearest or cheap- est in food is the best to buy. The first cost gives no direct clue to the real part which a food will play in the domestic economy, and different conditions of living must determine what it is wise to buy. Nevertheless we shall have to know the cost of the various essentials of the diet in order to formulate a working program which will most conveniently apportion our money so that due allowance is made for each. Since the energy supply is the largest item in the cost of food and since the easiest way to study cost of food is in relation to its fuel value, all considerations of cost in this book are related to calories. In the words of Armsby, one of the world's great investigators in the field of nutrition, "The up-to-date housewife 'riseth early while it is yet night' and giveth calories unto her household." That such emphasis is justifiable he makes clear by saying, "While it is true that a due supply of mineral matter, proteins, and vitamins in the food is equally essential, it is not from the present standpoint equally important, since comparatively slight modifica- tions in a diet supplying sufficient energy can ordinarily 250 FEEDING THE FAMILY remedy deficiencies in this respect. For this reason modern studies of human dietaries give prominence to the energy relations." If our food allowance is liberal and the fuel require- ment of our family low, we may indulge more freely in food materials purely for their esthetic appeal. But if we are trying to make every cent go as far as it will to- ward supplying actual nourishment, we must think, not only in terms of market conditions and our own task, but of absolute nutritive value. As Professor Graham Lusk has so often earnestly pointed out, it would be a great advantage to the purchaser if the manufac- turers of all kinds of package goods would not only in- dicate the nature of the contents (as they are now re- quired by law to do), but also say, "This package con- tains - calories of which - are protein." The house- wife, looking along the cereal shelf, would then see some- thing like this: Fuel Values and Cost of Cereals in Packages Total Calories Protein Calories Price oe Package (Cents) Rolled oats 2475 456 IO Flaked wheat 2495 368 19 Cracked wheat 2325 491 10 Rice 1590 145 IO Shredded wheat 1551 205 13 Cornflakes 1080 66 IO Puffed rice 702 64 18 Puffed wheat 420 73 14 FOOD FOR THE FAMILY GROUP: COST OF FOOD 251 The most casual inspection of the above shows that of all these cereal products rolled oats gives the best return for the money. Even taking into account that it requires long, slow cooking, it is cheaper than one of the cheapest ready-to-eat cereals - cornflakes. It may be perfectly legitimate to serve puffed wheat now and then, but it should be with full consciousness that one is paying about three-fourths for a special mode of preparation and one-fourth for actual fuel value. In canned goods there is a great amount of difference in fuel value, even with the same kind of food, owing to differences in the amount of water used to fill up the can and in the amount of sugar in sweetened products. At present the only way for the housewife to protect herself is to make her own observations on the amount of "solids" which she gets for her money, the richness of the syrup, etc., and buy those brands which give the best values.1 The discrepancy between nutritive value and cost is nowhere better seen than in a comparison of milk with other high protein foods. A quart of milk yielding 675 calories and costing, let us say 15 cents, is the equiva- lent in fuel value of about one pound of lean round steak, costing over 40 cents, or of nine eggs, which would be cheap at 30 cents. Even more striking is the case of oysters. A quart of solid oysters is equivalent in fuel to one quart of milk, but will cost from three to four times as much as milk at 15 cents per quart. 1 Cf. Canned Foods; Fruits and Vegetables. Florence R. Corbett. Teachers College Bulletin, No. 18. Also Net Weight of Foods Sold in Packages. J. P. Street. Conn. Agr. Exper. Sta. 252 FEEDING THE FAMILY For ordinary purposes of comparison, the roo-calorie portion serves as a most convenient unit, and in the Ap- pendix will be found tables (see pp. 362 and 385) classi- fying practically all the foods used in the dietaries in this book, or regarded as common household staples. These give only the cost of food materials; they do not include charges for fuel and labor. Good food cannot be bought for nothing. There are to-day very few kinds which cost less than three-fourths of a cent per 100 calories. These are mostly cereal products, such as cornmeal, rolled oats, and flour; fats, such as cottonseed oil, suet, lard, and lard substitutes; sugar, molasses, and corn syrup; and dried peas. A somewhat longer list may be had for one cent per 100 calories, including cornstarch, pearl barley, and flaked wheat, dried beans, bread, raisins, and salt pork, while for from one to one and one-half cents we may extend our list to cornflakes, plain crackers, butter at 50 cents per pound, or oleomargarine, maca- roni, rice, tapioca, and bacon. It will be observed that all of these foods belong to the non-perishable, easily transported class; meat, milk, eggs, fresh fruits, and vegetables are not included. For two cents per 100 calories we may add olive oil, cabbage, carrots, potatoes, dried apples and prunes, and milk at ten cents per quart. In the country, where fruits and vegetables are com- paratively cheap, it will be possible to have a greater variety of food materials than this without going be- yond two cents per 100 calories, but in the city fresh fruits and vegetables will range from three cents per 100 calories for apples, onions, and cabbage, to 20 or FOOD FOR THE FAMILY GROUP: COST OF FOOD 253 30 cents for lettuce, asparagus, celery, and melons. Most meats exceed three cents per 100 calories and choice cuts exceed five cents per 100 calories. It is by study of these relative values and judicious combinations of the inexpensive with the more costly foods that the house- wife controls her expenditure and yet provides "meals that shall be at once gratifying, satisfying, and funda- mentally right." The Cost of Protein, Ash Constituents, and Vitamins Feeding a family on a small income is no mean task. It demands intelligence and much thought, knowledge both of food values and human needs. One cannot become a finished mistress of the art in a week or a year, but the reward of patient study comes, not only in the saving which may be effected in the cost of living, but also in the increased happiness and efficiency of the well-nourished family and the personal satisfaction of ceasing to grope blindly (which is drudgery) and acquir- ing a conscious power over one's environment, which makes even the difficult task interesting and joyous. So far the discussion of cost has dealt with food chiefly in relation to fuel value. But we cannot rest content with learning which foods give us the most calories for our money. We must consider the price which we shall pay for building material - protein, iron, calcium, phos- phorus,1 etc.; and for vitamins and other regulating factors in the diet. Sugar and oatmeal have the same fuel value per pound (1800 calories) and can generally 1 See pages 21-25. 254 FEEDING THE FAMILY be bought for the same price. On the basis of calories they are, therefore, equivalent. But a pound of sugar yields nothing but fuel, while a pound of oatmeal will furnish 300 of its calories in the form of protein, and will also yield nearly one-third of a gram of calcium, or al- most half the whole day's requirement for a man; one and three-fourths grams of phosphorus, which gives a good margin of safety above his daily need; and 16 one-thousandths of a gram of iron, which is a very liberal day's supply. It will even yield considerable B vitamin, while sugar has none. We shall realize what a very cheap food oatmeal is as compared with sugar (which seems at first equally cheap) if we stop to consider what we shall have to pay to get from other foods the protein and ash constituents which the sugar lacks. Suppose we buy 300 protein calories in the form of lean round steak: they will cost us 33 cents, esti- mating the market cost of the meat as 40 cents per pound. In buying 300 protein calories from oatmeal for six cents we got 1500 additional calories; from the meat for our 33 cents we shall get only 250, which is small compensation for the difference in cost. From the beef we shall also get about one-tenth as much calcium as from the oatmeal, less than one-third as much phos- phorus, and about five-sixths as much iron. Hence, we shall have to go on spending more money to make up these missing amounts, and will begin to inquire how we can get the rest of these and our vitamin supply most cheaply. We shall find that the cheapest source of calcium is FOOD FOR THE FAMILY GROUP: COST OF FOOD 255 milk, and, as milk is also rich in protein and phosphorus, it will be interesting to see with what economy we can substitute milk for beef altogether. To secure 300 pro- tein calories we shall require about two and one-third quarts of milk, costing, at 15 cents per quart, 35 cents. Since 300 protein calories from beef cost 33 cents, we have come out about even on our investment for pro- tein. At the same time we shall find that we have ob- tained over 1200 calories in addition to our protein calories (nearly as many as from the oatmeal) as against a surplus of 250 calories from the meat; 68 times as much calcium, and over three times as much phosphorus. The only lack will be iron, of which we get about half as much as from the meat, but here again the milk has the advantage that its iron is in a specially available form and more likely to be completely utilized than that of meat. Granting that we must buy some food to supply the rest of the iron, the milk will be cheaper than the meat, to supplement which w'e shall need to purchase calcium, phosphorus, and iron, and probably calories too.1 1 Data upon which these statements are based Food Material Weight to Yield 300 Calories of Protein This Amount will Yield Total Calories Calcium (Grains) Phosphorus (Grams) Iron (Grams) Oatmeal . . . 1 lb. 1800 0.31 1.78 O.O16 Beef, lean round (E. P.) . . 0.78 lb. 555 0.04 0.76 O.OII Milk, whole. . 5-37 lb. 1575 2-75 2.27 0.006 256 FEEDING THE FAMILY In this reckoning we have not taken account of the vitamins. In the beef there will be a little B vitamin and traces of C vitamin. In the whole milk there will be a rich supply of A and B vitamins, certainly more than enough for a day for any human being, and more C vitamin than in the meat. If we had to buy vegetables and butter to supplement the vitamin shortage of meat, we should find the cost mounting very rapidly. Protein foods are, as a rule, a more expensive item in the dietary than carbohydrates and fats. This is partly because we like them in delicate, perishable, and highly flavored forms, such as meat, fish, and shell fish. From the nutritive point of view, eggs, cheese, and milk are interchangeable with them, and can usually be substituted with real economy. The grains and breadstuffs can also be depended upon to a considerable extent, hav- ing about the same pro- portion of protein to total fuel value that we aim to have in a well-balanced diet, i.e., io to 15 per cent of their calories in the form of protein. We must remem- The Cost of Protein POUNDS OF PROTEIN RETAINED The Chart Shows the Number of Pounds of Protein Retained for Growth out of 100 Pounds of Each Kind of Protein Fed (University of Wisconsin) DIFFERENCES IN THE NUTRITIVE VALUE OF PROTEINS FOOD FOR THE FAMILY GROUP: COST OF FOOD 257 ber, of course, that the grain or legume proteins will not make an ideal amino acid assortment by themselves. They must be supplemented, and for practical purposes milk, eggs, and meat are the supplements to depend on. Scientific investigation has brought to light interesting results from the combination of different protein-bearing foods; for example, oatmeal and gelatin (each of poor quality by itself) will together support growth in young Table Showing the Cost of ioo Protein Calories from Different Sources Food Material Cost per Pound Cost of Por- tion Yielding 100 Protein Calories Cheese, cottage $0.10 $0,020 Oatmeal 0.06 0.021 Beans, dried navy 0.12 0.030 Cornmeal . 0.05 0.030 Beans, dried Lima 0.12 0.036 Cod, salt 0.22 0.050 Bread, white O.IO 0.060 Bread, Graham O.IO 0.862 Peanuts (in shell) 0.30 0.063 Cheese, American 0.35 0.070 Macaroni . 0.20 0.082 Milk (io cents per quart) 0.05 0.085 Lamb, leg 0.30 0.087 Mutton, leg 0.32 0.093 Beef, lean round O.4O 0.108 Halibut 0.40 0.120 Eggs (40 cents per dozen) 0.30 0.120 Milk (15 cents per quart) 0.075 0.132 Porterhouse steak 0.50 0.150 Almonds (shelled) O.qO 0.153 Eggs (60 cents per dozen) 0-45 0.180 258 FEEDING THE FAMILY animals; peanuts and soy beans each have a protein content of excellent quality, though in general mixtures of seed proteins do not serve to bring about normal growth. It is worth while to keep in mind the re- markable supplementing power of milk as shown in the diagram on page 256. The table on page 21 shows the cost of the amounts of different food materials which will yield 100 protein calories, and serves as a rough measure of the relative economy of these foods as sources of protein, in spite of some difference in nutritive value. One may use milk and navy beans as the chief sources and have a mixture of excellent quality at less cost than the milk alone ; or one may choose porterhouse steak and have no more efficient a diet so far as protein is concerned (and less efficient in minerals and vitamins) at four or five times the cost of the beans and milk. The Cost of Calcium, Phosporus, and Iron It is worth while to compare in a similar fashion some of the foods which are the best sources of the different ash constituents, especially calcium, phosphorus, and iron. In the three tables following the foods are arranged in order of the amount of money required to purchase enough of any one to yield a quantity of the element under consideration sufficient to meet an adult man's daily requirement. From an inspection of these tables it is easy to see that some foods are cheap from all points of view; thus, FOOD FOR THE FAMILY GROUP: COST OF FOOD 259 I. Cost of Portions of Calcium-bearing Foods to Yield 0.67 Gram of Calcium Food Material Cost per Pound Cost op Por- tion Yielding 0.67 Gram of Calcium Cottage cheese $0.10 $0,016 Milk at io cents a quart 0.05 0.063 Buttermilk 0.05 0.070 Milk at 15 cents a quart 0.075 0.093 Beans, dried navy 0.12 O.III Oatmeal 0.06 0.126 Bread, Graham O.IO 0.127 Carrots 0.05 0.132 Peas, dried 0.12 0.212 Spinach O.IO 0.220 Beans, dried Lima 0.12 0.250 Onions 0.06 0.260 Celery 0.16 0.302 Beans, fresh string O.IO o.3i4 Raisins 0.15 0.346 Cornmeal 0.05 0.409 Prunes 0.18 0.492 Bread, white O.IO 0.546 Almonds 0.90 0.558 Peanuts 0.30 0.622 Eggs at 40 cents per dozen 0.30 0.660 Eggs at 60 cents per dozen 0.45 0.990 Cod, salt 0.22 1.180 Macaroni 0.20 1-340 Halibut O.4O 2.900 Beef, lean round 0.40 5-040 dried beans, costing less than a cent per 100 calories for fuel, are also the cheapest food for iron, third cheapest for phosphorus, and included in the cheapest five for calcium. Milk is a fairly economical source of fuel, protein, and phosphorus, exceptionally cheap for cal- 260 FEEDING THE FAMILY II. Cost of Portions of Phosphorus-bearing Foods to Yield 1.32 Grams of Phosphorus Food Material Cost per Pound Cost op Por- tion Yielding 1.32 Grams of Phosphorus Cottage cheese $0.10 $0,043 Oatmeal 0.06 0.045 Beans, dried navy 0.12 0.075 Cornmeal 0.05 0.078 Peas, dried 0.12 0.088 Beans, dried Lima 0.12 0.104 Bread, Graham O.IO O-I35 Buttermilk 0.05 0.149 Cheese, American o-35 0.150 Milk at io cents a quart 0.05 0-155 Peanuts, shelled 0.30 0.216 Milk at 15 cents a quart 0-075 0.235 Cod, salt 0.22 0.284 Bread, white 0.10 0.310 Carrots 0.05 0.311 Raisins 0.15 0.330 Cabbage 0.04 0.398 Lamb, lean leg 0.30 0.423 Macaroni 0.20 0.425 Spinach 0.10 0-435 Mutton, lean leg 0.32 0-437 Lettuce 0.07 0-475 Eggs at 40 cents a dozen 0.30 0.483 Prunes 0.13 0.490 Beef, lean round 0.40 0.532 cium, and dear only for iron, a condition compensated again in part by the fact that its iron is specially good as far as it goes. Taking all these things into considera- tion, we must regard milk as inexpensive. This is par- ticularly noticeable when we compare it with lean beef (round), which at 40 cents a pound is just as economical FOOD FOR THE FAMILY GROUP: COST OF FOOD 261 III. Cost of Portions of Iron-bearing Foods to Yield 0.015 Gram of Iron Food Material Cost per Pound Cost of Por- tion Yielding 0.015 Gram of Iron Beans, dried navy $0.12 $0,049 Beans, dried Lima 0.12 0.050 Oatmeal 0.06 0-053 Buttermilk 0.05 0.066 Spinach O.IO 0.091 Cabbage 0.04 0.120 Bread, Graham O.IO 0.132 Cornmeal 0.05 0.182 Prunes 0.18 0.198 Raisins 0.15 0.237 Cottage cheese O.IO 0.254 String beans O.IO 0.300 Onions 0.06 0.331 Eggs at 40 cents per dozen 0.30 0-333 Lamb, leg 0.30 0-345 Mutton, leg 0.32 0-355 Bread, white O.IO 0.363 Beef, lean round 0.40 0.432 Eggs at 60 cents per dozen o-45 0.486 Peanuts 0.30 0.498 Cod, salt 0.22 0.526 Macaroni 0.20 0.552 Milk at 10 cents a quart 0.05 0.685 Peas, dried 0.12 0.709 Almonds 0.90 0-757 a source of protein as milk at 15 cents per quart. The beef is not to be considered as a source of calcium; is more than twice as expensive as milk as a source of phosphorus, and, while much cheaper than milk as a source of iron, it is by no means the cheapest of iron- bearing foods. 262 FEEDING THE FAMILY The tables also show justification for the purchase of some of the green vegetables, which in general are expensive sources of fuel and protein. String beans afford cheap calcium, iron, and phosphorus ; and spinach and lettuce compare favorably with other foods as sources of iron. Eggs are hardly to be regarded as cheap from any point of view, if we compare them with peas, beans, and cereals. But if we compare them with other perishable protein food, like meat, it is evident that when they do not exceed 25 cents per dozen they may be regarded as a substitute for the cheaper cuts of meat, and when they cost as much as 40 cents per dozen they are, by the balancing of counts, cheaper than porterhouse steak and other expensive kinds of meat. The market price of fresh fruits varies so greatly that no attempt has been made to include them in these tables. They are negligible as regards protein, but are useful sources of the ash constituents, though as a rule more expensive than the green vegetables which have been chosen for illustration. The Cost of Vitamins It is still difficult to discuss the cost of vitamins be- cause of our meager knowledge as to the amounts likely to occur in different food materials and as to the vitamin requirements of human beings. Certain foods have already begun to stand out, however, as rich and economi- cal sources of these newer dietary essentials. The foremost of these is milk. The term " pro- tective food" has been happily applied to it because its FOOD FOR THE FAMILY GROUP: COST OF FOOD 263 liberal use protects against dietary deficiencies of so many sorts, and particularly of the A and B vitamins. It is quite generally agreed that a pint of milk for each child and a half pint for each adult should be set as a minimum below which no diet should fall. More is safer. A greater investigator of the vitamins, Professor Sherman, says : "A quart a day for every boy baby until he is full grown and a quart a day for every girl baby until she has weaned her last child." Since milk has already been shown to be a cheap source of protein and calcium, and since the vitamin content of milk is high, we may al- most say we get out vitamins "thrown in" when we buy milk. Among the green vegetables, economies are affected by choosing those which give rich yields of all three vitamins at the same time. One of these is spinach. Its season is long and it grows easily, hence its first cost is not high as compared with other leafy vegetables. Buying it primarily for iron, of which it is an economical source, we may regard its vitamins as pure profit on the investment. A second economical green vegetable is cabbage, fairly rich in all three vitamins, and contributing at the same time a considerable amount of ash. Its first cost is frequently lower than that of spinach and its availa- bility all through the winter when other fresh vegetables are difficult to procure gives it special importance as a source of the C vitamin. The habit of eating it shredded raw is an excellent one for adults. For little children it should be steamed only a few minutes and seasoned 264 FEEDING THE FAMILY with a little salt and cream or butter. Tiny babies can take the expressed juice when there is no more conven- ient source of the C vitamin procurable. The ease with which the C vitamin is destroyed by cooking cabbage and the likelihood of irritating substances being developed by long heating make it imperative that domestic cus- toms be improved in respect to cooking this vegetable in order that it may hold its rightful place in the econom- ical dietary. To be rich in the A vitamin its leaves must be really green, not white. The same is true of lettuce, celery, and the like. The carrot, though neither green nor leafy, must also be reckoned one of the cheap sources of vitamins. It contains a good supply of the A and B vitamins at all times, and more or less of the C vitamin, depending upon how long it has been stored and how young it was when taken from the garden. All summer young and tender carrots may add materially to the C vitamin content of little children's diets, and in the winter the older carrots, especially when creamed, are valuable for calories and ash constituents as well as the A and B vitamins. No catalogue of cheap vegetable sources of vitamins would be complete without the white potato. While it does not contain much vitamin A it is rich in B and C in addition to its calories, protein, and iron. It well deserves its place as a dietary staple. The only danger is, that contributing so much, its shortcomings will not be realized, and it will be used to the exclusion of vege- tables which yield the A vitamin and those which are laxative. FOOD FOR THE FAMILY GROUP: COST OF FOOD 265 The tomato lost its place in the culinary dictionary as a fruit just as it lost its name of love-apple, but it became a most valuable vegetable. It is like the orange in being rich in all three vitamins and like some other fruits in retaining its C vitamin when cooked or canned. This makes it available all the year round at a moderate cost in comparison with fresh vegetables. Each season and each locality will produce vegetables whose nutritive properties should be known, so that they may be used to the best advantage. Beet greens, dandelions, turnip tops, and the like are often available at no added cost, and should be regarded as so much clear profit. Whenever there is a garden there should be lettuce. All summer long it may function in the daily dietary, sometimes by itself, often an accompani- ment to more highly flavored fruits or vegetables, but always to be eaten and not left on the plate for "manners," which only reveals one's ignorance of the real rules of eating. In larger towns and cities lettuce is available practically all the year, but in the winter it commands a high price and the housewife may well content herself with cabbage and tomatoes, carrots and potatoes until the prices moderate, remembering that green lettuce is to be given preference over white. Canned vegetables have to be studied individually. As already stated, the tomato serves its nutritive pur- pose about as well canned as fresh. But that is not true of all vegetables. The greatest loss is of the C vita- min. The A and B vitamins stand processing better, but there is likelihood of some loss. Hence when fresh 266 FEEDING THE FAMILY vegetables are as cheap as canned they should be given preference and reliance should not be placed exclusively on canned ones (except tomatoes) until we know more about the changes which processing brings. Dried vegetables are the cheapest of all so far as first cost is concerned, but here again we must know what has happened to the vitamins in the drying process. Dried beans and peas are an excellent source of the B vitamin but not of the others. Sprouted beans and peas have been used in emergency for the C vitamin which develops in the process of germination. In the case of leafy vegetables like spinach, the more quickly the food is dried and the lower the temperature, the better the C vitamin will be preserved. Commercial preparations are dried at a low temperature in a vacuum and may in this way retain for a time their original properties. But aging is also a factor, so that we should not do well to depend entirely upon dried vegetables for our C vitamin. Fresh fruits which can be eaten raw or with very little cooking are particularly valuable for their contribution of the C vitamin, though generally good sources of B also. They are, with a few exceptions such as the orange, unimportant sources of A, and are generally somewhat more expensive than the vegetables which have been mentioned. Apples well deserve their place as a staple fruit almost the year round, and those who can grow them and store them for winter eating raw or freshly cooked, have a good source of the B vitamin and some C vitamin, at FOOD FOR THE FAMILY GROUP: COST OF FOOD 267 very low cost. Even in city markets the apple is generally an economical fruit. Oranges, being very rich in the C vitamin (and also yielding A as well as B), are for a considerable part of the year a good investment, though seldom as cheap as canned tomatoes. The practice of serving half an orange is commendable where economy must be prac- tical. Half an orange a day is probably sufficient C vitamin for any one, unless it is the very young child with no other source of this vitamin. Other fresh fruits may be cheap enough to use more or less freely in the height of their season. Dried fruits are not to be regarded as sources of the C vitamin, though they may contribute considerable B. Our knowledge of the vitamin content of fruits which are commonly canned is meager, but we should not ex- pect to depend upon them for the C vitamin. CHAPTER XIV FOOD FOR THE FAMILY GROUP: FOOD PLANS AND DIETARIES A simple, well-balanced menu provided from day to day for a family group of healthy persons with reason- able appetites ought to go a long ways toward insuring the continuance of health, and we have in experience abundant evidence that it will do so. As has already been pointed out, hundreds of laboratory experiments continuing through many generations of animals make it very clear that growth to full stature, freedom from susceptibility to infection, postponement of the signs of senility, and maintenance of youthful vigor depend in large measure upon the continuance of a suitable diet throughout the life history of the individual, his parents, and his grandparents. We should not be blinded to the teachings of such experiments by the fact that the human species grows slowly and has a longer life span than common animals. As soon as we examine human studies extending over even five-year periods (and five years is as two months in the life of a laboratory rat), we may begin to see the workings of the laws of nu- trition in the human world. It is only by patience and foresight that we can attain the highest nutritional state. 268 FOOD PLANS AND DIETARIES 269 No housewife will see startling returns from a good diet- ary program unless her family has been very distinctly below par at the outset. But every housewife may hope to increase year by year the endurance of her children and see them become vigorous men and women if she can enlist their cooperation in a perpetual " health campaign" in which one objective is always an adequate diet. The suggestions which have been made in the pre- ceding chapters in regard to the special needs of persons of different ages and occupations can be in the main carried out without detailed calculations of quantities consumed or of food values obtained. But, since the fundamental basis of nutrition is in the last analysis a quantitative matter, the housewife has a surer grasp on the situation if she can now and then make a study of the amounts of nutritive material which her group is actually consuming. She will in this way find out whether there is a tendency toward over- or under- consumption, or toward a one-sided diet, and can mod- ify her table accordingly. It is proposed, therefore, in this chapter, to describe a simple way of planning family dietaries and to give some illustrations of what can be done with different sums of money towards securing nourishing fare. Planning a Family Dietary Since energy is quantitatively the largest of the funda- mental requirements in nutrition, we should have at the outset some idea of the fuel needs of our family group. 270 FEEDING THE FAMILY Let us take for illustration a family consisting of a professional man, a woman doing all but the heaviest household tasks, a baby one year old, a boy three years old, two girls, six and nine, a boy of eleven, and a grandmother of ninety. From the data in preced- ing chapters we may estimate the requirements of the group as follows (assuming average body weights): Member of Family Age Weight Pounds Protein Calories 1 Total Calories Man 40 154 277-415 2770 Woman 37 125 225-338 2250 Baby 1 21 84-126 840 Boy 3 35 140-210 1400 Girl 6 4i 139-208 1394 Girl 9 56 184-276 1848 Boy 11 70 225-338 2250 Woman 9° IIO 150 1500 Total 1424-2061 14,252 Fuel Requirements of the Family Thus we find the total fuel requirement of our group is about 14,000 calories. In the typical family, consist- ing of father, mother, and three children under fifteen, where the man's occupation is sedentary, the energy requirement usually ranges from 8500 to 12,000 calories per day, depending upon the ages of the children. In a family of the same size, where the father is doing manual labor and often the mother also, or where the 1 Allowing io to 15 per cent of total fuel in the form of protein, which will be sufficient to cover all nitrogen requirements, when protein is of good quality. FOOD PLANS AND DIETARIES 271 children are over twelve years old, the requirement will range from 12,000 to 14,000 calories as a rule. The ex- act fuel intake will fluctuate somewhat from day to day, of course, with minor changes in the degree of activity of different members of the family, so all the housewife need aim to do is to keep the fuel supply fairly constant, without trying to make exact calcula- tions. A little care will prevent a feast of calories one day and a famine the next, and keeping track of body weight will tell whether each is getting his proper share. Essentials in the Family Dietary As a working basis in building up the family dietary, it is a good plan to make first a list of the food materials which need to be included in the day's rations, no matter what the particular menu. For the group which we are using by way of illustration there should be provided : Milk for all - one quart apiece if possible for each child and a pint for each adult Fruit juice for the one-year-old - At least one kind of fruit for the others Cereal for all the children - preferably for all the family A mild green vegetable for the three youngest At least one kind of vegetable besides potatoes for all the others Eggs for at least the three youngest children and some protein-bearing dish (meat or a meat substitute) for the rest To this list may be added those staples which are likely to appear in every day's menu, such as bread and butter, potatoes, and some other kind of vegetable. An estimate can quickly be made of the fuel that will probably be supplied by these items of the diet. 272 FEEDING THE FAMILY Calories Milk (5 quarts for children, i| for adults) . . . 4387 Cereal for all 600 Eggs (3 eggs and 1 yolk) 260 Fruit and fruit juice 600 Green vegetable 300 Bread I5OO Butter for bread I5OO Potatoes 600 Another vegetable 600 Meat or meat substitute (not including eggs) . . 800 Comparing these figures with the total energy require- ment of the family, it will be noted that the milk will furnish over one-fourth (nearly thirty per cent) of the total calories, the fruits and vegetables of all kinds taken together about half as many (fifteen per cent) and the eggs and meat together about half as many as the last (eight per cent). In other words these items will make up over half the total calories, leaving the rest to be supplied largely by bread, breakfast cereals and other grain products, fats including butter, and sugar. Such a diet is not likely to be deficient in pro- tein, ash constituents, or vitamins unless the fruits and vegetables are restricted to kinds notably deficient in some respect (as the exclusive use of dried fruits and vegetables which would be likely to result in deficiency of the C vitamin). FOOD PLANS AND DIETARIES 273 Planning the Menu Keeping in mind the fact that we are going to in- clude the above in the day's menu, we may next decide on the dishes which are to be served for some particular day. Usually the dinner will be planned first, as the most formal and substantial meal, and the meat dish taken as the keynote. Suppose, then, we are to have baked fish, as halibut. This gives us a characteristic protein food, but not in a highly flavored form. We may, therefore, have a soup and salad of pronounced flavor, and develop the following menu of simple, whole- some dishes of which most of the family may partake, thus saving the labor of preparing special dishes for the very young and the very old. Dinner Consomme Baked halibut, egg sauce Potatoes on the half shell String beans, buttered Bread and butter Tomato salad, French dressing Apple snow with boiled custard Lady fingers This will serve for the father, the mother, and the two older children as it stands, and for the grandmother with the omission of the egg sauce, salad, and lady fingers, and a serving of the custard part of the apple float for her dessert. Her bread should be toasted or zwieback be used. If this dinner be served at night, the younger children will have a simple supper before- hand ; the baby at 5.30 and the three- and six-year-olds at the same time or just afterwards. It is always an 274 FEEDING THE FAMILY advantage to serve the young children at a separate table, at least for all but one meal. Usually their meal hours do not coincide with those of the older members of the family, and if they do come to the adult table they need the undivided attention of some one to super- vise their eating. If that person is the mother, she does not have a chance to eat her own meal satisfactorily, and often goes undernourished. The children at their own table are less distracted by foods which they may not share, and more care can be given to their table manners and conversation, - a very important part of their education, for eating habits once formed are hard to break, and good ones are a valuable hygienic and so- cial asset for every child. The character of the luncheon will depend largely upon the breakfast and the occupations of the different members of the family. In the city, some are likely to be away from home at midday, and luncheon is a less formal meal than where all gather together at noontime. Having planned the dinner, it is best to decide on the breakfast next. Assuming that a medium-weight break- fast suits this family best, we might have: Breakfast Oranges Wheatena with cream Puffy omelet with bacon Toast Coffee for adults Milk for children Before this is served, the baby will have had a cup of warm milk at six o'clock, and the three-year-old will have FOOD PLANS AND DIETARIES 275 his breakfast just before the family breakfast (7 a.m.)> or, if the hours for the two coincide, he may take his with the rest - orange juice, wheatena with top milk, toast, and milk to drink. After breakfast the baby will have two or three tablespoons of orange juice (8 a.m.) and at ten o'clock the two youngest children will have their lunch; a crust of bread to munch, then for the baby thoroughly cooked wheatena with top milk and milk to drink, for the three-year-old a glass of milk and a piece of stale bread or hard cracker. It is to be hoped that the six-year-old will have a glass of milk and a cracker or other suitable food in the middle of the morning at school. Assuming that luncheon will be served for all the family except the youngest, a suitable menu to fit the day's scheme would be : Luncheon Creamed chicken on toast Baked bananas Boston brown bread and butter Rice pudding Tea for adults Milk for children This luncheon will need no modification for the six- year-old except that she should have day-old graham bread instead of the fresh Boston brown bread. After the family luncheon the baby will have another meal (2 p.m.), consisting of milk, egg yolk, strained vege- table pulp (which may be made into soup with part of the milk), and possibly a little stale bread to chew; the three-year-old will at the same time have a soft-cooked 276 FEEDING THE FAMILY egg, some toast, some of the strained green vegetable or some of the baked banana served in the regular luncheon, rice pudding, and milk to drink. In the evening, before the family dinner, the three youngest will have their suppers: the baby, milk and cereal jelly, baked potato, and a very little apple sauce; the three-year-old, cereal and milk, bread and butter, a little of the dessert set aside when preparing the family dinner, and milk to drink; the six-year-old, cereal and milk, bread and butter, apple snow, lady fingers, and milk to drink. It would be an easy matter to arrange for baked potatoes for the children's suppers, since potatoes on the half shell form part of the family dinner, but in this case let us assume that the rice (used also for the three-year-old's pudding) is a left-over from the day before. Late in the evening (io p.m.), the grandmother will enjoy a hot, nutritious beverage (such as hot milk, plain or flavored) and a cracker; but this entails little work by way of preparation. It is possible, therefore, by choosing simple, easily digested foods for the general menu (which are good for everybody), to provide for the special needs of the chil- dren without much extra cooking, even if meals must be served at a good many hours during the day. Having now estimated the quantitative needs of our family for protein and fuel, and planned a menu designed to give everybody something suitable to eat, our next Calculation of the Family Dietary FOOD PLANS AND DIETARIES 277 aim is to find out how nearly this will fulfill the theo- retical requirements. We must make a list of the amounts to be served and then, by reference to the tables in the Appendix, especially those of roo-calorie portions (Table I), and those giving food values in terms of common measures (Table II), we can very quickly estimate fuel values for the day. The dietary is given in detail on pages 278-280. Comparing our totals with the estimated day's re- quirements, we find that we have slightly exceeded our quota of fuel, and have a very liberal supply of protein, much of which is from milk, so that we know it will satisfy the protein needs of the growing children in the best possible way. The adults will get their protein largely from the halibut, chicken, and eggs, supplemented by milk, cereals, and bread. We have used a little over six quarts of milk, 600 calories of cereal in the form of wheatena and some rice; five eggs and one yolk in addi- tion to those in the egg sauce, apple snow, custard, and lady fingers; about 500 calories in the form of fruit exclusive of the bananas, which in this dietary may be regarded as a substitute for the root or other vegetable in our original plan; about 275 in green vegetables (string beans, tomatoes, lettuce, pea pulp); about 1700 in bread, over 2000 as butter, and about 900 as hali- but and chicken. The potatoes are not up to our esti- mate, because toast with the creamed chicken took the place of potato in the luncheon and the children had cereal for supper, whereas frequently they might have baked potatoes. 278 FEEDING THE FAMILY Family Dietary Number I Fuel Value: about 14,600 Calories Cost: 2-2 per 100 Calories Food Measure Protein Calories Total Calories Breakfast : Milk for baby 1 cup 34 170 Milk for 3-year-old .... 1 cup 34 170 Wheatena for 3-year-old1. . 4 tbsp. 4 33 Orange juice for baby . . . 2 tbsp. - 22 Orange juice for 3-year-old . 3 tbsp. - 33 Oranges for 6 3 large 20 300 Wheatena for 6 1 .... Omelet for 6 si cups 63 525 Eggs 4 eggs IOO 280 Milk 5 cup 17 85 Bacon 12 small pieces 39 300 Toast for 6 10 slices bread 70 500 Butter for 6 5 tbsp. 5 500 Milk for older children . . 3 cups 102 5io Milk for coffee2 and cereal . 3 cups 102 5io Sugar for coffee 2 tbsp, (scant) - IOO Coffee for adults .... - - - 4038 Lunches : IO A.M. For baby: Wheatena jelly .... 2 tbsp. 3 16 Milk for jelly .... 1 cup 1 34 170 Milk to drink For 3-year-old: 4 cup J Milk I cup 26 127 Bread For 6-year-old: i slice 7 50 Milk I cup 26 127 Crackers 2 crackers 5 50 540 1 Cf. farina. 2 The milk is estimated as whole milk throughout, assuming that it will be skimmed, the top used for coffee, cereal, and pudding, and the rest for cooking and drinking. FOOD PLANS AND DIETARIES 279 Food Measure Protein Calories Total Calories Family Luncheon (for 6): Creamed chicken .... i| cups') on toast 6 slices J 144 goo Baked bananas 6 bananas 3° 600 Boston brown bread . . . io slices 50 500 Butter 5 tbsp. 5 500 Rice pudding II1 . . . . r I cups 72 600 Milk for children .... 3 cups 102 5io Sugar for tea 2 tbsp. - 100 Tea for adults - - - 3710 Afternoon Meals: 2 P.M. For baby: Egg yolk i yolk II 56 Bread . . | slice 3 25 Milk i cup 34 170 Sifted pea pulp .... i tsp. i 4 Baked potato .... | small 3 25 Prune pulp For 3-year-old: i tbsp. i 50 Egg i egg 25 70 Toast i slice 7 50 Baked potato .... i small 6 5° Butter i tsp. -1 ■ 33 Sifted pea pulp .... 2 tbsp. 6 20 Rice pudding II1 ... 1 cup 12 100 Milk t cup 26 127 780 5-3° pm. For baby: Wheatena jelly .... 2 tbsp. 3 16 Milk for cereal .... 1 cupl 170 Milk to drink .... 4 cup J 34 Bread For 3-year-old: J slice 4 25 Steamed rice 4 cup 3 33 Milk for rice i cup 11 56 Bread i slice 7 5° Butter i tbsp. 33 Apple snow 2 tbsp. - 15 Boiled custard .... i cup 13 100 Milk to drink .... t cup 26 127 1 See Table III, Appendix, p. 413. 280 FEEDING THE FAMILY Food | Measure Protein Calories Total Calories For 6-year-old: Steamed rice i cup 6 66 Milk for rice i cup 17 85 Bread 2 slices 14 100 Apple snow 3 tbsp. 2 33 Boiled custard .... i cup 13 100 Lady fingers 2 fingers IO 100 Milk to drink s cup 26 127 1236 Family Dinner: Bouillon for 5 3 cups 63 75 Baked halibut for 5 ... 21 oz.(raw wt.) 366 600 Egg sauce for 4 white sauce 1 cup > 57 470 egg 1 egg J Potatoes on half shell for 4 potatoes 4 medium 1 butter 2 tbsp. > 62 656 milk i cup J Buttered string beans for 5 beans 2 J cups > 23 200 butter 1 tbsp. J Bread for 5 6 slices 42 300 Butter for 5 3 tbsp. 3 300 Tomato salad for 4 ... tomatoes 4 medium lettuce 8 leaves 20 416 French dressing .... 42 tbsp.1 Apple snow for 5 .... 2 cups 18 300 with boiled custard .... if cups 65 500 Lady fingers for 4 . . . . 8 fingers 40 400 4217 Night Lunch for Grandmother : IO P.M. Hot milk 5 cup 26 127 Cracker i cracker 3 25 152 Total for day 2206 14,673 17? tbsp, served; 3 tbsp, lost on plates FOOD PLANS AND DIETARIES 281 The important sources of vitamins in the diet are shown in the following table. Sources of Vitamins in Family Diet Number I1 Food Material Vitamins A B C Apples II 1 Bananas 1 1 Butter III Eggs III 1 Lettuce II2 II III Milk III II 1 Oranges II II III Pea pulp (fresh peas) .... 1 II III Potatoes 1 It III String beans II II II Tomatoes II III III This table is convincing evidence of the abundance of all three vitamins in this diet. Checking up on the ash constituents, we shall find that our requirement of about 7 grams of calcium per day for the family is met by the milk alone, while the eggs, Boston brown bread, oranges, and string beans furnish a gram and a quarter more. A phosphorus allowance of 6 grams is also met by the milk, and fully as much more is furnished by the rest of the diet. 1 The number of lines indicates the relative importance of the food as a source of each vitamin. 2 Valuable for A vitamin only when green. 282 FEEDING THE FAMILY There is not so much leeway on the iron, but an allow- ance adequate for the family, 0.07 gram per day, is covered by the small contributions of many foods, as the following estimate will show. Chief Sources of Iron in Family Dietary Number 11 Food Material Calories (Approxi- mate) Iron Grams Apples ioo 0.0005 Bananas 600 0.0037 Boston brown bread 500 0.0065 Chicken (canned) ......... 300 0.0041 Eggs 700 0.0146 Halibut 600 0.0050 Milk 4400 0.0154 Oranges 400 0.0016 Potatoes 400 0 0016 Prunes 75 0.0008 String beans IOO 0.0027 Tomatoes 150 0.0026 Wheatena 600 0.0084 0.0675 Thus, by following a simple general plan, and using our knowledge of food values to help in arranging an at- tractive menu, we can get a good family dietary without great difficulty, if we do not have to count cost too closely. cost too 1 Complete tables for the calculation of the ash constituents may be found in Sherman's Chemistry of Food and Nutrition. (Reproduced by courtesy of the author in Rose's Laboratory Handbook for Dietetics.) FOOD PLANS AND DIETARIES 283 Cost of the Family Dietary The dietary just planned will probably cost from S2.80-S3.50 per day, or from two to two and one-half cents per 100 calories, depending upon the locality, pro- vided milk costs fifteen cents per quart and eggs three to four cents apiece. With milk at ten cents per quart and eggs not over two and one-half cents apiece, fruit and vegetables correspondingly cheap, it would be possible to purchase such food for slightly under two cents per 100 calories. It must be remembered that in these estimates nothing is allowed for kitchen or table waste, beyond the unavoidable losses in paring vegetables, discarding meat bones, etc. If the cook spoils food in the kitchen, or leaves it in the cooking utensils through careless heating or bad scraping; if she is not careful to save every bit of edible food which comes back from the dining room, the food bills will go up, even though the family has no more to eat. Scientifically speaking, bread crumbs have the same food value as freshly cut slices of bread, bits of meat on bones are as nutritious as handsome roasts, sour milk as valuable as sweet. Every calorie thrown away either deprives the family of nu- triment which it needs or adds to the total cost of its food supply. At the table there is often much careless- ness about leaving food on individual plates, breaking bread or rolls and eating only a small portion, and otherwise performing a kind of "dog in the manger" act, refusing to eat and spoiling the food for others. Careful supervision of the serving will help to prevent this, and 284 FEEDING THE FAMILY children should be early trained to a sense of responsi- bility about the waste of food. In public places, where strangers are fed, it is not possible to gauge accurately their probable consumption and serve accordingly; con- sequently the table waste is often great, but at the home table, where individual requirements can easily be studied, there is little excuse for table waste. A food budget of $2.85 per day means $1000 a year for this item of family expenditure alone. To justify such an outlay, an income of at least three times this amount would be required, if the family is to have cloth- ing and shelter at all commensurate in quality with the food, and opportunity to satisfy its "higher" or intel- lectual and spiritual needs, such as education for the children, books, travel, music, entertainments, gifts to church and charity, and other good things which require money.1 Reducing the Cost of the Dietary The majority of families do not have incomes of $3000 or more a year; most housewives must spend less than two cents per 100 calories on their food in order to have money for decent clothing and shelter and any "higher life" at all. Yet these families have need of being well nourished and wish to enjoy some of the esthetic pleasure of a well-set table. Suppose, for in- 1 It is usually estimated that, with an income of $2000 to $4000, 25 per cent will be spent for food, but the family under consideration here is larger than that taken as " typical," the latter including only five persons - two adults and three children under fourteen years of age. A more liberal proportion for food would be justifiable in the present case. FOOD PLANS AND DIETARIES 285 stance, that we wish to reduce the cost of the foregoing dietary to about one and three-fourths cents per 100 calories, making a total cost of about $2.50 per day. In our first dietary we have used a liberal supply of fresh fruit and vegetables, and as these are expensive items when considered as sources of fuel, we shall be obliged to cut down the amount somewhat, using only one kind of fresh fruit and one fresh vegetable in a single day, or we may substitute canned or dried fruit for some of the fresh. While the milk seems to occupy a large place, its value and economy have already been demonstrated; and as long as the average cost of the dietary is over one and one-half cents per 100 calories it can be used freely to advantage. Eggs are usually expensive, and can be omitted for breakfast, in the sauce for the fish, and the dessert, and cookies substituted for the lady fingers. Chicken is an expensive form of meat and while not much is used, the cost could be lowered by substituting dried beef, without changing the form of the menu. The fish used in the dinner is usually not very dear and may be retained. The consomme adds little food value and, unless made of material not valuable for other purposes, can be omitted. Keeping in mind the general program first proposed for this dietary (see page 271), we may plan a second menu at lower cost.1 1 Table IV in the Appendix showing groups of foods at different prices will be helpful in this connection. 286 FEEDING THE FAMILY Menu I Breakfast: Oranges (very large) Wheatena with cream (top milk) Puffy omelet with bacon Toast Coffee for adults Milk for children Luncheon : Creamed chicken on toast Baked bananas Boston brown bread Rice pudding Tea for adults Milk for children Dinner : Consomme Baked halibut, egg sauce Potatoes on the half shell String beans, buttered Bread and butter Tomato salad, French dressing Apple snow with boiled custard Lady fingers Menu II Breakfast : Oranges (smaller) Wheatena with cream (top milk) Toast Coffee for adults Milk for children Luncheon: Creamed dried beef on toast Baked bananas Boston brown bread Rice pudding Tea for adults Milk for children Dinner : Baked halibut, white sauce Potatoes on the half shell String beans, buttered Bread and butter Cole slaw Chocolate blancmange with thin cream and sugar Plain cookies That the second menu will answer the food require- ments of the family quite as well as the first is shown by the following calculations. The calculation of the calories makes it evident that the changes in the menu have not materially affected the fuel value or protein values of the diet. The vitamin content, too, is little altered, for although the tomatoes, apple, and lettuce are omitted, cabbage has taken their place to some extent, and nearly a quart of milk has been FOOD PLANS AND DIETARIES 287 Family Dietary Number II Fuel Value: 14,600 Calories Cost: 11-2^ per 100 Calories Food Measure Protein Calories Total Calories Breakfast : Milk for baby 1 cup 34 170 Milk for 3-year-old .... I cup 34 170 Wheatena for 3-year-old . . 4 tbsp. 4 33 Orange juice for baby . . . 2 tbsp. - 22 Orange juice for 3-year-old . 3 tbsp. - 33 Oranges for 6 3 medium 14 200 Wheatena for 6 3k cups 63 525 Toast for 6 10 slices 70 500 Butter 5 tbsp. 5 500 Milk for older children . . 3 cups 102 5io Milk for coffee and cereal 3 cups 102 5io Sugar for coffee 2 tbsp, (scant) - 100 Coffee for adults .... - - - 3273 Lunches : IO A.M. For baby: Wheatena jelly .... 2 tbsp. 3 16 Milk for jelly Milk to drink J cup 1 fcup J 34 170 For 3-year-old: Milk „ . I cup 34 170 Bread For 6-year-old: i slice 7 50 Milk I cup 26 127 Crackers 2 crackers 5 50 583 Family Luncheon (for 6): Creamed dried beef II1 . . 3 cups 212 1040 on toast 6 thin slices 36 240 Baked bananas 6 bananas 3° 600 Boston brown bread . . . 10 slices 5o 500 Butter 5 tbsp. 5 500 Rice pudding II1 ... . 11 cups 72 600 1 See Table III, Appendix, pp. 413 and 424. 288 FEEDING THE FAMILY Food Measure Protein Calories Total Calories Family Luncheon - Continued: Milk for children .... 3 cups 102 5io Sugar for tea 2 tbsp. - IOO Tea for adults - - 4090 Afternoon Meals: 2 P.M. For baby: Egg yolk i yolk II 5<5 Bread | slice 3 25 Milk 1 cup 34 170 Sifted pea pulp .... 1 tsp. 1 4 Baked potato 2 small 3 25 Prune pulp 1 tbsp. 1 50 For 3-year-old: Egg 1 egg 25 70 Toast 1 slice 7 5° Baked potato 1 small 6 5° Butter 1 tsp. - 33 Sifted pea pulp .... 2 tbsp. 6 20 Rice pudding II *. . . . 1 cup 12 IOO Milk S cup 26 127 780 5:30 p.m. For baby: Wheatena jelly .... Milk for jelly 2 tbsp. 1 cup] 3 16 Milk to drink I cup / 34 Bread j slice 4 25 For 3-year-dd: Steamed rice i cup 3 33 Milk for rice .... 3 cup 11 56 Bread 1 slice 7 5° Butter 1 tsp. - 33 Boiled custard .... | cup 13 IOO Milk to drink i cup 26 127 1 See Table III, Appendix, p. 413 FOOD PLANS AND DIETARIES 289 Food Measure Protein Calories Total Calories For 6-year-old: Steamed rice i cup 6 66 Milk for rice 1 cup 17 85 Bread 2 slices 14 100 Chocolate blancmange . . 1 cup 8 100 Plain cookies 2 cookies 6 100 Milk to drink 1 cup 26 127 1188 Family Dinner : Baked halibut for 5 ... 21 oz. (raw wt.) 366 600 White sauce for 4 ... . 1 cup 32 400 Potatoes on the half shell 4 medium 62 656 String beans, buttered, for 5 2| cups 23 200 Bread for 5 6 slices 42 300 Butter for 5 3 tbsp. 3 3°o Cole slaw for 4 2 cups 12 200 Chocolate blancmange for 5 2| cups 80 1000 Top milk for blancmange 2 cups 68 340 Plain cookies for 4 . . . . 10 cookies 30 500 4496 Night Lunch for Grandmother : IO P.M. Hot milk | cup 26 127 Cracker 1 cracker 3 25 152 Total for day 2098 14,562 added. We are even better off as regards calcium and phosphorus on account of the extra milk. The iron is slightly lower, and the difference might well be made up by the use of whole wheat bread, as is always desirable in economical dietaries. It may seem surprising that the protein remains high in spite of the fact that seven eggs used in the first dietary 290 FEEDING THE FAMILY have been left out of the second. The reason is that a quart more milk has been used and the creamed dried beef yields more protein than the creamed chicken. The changes suggested in the fruit and vegetables may not always mean much saving; all depends upon season and locality and general market conditions. But cabbage is usually one of the cheapest vegetables, while fresh tomatoes are often rather dear ; fine, large oranges are always more expensive than medium-sized ones, and the reduction in the number of fruits used in the dietary, by the omission of the apples, is also in the nature of an economy, since fruits are always relatively expensive if one has to buy them in the market. The chocolate blancmange served with top milk gives nearly twice the fuel value of the apple snow and boiled custard, but costs less than one and one-half cents per 100 calories, while the other dessert will cost at least two cents per 100 calories. If these modifications of the first menu do not mean the most effective cost reduction under all circumstances, they will at least show how one may go about the reduction of the cost of food, once a general working plan has been thought out. Dietaries costing two to two and one-half cents per 100 calories are comparatively easy to plan; milk may be used freely, and a variety of fruits and vegetables can be obtained, fresh or canned, with dried ones occa- sionally for variety. Meats of choice cuts can be pro- vided in moderation, the more expensive kinds being offset by the introduction of a meat substitute or some specially cheap cut now and then. Dietaries costing FOOD PLANS AND DIETARIES 291 from one and three-fourths to two cents per 100 calories must be given more thought in order to keep them well balanced. Milk becomes a more important item, tak- ing the place, to some extent, of other protein, vitamin, and ash-bearing foods, especially expensive meats and fresh fruits and vegetables. Eggs must be used very little, except for the young children, and butter confined chiefly to table use and those dishes in which its flavor really counts. In others, cheaper forms of fat may be substituted. Dietaries Costing Less than One and Three-Fourths Cents per 100 Calories If now we wish to reduce the cost of food to one and three-fourths cents per 100 calories, distinct emphasis will have to be placed on the non-perishable, staple foods, such as cereals and dried fruits and vegetables, which in the main cost from three-fourths of a cent to one and one-half cents per 100 calories, and very careful selection will have to be made of meats and fresh or canned fruits and vegetables. In the family group under consideration, the children require over half the total fuel proposed as a standard. Their food, as already pointed out in the chapters especially devoted to their requirements, cannot be provided as cheaply as that for healthy adults, because of their greater need of the rela- tively expensive growth-promoting materials - pro- teins, ash, and vitamins. When the cost of food is as high as it is in New York City, it is difficult to provide an ideal dietary for children for less than one and three- 292 FEEDING THE FAMILY fourths cents per 100 calories. Milk at fifteen cents per quart can no longer be used freely, but with care one quart a day per child can be provided as long as the average cost of the dietary is not under one and three- quarters cents per 100 calories. Sometimes economy can be effected by buying two grades of milk, the better re- served for the little children and for table use, the less expensive used in cookery. Condensed milk may also be used in cookery or for the adults, and this is usually cheaper than fresh milk at fifteen cents a quart. When the dietary costs less than one and three-quarters cents per 100 calories, a quart of milk per day can be furnished only to the children under seven or eight years of age, and not more than a pint for each of the others. Cheap substitutes for the rest of the milk are soups made from dried beans, peas, lentils, or peanut butter for young children, and these legumes cooked in other ways for older children and adults. Cereals from whole grains can also be used to advantage to supplement the milk. The purchase of butter is seldom wise when the dietary is to cost less than one and three-fourths cents per 100 calories. Oleomargarine is equally valuable as fuel, and when fresh is sweet and clean and good - much better than inferior butter, which lacks the fine texture and flavor which we pay for in high-priced butter. Still cheaper fats than oleomargarine can be used in cookery, such as the lard substitutes made from cottonseed oil, suet, carefully tried-out beef fat, and salt fat pork. Cottonseed oil is equal as fuel to olive oil and costs much less. It must always be borne in mind, however, that FOOD PLANS AND DIETARIES 293 these fats contain little or none of the A vitamin, and their use instead of butter is only permissible when this vita- min is supplied in other foods, principally milk with its full content of butter fat. Dried fruits and vegetables must be to a considerable degree substituted for fresh. Bananas are usually cheap, and at certain seasons so are apples and oranges. Other fresh fruits must be purchased with care and only when their cost is at its very lowest. Bananas may be re- garded as a staple fresh fruit, high in fuel value, low in price, and easy to prepare. They are often cheapest when at their best, i.e., when the skins have darkened and the fruit is soft, though still firm. Digestive diffi- culties usually arise from eating them too green or too fast. They should be eaten only when all traces of green have disappeared, even at the ends. Baking ripe bananas in the skin, if properly done, produces a more suc- culent food of fine flavor. They must be quickly baked till soft and the juice begins to flow, but no longer, or the juice all oozes out and they become tough and dark and lose much of their flavor. Bananas baked before the skins darken will never be as palatable as the fully ripened ones, though they are more digestible than if eaten raw. Unripe bananas are best baked without the skins and basted with a syrup. These may be used as a dessert, while those baked in the skins may take the place of a vegetable in the menu. Bananas can be mashed and stewed with a little water, flavored with lemon juice and sugar, making a palatable sauce. Un- fortunately their vitamin content is low, so that they 294 FEEDING THE FAMILY must not be used to the exclusion of such a fruit as the orange, which has more of all three vitamins. The many and varied uses of apples, which resemble bananas in their vitamin content, are too well known to require comment. It is upon the dried fruits, however, that emphasis is to be placed in economical dietaries. Dates, raisins, prunes, peaches, figs, apricots, and apples may usually be obtained for less than two cents per 100 calories (raisins for less than one cent), and their uses are many and varied. Dates, figs, raisins, and apples will make bread crumbs or flour and cheap fat acceptable in the form of steamed puddings or plain cake. Raisins make a good sauce when stewed tender in a little water; their own store of sugar will make it sufficiently sweet. These stewed raisins may be used over rice or cornstarch blancmange as a change from milk. Dates may also be cooked soft in a little water, then put through a coarse sieve, making a palatable marmalade without added sugar. The addition of a little sugar and lemon juice will make a richer sauce, however. Dates make an excellent filling for sandwiches; or chopped dates, figs, and raisins may be combined. Dates may be served with breakfast cereals, being especially good with wheat preparations. Raisin or date bread will be appreciated by children. The fruit, cut in small pieces, is added to the dough when kneading for the pan. The dried fruits are not to be depended upon for the C vitamin, which disappears more or less completely in the drying pro- cess. But since they add so much to the diet in other ways - fuel, ash constituents, laxative properties, palat- FOOD PLANS AND DIETARIES 295 ability - their use should be encouraged and their defi- ciencies made up by other foods, - tomatoes, for example. Stewed figs, served in their own juice or with milk or cream, make a pleasing dessert. Prunes are often badly cooked and not as highly esteemed as they might be. Long, slow cooking in plenty of water to cover them well is necessary to make them soft and juicy, no sugar being added during the process. When done, they should be moderately sweetened and allowed to stand at least twenty-four hours before serving. They will then be plump and well seasoned to the center. Prunes of the cheapest grades are often little but skin and stone, and even careful cooking will not make them attractive. Hence it pays to buy prunes of good quality. The addi- tion of a few slices of lemon while cooking gives a pleasant change of flavor. Prunes keep well, and there are many uses for them. Prune whip or prune souffle, made of sifted prune pulp and whites of eggs, is an attractive and wholesome dessert. The juice may be stiffened with gelatin and served as prune jelly. Prunes and brown bread may be baked with milk and eggs like a plain bread pudding. A prune pie may be made with two crusts and a filling of prune pulp thickened with a little cornstarch. Variety can be given to the menu by com- binations of the more inexpensive fruits. Dried peaches stewed with raisins, prunes stewed with apricots, dates baked with dried apples in a pie, are all attractive combinations. Besides the dried legumes (peas, beans, lentils), the cheapest vegetables are usually potatoes, cabbage, 296 FEEDING THE FAMILY onions, carrots, turnips, and parsnips. While tomatoes are somewhat more expensive, they have great value as a source of vitamins and especially of the C vitamin which is most likely to be deficient as the dried and root vegetables have to be depended on more and more. Aside from requirements for certain dietary essentials we relish a diet of pronounced and varied flavor; bread, cereals, beans, potatoes, and the like are too bland to be wholly satisfying. The secret of making a palatable dietary at a low cost is to develop the characteristic flavor of the mild foods as far as possible (usually by long, slow cooking) and to include in the day's ration some of the highly flavored foods. Tea and coffee are desir- able for flavor, but they may satisfy the palate when the diet is wholly inadequate. They are a real menace to good nutrition in children. Wisely used, they may be helpful in the adult dietary. Meat is too expensive a source of protein to be de- pended upon for this foodstuff. It is to be regarded rather as a source of flavor and of fat. A little salt pork, bacon, or ham will cause a large dish of baked beans to be relished; creamed salt fish or dried beef will make bread (toast) or potatoes more acceptable; a small por- tion of beef or mutton will give character to a stew of vegetables and dumplings, or to the pastry and gravy which yield most of the fuel in a meat pie. Aside from the milk, the best sources of protein will be the legumes, including peanuts, especially in the form of peanut butter, and the less expensive kinds of cheese, including cottage cheese. Besides the ordinary baked FOOD PLANS AND DIETARIES 297 beans and bean soup, many attractive dishes can be made from the sifted pulp of well-cooked beans of differ- ent kinds. It may be molded around a center of sea- soned bread crumbs and baked in a loaf to be served with a brown or tomato sauce; or, again, a casserole may be lined with bean pulp, the center filled with corned beef hash, a cover of pulp laid over it, and the dish baked and served with a sauce. Lentils cooked and ground in a food chopper may be made into an excellent loaf with chopped peanuts or chopped beef. Cheese is valuable for its flavor as well as its food value. The United States Department of Agriculture has published a bulletin giving many recipes for this useful and economical food.1 It will give flavor to such bland foods as rice, macaroni, bread, and hominy in a variety of ways, not fully appreciated by many house- wives. It can be successfully combined with lentils, nuts, potatoes, or tomatoes, adding to their food value and giving an agreeable change from the ordinary ways of preparing these foods. Family Dietaries at the Lowest Cost If we try to plan a dietary for our family requiring about 14,000 calories at a cost of less than one and one- half cents per 100 calories, we shall find that we cannot afford much more than five quarts of milk if we have to pay ten or more cents per quart for it; this will give a quart apiece for each of the three younger children, a 1 Cheese and its Economical Uses in the Diet. Farmers' Bulletin, 487. 298 FEEDING THE FAMILY pint apiece for each of the older ones, and a pint for the adults. By using butter less freely than in the other dietaries, we may be able to provide it here, but to re- duce the cost to less than one and three-quarters cents per 100 calories it will be necessary to pay no more than 25 cents per pound - the usual city cost of oleomar- garine, which may be substituted for all the butter. To compensate for the reduction in the amount of butter, some increase in the amount of bread, breakfast cereal, and sugar has been made. Orange juice has been re- tained for breakfast for the little children, and bananas substituted for oranges for the rest. Cereal coffee to which an equal volume of hot milk is added will give the older children a wholesome beverage, and a cup of this may be more satisfying, though not more nutritious, than a half cup of milk would be. Eggs cannot be used every day, even for the young children, when the cost of the dietary must be less than one and one-half cents per 100 calories. Therefore a rice pudding with milk and raisins but no eggs has been chosen and oatmeal cookies, which are very high in nutritive value, take the place of the expensive lady fingers. A meat substitute for luncheon - macaroni and cheese - instead of creamed dried beef, and the use of salt fish for dinner instead of fresh will effect further economy. A rearrangement of Menu II, following these ideas, is given on next page. FOOD PLANS AND DIETARIES 299 Menu II Breakfast : Oranges (smaller) Wheatena with cream (top milk) Toast Coffee for adults Milk for children Luncheon: Creamed dried beef on toast Baked bananas Boston brown bread Rice pudding II1 Tea for adults Milk for children Dinner : Baked halibut, white sauce Potatoes on the half shell String beans, buttered Bread and butter Cole slaw Chocolate blancmange with thin cream and sugar Plain cookies Menu III Breakfast : Bananas (orange juice for two youngest) Wheatena with milk Toast Coffee for adults Cereal coffee for older children Milk for younger children Luncheon: Macaroni and cheese Boston brown bread Stewed apricots Oatmeal cookies Tea for adults Milk for youngest child Dinner: Creamed salt cod Baked potatoes Boiled onions Bread and butter Rice pudding III1 with milk and sugar Worked out in detail for the family, as shown below, this menu fulfills the requirements in most respects quite as well as either of the more expensive ones. Some changes in the little children's meals will be noted, as well as those for the older children and adults, such as the use of some of the macaroni without the cheese for the three-year-old's dinner, split pea instead of green pea puree, and apple sauce for apricots. 1 See Table III, Appendix, p, 413, 300 FEEDING THE FAMILY Family Dietary Number III Fuel Value: about 14,300 Calories Cost: 1per 100 Calories Food Measure Protein Calories Total Calories Breakfast: Milk for baby 1 cup 34 170 Milk for 3-year-old .... I cup 34 170 Wheatena for 3-year-old . . 4 tbsp. 4 33 Orange juice for baby . . . 2 tbsp. - 22 Orange juice for 3-year-old . 3 tbsp. I 33 Bananas for 6 6 bananas 30 600 Wheatena for 6 45 cups 72 600 Toast for 6 12 slices 84 600 Butter for 6 Milk for cereal coffee for 3 tbsp. 3 300 children aged 6, 9, 12 . . Milk 1 for coffee for adults . 1J cups Si 255 3 cups 102 5io Sugar for coffee and cereal for adults, cereal coffee for children 6 tbsp. - 360 3653 Lunches: IO A.M. For baby: Wheatena jelly .... 2 tbsp. 3 16 Milk for jelly 4 cup 1 34 170 Milk to drink For 3-year-old: i cup J Milk 1 cup 26 127 Bread For 6-year-old: 1 slice 7 50 Milk i cup 26 127 Crackers 2 crackers 5 50 540 Family Luncheon (for 6): Macaroni and cheese . . . 6 cups 204 1200 Boston brown bread . . . 10 slices 50 500 Butter 5 tbsp. 5 500 Stewed apricots 1 5 cups 24 600 1 See note to Dietary No. I. FOOD PLANS AND DIETARIES 301 Food Measure Protein Calories Total Calories Oatmeal cookies .... 6 cookies 88 800 Milk for 6-year-old .... s cup 26 127 Sugar for adults' tea . . . 2 tbsp, (scant) - 100 Tea for adults Afternoon Meals: - - 3827 2 P.M. For baby: Egg yolk i yolk II 56 Bread j slice 3 25 Milk 1 cup 34 170 Sifted pea pulp .... 1 tsp. 1 4 Baked potato | small 3 25 Apple sauce 1 tbsp. - 20 For 3-year-old: Split pea soup .... f cup 26 100 Bread . 1 slice 7 50 Butter 1 tsp. 33 Finely chopped creamed macaroni with J egg . . i cup 3° 160 Apple sauce i cup 1 100 743 5:3° p m. For baby: Wheatena jelly .... Milk for jelly 2 tbsp, i cup) 3 16 Milk to drink 5 cup j 34 170 Bread | slice 4 25 For 3-year-old: Cream toast 1J slices toast \ 6 tbsp, sauce J 20 150 Bread j slice 4 25 Rice pudding III1 . . . i cup 8 100 Milk for pudding . . . i cup 11 56 Sugar for pudding . . . 1 tsp. - 20 Milk to drink t cup 19 100 For 6-year-old: Cream toast i j slices toast 1 | cup sauce J 33 250 1 See Table III, Appendix, p. 413. 302 FEEDING THE FAMILY Food Measure Protein Calories Total Calories Afternoon Meals-Continued: Bread 1 slice 7 SO Rice pudding III1 . . . 5 cup 12 150 Milk for pudding . . . 5 cup 17 85 Sugar for pudding . . . 2 tsp. - 40 1237 Family Dinner : Creamed salt cod for 5 . . 4 cups 243 747 Baked potatoes for 5 . . . 8 medium 88 800 Boiled onions for 4 . . . . 8 medium 26 200 Bread for 5 10 slices 70 5°o Butter for 5 5 tbsp. 5 5°o Rice pudding III1 for 5 4 cups 80 1000 Milk for pudding .... 11 cups 5i 255 Sugar for pudding .... 3 tbsp. - 180 Night Lunch for Grandmother : 4182 IO P.M. Tea with | cup hot milk . . 1 cup 17 85 Sugar for tea 2 tsp. - 40 Cracker 1 cracker 3 25 150 Total for day 1762 14,332 The trend in reducing the cost of the dietary must be towards an increase in the amounts of bread, cereals, dried fruits and vegetables, and sugar, and a reduction in the proportion of meat and fish, milk, eggs, butter, and other expensive fats, green and other fresh vege- tables and fresh fruit. This is illustrated by the follow- ing figures, taken from the three dietaries which have been given here in detail. 1 See Table III, Appendix, p. 413. FOOD PLANS AND DIETARIES 303 Changes in the Proportions of Calories from Various Sources in Family Dietaries I, II, and III2 Dietary No. I Dietary No. II Dietary No. Ill Calories Calories Calories Milk 4400 495° 3300 Eggs 670 160 60 Fresh fruit1 1055 850 775 Dried fruit 5° 5° 675 Bread2 1685 1900 2390 Butter, etc 2966 2400 i960 Meat and fish 900 800 250 Sugar 720 1150 1320 Cereals 850 1290 1360 So far we have reduced the cost without sacrificing anything essential to nutrition. The total fuel values for the three dietaries are practically the same, and the protein calories are in each case well within the limits set; and since the protein is derived quite largely from milk, especially for the children, there can be no question of its being ample for all body needs. That the calcium and phosphorus are adequate is also assured by the milk, and by actual calculation the iron in the third dietary is quite as high as in the first one. The sources of vitamins are not so varied in the third dietary, but there is still sufficient milk to guarantee a diet ade- quate in the A vitamin, even if the butter were not there to supplement the milk. Milk, bananas, potatoes. 1 6oo calories from bananas in each dietary. 2 Including flour and Boston brown bread. 304 FEEDING THE FAMILY cheese, onions, and in the case of the little children, oranges and apples, provide liberally for the B vitamin. It is our resources for the C vitamin that we find rapidly decreasing when we begin to substitute dried fruits for fresh and cheaper root vegetables for green ones, and to increase the proportion of bread, cereals, and sugars. It is important, therefore, in such dietaries to see to it that each person has in his diet each day some good source of the C vitamin. In this third dietary of ours, we have potatoes for all as the most important source, except for the orange juice provided for the two young- est ; but bananas, onions, and apples add their quotas, and in places where good fresh cow's milk can be had (especially if one keeps a cow) the milk will be a considerable source of the C vitamin if the cow has pasture or fresh food. In any further attempts to reduce cost more careful planning will be necessary if the diet is not to fall short in the amount and quality of its protein, in its ash con- stituents and vitamins. It becomes increasingly diffi- cult to provide variety of diet at low cost. Cereal products, dried beans and peas, a few staple fresh vegeta- bles, such as potatoes, onions, cabbage, and tomatoes in limited quantities, dried fruits, and one or two fresh ones, as apples and bananas, very fat meats, such as fat beef plate and fat salt pork, and a high proportion of the calories from milk (from one-fourth to one-fifth) must be the chief reliance of the housewife. The temp- tation is often great to use large quantities of sugar and syrup or molasses rather than cereals, because of the FOOD PLANS AND DIETARIES 305 high flavor and the fact that these require no cooking. But the ash constituents of the grains and legumes assume greater importance when fruits, vegetables, and milk must be limited, and it is worth while to try to make acceptable as much oatmeal, barley, buckwheat, whole wheat preparations, beans, peas, and the like as one possibly can, these being also good sources of protein. One should always be on the watch for good sources of the C vitamin. Dandelions, water-cress, beet tops, and the like are often procurable at little or no cost. Canned tomatoes deserve their popularity because of their vita- min content. The needs of the children cannot be ideally met when the dietary falls under one and one-half cents per 100 calories, except in districts where milk, fruit, and vegetables are very cheap. With a limited number of foods to choose from, the day's menu will be very simple, variety being obtained by changes from day to day rather than by a number of different dishes in one meal. The following menu and dietary illustrate what can be done for about one and one-fourth cents per 100 calories, allowing one quart of milk for each of the two youngest children, a pint for each of the others, and one pint for the adults - four quarts in all. Menu IV Breakfast : Stewed dried apples (orange juice for baby and 3-year-old) Cornmeal mush with milk and sugar (oatmeal for 3-year-old) Bread Pork fat Sausage for father and mother Cereal coffee for older children and adults Milk for youngest children 306 FEEDING THE FAMILY Luncheon: Baked samp with cheese Stewed raisins Brown bread Oleomargarine Oatmeal wafers Tea for adults Cocoa for children Dinner: Beef stew with vegetables (potatoes, cabbage, tomatoes) Bread Oleomargarine Date pudding with liquid sauce Fuel Value: about 14,300 Calories Family Dietary Number IV Cost: ij^ per 100 Calories Food Measure Protein Calories Total Calories Breakfast : Milk for baby 1 cup 34 170 Orange juice for baby . . . 2 tbsp. - 22 Milk for 3-year-old .... 1 cup 34 170 Oatmeal for 3-year-old . . | cup 9 50 Orange juice for 3-year-old and 6-year-old .... 6 tbsp. - 66 Cornmeal mush for 6 . . . 3i cups 50 5°o Dried apple sauce for 5 . . 2j cups 6 600 Sausage for 2 | lb. (raw wt.)1 IOO Soo Bread for 6 12 slices 84 600 Milk for cereal coffee for children aged 6, 9, 11 . . Milk for coffee for adults 15 cups 51 255 i CUP 17 8S Milk for mush 2 cups 68 340 Sugar 8 tbsp. - 480 3838 1 Fat used on bread, FOOD PLANS AND DIETARIES 307 Food Measure Protein Calories Total Calories Lunches: IO A.M. For baby: Oatmeal jelly 2 tbsp. 3 16 Milk for jelly Milk to drink 4 cup 1 fcup j 34 170 For 3-year-old: Milk I cup 26 127 Bread For 6-year-old: i slice 7 50 Milk i cup 17 85 Crackers 4 crackers 10 100 Family Luncheon (for 6): 548 Baked samp with cheese . 4i cups 132 953 Boston brown bread . . . io slices 5° 5°o Oleomargarine ... 5 tbsp. 5 5°o Stewed raisins 2 cups 18 600 Oatmeal wafers .... 8 wafers 88 800 Cocoa 11 for children . . 3 cups 70 5°o Sugar for adults' tea . . . 2 tbsp, (scant) - 100 Tea for adults - - - Afternoon Meals: 3953 2 P.M. For baby: Milk 1 cup 34 170 Bread i slice 3 25 Sifted pea pulp .... i tsp. 1 4 Baked potato | small 3 25 Prune pulp For 3-year-old: i tbsp. 50 Split pea soup .... 1 cup 26 100 Bread 2 slices 14 100 Oleomargarine .... 2 tsp. 66 Baked potato i small 9 75 Baked apple i small 1 75 Milk to drink i cup 16 85 775 1 See Table III, Appendix, p. 388. 308 FEEDING THE FAMILY Food Measure Protein Calories Total Calories Afteroon Meals - Continued: 5 = 30 p.m For baby: Oatmeal jelly 3 tbsp. 4 25 Milk for jelly J cup 1 Milk to drink 4 cup J 42 For 3-year-old: Cream toast i slice 1 6 tbsp, sauce J 20 150 Bread 1 slice 7 5° Oleomargarine .... 1 tsp. 33 Rice pudding III1 . . . I cup 8 IOO Sugar for pudding . . . I tsp. - 20 Milk for pudding . . . 1 cup\ Milk to drink 1 cup J 34 For 6-year-old: Cream toast i j slices \ | cup sauce { 33 250 Rice pudding III1 . . . 1 cup 16 200 Milk for pudding . . . 2 cup 16 84 Sugar for pudding . . . 2 tsp. - 40 1334 Family Dinner (for 5): Beef stew with vegetables 4i cup 183 1132 Bread 10 slices 70 500 Oleomargarine 5 tbsp. 5 500 Date pudding 11 .... 5 servings 5° IOOO Brown sugar sauce . . . 25 cups - 660 3792 Night Lunch for Grandmother : IO P.M. Tea with | cup hot milk . . 1 cup 17 85 Sugar for tea 2 tsp. - 40 Cracker 1 cracker 3 25 150 Total for day 1528 14,390 1 See Table III, Appendix, pp. 4io and 413 FOOD PLANS AND DIETARIES 309 Dried apples have been substituted for fresh fruit for breakfast, and stewed raisins for stewed apricots, corn- meal for farina, samp for macaroni, oleomargarine for butter, oatmeal wafers without eggs for oatmeal cookies, date pudding with brown sugar sauce for rice pudding with milk and sugar. Thus the cost has been reduced without any material change in the amount of fuel or of the ash constituents. Beef has been substituted for fish for dinner because it has more fat and also gives more flavor. There has been some lowering of the quantity of protein, but it is still adequate in quality and quantity. The chief source of the A vitamin is milk, and there is still enough of this to make us feel reasonably certain that there will be no real shortage of this vitamin even if oleomargarine is substituted for butter. At any rate we probably should have on the whole a less adequate diet if we spent our money for butter when our allowance is so low. The B vitamin is probably ample, with milk, potatoes, dried fruit, cereals and several other foods contributing. The C vitamin is provided for the three youngest in orange juice. The rest have potatoes and other vegetables used in the stew as their main source. The supply of these should be as large as possible. The children whose supply of milk has been limited have been given warm beverages (cereal coffee and cocoa) to make their small allowance of milk more attractive. The sugar and cocoa also contribute to the total fuel value of their dietary. Other modifi- cations or additions to the menu are indicated in the 310 FEEDING THE FAMILY dietary. The sausage put in for breakfast for the father and the mother adds to the flavor of that meal, making the cornmeal mush and bread more acceptable; the fat is a cheaper source of fuel than oleomargarine, and the protein makes up for some of that lost by cutting down the milk. Instead of using the fat on the bread, one might fry the cornmeal mush for the adults in it for a change, and serve this with syrup, leaving more milk for the children. Some changes in the children's meals have been made, either for economy, or to save extra cooking, or to supply a more digestible food than that provided in the meals for the older members of the family. Oatmeal is used instead of cornmeal for the three-year-old's breakfast, as better suited to his digestive powers. No change has been made in the morning lunches except a decrease in the amount of milk and an increase in the number of crackers for the six-year-old child. The egg has been omitted from the baby's two o'clock meal for the sake of economy. An egg yolk should be given a couple of times a week, even if it cannot be afforded every day. Baked potato and more oleomargarine take the place of the macaroni with egg for the three-year-old. This change decreases the amount of protein, but with the full allowance of milk this is of no particular importance. The use of whole wheat bread to compensate for some of the iron lost by not using eggs for these two young chil- dren would be advisable. If the dietary must be kept under a cost of one and one-fourth cents per 100 calories, not more than three FOOD PLANS AND DIETARIES 311 quarts of milk can usually be allowed, and, if possible, one of these should be bought for ten cents a quart, this loose milk to be cooked in all cases. The two quarts of good grade must be reserved for the two youngest children, and the other distributed as the menu demands. Some menus which will supply a balanced ration under these conditions are given below. Menus for Very Low-Priced Family Dietaries (allowing three quarts of milk per day) I. Breakfast: ~ , f fried and served with com syrup for adults Cornmeal mush < , , , , £ vu ( steamed and served with milk for children Bread Oleomargarine Coffee for adults Apple sauce or orange juice for 3-year-old; orange juice for baby Luncheon or Supper: Pork and beans - bean and tomato soup for young children Stewed tomatoes Bread Oleomargarine Tea with milk and sugar for adults Milk for youngest children Cereal coffee or cocoa for older children Dinner: Liver Hashed browned potatoes Bread Oleomargarine Tea for adults Milk for youngest children Dried apple and date pie with cheese, for father, mother, and oldest child Dried apple sauce for others The breakfast and morning lunches for the children will be practically the same in all these menus, follow- 312 FEEDING THE FAMILY ing the plan in Dietary IV.1 The afternoon lunches will follow the family luncheon as closely as possible. In the menu above, part of the beans are put through a sieve and made into soup for the two o'clock dinner of the little ones. Baked potato and baked apple or stewed prunes may be used for the three-year-old, as in Dietary IV.2 The half past five meal for the baby will not change with changes in the menu for the rest of the group. Other suggestions for the three-year-old will be found in the chapter on feeding young children (pages 144- i52)- Since the meals for the two youngest and the supper for the six-year-old cannot follow the regular family menu, and are very simple, no attempt has been made to describe them in detail, but suggestive notes with each menu will indicate ways of adapting these to the children, thus saving extra labor. II. Breakfast: Hominy with milk and sugar Fried potatoes 1 c , . ..., „ , . . , . .. > for adults and oldest child Baking powder biscuit j Toast and milk for other children Coffee for adults Apple sauce, prune pulp, or orange juice for two youngest Luncheon or Supper: Vegetable soup with croutons Whole wheat bread Peanut butter Stewed dried peaches with raisins 1 Page 306. 2 Page 307. FOOD PLANS AND DIETARIES 313 Dinner : Pork sausage baked with parsnips Baked potatoes Bread Oleomargarine Steamed cranberry pudding Everyday sauce,1 flavored with nutmeg This menu can be quite easily adapted to the chil- dren's needs. Their breakfasts will be like those in Dietary IV,2 except that hominy may be substituted for oatmeal if hominy grits be used. Vegetable soup put through a sieve will serve for the two o'clock dinner of the three-year-old, and bread and peanut butter take the place of the baked potato; stewed dried peaches that of the baked apple. The family evening meal is not suited to the requirements of the young children. For their half past five supper, some such plan as out- lined in Dietary IV 3 had best be followed. III. Breakfast: Farina with milk and sugar Graham gems baked in a thin sheet Brown sugar syrup Cereal coffee for all but two youngest children Milk for two youngest children Luncheon or Supper: Split pea soup Bread Oleomargarine Sliced bananas with sugar (lemon juice if possible) Gingerbread 1 Water, cornstarch, sugar, and oleomargarine. 2 Page 306. 3 Page 308. 314 FEEDING THE FAMILY Dinner: Lentil-meat loaf Tomato sauce Mashed potatoes Scalloped dried apples Cocoa for children Tea for adults Baking the gems in a thin sheet will make them suit- able for all but the two youngest children. The syrup should be given very sparingly, if at all, to the children. The split pea soup can be used for the three-year-old's dinner and the six-year-old's supper. Gingerbread and scalloped apples may also be served for the latter's supper. IV. Breakfast: , ( with com syrup for adults Oatmeal mush < ... ... / V.,, ( with milk for children Corned beef hash Bread Coffee for adults Luncheon or Supper : Baked beans with salt pork Boston brown bread Tapioca-Indian meal pudding with raisins Milk for children Tea for adults Dinner: Braised stuffed heart with vegetables Baked potatoes Rye bread Oleomargarine Dried peach pudding Part of the baked beans can be put through a sieve and made into soup for the three-year-old's dinner and FOOD PLANS AND DIETARIES 315 the six-year-old's supper. Junket can easily be made for dessert for the children's half past five supper. V. Breakfast: Flaked wheat with milk and sugar Buckwheat cakes with corn syrup Coffee for adults Cocoa for children Luncheon or Supper : Scalloped potatoes with cheese German coffee bread Oleomargarine Apricot tapioca with caramel sauce Tea for adults Cereal coffee for children Dinner : Braised chuck rib of beef Stewed cabbage Browned potatoes Bread and oleomargarine Steamed fig pudding Everyday sauce Potato soup may be made for the three-year-old's luncheon, and the six-year-old's supper. For the latter, thoroughly toasted coffee bread will also be acceptable. All except the baby may have the apricot tapioca, but it should be served with milk instead of sauce for the three- and six-year-old children. VI. Breakfast: Oatmeal mush with milk and sugar Combread baked in a thin sheet Oleomargarine Coffee for adults Cereal coffee for children 316 FEEDING THE FAMILY Luncheon or Supper: Corn chowder with croutons Rye bread and oleomargarine Stewed prunes Tea for adults Dinner: Baked split peas with bacon Cabbage and potato salad Molasses cake Cocoa Some of the corn chowder can be put through a sieve and some of the baked split peas made into a puree for the three-year-old's dinner and supper. Rice molded and served with prunes would make a good dessert for the young children. CHAPTER XV FOOD FOR THE SICK AND CONVALESCENT A discussion of the problems of feeding a family would be incomplete without some reference to the care of the sick and convalescent. Few families are so for- tunate as to escape illness entirely. Good feeding is one of the greatest factors in maintaining health, but it must be supported by other conditions fostering nu- trition, such as sanitary and cheerful surroundings, freedom from chill, exhaustion, overwork, or worry. A well-fed person is much better able to resist the attacks of harmful bacteria than an undernourished one, but if their number is very great on account of impure water or food, they may overwhelm even strong defenses. Thus the best care to set a well-balanced table may fail to maintain health if the housewife works without the help of the community in securing a sanitary environment. Personal infringements on the laws of health, other than those in regard to food, undermine the resistance of the body to disease; fatigue, and chill, for instance, often, pave the way to colds and indigestion, which in their turn lower resistance still more. Then a stray germ which would be promptly destroyed if the person were in vigorous health, may find a favorable soil in which 317 318 FEEDING THE FAMILY to flourish. So, in one way and another, illness may enter the home where food is dispensed with intelligent care, and special adaptations of the diet to the needs of the patient have to be considered. When the case is serious enough to demand the care of a physician, he will give advice concerning the diet, and his directions should be implicitly obeyed. It re- quires knowledge and experience to diagnose disease and prescribe suitable food, and no book can take the place of the skillful doctor. In sickness, far more than in health, every person is a law unto himself and all rules must be modified according to the requirements of the individual. This can be done successfully only by one who is able to judge accurately the patient's true condition. The physician's advice is, however, often very general, especially where the diet is not a prominent factor in the treatment, and the home nurse is frequently at a loss to know how to carry out his instructions to the best advantage. She must obey the doctor, please the patient, and not over-strain the family pocketbook, and sometimes the three seem quite irreconcilable. More- over, many minor disturbances for which no physician is called require some modification of the ordinary family diet. The better the general principles of feeding are understood, the more successfully such emergencies can be met, especially if this knowledge is supplemented by some acquaintance with the lines of dietetic treatment which have proven most successful in practice. At the outset one must free one's mind from any FOOD FOR THE SICK AND CONVALESCENT 319 notion that any particular food is a specific for any dis- ease. As has already been pointed out, there are in health many choices of food, whether for fuel, building, or regulating materials. So in sickness, though the range of choice may be more limited, some flexibility is usually possible. There is no magic diet for any dis- ease. Even in the well-known case of diabetes, where the power to utilize carbohydrates is reduced to a low plane or lost, the avoidance of certain articles of food, while it may be important, is by no means the only feature of the diet. The aim of this chapter is to point out a few dietetic procedures which conform to the general principles involved and which have been shown by experience to be "safe and sane." For more detailed suggestions and other modes of treatment, the reader must consult the specialist in nutrition or refer to the writings of experts in the treatment of any particular disease.1 Energy Requirements in Sickness In sickness, as in health, the internal work of the body goes on at the rate of about two-fifths of a calorie per pound per hour during sleep and about three-fifths of a calorie per pound per hour during waking hours spent in bed. Seldom is the expenditure of energy less in sick- ness than under the same conditions of activity in health, and it may be more, particularly in cases of fever. In the first few days of illness, fasting or taking of very little 1 Much practical information about feeding in disease is to be found in Nutrition and Clinical Dietetics by Carter, Howe, and Mason. 320 FEEDING THE FAMILY food does no harm and has the advantage of giving the digestive tract a chance to rest. But the energy for body work must still be supplied, so it is drawn from the reserves of the body itself at the rate of about one-half a calorie per pound per hour for the 24-hour day, if the patient is lying quietly in bed; in other words, a man of average weight, confined to his bed, will need about 1850 calories per day. How long it will be wise to depend upon the body to furnish its own fuel wholly or in part depends upon circumstances. In disturbances of short duration, such as attacks of acute indigestion, it is quite safe to fast one to three days, or until the cause of disturbance is removed. Nature will quickly bring the digestive tract back to normal, so that in a few days a simple diet ample for all body needs can safely be taken. But in disease which is likely to run a long course and draw severely upon body tissues, food for fuel must be supplied as nearly as possible in accord- ance with energy expenditure, to save the patient from being very much weakened and having to undergo a long period of convalescence to regain what he has lost. Fluid Diet When for any reason the person is below par physi- cally, care must be taken to provide a diet easy of digestion. Some of the ways in which this may be done have already been considered in Chapter II. Since all food must eventually be reduced to fluid form for ab- sorption, a liquid diet is usually regarded as the type easiest to digest, and is often prescribed by the physician. FOOD FOR THE SICK AND CONVALESCENT 321 By this he means a diet which includes: (i) broths and clear soups of various kinds; (2) beef juice and tea; (3) cereal gruels; (4) milk, either plain or modified in such a way as to make it more digestible, more nu- tritious, or more attactive to the patient; (5) raw eggs in combination with water, milk, fruit juices, cocoa, or other fluid; (6) cream soups of various kinds. Broths and clear soups and beef tea have little or no fuel value, from a pint to a quart being required to yield too calories. Their chief virtues are that they are agreea- ble to taste, comforting when hot or refreshing when cold, and when they contain meat extracts (as they usually do) stimulating to the flow of the gastric juice. Broths can be made the carriers of extra nutriment by the addition of eggs, by thickening with cereal flours, such as barley or rice flour, or by combination with ordinary cereal gruels. Beef juice, made by pressing the juice from slightly warmed beef or from finely chopped beef which with a little added water has been kept at a temperature of 1500 F. for two hours (to draw out the juice) has a fuel value of about 100 calories per pint. It is an expensive fuel, since a pound of lean meat yields only about four ounces (| cup) of juice, or about 25 calories. It ranks with eggs and milk as an easily digested protein food, but it is not as attractive in flavor as beef broth or beef tea, and is served only in small quantities. Cereal gruels are useful in many cases in which the appetite is poor or the digestive and assimilative powers very weak. They are neither stimulating nor irritating 322 FEEDING THE FAMILY and are rapidly digested and absorbed. When made from cereal flours, one ounce (4 level tablespoonfuls) to the quart, they have a fuel value of from 70 to 90 calories per quart. They may be made as thick as two ounces to the quart, doubling their fuel value (140 to 180 calories per quart). If the cereal gruel is dextrinized,1 thus rendering it more fluid, as high as six ounces may be used per quart, the fuel value then ranging between 400 and 600 calories per quart, according to the kind of cereal flour used. It is evident that a man could not drink enough thin cereal gruel to furnish a day's quota of energy, and of a thick gruel dextrinized he would have to drink three or four quarts. Their virtue lies in allay- ing hunger and thirst and furnishing a little bland, easily digested food. Like broths, gruels may be en- riched by the addition of eggs, cream, or milk. Milk is one of the most valuable foods for the sick room. It is for most people easy of digestion in its natural state, and can be made still more digestible in various ways. As already pointed out many times, it contains all kinds of material required by the body, and may be considered as "a diet" in itself. Its usefulness can often be increased (1) by changing its flavor, which -is not always agreeable, especially to adults, (2) by altering the relative proportions of protein, fat, and carbohydrate, or (3) by combining it with some- thing which prevents the formation of large or hard 1 Cereal gruels are dextrinized by adding to the cooked gruel, when cooled to about ioo° F., a small amount of a commercial preparation of malt diastase. This causes the thick gruel to liquefy rapidly by changing the starch into dextrins and malt sugar. FOOD FOR THE SICK AND CONVALESCENT 323 curds in the stomach. Just how milk shall be prepared depends upon the individual to be fed. "Some like it hot, some like it cold," and a few like it warm from the cow. Those who find its sweetness unpleasant often enjoy the mild acid flavor of buttermilk and zoolak or the faint tang of fermented milk (kumiss). Coffee, tea, or cocoa may be added for flavor; malted milk not only changes the taste but adds to the fuel value and ease of digestion. With malted milk a number of differ- ent flavors are possible. For example, it may be served hot, slightly salted, or cold with a little fruit juice and sugar. Cereal gruels are added to milk chiefly to make it easier to digest. Raw eggs add to its food value and the eggnog may be flavored in a variety of ways - with vanilla, nutmeg, coffee, beef broth, or pineapple juice. Since whole milk has a fuel value of about 675 calories per quart, it follows that three quarts of milk will cover the energy requirement of the average man in bed, unless his disease is one demanding an extraordinary amount of fuel. Two and one-half quarts of milk plus two eggs will yield the same amount of energy in a little less bulky form. By the addition of some cream or carbohydrate food, as milk sugar, the volume may be reduced still further with ease. What are known as "albuminized" beverages are in reality combinations of white of egg (a kind of protein called albumin) with various fluids, such as milk, broth, orange, lemon, pineapple, or grape juice, or even water, making a soothing drink of some nutritive value, to be taken when the irritability of the digestive tract is par- 324 FEEDING THE FAMILY ticularly great. The white of one egg has an average fuel value of 13 or 14 calories. One white combined with half a cup of milk results in a drink yielding nearly 100 calories. One white plus the juice of one medium sized orange and a teaspoonful of sugar will supply from 55 to 60 calories.1 More nourishment is gained, of course, by introduc- ing the yolk as well as the white of the egg. An eggnog made with one egg, three-fourths of a cup of milk, three- fourths of a tablespoonful of sugar, and one tablespoon- ful of brandy will yield about 230 calories; others will yield from 125 to 200 calories. All of these present the egg in agreeable fluid forms which can be adapted to the palate of the most fastidious. Indeed, the chief reliance for nourishment in fluid diet, it will be perceived, is upon milk and eggs. Even cream soups generally owe their food value largely to milk and are to be re- garded as among the devices for making milk acceptable. Several illustrations of the nutritive value of cream soups will be found among the Dietary Recipes of Table HI, in the Appendix. If a fluid diet is to be maintained but for a short time (a few days), no attempt is usually made to meet the full energy requirement of the patient. The diet relieves sensations of hunger and thirst, and the dilute food has a better chance of digestion than more concentrated would have, for, when one is not taking any exercise, body processes are apt to be sluggish. The fluid diet should 1 Recipes for various foods for invalids with their fuel value stated may be found in Pattee's Practical Dietetics. Food Material Weight (oz.) Measure Food Material Weight (oz.) Measure i. Lemonade 11.0 if cup 1. Grape juice 35 J cup (scant) 2. Beef juice 14.1 ij cup 8. Milk, whole 5-i s cup 3. Buttermilk 9-9 is cup 9. Orange juice 8.2 1 cup 4. Cream, thick (40 % fat) 0.9 is tablespoon 10. Cocoa (J milk) 5-5 5 CUP 5. Cream, thin (18.5 % fat) 1.8 i cup 11. Cocoa (all milk) 3-8 I cup 6. Eggnog 3-7 | cup (scant) 12. Cocoa (milk and whipped cream) 2.9 i cup ioo-Calorie Portions of Beverages 1 1 Cf. Appendix, Tables I and III. FOOD FOR THE SICK AND CONVALESCENT 325 be administered in small amounts at frequent intervals. A liquid meal leaves the stomach quickly and enters the circulation quickly. If meals are too far apart, less food is given than the patient can advantageously take. If too large amounts are given at once, too much work is thrust upon the enfeebled system. An illustration of a typical fluid diet, showing amounts and time of meals, is given below. It will yield from 800 to 900 calories. A Sample Menu for a Fluid Diet 1 7 a.m. 1 cup coffee with | cup milk 9 A.M. Albuminized lemonade; 2 tbsp, lemon juice, 2 tbsp, sugar, egg white, 1 cup water 11 a.m. 1 cup broth 1 p.m. 1 cup gruel made with milk 3 p.m. Albuminized lemonade (as above) 5 p.m. i cup tea with | cup milk 7 p.m. 1 cup broth 9 p.m. 1 cup gruel made with milk 11 p.m. 1 cup broth When a fluid diet is to be given over a considerable period of time, running into weeks, more attention must be paid to its nutritive value. To keep the food dilute and administer over 1000 calories per day, meals may have to occur every two hours throughout the twenty- four. The best example of a very simple dietary of this type will be found in the discussion of typhoid fever. A simple illustration of a more varied menu, to yield about 1800 calories, is given below. Such a menu is 1 Very often the same mixture is used for every meal (see diets in typhoid fever, page 337). When the patient is indifferent to flavor, there is no need for varying the meals. 326 FEEDING THE FAMILY adapted to convalescence or other cases of weakness, where digestion is not greatly impaired. 7 a.m. i cup milk 9 a.m. i cup milk flavored with coffee essence n a.m. Albuminized orange juice; | cup orange juice, 2 tsp. sugar, white of one egg, | cup water 1 p.m. Cream soup with one egg, or broth with one egg and J cup cream 3 p.m. Grape juice eggnog; one egg, J cup milk, 1 tbsp, sugar, | cup grape juice, 1 tbsp, cream 5 p.m. Gruel made with milk 7 p.m. 1 cup tea made with | cup milk and 2 tbsp, cream 9 p.m. Gruel flavored with beef extract 11 p.m. 1 cup hot malted milk; 1 cup milk, 3 tbsp, malted milk Soft or Semi-Solid Diet The so-called soft or semi-solid diet represents an intermediate step between fluid diet and a very simple, wholesome, mixed diet, the latter often designated in hospitals as light or convalescent diet. Soft diet is gener- ally more acceptable to the patient than a wholly fluid diet, and has the advantage of less bulk in proportion to fuel value. The foods most commonly included are any of the fluid foods mentioned in the preceding section and, in addition, a considerable variety of simple dishes, such as toast softened with water, milk, or broth; cream of vegetable soups; custards, baked, steamed or "boiled"; whips, souffles, junkets, blancmange, gelatin jellies, ice creams, ices, and sherbets. Meats and fish are omitted and green vegetables given with caution, usually in soup. The following menu will give some idea of what foods are permissible. It will yield from 2000 to 2200 calories. FOOD FOR THE SICK AND CONVALESCENT 327 A Typical Menu for a Soft or Semi-solid Diet 7 a.m. i cup hot milk (may be flavored with tea or coffee) 9 : 30 a.m. | cup grape or pineapple juice 1 cup thick farina gruel served with rich milk 1 thin slice toast with butter 12 m. 1 cup beef broth with the white of 1 egg 1 thin slice toast with butter 2: 30 p.m. f cup chicken souffle 5 thin slice toast | cup lemon jelly with 1 tbsp, whipped cream 5 p.m. 1 cup milk flavored with tea or cocoa I thin slice toast 7 : 30 p.m. | cup bouillon i-egg omelet | cup cocoa or caramel junket 10 p.m. i cup gruel or malted milk (made with milk) 1 thin slice toast Light or Convalescent Diet The treatment of convalescence depends, of course, upon the nature of the disease. The severity and du- ration of the attack, the strength of the patient, and the nature of the diet during the acute stage are all factors to take into account in directing the diet during recovery, and no rule will exactly fit every case. But we may assume that the digestive tract will participate in the weakness of the rest of the body, even when not itself the seat of disturbance, and regard special attention to the diet as essential to rapid and complete restoration to health. If a fluid diet has been given, it will be fol- lowed by a semi-fluid one, and this in turn by one more like the patient's ordinary diet, but free from any foods which might overtax the system. When no special directions are given, except to take a "light" diet, it is 328 FEEDING THE FAMILY permissible to provide a fairly liberal food supply, allow- ing some surplus over daily energy requirements to replenish depleted cells and restore lost weight, but see- ing to it that the extra amount is not so great as to upset digestion at any time. For adults an allowance of from 2200 to 2500 calories per day is usually sufficient, since convalescents are not indulging in active exercise. Aside from such regulations as the physician may prescribe, the main point is to limit the diet strictly to foods that are not likely to disturb digestion, and to see that build- ing and regulating materials are generously represented. Some of the ways of adapting food to digestive difficulties have been discussed in Chapter II, and many of the sug- gestions made in regard to selection of food for children (Chapters VI-IX) can be applied to the convalescent. It is well to keep in mind also the following points: i. The diet should be simple - only a few kinds of food at a time, and those plainly but very carefully cooked and seasoned. 2. Meals should be served with strict regularity; a half hour of waiting may destroy all desire for food. 3. The appetite should be tempted by the appearance of the tray -• attractive dishes neatly arranged, no food slopped over, hot dishes hot and cold dishes cold when they reach the patient, a pleasant surprise in the shape of a pretty garnish, a flower, or a new dish. The following outline shows the type of food which should be chosen. General Plan for a Convalescent Diet Breakfast : Coffee or tea with milk and a little sugar Diluted fruit juice or cooked fruit, such as pears, prunes, apples A thoroughly cooked cereal (cooked 3 to 8 hours and strained if necessary) with thin cream and a little sugar A soft-cooked egg Dry toast - butter to spread it served separately FOOD FOR THE SICK AND CONVALESCENT 329 Dinner : Meat broth or soup (rice, barley, potato, pea, asparagus) Roast or broiled lean beef, chicken, mutton, lamb, or fish Potatoes baked, boiled, or mashed, or macaroni or rice A small portion of puree of green vegetable if none is served in soup Toast, stale bread, or plain crackers and butter A simple custard, ice cream, junket, cereal pudding, gelatin jelly, or mild stewed fruit Milk, to be flavored as desired Supper : Milk, served as soup, milk toast, or beverage, as perferred An omelet, souffle, or small chop Toast or stale bread and butter Stewed or baked fruit (prunes, apples, pears, bananas) If lunches are required between these meals, an eggnog, a glass of milk and a cracker, a cup of broth and a slice of toast, are safe to choose. Diet in Minor Illness There are many times when diets of the types indi- cated above (fluid, semi-solid, and light or convalescent) may be profitably employed. On occasions of strain, nervous or otherwise, the digestive functions are likely to be depressed, and if given their usual amount of work to do may rebel and precipitate a fit of acute indi- gestion. If, however, the diet is made lighter for a few days, they will regain their normal state with no mishaps. A light meal is always in order when one is weary; pass- ing quickly into the circulation, it helps to relieve the sense of fatigue. Nutritious soups are excellent for this purpose; so are milk toast, bread, rice, or other cereals with milk, especially if the milk or the cereal is taken hot. Colds and influenza are often contracted because of weariness or exhaustion, and frequently accompanied by constipation. At first a light laxative diet of low fuel 330 FEEDING THE FAMILY value is best - hot lemonade or orangeade, broths or gruels with crisp toast, baked potatoes, mild stewed fruits and vegetables being the chief articles of diet. This should be followed in a few days by one of full fuel value, and as soon as the cold seems to be "broken" by one of little higher value than usual, to aid the body in complete recovery. For additional fuel at such times, fats such as butter, cream, bacon, olive and cod-liver oil, seem especially desirable, with liberal use of milk, eggs, and fruit. Cod-liver oil has a higher concentration of the A vitamin than any other known substance. This "full feeding" should be continued until all traces of the cold are gone. It will do much to aid in quick recovery, and without it a cold may hang on a long time and even be the beginning of more serious troubles, such as chronic catarrh, bronchitis, pneumonia, or even tuberculosis. Acute Indigestion During an attack of acute indigestion it is best to refrain from food, or to take only broth, tea, white of egg, or modified milk, for a day or two, until the irritated digestive tract has partially recovered, then to take a semi-solid diet, followed by a light diet, as outlined previously.1 Sugars, which are irritating to the lining of the stomach and likely also to ferment, should be avoided. Fruit and vegetables must be introduced again cautiously. Baked potatoes, baked apples, and prunes are safest to begin with. Bread should be oven-dried or 1 See also " The Part of the Stomach in Good Digestion," page 40. FOOD FOR THE SICK AND CONVALESCENT 331 toasted crisp. Eggs, lean roast or broiled meat and fish, oysters, buttermilk, butter, cream, and bacon are all desirable. Under-feeding for a few days is better than over-feeding in this case. Only small quantities should be taken at one time. The following menu illustrates what may well be taken as soon as comparative com- fort has been secured by rest and lighter feeding. Menu for Diet in Convalescence from Acute Indigestion 7 a.m. Glass of water - preferably hot 8 a.m. Breakfast : Coffee with hot milk Soft-cooked egg Small serving of bacon Two thin slices of toast with butter ii a.m. A glass of buttermilk or sweet milk (the latter preferably hot) and a plain cracker 2 p.m. Dinner : Small serving of lean roast meat, chop, or broiled steak Pulled or toasted bread with butter Cup custard, junket, or cornstarch blancmange Milk or tea or coffee half milk to drink 6 p.m. Supper : Cup of broth Milk toast or omelet with dry toast Bread, tapioca, or other cereal pudding Intestinal Putrefaction The control of intestinal putrefaction has been a problem interesting many investigators, who have repeat- edly observed that changes in the character of the bacteria of the alimentary tract may result from changes in the diet. Milk has been one of the most effective foods, due in part to its lactose or milk sugar. Hence the taking of liberal amounts of milk and some lactose in addition (at 332 FEEDING THE FAMILY least a quart of milk and two or three ounces of lactose per day) has been found more effective than milk alone. This diet favors the growth of organisms which tend to drive out the bacteria of putrefaction. If such organisms can be taken in large numbers in the milk itself, the re- sults are so much the better. The most effective of these is Bacillus acidophilus. Unfortunately acidophilus milk needs to be prepared in the laboratory, but its value is so great that active measures are being taken to extend its use and it is to be hoped that before long it will not be difficult for any one to procure.1 In cases of mild putrefaction some less radical treat- ment of a dietary character is helpful. As indicated in Chapter II, protein food should be limited and the kind carefully considered. Meat proteins are very readily attacked by putrefactive bacteria and should be avoided. Milk protein is most satisfactory, and one may choose not only the various milk beverages, but also cottage and other cheeses as meat substitutes. Vegetable proteins may also be used, as those in cereals and bread, peas, and beans. Not more than two protein calories per pound of body weight should be taken per day by an adult. A liberal use of green vegetables and fruits not only helps to carry off putrefactive products from the intestine, so that they will not be absorbed to circulate in the body and do harm, but these foods by their ten- dency to ferment a little actually hinder the action of the putrefactive bacteria. Further help may be had from 'For further information consult The Intestinal Flora by Rettger and Cheplin. FOOD FOR THE SICK AND CONVALESCENT 333 lactose, by taking one to three ounces with each meal. Constipation is very likely to be associated with putre- faction, and most of the measures used to combat it1 may be tried when it is associated with putrefaction. Persistence is essential to success in the treatment of intestinal disturbances. One needs the patience of Job and grim determination not to backslide. The following suggestions may be helpful in planning a diet. A Suggestive Menu for Counteracting Mild Intestinal Putrefaction 7 a.m. Glass of water or dilute fruit juice Breakfast : Thoroughly cooked cereal, with cream Dry, crisp toast and butter Fresh or stewed fruit Luncheon: Hot vegetable dish, as scalloped cauliflower, cabbage, tomatoes, or potatoes; macaroni, rice, or hominy, with cheese; macaroni or rice with tomatoes; or stuffed tomatoes or peppers Crisp lettuce or celery Twice baked crusty rolls, or toast and butter Cereal pudding or fruit dessert Dinner : Vegetable or milk soup Egg, cheese, or nut dish Cooked green vegetable Vegetable, fruit, or cheese salad Simple pudding, or frozen dessert, or crackers, cheese and coffee 10 P.M. Glass of hot water Food in Fevers In the early stages of fever, digestion is often much disturbed - sometimes to such a degree that no food at all can be retained. No food should be given which 1 See page 48. 334 FEEDING THE FAMILY cannot be readily digested and absorbed, for undigested food will do more harm than good. A liberal supply of liquid is important to relieve thirst and help in elimi- nation of waste products, but when the digestive tract is very irritable even fluids will have to be given in small quantities at a time, though at frequent intervals. For a few days after the first onset of fever, the beverages, aside from water, may be only slightly nutritive, being confined principally to cereal waters (very thin gruels), diluted fruit juices (lemonade, orangeade, etc.), whey, and broth. But the energy output in fever is higher than when the body is free from fever and increases with each de- gree of rise in temperature. Hence the higher the tem- perature the greater the need for food and to an energy allowance suitable for a healthy man lying in bed there must be added allowances for the rise in temperature, restlessness, and perhaps also a special toxic stimulation of energy expenditure due to the infection. As a result, the total energy requirement in fever may be 30, 40, or 50 per cent higher than normal, so that the bedridden man, instead of requiring from 1800 to 2200 calories per day will need as much as if he were doing moderate muscular work in health, i.e., 2800 to 3000 calories. Even this may not be sufficient to keep the body from wasting by loss of nitrogen in such a fever as typhoid, and such loss cannot be prevented by increasing the protein of the diet, but only by raising the calories to perhaps 4000 or 5000 per day. The protein requirement in fever is little higher than normal and will be met by from two to two and one-half calories per pound of body weight. FOOD FOR THE SICK AND CONVALESCENT 335 The administration of food in fever calls for the exer- cise of skill and good judgment in deciding how far the patient's energy needs can be met when the alimentary tract is very sensitive and indigestion may be worse than under-feeding, and in selecting the food which can be taken most successfully. A fluid diet is safest and easiest to give, as a rule. Meals may be served at inter- vals of one and one-half to two hours. Milk is an ideal fever food, if modified to suit the digestive state of the patient. Whole cow's milk is so high in protein that it will make a better balanced diet if something contain- ing little or no protein is combined with it - cream or milk sugar or both, or some cereal gruel or proprietary infants' food prepared from cereal flours, malted or otherwise. The aftertaste of milk is disagreeable to many, especially when the mouth is parched with fever, and this can be avoided by carefully cleansing the mouth with water, plain or slightly acidified with lemon juice, immediately after each feeding. The outline of a fluid diet of high fuel value, on page 326, may be used in fever as soon as the digestive tract will tolerate it - usually in a few days. Diet in Typhoid Fever Typhoid fever furnishes a striking example of a dis- ease in which diet is one of the most important factors in treatment. The very life of the patient depends upon absolute obedience to physician and nurse in regard to every mouthful that the patient receives. A single indiscretion in diet may prove fatal, and no one but a 336 FEEDING THE FAMILY person expert in reading the signs of the patient's con- dition (often entirely unperceived by the inexperienced and untrained person) should venture to prescribe the diet. Since, however, the home nurse has the responsi- bility of preparing the food ordered by the doctor, she will be able to cooperate more easily and cheerfully if she understands the general principles of the dietetic treatment of the disease, and it is only with the thought of giving this background that the following suggestions are made. As in other cases of fever, there is an increase in the energy expended, due to the influence of the heightened temperature. There is an added expenditure due to the wasting of body substance brought about by the bacteria which cause the disease. These bacteria en- ter the system by way of the mouth, usually in contami- nated food or water. A typhoid patient is always the victim of somebody's carelessness. Proper safeguard- ing of the water and milk supply in a community, with prompt isolation of any typhoid subject who may appear, will practically eliminate the disease. Typhoid bacteria find a congenial soil in the large intestine and flourish there at the expense of the intestinal wall, causing ulcers and giving off poisons which are absorbed and circulate in the blood to poison the whole body. On account of the intestinal ulcers, the diet must not cause irritation or undue distension of the intestinal walls. This is one reason why the food must be very easy to digest and absolutely free from all indigestible substances, such as cellulose, seeds, or even large undigested food fragments. FOOD FOR THE SICK AND CONVALESCENT 337 In the early stages, the digestion may be greatly dis- turbed and little food of any kind can be given. But typhoid runs a long course (four to six weeks) and these first symptoms subside more or less completely in a com- paratively short time, after which digestion may con- stantly improve. The power of the body to absorb and utilize food is not much impaired, so that once digestion is good the increased energy demands can be nearly, if not fully met, and the great wasting once thought inevitable prevented. There are cases on record in which the patients have actually gained weight while the disease was in progress. If such feeding is possible, the dangers of exhaustion and slow convalescence are much lessened. For the early stages, then, it is likely that a fluid diet will be adhered to very strictly, one consisting princi- pally of modified milk being most generally employed. The amount and nutritive value will depend upon the condition of the patient, the best success being generally obtained with from 1000 to 3000 calories per day. The following are good examples of the modified milk diets. Modified Milk Diets for Typhoid Fever 1 Calories For 1000 Calories a Day: Milk, 1000 c.c. (1 quart) 700 Cream, 50 c.c. (if oz.) 100 Lactose, 50 gm. (if oz.) 200 This furnishes eight feedings, each containing: Milk, 120 c.c. (4 oz.) 80 Cream, 8 gm. (2 dr.) 15 Lactose, 6 gm. (if dr.) 24 1 Coleman, American Journal of Medical Sciences, January, 1912. 338 FEEDING THE FAMILY For 2000 Calories a Day: Milk, 1500 c.c. (ij quarts) 1000 Cream, 240 c.c. (8 oz.) 500 Lactose, 125 gm. (4 oz.) 500 This furnishes seven feedings, each containing: Milk, 210 c.c. (7 oz.) 140 Cream, 30 c.c. (1 oz.) 60 Lactose, 18 gm. (45 dr.) 72 For 3000 Calories a Day: Milk, 1500 c.c. (i| quarts) 1000 Cream, 480 c.c. (1 pint) 1000 Lactose, 250 gm. (8 oz.) 1000 This furnishes eight feedings, each containing: Milk, 180 c.c. (6 oz.) 120 Cream, 60 c.c. (2 oz.) 120 Lactose, 30 gm. (1 oz.) 120 It is not necessary always to limit the kinds of food in the fluid diet for typhoid so strictly as in the diets above. Many patients can take and will enjoy a little more variety and may be given such a diet as the following:1 A Mixed Fluid Diet for Typhoid Fever 8 a.m. Milk and coffee, each 120 c.c. (4 oz.) 10 a.m. Milk, hot or cold, 240 c.c. (8 oz.) 12 noon Oatmeal gruel, 120 c.c. (4 oz.), with milk, 60 c.c. (2 oz.) 2 p.m. Junket with cane- and milk-sugar 4 p.m. Oatmeal gruel, 120 c.c. (4 oz.), with milk, 60 c.c. (2 oz.) 6 p.m. Junket with cane- and milk-sugar 8 p.m. Hot milk, 240 c.c. (8 oz.) 10 p.m. Whey, 180 c.c., with one whole egg and sherry 12 p.m. Oatmeal gruel, 120 c.c. (4 oz.), with milk, 60 c.c. (2 oz.) 2 a.m. Junket with with cane- and milk-sugar 4 a.m. Milk, 240 c.c. (8 oz.) 6 a.m. Milk, 240 c.c. (8 oz.) 15 gm. (| oz.) of lactose added to each of the four milk feedings APPROXIMATE VALUES Protein, 71 gm. (2$ oz.); fat, 81 gm. (25 oz.); carbo- hydrates, 160 gm. (sJ oz.); Calories, 2300. 1 F. P. Kinnicutt, Diet Lists of the Presbyterian Hospital, New York City, page 15. FOOD FOR THE SICK AND CONVALESCENT 339 A typhoid patient is not always limited to a fluid diet, though solid foods must be given cautiously and intro- duced gradually. The foods from which the diet should be chosen are: 1. Milk in various forms 2. Broths - beef, veal, chicken, mutton 3. Soups - potato, pea, bean, carefully strained and thickened with flour. Milk, cream, and egg may be used 4. Gruels - always strained 5. Eggs, raw or soft-cooked 6. Cream and butter 7. Custards, ice creams and sherbets, blancmanges, and gelatin jellies. Milk sugar used for sweetening will increase the fuel value 8. Toast 9. Breakfast cereals, thoroughly cooked and strained 10. Rice, baked and mashed potatoes 11. Apple sauce, orange juice and grape juice Such a diet is adapted to the early stages of conva- lescence, when not prescribed during the fever. A dietary which illustrates the high feeding on a very simple, easily digested, mixed diet, free from anything likely to cause intestinal irritation or other disturbance, is here quoted.1 A Soft Diet for Typhoid or Typhoid Convalescence Calories 7 A.M. Egg, 1 . 80 Toast, 1 slice 80 Butter, 20 grams 150 Coffee Cream, 2 ounces 120 Lactose, 20 grams 80 1 Coleman, American Journal of Medical Sciences, January, 1912. 340 FEEDING THE FAMILY 9 A.M. Milk, 6 ounces 123 Cream, 2 ounces 120 Lactose, 10 grams 40 II A.M. Egg, 1 80 Mashed potato, 20 grams 20 Custard, 4 ounces 250 Toast (or bread) 1 slice 80 Butter, 20 grams 150 Coffee Cream, 2 ounces 120 Lactose, 20 grams 80 1 P.M. Same as 9 a.m 283 3 p.m. 1 Same as 9 a.m 283 5 p m. Egg, 1 80 Cereal, 3 tablespoons 150 Cream, 2 ounces 120 Apple sauce, 1 ounce 30 Tea Cream, 3 ounces 180 Lactose, 20 grams 80 7 P.M. Same as 9 a.m 283 10 P.M. Same as 9 a.m 283 1 A.M. Same as 9 a.m 283 4 a.m. Same as 9 a.m 283 Total calories for day 3911 1 Lactose lemonade may be substituted for the milk mixture at three o'clock. See Table III, Appendix, page 390. FOOD FOR THE SICK AND CONVALESCENT 341 Diet in Tuberculosis When the tubercle bacillus gains a foothold in the human body, it not only proceeds to destroy the organ upon which it encamps, - lungs, kidney, or whatever it may be - but it produces poisons which permeate the whole system, causing fever, loss of appetite, and other bad conditions which result in the wasting so familiar in this dread disease. There is no drug which will kill or drive out the germ : the body must elaborate its own weapons of defense, and the object of treatment is to build the person up so that resistance to the disease will become great enough to bring about a cure. Every thing which will help to promote good nutrition must be emphasized - all the fresh air obtainable, carefully regulated rest and exercise, and good food in abundance. As in typhoid fever, the amount and kind of food is of the greatest importance. But in tuberculosis the appe- tite is apt to be poor and fitful and no guide whatever as to how much the patient should eat. Often he must continue eating when he does not want food at all. But this does not mean that he should be indiscriminately "stuffed." In the past this has often been done to the detriment of the patient through upsetting his diges- tion and otherwise overtaxing his system. Laboratory studies of the energy expenditure in tuberculosis, together with the carefully recorded observations of sanitaria, indicate that energy requirement is not raised greatly above the normal in this disease, and it has been sug- gested that in pulmonary tuberculosis excessive food 342 FEEDING THE FAMILY intake, bringing a production of extra heat by its stimu- lating effect upon the body, may do harm to the lungs by increasing their work, especially in the active stages of the disease. The total energy value of the diet must therefore be adapted to the individual patient, and should be just sufficient to maintain a body weight slightly above normal. In general such diets range be- tween 2500 and 3500 calories, according to whether the patient is permitted to engage in physical activity or not. In selecting foods to make a liberal but not excessive diet, it has lately been suggested that the generous use of fat is very desirable, as it is burned with less tax on the lungs than carbohydrate or protein. At least there is less emphasis upon a high protein diet than formerly, and recent laboratory experiments show that from 240 to 360 protein calories per day are sufficient for patients having enough total calories to meet their energy re- quirements. In other words, the proportion of protein in the diet should not be higher than a liberal normal value - from 12 to 15 per cent of the total calories. In addition to fulfilling protein and energy require- ments quantitatively, it is important that the protein be of good quality and that the ash constituents and vitamins be liberally supplied. In view of the demon- strated effect of the vitamins (and especially the A vita- min) in enabling the animal body to resist infection, the well-known beneficial effects of milk, eggs, butter, cream, and cod liver oil do not seem surprising. The tendency of the tuberculous to digestive disorders has limited, FOOD FOR THE SICK AND CONVALESCENT 343 perhaps more than necessary, the use of green vegetables. When they cannot be taken in ordinary ways, it is still possible to give purees or to use their juices in soups, and thus to guard against shortage of the C vitamin. For the same reason a certain amount of fruit is desirable, and juices may be used or mild fruit freshly stewed. The full amount of a well-balanced diet, arranged with regard to the state of appetite and digestion of the patient, must be taken with as complete regularity as possible. Each day's food should be measured, at least roughly, and by cheerful encouragement, mild diver- sion, carefully cooked and attractively arranged meals, its consumption secured. Three regular meals a day are sufficient with moderate energy intake, an extra glass of milk or two being sometimes prescribed. The weight should be watched and if it goes down, the diet should be altered accordingly. Constipation is common, hence a gently laxative diet is desirable. In case of serious gastric disturbance, readjustment of the diet should be made under the physician's guidance. A Day's Food Plan for a Moderate-Priced Diet for Tuberculosis Fuel Requirement: 2500-3500 Calories Cost: 2^-3^ per 100 Calories Breakfast: Fruit or fruit juice 75-100 Calories Cooked cereal 100-200 Calories Bacon or Fish or Eggs 75_i5o Calories Toast or Crisp rolls . . 100-150 Calories 344 FEEDING THE FAMILY Breakfast: Continued Butter 100-150 Calories Rich milk (may be flavored with coffee and sugar) 150-200 Calories Thin cream for cereal 150-250 Calories 700-1000 Calories Dinner : Meat (roast or broiled) or Fish (baked or broiled) or Cheese dish (fondue, souffle) . . 100-200 Calories Potatoes (baked or boiled) .... 100-150 Calories Cooked green vegetable 75-150 Calories Lettuce or other vegetable salad Cream or oil dressing . 150-250 Calories Bread or rolls 100-150 Calories Butter 150-250 Calories Junket or Custard or Cream or Dutch cheese and crackers 100-200 Calories Milk to drink (may be flavored with coffee) 150-200 Calories 1000-1300 Calories Supper : Cream soup or Hot cooked cereal with cream or Vegetable cooked with milk . . 150-250 Calories Baked potato or Omelet or Egg, fruit or vegetable salad . . 100-200 Calories Bread 75-150 Calories Butter 100-150 Calories Very mild cooked fruit 100-150 Calories Milk to drink (sweet or buttermilk) . 150-200 Calories 800-1100 Calories FOOD FOR THE SICK AND CONVALESCENT 345 A Moderate-Priced Dietary for Tuberculosis Measure Weight Protein Total Oz. Calories Calories Breakfast : Orange juice (C, B, A) . . i cup 2.0 - 25 Farina (B) i cup 6,o 12 IOO Cream, thin (A, B) . . . 5 CUp 3-6 IO 200 Poached egg (A, B) . . . i egg i.6 25 70 Toast 2 slices i-3 14 IOO Butter (A) i tbsp. 0-5 i IOO Sugar 2 tbsp. 1.0 - IOO Milk (A, B) i cup 8-5 34 170 Coffee - - - 865 Dinner : Roast beef 2 slices 3-2 92 200 Gravy i cup i-7 7 50 Mashed potato (C, B) . . t cup 4-7 ii 150 Creamed peas (A, B, C) i cup 2-7 18 IOO Bread i slice 0-7 7 50 Butter (A) i tbsp. o-5 i IOO Apple tapioca (B, C) . . 5 cup 7-2 2 200 Cream (A, B) 4 cup i.8 5 IIO Milk (A, B) I cup 8-5 34 170 1130 Supper: Cream of celery soup (B, A) I cup 7-2 22 200 Baked sweet potato (A, B) i small 4-5 9 150 Bread i slice 0-7 7 50 Butter (A) 2 tbsp. 1.0 2 200 Stewed pears (B) .... 1 cup 5-5 4 150 Milk to drink (A, B) . . I cup 8-5 34 170 920 Total for day .... 35i 2915 346 FEEDING THE FAMILY Measure Weight Oz. Protein Calories Total Calories Breakfast: Apple sauce (B, C) . . . 8 CUp 3-5 I 100 Oatmeal (B) I cup 7-9 i7 100 Bacon, broiled 5 large pieces 1.0 26 200 Bacon fat i tbsp. o-5 - 100 Bread, whole wheat (B) 4 slices 2.8 32 200 Sugar 2 tbsp, (scant) 0-9 100 Milk (A, B) i cup 8.5 34 170 Coffee - - - - 970 Dinner : Beef stew with vegetables (B, C, A) 8 CUp 6.o 32 200 Boiled potato (C, B) . . i large 5-4 16 150 Bread, whole wheat (B) 2 slices i-4 16 IOO Butter (A) Tapioca-cornmeal pudding i tbsp. o-5 I IOO (A, B) I cup 7.2 44 400 Sugar i tbsp. 0-5 - 53 Milk (A, B) i cup 8.5 34 170 Coffee - - - - 1173 Supper: Pea soup (A, B) . . . . I cup 10.0 43 167 Sausages 2 small 2.2 40 200 Bread, whole wheat (B) 2 slices 1-4 16 IOO Sausage fat i tbsp. 0-5 - IOO Cheese, American (A, B) . i in. cube 0.4 13 50 Stewed figs (B) .... 4 figs 4-0 10 200 Milk (A, B) I cup 8-5 34 170 987 Night Lunch: Bread, whole wheat (B) 2 slices i-4 16 IOO Butter (A) i tbsp. o-5 1 IOO Milk (A, B) i cup 8.5 34 170 370 Total for day .... 460 3500 A Low-Priced Tuberculosis Dietary for a Working Man FOOD FOR THE SICK AND CONVALESCENT 347 A tempting diet of high fuel value is likely to be ex- pensive. Cream, butter, eggs, choice meats, fruits and vegetables, dainty cookery, and service are beyond the reach of many tuberculous patients. That tuberculosis can, however, be cured on foods which are within the reach of the ordinary purse has been demonstrated at the Loomis Sanitorium 1 in this country and at those in England under the supervision of the well-known authorities, Bardswell and Chapman.2 Diets even less expensive than that on page 345 are those of Bardswell and Chapman. The following modi- fication of their plan, adapted to American conditions, is a very satisfactory basis for low-priced diets.3 In these milk is the main dependence for vitamins. A Plan for Low-Priced Tuberculosis Diets Breakfast: Large dish of oatmeal, milk and sugar, 2 oz. of bacon or smoked fish, 2 slices of bread and oleomargarine 10 a.m. 3 slices of bread and oleomargarine with prune or date marmalade prepared at home Luncheon: 8 oz. of soup from one of the dried vegetables (vary by making part milk), 2 slices of bread and cheese, glass of milk Dinner: Plate of meat stew with potatoes, slice of bread and oleo- margarine, dish of well-cooked vegetables, 8 oz. of rice or tapioca pudding made with milk, glass of milk 1 King, On the Construction of a Practical and Efficient Diet in Tuberculosis. 2 Bardswell and Chapman, Diet in Tuberculosis. 3 Gibbs, Food for the Invalid and Convalescent, page 8i. 348 FEEDING THE FAMILY Diet in Diabetes The regulation of the diet is the most important con- sideration in the treatment of diabetes mellitus. The most striking symptom of the disease is an impaired power of utilizing carbohydrates. These ordinarily circulate in the blood as sugar and are burned by the muscles for fuel or stored in muscles and liver. In the diabetic the sugar in the blood cannot be burned and accumulates in the blood until a certain point is reached, when it passes into the urine. Not every one who ex- cretes sugar is a diabetic, but the appearance of sugar in the urine should be regarded with suspicion and the state of health thoroughly investigated, for the sooner this disease is treated the better the chance of arresting its progress and keeping the patient in comparatively good health and comfort. The presence of excessive sugar in the blood lowers resistance to bacterial infection and invites numerous complications, besides hasten- ing the progress of the disease itself - that is, the dis- turbance of the sugar-burning power of the body. Middle-aged and elderly people ought to have their urine tested once a year as a precautionary measure. While certain general principles in regard to diet for diabetes can be laid down, each patient presents an individual problem which must be studied, not only at the beginning of the treatment, but throughout the course of the disease. The power to burn sugar perfectly, once lost, is never completely regained ; the diet must always be carefully prescribed and changed from time to time FOOD FOR THE SICK AND CONVALESCENT 349 according to the development of the disease. If the loss of sugar-burning power is very great, it is likely to be accompanied by other signs of a disturbed state of nutrition, particularly the appearance of certain acids in the urine indicative of a condition called acidosis. A Convenient Food Scale Dietetic treatment must be directed to the control of acidosis, as well as to the elimination of sugar from the urine. It has been found that the urine may be made sugar free by complete fasting, or by partial deprivation of food, in which case the fat is usually withdrawn first, then the carbohydrates and protein gradually but rather quickly reduced according to the judgment of the physi- 350 FEEDING THE FAMILY cian. Sometimes there is a reduction of the total calories to about half the patient's requirement, protein and carbohydrate being greatly restricted but fat used more liberally. When the urine is sugar free and there is no acidosis, the diet is cautiously and systematically increased until the patient's tolerance (the amount of protein, fat, and carbohydrate respectively which he can utilize in a nor- mal manner) has been determined. Such a series of diets as the following might be used for this purpose. A Series of Diets for Testing Tolerance of Diabetics1 Carbohydrate Grams Protein Grams Fat Grams Total Calories I IO II 6 138 II 22 13 18 302 III 32 24 24 440 IV 42 29 39 635 V 52 32 53 813 VI 63 43 65 1009 VII 73 5i 7° 1126 VIII 83 59 87 1351 IX 96 62 93 1469 X 107 63 93 1517 By careful watching of the patient, with suitable examinations of blood and urine, the limit beyond which he cannot go without sugar in the urine will be found. Then the patient must be educated to select his diet according to the physician's directions unless he be rich 1 From Joslin, in Pattee's Practical Dietetics, page 381. FOOD FOR THE SICK AND CONVALESCENT 351 enough to engage the services of a trained dietitian.1 One of the first things to be learned is that slight under- nutrition is more favorable to progress than over-nu- trition. Body weight must therefore be kept slightly under normal and attention paid to the total energy value of the diet as well as its content of any particular foodstuff. Opinion is somewhat divided as to the proportion of fat which is most advantageous, but there is no disagreement as to the necessity for low levels for total calories and protein, with carbohydrate well within the tolerance of the individual. The diabetic must have at hand convenient tables of food values so that he can make his calculations with ease and accuracy. Food should be weighed on scales weighing in grams if possible. His physician will tell him just how many grams of protein, fat, and carbo- hydrate he may have per day. In order that a diet of low fuel value may have sufficient bulk to satisfy the appetite, liberal use is made of the more watery and fibrous vegetables which contain less than ten per cent of carbohydrate and may be eaten in considerable quanti- ties without increasing markedly the total carbo- hydrate of the ration. Vegetables having the same per cent of carbohydrate may be used interchangeably and thus the patient can make adaptations to his own cir- cumstances. A simple list as used in a dispensary where patients can be taught only crude methods is as follows: 1 Books to help are Joslin's Diabetic Manual and Huddleson's Food for the Diabetic. 352 FEEDING THE FAMILY Vegetables Grouped According to Carbohydrate Content 1 Less than 5 Per Cent 5 Per Cent 10 Per Cent Lettuce Tomatoes String beans (fresh) Cucumbers Brussels Sprouts Pumpkin Spinach Cauliflower Squash Asparagus Egg plant Turnip Rhubarb Cabbage Beets Sauerkraut String beans (canned) Carrots Beet greens Celery Onions One and one-half cups of any five per cent vegetable and one-half cup of any ten per cent vegetable will yield approximately five grams of carbohydrate. This may be practically all removed from most vegetables by thrice cooking, i.e., by cutting them up, soaking in water for a short time, bringing to a boil, removing the water, soaking and boiling twice more. These give extra bulk and serve sometimes as carriers for fat. Tables giving the weights of portions of food to yield a certain number of grams of protein or carbohydrate are also useful and can be arranged from a standard handbook of food values2 with little trouble.3 Making a diabetic diet acceptable depends not only upon ability to regulate the kind and amount of food, but upon skill in cookery, and the amount of money 1 For a more extensive table consult Joslin's Diabetic Manual, page 53. 2 Such as Rose's Laboratory Handbook for Dietetics. 3 Or they may be found with household measures in Mosenthal's Diabetes Mellitus, A System of Diets and in Huddleson's Food for the Diabetic. FOOD FOR THE SICK AND CONVALESCENT 353 available for food. Since carbohydrates constitute the largest part of an ordinary diet, their withdrawal changes eating habits materially, and people find it difficult to do without the familiar bread, potatoes, cereals, sugars, and fruits. Furthermore, the carbohydrate foods are rela- tively the cheapest part of the diet, so that a diabetic diet will always cost more than a mixed diet of the same general char- acter. Most books on invalid cookery give recipes for diabetic diets.1 These are very helpful because the cook is deprived of her ordinary thickening agents, such as flour, also of sugar and milk, and special devices are necessary to make acceptable dishes. The best fats are butter, cream, cream cheese, olive oil, bacon fat, meat fats of other kinds, bone marrow, fat and highly flavored fish (as canned sardines, salmon, mackerel, and white-fish). Green vegetables are the best fat carriers. When the fat is not greatly restricted, melted butter may be poured over those served hot and olive oil or cream dress- ing over salads. Cream can be used in place of milk A Comparison of the Distribu- tion of Calories in a Typical Normal Diet and a Diet for Severe Diabetes without Acidosis 1 Farmer, Food for the Sick and Convalescent, Pattee, Practical Dietetics, Huddleson, Food for the Diabetic, Joslin, Diabetic Manual. 354 FEEDING THE FAMILY in many dishes. In others, cream diluted with water, to which raw white of egg is added will make a satis- factory milk substitute. As a rule, the best success in feeding comes from judicious use of the ordinary foods in correct amounts. Special diabetic foods on the mar- ket are expensive and not always reliable. They should not be used without knowledge of their exact composi- tion.1 The more the carbohydrate is removed, the greater the cost. On account of the restrictions in breadstuffs, muffins, wafers, and so forth, made with almond, soy bean, or pure gluten flour are useful oc- casionally for the sake of variety, but wafers or biscuit of washed bran may be regarded as a regular part of the diet. Saccharine may be used for sweetening in place of sugar. It has no food value, but is intensely sweet, having 500 times the sweetness of cane sugar. The taste remains in the mouth much longer than that of sugar, and if much is used a bitter taste develops. It should, therefore, be used as little as possible to get the best results in the long run. There is always danger of mild diabetes becoming severe; the only way to prevent this is by eternal vigi- lance in regard to diet, and careful living, without physical overwork or nervous strain. Even when the patient is tempted by long periods of continued well- being to disregard his dietetic limitations, he should be 1 The composition of many diabetic foods may be found in a bulletin by Mendel and Street, Diabelic Foods, published by the Connecticut Agricultural Experiment Station, New Haven, Conn. FOOD FOR THE SICK AND CONVALESCENT 355 prevented from doing so. A diabetic patient should not have charge of his own diet. The unhappy feeling of restriction will be less and the temptation to overstep the boundaries diminished if some one else plans and prepares the meals. The discovery of insulin marks a new era in the history of diabetes mellitus. It is an extract of certain cells in the pancreas which has the power, when injected into the body by means of a hypodermic needle, of tem- porarily enabling it to burn more sugar. Its use is still in the experimental stage, and no great quantities of it are to be had, so that it is being used for the cases which need it most, those who can burn little or no sugar and who consequently cannot take enough total calories to cover more than a mere maintenance requirement at rest without acidosis or glycosuria or both, and have added to their other troubles the depression from severe under-nutrition. Insulin, by enabling them to burn more sugar, also enables them to burn more protein and fat, hence to be better nourished, to feel better, and to be able to go about their affairs. While not a cure for the disease, it is a wonderful palliative. But it does not offer relief from the necessity of keeping the diet strictly within prescribed limits. Food must be weighed with the same care as before. With insulin, too little carbo- hydrate as well as too much is dangerous. "These calculations" (of food requirement) says an eminent specialist, "are not matters of lucky guess or mere opinion. They can be estimated more accurately than the gasoline consumption of a motor car." 356 FEEDING THE FAMILY Diet in Gout Gout is a disease of the overfed rather than the under- nourished. Luxurious living, with its constant temp- tation to overeat, especially of protein foods, and to avoid exercise, often brings its penalty in the form of acute or chronic gout. Indulgence in alcoholic beverages, es- pecially as an accompaniment to a sumptuous repast, increases a man's chances of acquiring the disease. Sometimes he suffers for the sins of his ancestors, the tendency to the disease being said to be transmissible. There are usually disturbances of the digestive system - gastric indigestion, intestinal putrefaction, and con- stipation - but the most constant symptom is an excess of uric acid in the blood, indicating a faulty elimination of this substance. Uric acid is formed in the body, but in health it is excreted in the urine, so that the amount in circulation in the blood is very small. In gout this substance accumulates in the blood and is eliminated with difficulty. The following are to be avoided: (i) all foods which disturb digestion; (2) all foods which tend to induce intestinal putrefaction and constipation; (3) all excess of total fuel and of protein food; and (4) all foods which by their composition tend to increase the amount of uric acid which the body has to get rid of. Uric acid belongs to a group of closely related substances called purins. These are found in flesh foods of all kinds and in some vegetable foods. The purins other than uric acid in these foods are mostly converted into uric acid in the body. Hence, if elimination is faulty, they FOOD FOR THE SICK AND CONVALESCENT 357 raise the amount of uric acid in the blood, a condition considered very unfavorable in cases of gout, though the relation of this substance to the disease is not fully understood. The taking of alcoholic beverages also tends to hinder uric acid elimination, and these should be excluded in gout. The treatment is largely dietetic and the diet should be adapted to the needs of the patient by the physician. Some information, however, as to the purin content of foods will be helpful in carrying out his orders. Milk, eggs, cheese, nuts, gelatin, fruits, sugars, breadstuffs made with white flour, cornstarch, tapioca, farina, rice, potatoes, and other root vegetables, most green vege- tables (spinach and asparagus excepted) and all kinds of fat are practically purin-free. Sweetbreads, kidney, liver, sardines, and anchovies are very rich in purins and should be entirely avoided. Beef, veal, mutton, pork, chicken, turkey, goose, and other kinds of game, fish with the exception of cod, are fairly high in purin content, and should be sparingly if at all indulged in. Boiling meat will remove some of the purins; hence boiled meats are sometimes allowed where roasted or broiled ones are not. Among vegetable foods, spinach, asparagus, peas, and beans are richest in purins, though none of these contains as much as meat. A die- tary indicating the type of food best adapted to use in gout is given on the following page. 358 FEEDING THE FAMILY A Day's Dietary Suggested for Chronic Gout Measure Weight Oz. Protein Calories Total Cal- ories 7 a.m. : Hot water I cup - - - 8 a.m. : Orange (C, B, A) . . . i large 9-5 7 100 Rice t cup 2.0 5 50 Cream, thick (A, B) . . i tbsp. 0-5 i 50 (scant) Sugar i tbsp. 0.5 - 50 (scant) Hot milk (A, B) . . . I j cups 10.2 38 200 Bread 4 slices 1-3 28 200 Butter (A) i tbsp. 0-5 I 100 Peaches (B, C) . . . . if medium 5-3 3 50 800 i p.m. : Soft-cooked eggs (A, B) . 2 eggs 3-4 54 150 Baked potato (C, B) . . 2 medium 6.o 22 200 Celery (B) 4-8 6 25 Bread 4 slices 2.6 28 200 Butter (A) i tbsp. 0-5 1 IOO Peaches (B, C) . . . . i| medium 5-3 3 50 Tea, very weak and un- sweetened - - - - 725 6 P.M. Milk (A, B) I j cups 10.2 38 200 Bread 6 slices 3-9 42 300 Baked apple with whipped cream (B, A, C) . . . i small apple 2.4 1 IOO Sugar i tbsp. 0-5 - 50 (scant) Butter (A) i tbsp. 0-5 I IOO 750 Total for day .... 279 2275 APPENDIX APPENDIX Table I. 100-Calorie portions of foods as we eat them Table II. Fuel values of food materials in terms of common measures Table III. Dietary recipes Table IV. Fuel values in relation to cost Table V. Height and weight of men at different ages Table VI. Height and weight of women at different ages Table VII. Height and weight of boys at different ages Table VIII. Height and weight of girls at different ages Table IX. Height and weight of boys from birth to school age Table X. Height and weight of girls from birth to school age Table XI. Amounts of vitamins in food materials TABLE I ioo-Calorie Portions of Foods as We Eat Them Introductory Note Most of these foods have been measured and weighed in the author's laboratory, some of them many times. Nevertheless, standardization of measures and weights is exceedingly difficult, and these tables make no claim to strict mathematical accuracy. They are presented with the hope of enabling the housewife who does not wish the burden of weighing and making calculations - or the persons who cannot go behind the scenes, i.e. into the kitchen - to get quickly some fair conception of the relative value of various foods as they appear on the table. The data on uncooked single food materials have been taken largely from the author's Laboratory Handbook for Dietetics, based on the Analyses of Ameri- can Food Materials, published as Bulletin 28, Office of Experiment Stations, U. S. Department of Agriculture, from which latter source have also been taken some analyses of cooked foods. 362 APPENDIX 363 ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Beverages Buttermilk (see Dairy Products) . . Chocolate I . . . 2 cup (scant) 4-i IO 48 42 Chocolate II . . . i cup 3-i 13 49 38 Cocoa I .... 5 CUp 5-5 14 39 47 Cocoa II .... s cup 3-8 16 44 40 Cocoa III .... i cup 2.9 12 34 54 Cream (see Dairy Products) . . Egg lemonade . . i cup 4.8 13 24 63 Eggnog 2 cup (scant) 3-7 21 48 3i Fruit punch . . . | cup (scant) 1.8 I 1 98 Grape juice (see Fruits) Lactose lemonade | cup (scant) 2.6 - - 100 Lemonade .... if cups 11.0 - - 100 Milk (see Dairy Prod- ucts) .... Orange juice (see Fruits) Bread, Biscuit, Crack- ers, and Muffins Baking powder biscuit 2 small biscuit i-3 II 27 62 Bread, Boston brown f in. slice 3 in. diam. 1.8 IO IO 80 Graham .... 3 slices | in. X 2 in. X 31 in. 1-4 14 6 80 Old New England com .... piece 25 in. x 1 in. X 1 in. 1.0 8 3° 62 White .... 2 slices 3 in. X 35 in. x i in. i-3 14 6 80 Whole wheat . . 2 slices 2j in. x 2f in. X 1 in. 1.4 16 3 81 Com cake .... slice 2 in. x 2 in. X 1 in. 1.2 10 24 66 364 FEEDING THE FAMILY ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Bread, etc. - Cant'd, Crackers, graham 2 crackers 0.8 9 20 71 Oyster .... 24 crackers 0.8 10 22 68 Saltines .... 6 crackers 0.8 10 26 64 Soda 4 crackers o-9 10 20 70 Croutons (fried) 15 croutons, | in. cubes 0.8 7 49 44 Croutons (toasted) . 27 croutons, j in. cubes i-4 14 4 82 Griddle cakes . . . 1 cake 4I in. diam. 1.8 14 25 6l Muffins, cornmeal | muffin 1.2 13 25 62 Graham .... t muffin i-4 13 16 71 One egg ... . f muffin 1.2 12 24 64 Twin mountain f muffin 1.0 9 36 55 Popovers .... 1 popover 2.0 18 27 55 Rolls, French . . . 1 roll i-3 12 8 80 Sandwich, club . . e sandwich i-5 i5 69 16 Date 1 triangle 3 in. X 3? in. X 4t in- 1.1 6 27 67 Date and cream . cheese .... 1 triangle 3 in. X 3I in. X 45 in. 1.0 10 39 5i Toast, cream . . . f slice toast and | cup sauce 2.2 13 43 44 French .... slice 3 in. X 3 in. X | in. i-4 10 48 42 Waffles | waffle 6 in. diam. 0.9 14 35 51 Zwieback .... 3 pieces 3I in. X i in. X i| in. 0.8 9 21 70 Cake and Cookies Angel cake .... piece if in. x 2 in. X 2j in. i-3 12 1 87 Apple sauce cake . . piece ij in. X I in. X 3? in. 0.8 5 11 84 Chocolate loaf cake . piece 2| in. x 25 in. x I in. 0.9 5 4i 54 Chocolate drop . . cookies . . . i| cookies 2| in. diam. 0.8 8 52 40 APPENDIX 365 ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Cake, etc.--Cont'd Cream puff shells 11 puffs 0.8 10 68 22 Doughnuts .... J doughnut 0.8 6 45 49 Fruit cake .... piece i j in. X if in. x f in. 0.9 6 26 68 Gingerbread I . . piece i in. x if in. X 2 in. 1.1 7 21 72 Gingerbread II . . piece i in. X 2 in. X 2 in. 1.2 8 22 70 Hermits .... 2 J cookies 2 in. diam. 0.9 6 29 65 Lady fingers . . . 2-4 fingers 1.0 10 13 77 Macaroons . . . 2 macaroons 0.8 6 33 61 Marguerites . . . 2 crackers 0.9 10 4i 49 Molasses cookies I . 3 cookies 2 in. diam. o-7 6 34 60 Molasses cookies II 2| cookies 2| in. diam. 0-9 6 32 62 Oatmeal cookies . . t cooky 3 in. diam. 0.7 11 21 68 Oatmeal wafers . . 1 wafer 2| in. diam. o-5 11 23 66 One egg cake . . . if in. cube 1.0 8 32 60 Peanut cookies . . i| cookies 2 in. diam. 0.8 11 43 46 Plain cookies . . . 2 cookies 2| in. diam. 0.9 6 33 61 Sponge cake . . . piece if in. x if in. x 2 in. 0.9 11 19 70 Sponge cake, hot water .... piece 2 in. X 2| in. X I in. 0.9 7 7 86 White mountain icing 2f tbsp. 1.0 1 - 99 Candies, Confections, and Sugars Cherries, candied 10 medium cherries 1.0 1 - 99 Chocolate fudge . . piece if in. x I in. X 1 in. 0.9 2 20 78 Chocolate nut car- amels .... piece 1 in. x 1 in. X 5 in. 0.7 4 32 64 366 FEEDING THE FAMILY ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy drate Candies, etc. - Cont'd Chocolate, milk, sweetened . . piece in. X i in. X i in. o-7 7 58 35 Coconut caramels piece i in. x i in. X f in. o-7 3 24 73 Corn syrup . . . if tbsp. 1-5 - - 100 Ginger, crystallized . 6 pieces ij in. x 1 in. X i in. 1.0 I - 99 Honey i tbsp. 1.1 I - 99 Maple sugar . . . 4 tsp. 1.1 - - 100 Maple syrup . . . 11 tbsp. 1.2 - - 100 Molasses .... 11 tbsp. 1.2 3 - 97 Penouche .... piece r in. x i in. X if in. o-9 2 18 80 Sugar, white, granu- lated .... 2 tbsp, (scant) 0.9 - - 100 White, loaf . . . 3I lumps (full size) 0.9 - - 100 White, powdered . 2 tbsp. 0.9 - - 100 Brown .... 2 tbsp. 0.9 - - 100 Cereals Cornflakes .... if cups 1.0 6 4 90 Cornmeal, cooked i cup 6.0 10 5 85 Farina, cooked . . I cup 6.0 12 4 84 Grapenuts . . . 3 tbsp. 1.0 12 2 86 Hominy grits, cooked 1 cup 6.8 9 1 9° Macaroni, cooked 1 cup 5-2 15 2 83 Macaroni and cheese (see Eggs and Cheese Dishes) Macaroni croquettes i croquette 1.2 10 45 45 Macaroni, tomato sauce .... 5 tbsp. 3-6 10 36 54 Oatmeal, cooked 1 cup 7-9 17 16 67 Popcorn, popped unpopped 11 cupsl i cup J 0.6 11 11 78 Puffed corn . . . i| cups 1.0 6 4 9° APPENDIX 367 ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Cereals - C ant'd Puffed rice . . . 11 cups 1.0 9 I 90 Puffed wheat . . . if cups 1.0 15 3 82 Rice, steamed . . i cup 4.0 9 1 90 Rice fondue (see Eggs and Cheese Dishes) Rice with cheese and tomatoes (see Eggs and Cheese Dishes) . . . Turkish pilaf . . I cup 7-5 9 22 69 Wheat, flaked, cooked 3 cup 6.0 13 3 84 Wheat, shredded . . 1 biscuit 0.9 13 5 82 Custards, Puddings, and Ices Apple snow . . . | cup 2.0 6 2 92 Apple tapioca . . i cup 3-6 1 1 98 Boiled custard . . | cup (scant) 2.2 13 44 43 Brown Betty . . . 1 cup 2.1 3 35 62 Chocolate blanc mange . . . | cup (scant) 1.9 8 33 59 Coffee jelly . . . if cups 9-9 11 - 89 Cornstarch blanc mange . . . 1 cup 2.7 9 24 67 Cottage pudding . . Cup custard . . . slice if in. X 2 in. X 2| in. 3 cup 1.1 3-3 7 17 26 39 67 44 Date pudding I . . Date pudding II . . Lemon ice ... . slice 1 in. X 1 in. X if in. slice 3 in. diam. J in. thick I cup (scant) 0.8 1.1 3-i 5 7 3° 27 65 66 100 Lemon jelly . . . I cup 3-8 9 - 9i Lemon milk sherbet | cup i-9 4 12 84 Peach ice cream i cup 1.8 4 51 45 368 FEEDING THE FAMILY 100-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy drate Custards, etc.-Coni'd Prune souffle . . . I cup 1.8 IO - 90 Raspberry sherbet . 1 cup 2.1 I - 99 Rice pudding I . . J cup (scant) 3-i 18 32 5° Rice pudding II . i cup 2.2 12 27 61 (creamy) Rice pudding III I cup i-5 8 7 85 Snow pudding . . I cup 2.2 10 - 90 Spanish cream . . 1 cup 2-5 18 28 54 T apioca-cornmeal pudding . . . 2 tbsp. 1.8 11 20 69 Tapioca cream . . 1 cup 2.8 12 28 60 Vanilla ice cream I . 25 tbsp. 1.6 4 63 33 Vanilla ice cream II . 1 cup 2.0 6 55 39 Dairy Products and Fats Bacon fat ... . 1 tbsp. 0.4 - 100 - Beef drippings . . 1 tbsp. 0.4 - 100 - Butter 1 tbsp, (scant) o-5 I 99 - Buttermilk . . . 11 cups 9-9 33 13 54 Cheese, American pale .... 11 in. cube 0.8 26 71 3 Cottage .... 5s tbsp. 3-2 76 9 15 Full cream . . . piece 2 in. X 1 in. X t in. 0.9 25 72 3 Neufchatel . . . 2 tbsp. 1.1 23 75 2 Swiss slice 4> in. X 35 in. X 1 in. (ij cu. in.) 0.8 25 73 2 Cream, thin (18% fat) i cup 1.8 5 86 9 thick (40% fat) i| tbsp. 0.9 2 95 3 whipped .... 2 tbsp. 0.9 2 95 3 Milk, condensed, sweetened . . 15 tbsp. 1.1 11 23 66 APPENDIX 369 ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Dairy Prod. -• Cont'd Milk, condensed, un- sweetened . . 3s tbsp. 2.1 23 51 26 skim i| cups 9.6 37 7 56 top IO oz. ... 3 cup 2.1 9 78 13 top 12 OZ. ... t cup 3-0 10 75 15 whole .... t cup 5-i 19 52 29 Oleomargarine . . i tbsp. o-5 1 99 Olive oil .... 1 tbsp. 0.4 - 100 - Eggs and Cheese Dishes Eggs, a la goldenrod 1 serving 2.0 18 42 40 raw (in shell) . . 11 eggs 2.7 36 64 - scrambled . . . 3 cup 2.1 20 76 4 whites .... 7 whites 6.9 97 3 - yolks 2 yolks 1.0 17 83 - timbale .... t cup 4.2 26 55 19 Cheese souffle . . . 1 cup i-7 18 70 12 Cheese straws . . 2 j straws 5 in. x t in. X t in. 0.8 17 52 31 Macaroni and cheese J cup 2.1 17 39 44 Rice fondue with crackers . . . i| saltines and 25 tbsp, sauce i-4 22 48 30 Rice with cheese and tomatoes . . . 3 cup 2.1 19 42 39 Samp baked with cheese . . . 1 cup 4.0 14 20 66 Welsh rarebit . . i| tbsp, rarebit and J slice toast i-3 22 57 21 Fruits Apple, baked, with 2 tbsp, sugar . . i large apple 2-3 1 3 96 baked, with whipped cream .... | serving 2.4 1 3i 68 fresh 1 large 7-5 3 5 92 Apple sauce . . . t cup 3-5 1 3 96 370 FEEDING THE FAMILY ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy drate Fruits - Cant'd Apricots, canned . . 3 large halves and 2 tbsp, juice 4-8 5 95 dried 9 halves i-3 7 3 90 dried, stewed . . i cup 2.7 4 2 94 Bananas .... i large 5-5 5 6 89 Blackberries, fresh J cup (50 berries) 6.1 9 16 75 stewed .... 1 cup 2.2 2 4 94 Cantaloupe . . . 1 melon 4I in. diam. 18.0 6 - 94 Cherries, stoned . . 1 cup 4-5 5 9 86 Cranberry jelly . . 2 tbsp. i-5 - 1 99 Cranberries, fresh 2 cups 7.6 3 12 85 Cranberry sauce . . | cup (scant) 1-5 - 1 99 Currants, fresh . . i| cups 6.2 II - 89 Dates, unstoned 3-4 dates 1.1 2 7 9i Figs, dried .... ij large 1.1 5 I 94 Grapes, Concord . . 1 large bunch 4-9 5 15 80 Grape juice . . . i cup 3-5 - - 100 Grapes, Malaga . . 22 grapes 3-7 5 15 80 Huckleberries, fresh 1 cup 4-7 3 7 9° Lemons 3 large 11.4 9 15 76 Lemon juice . . . ij cups 9.0 - - 100 Olives, green . . . 6-8 olives 1.6 I 83 16 ripe 6-8 olives i-7 3 90 7 Oranges 1 large 9-5 7 2 9i Orange juice . . . 1 cup 8.2 - - 100 Peaches, fresh . . 3 medium io-5 6 3 9i canned .... 2 large halves and 3 tbsp, juice 7-5 6 2 92 stewed .... 1 cup 3-5 2 - 98 Pears, canned . . . 3 halves and 3 tbsp, juice 4-7 2 4 94 fresh 2 medium 6-3 4 6 9° Pineapple, canned 1 slice and 3 tbsp, juice or | cup shredded 2-3 1 4 95 fresh 2 slices 1 in. thick 8.2 4 6 9° APPENDIX 371 ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Fruits - Coni'd Plums, fresh . . . 3-4 large 4.4 5 - 95 Prunes 4 medium 1-4 3 - 97 stewed .... 2 prunes and 2 tbsp, juice 2.8 2 - 98 Prune pulp . . . 2 tbsp. i-4 2 - 98 Raisins 1 cup 1.1 3 9 88 Raspberries . . . i| cups 5-3 10 14 76 Rhubarb, fresh . . 4 cups of 1 in. pieces iS-3 10 27 63 stewed .... i cup 1-7 1 2 97 Strawberries, fresh . 13- cups 9.0 10 14 76 Watermelon (edible portion) . . . 11.7 5 6 89 Meats and Fish (Cooked) Beef, corned, boiled (less J fat con- tent)1 .... slice 4I in. X 15 in. X t in. 3-o 53 47 corned, boiled (with fat) .... 1.0 21 79 - dried 4 thin slices 4 in. x 5 in. 2.0 67 33 dried, creamed I 3 cup 2.4 16 65 19 dried, creamed II I cup 2-3 20 62 18 flank, fat, stewed2 0.9 20 80 - Hamburg steak, broiled . . . cake 2| in. diam. 1 in. thick 2.0 55 45 heart, stuffed . . slice 2? in. X 2j in. X J in. 1.0 21 68 II loaf slice 4 in. x 6 in. X | in. i-4 40 60 - pie | serving i-7 10 43 47 1 i5 % of weight lost in cooking. 2 Bull. 162, Office of Experiment Stations, U.S. Dept. Agriculture. 372 FEEDING THE FAMILY ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Meats, etc. - Cont'd rib, lean, roasted slice 5 in. x zj in. X 1 in. 1.6 46 54 round, lean, boiled 1 2.2 9° 10 - round, lean, pot roast1 ... i.6 62 38 round steak, lean, pan broiled 1 slice 4 in. x 3 in. X ij in. 2.0 48 52 round steak, stuffed slice 3 in. diam. 3 in. thick 1-7 39 49 12 round steak, Swiss style .... slice 4 in. X i in. X t in. 1.2 35 48 17 sirloin steak, lean, broiled . . . slice 2 in. x ij in. X I in. 2.0 47 53 sirloin steak, me- dium fat, broiled slice if in. X ij in. X f in. 1-3 3i 69 stew with vege- tables .... i cup 3-0 16 45 39 Fish Bluefish .... medium serving 2.4 72 28 - Codfish, balls . . i ball 2 in. diam. i-7 14 65 21 creamed . . . 1 cup 2-5 32 46 22 Halibut steak, broiled . . . piece 3 in. x 2? in. X i in. 3-o 61 39 Mackerel, Spanish, broiled . . . 2.6 56 44 - Salmon, canned . | cup (scant) 1.8 45 55 - creamed, on toast 1 cup salmon and | slice toast 2.4 22 42 36 loaf .... j cup 2.1 37 52 II 1 Bull. 162, Office of Experiment Stations, U. S. Dept. Agriculture, APPENDIX 373 ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Fish - Cant'd Sardines, canned . 3-6 sardines 1-7 46 54 Tunnyfish a la New- burg .... | cup (scant) 1.8 36 60 4 canned . . . 2 cup 2.8 70 3° - Frankforters . . . 1 sausage 1.1 3i 67 2 Lamb, chops, broiled 1 chop (piece 2 in. X 2 in. X i in.) 1.6 40 60 - leg, roast.... slice 3! in. X 4I in. X i in. 1.8 4i 59 - Mutton, leg, roast . slice 3 in. X 3s in. X | in. 1.2 33 67 - Pork, bacon . . . 4-5 small slices 0.5 13 87 - ham, boiled . . . slice 4s in. x 4 in. X i in. i-3 29 7i - sausage . . . if sausages 3 in. long f in. diam. (after cooking) 1.1 20 78 2 Poultry Capon, roast . . slice 4 in. x 2 j in. X s in. i-7 Si 49 Chicken, broiled . 2.6 80 20 - canned . . . 0.9 23 77 - creamed . . . s cup (scant) 1.6 16 73 II Turkey, roast . . i-3 40 60 - roast with stuff- ing .... i-9 36 52 12 stuffing . . . 1 cup 0.8 9 48 43 Shell Fish (uncooked) Clams .... 12 clams or j cup 7.6 56 8 36 Lobster, canned . Oysters .... 1 cup 4-3 86 12 2 I cup solid or 6-15 oysters 7.2 49 24 27 Scallops .... 1 cup 4.8 80 1 19 Shrimp .... i cup 3-2 9i 8 1 Veal, cutlets, breaded f serving 2.0 30 52 18 374 FEEDING THE FAMILY ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Veal - Cont'd leg, roast.... slice 2 in. x in. X i in. 2-3 71 29 kidney .... 2.1 54 46 - liver . . . . • . 2.1 47 53 - Nuts (Edible Por- tion) Almonds .... 12-15 nuts 0-5 13 76 II Brazil nuts .... 2 nuts 0-5 10 86 4 Butternuts .... 4-5 nuts 0.5 17 81 2 Coconut, prepared . i cup 0.6 4 77 19 Chestnuts, Italian . 7 nuts i-5 10 20 70 Filberts 8-10 nuts 0.5 9 84 7 Hickory nuts . . . 15 nuts 0.5 9 85 6 Nut loaf .... 1 cup i-4 16 62 22 Nut and cheese roast slice if in. X if in. X t in. 0.9 15 68 17 Peanuts 20-24 single nuts 0.6 19 63 18 Peanut butter . . 23 tsp. 0.6 19 69 12 Pecans 12 meats o-5 5 87 8 Pine nuts .... 1 cup 0.6 22 73 5 Walnuts, English . . 8-16 meats o-5 11 82 7 Pies Apple Sector i| in. at cir- cumference 1 1.6 3 4i 5*5 Cranberry .... Sector if in. at cir- cumference 2 i.4 2 18 80 Cream with meringue Sector it90- in. at circumference 3 1.6 10 37 53 Custard Sector 2 in. at cir- cumference 1 i-9 9 32 59 Lemon meringue . . Sector 1 in. at cir- cumference 1 1.0 5 27 68 1 Pie q inches in diameter. 2 Pie 8 inches in diameter. 3 Pie io inches in diameter. APPENDIX 375 ioo-Calorie Portion Distribution or Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Pies - Cant'd, Mince Sector i in. at cir- cumference 1 1.2 8 39 53 Plain pastry . . . } of i crust, 9 in. diam. 0.7 2 6 58 36 Raisin and cranberry Sector i in. at cir- cumference 3 1.0 3 27 70 Rhubarb .... Sector if in. at cir- cumference 1 i-7 5 18 77 Squash Sector 2 in. at cir- cumference 1 1.8 IO 25 65 Salads and Dressings Banana salad . . i small serving 2.6 12 36 52 Boiled dressing . . i cup 2.8 IO 64 26 Cheese and pineapple salad .... I serving i-7 9 58 33 Chicken salad . . i small serving 1.6 12 86 2 Cole slaw .... i cup 2.8 6 78 16 Egg salad .... f serving i-4 14 85 1 French dressing . . i j tbsp. 0.6 - 100 - Fruit salad . . . j cup fruit and | tbsp, dressing i-5 3 75 22 Lettuce salad with French dressing i small serving 1.2 1 95 4 Mayonnaise dressing i tbsp. 0.5 1 97 2 Potato salad . . . j serving i-7 3 68 29 Sardine salad . . . i serving 1.1 27 63 IO Tomato and cucum- ber salad . . . f serving 2.0 4 81 15 Tomato and lettuce salad .... i serving 2.7 3 86 11 Waldorf salad . . . j serving 1.2 4 76 20 1 Pie 9 inches in diameter. 2 Weight uncooked, 0.9 ounces. 3 Pie 8 inches in diameter. 376 FEEDING THE FAMILY ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Sauces Brown sauce . . . i cup 3-4 14 49 37 Brown sugar sauce . 5 tbsp. 3-o - - IOO Charlotte russe filling i cup i-5 4 74 22 Cream filling I . . 3 3 tbsp. i.8 io 24 66 Cream filling II . . i cup 1.2 5 77 18 Cream sauce . . . 1 cup 1.1 3 68 29 Hard sauce . . . i tbsp. o-7 - 5° 50 Lemon sauce . . . i cup i-5 - 30 70 Tomato sauce . . . 5 tbsp. 2-5 5 7° 25 White sauce . . . 1 cup 2.4 8 70 22 Soups Asparagus, cream of J cup (scant) 4.0 17 56 27 Baked bean, cream of I cup 2.6 i5 45 40 Bouillon .... 4 cups 33-6 84 8 8 Celery, cream of . . i cup 3-6 11 61 28 Corn chowder . . 5 cup 3-3 12 43 45 Com, cream of . . 5 cup 3-9 12 38 50 Green pea, cream of 3 CUp 5-2 16 46 38 Lentil I cup 9.0 i7 27 56 Lentil and tomato . 6 CUp 6-7 28 3 69 Oyster stew I . . . I cup (scant) 3-5 18 58 24 Oyster stew II . . 2 cup (large) 4-7 16 63 21 Peanut butter, cream of s cup (scant) 2.6 18 54 28 Potato j cup (scant) 4-2 15 38 47 Spinach, cream of (for children espec- ially) .... i cup 4-2 16 56 28 Split pea .... f cup 6.o 26 2 72 Tomato, canned . . clear 1 cup 7-o 12 12 76 i cup (scant) 7-4 8 48 44 cream of ... . 1 cup 3-2 11 63 26 Vegetables Asparagus, fresh 20 large stalks 8 in. long 15-9 32 8 60 APPENDIX 377 ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Vegetables - Cont'd Asparagus on toast . t serving 4.6 13 46 41 Beans, baked, canned i cup 2.7 21 18 6l Lima, fresh . . . i cup 2.9 23 5 72 Lima, buttered. . I cup i-7 16 36 48 Lima, dried . . . 1 cup 1.0 21 4 75 string 2| cups of i in. pieces 8-5 22 7 7i Beets 4 beets 2 in. diam. (ij cups sliced) 7-7 14 2 84 Cabbage, shredded 5 cups 11.2 20 9 7i Carrots .... 4-5 young carrots 3-4 in. long IO.I IO 5 85 Cauliflower . . . 1 very small head IM 23 15 62 Celery 4 cups of | in. pieces 19.1 24 5 7i Com a la Southern . i cup 3-4 l6 4i 43 canned .... 1 cup 3-6 II 11 78 fresh I cup 3-5 12 10 78 on cob .... 2 ears 6 in. long 9.0 12 9 79 Cucumbers . . . 25 cucumbers 7 in. long 23-5 19 12 69 Kidney bean stew . i cup 4-9 26 18 56 Lentils, baked . . 1 cup (scant) 1.6 24 20 56 dried 2| tbsp. 1.0 29 3 68 Lentil meat loaf . . slice 11 in. X 2 j in. X 1 in. 1.1 28 14 31 Lettuce .... 2 large heads 18.5 25 14 61 Macaroni (see Cereals) .... Mushrooms, fresh 22 mushrooms 1 in. diam. 7-9 31 8 61 stewed .... 5 cup 2-3 8 75 17 Onions, raw . . . 3-4 medium 7-2 13 6 81 scalloped .... i cup 2-5 8 59 33 Parsnips, stewed 7 pieces 3I in. X ii in. x s in. 5-8 10 7 83 378 FEEDING THE FAMILY ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Vegetables - Cont'd Peas, canned . . . 1 cup (drained)1 4.4 26 3 71 creamed . . . I cup (scant) 2.7 18 37 45 green, shelled . . s cup 3-5 28 4 68 Peppers, stuffed I i pepper 4-7 17 16 67 stuffed II . . . i pepper 7.0 II 21 68 stuffed III . . . I pepper 2-5 16 55 29 Potatoes, sweet, raw sweet, baked . . | medium 3-6 6 5 89 1 medium 3-o 6 5 89 sweet, glazed . . j small 2.1 4 7 89 white, baked . . i medium 3-o 11 1 88 white, boiled . . i medium 3-6 11 1 88 white, chips . . 8-io large pieces 0.6 5 63 32 white, creamed i cup 2.7 9 5° 4i white, mashed . . I cup (scant) 3-i 7 48 45 white, raw . . . i medium 5-3 11 1 88 white, scalloped . s cup 3-5 9 30 61 Radishes .... 3 doz. red button 12.0 18 3 79 Spinach, boiled, chopped .... 2 j cups 21.0 12 8 80 with egg . . . 5 CUp 7-6 22 60 18 a la creme . . . i cup 4.1 10 70 20 Succotash, canned . 3 cup 3-5 15 9 76 Tomatoes, canned . if cups 15-6 21 8 7i fresh 2-3 medium 15-5 16 16 68 stuffed .... 1 tomato 4-o 13 45 42 Turkish pilaf (see Cereals) Turnips, creamed i cup i-4 10 5° 40 raw 2 cups | in. cubes 9-0 13 5 82 1 Water drained off estimated as 30 per cent can contents. APPENDIX 379 TABLE II Food Values in Terms of Common Measures Introductory Note This table is designed to supplement Table I, as an aid in the estimation of the food value of various dishes made in the kitchen. It consists of information as to the food value of materials which the cook is accustomed to using by measure and generally uncooked. In har- mony with modern culinary practice, level measurements have been employed throughout. By this means we secure greater exactness and uniformity in the quantity meant by a half-pint cupful, a tablespoonful, or a tea- spoonful. Even thus, the quantities obtained by meas- urement are rather variable. Foods which pack down easily, such as flour or chopped fruits, give a cupful whose weight will vary a great deal, while other foods, like butter and granulated sugar, give a cupful of much more constant weight. Similarly, a tablespoonful of sugar is a fairly constant quantity, while a tablespoonful of molasses, cream, or olive oil, weighs more or less according to the viscosity of the material or one's inter- pretation of a level tablespoonful of a liquid which can actually be heaped up to some extent on the spoon. It is believed that the weights given in the table are fair averages, but the difficulties inherent in producing such a table must be borne in mind. To get a quantity exactly corresponding to the food values stated for any measurement, the food must actually be weighed. And, strictly speaking, weights in ounces are too crude for the 380 FEEDING THE FAMILY purpose. The gram (28.35 grams equal 1 ounce) is the unit upon which the calculation of calories is based.1 This is a unit too small to have much significance in the kitchen, but it is mentioned here to explain any dis- crepancies which seem to occur between the weights and food values as given in the table. Anyone wishing accurate data on food values by weight can find them elsewhere.2 With this table, in conjunction with Table I, any- one can estimate the food values of a given recipe, if it is not to be found in Table III. For example, suppose one makes a cake by the following recipe: 3 eggs 1 cup sugar 1 tbsp, milk i tbsp, butter i cup flour 2 tsp. baking powder 1 tsp. salt Referring to the table for the total fuel value of each ingredient, 3 eggs = 3 X 70 Calories = 210 Calories 1 cup sugar = 1 X 840 Calories = 840 Calories I tbsp, milk = i X 14 Calories = 7 Calories 1 tbsp, butter = 1 X 109 Calories = 109 Calories 1 cup flour = 1 X 395 Calories - 395 Calories Total for recipe 1561 Calories The salt has no fuel value, and the small amount con- tributed by starch in baking powder may be disregarded. 1 i gram of protein yields 4 Calories. 1 gram of fat yields 9 Calories. 1 gram of carbohydrate yields 4 Calories. 2 Rose's Laboratory Handbook for Dietetics. APPENDIX 381 TABLE II Fuel Value of Food Materials in Terms of Common Measures 1 Material Measure Weight Oz. Distribution of Calories Total Calories Pro- tein Fat Carbo- hydrate Almonds, chopped . . i cup 3 76 446 63 585 shelled I cup 4 95 560 79 734 Apples, dried .... I cup 3 5 17 225 247 Apricots, dried . . . I lb. 16 85 41 1134 1260 Barley, flour .... r tbsp. 3 5 5 2 50 57 i cup 8 76 23 697 796 pearl i tbsp. 1 2 5 I 44 50 i cup 7i 72 21 662 755 Beans, navy, dried . . Lima, dried .... i cup 7 179 32 473 684 i cup 5i 112 21 408 54i Bran i cup 2$ 31 13 174 218 Bread crumbs, oven dried i cup 3i 52 17 304 373 soft I cup 2 21 6 120 147 stale I cup 3 34 II 194 239 Butter i tbsp. 1 2 - ICQ - 109 i cup 8 8 1736 - 1744 r lb. 16 16 3472 - 3488 Buttermilk I cup 8i 29 12 47 88 Celery (cut in J in. pieces) Cheese, American, grated, I cup 4i 6 I 17 24 dry i tbsp. I 4 12 - 16 i cup 2 6S 183 I 249 fresh i tbsp. 1 8 23 - 3i i cup 4 130 366 2 498 Chocolate, unsweetened, i lb. 16 523 1465 5 1993 grated r tbsp. 1 6 2 21 6 29 i square I 15 124 34 173 Citron, chopped . . . i cup 2f 2 II 250 263 Cocoa i tbsp. 1 6 18 11 35 i cup 4i IIO 332 192 634 1 For food values in terms of weight (grams, ounces or pounds) see Rose's Laboratory Handbook for Dietetics. 382 FEEDING THE FAMILY Material Measure Weight Oz. Distribution of Calories Total Calories Pro- tein Fat Carbo- hydrate Coconut, shredded Condensed milk (sweet- I cup 25 20 414 IOI 535 ened) i tbsp. 2 3 6 16 42 64 Condensed milk (un- i cup II IIO 232 675 1017 sweetened) . . . i tbsp. f 6 14 7 27 i cup 8 87 189 IOI 377 Corn, canned .... i cup 9 29 28 198 255 fresh i cup 7 25 20 157 202 Cornmeal i tbsp. 1 3 3 I 29 33 i cup 5 52 24 428 504 Cornstarch i tbsp. i - - 34 34 I cup 45 - - 459 459 Cottolene i tbsp. 2 5 - IOO - IOO i cup 65 - 1575 - 1575 i lb. 16 - 4082 - 4082 Cracker crumbs . . . i tbsp. 1 4 3 4 22 29 i cup 4* 52 65 350 467 Cranberries, fresh . . i cup 31 2 5 39 46 Cream, thick .... i tbsp. 2 3 1 66 2 69 i cup 7f 19 79i 26 836 thin i tbsp. 1 2 1 24 3 28 i cup 8 23 377 40 440 Crisco i tbsp. 2 5 - 100 - IOO I cup 6i - 1575 - 1575 Currants, dried . . . I cup 55 15 24 463 502 Dates, stoned .... I cup 6i 15 44 549 608 I lb. 16 38 114 1423 1575 unstoned I cup 12 36 460 508 I lb. 16 34 102 1280 1416 Egg, whole (in shell). . i egg 25 25 45 - 70 white i white 1 13 1 - 14 yolk i yolk 3 5 11 45 - 56 Farina i tbsp. i 4 1 29 34 i cup 6 75 21 519 615 Figs, chopped . . . i cup -3 5k 28 4 475 507 i lb. 16 78 13 1346 1437 APPENDIX 383 Material Measure Weight Oz. Distribution oe Calories Total Calories Pro- tein Fat Carbo- hydrate Flour, buckwheat . . x tbsp. 2 5 3 I 36 40 i cup 5s 40 17 486 543 Graham i tbsp. 1 3 5 2 27 34 i cup 5 75 28 405 508 Rice i tbsp. i 5 7 39 5i i cup 85 127 655 867 Rye i tbsp. 1 3 2 1 30 33 i cup 5 38 12 446 496 Wheat, unsifted . . i tbsp. 1 3 4 1 28 33 i cup 42 58 12 389 459 Wheat, sifted . . . i tbsp. 1 3 1 24 28 i cup 4 5° 10 335 395 Gelatin, granulated i tbsp. 1 3 37 - - 37 Hickory nuts, chopped i cup 6 105 1032 78 1215 Hominy grits, uncooked i cup si 52 8 493 553 cooked i cup 9 13 2 126 141 Lard i tbsp. 1 2 - 117 - 117 i cup 8 - 1914 - 1914 Lemon juice .... i tbsp. 1 2 - - 5 5 Macaroni, cooked1 i cup si 15 2 83 100 uncooked,2 .... i cup 3i 53 8 294 355 Milk, skim i tbsp. A 2 1 4 7 i cup 8i 32 7 49 88 i qt. 34 132 27 199 358 whole i tbsp. A 3 7 4 14 i cup 8i 34 88 48 170 i qt. 34 132 35i 195 678 Molasses, cane .... i tbsp. 4 5 2 - 63 65 i cup 12 33 - 943 976 Oatmeal i cup Si 107 105 424 636 Oats, rolled .... i cup 2 2 47 46 187 280 Oleomargarine . . . i tbsp. 1 2 - 105 - 105 i cup 7 10 1482 - 1492 Olive oil i tbsp. 2 5 - 100 - 100 Orange juice . . i tbsp. 2 - - 6 6 i cup 8 - - 104 104 1 i in. pieces. 2 io sticks 9 in. long. 384 FEEDING THE FAMILY Material Measure Weight Oz. Distribution of Calories Total Calories Pro- tein Fat Carbo- hydrate Peanuts, chopped . . I cup 3t^ 108 365 102 575 shelled I cup 41 125 420 118 663 Peas, canned, drained, I cup 6 35 4 95 134 dried i tbsp. 1 2 13 1 32 46 i cup 71 187 17 47i 675 Pecans, shelled . . . i cup 51 60 990 95 1145 Pineapple, canned, grated i cup 81 4 15 350 369 Pumpkin, cooked . . I cup 61 7 4 59 70 Raisins I cup 5 IS 42 432 489 I lb. 16 48 I3S 1380 1563 Rhubarb, fresh, i in. pieces I cup 4 3 7 16 26 Rice, uncooked . . . i tbsp. 1 2 4 I 45 5° i cup 7 63 6 627 696 steamed i cup 5i 11 1 ii5 127 Saltines i cracker A 2 4 10 16 Spinach, cooked and chopped .... i cup 8> 15 5 23 43 Squash, cooked (Hub- bard) i cup 7z 8 10 92 IIO Suet i cup 31 19 73° - 749 i lb. 16 85 3340 - 3425 Sugar, brown .... i tbsp. 1 3 - - 36 36 i cup st - - 625 625 i lb. 16 - - 1724 1724 granulated .... i tbsp. 1 2 - - 53 53 i cup 7 5 - - 840 840 i lb. 16 - - 1814 1814 powdered .... i tbsp. 1 2 - - 48 48 i cup 6 - - 672 672 i lb. 16 - - 1814 1814 Tapioca i tbsp. 1 2 - - 48 48 i cup 61 3 2 635 640 Tomatoes, canned . . i cup 9 12 s 40 57 Turnips, J in. cubes . . i cup 4z 6 2 44 52 Walnuts, English, chop- ped i cup 3 63 493 44 600 Wheat, flaked . . . i cup 3 46 10 253 3°9 APPENDIX 385 TABLE III Dietary Recipes Since a great deal of variation in food value is pos- sible in the same dish, according to the recipe used, it has seemed desirable to indicate the ingredients of the dishes whose food values in terms of 100-calorie portions have been given in Table I. Here are included almost all the combinations of food materials used in prepara- tion of the dietaries given throughout the book, as well as a number of other dishes with which any cook is likely to be familiar. The ingredients of each recipe have been measured and weighed separately, their food values calculated on these weights, and then added together to give the food value of the whole recipe. Each dish has then been cooked and when ready to eat measured and weighed. From the weight and total calories of the cooked product the zoo-calorie portion has in each case been estimated, then weighed out and measured as accurately as possible with ordinary kitchen equipment, i.e. half-pint cups divided into quarters and thirds, tablespoons and teaspoons, supplemented by an ordi- nary foot rule. From the scientific point of view such a method is very crude. No two people measuring flour for a cake will get exactly the same weight. Then, too, the finished cake will vary in weight according to these differences in weight of ingredients and also according to the size and shape of the pan, the intensity of the oven heat, and the length of time of baking. Further- more, it is not possible to measure the cubical contents Introductory Note 386 FEEDING THE FAMILY exactly with a ruler, as few cakes are perfectly flat on top. Moreover, a sample cut from the soft center may weigh the same as one from a hardened corner, but the measurements will not agree exactly. For such reasons, data on cooked food materials, unless prepared by the methods of the chemical laboratory instead of the kitchen, must be regarded as approximate rather than absolutely accurate. To the housewife, intent on learning to esti- mate food values for the general welfare of her family, these discrepancies are of no moment. A variation of a few calories in a day's dietary has no particular sig- nificance. What she needs to know is the approximate food value of any dish which she is preparing. She can then estimate the food value of each individual serving without difficulty. This is why the food values for the whole recipe have been stated. Moreover, if any- one will take the trouble to measure a 100-calorie por- tion, she will find it possible to remember this well enough to judge of the food value of any portion served. For example, zoo calories of mince pie require a sector one inch on the outer circumference; a 9-inch pie is about 28 inches in circumference, and hence will yield about 2800 calories; if each serving is three inches on the outer edge, it will contain 300 calories - if four inches, 400 calories, etc. Such estimates are perfectly practical for home use. In the collection which follows, the recipes are drawn from many sources - standard cookbooks or contribu- tions from students in the author's laboratory - and it is believed that they represent the common way of making most of the dishes, though a few have been APPENDIX 387 specially arranged for economy's sake. In the latter case, the more usual way has sometimes been given in a second recipe. No attempt has been made to keep them uni- form for any particular number of servings. The aim has been merely to indicate proportions of ingredients, so that the housewife can compare these recipes with her own and where they are alike multiply or divide the values of each according to the size of her family. As this book is not intended as a substitute for a cookbook, the kind and quantity of seasonings have not been given, these having no appreciable fuel value. 388 FEEDING THE FAMILY o o to KJ H U N M M|W r* r* O O r* r* r> <1 O r* Cfi 2 8 |a c 8 O " » g F p 8 S' *- Oto p p -« p - CD Chocolate I | cup milk I cup water | sq. chocolate 1 tbsp, sugar Chocolate II 1 cup milk o o C C Xi 1 cup 1 cup Measure Food o-6 o'6 Sp 03 b Weight Oz. (cooked) £ a 03 tO 00 to O to 03 Protein Calories Zoi £o o£i 901 Fat Calories SO *4 tn O ■*4 sQ Carbo- hydrate Calories 101 240 <0 O 223 Total Calories oMw oSw w*H 2 2 2 -Q T5 -U i cup (scant) Measure too-Caix Co Cn 00 Cn 03 tH Weight Oz. (cooked) )RIE Pt Os -£ £ 0 Protein Calories >RTI0N £ O 0 w Fat Calories 47 40 a ^o Carbo- hydrate Calories BEVERAGES APPENDIX 389 Cocoa III i cup milk 2 tsp. cocoa 3 tbsp, lactose 1 cup 9.2 39 107 174 320 1 cup 2.9 12 34 54 Egg Lemonade i egg 2 tbsp, lemon juice 2 tbsp, sugar | cup water i cup 9.0 25 45 120 190 | cup 4.8 13 24 63 Eggnog t cup milk i egg 2 tsp. sugar Flavorings i cup 8-5 48 no 72 230 I cup (scant) 3-7 21 48 3i Fruit Punch i cup raspberry juice i| cups currant juice t cup orange juice | cup lemon juice 2| cups sugar 6 cups water 3 qts. 5°-2 36 27 2664 2727 | cup (scant) 1.8 1 1 98 390 FEEDING THE FAMILY Food 5 /alue or Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Lactose Lemonade i tbsp, cane sugar 2 tbsp, lemon juice 6 tbsp, lactose I cup water I cup 8.6 - - 356 356 I cup (scant) 2.6 - - IOO Lemonade i cup water i| tbsp, sugar 2 tbsp, lemon juice ij cups 10.0 - 9° 90 11 cups II.O - - IOO BEVERAGES - Continued APPENDIX 391 Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories I Total 1 Calories Measure Weight Oz. 1 (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Baking Powder Biscuit 2 cups flour 4 tsp. baking powder i tsp. salt i tbsp.lard i tbsp, butter i cup milk 24 small biscuit 14.8 128 319 735 1182 2 small biscuit i-3 11 27 62 Boston Brown Bread i cup rye meal i cup corn meal i cup graham flour ttbsp, soda i tsp. salt | cup molasses 2 cups sour milk 4 loaves 3 in. diam. 4I in. high 40-9 219 227 1814 2260 Slice | in. thick 1.8 IO IO 80 BREAD, BISCUIT, AND MUFFINS FEEDING THE FAMILY 392 Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Club Sandwich 2 slices toast 2 slices cooked bacon 2 large leaves lettuce 3 tbsp, chopped chicken 3 tbsp, mayonnaise dressing 4 olives 2 slices tomato i egg Corn Cake | cup cornmeal i| cups flour | cup sugar 5 tsp. baking powder i sandwich Loaf 6 in. X io in. X i in. 9-0 18.0 91 162 417 364 IOI 1012 609 1538 1 sandwich Slice 2 in. X 2 in. X 1 in. 1-5 1.2 15 IO 69 24 16 66 BREAD, BISCUIT, AND MUFFINS - Continued APPENDIX 393 | tsp. salt i cup milk i egg 2 tbsp, butter Cornmeal Muffins | cup cornmeal i cup flour 3 tsp. baking powder i tbsp, sugar i tbsp, melted butter | tsp. salt | cup milk I egg 8 muffins 13.0 i43 271 686 1100 1 muffin 1.2 13 25 62 Cream Toast 6 slices bread 2 cups milk 3 tbsp, flour 2 tbsp, butter 6 slices toast and 2 cups sauce 21.0 124 4i3 421 958 | slice toast and | cup sauce 2.2 13 43 44 Croutons (Fried) 4 oz. bread i oz. fat 8o croutons | in. cubes 4.2 40 264 239 543 15 croutons | in. cubes 0.8 7 49 44 394 FEEDING THE FAMILY Food Value of Recipe 100-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Croutons (Toasted) 51 oz. bread 112 croutons | in. cubes 4.4 58 16 33° 404 27 croutons | in. cubes 14 14 4 82 Date Sandwiches 3 thin slices bread 2 tsp. butter 6 dates 3 triangles 3 in. X 3a in. X 4f in. 3-4 17 81 202 300 1 triangle 3 in. X 35 in. X 45 in. 1.1 6 27 67 Date and Cream Cheese Sand- wiches 3 slices bread 2 tsp. butter 3 dates i tbsp. Neuchatel cheese 3 triangles 3 in. X 3I in. X 4f in. 3-o 27 114 149 290 1 triangle 3 in. X 3> in. X 45 in. 1.0 10 39 51 French Toast 12 slices bread 3 in. X 3 in. X j in. 12 slices 18.0 132 588 528 1248 1 slice 3 in. X 3 in. X 1 in. 1.4 10 48 42 BREAD, BISCUIT, AND MUFFINS - Continued APPENDIX 395 4 tbsp, butter i egg i cup milk Graham Muffins i cup graham flour i cup white flour | cup sugar i tsp. salt i cup milk i egg 2 tbsp, melted butter ii muffins 20.0 186 234 1040 1460 J muffin 1-4 13 16 7i 4 tsp. baking powder Griddle Cakes 2 cups flour i tbsp, melted butter 2 cups sour milk i tbsp, sugar i egg i tsp. soda j tsp. salt 14 cakes 45 in. diam. 25-0 191 34i 826 1358 1 cake 4! in. diam. 1.8 14 25 61 396 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure 5 .? Protein Calories Fat Calories Carbo- hydrate Calories t/) _< V 0J2 Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories One Egg Muffins 2 cups flour 4 tsp. baking powder J tsp. salt 2 tbsp, sugar i cup milk 2 tbsp, melted butter i egg Old New England Corn Bread 2 cups cornmeal i cup flour j cup suet | cup molasses Popovers x cup flour | tsp. salt io muffins Loaf i in. X 6 in. X 8 j in. 16.6 20.0 160 160 310 59° 846 1250 1316 2000 f muffin Piece 25 in. X 1 in. X 1 in. 1.2 1.0 12 8 24 30 64 62 BREAD, BISCUIT, AND MUFFINS - Continued APPENDIX 397 1 cup milk 2 eggs | tsp. melted butter 7 popovers i5-° 128 188 39° 706 1 popover 2.0 18 27 55 Twin Mountain Muffins | cup butter j cup sugar i egg t cup milk 2 cups flour 4 tsp. baking powder ♦ io muffins 14.8 138 546 810 1494 j muffin 1.0 9 36 55 Waffles 2 cups flour 2 tbsp, butter 3 eggs i tbsp, sugar i cup milk 3 tsp. baking powder 6 waffles 6 in. diam. 13.6 201 498 7i7 1416 I waffle 6 in. diam. 0.9 14 35 5i 398 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Angel Cake i cup sugar s cup flour Whites 8 eggs i tsp. vanilla i tsp. cream of tartar Loaf 2 j in. X sf in. X si in. 14.O 156 12 1092 1260 Piece if in. X 2 in. X 25 in. 1-3 12 I 87 Apple Sauce Cake i cup sugar 2 tbsp, butter i cup apple sauce 2 cups flour i tsp. soda j cup raisins Spices Loaf st in. X 8 in. X if in. 21.2 Il6 281 2077 2474 Piece i| in. X | in. X in. 0.8 5 II 84 Chocolate Cake I cup butter i cup sugar CAKES AND COOKIES APPENDIX 399 2 eggs | cup milk i| cups flour 2 j tsp. baking powder 2 sq. chocolate Loaf si in. X io| in. X 2| in. 28.0 165 1252 1653 3070 Piece 2 j in. X 25 in. X f in. 0.9 5 4i 54 Chocolate Drop Cookies | cup butter i cup brown sugar | cup milk 2 cups flour 2 eggs 3 sq. chocolate i cup nut meats 2 tsp. soda 2 tsp. vanilla 56 cookies 2J in. diam. 32.0 292 1980 1488 3760 1 j cookies 2$ in. diam. 0.8 8 52 40 Cream Puff Shells i cup flour J cup butter 4 eggs x cup water 20 puffs 11.6 158 1017 335 1510 1 i puffs 0.8 IO 68 22 400 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Gingerbread I i cup molasses | cup water cups flour i tsp. soda ij tsp. ginger 4 tbsp, melted butter | tsp. salt Loaf 8| in. X 9 in. X 1 in. 25-5 143 456 1590 2189 Piece 1 in. X ij in. X 2 in. 1.1 7 21 72 Gingerbread II i cup molasses i cup sour milk 25 cups flour if tsp. soda 2 tsp. ginger I tsp. salt | cup melted butter Loaf 9I in. X 10 in. X 1 in. 30.0 l8l 508 1718 2407 Piece 1 in. X 2 in. X 2 in. 1.2 8 22 70 CAKES AND COOKIES - Continued APPENDIX 401 Hermits I cup butter f cup sugar i egg 2 tbsp, milk 50 cookies 2 diam. in. 18.5 127 617 1372 2116 2| cookies 2 in. diam. o-9 6 29 6S if cups flour 2 tsp. baking powder j cup raisins Marguerites i egg white 2 tbsp, powdered sugar 8 crackers 3-7 43 164 193 400 2 crackers 0.9 10 4i 49 12 nuts 8 saltines Molasses Cookies I i cup molasses 1 cup lard | cup oleomargar- ine i tbsp, ginger i tbsp, soda 2 tbsp, milk 2 cups bread flour 73 cookies 2 diam. in. 17-4 136 820 1504 2460 3 cookies 2 in. diam. 0.7 6 34 60 402 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Molasses Cookies II i cup molasses | cup butter J cup lard 25 cups flour 2 tbsp, milk i tbsp, ginger i tbsp, soda i tsp. salt 68 cookies 2| in. diam. 27.O 170 949 1830 2949 25 cookies 2} in. diam. 0.9 6 32 62 Oatmeal Cookies i egg | cup sugar | cup skim milk | cup oatmeal 2 cups flour 2 tbsp, crisco i cup raisins | cup peanuts 20 cookies 3 in. diam. 18.7 290 551 1780 2621 i cooky 3 in. diam. 0-7 11 21 68 CAKES AND COOKIES - Continued APPENDIX 403 2 tsp. baking powder i tsp. salt Oatmeal Wafers i cup oatmeal i cup rolled oats 2 cups flour | cup sugar i tsp. salt | tsp. soda 1 cup crisco | cup hot water 30 wafers 2$ in. diam. 15-0 327 616 1858 2801 1 wafer 2$ in. diam. o-5 11 23 66 One Egg Cake 1 cup butter J cup sugar i egg J cup milk ij cups flour 2j tsp. baking powder Loaf if in. X 3I in. X 41 in. 16.0 123 502 959 1584 Piece if in. X ij in. X i| in. 1.0 8 32 60 404 FEEDING THE FAMILY Food /alue of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Peanut Cookies 2 tbsp, butter { cup sugar i egg f cup (scant) flour 2 tbsp, milk | cup chopped peanuts | tsp. lemon juice i tsp. baking powder | tsp. salt Plain Cookies | cup butter i cup sugar i egg | cup milk 2 tsp.bakingpowder 2? cups flour 18 cookies 2 in. diam. 6o cookies 2| in. diam. 9-3 26.0 I32 166 493 957 529 1788 1154 2911 if cookies 2 in. diam. 2 cookies 2| in. diam. 0.8 0-9 II 6 43 33 46 6l CAKES AND COOKIES - Continued APPENDIX 405 Sponge Cake 6 eggs i cup sugar i cup flour i tbsp, lemon juice | rind one lemon i tsp. salt Loaf io in. X 4j in. X i j in. 16.0 192 323 ii77 1692 Piece i| in. X 15 in. X 2 in. 0.9 11 19 70 Sponge Cake Hot Water 2 eggs i cup sugar i cup flour tsp. baking powder 2 tsp. lemon juice f cup hot water Sheet 8| in. X 8| in. X f in. 12.7 98 95 1162 1355 Piece 2 in. X 2| in. X 5 in. 0.9 7 7 86 White Mountain Icing i cup sugar i egg white | cup water 11 cups 8.7 12 1 840 853 25 tbsp. 1.0 1 - 99 406 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Chocolate Fudge 2 cups sugar j cup milk i tbsp, butter 2 sq. chocolate i tsp. vanilla Sheet 6 in. X 4 in. X i in. 20.6 56 444 1744 2244 Piece 1 j in. X | in. X 1 in. 0-9 2 20 78 Chocolate Nut Caramels f cup condensed milk 1 cup cream 2 cups sugar | cup glucose 2 sq. chocolate I cup English wal- nuts J cup almonds Sheet 8 in. X 4 in. X i in. 26.0 173 1260 2459 3892 Piece 1 in. X 1 in. X f in. 0-7 4 32 64 CANDIES APPENDIX 407 Coconut Cara- mels i cup condensed milk | cup cream 5 cup maple syrup 2 cups sugar j cup glucose i cup coconut Sheet 8 in. X 4 in. X i in. 26.0 118 881 2736 3735 Piece 1 in. X 1 in. X t in. o-7 3 24 73 Penouche i cup brown sugar 1 cup milk Sheet 3 in. X 4} 8.2 171 749 Piece 1 in. X 1 18 6 English wal- nuts i tsp. butter | tsp. vanilla in. X i in. 22 942 in. X if in. 0.9 2 80 408 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Apple Snow 3 egg whites t cup steamed apple pulp | cup sugar 51 cups 15-7 48 18 696 762 f cup 2.0 6 2 92 Apple Tapioca j cup tapioca 4 apples i cup sugar 3 cups water Few grains salt 2 j CUpS 34-5 6 12 932 950 1 cup 3-6 1 I 98 Boiled Custard 2 cups milk 3 egg yolks i cup sugar | tsp. vanilla 2 CUpS 15.0 9i 303 298 692 i cup (scant) 2.2 13 44 43 CUSTARDS, PUDDINGS, AND ICES APPENDIX 409 Brown Betty 2 cups bread crumbs 4 tbsp, butter 3 large apples i cup sugar i cup water 21 cups 25-5 44 434 762 1240 i cup 2.1 3 35 62 Chocolate blanc MANGE 3 tbsp, corn- starch 2 cups milk | cup sugar r| sq. chocolate j tsp. vanilla 2 j cups 21.2 88 362 627 1077 1 cup (scant) 1.9 8 33 59 Cornstarch blanc mange 4 tbsp, corn- starch 1 cup sugar 2 cups milk 5 tsp. vanilla 2 CUpS 19-5 64 176 493 733 i cup 2-7 9 24 67 410 FEEDING THE FAMILY Food Valve of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories 1 Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Cottage Pudding | cup butter f cup sugar i egg i cup milk 2f cups flour 4 tsp. baking powder | tsp. salt 2 loaves 6 in. X 4 in. X in. 24-3 179 549 1372 2100 Slice if in. X 2 in. X 2j in. 1.1 7 26 67 Cup Custard 3 cups milk 3 eggs 6 tbsp, sugar 3s cups 33-8 172 400 458 1030 3 cup 3-3 17 39 44 Date Pudding I i j cups dates ij cups flour I cup sugar i cup drippings | tsp. cinnamon Loaf 4 in. diam. 6 in. high 20.0 123 743 1620 2486 Slice 1 in. X 1 in. X i| in. 0.8 5 3° 65 CUSTARDS, PUDDINGS, AND ICES - Continued APPENDIX 411 Date Pudding II { cup butter | cup molasses 1 cup milk i egg i j cups graham flour i cup dates | tsp. soda | tsp. salt 2 loaves 3 in. diam. 45 in. high 24-3 i57 565 1390 2112 Slice 3 in. diam. 5 in. thick 1.1 7 27 66 Lemon Ice i cup water 8 tbsp, sugar 4 tbsp, lemon juice. if cups i3-5 - - 427 427 i cup (scant) 3-i - - 100 Lemon Jelly | cup sugar i tbsp, gelatin | cup lemon juice if cups water 2 cups 16.8 38 - 397 435 i cup 3-8 9 - 9i Lemon Milk Sherbet 2 J cups milk i J cups sugar | cup lemon juice 4i cups 30.8 66 179 1329 1574 1 cup i-9 4 12 84 412 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Peach Ice Cream 6 peaches | cup sugar i cup thick cream i cup milk 4 cups 30.2 66 842 747 1655 i cup 1.8 4 Si 45 Prune Souffle | lb. prunes (un- cooked) 5 egg whites J cup sugar 3 s cups 16.O 85 3 772 860 i cup 1.8 IO - 9° Raspberry Sherbet x qt. raspberries ii cups sugar i cup water 2 tbsp, lemon juice i egg white 3i cups 26.5 14 1 1241 1256 i cup 2.1 1 - 99 CUSTARDS, PUDDINGS, AND ICES - Continued APPENDIX 413 Rice Pudding I | cup boiled rice j cup milk i egg i tbsp, sugar j tsp. lemon extract if cups 8.2 45 85 130 260 I cup (scant) 3-i 18 32 50 Rice Pudding II (Creamy) 2 cups milk 1 cup rice 13 cups 14.1 79 175 392 646 icup 2.2 12 27 61 i cup sugar i tsp. salt Rice Pudding III 1 cup rice 30 raisins 6 tbsp, sugar 1 cup milk 2 cups water | tsp. salt 4| cups 18.0 89 87 992 1168 icup i-5 8 7 85 Snow Pudding 1 tbsp, gelatin 1 cup sugar 3 egg whites | cup lemon juice 1 j cups water 6 cups 20.0 88 1 836 925 I cup 2.2 10 - 90 414 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Spanish Cream i tbsp, gelatin 2 cups milk 2 eggs | cup sugar j tsp. vanilla 4$ cups n-5 82 132 251 465 I cup 2-5 18 28 54 Tapioca-Cornmeal Pudding 5 tbsp, tapioca 4 tbsp, cornmeal 5 cups skim milk j cup molasses | cup sugar 3 tbsp, butter | tsp. salt 2| cups 29.6 192 338 1154 1684 2 tbsp. 1.8 II 20 69 Tapioca Cream 2 cups milk | cup sugar 3 cups 22.0 91 219 456 766 1 cup 2.8 12 28 60 CUSTARDS, PUDDINGS, AND ICES - Continued APPENDIX 415 3 tbsp, tapioca i egg I tsp. vanilla ■ Vanilla Ice Cream I i qt. thin cream s cup sugar i J tbsp, vanilla 4 qt. 37-2 92 1508 790 2390 21 tbsp. 1.6 4 63 33 Vanilla Ice Cream II 2 cups skim milk i tbsp, flour i cup sugar i egg i qt. thin cream 2 tbsp, vanilla 2 qt. 57-7 184 1568 1122 2874 i cup 2.0 6 55 39 416 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Eggs a la Golden- rod 2 cups milk 4 tbsp, flour 4 tbsp, butter 8 eggs 8 slices bread 8 servings 45-3 404 955 928 2287 | serving 2.0 18 42 40 Seasonings Egg Timbale i egg 1 cup milk Seasonings I cup 7-8 49 i°5 36 190 i cup 4-2 26 55 19 Scrambled Eggs 5 eggs 5 cup milk 2 tbsp, butter Seasonings cups 12.7 119 440 25 584 I cup 2.1 20 76 4 EGGS AND CHEESE DISHES APPENDIX 417 Cheese Souffle 2 tbsp, butter 3 tbsp, flour | cup milk | cup cheese 3 eggs. Seasonings 3 cups U.S 119 467 75 661 i cup 1.7 18 70 12 Cheese Straws i tbsp, butter j cup flour i cup bread crumbs 2 tbsp, milk i cup grated cheese Seasonings 28 straws 5 in. X j in. X f in. 8.0 182 542 326 1050 2§ straws 5 in. X f in. X f in. 0.8 17 52 3i Macaroni and Cheese | cup uncooked macaroni | cup grated cheese i tbsp, flour i| tbsp, butter f cup milk 3 tbsp, bread crumbs 5 cups 21.0 170 39° 444 1004 a cup 2.1 17 39 44 418 FEEDING THE FAMILY Food Value or Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Nut and Cheese Roast i cup grated cheese i cup chopped walnuts i cup dry bread crumbs 2 tbsp, chopped onion i tbsp, butter 2 tbsp, lemon juice Salt and pepper Loaf 3 in. X 4 in. X i| in. 14.8 232 1060 266 1558 Slice i{ in. X ij in. X t in. 0.9 15 68 17 Rice Fondue on Crackers i tbsp, raw rice 4 tbsp, grated cheese | tbsp, milk 4 crackers and 8 tbsp, sauce 4.4 72 L53 96 321 if crackers and 21 tbsp, sauce 1-4 22 48 30 EGGS AND CHEESE DISHES - Continued APPENDIX 419 i egg 4 saltines Seasonings Rice with Cheese and Tomatoes i cup uncooked rice 8 oz. American cheese i pt. canned to- matoes 4$ cups 37-5 347 746 7°7 1800 Jcup 2.1 19 42 39 Samp Baked with Cheese i cup samp (un- cooked) 4| cups 38.0 132 194 627 953 1 cup 4-o 14 20 66 2 oz. cheese Salt Welsh Rarebit | cup milk i cup grated cheese i egg i cup rarebit and toast 10.7 185 478 177 840 i j tbsp, rarebit and | slice i-3 22 57 21 2 tsp. butter 4 slices toast Seasonings toast 420 FEEDING THE FAMILY Food Value oe Recipe ioo-Calorie Portion Measure uO © £ 8 Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Apple Sauce 4 large apples 6| tbsp, sugar Water 2 3 CUpS 23-0 9 26 636 671 i cup 3-5 1 3 96 Baked Apple i large apple 2 tbsp, sugar i tbsp, water i serving 4-5 3 5 IQ2 200 j serving 2-3 I 3 96 Baked Apple with Whipped Cream i large apple i tbsp, sugar i tbsp, water i tbsp, cream i serving 4.8 3 61 136 200 j serving 2-4 I 31 68 Cranberry Jelly 4 cups cranberries i cup water 3l cups 30.0 12 41 1929 1982 2 tbsp. 1-5 - 1 99 2 cups sugar FRUITS APPENDIX 421 Cranberry Sauce i cup cranberries | cup sugar | cup water i| cups 8.0 2 6 512 520 1 cup (scant) x-5 - 1 99 Stewed Dried Apricots i lb. apricots i cup sugar Water Si cups 56.4 85 4i 1974 2100 i cup 2-7 4 2 94 Stewed Peaches 2 peaches 2 tbsp, sugar 1 cup water <cup 5-5 4 1 153 158 J cup 3-5 2 - 98 Stewed Prunes i lb. prunes i cup sugar Water 48 prunes and 4 cups juice 56-0 32 - 2036 2068 2 prunes and 2 tbsp, juice 2.8 2 - 98 Stewed Rhubarb i cup rhubarb (f in. pieces) 8J tbsp, sugar 2j cups 7.6 3 7 448 458 I cup i-7 1 2 97 422 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Beef Loaf 2 lb. lean beef i egg 2 tbsp, melted butter Seasonings Loaf 4 in. X 6 in. X 2| in. 26.0 719 1092 - l8ll Slice 4 in. X 6 in. X | in. i-4 40 60 - Beef Stew with Vegetables | lb. beef plate | cup carrot cubes i onion 3 potatoes | cup turnip cubes f cup flour Water and season- ings 41 cups 34-0 183 510 439 1132 1 cup 3° 16 45 39 Codfish Balls i cup codfish 2 cups potato MEATS, FISH, AND POULTRY 2 tbsp, butter i egg Fat for frying 10 balls 2 in. diam. 16.6 138 632 210 980 1 ball 2 in. diam. i-7 14 65 21 Creamed Chicken 1 cup canned chicken i tbsp, butter i tbsp, flour | cup milk 1 cup 7.2 72 3i5 48 435 i cup (scant) 1.6 16 73 11 Creamed Salt Cod 2 cups salt cod (shredded) i cup skim milk i cup water 3 tbsp, butter 4 tbsp, flour 4 cups 18.4 243 343 161 747 i cup 2-5 32 46 22 Creamed Dried Beef I i oz. dried beef (slice 4 in. X 5 in.) 1 tbsp, beef drip- pings 1 tbsp, flour f cup milk Seasonings s CUp 6.0 4° 162 48 250 i cup (scant) 2.4 16 65 19 APPENDIX 423 424 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories A " u Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Creamed Dried Beef II | cup (2 oz.) dried beef 1 cup milk 2 tbsp, butter 2 tbsp, flour Seasonings Creamed Salmon on Toast | cup salmon | cup skim milk 1 tbsp, oleomar- garine 1 j tbsp, flour 2 slices toast 11 cups i cup salmon and toast 12.0 10.0 106 92 322 178 92 i54 520 424 i cup (scant) 1 cup salmon and | slice toast 2-3 2-4 20 22 62 42 18 36 MEATS, FISH, AND POULTRY - Continued APPENDIX 425 Irish Stew with Dumplings Stew: 2 lb. mutton 2 lb. potatoes (4 cups) 5 lb. carrots (i cup) 1 lb. turnips (f cup) f cup flour I small onion Seasonings Dumplings: 2 cups flour 2 cups chopped suet t cup milk 4 tsp. baking powder | tsp. salt 4 qts. and 12 dumplings I35-Q 804 3943 2310 7057 f cup and 5 dumpling 1.9 12 56 32 426 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Meat Pie Pastry: i j cups flour | cup crisco | tsp. baking powder i tsp. salt Filling: j lb. beef rump 5 medium po- tatoes I Ib.carrots 2 large) J oz. salt pork i small onion 3 tbsp, corn- starch i tbsp, butter Seasonings Pie 9 in. diam. 3! in. deep or 8 large servings 52.0 320 I3U 1416 3050 i serving 1-7 IO 43 47 5 8 c U I >< H U B Am § < E cn E co w APPENDIX 427 Poultry Stuffing 2 cups soft bread crumbs 2 tbsp, melted butter { cup milk Seasonings 1 cup 5-o 58 300 266 624 1 cup 0.8 9 48 43 Salmon Loaf i cup salmon I cup bread crumbs I j cups 11.2 205 288 57 550 i cup 2.1 37 52 11 i egg i tsp. butter Seasonings Stuffed Beef Heart i beef heart (3 lb.) 9 oz. salt pork i heart and gravy 48.0 94° 2810 468 4218 Slice 2j in. X 2| in. X J in. and 1.0 21 68 11 6 oz. bread crumbs J cup flour Seasonings 1 tbsp, gravy 428 FEEDING THE FAMILY Food Value of Recipe 100-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories | Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Stuffed Steak 2 lb. lean steak 2 oz. suet 4 oz. bread crumbs Seasonings Roll 6 in. or 7 in. long 3 in. diam. 36.0 800 1051 256 2107 Slice 3 in. diam. | in. thick 1-7 39 49 12 Swiss Steak i lb. lean beef round j cup flour 2 tbsp, drippings i slice onion i tbsp, vinegar Seasonings Piece 4$ in. x 7 in. X 1 in. 15-0 418 585 212 1215 Piece 4 in. X 1 in. X f in. 1.2 35 48 17 Tunny Fish A la Newburg 2 cups tunny fish 3 tbsp, butter i j tsp. flour i tsp. lemon juice 2 cups 16.O 318 538 37 893 1 cup 1 (scant) 1.8 36 60 4 MEATS, FISH, AND POULTRY - Continued APPENDIX 429 2 egg yolks j cup skim milk Seasonings Veal Cutlets if lb. veal (trimmed) 2 eggs 4 tbsp, butter 6 tbsp, flour i cup bread crumbs 3 cups water Seasonings 6 servings 33-8 512 875 310 1697 I serving 2.0 30 52 18 430 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Apple Pie 4 apples | cup sugar Water Plain pastry for 2 crusts Pie 9 in. diam. 28.0 64 744 1022 1830 Sector 11 in. at circumference 1.6 3 41 56 Cranberry Pie 2 cups cranberries i cup sugar | cup water Plain pastry for undercrust and strips over top Pie 8 in. diam. 21.2 28 266 Il68 1462 Sector if in. at circumference 1-4 2 18 80 Cream Pie with Meringue 2 cups milk 5 tbsp, flour I cup sugar Pie io in. diam. 25.8 163 594 840 1597 Sector iA in. at circum- ference 1.6 IO 37 53 PIES APPENDIX 431 2 eggs Flavoring Plain pastry for undercrust Lemon Meringue Pie 3 eggs 11 cups sugar 2 tbsp, flour 3 tbsp, powdered sugar 2 cups water Juice 2 lemons Plain pastry for undercrust Pie 9 in. diam. 27.0 140 729 1831 2700 Sector 1 in. at circumference 1.0 5 27 68 Plain Pastry i| cups flour 3 tbsp.lard 3 tbsp, butter J tsp. salt Water 3 crusts 9 in. diam. 10.2 (un- cooked) 8-5 (cooked) 64 653 420 ii37 J of 1 crust 9 in. diam. 0.9 (un- cooked) o-7 (cooked) 6 58 36 432 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Raisin and Cran- berry Pie i cup cranberries i cup raisins i cup sugar i tbsp, flour i cup water Plain pastry for 2 crusts Pie 8 in. diam. 25-0 84 702 1736 2522 Sector 1 in. at circumference 1.0 3 27 70 Rhubarb Pie 2 J cups rhubarb if cups sugar 1 egg 2| tbsp, flour Plain pastry for 2 crusts Pie 9 in. diam. 31-2 92 326 1384 1802 Sector if in. at circumference 1-7 5 18 77 PIES - Continued APPENDIX 433 Squash Pie i| cups cooked squash 2 eggs | cup brown sugar 2 tbsp, molasses i| cups skim milk Plain pastry for undercrust Pie g in. diam. 25.0 132 357 907 1396 Sector 2 in. at circumference 1.8 IO 25 65 FEEDING THE FAMILY 434 Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) ' Protein Calories Fat Calories Carbo- hydrate Calories Banana Salad 4 bananas i tbsp, lemon juice 8 lettuce leaves j cup chopped peanuts | cup boiled dress- ing Boiled Salad Dressing 2 egg yolks | tbsp, flour i j tbsp, sugar i| tbsp, melted butter f cup milk | cup vinegar Seasonings 8 servings if cups 23.2 13-0 105 47 317 292 459 123 881 462 1 small serving I cup 2.6 2.8 12 IO 36 64 52 26 SAI.ADS AND DRESSINGS APPENDIX 435 Cheese and Pine- apple Salad 5 head lettuce 6 slices canned pineapple i cream cheese 6 tbsp. French dressing 6 servings 22.4 121 754 440 1315 | serving i-7 9 58 33 Chicken Salad i cup cooked chicken i cup celery 8 lettuce leaves 4 tbsp. French dressing 4 tbsp, mayonnaise dressing 8 servings 14.1 112 783 20 9i5 1 small serving 1.6 12 86 2 Cole Slaw 2 cups shredded cabbage i cup thick cream 11 tbsp, vinegar Seasonings 2 j cups 7.2 i5 202 42 259 1 cup 2.8 6 78 16 436 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Egg Salad 2 eggs 4 leaves lettuce 2 j tbsp, mayon- naise 2 servings 6.6 65 395 4 464 I serving 1.4 14 85 I French Dressing 4 tbsp, olive oil 2 tbsp, vinegar Seasonings 6 tbsp. 2-5 - 400 - 400 i| tbsp. 0.6 - IOO - Fruit Salad f lb. grapes 3 small oranges i small banana 24 walnuts 9 leaves lettuce 1 cup mayonnaise dressing 6 cups 36.8 80 1780 515 2375 1 cup fruit and j tbsp, mayon- naise i-5 3 75 22 SALADS AND DRESSINGS - Continued APPENDIX 437 Lettuce Salad with French Dressing i head lettuce 6 tbsp. French dressing 9 servings II.O i3 9°7 30 95° 1 small serving 1.2 1 95 4 Mayonnaise Dressing i egg yolk i tsp. sugar i tbsp, lemon juice i tbsp, vinegar t cup olive oil Seasonings if cups 8.8 12 1740 41 1793 1 tbsp. 0.5 1 97 2 Potato Salad i large potato 6 small leaves lettuce 2 J tbsp, mayonnaise 2 servings 7-3 14 282 124 420 j serving i-7 3 68 29 Sardine Salad 5 sardines 2 egg yolks i egg white 2 leaves lettuce i tsp. mayonnaise i large serving 3-5 85 195 3° 310 i serving 1.1 27 63 10 438 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Tomato and Cu- cumber Salad 6 slices cucumber 3 slices tomato 3 leaves lettuce i j tbsp, mayon- naise i serving 3-7 8 149 28 I8S | serving 2.0 4 81 15 Tomato and Let- tuce Salad 4 medium tomatoes i head lettuce 6 servings 32.0 38 999 125 1162 i serving 2-7 3 86 II j cup mayonnaise Waldorf Salad 6 walnut halves I medium apple J cup cut celery i large leaf lettuce 11 tbsp, mayonnaise i large serving 3-3 11 195 52 258 i serving 1.2 4 76 20 SALADS AND DRESSING - Continued APPENDIX 439 Food Value or Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Brown Sauce 2 tbsp, butter | slice onion 3 tbsp, flour i cup brown stock Seasonings ij cups 7-8 32 112 84 228 5 cup 3-4 14 49 37 Brown Sugar Sauce | cup brown sugar | tbsp, cornstarch i cup water i tsp. vinegar i cup (very full) 9-9 - - 33° 330 5 tbsp. 3-o - - IOO Charlotte Russe Filling i cup thick cream | cup skim milk I tsp. gelatin J cup sugar 4 tbsp, water 2| cups 17.2 44 879 254 1177 1 cup i-5 4 74 22 SAUCES AND FILLINGS 440 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Cream Filling I f cup sugar j cup flour 2 eggs 2 cups milk i tsp. vanilla 2 3 CUpS 22.7 130 293 812 1235 3$ tbsp. 1.8 IO 24 66 Cream Filling II i cup thick cream | cup milk i egg white | cup sugar i tsp. vanilla 3 cups 14.6 56 9°9 205 II7O 1 cup 1.2 5 77 18 Cream Sauce i cup thick cream j cup skim milk | cup powdered sugar i tsp. vanilla I j cups 10.0 22 595 256 873 i cup 1.1 3 68 29 SAUCES AND FILLINGS - Continued APPENDIX 441 Hard Sauce | cup butter | cup powdered sugar | tsp. lemon extract j tsp. vanilla t cup 7-4 3 545 555 1103 1 tbsp. o-7 - 50 50 Lemon Sauce | cup sugar i cup water 2 tbsp, cornstarch 2 tbsp, butter i| tbsp, lemon juice 8 cup 10.7 1 205 478 684 i cup 1-5 - 30 70 Tomato Sauce i cup tomato juice 2 tbsp, flour 2 tbsp, butter | onion i pepper corn Salt I cup 8-3 18 230 84 332 5 tbsp. 2.5 5 70 25 White Sauce i cup milk 2 tbsp, flour 2 tbsp, butter | tsp. salt I cup 10.0 38 286 92 416 i cup 2.4 8 7o 22 442 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Clear Tomato Soup 2 cups tomato juice 2 cups water 2 tsp. sugar 2 tbsp, butter 3 tbsp, flour Soda and season- ings 4 cups 32.0 33 210 192 435 1 cup (scant) 7-4 8 48 44 Corn Chowder i cup canned corn 2 cups potatoes 8 soda crackers 2 cups milk i J tbsp, butter 11 oz. salt pork Seasonings 5 cups 41-7 144 540 560 1244 t cup 3-3 12 43 45 SOUPS APPENDIX 443 Cream of Aspara- gus Soup i can asparagus i bouillon cube 4 cups milk 4 tbsp, butter 5 tbsp, flour 2 eggs Seasonings 2 qt. 60.0 250 845 4i5 1510 | cup (scant) 4.0 17 56 27 Cream of Baked Bean Soup 2 tbsp, butter 4 tbsp, flour 11 cups milk i cup bean pulp i J cups water Seasonings 4 J cups 21.5 120 372 332 824 j cup 2.6 15 45 40 Cream of Celery Soup 2 bunches celery 4 tbsp, butter 6 tbsp, flour 3 cups milk Seasonings 5i cups 40.0 128 666 303 1097 j cup 3-6 11 61 28 444 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Cream of Corn Soup 2 cups canned corn 2 cups milk 2 tbsp, butter 2 tbsp, flour 2 cups water Seasonings 5i cups 44-7 137 439 587 1163 j cup 3-9 12 38 50 Cream of Green Pea Soup i j cups peas i cup milk i cup water i tbsp, flour i tbsp, butter Seasonings 3 cups 24.O 72 207 176 455 i cup 5-2 16 46 38 SOUPS - Continued APPENDIX 445 Cream of Peanut Butter Soup i cup milk i| tbsp, peanut butter ij tbsp, flour Seasonings IJ CUpS 9.8 68 200 102 37o i cup (scant) 2.6 18 54 28 Cream of Spinach Soup 4 cups milk 2 tbsp, butter 2 2 tbsp, flour i cup cooked spinach Seasonings 5i cups 42.0 153 554 278 985 I cup 4.2 16 56 28 Cream of Tomato Soup 2 cups canned tomatoes 2 tsp. sugar i qt. milk 4 tbsp, flour | cup butter | medium onion Soda and seasonings 5? cups 47-6 165 927 388 1480 8 CUp 3-2 II 63 26 446 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Lentil Soup 2 tbsp, lentils (un- cooked) i j tbsp, flour | tbsp, butter i tsp. sugar j tsp. salt 2 cups water Seasonings Lentil and Tomato Soup | cup lentils (cooked) i cup tomatoes | tsp. sugar | tsp. salt | onion | tsp. lemon rind 2 cups water Seasonings 2 CUpS 3 cups 18.0 24.2 34 104 54 12 112 256 200 372 1 cup f cup 9.0 6-7 17 28 27 3 56 69 SOUPS - Continued APPENDIX 447 Oyster Stew I i cup (12) oysters 2 soda crackers 1 j tbsp, butter 1 cup milk Seasonings 2 cups 16.5 85 270 109 464 i cup (scant) 3-5 18 58 24 Oyster Stew II 18 oysters 11 cups oyster liquor 5 cups milk 4 tbsp, butter Seasonings 7 cups 64.0 224 862 274 1360 2 cup (large) 4-7 16 63 21 Potato Soup 3 cups milk 3 medium potatoes 1 slice onion | tbsp, butter 1 tbsp, flour Seasonings 4 cups 36.0 126 324 402 852 i cup (scant) 4-2 IS 38 47 Split Pea Soup | cup split peas 1 tsp. flour 2 cups water Seasonings 2j cups 23-0 100 9 272 381 i cup 6.0 26 2 72 448 FEEDING THE FAMILY Food Value or Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) ri 1/5 Fat Calories Carbo- hydrate Calories Asparagus on Toast i can (20 stalks) asparagus 4 slices toast 1 cup white sauce 4 servings 30-8 92 309 277 678 1 serving 4.6 13 46 41 Baked Lentils j cup dry lentils 1 tbsp, bread crumbs 2 tsp. butter | small onion Water Seasonings 1 cup 7-0 107 86 252 445 t cup (scant) 1.6 24 20 56 Corn a la Southern 1 cup canned corn 1 egg I tbsp, butter 1 cup milk Seasonings 2 cups 20.8 95 243 252 59° i cup 3-4 16 41 43 VEGETABLES APPENDIX 449 Creamed Peas | cup peas 5 tbsp, white sauce i cup 6.2 39 83 100 222 i cup (scant) 2.7 18 37 45 Creamed Potatoes 2 cups potato cubes 2 tbsp, butter 2 tbsp, flour i cup milk 4 tsp. salt 3> cups 20.2 67 366 310 743 1 cup 2.7 9 50 4i Creamed Turnips 3 medium turnips | cup milk i tbsp, butter i tbsp, flour Seasonings i j cups 4-3 29 147 116 292 J cup i-4 10 5° 40 Glazed Sweet Po- tatoes 6 sweet potatoes J cup sugar J tbsp, butter 12 medium halves 34-3 70 107 1488 1665 1 small half potato 2.1 4 7 89 450 FEEDING THE FAMILY Food Value or Recipe 100-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat , Calories Carbo- hydrate Calories Kidney Bean Stew | cup kidney beans | onion i tbsp, rice 2 small potatoes 2 cups canned tomatoes i tbsp, butter Seasonings 3l cups 36.0 189 130 411 730 2 cup 4-9 26 18 56 Lentil Meat Loaf | lb. round steak i cup cooked lentils i egg J cup milk 4 tbsp, butter | cup chopped walnuts | cup bread crumbs | small onion Loaf 2 in. X 3 in. X 5 in. 18.8 460 672 508 1640 Slice if in. X 22- in. X | in. I.X 28 41 31 VEGETABLES - Continued APPENDIX 451 Lima Beans, But- tered i cup beans i tbsp, butter i cup 5-2 46 109 142 297 1 cup 1.7 16 36 48 Macaroni Cro- quettes i cup uncooked macaroni 2J tbsp, butter i cup milk 16 croquettes 25-0 208 898 9°4 2010 1 small croquette 1.2 10 45 45 i egg | cup flour 4 tbsp, butter 11 cups bread crumbs Macaroni with To- mato Sauce i cup macaroni (uncooked) 11 cups tomatoes 3 tbsp, butter 3 tbsp, flour Seasonings 4 cups 33-o 97 318 49° 905 5 tbsp. 3-6 10 36 54 - 452 FEEDING THE FAMILY Food Value of Recife ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Mashed Potatoes 5 medium potatoes 3 tbsp, butter 1 cup milk 3< cups 21.8 5° 33° 310 690 1 cup (scant) 3-i 7 48 45 Nut Loaf i cup chopped walnuts 2 eggs i cup bread crumbs j cup milk Seasonings 2$ cups 14.8 164 632 224 IO2O i cup 1-4 16 62 22 Scalloped Onions 4 onions (io oz.) i cup milk 2 tbsp, flour 3 tbsp, butter 1 cup bread crumbs 2 j CUpS 22.4 72 522 286 880 i cup 2-5 8 59 33 VEGETABLES - Continued APPENDIX 453 Scalloped Pota- toes 4 medium potatoes i tbsp, flour I tbsp, butter i cup milk i tsp. salt j tsp. pepper 4 cups 22.8 6o 196 396 652 1 cup 3-5 9 3° 61 Spinach a la Creme 2 lb. spinach 2 tbsp, butter | cup thick cream i tsp. sugar Seasonings 5i cups 37-2 9i 639 178 908 i cup 4.1 10 7° 20 Spinach with Egg 2 cups finely chopped spinach i hard boiled egg i tbsp, butter Seasonings 2 CUpS 19-4 56 153 46 255 t cup 7-6 22 60 18 Stewed Mushrooms I lb. mushrooms 3 tbsp, butter i tbsp, flour i j cups water 2$ CUpS 10.0 32 333 75 44° 5 cup 2.3 8 75 17 454 FEEDING THE FAMILY Food Value of Recipe ioo-Calorie Portion Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Total Calories Measure Weight Oz. (cooked) Protein Calories Fat Calories Carbo- hydrate Calories Stuffed Peppers I 6 large peppers i cup stale bread crumbs f cup brown sauce | cup chopped mushrooms 6 peppers 25-4 95 85 36° 540 1 pepper 4-7 17 16 67 Stuffed Peppers II 6 large peppers 2 cups boiled rice 1 cup tomato i tbsp, butter i onion i tsp. salt 6 peppers 3^-5 57 IIO 354 521 1 pepper 7-0 II 21 68 Stuffed Peppers III 6 large peppers i| cups bread crumbs 6 peppers 33-9 220 738 396 1354 i pepper 2-5 16 55 29 VEGETABLES - Continued APPENDIX 455 ii cups chopped boiled ham Seasonings Stuffed Tomato i tomato i tsp. butter i tsp. chopped onion 2 tbsp, bread crumbs i tsp. chopped ham i tomato holding 1 cup 4.0 13 45 42 100 1 tomato holding 1 cup 4.0 13 45 42 Turkish Pilaf I cup raw rice i tbsp, butter i cup water ii cups canned tomato Seasonings 5i cups 41.8 52 121 384 557 1 cup 7-5 9 22 69 456 FEEDING THE FAMILY TABLE IV Fuel Values in Relation to Cost A. Some Foods Costing f Cent or Less per ioo Calories Butter (24 cents per pound) Corn oil Cottonseed oil Cornmeal Cornstarch Corn syrup Flour, graham rye white Lard Molasses Oatmeal Oats, rolled Oleomargarine (24 cents per pound) Peas, dried split Rice (8 cents per pound) Samp Suet Sugar B. Some Foods Costing I to i Cent per ioo Calories Apple sauce cake Bacon (all fat eaten) Baking powder biscuit Beans, dried Bread, Boston brown corn (old New England) white Chocolate caramels Coconut caramels Cookies, plain Corn flakes Cornmeal muffins Farina Fudge, chocolate Gingerbread Griddle cakes Hermits Hominy grits Lentils Lemon sauce Molasses cookies Oatmeal cookies Oleomargarine (25 to 35 cents per pound) One egg cake One egg muffins Peanut butter Popovers Pork, salt Raisins Shredded wheat Split pea soup Sponge cake (hot water) Tapioca, pearl Wheat, flaked C. Some Foods Costing 1 to Cents per ioo Calories Apple pie Apple sauce Apple snow Blancmange, chocolate cornstarch Butter (35 to 50 cents per pound) Cheese straws Cake, angel chocolate sponge APPENDIX 457 C. Some Foods Costing i to i| Cents per ioo Calories (Confd) Chocolate (unsweetened) Cocoa (powder) Cookies, chocolate drop Crackers, graham oyster soda Cranberry pie Cream puffs (shells) Date pudding, steamed Figs (unpressed) French toast Force Grapenuts Irish stew with dumplings Lemon milk sherbet Lemon meringue pie Meat pie Macaroni Macaroni and cheese Milk (7 to 13 cents per quart) Milk, evaporated Milk, condensed, sweetened Muffins, graham Peanuts Penouche Potatoes, creamed Prunes, stewed Rice pudding, creamy Rhubarb, stewed Salmon, creamed, on toast Tapioca (granulated) Waffles Zwieback D. Some Foods Costing i| to 2 Cents per ioo Calories Apples, dried Beef heart, stuffed Butter (52 to 70 cents per pound) Brown betty Cheese, American cottage Chocolate (sweet) Cup custard Eggs a la goldenrod Filberts Lemon ice Lemon jelly Lentil soup Macaroni croquettes Macaroni with tomato sauce Marguerites Mayonnaise dressing Milk (io to 13 cents per quart) Olive oil Peaches, dried Pecans Peanut butter soup Potatoes, Irish Potatoes, sweet Prunes Prune souffle Rice with cheese and tomatoes Scalloped potatoes Snow pudding Squash pie Tapioca cream Turkish pilaf E. Some Foods Costing 2 to 2| Cents per ioo Calories Almonds Baked bean soup Boiled custard Boiled salad dressing Brown sauce Corn chowder 458 FEEDING THE FAMILY E. Some Foods Costing 2 to 25 Cents per ioo Calories (Cont'd) Cranberry jelly Eggs (27 to 33 cents per dozen) Lamb, shoulder Lentil meat loaf Lemonade Milk (14 to 17 cents per quart) Pineapple, canned Potato soup Saltines Scalloped onions String beans, canned Stuffed steak Swiss steak Tomato soup (cream of) Vanilla wafers F. Some Foods Costing 2I to 3 Cents per ioo Calories Baked apples Buttermilk Corn, canned Corn soup (cream of) Dates Dried beef, creamed Egg lemonade Flank steak French dressing Kidney bean stew Milk (18 to 20 cents per quart) Milk, powdered, skim Milk, powdered, whole Nut loaf Nut and cheese roast Onions Rice pudding (with egg) Spinach soup (cream of) Tunny fish a la Newburg Apples Apple sauce Apricots, canned dried Asparagus soup (cream of) Bananas Banana salad Beef, chuck (all fat eaten) liver round (all fat eaten) Beef loaf Beets Cabbage Cauliflower Celery soup (cream of) Cheese, cream Cheese, Neufchatel Cheese souffle G. Some Foods Costing 3 to 5 Cents per ioo Calories Cheese and pineapple salad Club sandwich Com a la Southern Cole slaw Cream Eggs (40 to 67 cents per dozen) Egg timbale Egg salad Figs, pressed Fruit salad Grapefruit Honey, strained Lady fingers Olives, green Potato salad Peas, canned Pears, canned Pork chops APPENDIX 459 G. Some Foods Costing 3 to 5 Cents per ioo Calories (Cant'd) Puffed com Puffed rice Puffed wheat Salmon (canned) Salmon loaf Sardines (canned) Scrambled eggs Tomato sauce Walnuts H. Some Foods Costing over 5 Cents per ioo Calories Asparagus Beef, most cuts Blackberries Blue fish Cantaloupe Chicken, canned creamed Carrots (young) Celery Cod, fresh Dried beef Grape juice Halibut Ham, boiled Lamb chops Lemons Lettuce Olives, ripe Oranges Peaches, canned fresh Pears, fresh Peppers, green green, stuffed Raspberries Spinach Tomatoes, canned Tunny fish Turnips, fresh 460 FEEDING THE FAMILY TABLE V Symonds's Table of Height and Weight for Men at Different Ages 1 (Based on 74,162 accepted applicants for life insurance.) Ages 15-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 5 ft. o in. 120 125 128 131 133 134 134 134 131 i in. 122 126 129 131 134 136 136 I36 134 2 in. 124 128 131 133 I36 138 138 138 137 3 in. 127 131 134 I36 139 141 141 141 140 140 4 in. 131 135 138 140 143 144 145 145 144 143 5 in- 134 138 141 143 I46 147 149 149 I48 147 6 in. 138 142 145 147 150 151 153 153 153 151 7 in. 142 147 150 152 155 156 158 158 158 IS6 8 in. 146 151 154 157 l6o 161 163 163 163 l62 9 in. 150 155 159 162 165 166 167 168 168 168 io in. 154 159 164 167 170 171 172 173 174 174 ii in. 159 164 169 173 175 177 177 178 l8o l8o 6 ft. o in. 165 170 175 179 l8o 183 182 183 I8S 185 i in. 170 177 181 185 l86 189 188 189 189 189 2 in. 176 184 188 192 194 196 194 194 192 192 3 in. 181 190 195 200 203 204 201 I98 1 Medical Record, Sept. 5, 1908. APPENDIX 461 Symonds's Table of Height and Weight for Women at Different Ages 1 TABLE VI (Based on 58,855 accepted applicants for life insurance.) Ages 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 4 ft. ii in. in 113 HJ 117 IIQ 122 125 128 128 126 5 ft. o in. »3 114 117 HQ 122 125 128 130 131 129 i in. US 116 Il8 121 124 128 131 i33 134 132 2 in. 117 118 120 123 127 132 i34 i37 137 136 3 m. 120 122 124 127 131 i35 138 141 141 140 . 4 in- 123 125 127 130 J34 138 142 i45 145 144 5 m. 125 128 131 135 139 i43 147 149 149 148 6 in. 128 132 135 137 i43 146 151 i53 153 152 7 in. 132 135 139 143 i47 150 154 i57 156 155 8 in. 136 140 143 147 iSi i55 158 161 161 160 9 in. 140 144 147 151 i55 159 163 166 166 165 io in. 144 147 151 155 159 163 167 170 170 169 1 McClure's Magazine, Jan., 1909 462 FEEDING THE FAMILY 6o 61 62 63 64 55 56 57 58 59 4^ Oj O "OO-M iooi 40 41 42 43 44 50 00 Height (Tn.) 94 99 104 in 117 00 00 00^1 *<I <0 Gn KJ 004^ 58 61 64 68 7i tn Gn Gn 4^ 4* Gn Oj O 00 O 4x 4k oj Oj Oj 4- m 50 00 O' OJ OJ Average Weight for Height (Lbs.) 46 47* 49* 4k 4x oj Oj Oj 4 oo©\ Oj Oj 5 Years Gn * Gn Gn Gn 4k 4^ on KJ O 00 O> 36* 38 39 41 44 St' 6 Years 58 61 63 66* Gn Oj <0 "oo^\ 38* 39* 41* 44 7 Years Gn KJ * * ■*4 O' 05 OCn 0 H oo 46* 48 50 53 55 39* 41* 44* 8 Years 72 76 79* 83* 58 61 64 67 70 46* 48* 5°* 53 55 9 Years vO * 73 77 80 84 O' O OOi OMA « Co 50* 53* 55 10 Years 92 95 100* 105* 00 00 00^7 -4 OOA H MO 58* 61 64 67 70 * 11 Years 601 901 101 96 z6 CO co 00^4 58* 61* 64 68 7i 12 Years 93 97 102 107 in 00 00 00*4 O Gn KJ 004^ 64* 68* 7i 13 Years £11 801 £01 66 t6 74* 78 83 86 90 KJ * 14 Years Sn on £01 001 S6 00 00 00 0 ~4 OJ 0 * * 15 Years 96 103 107 H3 117 O 16 Years 106* III 118 121 17 Years 931 tzi ,911 18 Years Gi KJ O *4 ♦ * 19 Years 60 61 62 63 64 55 56 57 58 59 50 51 52 53 54 O 00*4 Q\Gn 4° 41 42 43 44 0 00 Height (In.) TABLE VII Weight - Height - Age Table for Boys of School Age 1 APPENDIX 463 6S 123 114* 117 118 120 122 127 131 134 65 66 129 119 122 125 128 132 136 139 66 67 133 124* 128 130 134 136 139 142 67 68 139 134 134 137 141 143 147 68 69 144 137 139 143 146 149 152 69 70 147 143 144 145 148 151 155 7° 71 152 148* 150 151 152 154 159 7i 72 157 153 155 156 158 163 72 73 163 157* 160 162 164 167 73 74 169 160* 164 168 170 171 74 Age - Years 6 7 8 9 10 II 12 13 14 15 16 17 18 19 Average ( Short 43 45 47 49 51 53 54 56 58 60 62 64 65 65 Height ( Medium 46 48 5° 52 54 56 58 60 63 65 67 68 69 69 (inches) (Tall 49 51 53 55 57 59 61 64 67 70 72 72 73 73 Average ( Short 3 4 5 5 5 4 8 9 II 14 13 7 Annual < Medium 4 5 6 6 6 7 9 II 15 11 8 Gain (lbs.) (Tall S 7 7 7 7 8 12 16 II 9 7 3 4 The tables are to be used as follows: Take, for example, a 14-year-old boy who is 64 inches tall. By following the numbers horizontally opposite the figure 64 it will be found that he should weigh 113 pounds. A 12-year-old boy who is 64 inches tall should weigh 109 pounds, and an 18-year-old boy should weigh 126 pounds. Age is taken at the nearest birthday; height at the nearest inch; and weight at the nearest pound. A child is considered 6 years old at any time between 5! and 6| years. The figures not starred represent exact averages in round numbers. The starred figures represent smoothed or interpolated values. The following percentage of net weight has been added for clothing (shoes, coats, and sweaters are not included): For weights from 35 to 63 lbs. -3.5% of net weight is added. For weights 64 lbs. and over - 4% of net weight is added. 1 Prepared by Bird T. Baldwin, Ph.D., and Thomas D. Wood, M.D., published by the American Child Health Association and reprinted by their permission. ' 464 FEEDING THE FAMILY TABLE VIII Weight - Height - Age Table for Girls of School Age1 O' O' O' O' O' l J h O Cn Gn Gn tn Gn O 00*4 O'Gn Gn Gn tn Gn Gn 4- w H 0 O 00*4 "o'Ua "m "o Co Co 43 00 Height (In.) IOI 108 114 118 121 \0 00 00*4 *4 Gn O 4^ >O Czi S8 61 64 68 7i s g 55 -U. Qo Co Co W H OM O S <2 Average Weight for Height (Lbs.) 45 47* 49* "w "m kO £ i 5 Years Gn * 45 47 50 52 54 io "m go ^4 Co Co 6 Years 56 59 63* 66* 45 47 50 52 54 36* 37* 39* 4i 42 7 Years O' O' O' O'Gn O *4 4* O *4 Gn Gn Gn A 4^ G/i to O 00 Gn W "m * * 8 Years 74 76 80* *4 O' O' O'Gn O *4 A H. 0O 45* 48* 5° 52 55 9 Years * 00 00 00*4 *J 'J (G 004^ *4 O' O' O' Ga 0 0044. M \O £ 10 Years 95 99 104* O 00 00*4 *4 O O' w 004^ M 00Gn Go h 53* _56^_ 11 Years on So 1 001 S6 75 79 82 86 90 62* 65 67 69 _Z£_ 12 Years Su on 901 IOI Z6 O COCO 00*4 K> 004^ M *4 2 "S * * 13 Years in in 601 Soi IOI 78* 83* 88 93 96 14 Years 611 911 £11 go 1 Soi 92* 96* 100 15 Years 108 112 115 117 120 0 0 # # 16 Years 109 113 117 H9 122 0 * 17 Years Szi 021 8" 911 .111 18 Years S'S' S' S' o' Gn Gn Gn Gn Gn 'O 00*4 O'Gn Gn Gn Gn Ga Gn 4^W M H O O 00*4 'O'^I W M "o 38 39 Height (In.) APPENDIX 465 65 66 67 68 69 125 129 133 138 142 118* 120 124 128* 131* 121 124 130 133 135* 122 125 131 135 137* 123 128 133 136 138* 125 129 133 138 140* 126 130 135 138 142* 65 66 67 68 69 7° 7i 144 145 136* 138* 138* 140* 140* 142* 142* 144* 144* 145* 70 71 Age - Year 6 7 8 9 10 II 12 13 14 15 16 17 18 Average Height (inches) f Short < Medium [Tall 43 45 47 45 47 5° 47 5° 53 49 52 55 50 54 57 52 56 59 54 58 62 57 60 64 59 62 66 60 63 66 61 64 67 61 64 67 61 64 67 Average ( Short Annual < Medium Gain (lbs.) [ Tall 4 5 6 4 5 8 4 6 8 5 7 9 6 8 11 6 10 13 10 13 9 13 10 8 10 6 4 7 4 4 2 3 I I I I The following percentage of net weight has been added for clothing (shoes and sweaters are not included): For weights from 35 to 65 lbs. - 3% of net weight is added. For weights from 66 to 82 lbs. - 2.5% of net weight is added. See also notes on Table VII " W61gtS fr°m 83 °VW ~ 2% °f net Weight is added' 1 See Footnote to Table VIL 466 FEEDING THE FAMILY TABLE IX Weight - Height - Age Table for Boys from Birth to School Age 1 Ht. (In.) Average Weight FOR Height (Pounds) Mo. 3 Mos. 6 Mos. 9 Mos. 12 Mos. 18 Mos. 24 Mos. 30 Mos. 36 Mos. 48 Mos. 60 Mos. Mos. 20 8 8 21 91 9 IO 22 ioJ IO II 23 12 II 12 13 24 i3i 12 13 14 25 15 13 14 15 16 26 16J 15 17 17 18 27 18 16 18 18 19 28 19I 19 19 20 20 29 2©1 20 21 21 21 30 22 22 22 22 22 22 31 23 23 23 23 23 24 32 242 24 24 24 25 25 33 26 26 26 26 26 26 34 27 27 27 27 27 35 291 29 29 29 29 29 36 31 30 31 31 31 37 32 32 32 32 32 32 38 331 33 33 33 34 39 35 35 35 35 35 40 361 36 36 36 36 4i 38 38 38 38 42 391 39 39 39 43 41! 4i 4i 4i 44 431 43 43 45 451 45 45 46 48 48 47 5° 50 48 521 52 49 55 - - 55 Notes : i. Weight is stated to the nearest pound; height to the nearest inch; age to the nearest birthday. 2. Up to and including 34 inches the weights are net. Above this the following amounts have been added for clothing (shoes, coats, and sweaters are not included): 35 to 39 in. il pounds. 40 to 44 in. i| pounds. 45 to 49 in. 1 ' pounds. »Prepared by Robert M. Woodbury, Ph.D., published by the American Child Health Association, and reprinted with their permission. APPENDIX 467 TABLE X Weight - Height - Age Table for Girls from Birth to School Age 1 Ht. (In.) Average Weight for Height (Pounds) Mo. 3 Mos. 6 Mos. 9 Mos. 12 Mos. 18 Mos. 24 Mos. 30 Mos. 36 Mos. 48 Mos. 60 Mos. 72 Mos. 20 8 8 21 9 9 IO 22 10$ IO II 23 12 II 12 13 24 131 12 13 14 14 25 15 13 14 15 15 26 16I 15 16 17 17 27 175 16 17 18 18 28 19 19 19 19 19 29 20 19 20 20 20 30 2ii 21 21 21 21 21 31 22I 22 22 23 23 23 32 24 23 24 24 24 25 33 25 25 25 25 26 34 261 26 26 26 27 35 29 29 29 29 29 29 36 30 30 30 30 30 31 37 311 31 31 31 31 32 38 321 33 33 33 33 39 34 34 34 34 34 34 40 351 35 36 36 36 4i 371 37 37 37 42 39 39 39 39 43 4i 40 4i 4i 44 421 42 42 45 45 45 46 471 47 47 5° 5° 48 5 21 52 Notes : i. Weight is stated to the nearest pound; height to the nearest inch; age to the nearest month. 2. Up to and including 34 inches the weights are net. Above this the following amounts have been added for clothing (shoes and sweaters are not included): 35 to 39 in. 1 pound. 40 to 44 in. 1 j pounds. 45 to 49 in. i| pounds. 1 See Footnote to Table IX. 468 FEEDING THE FAMILY TABLE XI Relative Amounts of Vitamins in Food Materials (Including such as have been investigated up to the present time.) How to Interpret the Table If the vitamin is known to be present in amounts sig- nificant for nutrition, this is indicated by a single line ('); if it occurs in considerable quantity, two lines are used (' '); and if it is present in large enough quantity to call the food a rich source, three lines (' ' ') designate this. When the food has not been investigated, a question mark (?) shows this discrepancy in our knowl- edge, and when little or no vitamin has been found, the zero (o) sign is used. In case of cooked or dried foods, where for instance the vitamin may be destroyed by a long slow process or conserved in large measure by a short one, attention has been called to this fact by saying " Depends on Process." Source A B c Almonds / / ? Apples ? / / Bananas ? / f Barley, whole / / / ? Beans, kidney ? / / / ? navy ? o soy o string / / / / / Beets o / Brain t / ! ? Brazil nuts ? ! / ? APPENDIX 469 Source A B c Bread, white (yeast) .... o f o whole wheat (yeast) . . . / f f o Butter / / / o o Cabbage, fresh raw / / f f t / / / cooked a short time .... / / / / f Carrots, fresh raw / / / f cooked / / / Depends on process Cauliflower / / / ? Celery ? 9 / ? Chard / 9 ? Cheese / / 9 9 o Chestnuts ? 9 ? Coconut / 9 9 o Coconut oil o o o Codfish / f ? Cod-liver oil / / / o o Corn oil o o o Cottonseed oil o o o Cream f f f / ? Dandelion greens f 9 9 f f Dasheens o f f Eggs III / o Egg yolk Iff f o Endive t ? ? Fat of beef f o o Filberts ? / / ? Germinated legumes .... f / / 9 9 9 Grapefruit ? f 9 f / Grape juice (commercial) . . ? f / Grapes ? f f Heart f 9 ? Herring . . f / ? Hickory nuts ? / f ? Honey o f o Kidney f f f / ? Lard o o o Lemon juice o / t 9 9 9 Lettuce f f r f t t 9 470 FEEDING THE FAMILY Source A B c Limes 0 ? 9 9 Liver . / 9 9 9 ? Maize, white 0 9 9 ? yellow / 9 9 ? Meat (muscle) 0 ? Almost none Milk, fresh / 9 9 9 9 Depends on cow's diet condensed 9 9 9 9 9 Depends on evaporated . 9 9 9 9 9 process dried, skim / 9 9 Depends on process dried, whole / / / 9 9 Depends on process skimmed / 9 Depends on cow's diet Nut margarine (vegetable fat) . 0 0 0 Oats / 9 9 0 Oleomargarine (animal fat) . . / 0 0 Olive oil 0 0 0 Onions ? 9 9 9 9 9 Oranges / 9 9 9 9 9 Pancreas 0 9 9 9 ? Parsnips 0 9 9 ? Peaches, fresh ? ? 9 Peanuts / 9 9 ? Pears 0 9 ? Peas, dry 9 9 9 0 fresh 9 9 9 9 9 9 Pecans ? 9 ? Pineapple, fresh 9 9 9 9 9 9 canned 9 9 9 9 9 Pine nuts 0 9 0 Potatoes, sweet 9 9 9 ? white, raw 9 9 9 9 9 9 white, boiled 15 minutes . . 9 9 9 9 9 Prunes ? 9 0 Raspberries, fresh ? ? 9 9 canned ? ? 9 9 APPENDIX 471 Source A B c Rhubarb, fresh ? ? / Rice, polished o o o whole grain / / / o Roe, fish / / / ? Rutabaga o / / Ill Rye, whole grain / / / ? Spinach / / / fit Ill Squash, yellow / / ? ? Sweetbreads (thymus gland) o o o Tomatoes / / III III Turnips, swede o ! ! III Walnuts o / / ? Wheat, kernel ! ! ! o bran o Ill o Whey ? / / ? Yeast o III o INDEX Active man, dietary for, 64. energy requirement of, 60. food plan for, 62. vitamin requirement, 80. Active persons, type of luncheons for, 222. Active women, dietary for, 87. energy requirement of, 84. food plan for, 85. vitamin requirement, 95. Activity, influence on energy require- ment of men, 61. of women, 84. Acute indigestion, diet for, 330. Adolescence, energy requirement dur- ing, 192. food during, 185. protein requirement during, 192. Aged, the, 207. dietary for, 216. energy requirement of, 210. food plan for, 215. number of meals for, 213. protein requirement of, 212. warm food for, 212. weight of, 210. Albuminized beverages, food value of, 323. Almonds, 374. chopped, 381. shelled, 381. Amino acids, 19. Angel cake, 364, 398. Anti-constipation menus, 51. Apple, baked, 369, 420. fresh, 369. Pie, 374, 430- sauce, 369, 420. sauce cake, 364, 398. snow, 367, 408. tapioca, 367, 408. Apples, dried, 381. Apricots, canned, 370. dried, 370, 381. dried, stewed, 370, 381. Art of food combination, 229. Artificial feeding of infants, 121. Ash constituents, amount in body, 17. calcium, 23. cost of, 253. iron, 23. phosphorus, 22. function of, 27. in restricted diets, 78. Ash requirement, baby's, 124. man's, 77. woman's, 95. Asparagus, fresh, 376. on toast, 377, 448. soup, cream of, 376, 443. Baby, artificial feeding of, 121. ash requirement, 124. breast feeding of, in. care of food for, 117. energy requirement of, 122. foods, proprietary, 129. protein requirement of, 123. schedule for breast feeding, 113, 119. for artificial feeding, 127. vitamin requirement, 124. Bacon, 373 fat, 368. Baked apple, 369, 420. Baking powder biscuit, 363, 391. Banana, 293, 370. salad, 375, 434. Barley, flour, 381. pearl, 381. Bean soup, cream of, 376, 443. stew, kidney, 377, 450. Beans, baked, canned, 377. 473 474 INDEX Beans - Cont. Lima, buttered, 377, 461. Lima, dried, 377, 381. Lima, fresh, 377. navy, dried, 381. string, 377. Beef, corned, 371. dried, 371. dried, creamed, 371, 423, 424. drippings, 368. flank, stewed, 371. Hamburg steak, 371. heart, stuffed, 371, 417. juice, 321. lean, compared with milk, 251, 255. roast, rib, 372. round, boiled, 372. round, pot roast, 372. sirloin, 372. steak, Hamburg, 371. steak, sirloin, 372. steak, stuffed round, 428. stew with vegetables, 372, 422. Beets, 377. Beverages, 363, 388. albuminized, 323. Biscuit, baking powder, 363, 391. muffins, and bread, 363, 391. Blackberries, 370. Blanc mange, chocolate, 367, 409. cornstarch, 367, 409. Bluefish, 372. Body, building material for, 18, 69. composition of, 17. fuel, sources of, 6. processes, regulation of, 26. Boiled custard, 367, 408. salad dressing, 375, 434. Bomb calorimeter, 8. Boston brown bread, 363, 391. Bouillon, 376. Box lunch for school, 176. Boy 16 years old, dietary for, 195. Boys, normal growth of, 167, 168. height and weight of, 462, 466. Bran, 381. Brazil nuts, 374. Bread, biscuit, and muffins, 363, 392. Boston brown, 363, 391. crumbs, 381. for adolescents, 188. for child 3 to 4 years old, 146. for child 5 to 7 years old, 158. graham, 363. white, 363. whole wheat, 363. Breakfast, different types of, 221. for family group, 274. Breast feeding, schedule for, 113, 119, value of, 109. Broths, 321. Brown Betty, 367, 409. sauce, 376, 439. sugar, 366, 384. sugar sauce, 376, 439. Buckwheat flour, 383. Building material, for body, 18. for a man, 69. for a woman, 95. Butter, 368, 381. peanut, 374. substitutes, 292. Buttermilk, 368, 381. Butternuts, 374. Cabbage, 377. Cake, angel, 364, 398. apple sauce, 364, 398. chocolate, 364, 398. com, 363, 392. one egg, 365, 403. sponge, 365, 405. sponge, hot water, 365, 405. Cakes and cookies, 364, 398. griddle, 364, 395. Calcium, cost of, 258. in food, 25. in restricted diets, 78. Calculation of family dietary, 276. Calorie, definition of, 9. portions, table of one hundred, 362 Candied cherries, 365. Candies, 365, 406. Candy for children, 173. Canning, effect on cost of food, 246. effect on vitamins, 265. Cantaloupe, 370. Capon, 373. INDEX 475 Caramels, chocolate nut, 365, 406. coconut, 366, 407 n Carbohydrates, fermentation of, 43. foods rich in, n. sources of, 6. Care of baby's food, 117. Carrots, 377. Cauliflower, 377. Celery, 377, 381. soup, cream of, 376, 443. Cellulose, foods rich in, 12. Cereal gruels, 321. Cereals, 366. for adolescents, 186. for child 1 to 2 years old, 136. for child 3 to 4 years old, 145. for child 5 to 7 years old, 157. for child 8 to 12 years old, 171. in packages, food value and cost, 250. Charlotte russe filling, 376, 439. Charts of normal growth of boys, 167, 168. of girls, 169, 170. Cheap family dietaries, 297. foods, 251, 456. menus for family dietaries, 311. sources of vitamins, 264. Cheese, American, 368. American, grated, 381. and nut roast, 374, 418. and pineapple salad, 375, 435. cottage, 368. cream, 368. dishes, 369, 416. Neufchatel, 368. souffle, 369, 417. straws, 369, 417. Swiss, 368. uses of, 297. Cherries, candied, 365. fresh, stoned, 370. Chestnuts, Italian, 374. Chewing, importance of, 39. Chicken, broiled, 373. canned, 373. creamed, 373, 423. salad, 375, 435. Children, energy requirement of, 122, 142, 149, 161, 181, 192. hours for meals, 113, ng, 127, 136, 151, 161, 174. lunch boxes for, 176. protein requirement of, 123, 142, 149, 161, 181, 192. vitamins for, 115, 124, 135, 147, 158. weight of, 462-467. Child's diet, 1st year, 119, 127. 2d year, 136. 3d and 4th year, 144. 5th to 7th year, 153. 8th to 12th year, 171. Child's dietary, age 11 years, 143. age 3 to 4 years, 152. age 5 to 6 years, 165. age 8 years, 183. age 10 years, 184. Child's food plan, age i| to 2 years, 141. age 3 to 4 years, 150. age 5 to 7 years, 163. age 8 to 10 years, 182. age 14 to 16 years, 193. Chocolate, 363, 388. blanc mange, 367, 409. cake, 364, 398. cookies, 364, 399. fudge, 365, 406. grated, 381. milk, 366. nut caramels, 365, 406. Chowder, corn, 376, 442. Citron, 381. Clams, 373. Club sandwich, 364, 392. Cocoa (beverage), 363, 388, 389. dry, 381. Coconut, caramels, 366, 407. prepared, 374, 382. Codfish, balls, 372, 422. creamed, 372, 423. Coffee jelly, 367. Cold slaw, 375, 435. Cold storage, effect on cost of food, 246. Cold weather diet, 240. menus, 242. Colds, diet for, 329. I College youth, food for, 202. 476 INDEX Combinations of food, artistic, 229. effect on digestion, 222, 225. scientific, 224. Concentration, effect on digestion, 42. Condensed milk, sweetened, 368, 382. unsweetened, 369, 382. Constipation, diet for, 48. Construction of menu, 220. Convalescent diet, 327. menus for, 328, 339. Cookies and cakes, 364, 398. chocolate drop, 364, 399. molasses, 365, 401, 402. oatmeal, 365, 402. peanut, 365, 404. plain, 365, 404. Com, a la Southern, 377, 448. bread, Old New England, 363, 396. cake, 363, 392. canned, 377, 382. chowder, 376, 442. fresh, 377, 382. on cob, 377. puffed, 366. soup, cream of, 376, 444. syrup, 366. Corned beef, 371. Cornflakes, 366. Cornmeal, 366, 382. and tapioca pudding, 368, 414. muffins, 364, 393. Cornstarch, 382. blanc mange, 367, 409. chocolate blanc mange, 367, 409. Cost of calcium in food, 258. of cereals in packages, 250. of eggs, 262. of family dietary, 283. of food, 244. of food, effect of market factors on, 249. of iron in food, 261. of phosphorus in food, 260. of protein in food, 256. of vitamins, 262. per 100 calories of common foods, 456. reduction in family dietary, 284, 291, 297. relation to fuel value, 245, 456. Cottage cheese, 368. pudding, 367, 41g. Cottolene, 382. Courses in meals, value of, 233. Cracker crumbs, 382. Crackers, graham, 364. oyster, 364. saltine, 364. soda, 364. Cranberries, 370, 382. Cranberry and raisin pie, 375, 432. jelly, 370, 420. pie, 374, 430. sauce, 370, 421. Cream cheese, 368. cheese and date sandwiches, 364, 394. filling, 376, 440. of asparagus soup, 376, 443. of baked bean soup, 376, 443. of celery soup, 376, 443. of com soup, 376, 444. of green pea soup, 376, 444. of peanut butter soup, 376, 445. of spinach soup, 376, 445. of tomato soup, 376, 445. pie, 374> 430. puS shells, 365, 399. sauce, 376, 440. Spanish, 368, 414. tapioca, 368, 414. thick, 368, 382. thin, 368, 382. toast, 364, 393. whipped, 368. Creamed chicken, 373, 423. dried beef, 371, 423, 424. peas, 378, 449. potatoes, 378, 449. salmon on toast, 372, 424. salt cod, 372, 423. turnips, 378, 449. Creamy rice pudding, 368, 413. Crisco, 382. Croquettes, macaroni, 366, 451. Croutons, fried, 364, 393. toasted, 363, 394. Crumbs, bread, 381. cracker, 382. Crystallized ginger, 366. INDEX 477 Cucumber and tomato salad, 375, 438. Cucumbers, 377. Cup custard, 367, 410. Currants, dried, 382. fresh, 370. Custard, boiled, 367, 408. cup, 367, 410. Custards, puddings, and ices, 367, 408. Cutlets, veal, 373, 429. Date and cream cheese sandwiches, 364, 394- pudding, 367, 410, 411. sandwiches, 364, 392. Dates, stoned, 382. unstoned, 360, 382. Desserts, for adolescents, 188. for children, 156. Diabetes, diet in, 348. Diet, fluid, 320, 337, 338. for acute indigestion, 330. for cold weather, 240. for colds, 329. for constipation, 48. for convalescence, 327. for diabetes, 348. for fat men, 65. for fat women, 91. for fever, 333. for gout, 356. for hot weather, 235. for minor illness, 329. for thin men, 63. for thin women, 93. for tuberculosis, 341. for typhoid fever, 335. light, 327. semi-solid, 326. soft, 326. Dietary, for active woman, 87. for aged person, 216. for boy 16 years old, 195. for child 11 years old, 143. for child 3 to 4 years old, 152. for child 5 to 6 years old, 165. for child 8 years old, 183. for child 10 years old, 184. for family, cost of, 283. for family, menu for, 273, 286, 299. for family, No. i, 278. for family, No. 2, 287. for family, No. 3, 300. for family, No. 4, 306. for family, reducing the cost of, 284, 291, 297. for fat man, 68. for fat woman, 92. for fattening, 66. for girl 16 years old, 196. for nursing mother, 107. for sedentary man, 58, 59. for sedentary woman, 89, 90. for thin man, 66. for thin woman, 96. for tuberculosis, 345, 346. for working man, 64. for working man, tuberculous, 346. recipes, 388. Digestion, effect of concentration on, 42. eSect of food combinations on, 227. eSect of food mixtures on, 42. eSect of mastication on, 39. eSect of regularity on, 40. in large intestine, 46. in mouth, 37. in small intestine, 44. in stomach, 40. Dinner, family, 273. types of, 223. Doughnuts, 365. Dressing, boiled salad, 375, 434. French, 375, 436. mayonnaise, 375, 437. Dried beef, 371. beef, creamed, 371, 423, 424. fruits, as sources of vitamins, 266. uses of, 293. Drippings, beef, 368. Egg lemonade, 363, 389. salad, 375, 436. timbale, 369, 416. Eggnog, 363, 389. Eggs, 369, 382. a la goldenrod, 369, 416. cheese dishes, 369, 416. relative cost of, 262. scrambled, 369, 416. 478 INDEX Eight year old child, dietary for, 183. energy requirement of, 181. food for, 171. food plan for, 182. protein requirement of, 181. Elderly person, food plan for, 214. Energy, measurement in food, 8. requirement, adolescents, 192. requirement, aged persons, 210. requirement, baby, 122. requirement, child 1J to 2 years old, 142. requirement, child 3 to 4 years old, 149. requirement, child 5 to 7 years old, 161. requirement, child 8 to 12 years old, 181. requirement, child 12 to 13 years old, 192. requirement, family, 270. requirement, farmers, 16. requirement, in sickness, 319. requirement, in tuberculosis, 342. requirement, man, 53. requirement, man, active, 57. requirement, man, sedentary, 53. requirement, measurement of, 14. requirement, woman, 82. requirement, youth 14 to 17 years old, 192. sources of, 6. value of food, 8, 363, 381. value of luncheons, 180, 200. value, relation to market cost, 249, 456. English walnuts, 374, 384. Enzymes, description of, 38. Factors in market cost of food, 245. Family, breakfast menu, 274. breakfast plan, 221. dietary, calculation of, 276. dietary, cost of, 283. dietary, essentials of, 271. dietary, iron in, 282. dietary, menus for, 273, 286, 299, 305, 311. dietary No. 1, 278. dietary No. 2, 287. dietary No. 3, 300. dietary No. 4, 306. dietary, reducing cost of, 284, 291, 297. dietary, vitamins in, 281. dinner, plan, 223. energy requirement of, 270. luncheon, plan, 273. Farina, cooked, 366. uncooked, 382. Farmers, energy requirement of, 16. Fat, foods rich in, 11. man, diet for, 65. man, dietary for, 68. sources of, 6. woman, diet for, 91. woman, dietary for, 92. Fattening dietary for a sedentary man, 66. for a woman, 96. Fermentation, influence of carbohy- drates on, 43. Fever, diet in, 333. energy requirement in, 334. typhoid, diet in, 335. typhoid, mixed fluid diet for, 338. typhoid, modified milk diets for, 337. typhoid, soft diet for, 339. Figs, chopped, 382. whole, 370. Filberts, 374. Filling, cream, 376, 440. for charlotte russe, 376, 439. Fillings and sauces, 376, 439. Fish, bluefish, 372. codfish, 372, 422. halibut steak, 372. mackerel, Spanish, 372. meats, and poultry, 371, 422. salmon, 372, 424, 427. sardines, 373, 375, 437. tunny, 373, 428. Five year old child, dietary for, 165. energy requirement of, 161. food for, 153. food plan for, 163. protein requirement of, 161. vitamins for, 158. INDEX 479 Flaked wheat, cooked, 367. uncooked, 384. Flank, beef, stewed, 371. Flavor, value of, 296. Flour, barley, 381. buckwheat, 383. graham, 383. rice, 383. rye, 383. wheat, 383. Fluid diet, 320. menus for, 325, 326, 337, 338. Fondue, rice, 369, 418. Food after fifty, 207. amounts to yield 100 calories, 13, 362. calcium in, 25. classified according to cost, 456. classified according to foodstuff, 10. energy value of, in common meas- ures, 381. energy value of recipes, 388. for adolescents, 185. for baby, 109. for child 1 to 2 years old, 133. for child 3 to 4 years old, 144. for child 5 to 7 years old, 153. for child 8 to 12 years old, 166. for college youth, 202. for the aged, 207. for the family group, menus, 218. for the nursing mother, 103. for the prospective mother, 97. for the school lunch box, 176. for the sick and convalescent, 317. for typhoid fever, 335. from 17th to 25th year, 197. in pregnancy, 97. iron in, 24. one hundred calorie portions of, 362. order in meals, 228. phosphorus in, 22. plan, aged person, 215. plan, child to 2 years old, 141. plan, child 3 to 4 years old, 150. plan, child 5 to 7 years old, 163. plan, child 8 to 10 years old, 182. plan, elderly person, 214. plan, man, active, 62. plan, man, sedentary, 56. plan, man, working, 62. plan, woman, active, 85. plan, woman, sedentary, 88. plan, youth 14 to 16 years old, 193. protein in (see also table of 100- calorie portions), 21. value and cost of cereals in packages, 250. value of common measures, 381. value of recipes, 388. value of 100-calorie portions, 36'2. vitamins in, 468. warm, in old age, 212. Four year old child, dietary for, 152. energy requirement of, 149. food for, 144. food plan for, 150. protein requirement of, 149. vitamins for, 147. Fourteenth to sixteenth year, dietary for boy, 195. dietary for girl, 196. energy requirement of, 192. food plan for, 193. protein requirement of, 192. Frankforters, 373. French dressing, 375, 436. rolls, 364. toast, 364, 394. Fried croutons, 364, 393. Fruit cake, 365. Fruit, for adolescents and youths, 186. for children, 138, 146, 157, 171. for college youth, 205. punch, 363, 389. salad, 375, 336. vitamin value, 266, 468. Fruits, 339, 420. Fudge, chocolate, 365, 406. Fuel requirement - see Energy Re- quirement. Fuel value - see Food values or Energy values. Gelatin, 383. Ginger, crystallized, 366. Gingerbread, 365, 400. Girl 16 years old, dietary for, 196. 480 INDEX Girls, normal growth of, 169. height and weight of, 464, 467. Glazed sweet potatoes, 378, 449. Gout, diet in, 356. Graham, bread, 363. crackers, 364. flour, 383. muffins, 364, 395. Granulated sugar, 366, 384. Grape juice, 370. Grapenuts, 366. Grapes, Concord, 370. Malaga, 370. Green vegetables for children, 138, 147, 158, 172. Griddle cakes, 364, 395. Growth, charts of normal, 167-170. Gruels, food value of, 321. Halibut steak, 372. Ham, boiled, 373. Hamburg steak, 371. Hard sauce, 376, 441. Heart, beef, stuffed, 371, 427. Height and weight, boys, 167, 168, 462, 466. girls, 169, 170, 464, 467. men, 460. women, 461. Hermits, 365, 401. Hickory nuts, 374. chopped, 383. High school luncheons, 189. Hominy grits, cooked, 366. uncooked, 383. Honey, 366. Hot food, value of, 222. water sponge cake, 335, 405. weather diet, 235. Hours for babies' meals, 113, 119, 127. for children's meals, 136, 150, 161. Huckleberries, 370. Ice cream, for children, 156. peach, 367, 412. vanilla, 368, 415. Ice, lemon, 367, 411. Ices, custards, and puddings, 367, 408. Icing, White Mountain, 365, 405. Indigestion, acute, diet after, 331. Infant - see Baby. Intestinal putrefaction, diet for, 331 Intestine, large, digestion in, 46. small, digestion in, 44. Irish stew, 425. Iron, in children's diet, 124, 137. in family diet, 282. in food materials, 24. in restricted diets, 78. relative cost of, 261. Jelly, coffee, 367. cranberry, 370, 420. lemon, 367, 411. Kidney bean stew, 377, 450. Kidney, veal, 374. Lactose lemonade, 363, 390. Lady fingers, 365. Lamb, chops, 373. roast leg, 373. Lard, 383. Large intestine, digestion in, 46. Leftovers, use of, 234. Lemon ice, 367, 411. jelly, 367, 411. juice, 383. milk sherbet, 367, 411. Pie, 374, 431. sauce, 376, 441. Lemonade, 363, 390. egg, 363, 389. lactose, 363, 390. Lemons, 370. Lentil and tomato soup, 376, 446. meat loaf, 377, 450. soup, 376, 446. Lentils, baked, 377, 448. dried, 377. Lettuce, 377. and tomato salad, 375, 438. salad, 375, 437. Light diet, 327. Lima beans, buttered, 377, 451. dried, 377, 381. fresh, 377. Liver, veal, 374. INDEX 481 Loaf, lentil meat, 377, 450. nut, 377, 452. salmon, 372, 427. sugar, 366. Lobster, 373. Lunch box, plan for, 176. Luncheon, family, menu for, 275. high school, 190. menus, with fuel values, 190, 200. school, menus for, 180. school, value of, 162, 176. types of, 222. Macaroni and cheese, 369, 417. cooked, 366. croquettes, 366, 451. uncooked, 383. with tomato sauce, 366, 451. Macaroons, 365. Mackerel, Spanish, 372. Man, active, dietary for, 64. active, energy requirement of, 60. active, food plan for, 62. ash requirement of, 77. building material for, 69. energy requirement of, 53. fat, 65. fat, dietary for, 68. fattening dietary for, 66. protein requirement of, 70. sedentary, dietaries for, 58, 59. sedentary, energy requirement of, 53. sedentary, fattening dietary for, 66. sedentary, food plan for, 56. thin, 63. thin, dietary for, 66. vitamin requirement of, 80. Maple sugar, 376. syrup, 376. Marguerites, 375, 401. Market cost of food, factors influencing, 249. relation to fuel value, 245, 456. Mashed potatoes, 348, 452. Mastication, importance of, 39. Mayonnaise dressing, 375, 437. Meal hours for children, 113, 119, 127, 136, 150, 161, 174. plans, types of, 221. Meals - see also Menus. balanced, 224. in courses, value of, 233. number in old age, 213. sequence of foods in, 228. value of variety in, 229. Meat, compared with milk and eggs, 76. loaf, lentil, 377, 450. pie, 371, 426. place in diet, of adults, 76. place in diet, of adolescents, 187. place in diet, of children, 159, 173. Meats, fish, and poultry, 371, 422. Men, aged, weight of, 210. height and weight of, 460. Menu, construction of, 220. for convalescents, 328, 339. for diet after acute indigestion, 331- for family dietary, 273, 286, 299, 305, 3n. for fluid diet, 320, 337, 338. for intestinal putrefaction, 331. for soft or semi-solid diet, 326. value of contrast in, 229. value of variety in, 225. Menus, anti-constipation, 51. for cold days, 242. for convalescence, 328, 339. for family dietaries, 273, 286, 299, 305, 3U- for hot days, 239. for prospective mother, 102. for school luncheons, 180, 190, 200. for summer, 235. for winter, 242. types of, 221. Milk, as food in fever, 335. as source of calcium, 78, 135. as source of vitamins, 135. care of, 117. chocolate, 366. compared with lean beef, 251, 255. compared with other high protein foods, 251. condensed, sweetened, 368, 382. condensed, unsweetened, 369, 382. 482 INDEX Milk - Cont. for adolescents, 186. for children, 121, 133, 144, 156, 171, 186. for college youth, 294. for the sick, 322. relative cost of, 251. sherbet, 367, 411. skim, 369, 383. top, 369. whole, 369, 383. why cheap food, 259. Mince pie, 375. Minor illness, diet in, 329. Mixed fluid diet for typhoid, 339. Mixtures of food, influence on digestion, 42. Modified milk diets for typhoid, 337. Molasses, 366, 383. cookies, 365, 400, 402. Mother, nursing, dietary for, 107. nursing, food for, 103. nursing, vitamins for, 105. prospective, food for, 97. prospective, menus for, 102. prospective, vitamins for, 98. Muffins, biscuit, and bread, 363, 391. cornmeal, 364, 393. graham, 364, 395. one egg, 364, 396. twin mountain, 364, 397. Mushrooms, fresh, 377. stewed, 377, 453. Mutton, roast leg, 373. Navy beans, dried, 381. Neufchatel cheese, 368. Nitrogen, importance of, 18. occurrence in food (see also Protein), 21. requirement - see Protein require- ment. Normal growth, charts of, 167-170. Nursing mother, dietary for, 107. food for, 103. Nut and cheese roast, 374, 418. loaf, 374, 452. Nuts, almonds, 374, 381. Brazil, 374. coconut, 374, 382. filberts, 374. for children, 174. hickory, 374, 383. peanuts, 374, 384. pecans, 374, 384. pine, 384. walnuts, English, 374, 384. Oatmeal, cooked, 366. cookies, 365, 402. uncooked, 383. wafers, 365, 403. Oats, rolled, 383. Occupation, influence on energy re- quirement, of men, 61. of women, 83. Oil, olive, 369, 383. Old age - see the Aged. Old New England com bread, 363, 396. Oleomargarine, 369, 383. compared with butter, 292. Olive oil, 369, 383. Olives, 370. One egg cake, 365, 403. muffins, 364, 396. One hundred calorie portions, 13. table of, 363. Onions, 377. scalloped, 377, 452. Orange juice, 370, 383. preventive of scurvy, 115. Oranges, 370. Oyster crackers, 364. stew, 376, 447. Oysters, 373. compared with milk, 251. Package cereals, fuel value and cost, 250. Parsnips, stewed, 377. Pasteurized milk, how to supplement for babies, 118. Pastry, plain, 375, 431. Peach ice cream, 367, 412. Peaches, canned, 370. fresh, 370. stewed, 370, 421. INDEX 483 Peanut, butter, 374. butter soup, 376, 445. cookies, 365, 404. Peanuts, 374, 384. Peas, canned, 378, 384. creamed, 378, 449. dried, 384. green, 378. Pea soup, cream of green, 376, 444. split, 376, 447. Pecans, 374. shelled, 384. Penouche, 366, 407. Peppers, stuffed, 378, 454. Perishability, effect on cost of food, 246. Phosphorus, cost of, 260. in food, 22. in restricted diets, 78. Pie, apple, 374, 430. cranberry, 374, 430. cranberry and raisin, 375, 432. cream, 374, 430. lemon, 374, 431. meat, 371, 426. mince, 375. raisin and cranberry, 375, 432. rhubarb, 375, 432. squash, 375, 433. Pies, 374, 430. Pilaf, Turkish, 367, 455. Pineapple and cheese salad, 375, 435. canned, grated, 384. fresh, 370. Pine nuts, 374. Plain cookies, 365, 404. pastry, 375, 431. Plans for meals - see Meals, Menus, Food plans. Plums, 371. Popcorn, 366. Popovers, 364, 396. Pork, bacon, 373. ham, 373. sausage, 373. Portions, table of 100-calorie, 363. Potato chips, 378. salad, 375, 437. soup, 376, 447. Potatoes, creamed, 378, 449. mashed, 378, 452. scalloped, 378, 453. sweet, baked, 378. sweet, glazed, 378, 449. sweet, uncooked, 378. white, baked, 378. white, boiled, 378. white, mashed, 378, 452. white, uncooked, 378. Pot roast, 372. Poultry, meats, and fish, 371, 422. stuffing, 373, 427. Powdered sugar, 384. Pregnancy, food during, 97. Proprietary infant foods, 129. Prospective mother, food for, 97. Protein, cheap sources of, 296. cost of, 256. foods rich in, 10, 11, 12. in foods, amounts, 21, 363, 381. proportion in diet, 73. requirement, adolescence and youth, 192. requirement, aged persons, 212. requirement, child 1 to 2 years old, 123. requirement, child 3 to 4 years old, 142. requirement, child 5 to 7 years old, 149. requirement, child 8 to 12 years old, 161. requirement in tuberculosis, 342. requirement, man, 70. requirement, woman, 95. sources of, 7. use, in cold weather, 72. use, in hot weather, 72. value of different kinds, 19. Proteins, purin-free, 75, 357. Prune pulp, 371. souffle, 368, 412. Prunes, 371. choice and preparation of, 295. stewed, 371, 421. Pudding, cornmeal-tapioca, 368, 414. cottage, 367, 410. date, 367, 410, 411. rice, 368, 413. 484 INDEX Pudding - Cont. snow, 368, 413. tapioca-cornmeal, 368, 414. Puddings, custards, and ices, 368, 408. use in adolescence and youth, 188. Puffed corn, 366. rice, 367. wheat, 367. Pumpkins, cooked, 384. Punch, fruit, 363, 389. Purins, foods containing, 75, 357. Putrefaction, intestinal, diet for, 331. Radishes, 378. Raisin and cranberry pie, 375, 432. Raisins, 371, 384. uses of, 295. Rarebit, Welsh, 369, 419. Raspberries, 371. Raspberry sherbet, 368, 412. Recipes, dietary, 388. Reducing cost of family dietary, 284, 291, 297. Reducing dietary, for fat man, 68. for fat woman, 92. Requirement, for ash - see Ash con- stituents. for energy - see Energy. for fuel - see Energy. for protein - see Protein. Rhubarb, fresh, 371, 384. Pie, 375. 432. stewed, 371, 421. Rice flour, 383. fondue, 369, 418. pudding, 368, 413. puffed, 367. steamed, 367, 384. uncooked, 384. with cheese and tomatoes, 369, 419. Roast, beef, rib, 372. lamb, leg, 383. mutton, leg, 373. pot, 372. turkey, 373. veal, 374. Rolls, French, 364. Round of beef compared with milk. 251, 255. steak - see Steak. Saccharine, 354. Salad, banana, 375, 434. cheese and pineapple, 375, 435. chicken, 375, 435. cucumber and tomato, 375, 438. egg, 375, 436. fruit, 375, 436. lettuce, 375, 437. lettuce and tomato, 375, 438. pineapple and cheese, 375, 435. Potato, 375, 437- sardine, 375, 437. tomato and cucumber, 375, 438. tomato and lettuce, 375, 438. Waldorf, 375, 438. Salads and dressings, 375, 434. Salmon, canned, 372. creamed on toast, 372, 424. loaf, 372, 427. Saltines, 364, 384. Samp with cheese, 369, 419. Sandwich, club, 364, 392. date, 364, 394. date and cream cheese, 364. Sardines, canned, 373. salad, 345, 437. Sauce, apple, 369, 420. brown, 376, 439. brown sugar, 376, 439. cranberry, 370, 421. cream, 376, 440. hard, 376, 441. lemon, 376, 441. tomato, 376, 441. white, 376, 441. Sauces and fillings, 376, 43g. Sausage, Frankfort, 373. pork, 373. Scalloped onions, 377, 452. potatoes, 378, 453. Scallops, 373. Schedule for children's meals, 113, 119, 127, 136, 150, 161. School lunch box, 176. luncheons, 162, 176, 189, 200. rice, 367. INDEX 485 Science of food combinations, 224. Scrambled eggs, 369, 416. Seasonal variation in menus, 235. Second year, food for (see also Two year old child), 136. Sedentary man, dietaries for, 58, 59, 63. energy requirement of, 55. fattening dietary for, 63. food plan for, 56. protein requirement of, 70. Sedentary persons, type of luncheon for, 200, 222. Sedentary woman, dietary for, 89, 90. energy requirement of, 83. food plan for, 88. protein requirement of, 95. Semi-solid or soft diet, 326. menu for, 327. Shellfish, 373. Sherbet, lemon milk, 367, 411. raspberry, 368, 412. Shredded wheat, 367. Shrimp, 373. Sick, energy requirement of, 319. food for, 317. Sirloin steak, 372. Sixteen year old, boy, dietary for, 195. girl, dietary for, 196. Skim milk, 369, 383. Slaw, cole, 375, 435. Small intestine, digestion in, 44. Snow, apple, 367, 408. pudding, 368, 413. Soda crackers, 364. Soft or semi-solid diet, 326. for typhoid fever, 335. Souffle, cheese, 369, 417. prune, 368, 412. Soup, clear tomato, 376, 442. cream of asparagus, 376, 443. cream of baked bean, 376, 443. cream of celery, 376, 443. cream of corn, 376, 444. cream of green pea, 376, 444. cream of peanut butter, 376, 445. cream of spinach, 376, 445. cream of tomato, 376, 445. lentil, 376, 446. lentil and tomato, 376, 446. pea, split, 376, 447. potato, 376, 447. Soups, 376, 442. Spanish cream, 368, 414. mackerel, 372. Special diabetic foods, use of, 354. Spinach, a la creme, 378, 453. cooked, 378, 384. soup, 376, 445- with egg, 378, 453. Sponge cake, 365, 405. hot water, 365, 405. Squash, cooked, 384. Pie, 375, 433- Steak, halibut, 372. Hamburg, 371. round, pot roast, 372. round, stuffed, 372, 428. sirloin, 372. stuffed, 372, 428. Swiss, 372, 428. Stew, beef with vegetables, 372, 422. Irish, 425. kidney bean, 377, 450. oyster, 376, 447. Stewed dried apricots, 370, 421. mushrooms, 377, 453. peaches, 370, 421. primes, 371, 421. rhubarb, 371, 421. Strawberries, 371. String beans, 377. Stuffed beef heart, 371, 427. peppers, 378, 454. steak, 372, 428. tomato, 378, 455. Stuffing, poultry, 373, 427. Successful infant feeding, criteria of, 114. Succotash, canned, 378. Suet, 384. Sugar, brown, 366, 384. for children, 173. granulated, 366, 384. loaf, 366. maple, 366. powdered, 366, 384. Sulphur in food, 21. 486 INDEX Summer and winter diet, 235. menus, 239. Swiss cheese, 368. steak, 372, 328. Syrup, com, 366. maple, 366. Table of calcium in food materials, 25. cost of cereals in packages, 250. cost of food to yield 0.67 gram cal- cium, 258. cost of food to yield 0.015 gram iron, 261. cost of food to yield 1.32 grams phosphorus, 260. cost of one hundred calorie portions of food, 456. cost of one hundred protein calories from different sources, 257. dietary recipes, 385. food value and cost of cereals in packages, 250. food value in relation to cost, 456. food value in terms of common measures, 381. foods rich in carbohydrates, n. foods rich in cellulose, 12. foods rich in fat, 11. foods rich in protein, 10. foods rich in protein and fat, n. foods rich in water, 12. height and weight of boys from birth to school age, 466. height and weight of school boys, 462. height and weight of girls from birth to school age, 467. height and weight of school girls, 464. height and weight of men, 460. height and weight of women, 461. iron in food, 24. nitrogen in food, 21. phosphorus in food, 22. protein in food - see table of 100 calorie portions. vitamins in food materials, 468. weight and height - see Height and weight. weight of old men and women, 210. Tapioca, 384. apple, 367, 408. cornmeal pudding, 368, 414. cream, 368, 414. Ten year old child, dietary for, 184. Thin men, 63. dietary for, 66. Thin women, 93. dietary for, 96. Three or four year old child, dietary for 152. energy requirement of, 149. food for, 144. food plan for, 150. protein requirement of, r42. vitamin requirement of, 147. Timbale, egg, 366, 4r6. Toast, cream, 369, 393. French, 364, 394. Toasted croutons, 364, 394. Tomato and cucumber salad, 375, 438 and lentil soup, 376, 446. and lettuce salad, 375, 438. sauce, 376, 441. soup, clear, 376, 442. soup, cream of, 376, 445. stuffed, 378, 455. Tomatoes, canned, 378, 384. fresh, 378. Tuberculosis, diet in, 34r. dietaries for, 345, 346. energy requirement in, 34r. food plans for, 343, 347. protein requirement in, 342. Tunny fish a la Newburg, 373, 428. canned, 373. Turkey, roast, 373. roast with stuffing, 373. Turkish pilaf, 367, 455. Turnips, 378, 384. creamed, 378, 449. Twin mountain muffins, 364, 397. Two year old child, food for, 133. food plan for, 141. protein requirement of, 142. vitamin requirement of, 135. Types of meal plans, 221. Typhoid fever, diet in, 335. mixed fluid diet for, 338. INDEX 487 Typhoid fever - Cont. modified milk diets for, 337. soft diet for, 339. Vanilla ice cream, 368, 425. Variety in meals, value of, 229. Veal cutlets, 373, 429. kidney, 374. leg, roast, 374. liver, 374. Vegetables, 376, 448. for adolescents, 186. for children, 128, 147, 158, 172. for college youth, 205. for nursing mothers, 135. for prospective mothers, 101. vitamins in, 264. Vitamins, 29, 468. A, 29. B, 31. C, 32. cheap sources of, 264. cost of, 262. family dietary, sources in, 281. for baby, 115, 124. for child 2 years old, 135. for child 3 to 4 years old, 147. for child 5 to 7 years old, 158. for man, 80. for nursing mother, 105. for prospective mother, 98. in food materials, table, 468. Wafers, oatmeal, 365, 403. Waffles, 364, 397. Waldorf salad, 365, 438. Walnuts, English, 374. chopped, 384. Warm food in old age, 212. Water, foods rich in, 12. Water melon, 371. Weaning, preparation for, 114. Weight - see also Height and weight, aged, 210. Wheat bread, 363. flaked, 367, 384. flour, 383. White Mountain icing, 365, 405. sauce, 376, 441. Whole milk, 369, 383. Winter and summer menus, 235. Woman, active, dietary for, 87. active, energy requirement of, 84. active, food plan for, 85. ash requirement of, 95. fat, diet for, 91. fat, dietary for, 92. fattening dietary for thin, 96. nursing, dietary for, 107. nursing, food for, 103. pregnant, food for, 197. protein requirement of, 97. sedentary, dietary for, 89, 90. sedentary, food plan for, 88. thin, diet for, 93. thin, dietary for, 96. vitamin requirement of, 95. Women, aged, weight of, 210. height and weight of, 461. Youth, energy requirement of, 192. food for, 185. protein requirement in, 192. Zwieback, 364. kidney, 374.