ILLINOIS. DEPT. OF PUBLIC HEALTH DENTAL CARIES CONTROL BY DIET DENTAL CARIES CONTROL BY DIET It has been demonstrated that a close correlation exists between the number of Lactobacilli in the saliva and the degree of dental caries activity. It has also been found that the number of these oral organisms can be reduced and dental caries arrested by the restriction of carbohydrate in the diet. In the dietary treatment of caries it is first necessary to determine the patient's lactobacillus count by culturing a specimen of saliva. The specimen is obtained by chewing a pellet of paraffin and expectorating the stimulated saliva into a sterile bottle. The bottle and information card may be obtained . by writing to one of the laboratories of the]Illinois Department of Public Health. \ The specimens are cultured and the count is reported”tlTThe*'Heritlit as the number of lactobacilli per c.c* of saliva. If the count is 10,000 or higher Diet (I) is prescribed for a two week period. At the end of that time another saliva specimen is sent to the laboratory and the patient immediately changes to Diet (II) without waiting for a report of his count. After two weeks on Diet (II) another saliva specimen is sent to the laboratory. Ordinarily the count taken after the first dietary period is low. If the count taken after the second dietary period has not increased over the previous test, the patient may proceed with Diet III, On the other hand, if the count has gone up following Diet II the patient remains on this diet for a longer period and does not change to Diet III. After two weeks on Diet III another culture is taken, and if the count is still low the restriction of sugar is no longer necessary. Periodic checks may be made thereafter in order to determine the need for future dietary direction. PLAN I Preliminary dietary period (two weeks). This diet contains approximately 100 grams of carbohydrate with protein and calories adequate for the age and activity of the patient. PLAN II Select any of the foods from diet Plan I and include whole wheat bread not to exceed 6 slices. Also increase fruits and vegetables (including potato) to desirable.amounts, being certain that none have been prepared with sugar. That is, all fruits and vegetables eaten must be fresh or canned without sugar. Commercially canned vegetables (except peas and corn) may be used. PLAN III Continue diet Plan II, adding as much sugar as is desirable at one meal during the day. This sugar is to be taken with the meal—not between meals. If the lactobacillus count has not increased during a two-week period on Plan III, the diet is then unrestricted. These diets were planned in accordance with the nutritional requirements set up by National Research Council. i/OW CARBOHYDRATE DIET—PLAN I For 1-3 year old child 2 This diet contains approximately 53 grams protein, 72 grams fat and 98 grams carbohydrate. It yields approximately 1200 calories. TOTAL DAILY FOOD INTAKE ij pints whole milk *2 eggs #1 3A ounces meat, fish or poultry l/k cup puffed rice or puffed wheat 6 servings of fruit and vegetables. Your choice of fruits and vegetables should not include more than 1 serving of 12$ and 1 serving of 15$ carbohydrates in one day. During the first two-week period none of the foods classified in the 18 and 21$ carbohydrate group should be included in diet. See list of fruits and vegetables classified according to their carbohydrate content, A serving* of fruits and vegetables consists of one half cup cooked or three fourtnc cup raw, *2 tablespoons butter or fortified margarine -K-More than the indicated amounts of these foods may be used providing all of the food recommended is eaten during the day. GENERAL DIETARY SUGGESTIONS 1. ' Plain unflavored gelatin (not jcllo), salt, flavoring extracts and vegetable colorings may be used as desired. 2. Saccharin may be used as a substitute for sugar. One-fourth grain has the sweetening value of one teaspoon of sugar, (Saccharin may be obtained in 1/k, 3/8, y>2 > and 1 grain tablets.) 3. Clear broth or bouillon may be used as desired. Soup may be made with cream, milk and vegetables as the dietary plan follows, i*. No foods prepared with sugar are allox\'ed. Canned or frozen fruits must be prepared without sugar, 5, Salad dressings should be home prepared for commerical preparations Usually contain some form of carbohydrate. 6. Do not use: Confections of any kind. Chewing gum. Beverages prepared with sugar similar to those served at fountains, and other soft drinks sold in bottles, (The use of sugar-coated pills and cough mixtures should be restricted where possible.) Catsup and chili sauce. LOW CARBOHYDRATE DIET—PLAN I For U-6 year old child This diet contains approximately 75 grams protein, 90 grams fat and 119 grams carbohydrate. It yields approximately 1600 calories. TOTAL DAILY FOOD INTAKE 1 quart whole milk *2 eggs ounces meat, fish or poultry l/2 cup puffed rice or puffed wheat 7 servings of fruit or vegetables. Your choice of fruits and vegetables should not include more than 1 serving of 12$ and 1 serving of 1$% carbohydrates in one day. During the first two-week period none of the foods classified in the 18 or 21$ carbohydrate group should be included in the diet. See list of fruits and vegetables classified according to their carbohydrate content. A serving of fruits and vegetables consists of one half cup cooked or three fourths cup raw* *-2 tablespoons butter or fortified margarine. •frMore than the indicated amounts of these foods may be used providing all of the food recommended is eaten during the day. GENERAL DIETARY SUGGESTIONS 1. Plain unflavored gelatin (not jello) salt, flavoring extracts and vegetable colorings may be used as desired. 2. Saccharin may be used as a substitute for sugar. One-fourth grain has the sweetening value of one teaspoon of sugar. 3# Clear broth or bouillon may bo used as desired. Soup may be made with cream, milk and vegetables as the dietary plan allows. k» No foods prepared with sugar are allowed. Canned or frozen fruits must be prepared without sugar, 5>. Salad dressings should be home prepared for commercial preparations usually contain some form of carbohydrate. 6. Do not use: Confections of any kind. Chewing gum. Beverages prepared with sugar similar to those served at fountains, and other soft drinks sold in bottles. (The use of sugar-coated pills and cough mixtures should be restricted where possible.) 7. The following foods are low in carbohydrates and may be eaten in moderate amounts if desired: Fresh mushroom, olives, dill pickles. LOW CARBOHYDilATE DIET—PLAN I For 7-9 year old child This diet contains approximately 86 grams protein, 126 grams fat and 120 grams carbohydrate. It yields approximately 2000 calories. TOTAL DAILY FOOD INTAKE 1 quart whole milk *2 eggs •*Ij. ounces meat, fish, or poultry *1 oz, cheese and/or J cup cream (Approximately 20$ butterfat) J cup puffed rice or puffed wheat 7 servings fruit or vegetable. Your choice of fruits and vegetables should not include more than 1 serving of 12$ and 1 serving of 1$% carbohydrates in one day. During the first two-week period none of the foods classified in the 18 and 21$ carbohydrate group should be included in diet. See list of fruits and vegetables classified according to their carbohydrate content, A serving of fruits and vegetables consists of one half cup cooked or three fourths cup raw. *■1* tablespoons butter or fortified margarine. •K-Morc than the indicated amounts of these foods may be used providing all of the food recommended is eaten during the day. GENERAL DIETARY SUGGESTIONS 1, Coffee, tea, plain unflavored gelatin (not Jello), salt, pepper, spices, diy mustard, vinegar, flavoring extracts and vegetable colorings may be used as desired, (Suggestions will be altered in relation to the age of the child.) 2, Saccharin may be used as a substitute for sugar. One-fourth grain has the sweetening value of one teaspoon of sugar. 3, Clear broth or bouillon may be used as desired. Soup maybe made with cream, milk and vegetables as the dietary plan allows, U, No foods prepared with sugar are allowed. Canned or frozen fruits must be prepared without sugar, 5, Salad dressings should be home prepared for commercial preparations usually contain some form of carbohydrate, 6, Do not use: Confections of any kind. Chewing gum. Beverages prepared with sugar similar to those served at fountains, and other soft drinks sold in bottles, (The use of sugar-coated pills and cough mixtures should be restricted where possible.) 7, The following foods are low in carbohydrates and may be eaten in moderate amounts if desired; Fresh mushrooms, olives, and dill pickles. low carbohydrate diet—plan i For Sedentary man, moderately active woman, pregnancy (latter half), Child 10-12 and Girl 16-20 years old This diet contains approximately 97 grams protein, 166 grams fat and 129 grams carbohydrate. It yields approximately 2500 calories. TOTAL DAILY FOOD INTAKE 1 quart whole milk *2 eggs *2 strips bacon *5 ounces meat, fish or poultry *1 ounce cheese (if cheese is not eaten more cream must be added to diet) cup cream (approximately 20$ butterfat) J cup puffed rice or puffed wheat 7 servings of fruit and vegetables. Your choice of fruits and vegetables should not include more than 1 serving of 12$ and 1 serving l£$ carbohydrates in one day. During the first two-week period none of the foods classified in the 18 and 21$ carbohydrate group should be included in diet. See list of fruits and vegetables classified according to their carbohydrate content. A serving of fruits and vegetables consists of one half cup cooked or three fourths cup raw, tablespoons butter or fortified margarine. *-More than the indicated amounts of these foods may be used providing all of the food recommended is eaten during the day. GENERAL DIETARY SUGGESTIONS 1# Coffee, tea, plain unflavored gelatin (not jellc), salt, pepper, spices, dry mustard, vinegar, flavoring extracts and vegetables colorings may be used as desired, (Suggestions will be altered in relation to the age of the individual) 2, Saccharin may be used as a substitute for sugar. One-fourth grain has the sweetening value of one teaspoon of sugar, 3# Clear broth or bouillon may be used as desired. Soup may be made with cream, milk and vegetables as the dietary plan allows. It. No foods prepared with sugar are allowed. Canned or frozen fruits must be prepared without sugar, 5>, Salad dressings should be home prepared for commercial preparations usually contain some form of carbohydrate, 6, Do not use! Confections of any kind. Chewing gum. Beverages prepared with sugar similar to those served at fountains, and soft drinks sold in bottles. (The use of sugar-coated pills and cough mixtures should be restricted where possible.) 7. The following foods are low in carbohydrates and may be eaten in moderate amounts if desired; Fresh mushrooms, olives, and dill pickles* LOW CARBOHYDRATE DIET—PLAN I For 13-15 year old girl This diet contains approximately 132 grams protein, 198 grams fat and 12k grams carbohydrate. It yields approximately 2800 calories. TOTAL DAILY FOOD INTAKE 1 quart whole milk *2 eggs #2 strips bacon *9 ounces meat, fish or poultry -*1 ounce cheese (if cheese is not used more cream must be added to diet) c, cream (approximately 20$ butterfat) § c. puffed rice or puffed wheat 7 servings fruit or vegetables. Your choice of fruits and vegetables should not include more than 1 serving of 12$ and 1 serving of 13$ carbohydrates in one day. During the first two-week period none of the foods classified in the 18 and 21$ carbohydrate group should be included in diet. See list of fruits and vegetables classified according to their carbohydrate content, A serving of fruits and vegetables consists of one half cup cooked or three fourths cup raw, *5 tablespoons butter or fortified margarine. *More than the indicated amounts of these foods may be used providing all of the food recommended is eaten during the day. GENERAL DIETARY SUGGESTIONS 1. Coffee, tea, plain unflavored gelatin (no jello), salt, pepper, spices, dry mustard, vinegar, flavoring extracts and vegetable colorings may be used as desired. (Suggestions will be altered in relation to the age of the individu- al.) 2. Saccharin may be used as a substitute for sugar. One-fourth grain has the sweetening value of one teaspoon of sugar. 3. Clear broth or bouillon may be used as desired. Soup may be made with cream, milk, and vegetables as the dietary plan allows, ii. No foods prepared with sugar are allowed* Canned or frozen fruits must be prepared without sugar. 3. Salad dressings should be home prepared for commercial preparations usually contain some form of carbohydrate. 6, Do not use: Confections of any kind. Chewing gum. Beverages prepared with sugar similar to those served at fountains, and other soft drinks sold in bottles. (The use of sugar-coated pills and cough mixtures should be restricted where possible,) 7, The following foods are low in carbohydrates and may be eaten in moderate amounts if desired: Fresh mushrooms, olives, and dill pickles. LOW CARBOHIDRATE DIET—PLAN I For moderately active man, woman (lactation) This diet contains approximately 1U0 grams protein, 203 grams fat and 133 grams carbohydrate. It yields approximately 3000 calories. TOTAL DAILY FOOD INTAKE 1 quart whole milk *2 eggs *2 strips of bacon #10 ounces meat, fish or poultry *1 oz, cheese (if cheese is not used more cream must be added to diet) *2 cup coffee cream (approximately 20$ butterfat) 1 cup puffed rice or puffed wheat 7 servings fruit or vegetables. Your choice of fruits and vegetables should not include more than 1 serving of 12$ and 1 serving of l£$ carbohydrates in one day. During the first two-week period none of the foods classified in the 18 and 21$ carbohydrate group should be included in diet. See list of fruits -and vegetables classified according to their carbohydrate content. A serving of fruits and vegetables consists of one half cup cooked or three fourths cup raw. *5> tablespoons butter or fortified margarine. #More than the indicated amounts of these foods may be used providing all of the food recommended is eaten during the day. GENERAL DIETARY SUGGESTIONS 1. Coffee, tea, plain unflavored gelatin (not jello), salt, pepper, spices, dry mustard, vinegar, flavoring extracts and vegetable colorings may be used as desired. (Suggestions will be altered in relation to the age of the individu- al.) 2. Saccharin may be used as a substitute for sugar. One-fourth grain has the sweetening value of one teaspoon of sugar, 3. Clear broth or bouillon may be used as desired. Soup may be made with cream, milk, and vegetables as the dietary plan allows. No foods prepared with sugar are allowed. Canned or frozen fruits must be prepared without sugar. 5. Salad dressings should be home prepared for commercial preparations usually contain some form of carbohydrate. 6. Do not use; Confections of any kind. Chewing gum. Beverages prepared with sugar similar to those served at fountains, and other soft drinks sold in bottles, (The use of sugar-coated pills and cough mixtures should be restricted where possible.) 7. The following foods are low in carbohydrates and may be eaten in moderate amounts if desired; Fresh mushrooms, olives, and dill pickles. LOW CARBOHYDRATE DIET—PLAN I For 13-15 year old boy This diet contains approximately 162 grams protein, 233 grams fat and 13U grams carbohydrate. It yields approximately 3200 calories. TOTAL DAILY FOOD INTAKE 1 quart whole milk *2 eggs *2 strips bacon *12 ounces meat, fish or poultry *2 ounces cheese (if cheese is not eaten more cream must be added to diet) CUP coffee cream (approximately 20$ butterfat) 1 cup puffed rice or puffed wheat 7 servings fruit or vegetables. Your choice of fruits and vegetables should not include more than 1 serving of 12$ and 1 serving of 15$ carbohydrates in one day. During the first two-week period none of the foods classified in the 18 and 21$ carbohydrate group should be included in diet. See list of fruits and vegetables classified according to their carbohydrate content, A serving of fruits and vegetables consists of one half cup cooked or three fourths cup rrw, *5 tablespoons butter or fortified margarine. *More than the indicated amounts of these foods may be used providing all of the food recommended is eaten during the day. GENERAL DIETARY SUGGESTIONS 1, Coffee, tea, plain unflavored gelatin (not jello), salt, popper, spices, dry- mustard, vinegar, flavoring extracts and vegetable colorings may be used as desired. (Suggestions will be altered in relation to the age of the indi- vidual.) 2, Saccharin may be used as a substitute for sugar. One-fourth grain has the sweetening value of one teaspoon of sugar, 3, Clear broth or bouillon may be used as desired. Soup may be made with cream, milk and vegetables as the dietary plan allows. U. No foods prepared with sugar are allowed. Canned or frozen fruits must be prepared without sugar, 5, Salad dressings should be home prepared for commercial preparations usually contain some form of carbohydrate. 6, Do not usei Confections of ary kind. Chewing gum. Beverages prepared with sugar similar to those serve at fountains, and other soft drinks sold in bottles, (The use of sugar-coated pills and cough mixtures should be restricted where possible.) 7, The following foods are low in carbohydrates and may be eaten in moderate amounts if desiredt Fresh mushrooms, olives, and dill pickles. LOW CAifflOHYDRATE DIET—PLAN I For 16-20 year old boy This diet contains approximately 1?6 grams protein, 269 grams fat and lijl grams carbohydrate. It yields approximately 3800 calories. TOTAL DAILY FOOD INTAKE 1 quart whole milk *2 eggs *3 stips bacon *1k ounces meat, fish or poultry *1 oz, cheese (if cheese is not eaten more cream must be added to diet) *1 cup coffee cream (approximately 20$ buttorfat) 1 cup puffed rice or puffed wheat 9 servings fruit or vegetables, lour choice of fruits and vegetables should not include more than 1 serving of 12$ and 1 serving of 1% carbohydrates in one day. During the first two-week period none of the foods classified in the 18 and 21$ carbohydrate group should be included in the diet. See list of fruits and vegetables classified according to their carbohydrate content, A serving of fruits and vegetables consists of one half cup cooked or thyee fourths cup raw, *6 tablespoons butter or fortified margarine. •K-More than the indicated amounts of these foods may be used providing all of the food recommended is eaten during the day. GENERAL DIETARY SUGGESTIONS 1, Coffee, tea, plain unflavored gelatin (not jello), salt, pepper, spices, dry- mustard, vinegar, flavoring extracts and vegetable colorings may be used as desired. (Suggestions will be altered in relation to the age of the indi- vidual. ) 2. Saccharin may be used as a substitute for sugar. One-fourth grain has the sweetening value of one teaspoon of sugar. 3* Clear broth or bouillon maybe used as desired. Soup may be made with cream, milk and vegetables as the dietary plan allows, ii, No foods prepared with sugar arc allowed. Canned or frozen fruits must be prepared without sugar. 5, Salad dressings should be home prepared for commercial preparations usually contain some form of carbohydrate. 6, Do not use; Confections of any kind. Chewing gum. Beverages prepared with sugar similar to those served at fountains, and other soft drinks sold in bottles, (The use of sugar-coated pills and cough mixtures should be restricted where possible,) 7, The following foods are low in carbohydrates and may be eaten in moderate amounts if desired; Fresh mushrooms, olives, and dill pickles. _ VITAMINS Calories Protein Calcium Iron I Thiamine .AscorDic acid (C) (ii) 1 Ribo Nicotin flavin ! ic acid -j D 1 Man (70Kg.) 0ms. Gms. Mgs. i I.U. Mgs. Kgs. Mgs. Mgs. jl.U. Moderately act, 5000 70 0.8 12 1 5000 1.8 75 2.7 i 18 Very active I4.5OO 70 0.8 12 i 3000 2.5 75 3.3 23 ♦(**) Sedentary 23OO 70 0.8 12 i 3000 1.5 75 2.2 1 15 Ionian ( 56kg. ) ! i Moderately act. 25OO 6o 0.8 12 1 5000 1.5 70 2.2 j IS Very active 3000 60 0.8 12 3000 1.8 70 2.7 ( 18 (*») Sedentary 2100 60 0.8 12 S000 1.2 70 _ 1.8 1 12 Pregnancy (lat.)2300 .... 85 1 .1.5. ! 15 .. 6000 i.s ■ 100 r 2.5 x.. ih—_ ■5,06-806 Lactation 3000 100 2.0 ,15 . Hooo 2.3 150 3.0 ■ 23 ■500-800 “Children up to 12 years y ■ — 1 . i Under lOOper Kg. 3-5perKg. 1.0 6 1500 04 30 0.6 L 1-3 years 1200 ho 1.0 7 • 2000 0.6 35 0.9 ! 6 I{-6ye ars () 1600 5° 1.0 i 0 ! 2300 0.8 5° 1.2 8 7-9 years 2000 60 1.0 ;io : 5500 1.0 60 i.s ! 10 (•*) 10-12 years 25OO ?o 1.2 — j 12 j feoo 1.2 75 1.8 ■ 12 ~Sh3Mreh over 1.2* * Girls—15-15yr. 2800 So 1.5 ;is i 5000 i.it. 80 2.0 i l6-20yr. 25.00 75 1.0 115 1 3000 1.2 60 1.8 12 («) Boys —13-15yr. 3200 85 14 1 5000 1.6 90 2.1+ | 16 i l6-20yr. 3800 100 i.li I15 J 6000 1 2.0 100 3,0 1 20 (**) 1 These are tentative alld Wances toward which to aim in planning practical dietaries. These allow- ences can be met by a good diet of natural foods; this vd11 also provide other minerals and vitamins. the requirements for which are less well known. 1X1 mg. thiamine equals 355 International Units: 1 mg. ascorbic acid equals 20 International Units; (1 International Unit equals 1 U. S. P. uni t). Requirements may be less than these amounts if provided as vitamin P, greater if chiefly as the pre-vitamin carotene. ** Needs of infants increase from month to month. The amounts given are for approximately 6 to lo months. The amounts of protein and calcium needed are less if from breast milk. Vitamin D is undoubtedly necessary for older children and adults. Vhen not available from sunshine. it should be provided probably up to the minimal amounts recommended for infants. #jhc-Allowances are based on the middle age for e ach group (as 2,5,9,etc.), and for moderate activity. CH/RT OP RECOMrENI)ED PLLOv /NCES FOR SPECIFIC NUTRIENTS Committee on Foods and Nutrition, National Reseerch Council 3 Percent 6 Percent 9 Percent 12 Percent 15 Percent l8"Percent f 21Percent * Carbohydrate Carbohydrate .Carbohydrate Carbohydrate Carbohydrate Carbohydrate Carbohydrate, Vegetables Vegetables Vegetables Vegetables Vegetables Vegetables Vegetables! .Asparagus I Beans,green j Artichokes Soybeans, dry Beans, i red 1 • * ■ — - — Horeseradish1 Beans, lima Bean sprouts Beans, wax Beets kidney ,canned Potato fresh Beet greens Chives Brussel- Fruits: Parsnips i Corn, fresh! Broccoli Collards Sprouts Apricots Peas Fruits : j Cabbage Dandelion Carrots Cherries,sour Salsify Cherries, Fruits; Cabbage greens Onions Kumquats sweet Bananas Chinese Eggplant Rutabagas Loganberries Fruits ♦ • Crab a pples i Prunes, Ceuli flower Kale Oranges Apples Figs, fresh fresh Celery Kohlrabi Fruits: Orange juice Blueberries Grape Ju: ce; Chard Lajnbs quarters Leeks Blackberri es Peaches Grapes Pomegranates Chicory Cranberries Pineapple Huckleberriea Prune juice; \ Cucumber Okra Currants Pineapple Mangos i 1 Endive Parsley Gooseberries juice • Necta r i nes i t Escarole Pepper,green j Grapefruit Plums Pears Lettuce Pepper,red Grapefruit Cul nc e 1 Mustard Pumpkin juice Raspberries j 1 i ! greens Radishes Soybeans- Lemons i - t . t - i j green,shelled Limes . 1 • ; 1 Sauerkraut Sorrel Squash, winteij Turnips Tangerines ■ 6% 9% \ 12% 15$ i 18% , ! 1 Spinach i t ! i i , Squash,summer i ! i i 1 Tomatoes Fruits: 1 ! 1 t ! ! Tomato juice Melons- j i { \ • 1 Turnip tops Cantaloupe ; ! i 1 1 Watercress C as aba Honeydew * i i 1 ( 1 1 i Fruits: Spanish , 1 1 ! ! Rhubarb .. . i Watermelon , Strawberries , i i 1 j i . I i 1 1 1 { < 1 FRUITS AND VEGETABLES CLASSIFIED AS TO THEIR CARBOHYDRATE CONTENT Chetfield end Adams, U. S. Dept of Agriculture Circular No. June I9I4D