Fairfax T. Proudfit

“ Uses of Food in Body.—Physiological chemistry proves that when more food is taken than is needed for the internal and external work of the body, the surplus is stored for future use, first, in the liver and muscles as glycogen for the general expenditures, and, second, as adipose tissue for future use. ”

“ Tact on the part of the nurse is necessary in all cases, both young and old. It is often more difficult to instill good dietary habits in heart patients, after acute symptoms have subsided, than to carry them out during the acute attack, when the life itself depends upon a rigid adherence to the diet prescribed. But as these rules and regulations are essential to the future welfare of the patient, he must be taught with care, and in such a way that he will not be alarmed to an extent when more harm than good will come of the teaching. ”

“ Comparison of Food Intake and Energy Output.—Many fat people who claim to be small eaters in reality constantly consume more food than their age, weight, or mode of living would necessitate. If such patients could be prevailed upon to keep a correct chart of their daily intake of food and the amount of exercise taken, they would be astounded to find how much greater was the intake in comparison to the output of energy, in other words, how much more food they ate than they required to keep them in health. ”

“ Milk is, in fact, by no means a perfect food, so far as its vitamine content is concerned. First, because the presence of the vitamine in milk is so dependent upon the diet of the mother or the animal, second, because the pasteurization temperatures used to insure cow’s milk of purity from a bacterial standpoint, destroys in it the greater part of its antiscorbutic power. Either of which makes it necessary to supplement the formula of the artificially fed infant, and, in case of the former, the mother’s milk of the breast-fed baby, with orange, or canned tomato juice. ”

“ For the Child.—The factors influencing the food requirements are different, to a certain extent, from those of the adult. The main difference lies in the fact that the adult needs food only for the maintenance and repair of the body, while the child must have food, not only to cover its maintenance requirements, but to support the growth and development which should be continuous from birth to maturity. Resistance, too, must be developed during this period in order to safeguard the child through life. ”

“ Anything which interferes with the secretion of the juices or delays the food over its normal length of time in the stomach surely exerts unfavorable influences on the general metabolism of the food, for while, as we have already found, gastric digestion is not essential to the final utilization of the food in health, in disease it undoubtedly exerts a marked influence upon the general nutrition of the individual. ”

“ It would be decidedly unwise to attempt to build up the body by giving building foods alone, without due consideration to the foods containing the agents provided by Nature to neutralize the acid formed during the process of their metabolism. It is readily seen in the table just given that meat and eggs show a marked excess of acid-forming elements, whereas vegetables and fruits yield an excess of base-forming elements. With these data, it becomes more simple to balance the diet and to avoid the acidosis which may arise from impairment of the fat metabolism of the body. ”

“ The use of a high fat diet in the treatment of diabetes is based primarily on one fact—namely, that if the food eaten is not sufficient for the needs of metabolism, the body itself supplies the deficiency. Fat is used as long as it lasts, body protein being drawn upon for fuel when this is exhausted. It is of distinct advantage to the patient to have a diet of sufficient fuel value to run his body machine and permit him a moderate degree of exercise. ”

“ Causes of Liver Disorders.—Is it any wonder, then, that with such abuses as overeating and drinking, especially of those foods rich in fats and carbohydrates which depend upon the liver for their availability in the body, Nature cries aloud for help and for the comparative rest of this, her largest organ? ”

“ Reënforcing the Diet with eggs and lactose is often found of great value in increasing the weight quickly, as is the giving of one-third of a glass of cream and two-thirds of a glass of milk after each meal and at bedtime. The whole scheme of putting on pounds resolves itself into the giving of proper food in larger quantities than are ordinarily given, but dividing it up into frequent meals in order not to upset the digestion and do away with the good already accomplished. ”

“ The value of a knowledge of food and its effect in the human body cannot be overestimated. In health, this knowledge leads to higher standards, since by pointing out the errors in one’s mode of living, good health habits may be established, which will, undoubtedly assure the individual of a better nourished and a more vigorous body. ”

“ There is something in the mother’s milk which gives strength and resistance to the baby which is absolutely lacking in any other food no matter how carefully it is selected and prepared, and for this reason young mothers must be prevailed upon to nurse their babies whenever it is possible for them to do so. When circumstances, such as having to be away all day at work, make it impossible for a mother to nurse her baby at regular intervals, she can be taught how necessary are two or three breast feedings a day to the future welfare of her child. ”

“ The treatment in chronic gastritis is very like that in the more acute form; that is, it must be combated by removing the cause. Lack of fresh air and exercise have much to do with the development of chronic gastritis, but even they combined with a judicious amount of rest would be wasted without a proper adjustment of the diet to cover the main points of the disturbance. As has already been mentioned, the cause may be a lack of gastric juice or it may be an excess of it; it may be intensified by an atonic condition of the organ or from the food passing too quickly into the duodenum. ”

“ Selecting the Diet to conform to the character of the disease is as important a factor in the recovery of the patient as food itself. This selection is left largely to the nurse, consequently it is necessary that she should understand just which foods are indicated or contraindicated under the circumstances, and adjust the diet after the abstinence period accordingly. For example, the diet fulfilling all the needs of a patient who has just undergone an operation for a broken leg might be highly injurious for a patient just operated upon for some disturbance of the liver or kidneys. ”

“ It is well for the nurse to remember that when the child is confined to bed, he will not need so much food as he would if he were up and about, but that if the fever is of long duration, as in typhoid, the increased rate of metabolism must be met by an increased amount of food, as the ordinary requirement standards for a child in health cannot be applied to the diet of a child under these conditions. ”

“ Regulating the Diet.—As has been stated in a former chapter, any persistent loss of weight or failure to gain on the part of an infant whose chief business in life should be to grow, should be given immediate and careful attention. As a rule the diet is to blame; it is either improperly balanced, insufficient in amount, or poorly prepared, any of which might readily cause a disturbance to the delicate apparatus of the child. ”

“ Dietetic Treatment.—In the dietetic treatment of cancer of the stomach the most digestible forms of foods must be given, milk forming in this, as in other gastric disorders, the chief article of diet. As too much food cannot be tolerated, the meals must be small, even if given more frequently. The patient is often found to evince a distaste for meat, in which case fish may be substituted. When meat is given, it must be simple in form and preparation, such as boiled or broiled sweetbreads or brains, scraped beef or stewed chicken. ”

“ The keynote of to-day’s work is prevention, rather than cure, children are taught to eat correctly that they may grow into the strong, healthy men and women which are needed to make any nation great. This instilling of good health habits must rest upon the nurse, the nutrition worker, the physician and the home-maker. ”

“ Glycogen is readily reconverted into glucose, which is used by the body for the production of energy. It has been estimated that over half the energy manifested in the human body is derived from glucose, and it is in this form that the tissues of the body will ultimately make use of most of the carbohydrates in food. Practically all of the fruits, and many of the vegetables, are rich in this form of carbohydrate, but grapes contain more than any of the other fruits, while sweet corn, onions, and unripe potatoes contain appreciable amounts. ”

“ But babies of people in moderate circumstances, and even of wealthy parentage, are at times badly nourished, and require the same exacting care, the same attention to the food, the fresh air, and the sunshine that the poorer babies need in order to survive. Malnutrition may be the result of insufficient food, and it may also be due to the lack of one definite food element. Again, it may be brought on by some deformity of the mouth or stomach, which make it impossible for the baby to get all the food which he requires for his maintenance and growth. ”

“ Dietetic Treatment is practically the only means of combating and overcoming emaciation, since it is by food alone that the body is built.
Fat-forming foods, which in obesity were prohibited, have a prominent place in the diet for emaciation. Padding the nerves and organs with a layer or covering of fat protects them from the jars and shocks incidental to daily life, besides lending grace and contour to the body. ”

“ It has been found advisable in the majority of cases of acidosis to restrict the fat in the diet of all patients who, during the course of a disease, have given evidence of this condition; at the same time it is well to remember that fat is one of the essential food constituents and absolutely necessary to the welfare of the individual, consequently it is impossible to eliminate it from the diet entirely. ”

“ To be able to judge whether the food one eats daily is giving the best possible value from a physiological and economic standpoint, requires a definite knowledge of food, its source, composition and nutrient value, as well as its relation to the body in health and disease.
No one is capable of giving constructive advice upon matters pertaining to diet, unless he has acquired this knowledge through training. A nurse should obtain this training during her course in the hospital, through the class room, the wards and the diet kitchen. ”

“ The dividing line between health and disease is frequently almost imperceptible, and without a knowledge of the normal body, it is, at times, impossible to tell where the normal leaves off and the abnormal begins. ”

“ Thus it is seen that when the intake is constantly greater than the energy expenditure there must necessarily be some way in which the body can store up the surplus fuel, and so long as the digestion remains good and the amount of exercise limited there is no reason why there should not be a constant and steady accumulation of surplus fat which inevitably terminates in obesity. ”

“ Among the best known obesity cures may be mentioned those formulated by Banting, Oertel and Ebstein.
Most physicians have their own methods of treating obesity, but all are based primarily on diet and exercise.
Food is the chief cause of obesity and since some foods are more readily converted into adipose tissue than others, it is necessary to understand the behavior and functions of the various food combinations in the body before it is possible to say which are the offending articles of diet.
Water has no fattening properties of its own. ”

“ Certain foods, as has already been stated, require a high degree of temperature to make them wholesome, but if this temperature is applied by means of heated fat, as in frying, the food is changed from a wholesome to a more or less indigestible article. In health the organs of digestion are capable of overcoming much of the harm wrought by wrong preparation, but even in the healthy, normal individual a steady diet of fried food will eventually undermine what is [Pg 70] known as good digestion. In abnormal conditions (illness) frying is a method seldom, if ever, used. ”

“ With infants it is always best, when it is possible, to give breast milk. As this is the natural food it requires less effort on the part of the digestive apparatus to become available. It has been proved that even during the time when the baby is nursing the milk is projected in spurts into the duodenum without waiting to be attacked by digestive enzymes in the stomach, and [Pg 244g] for this reason the breast-fed infant is more apt to be efficiently nourished than the artificially fed baby, who loses his dinner by vomiting before absorption has had a chance to occur. ”

“ The metabolism of protein is more complex than that of any of the foodstuffs. It is probable that each living cell contains enzymes which are capable of breaking down the body proteins with the production of amino acids just as the proteins of the food are broken down by enzymes of digestion, and according to Sherman “it is not improbable that protein synthesis also may be brought about by every living cell.” ”