FEEDING THE FAMILY THE MACMILLAN COMPANY NKW YORK • BOSTON • CHICAGO • DALLAS ATLANTA • SAN FRANCISCO MACMILLAN & CO., Limited LONDON • BOMBAY • CALCUTTA MELBOURNE THE MACMILLAN CO. OF CANADA, Ltdw TORONTO Digitized by the Internet Arciiive in 2007 with funding from IVIicrosoft Corporation http://www.archive.org/details/familyfeedingOOroserich FEEDING THE FAMILY. CTxil^^-vv. BY MARY SWARTZ ROSE, Ph.D. ASSISTANT PROFESSOR, DEPARTft^kNT OF NUTRITION TEACHERS COLLEGE, COLUMBIA UNIVERSITY THE MACMILLAN COMPANY 192 1 AU rights reserved \r ^1 Copyright, 1916, By the MACMILLAN COMPANY. Set up and electrotyped. Published October, 1916. Nortaioot) i^rtss J. S. Cashing Co. — Berwick &. Smith Co. Norwood, Mass., U.S.A. d 1a ^^-^7 /|YV^. / \i PREFACE (f While many things contribute to health, — sleep, fresh air, and exercise, for instance, — the foremost considera- tion 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 nutrition 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 thie present Volume separate Ifjj^apters 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. V 4888r)7 vi PREFACE 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 beHeves, 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 appHed to materials tending to vary considerably in their composition. 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 so much that the name of a dish does not always PREFACE va 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, Cqlumbla UNivERsmr, February i6, 191 6. TABLE OF CONTENTS Preface v List of Food Plans and Dietaries xiii List of Illustrations xvi CHAPTER I. The Significance of Food 1 Introduction 1 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 ... 25 II. Care of the Digestive Mechanism .... 29 The part of the mouth in good digestion . . .31 The part of the stomach in good digestion . . 34 Good digestion in the small intestine .... 38 Good digestion in the large intestine .... 40 Diet for constipation 42 III. Food for the Adult Man 46 Energy requirements — the sedentary man . . 47 Energy requirements — the muscularly active man . 51 Thin and fat men .58 Building material for the adult man .... 62 The protein or nitrogen requirement ... 63 The ash requirement 69 ix X CONTENTS CHAPTKR PAGE IV. Food for the Adult Woman 74 Energy requirements 74 Thin and fat women 83 The protein and ash requirements .... 86 Food for the prospective mother .... 88 Food for the nursing mother . . , . . 93 V. Food for the Baby 98 Energy requirement 102 Artificial feeding . . . . . . . . 104 Care of the baby's food 112 Use of proprietary infant foods 113 Food after weaning 115 VI. Food for the Two-year-old Child .... 119 VII. Food for Children Three and Four Years Old . 128 VIII. Food for Children Five to Seven Years Old . 135 IX. Food for Children Eight to Tw^elve Years Old . 145 V X. Food in Adolescence and Youth .... 162 Food from the seventeenth to the twenty-fifth year . 174 XI. Food after Fifty 184 XII. Food for the Family Group: Menus . . . 194 The construction of the menu 196 Types of meal plans 197 Food combinations from the scientific standpoint . 200 Food combinations from the esthetic standpoint . 205 Summer and Winter menus 210 XIII. Food for the Family Group: Cost of Food . . 220 Factors in market cost 221 Market cost and fuel value 225 Cost of other nutritive factors 231 CONTENTS xi CHAPTER PAGE XIV. Food for the Family Group : Food Plans and Dietaries 241 Planning a family dietary 242 Essentials in the family dietary 243 Planning the menu 244 Calculation of the dietary 248 Cost of the dietary 252 Reducing the cost 254 Dietaries costing one cent per 100 Calories or less . 261 Family dietaries at the lowest cost .... 267 XV. Food for the Sick and Convalescent . . . 285 Energy requirements in sickness .... 287 Fluid diet 288 Soft or semi-solid diet 294 Light or convalescent diet 295 Diet in minor illness 298 Colds . . ' 298 Acute indigestion . . . . . . 299 Intestinal putrefaction 300 Food in fevers 301 Diet in typhoid fever . 303 Diet in tuberculosis 309 Diet in diabetes 314 Diet in gout 327 APPENDIX TABLE I. 100-Calorie Portions of Foods as We Eat Them . 332 II. Food Values in Terms of Common Measures . . 349 III. Dietary Recipes 355 IV. Fuel Value in Relation to Cost .... 426 V. Height and Weight of Men at Different Ages . 429 VI. Height and Weight of Women at Different Ages 430 VII. Height and Weight of Boys at Different Ages . 431 VIII. Height and Weight of Girls at Different Ages . 432 IX. Average Weight of Children from Birth to the Fifth Year 433 LIST OF FOOD PLANS AND DIETARIES 1. For a Sedentary Man: A day's food plan 50 A dietary costing 1^ to 2 cents per 100 Calories . . 52 A dietary costing 1 to IJ cents per 100 Calories . . 53 2. For a Muscularly Active Man : A day's food plan 55 A dietary costing f to 1 cent per 100 Calories . . 57 3. For a Thin Man : A fattening dietary yielding 3450 Calories ... 59 4. For a Fat Man : A reducing dietary yielding 1400 Calories ... 61 5. For an Active Woman : A day's food plan 77 A dietary costing 1^ to 1^ cents per 100 Calories . . 79 6. For a Sedentary Woman : A day's food plan 80 A dietary costing 1^ to 2 cents per 100 Calories . . 81 A dietary costing 1 to IJ cents per 100 Calories . . 82 7. For a Fat Woman : A reducing dietary yielding 1052 Calories ... 84 8. For a Thin Woman : A fattening dietary yielding 3000 Calories ... 87 9. For a Nursing Mother Doing Moderate Muscular Work : A dietary costing | to 1 cent per 100 Calories . » , ^ K^ For a Child 1^ to 2 Years Old: A day's food plan 126 A dietary costing If cents per 100 Calories . . . 127 XIV LIST OF FOOD PLANS AND DIETARIES .^AGB 11. For a Child 3 to 4 Years Old : A day's food plan 133 A dietary costing IJ cents per 100 Calories . . . 134 12. For a Child 5 to 7 Years Old : A day's food plan 143 A dietary costing | to 1 cent per 100 Calories . . 144 13. For a Child 8 to 10 Years Old: A day's food plan 159 A dietary for a child 8 years old costing 1| to IJ cents per 100 Calories 160 A dietary for a child 10 years old costing 1^ to 1^ cents per 100 Calories 161 14. For Boys and Girls 14 to 16 Years Old: A day's food plan 170 A dietary for a 16-year-old boy costing 1 to 1^ cents per 100 Calories 172 A dietary for a 16-year-old girl costing 1^ to IJ cents per 100 Calories 173 15. For an Elderly Person: A day's food plan 190 16. For an Aged Person : A day's food plan 191 A dietary 192 17. For the Family Group: A dietary costing 1| to 2 cents per 100 Calories . . 249 A dietary costing 1^ to 1^ cents per 100 Calories . . 257 A dietary costing | to 1 cent per 100 Calories . . 269 A dietary costing f to | cent per 100 Calories . . 274 18. For a Convalescent: A general food plan 297 19. For Typhoid Fever: Modified milk diets 305 A mixed fluid diet 306 A soft diet 308 LIST OF FOOD PLANS AND DIETARIES xv PAGB 20. For Tuberculosis: A moderate-priced dietary 311 A low-priced dietary . 312 A plan for low-priced diets 313 21. For Diabetes : A dietary containing 50 grams of carbohydrate . . 325 A dietary containing 75 grams of carbohydrate . . 326 22. For Chronic Gout: A dietary yielding 2275 Calories 329 LIST OF ILLUSTRATIONS " The welfare of the family is largely in the hands of the one who provides the three meals a day " . . Frontispiece PAGB A bomb calorimeter — a device used for measuring the fuel value of foods 8 A respiration calorimeter for measuring the energy require- ment of babies facing 15 I oo-Calorie portions of fruit " 25 loo-Calorie portions of vegetables .... " 56 I oo-Calorie portions of desserts .... " 86 "Twelve, thirteen, /b//r/ ^.Am ^^^^^^^^^■fBMBy m^^^ ^^^^V&H^^L *'^^PI^^H ^^^^^^^Kt^^P^^Ha ^^K /^^^^^I ^^^^^^^^■f ^ 'In ■jj^^^^^^H ^^^^^^V ^ M ^ '^^^^1 ^^^^^■L ^^K^ ^'^^^^1 ^^^^^^B IpI^^^^kIb h ** ^^1 ^^^^^^K ^^ '^^BHV ' i^M^^I ^H9||mn ^^^^^^^A^R' '''^ IhH i & « l;:* r^OvOiO -S "^tic! g s 2 lllll U3 n Hill H mSnaoui w vdt^OCJd 3 > 1 o M o U 1 § ^ § 4 o H bc §. 1 1 'hh •M c2 2 a=3--^ a CJ o H«on H M«*« u ^ § -5t CO ""to tow II FOOD FOR THE ADULT MAN 57 A Dietary for a Working Man, Based on the Preceding Plan Fuel Value: 3945 Calories Cost: f-ijif per 100 Calories Weight Protein Total Oz. Calories Calories Breakfast : Oatmeal mush .... i^ cups 12.0 25 150 Creamed dried beef . . f cup 6.0 40 250 Old New England com bread large slice 4.0 32 400 Oleomargarine .... 2 tbsp. 0.9 — 200 Milk for cereal and coffee f cup S-i 19 100 Sugar for cereal and coffee 2 tbsp. (scant) 0.9 100 Coffee I cup ~ — 1200 Luncheon : Kidney bean stew . . . if cups 18.0 100 355 Rye bread iloaf 2.8 28 200 Oleomargarine .... 2 tbsp. 0.9 — 200 Banana I large 5.5 5 100 Molasses cookies I ^ 2 large 1.5 12 200 Milk for coffee .... 3 tbsp. 2.0 8 40 Sugar for coffee .... I tbsp. (scant) 0.5 — 50 Coffee . I cup "45 Stuffed beef heart . . . I serving 4.0 84 400 Potatoes, boiled .... 2 small 5-4 16 150 Carrots 2 small S-o 5 50 White bread floaf 3.9 42 300 Oleomargarine .... 2 tbsp. 0.9 — 200 Date pudding II ^ ... I serving 3-5 22 310 Brown sugar for clear sauce 2 tbsp. (scant) 0.8 — 100 Milk for coffee .... 3 tbsp. 2.0 8 40 Sugar for coffee .... I tbsp. (scant) o-S — 50 Coffee . ' I cup ~ — 1600 Total for day . . 446 3945 * See Table III, Appendix, pp. 371 and 381. S8 FEEDING THE FAMILY 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 disease, 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 substance, persistent overfeeding 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 effort to take more fuel. 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 mayonnaise, French, or cream dressings ; milk enriched with cream, cocoa and choco- late made with milk, or tea and coffee with cream and sugar liberally used are comparatively easy to FOOD FOR THE ADULT MAN 59 take. Custards and creams of various kinds are valu- able means of adding to the fuel value of the meal. Meat is best used in moderation. A Fattening Dietary Suggested for a Sedentary Man Fuel Value : 3450 Calories Ordinary Requirement : 2400 Calories Breakfast : Grape juice . . Farina with 4 dates Scrambled egg Toast .... Butter .... Cream, thin . . Sugar .... Coffee .... Luncheon : Creamed chicken on Toast .... Lettuce salad . . Saltines . . . Vanilla ice cream II Dinner : Cream of corn soup Roast beef . . . Baked potato . . Buttered Lima beans Whole wheat bread . Butter Baked apple . . . Cream, thin . . . Sugar Measure I cup f cup h cup I slice I tbsp. 1 cup 2 tbsp. (scant) I cup cup slice serving saltines cup Chocolate II ^ I cup Total for day I cup 2f sUces I medium 1 cup 2 slices 2 tbsp. I large I cup I tbsp. (scant) Weight Oz. 7.0 7.0 4.2 0-5 0.2 6.3 0.9 3-2 0.5 1.2 0.4 4.0 7.8 8.0 4.0 3-0 2.5 1.4 0.9 4.6 3.6 0.5 Protein Total Calories Calories 14 40 7 18 32 7 I 5 12 33 24 115 II 24 16 2 10 371 See Table III, Appendix, pp. 358 and 385. 6o FEEDING THE FAMILY 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 years, with the result that they steadily take in more fuel than they use up, and gradually increase in weight. 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 usually much easier to keep the weight from becoming excessive than to reduce fat after it has been stored. Hence it should be borne in mind that persistent gain in weight in a healthy per- son means that he has been overeating and he should make consistent efforts to lower his food intake. In- creasing exercise will help to burn off fat, but is likely to stimulate the appetite, so that accurate measurement 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 FOOD FOR THE ADULT MAN 6i A Reducing Dietary Suggested for an Overfat Man Fuel Value : 1400 Calories Ordinary Requirement : 2400 Calories Measure Weight Protein Total O2. Calories Calortks/ Breakfast : Orange I large 9-5 7 100 Eggs 2 eggs 4.8 54 150 Graham bread .... 2 thin slices 0.7 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 6.0 122 200 lemon servmg Asparagus, plain .... 10 stalks 8.0 16 50 Potato, boiled .... I medium 3.6 II 100 Butter (for potato and asparagus) i tbsp. 0-3 — 50 Apple, raw I medium 4.9 2 6s S15 Dinner : Raw oysters . . , . . 12 oysters 7.2 49 TOO Roast beef, strictly lean . large serving 5.8 162 250 String beans, plain boiled . ^cup 2.0 5 25 Potato, boiled .... I medium 3-6 II 100 Tomatoes, sliced, with vine- gar, salt and pepper . . I medium 7.7 8 50 Cheese, pineapple ^ . . . 0.4 12 SO Water cracker .... I cracker 0.1 I 10 Coffee (clear) I cup — 585 Total for day . . . 491 1400 cream soups, butter and cream be almost eliminated, sugar used very sparingly, and confectionery avoided. ^ Roquefort, Swiss, Brie, or American may be substituted. 62 FEEDING THE FAMILY Green vegetables of all kinds, raw or plainly cooked, such as cabbage, celery, lettuce, spinach, asparagus, cauliflower, can be freely eaten. Bread, cereals, pota- 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 — suppUes fuel in suitable forms and amounts, keeps within the Umits of its work capacity, and sees that it is well oiled (furnished with regulating materials) and clear of waste. FOOD FOR THE ADULT MAN 63 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 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 64 FEEDING THE FAMILY 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- 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 Uke 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 FOOD FOR THE ADULT MAN 65- or fat and carbohydrate, as potatoes, bread, butter, and the like, for part of the protein, a much more satisfac- tory diet can be arranged. 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 hmits, how- ever, beyond which it does not seem wise to go. When a very large proportion of the day's fuel is protein material 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 utiHze this heat to maintain his body temperature instead of gener- ating more by shivering or more active muscular activity. In extremely cold climates or in severe winter weather in temperate regions, a liberal supply of protein in the 66 FEEDING THE FAMILY diet may promote physical comfort. On the other hand, in hot weather, especially with much humidity, dissipa- tion of heat which the body is inevitably generating becomes difficult, and an extra supply of heat arising from a large amount of protein in the diet simply in- creases 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 cer- tain 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 serving 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 Calories, 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, FOOD FOR THE ADULT MAN 67 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 ^ it will be seen that the protein supply falls within the Kmits suggested here. Liebig's notion that meat is a peculiar source of body strength having caught the popular fancy, and agreeing well with the food preferences of many, it has been slow in giving way to newer conceptions 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. 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 has already been pointed out. Meat has certain dis- advantages as the sole or chief protein food of the diet. Associated more or less intimately with the protein of ^ See pages 52, 53, 57, 59, and 61. 68 FEEDING THE FAMILY 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 avoided. 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 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 Mt 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 24 cents (with beef at 28 cents a pound in the market) and * Protein in looCalorie portions. FOOD FOR THE ADULT MAN 6g if his fuel requirement is 3000 Calories, 2400 must still be bought to make up the day's total. If milk be selected, it will take 17 portions, costing 22.6 cents (with milk at 9 cents per quart), but leaving only 1300 Calories to be obtained from other sources. If eggs are chosen, 9 por- tions will be required, costing 22.5 cents (with eggs at 25 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 valuable ash constituents which would have to be added to the meat ration to make it equally valu- able 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 depriv- ing 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 average for each adult man will provide approximately one-third of his protein require- ment; 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. THE ASH REQUIREMENT Attention has already been called in Chapter I^ 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. ^ See pages 21-25. 70 FEEDING THE FAMILY The results of ash starvation would not be manifested so quickly as those of deprivation of water, fuel, or pro- tein (nitrogen) because the amounts lost daily are small and in an adult the reserves in the body are compara- tively great. Nevertheless, the ash supply is worthy of consideration in any food. Studies of what men actually do eat reveal that the elements most Hkely to be taken in too small amounts for a good daily balance are phos- phorus, calcium, and iron. A comparison of a reason- able supply of these elements for an adult with the amounts furnished by several combinations of food other- wise very excellent will show how ash-bearing foods might be neglected (i 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 : Phosphoric acid 2.75 grams Calcium oxide 0.70 gram Iron 0.015 gram (i) 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 Calcixtm OXTOE Grams Phos- phoric Aero Grams Iron Grams Bread, white (if loaves) . . Beef, lean . . Butter . . . 20.7 9.0 2.8 2X6 216 4 1500 400 600 0.16s 0.036 0.018 1. 125 1.680 0.024 0.0045 0.0128 Total . . 436 2500 0.219 2.829 0.0173 FOOD FOR THE ADULT MAN 71 (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 Oxide Grams Phos- phoric Acid Grams Iron Grams Milk (7^ cups) Bread, white (i| loaves) . . 61.2 17.9 228 187 1200 1300 2.868 0.143 3.636 0.975 0.0041 0.0039 Total . . 415 2500 3.011 4.611 0.0080 (3) It is evident that the substitution of some milk in the bread-beef-butter diet will remedy its defect. Weight Oz. Protein Calories Total Calories Calcium Oxide Grams Phos- phoric Acid Grams Iron Grams Bread, white (i^ loaves) . . Beef .... Butter . . . Milk (2I cups) 17.9 6.8 2.3 20.4 187 76 1300 300 500 400 0.143 0.027 0.015 0.956 0.975 1.260 0.020 1. 212 0.0039 0.0096 0.0014 Total . . 429 2500 1. 141 3.467 0.0149 (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 Oxide Grams Phos- phoric Acid Grams Iron Grams Milk (ri cups) Bread, graham (ih loaves) . 61.2 17.6 228 177 1200 1300 2.868 0.247 3.636 2.470 0.0041 0.0169 Total . . 405 2500 3.115 6.106 0.0210 72 FEEDING THE FAMILY 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 on pages 70 and 7 1 . Milk is the most valuable source of calcium ; a single 100 Calories will supply one-third of the day's requirement. Other valuable sources are indicated in the table on page 24} One portion of milk will also supply one-ninth of the day's phosphorus requirement. Eggs (especially the yolk), cereals from whole grains, lean meat, dried peas and beans, are desirable for their phosphorus content. (See table, page 22).^ With the exception of milk, the foods just named and fruits and green vegetables are rich sources of iron. (See table, page 23).^ A large serving of spinach will of itself supply one-third of the day's iron requirement. With a little knowledge, it is not necessary to have elaborate cookery or many kinds of food to keep a man well nourished. As indicated above, so simple a ration as milk and graham bread will furnish all the essentials of a well-balanced diet, provided some or all of the milk is uncooked, to secure those ^'accessory food sub- stances," ^ which in milk are affected unfavorably by high temperature. The amount of waste to make ^ Calcium in loo-Calorie portions. 2 Phosphorus in loo-Calorie portions. ' Iron in loo-Calorie portions. * Seepage 27. FOOD FOR THE ADULT MAN 73 ballast for the intestines is not very large ; it could be increased by the addition of fresh fruit, such as apples or oranges, or of some green vegetable like radishes or onions. The bread-butter-beef -milk diet is not quite so ideal from the point of view of counteracting consti- pation, and needs even more the addition of some coarse material. Changes in the kind of bread (or use of equiv- alent fuel in the form of cereals and potatoes) and in the kind of meat and fruit will give that variety which maintains good appetite. Warm food usually adds to the ease with which a meal is digested, and often to its relish. Any one trying to live on a rather monotonous diet finds that soup, tea or coffee, ''help one to eat bread. '^ Whether tea and coffee add to the food value of the diet or not depends chiefly upon how much milk (or cream) and sugar are taken in them. 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 essentip^l food needs we find that the laws of energy exchange are practically the same for both sexes. Respiration, circulation, digestion, and muscular ten- sion, — all forms of internal body work, — demand their daily quota of fuel; the larger the body, the more fuel required to run it; the more external work done by the human machine, the more fuel demanded for this purpose. In actual comparisons between living 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 ex- 74 FOOD FOR THE ADULT WOMAN 75 eluded, 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 requirements of men. Kind of Actiyity Calories per Pound per Hour Sleeping Sitting (reading, hand or power machine sewing, knit- ting, writing) Standing Light exercise (dishwashing, cooking for 2-4 persons, bed making, sewing with foot power) Moderate exercise (cooking for 6-12 persons, sweeping, ironing, scrubbing by hand) Active exercise (cooking for large groups, ironing, scrub- bing with heavy implements, etc.) lF2 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 : 76 FEEDING THE FAMILY Calculated Energy Requirement for Twenty-four Hours for A Moderately Active Woman Weighing 123 Pounds Activity Hours Calories Sleeping . . . Sitting . . . . Standing . . . Light exercise . . Moderate exercise Total . '. '. 8 492 5 369 2 185 6 J38 3 461 24 2245 The daily requirement for the average woman in some of her common occupations will be approximately as follows : 1. At rest 1 600-1 800 Calories per day 2. Sedentary occupations .... 2000-2200 Calories per day Milliners Teachers Bookkeepers Seamstresses Stenographers Machine operatives 3. Occupations involving standing, walking, 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 77 appetites. They have stayed too much indoors, taken too little systematic exercise, 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. With the general improvement in the health of women, which is already remarked by careful observers, we are getting far from the ''ladylike" notion of Janice Meredith and her kind that it would be a dis- grace to let a man see one really relish food, and are rec- ognizing the inevitable connection between the machine and its source of energy. Eating is primarily a duty ; na- ture has graciously made it also a physiological 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 constant practical use. The following food plans and dietaries are suggestive of ways of supplying suitable fuel for active and seden- tary women. A Day's Food Plan for an Active Woman Fuel Requirement : 2600-3000 Calories Cost: i^i|f5 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 100-200 Calories 78 FEEDING THE FAMILY Breakfast : — Continued Toast or muffins Sugar . . . Coffee Luncheon : Thick soup with crackers Dinner : Cheese or nut salad or Scalloped eggs and tomatoes or Cold meat and potatoes Bread Butter Canned, dried, or fresh fruit with cake Soup with rice, noodles, or vegetables . Roast rump of beef ^ or Mutton or Pork chop Potatoes or macaroni Boiled onions or other seasonable vege- table Simple vegetable salad or Celery or Olives Bread Butter Fruit gelatin or tapioca or Brown Betty or Fruit pie 50-150 Calories 50-100 Calories 600-800 Calories 250-400 Calories 100-200 Calories 100-200 Calories 200-400 Calories 700-1200 Calories 25-100 Calories 200-350 Calories 150-250 Calories 150-200 Calories 50-150 Calories 50-200 Calories 50-200 Calories 200-400 Calories 900-1400 Calories FOOD FOR THE ADULT WOMAN 79 A Dietary for an Active Woman, Based on the Preceding Plan Fuel Value : 2865 Calories Cost : i|-i^ ^ per 100 Calories Breakfast : Canned pineapple Cornflakes . . . Milk . . . . Fish balls . . . Toast . . . . Sugar . . . . Butter . . . . Cream, thin . . Coffee . . . . Luncheon : Cheese souffl6 Turkish pilaf . Com muffins . Butter . . . Canned apricots Chocolate loaf cake Milk Dinner : Vegetable soup Pork chops Glazed sweet potatoes Mashed turnips . . Cold slaw .... Rolls Butter Apple tapioca . . Cream sauce . . . Measxjee I slice I cup 1 cup 2 small 2 slices I tbsp. (scant) I tsp. icup I cup f cup 1 cup 2 small I tbsp. h cup piece 2^ in. X 2I in. X i| in. I cup t cup I large 2 halves 3 cup h cup 2 small I tbsp. f cup icup Weight Oz 1.2 o-S 8.5 2.6 I.I 0.5 o.i 1.8 2.5 7.5 2.4 0.5 4-8 1.8 8.5 6.0 2.4 (Raw weight) 5.2 4.5 1.4 1-5 0.5 5-4 1-7 Protein Calories 3 34 21 14 27 9 26 I 5 10 34 18 92 10 7 3 15 I 2 5 Total for day 342 8o FEEDING THE FAMILY A Day's Food Plan for a Sedentary Woman Fuel Requirement : 1800-2300 Calories Cost : 1^2 ff per 100 Calories 100 Calories Breakfast : Luncheon Dinner : Fruit Cereal or omelet or bacon .... 50-100 Calories Toast or muffins 50-200 Calories Butter 33-100 Calories Cereal coffee with cream and sugar 1 or milk or cafe au lait or cocoa j 100-200 Calories 400-600 Calories 150-250 Calories Cream soup or creamed meat on toast or macaroni croquettes, cheese sauce or egg, fish, or cheese salad Rolls 100-150 Calories Butter 50-100 Calories Fruit 100-150 Calories Cocoa or milk 150-175 Calories 600-800 Calories Soup Croutons or crackers Roast beef or Nut loaf or Meat pie Potatoes or Rice or Baked banana . Spinach or other green vegetable . Crackers or bread and butter . . Lettuce, tomato or other simple salad Sherbet or Custard Fruit jelly or whip 25-100 Calories 25-50 Calories' 150-300 Calories 100-150 Calories 10-50 Calories 15-50 Calories 75-150 Calories 200-300 Calories 800-1100 Calories FOOD FOR THE ADULT WOMAN 8l A Dietary for a Sedentary Woman, Based on the Preceding Plan. I Fuel Value : 2000 Calories Cost : i§-2 ff per 100 Calories Breakfast : Orange Omelet Toast Butter Cocoa I ^ . . . . . Luncheon : Corn k la Southern Fruit salad (mayonnaise) French rolls .... Butter Milk Sugar cookies . . . Dinner : Cream of pea soup . . Croutons Lean roast beef . . . Baked potato Spinach a la crdme Tomato salad (French dressing). Saltines . . . Tapioca cream . Measure I orange I egg I slice I tsp. I cup I cup (scant) I cup 1 roll 2 tsp. f cup 2 large f cup ^ doz. slice 5 in. X 6 in. X|in. I medium I cup (scant) I serving I saltine I cup Weight Oz. 9-5 2.0 o.S 0.1 6.7 4.2 3-0 1-3 0-3 6.3 i.o 5.2 0.4 3-0 1.8 4-5 0.1 7.0 Protein Calories 16 20 6 12 24 7 16 3 42 II 4 3 I 30 Total for day 237 1 See Table III. Appendix, p. 358. 82 FEEDING THE FAMILY A Dietary for a Sedentary Woman, Based on the Preceding Plan. II Fuel Value : 2035 Calories Cost : i-iiji per 100 Calories Weight Protein Total Oz. Caloboes Calortks Breakfast : Orange ^ orange 4.7 3 50 Cream of wheat .... fcup 3-0 6 50 Cornmeal muffins . . . 2 small 2.4 26 200 Butter 2 tsp. 0.3 — 60 Top milk for cereal and coffee (10 oz.) .... f cup 3-1 14 150 Sugar I tbsp. 0.6 60 Coffee I cup — — — 570 Luncheon : ' Creamed salmon on toast . I cup and 2 slices ' 7.0 77 350 Cold slaw ^cup 1.4 3 50 Bread I slice 0.7 7 50 Butter h tbsp. 0.2 50 Apple sauce fcup 3-5 I 100 Sponge cake piece i^in. Xi^n. X2in. 0.9 II 100 Russian tea I cup — — — Sugar for tea 1 tbsp. 0.3 — 30 730 Dinner : Lentil-meat loaf .... slice if in. X 2iXi| in. 2.2 56 200 Tomato sauce .... 3- cup 2-5 5 100 Browned potatoes . . . I medium potato 3.5 :ii 125 Boiled onions .... 2 onions SA 10 100 Bread I slice 6.7 7 50 Butter h tbsp. 0.2 50 Coffee jelly |cup 4.0 4 40 Whipped cream (sweetened) i^ tbsp. 0.7 I 70 735 Total for day 242. 2035 FOOD FOR THE ADULT WOMAN 83 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.^ If ordinary eating habits result in this, as they should, we may rest assured that the diet is satisfactory as to quantity of fuel ; if not, some attention should be given to the matter. The tendency to take on extra fat is apparently 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 according to the general health. But in the early stages of grow- ing fat, careful weighing of food or "counting the Calo- ries" will prove effectual and safe, but must be per- sisted 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. » See Table VI, Appendix, p. 430. 84 FEEDING THE FAMILY A Reducing Diet Suggested for an Overfat Woman Fuel Value: 1052 Calories Ordinary Requirement: 2200 Calories Breakfast : Apple Egg Toast Coffee 1 Skim milk 10.30 A.M : Bouillon Water cracker .... Luncheon : Lean cold roast beef . . Rye bread Lettuce and cottage cheese salad Lettuce Cheese French dressing . . . 4.30 p.M : Tea with lemon ^ ... Water cracker .... Dinner : Boiled cod with lemon . Boiled potato .... Cauliflower (plain) . . . Butter Watercress and egg salad Watercress Egg French dressing . . . Orange Black coffee 10.30 p.M : Hot skim milk .... Measure I medium I egg I slice I cup i^ tbsp. h cup 1 cracker medium serving 2 thin slices ad libitum 1 2^ tbsp. [ I tbsp. J I cup 1 cracker large serving ^ medium large serving I tsp. (scant) ad libitum I egg I tbsp. I large demi tasse h cup Weight Oz. 4.9 2.4 0-5 i.o 4.0 0.1 3.5 0.7 O.I 8.2 1.8 3-0 0.1 4.7 4.3 Protein Calories 10 I 97 7 40 209 6 6 27 3 16 Total for day 462 ^ Saccharine may be used for sweetening if desired. FOOD FOR THE ADULT WOMAN 85 THIN WOMEN Women of nervous temperament are apt to be too thin. They expend much energy in heightened mus- cular tension, and 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. Food must be taken regardless of appetite, and often also regardless of minor digestive disturbances, for these do not neces- sarily 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 a food, can be taken in many forms : hot, cold, with added cream or milk sugar, or both ; in cocoa and chocolate ; in sher- bets and ice creams ; as buttermilk, zoolak or kumiss ; 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 1 See Lactose Lemonade, Table III, Appendix, p. 360. 86 FEEDING THE FAMILY 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 acceptable 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, but even a slight surplus over immediate needs, if persistently taken, will in time have its favorable effect on the general health and especially on the nervous system. To get the best results, considerable increases in the food intake should be maintained, with just enough exercise to promote a good appetite. One ex- ample of a fattening diet has already been given ; ^ another, approximating a little more closely the average requirement of a woman, is presented on the next page. The Protein and Ash Requirement Just as the laws which control energy requirement operate in the same way for women as for men, so the * See page 59. "§, w d pJ fO ro B ^ O 3 U S 4) CI ^™ O ^ 5 «SS^ ^ QUC§ CO TtlONO FOOD FOR THE ADULT WOMAN 87 A Fattening Dietary suggested for a Thin Woman Fuel Value: 3000 Calories Ordinary Requirement: 2200 Calories Measure Weight Protein Total O2. Calories Calories Breakfast : Prunes 4 medium ^ 1.4 (dry) 3 100 Grapenuts 3 tbsp. I.O 12 100 Egg I egg 2.4 25 70 Toast 2 slices 1.0 14 100 Butter I tbsp. o.S I 100 Cream, thin f cup 5-4 IS 300 Sugar I tbsp. (scant) 0.5 — 50 Coffee I cup — — — 10 :30 A.M. : Cocoa III2 fcup 7.6 32 250 Luncheon : Corn chowder f cup 4.4 18 ISO Fruit salad I serving 3-0 6 200 RoU I roll 1-3 12 100 Butter ih tbsp. 0.7 I ISO Chocolate blanc mange with ^cup 5-4 18 200 whipped cream . . . 2 tbsp. 0.9 2 100 4 P.M. : Egg in orange juice . . I egg 3 tbsp. juice > 4.2 25 130 2 tsp. sugar J Dinner : ■ Broiled steak piece 3 in. X i| in. Xfin. 3-0 70 ISO Scalloped potatoes . . . I cup (scant) 5-2 13 ISO. Buttered beets .... fcup 2.0 3 SO Lettuce and tomato salad I serving 5.4 6 200 Salted almonds .... 12 nuts 0.5 13 100 Boiled custard .... |cup 3-3 20 ISO Macaroons 2 macaroons 0.8 6 100 Total for day 315 3000 1 Soaked 24 hours, then allowed to stand 24 hours to dry. 2 Two tbsp. milk sugar instead of cane sugar. See Table Appendix, p. 359. Ill 88 FEEDING THE FAMILY 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.^ 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- * See discussion of phosphorous, calcium, and iron contents of foods, pages 21-25. FOOD FOR THE ADULT WOMAN 89 bine into its own kinds of protein ; the proteins of milk and eggs, and many of the proteins of vegetables will )deld 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 to be the first to suffer loss, though, of course, a great scarcity is eventually Hkely to affect the baby. For the most part, the same kinds of food which are well adapted to the mother under ordinary 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 exer- cised in this respect, bearing in mind that fatigue, anx- iety, and constipation may be large factors in indiges- tion. The majority of mothers suffer in the early stages of gestation from nutritional disturbances fa- miliarly 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 connec- tion 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 go FEEDING THE FAMILY 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 estabhshed, and from this time on the mother's appetite should steadily improve. Any special food requirements on the part of the developing child before the end of the fourth month of gestation have been shown to be practically 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 energy demands be increased more than 20 per cent, or one- fifth of the mother's usual daily supply. 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 somewhat less so, and is seldom likely to require over 3000 Calories. The increased require- ments for building material will be best met by the liberal use of milk and eggs, supplemented by fruit and green vegetables. Frequent small meals are often util- ized 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 : I. 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. FOOD FOR THE ADULT WOMAN 91 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 v/here digestion is disturbed. 4. A green vegetable, as spinach, peas, beans, lettuce, celery, cabbage, onions, etc. These may be served as salads, buttered, creamed, or in soups. When cooked, the cooking water should be used if possible, because it contains a large part of the ash constituents. 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, oUve oil, bacon, peanut butter, or oleo- margarine in moderate quantities to add to the fuel value of the diet. For the sake of ease of digestion, these 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 modified 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 digestion is good, and the fuel value can be easily increased by the use of 92 FEEDING THE FAMILY milk or eggs, which, as already indicated, also give desirable increases in building material. Where cost must be carefully considered such menus as the following may prove useful : 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 : Lentil and tomato soup Cold corned beef Whole wheat bread, butter or butterine Tea or coffee (one-half milk), or cocoa Dinner: Lamb stew with vegetables (carrots, potatoes, onions) Whole wheat bread, butter or butterine Custard pie Tea or coffee (one-hdf milk), or cocoa II Breakfast : Wheatena, mUk, 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: Bean or lentil loaf Boston brown bread Stewed onions Apple betty, milk and sugar Coffee (one-half milk), or cocoa FOOD FOR THE ADULT WOMAN 93 III Breakfast : Cracked wheat, milk and sugar Rye bread and butter 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 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 food supply. 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 94 FEEDING THE FAMILY a child will be 560 Calories. But making milk is hard work ; it is believed that about two Calories of extra food are necessary to produce one of milk, so that the above daily milk supply will demand an addition of some 1 1 20 Calories to the mother's ordinary energy intake, or in general we may make the following estimates of the increased requirement: Additional fuel requirements for nursing a baby First 3 months . . 90 Calories per pound of infant's weight Second 3 months . 85 Calories per pound of infant's weight Third 3 months . . 80 Calories per pound of infant's weight Fourth 3 months . 70 Calories per pound of infant's weight This means that a woman of average weight and sedentary occupation will require while nursing a baby as much food as a laboring man doing moderately heavy muscular work, i.e.y 3000 to 3500 Calories per day; while a woman at the same time employed in moder- ately active physical labor will need as much as a man doing severe muscular work, or from 3500 to 4000 Calories per day. Not only is there this marked increase in the energy requirement, but the construction of milk demands extra quantities of such important materials as protein, calcium, phosphorus, and even iron. Studies with cows show that the efficiency of milk protein for the produc- tion of a new milk supply is about 60 per cent. Such data 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 FOOD FOR THE ADULT WOMAN 9S 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 phosphoric acid, and 76 per cent in calcium oxide. In other words, the most marked increase as regards ash is in the calcium requirement. 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 general plan of diet suggested for the prospective mother 1 may be followed by the nursing mother and the dietaries for thin men and women ^ will be sug- 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 particular foods have specific effects upon the character of the milk. Any wholesome diet, ample in fuel and building materials, is suitable for good milk production. At the same time it must be borne in mind that the mammary glands are very sensitive to 1 See page 90. 2 gee pp. 59 and 87. 96 FEEDING THE FAMILY nervous influences, and disturbances of digestion react very unfavorably upon the milk-secreting mechanism. Therefore 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 diges- tion. Excitement, worry, fatigue, chill, constipation, all react quickly and unfavorably upon the milk secre- tion, and must be carefully guarded against. Successful nursing demands a quiet, contented life, in which food is carefully chosen, and exercise, fresh air, and mental diversion 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, adapted to the fuel requirements of the nursing mother also engaged in physical labor, from one of the menus on page 92, is given below. 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. FOOD FOR THE ADULT WOMAN 97 A Day's Dietary for a Nursing Mother Also Doing Moderate Muscular Work Fuel Value : 3595 Calories Cost: f-ijf per 100 Calories Measure Weight Oz. Protein Calories Breakfast: Oatmeal Milk Sugar Whole wheat bread . . Butterine Cocoa III Stewed prunes .... Luncheon : Lentil and tomato soup Cold corned beef (with fat) Whole wheat bread . . Butterine Milk for tea Sugar for tea Doughnut Tea Dinner : Lamb stew with vegetables Whole wheat bread . . Butterine Custard pie Milk for tea Sugar for tea Lunch at Night: Bread Butterine Peanut butter .... Milk i^ cups f cup 1 tbsp. (scant) 3 slices f tbsp. f cup 5 prunes and juice i^ cups small serving 4 slices 1 1 tbsp. icup 2 tsp. I doughnut 1 cup 2 cups 4 slices i^ tbsp. 1 large piece icup 2 tsp. 3 slices I tbsp. 2I tsp. f cup 12.0 5.1 0.5 2.1 0.4 7.6 6.0 13-4 2.0 2.8 0.7 2.6 0-3 1.6 17.0 2.8 0.7 7.6 2.6 0.3 1.9 o.S 0.6 5-1 24 32 4 56 42 32 I 10 67 32 I 36 10 21 I 19 Total for day 463 » See Table III, Appendix, p. 358. 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 faithful 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. That the baby not only has a better chance of surviving the perilous first year, but of growing to manhood as well, was made evident in a hygiene exhibition recently 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- 98 Courtesy of the New York Milk Committee. Twelve, Tkirteeh— FOURTEEN Pounds FOOD FOR THE BABY 99 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 recently 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 Kfe. 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. If the milk supply is insufficient, it may be necessary to give addi- tional food, but this does not justify the discarding of the natural food so far as it is available. 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 sustenance. 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 indigestible food, or food that spoils her appetite so as to prevent suJfi- FEEDING THE FAMILY / . . w^ Quantities of food being taken ; must have regulai hours for meals and rest; get fresh air and exercise, 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 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 plenty 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 ahmentary tract responds better to the food. The stomach needs an interval of rest between meals, and the secretions of the ahmentary tract are strongly influenced by habit, pouring out more freely under the stimulus of regular feeding. The appetite is less fickle, too, when meals FOOD FOR THE SABY loi 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. Probably the best practice up to the time a child is three months old is to feed every three hours through the day and once at night — seven feed- ings in the twenty-four hours ; e.g. at six and nine a.m., noon, three, six, and nine p.m., and midnight. After the child is three months old no night feeding need be given unless the baby wakens. ' From the fourth to the sixth month there may be six feedings, three and one- half hours apart; six and nine-thirty a.m., one, four- thirty, and eleven- thirty p.m., and after that five feed- ings; six and ten a.m., two, six, and ten p.m. Suggested Schedule for Infant Feeding Number of Feedings Per Day Hours for Feeding A.M. P.M. First 3 months 4th, sth, and 6th months . . 7th, Sth, and 9th months . . 7 6 5 6, 9, 12 6, 9:30 6, 10 3, 6, 9,, 12 I, 4:30, 8, 11:30 2, 6, 10 If the baby is delicate, shorter intervals between feedings are sometimes prescribed, but never less than two hours ; if very sturdy, four-hour intervals are some- times 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 I02 fBEDlNG THE FAMILY 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 be made to amuse him. The healthy baby when awake will play quietly by himself and not get over-excited nor exhausted. J The Energy Requirements of the Baby The baby requires fuel for his life processes just as an adult does, but these processes are more rapid in the child than in the adult, so that even when lying quietly he needs more fuel in proportion to his weight than he will require later in life. From calorimetric studies it has been found that babies asleep in bed beside their mothers, who were awake, give off nearly two and one- half times as many Calories per pound as the mothers. An allowance of from 30 to 35 Calories per pound is necessary merely to keep a baby alive. FOOD FOR THE BABY 103 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 crjdng, kicking, pounding with their fists, and other movements. This means work, requiring a further supply of energy. A five-months-old baby has been 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 12 to 15 per cent of the Calories represented in his food may be used in this way. All the energy demands of the baby — (i) for the main- tenance of life processes, more rapid than in the adult, (2) for muscular activity, often great, and (3) for stor- age in growth — make the infantas total energy require- ment 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 third three months about 40 Calories per pound per day, and for the last three months of the first year about 35 Calories per pound per day. In the case of the breast-fed baby, we judge the feed- ing 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 I04 FEEDING THE FAMILY week; and when by quiet sleep, absence of fretfulness, and other signs of health he shows that his diet agrees with him. Artificial Feeding Unfortunately there will always be some babies de- prived more or less completely of their natural food. Mothers with the best of intentions sometimes fail to produce milk, or furnish an inadequate supply, and other causes may rob the baby of his birthright. For such children a substitute for the natural food must be pro- vided. Nothing can take the place of milk for this pur- pose, 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 digest the strange food. 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 fuel and building material. There are many special devices by which these objects FOOD FOR THE BABY 105 can be attained, and the wise physician adopts the one which seems best suited to the individual case. For home use, when there is no expert to direct the feeding, the simplest plan is to take rich, well-mixed, whole milk, containing from four to five per cent of fat, and prepare it according to the following scheme : ^ Scheme for Whole Milk Feeding During the First Year I St day I to 2 ounces of water every 4 hours. 2d to 4th days 3 ounces of milk, 7 ounces of water, 2 teaspoon- fuls of milk sugar ,2 divided into 7 feedings. Sth to 7th days 4 ounces of milk, 8 ounces of water, 3 teaspoon- fuls of milk sugar, divided into 7 feedings. Sth day to end Beginning with 5 ounces of milk, 10 ounces of of 3d month water, and i^ tablespoonfuls of milk sugar, increase the milk by ^ ounce every four days ; the water by ^ ounce every eight days ; the mUk sugar by ^ tablespoonful every 2 weeks. Thus on the i6th day give 6 ounces of milk, io| ounces of water, 2 tablespoonfuls of milk sugar, divided into 7 feedings ; on the 20th day increase the milk to 6| ounces, using io| oimces of water and 2 tablespoonfuls of milk sugar as before. Beginning of At the end of the third month the baby wiU be 4th month to getting approximately 16 ounces of milk, 16 end of 6th ounces of water, and 4I tablespoonfuls of milk month sugar, divided into 6 feedings. Now increase ^ Adapted from Holt and Shaw's Save the Babies, published by the American Medical Association. 2 Malt food (dextrimaltose, for example) may be substituted for part or all of the milk sugar. io6 FEEDING THE FAMILY the milk by ^ ounce every 6 days, reduce the water by | ounce every 2 weeks, using 4^ table- spoonfuls of milk sugar per day. If the food does not digest readily, barley water may be used instead of the plain water. It is made by cooking ^ tablespoonful of barley flour in the water for 20 minutes and cooling before adding to the milk. Beginning of 7 th At the end of the 6th month the baby will be month to end receiving about 24 ounces of milk, 12 ounces of 9th month of water, and 4^ tablespoonfuls of milk sugar daily, divided into 5 feedings. Now increase the milk by ^ ounce every week, reduce the water by | ounce every 2 weeks, and reduce the milk sugar to 3 tablespoonfuls per day. Midway between two of the morning feedings give from i to 2 tablespoonfuls of strained orange juice. This helps to keep the bowels in good condition and serves as a safeguard against scurvy when pasteurized milk is fed exclusively. If barley flour has not been used earlier, it may be advantageously introduced during this period, cooking i| tablespoonfuls of the flour with the water for the day, and gradually increasing to 3 tablespoonfuls. Beginning of At the end of the 9th month the child will be loth month receiving about 30 ounces of milk, 8 ounces to end of of water cooked with 3 tablespoonfuls of bar- I2th month ley flour, 3 tablespoonfuls of milk sugar, given in 5 feedings, and from i to 2 tablespoonfuls of orange juice between two morning meals. Now increase the milk i ounce per month, decrease the milk sugar i tablespoonful per month, and add barley gruel made with 3 tablespoonfuls of barley flour cooked in 8 FOOD FOR THE BABY 107 ounces of water. Continue the use of the orange juice, which may be increased to 3 tablespoonfuls if the bowels are not loose. After one feeding, the soft yolk of an egg may be fed warm, with a spoon, or a small piece of stale bread crust be given to chew. No other foods should be given during the first year. If the baby is much above average weight he may require a little more food than that provided in the pre- ceding plan. For the first eight months he should average one and one-half ounces of milk for every pound of body weight per day, and from then till the end of the first year from one and one-third to one and one-fourth ounces per pound per day. This insures adequate protein for body building. Dilution with water is the simplest means of making milk easier of digestion, but this brings down the fuel value of the food as taken by the baby, whose capacity is limited by the size of his stomach and the ne- cessity for time between meals to digest his food. Since cow^s milk is richer in protein in proportion to fat and carbohydrate than human milk, some of the fuel value can be regained by the addition of milk sugar throughout the nursing period, and after the first two or three months by barley or other cereal gruel, without increasing the difficulty of digestion. In fact, the use of barley water in the first three months is primarily to make digestion easier. The suggested schedule, outlined above, will supply fuel per day as follows : Io8 FEEDING THE FAMILY At the end of the first month At the end of the third month At the end of the sixth month At the end of the ninth month 30 Calories per pound 41 Calories per pound 43 Calories per pound 40 Calories per pound The addition of orange juice, barley flour, and egg yolk will raise the fuel value from the sixth month to the end of the nursing period to about 45 Calories per pound. Comparing these figures with the baby's actual energy requirements,^ it is noticeable at once that the food supply during the first month is far below what a normal baby gets when taking mother's milk, and is barely enough to supply his daily needs for energy, withHttle or no surplus for gain in weight. But it is absolutely essential that the baby digest his food if it is to do him any good, and it is unwise to overtax his stomach while he is getting used to the artificial food. Hence we must increase the strength of the feedings gradually and try to make up later for these early deficiencies. After the first two weeks if digestion is good, the fuel value might be raised by increasing the milk one-half ounce every three instead of every four days up to the end of the third month, after which the energy supply is adequate for normal growth. Very rapid increase in weight is to be regarded as a doubtful good, especially on artificial food; small, steady gains are less likely to be followed by nutritional disturbance later. Another way of raising the fuel value of diluted whole milk is by increasing the proportion of fat. Healthy 1 See page 103. FOOD FOR THE BABY 109 babies are very successfully fed by starting with milk which is richer than the whole cow's milk. A quart bottle of milk is allowed to stand five or more hours for the cream to rise, and then the richer milk from the top is removed ounce by ounce by means of a Chapin dipper, the required quantity thoroughly mixed, diluted as desired, and milk sugar or malt food added. This is known as the Top Milk Method. A series of progressive formulas, illustrating the use of this method, is given below. Top Milk Formulas I. From the 3d to the loth day : Top milk (upper 10 ounces) 3 ounces Water 11 ounces Milk sugar i tablespoonful 7 feedings of 2 ounces each II. From the loth to the 20th day : Top milk ( upper 10 ounces) 4 ounces Water 10 ounces Milk sugar i tablespoonful 7 feedings of 2 ounces each III. From the 20th day to end of ist month : Top milk (upper 10 ounces) 6 ounces Water 12 ounces Milk sugar 2 tablespoonfuls 7 feedings of 2^ ounces each IV. Second month : Top milk (upper 12 ounces) 8 ounces Water 13 ounces Milk sugar 3 tablespoonfuls 7 feedings of 3 ounces each no FEEDING THE FAMILY V. Third month : Top milk (upper i6 ounces) Water Milk sugar 7 feedings of 3! ounces each VI. Fourth month : Top milk (upper 16 ounces) Water MUk sugar Barley flour 6 feedings of 5 ounces each VII. Fifth month: Top milk (upper 20 ounces) Water Milk sugar Barley flour 6 feedings of 6 ounces each VIII. Sixth and seventh months : Top milk (upper 20 ounces) Water Milk sugar Barley flour 5 feedings of 7 ounces each From one to two tablespoonfuls of orange juice once a day, between two morning feedings ^ IX. Eighth month : Top milk (upper 24 ounces) Water Milk sugar Barley flour 5 feedings of 7^ ounces each Orange juice once a day, between two morning feedings 12 ounces 14 ounces 3 tablespoonfuls 14 ounces 16 ounces 3 tablespoonfuls I tablespoonful 18 ounces 18 ounces 3 tablespoonfuls I tablespoonful 20 ounces 15 ounces 3 tablespoonfuls 2 tablespoonfuls 24 ounces 13I ounces 4I tablespoonfuls 3 tablespoonfuls ^ With artificially fed babies orange juice is often given a month or two earlier than this. FOOD FOR THE BABY iii X. Ninth month : Whole milk 30 ounces Water 10 ounces Milk sugar 3 tablespoonfuls . Barley flour 3 tablespoonfuls 5 feedings of 8 ounces each Orange juice once a day, between two morning feedings These formulas will give approximately the following amounts of fuel per day : At the end of the ist month .... 35 Calories per pound At the end of the 3d month 43 Calories per pound At the end of the 6th month .... 45 Calories per pound At the end of the 9th month .... 43 Calories per pound For the remainder of the first year the feedings will follow the directions already given on page 106. No scheme of feeding can be followed slavishly. Babies show individuality in their capacity for food as in other respects; frail babies cannot be advanced to stronger food and larger quantities as fast as hardy ones. When in doubt, go slowly. Overfeeding is as harmful as underfeeding — so far as the digestive system is concerned, it is likely to be more so. When signs of indigestion appear, it is well to reduce the strength of the food temporarily. The two types of feeding schedule given illustrate the general principles of all successful artificial feeding : Regular meal times ; Gradual increases in strength and amount of food ; Giving less than the full energy requirement at first, and making up the deficiency later ; 112 FEEDING THE FAMILY Supplementing the iron in the milk by egg yolk (and orange juice) as the normal time of weaning approaches ; Giving orange juice to prevent constipation and possible scurvy ; Using barley flour made into gruel to promote ease of digestion, primarily in the early months; to add also to the food value of the diet in the later months. Care of the Baby's Food Only clean milk should be bought. Fresh milk is best 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. Nature provides fresh sterile milk for the young; if they are deprived of this, it is their right to have the best obtainable substitute. "Laboratory" and "certified" 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 and kept cold from the time of milking. Pasteurized milk must be used when there is danger of contamination, but pasteurized milk has changed somewhat by heating and if used exclusively should be supplemented as early as possible by orange juice, as a precaution against scurvy. Sometimes it is necessary to use boiled milk, to avoid all possible danger of bacterial poisoning, but if its use is long continued, it is even more important that some uncooked food be added to the diet. All milk must be protected from contamination at home ; kept in a cold place and covered. Food for the baby should be made up for one day at a time, each meal put into a clean feeding bottle (washed with hot soda FOOD FOR THE BABY II3 water and boiled in clear water for twenty minutes), stoppered and kept cold till used. Just before feeding it can be warmed in hot water. Any food left over should be thrown away. A thermos bottle should never be used to keep the milk warm. Germs are likely to grow in the milk under such conditions and it may make the baby sick. Nipples must be thoroughly scrubbed inside with soda water after use, and kept in a covered bowl of borax water, ready for use. If there is the least doubt about the quality of the milk, it should be pasteurized at home. The feeding bottles can be set in a wire rack and this in a deep sauce- pan, full of cold water. When the water boils, the pan is to be removed from the stove, but the bottles left standing in the hot water twenty minutes, after which they should be cooled as rapidly as possible with cold water and placed on ice. Use of Proprietary Infant Foods In spite of all one may say about the value of clean, fresh cow's milk, properly prepared, for the baby, the mother's faith is often shaken by glowing advertisements of patent infant foods and she is tempted by their con- venience to give credence to their flaunted virtues. In composition they differ widely, some of them consisting 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 sugar and baked wheat flour, to be used with water but requiring cooking ; and a large group made chiefly from 114 FEEDING THE FAMILY wheat or barley flour, sometimes simply baked and sometimes 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. It becomes evident at once that such foods cannot be used intelligently without information as to their com- position. It is impossible to make the necessary adap- tation of food to the growth of the individual baby simply by following directions on the label of a box of food. Those not requiring the addition of milk are to be criticized because they deprive the baby of fresh food, and because they often contain but little fat and ash, while they have a very high percentage of carbo- hydrate. This means that the baby may have his fuel needs met without getting proper building material ; the result is an increase in weight, often beyond the normal, as a result of the high carbohydrate feeding. 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 brittle bones, which have to bear too much weight for their strength. The foods designed to be used with milk serve the same useful purpose as plain barley or other cereal flour made into gruel, provided sufficient quantities of milk are used. Those which are dextrinized are conven- ient because they go into solution readily, but barley can be easily dextrinized at home with any reliable preparation of diastase, and usually at much less expense. FOOD FOR THE BABY 115 Food after Weaning If the baby has had the good fortune to be nursed by his mother, the problems of preparing other food for him are delayed normally until about the ninth month, and if the mother is strong and well and the baby thriv- ing, even to the twelfth month. Nursing after the end of the first year is seldom desirable unless to avoid wean- ing in hot weather. The quality of the milk is apt to deteriorate, and tlie baby begins to need iron in larger quantities than furnished in milk. He comes into the world with a special store of this precious material of growth — three times as much being found in his body in proportion to his weight as in the full-grown adult. But by the end of the first year, having tripled his original weight, and having received only a very small daily supply of iron in his milk, he needs to have this diet supplemented by such easily digested iron-bearing foods as yolk of egg and orange juice. The period from the ninth to the fifteenth month may be regarded as one of transition from mother's milk to other food. The best substitute with which to begin is cow's milk. This will not tax the baby's digestive tract as severely as it would have in the very early months of his life; still, it is a strange food, and care must be taken to make it easy of digestion. For this reason it should be diluted, pref- erably with barley gruel, and following the directions for artificial feeding of a baby one or two months younger (page 106). If possible, weaning should be done gradu- ally, giving at first one feeding from a bottle in place of Ii6 FEEDING THE FAMILY a nursing, and increasing the number of bottle feedings until the baby is entirely weaned at eleven or twelve months. This means less shock to his digestive system than if his food be suddenly changed entirely. When the baby digests the diluted milk well, the amount of gruel can be gradually decreased and a tablespoonful or two of strained cereal be given with a spoon twice a day. Most children can digest plain whole milk by the end of the first year if weaning has begun in the ninth or tenth month. If at all possible, weaning in the summer time should be avoided, as change of food is likely to cause some digestive disturbance which will be increased by the hot weather, and market milk in hot weather is seldom in quite so good condition as in cold. As soon after the eight or ninth month as the baby be- comes accustomed to taking cow's milk, he should be given from one to three tablespoonfuls of strained fruit juice once a day unless he has trouble with loose bowels. By the time he is ten months old he may have a soft egg yolk to give him iron, and a small piece of stale bread crust or zwiebach to chew, immediately after his milk feeding. 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,^ taking about one quart a day, one to three tablespoonfuls of strained, mild fruit juice once a day, the yolk of an egg ^ 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. FOOD FOR THE BABY 117 about once a day, two or three tablespoonfuls of thoroughly cooked, strained cereal daily (given at one or two meals), and a piece of stale bread, crisp toast or zwiebach to chew at least once a day. The milk pro- vides the great bulk of his food. The fruit juice is partly to keep his bowels in order, partly to help in accustom- ing him to other foods besides milk, and partly to give him more iron than the milk afiords. The cereal jelly serves as a good introduction to other foods which have to be eaten with a spoon, and also helps to keep a good proportion between the protein and the other fuel foods (fat and carbohydrate) in the diet. Cow's milk alone has too high a proportion of protein to be quite ideal for the slow-growing human child, although perfectly suited to the quick-growing calf. Toast or other forms of dry, hard bread give exercise to the jaws and help to develop good teeth later, while serving as a means of teaching the important habit of mastication. Nothing else is needed to keep the baby healthy and no risk of upset- ting his digestive tract should be run by adding other foods. Because a baby is not made violently ill by meat, tea, coffee, sweet crackers, and what not, it does not follow that he has not been injured. Even the perver- sion 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 business in life in his early years is to grow strong and develop good habits. This applies not only to eating, but to sleeping also. Regular hours, regular supplies of carefully chosen food, and plenty of Il8 FEEDING THE FAMILY fresh air mean not only the development of sturdy legs and rosy cheeks, but of a strong digestive tract able to stand the inevitable strains of later life. Good growth of muscles and nerves in this part of the body cannot be seen directly, but they count tremendously when the whole Kfe is in review. One year of good feeding at the beginning of Ufe 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 impulse, and 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 CHH^D The feeding of the baby during the first nine or ten months of its life is so important for its welfare that nature does not wilHngly entrust it to anyone but her- self. The sensitive, rapidly-growing digestive tract is confined to a single food material, ideally adapted to its needs. By the end of the year the digestive apparatus is ready for new tasks; teeth demand material for chew- ing, the body store of iron is used up, the mother's milk deteriorates, and there is every indication of readiness for more kinds of food in the diet. But we must not assume that the year-old child is ready for the diet of an adult. Statistics from cities where the mothers generally nurse their babies show that the mortality rises at the end of the first year, when the diet changes. The still delicate digestive tract is given tasks far too great for it; as if a year-old child were asked to chop down a tree or run a race ! The fundamental principle in child feeding is to develop the digestive powers gradually. The woes of the *' second summer'* and *' teething" are very largely the result of an unwise choice of diet. To boast that a fifteen-months-old baby ''eats everything" is not a tribute to its precocity, but to the ignorance or 119 t20 FEEDING THE FAMILY culpable negligence of its mother. With a carefully regu- lated diet, the second year is less perilous than the first. Feeding during the Second Year At the end of the first year the main part of the diet is cow's milk to the amount of nearly a quart a day. It should remain the chief staple throughout the second year, from three cups to a quart being given daily. Scientific study of milk has year by year emphasized its value as a food for growth ; its proteins contain nitrogen in ideal forms for cell and muscle building ; its fat carries some constituent essential to growth; its supplies of calcium and phosphorus are ample for bone construc- tion; its iron compounds although present in small amount are of high value ; its supply of other building and regulating ash constituents is liberal ; and its ease of digestion insures utilization of these valuable elements. To cut down the supply of milk after the period of in- fancy is a great mistake; even chickens grow larger and healthier when milk is made a part of their diet. The same care to have it clean and fresh should be taken as in the first year. During the first two or three months of the second year, cereals in the form of gruel may still be added to the milk, up to about one-third of its volume. But if whole milk can be digested readily, it is time to give the cereal food separately in the form of a ** jelly." This is made by cooking rolled oats, wheat, or other cereal very thoroughly (four to six hours), as for ordi- nary breakfast food, and then putting it through a fine FOOD FOR THE TWO-YEAR-OLD CHILD 121 strainer. From one-half an ounce to an ounce of dry cereal cooked in this way can be given in a day, in one or two meals. After two or three months of strained cereals, the finer varieties, such as farina and wheatena, may be given unstrained ; and, subsequently, any thor- oughly cooked cereal may be fed without straining. Thus the principle of gradually training the digestive tract to take care of solid food and of food containing some in- digestible material (cellulose) is carried out. Preference should be given to cereals made from the whole grain on account of their richer supply of ash. Oatmeal seems to be one of the most valuable cereals for growth, and, unless there is a tendency to looseness of the bowels, it can well be used three or four times a week at least. These cereal foods should be carefully seasoned with a very Uttle salt, and served with milk or thin cream, but no sugar. The use of the yolk of one egg daily, for the sake of its iron and phosphorus, should be continued. Once in a while the whole 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, as it tends to make the protein content of the diet very high. 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 122 FEEDING THE FAMILY 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 for growth. Before the middle of the second year the habit of taking some stale dry bread, zwiebach, or thoroughly dry toast can usually be established. The exact time depends on the state of development of the teeth, as the main purpose of this addition to the diet is to foster the habit of mastication, so important to the easy digestion of solid foods, which are to constitute a large part of the diet later on. If this principle is kept in mind about the breadstuffs, most questions in regard to suitable kinds will be answered. Those that offer no resist- ance to the teeth and jaws will be excluded. After the middle of the second year one green vege- table should be included in the diet every day. In the form of a dilute and thoroughly cooked soup, strained and mixed with milk, it is sometimes given by the end of the first year. But it is well to remember that the behavior of a new food in the alimentary tract is always problematical and it is unwise to experiment with more than one at a time. So in these early months of the second year, when new fruits and new cereals are being tried, one need not be in great haste to add vegetables. In any case, the amount given at first must be small (from one to three teaspoonfuls) ; it can be gradually increased as the child grows accustomed to it. The vegetable chosen must be mild in flavor and strained FOOD FOR THE TWO-YEAR-OLD CHILD 123 after cooking. Green vegetables are introduced for the sake of their ash constituents and care must be taken that these are not thrown away in cooking. Spinach is richer in iron than any other vegetable, and is the ideal one to add first. Green peas, asparagus tips, young beets and carrots (if thoroughly softened in cooking) are practical to strain and are usually well digested by children. The vegetable pulp (or pulp and juice) may simply be salted, or a little cream may be added. Often they are most acceptable when made into soup with milk, a little flour being used for thickening. To recapitulate, the foods from which the two-year- old's dietary should be built up are the following : Milk (the chief article in the diet) ; Well-cooked cereals (at first strained, later unstrained) ; Fruit juice or pulp (two or three kinds, small amounts) ; Yolk of egg (not over one a day) ; Vegetable pulp or juice (a few kinds, given especially in the second half of the year) ; Stale bread or its equivalent (for training in masti- cation). These foods, in suitable amounts and at prope times, will supply everything essential to good nutrition during the second year. Greater variety is not only unneces- sary, but positively harmful; partly because it tempts the child to discard milk, and partly because of dangers of indigestion. Milk should remain the staple food for some years to come, if the child is to build firm, thick bones instead of spongy, thin-walled ones, and real muscle instead of a padding of fat and water to cover 124 FEEDING THE FAMILY them ; and a great variety of food, especially if highly flavored, is almost certain to result in a refusal of the milk. Just as the alimentary tract is gradually trained to solid foods, so it must be gradually trained to variety in diet. 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 slippers on an eigh teen-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 sub- sequently fretful and restless — that is "bad temper" ! While personal traits develop early, and manifest Ukes and disHkes have to be met as best one can, it is a foolish notion that any whim should be allowed to con- 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 FOOD FOR THE TWO-YEAR-OLD CHILD 125 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 harm- ful 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 with them, to prepare these with care, so that appetite and digestion may be fostered, and to serve them with unfailing regularity. When children run about and play actively, they need to be guarded against eating when exhausted or excited, and also against any interference with their hours for rest and sleep. During the second year there should be four meals a day; the j&rst not earlier than 6 a.m., nor later than 7 : 30 ; the second at 9, 10, or 10 : 30, depending on tlie hour for the first; the third at i, 2, or 2 : 30 p.m. ; and the fourth at 5, 5 : 30, or 6 p.m. Care should be taken to offer water between meals. Thirstiness is often mis- taken for hunger. The food plan given below illus- trates the arrangement of a schedule for meals, and the 126 FEEDING THE FAMILY 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. Weighings should be made at frequent inter- vals, just as in the first year, as one test of the child's progress. An allowance of about 40 Calories per pound will cover the energy needs of the second year. Four protein Calories per pound will meet his need for nitrogen, and the selection of foods indicated will afford an abundance of ash constituents. A Day's Food Plan for a Child One and One-Half to Two Years Old Fuel Requirement : 900-1200 Calories Cost: i|-2 per 100 Calories 6 A.M. : Warm milk, i cup 170 Calories 8 A.M. : Orange juice or Prune pulp or Baked apple pulp 10 A.M. : Strained cereal jelly, 2-3 tbsp 25-50 Calories Top milk for cereal, 1-2 tbsp 25-50 Calories Warm milk to drink, |-i cup .... 125-170 Calories Stale bread 2-3 tbsp 10-25 Calories or Dry toast or Plain zwiebach 1-2 slices .... 50-100 Calories 2 P.M. : Yolk of egg 5° Calories Stale bread or 1-2 slices 50-100 Calories Dry toast J Sifted spinach ] or 2-3 tsp 2-5 Calories Sifted green peas J Warm milk to drink, i cup 170 Calories FOOD FOR THE TWO-YEAR-OLD CHILD 127 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, i cup 170 Calories 10 P.M. ; Warm milk to drink, i cup. (To be 170 Calories given only if the child wakens very early in the morning.) A Day's Dietary for a Child One and One-half Years Old Fuel Value : 1050 Calories Cost : if |i per 100 Calories Measure Weight Oz. Protein Calories Total Calories 6 A.M. : Warm milk .... 1 cup 2 tbsp. 3 tbsp. 2 tbsp. I cup I slice I yolk 1 slice 2 tsp. 1 cup 2 tbsp. 2 tbsp. isKce I cup 8.5 1.0 1.5 1.0 8.5 0.7 0.6 0.5 0.5 8.5 1.0 1.0 0.7 8.5 34 5 5 34 7 II 7 34 3 5 7 34 170 8 A.M.: Orange juice. . . . 170 12 10 A.M. : Strained oatmeal jelly Top milk (10 oz.) Warm milk .... Stale bread .... 12 30 s 50 170 50 2 P.M.: Yolk of egg .... Toast Sifted spinach . . Warm milk .... 300 56 50 2 170 5 : 30 P.M. : Strained oatmeal jelly Top milk (10 oz.) Stale bread .... Warm milk .... 278 20 50 50 170 290 Total for day 186 10^0 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 ; one of milk toast ; or with rice or some other cereal taking up milk readily (such as crisp com flakes). In this way adaptations can be made to the tastes of individual children without any real change in the character of the diet. Milk is milk whether 128 FOOD FOR CHILDREN THREE AND FOUR 129 drunk from a cup or eaten with a spoon as rice pudding or delicate pink junket.^ One whole egg per day can now be used, though the yolk is still the important part from the point of view of the child's body needs. It 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 tim- bale, etc. ; but never hardened by high temperatures or coated with fat as in frying. Often it will be incor- porated into the dessert ; and sometimes instead of the cooked desserts children relish an ''egg pudding," which is really an eggnog, the egg beaten up in milk and moderately sweetened. 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 ^ Excellent suggestions in the way of menus and recipes for young children may be found in " Food for Young Children," Farmers' Bul- letin No. 717, U. S. Department of Agriculture. K 13© FEEDING THE FAMILY 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 no sugar ; this should be reserved for desserts and not put on plain foods like cereals and bread, because sugar blunts the appetite so that less is likely to be eaten and children are apt to tire of them sooner. Some form of dry, rather hard bread can now be in- cluded in at least two meals a day, and for the sake of tooth and jaw development should never be neglected. Most crackers are too easily softened to serve the pur- pose 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 immaterial whether the bread be white or brown. Wlien there is danger of lack of iron, whole wheat preparations should be used. Fruit should be given at least once a day. If digestion is feeble, only the fruit juices 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), apple sauce, stewed Bartlett pears, baked or steamed banana, may be gradually introduced into the diet. All of these should be cooked with little or no FOOD FOR CHILDREN THREE AND FOUR 131 sugar and only two to four tablespoonfuls given at one time, according to the age and the strength of the child. A green vegetable of mild flavor and delicate texture should be made a regular part of the diet, given once a day; 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 vege- tables should not be used, nor cooked ones of strong flavor or coarse texture. Where great economy is' necessary, dried peas and beans may be used in soups. As with cereals, care in cooking is necessary to make green vegetables wholesome and attractive, and since in later life these become more and more a source of the indispensable ash constituents, pains should be taken to teach children to like them. At this period, how- ever, they only supplement milk, eggs, and fruit, and it is often better to be content if the child tastes a vege- table than 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 overcome many seeming aversions. Extra fuel can be provided by the addition of baked potato, which in general should be introduced as soon as the types of food already mentioned in suitable amounts do not give the full quota of energy for the day. Butter may also be used in moderate amounts on the bread. 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 132 FEEDING THE FAMILY 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 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 children for the third and fourth years is in round numbers 35 and 37 J 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 individual children will vary considerably from any standard be- cause 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 equal to the standards 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 he is really in FOOD FOR CHILDREN THREE AND FOUR 133 need of food, he will eat plain bread ; if not, such food will not tempt him to overeat merely to please the palate. In no case should food be offered except at mealtime, but water should be given now and then between meals. The food plan and dietary given below illustrate the practical working out of the principles discussed above. A Day's Food Plan for A Child Three to Four Years Old Fuel Requirement: 1 100-1400 Calories Cost: 1^-2 i per 100 Calories 7 A.M.: .Orange juice or prune pulp I .5-50 Calories or apple sauce J ', Well-cooked cereal 50-75 Calories Top milk, 2-4 tbsp 50-100 Calories Milk to drink, i cup 170 Calories Toast ] or 1-3 slices 50-150 Calories Dry bread . Milk, I cup 170 Calories Bread and butter, i slice 5o~75 Calories Milk or Milk soup with 1 >-> i • ^ ^-i • • ^ \ .... I ',0-200 Calories vegetable juice or pulp J '^ Egg, soft cooked 60-80 Calories Sifted green vegetable, as spinach, asparagus tips, peas, 1-2 tbsp. . . Buttered stale bread, 1-2 slices 1 10 : 30 A.M. 2 P.M. 5 :30 P.M. : or Zwiebach Plain custard or junket | or cereal pudding J Bread and milk or Milk toast or Cereal and milk 5-15 Calories 75-150 Calories f-fcup 100-200 Calories 200-300 Calories Mild cooked fruit, as baked apple, stewed pears, steamed (and warm) mashed banana 25-150 Calories 134 FEEDING THE FAMILY A Day's Dietary for a Child Three to Four Years Old Fuel Value : 1300 Calories Cost : 15^ per 100 Calories ' Measure Weight Oz. Protein Calories Total Calories Breakfast : 7 A.M. Prune pulp . . Wheatena . . . Top milk (10 oz.) Toast .... Milk to drink . . • • 1 tbsp. fcup 2 tbsp. I slice |cup fcup I cracker fcup I egg I slice I slice I tsp. fcup icup icup fcup I slice I tsp. I tbsp. 0.7 3.0 I.O 6.4 6.4 0.2 5-2 1.8 0.5 0.7 0.1 2.8 2.6 2.1 6.4 0.7 0.1 0.5 I 6 5 7 24 24 2 16 25 7 7 12 6 9 24 7 I 50 125 Lunch: 10 : 30 A.M. Milk Soda cracker .... 325 125 25 Dinner: 2 P.M. Cream of pea soup Poached egg Toast . . . Bread . . . Butter . . . Tapioca cream • 150 100 70 SO SO 32 100 Supper : 5 :3o P.M. Steamed rice . . Top milk (10 oz.) Milk to drink . . Bread .... Butter .... Date marmalade . 402 66 100 125 SO 32 50 423 Total for day 183 1300 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 parents 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 135 136 FEEDING THE FAMILY even know what a normal child really is. And one oi 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. All through childhood weighing should be done at frequent intervals and tables of weight and height of normal children con- sulted. (See Appendix, pp. 431-433.) Due regard should also be given to such other evidences of good health as sound sleep, reasonable appetite, absence of peevish- ness, firm flesh, and rosy skin. And while fresh air, wholesome exercise, and plenty of rest must always be counted as factors in good nutrition, suitable food re- mains the most fundamental thing in the physical progress of the child. Feeding during the fifth, sixth, and seventh years differs Httle 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 extra fuel. 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 FOOD FOR CHILDREN FIVE TO SEVEN 137 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 quahty, ice cream purchased outside the home 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. Icecreams 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. 138 FEEDING THE FAMILY Raw fruits, except in the form of juice, should be in- troduced into the diet cautiously. Perfectly ripe pears, peaches, and grapes, free from skins and seeds, are the best to experiment 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 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. Green vegetables 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. Potatoes should always be mealy. Baking is the most desirable 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- FOOD FOR CHILDREN FIVE TO SEVEN 139 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. 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. With milk freely supplied and an average of one egg a day, there is no call for the introduction of meat into the diet until after a child is seven years old, and, on the other hand, there are several good reasons for with- holding it 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 putrefaction 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, ^vhile kittens fed largely on meat are Hable 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 disappear and meat protein is no better for growth than milk protein, the ad- vantage is decidedly with the milk rather than the meat. Another reason for withholding meat is that it naturally tends to displace milk on account of its higher flavor, and meat is much poorer in ash constituents than 140 FEEDING THE FAMILY milk, being totally deficient in calcium, of which milk is the most important source. 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 seriously interferes with the utili- zation 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. Meat broths are of course merely stimulating, and their only possible virtue in the ordinary child's dietary is to induce the eating of cereals or vegetables which may be cooked in them, and this can usually be accomplished in some other way. They almost inevitably limit the amount of milk taken, and therefore should be reserved till the child is older, his need of materials for growth less pronounced, and his total capacity for food greater. The average weight of normal children for the fifth, sixth, and seventh years and the energy requirement per pound of body weight per day is, in round numbers : FOOD FOR CHILDREN FIVE TO SEVEN 141 Energy Requirements for Fifth, Sixth, and Seventh Years Year Weight in Pounds Calories per Pound Fifth Sixth Seventh 41 45 50 35-37 34-35 32-34 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 excess of the actual requirement. 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 or 10 : 30 ; a substantial dinner at i or i : 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 no child should be permitted to go to school without break- fast. 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 diges- tion, 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 a surplus for growth, he cannot afford to miss break- fast with the hope of making good the loss later in the day. Numerous studies of school children show that no 142 FEEDING THE FAMILY breakfast 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 simplest character ; a slice of bread and butter, a glass of milk and a cracker, or a bowl of cereal and milk being quite suffi- cient. 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 ser- vice in extending the practice where it is not in vogue.^ 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 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 ^ For information on the school feeding movement, see School Feeding: Its History and Practice at Home and Abroad, by Louise Stevens Bryant. FOOD FOR CHILDREN FIVE TO SEVEN 143 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: 1 400-1 700 Calories Cost: 4^-ili per 100 Calories Breakfast : Orange 7-7 : 30 A.M. or Baked apple 50-100 Calories or Prunes Well-cooked cere^ 50-100 Calories Milk 150-200 Calories Dry toast or stale bread . . . 50-100 Calories Butter or Cream 25-50 Calories or Bacon fat , 10-10 130 A.M. Milk .... 125-175 Calories Bread 50-75 Calories Butter . .^ 25-50 Calories Dinner : Soft cooked egg 50-75 Calories i-i : 30 P.M. Mashed or sifted vegetable, as spinach, peas, beans, carrots . 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 Supper : Cereal with milk 5 : 30-6 P.M. or Cream soup or Milk toast or Bread and milk Stewed fruit, custard, or junket, with or without stale sponge cake or plain cookies .... 100-200 Calories 150-300 Calories 100-200 Calories 144 FEEDING THE FAMILY A Day's Dietary for a Child Five to Six Years Old Fuel Value: 1608 Calories Cost: |-i^ per 100 Calories Measure Weight Protein Total Oz. Calories Calories Breakfast : 7 : 30 A.M. Baked apple, without sugar I apple 4.0 I 100 Oatmeal ...... ^cup 4.0 8 50 Milk to drink .... f cup 6.4 24 125 Milk for cereal .... ^cup 1.2 5 25 Toast 2 slices I.O 14 100 Butter^ . ^ tbsp. 0.2 50 450 10 : 30 A.M. : Milk f cup 5.1 19 100 Soda crackers 2 crackers 0.4 5 50 150 Dinner: 12:30 P.M. Split pea soup . , . . f cup 6.0 26 100 Croutons • (toasted) 27 croutons 1.4 14 100 Spinach h cup 4.2 4 33 Bread 2 slices 1-3 14 100 Butter 1 h tbsp. 0.2 50 Stewed prunes .... 6 small 2.8 2 100 483 Supper : S : 30 P.M. Baked potato I medium 3-0 II 100 Bread 2 slices 1-3 14 100 Milk f cup 6.4 24 I2S Creamy rice pudding . . icup 44 24 200 525 Total for dav 209 1608 * If not over 24jif per pound; otherwise oleomargarine. 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 pre- ceding 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 retribution, 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 development 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, as the diagram below plainly shows. We attend to his cloth- ing and shelter — how much more important to see that he has proper food ! During the school years no such reserve of fuel is carried in the tissues as we find in the case of adults. A grown man can go three or four days without food and L 145 146 FEEDING THE FAMILY no important tissue or organ will suffer harm, but a growing child needs his proper amount of food at proper intervals every day, or he runs the risk of malnutrition Pounds 140 120 100 €0 40 20 y Boys &irl« Tmtb 2 4 6 e 10 12 14 16 Chart Showing Normal Growth of Boys and Girls from Birth to the Sixteenth Year and a stunted body in consequence. Too much em- phasis cannot be put upon the importance of establish- ing a regular meal schedule and of forbidding food at all FOOD FOR CHILDREN EIGHT TO TWELVE 147 other times. Irregularity is one of the commonest errors in child feeding. 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 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 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 ! 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 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 148 FEEDING THE FAMILY early life when the sensibilities are keenest. An acci- dent at the table with humiliating consequences, an un- 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 childhood to prevent such misfortunes. Table con- versation should deal with topics other than food, and when disturbances arise at the table eating should be stopped until tranquillity is restored. Food taken in grief or anger has a poor chance of fulfil- ling 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 decided improvement in the quantity of food taken. It is worth while to take thought as to how to keep children'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, FOOD FOR CHILDREN EIGHT TO TWELVE 149 full-flavored porridge is less likely to be tired of. By the eighth year, raw fruits can be used more freely, only 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 steriHze them, then cooled and packed in jars for future use. Figs are best stewed in a httle 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, thoroughly cooked, green vegetable, and one should be provided, if possible, every day. Raw vegetables should not be made a regular part of the diet before the tenth or the twelfth year. Pains should be taken to cook ^ The significance of the ash constituents of food was discussed in Chapter I. I50 FEEDING THE FAMILY 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. By the time a child is eight or nine years old, meat may be 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, as 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 these should never be given between meals. Not only candy, but the delectables of the soda fountain and ice cream parlor, are entirely out of place except at the end of a regular meal. 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 beginning of a meal ; and it is not only likely to dis- turb the normal appetite, but seriously to upset diges- tion 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 concentrated to be an ideal food, but 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 confec- Always Hungry FOOD FOR CHILDREN EIGHT TO TWELVE 151 tions from chocolate and nuts are too difficult of diges- tion. Plain sweet chocolate is a good substitute for candy and so are the sweet fresh and dried fruits. Gin- gerbread and plain cookies also satisfy the taste for sweets, and ice creams and ices can be used more and more 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 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, crackers, or milk are best. Mild fresh fruits are allow- able if the child is well and strong. 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 152 FEEDING THE FAMILY the well-to-do because the single school session often extends beyond what should be the dinner hour. The luncheon of the school child, therefore, deserves special consideration. Where the school authorities give it no attention, the children usually take their food from home. In this case they lose the advantage of warm food in promoting easy and rapid digestion, and their minds are not so clear for the afternoon 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 selec- tion of food, so tliat 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 housewife 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 jelHes are also desirable. Sandwiches of raisin or date bread without other filling than butter wiU help to give variety. FOOD FOR CHILDREN EIGHT TO TWELVE 153 2. Fruit is appetizing and carries weU. 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. Tomatoes are juicy enough to take the place of fruit for the older children. 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 dozens of rural schools shows that it results in improved physical condition of the pupils. When 154 FEEDING THE FAMILY they leave home early in the morning, travel a consider- able 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 development 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 sufiferer, and the painstaking work of the school lunch supervisors to secure wholesome and adequate noon FOOD FOR CHILDREN EIGHT TO TWELVE 155 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. 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 sweet dishes ; milk or cocoa should always be obtainable. A week's menu as actually served by the School Lunch Committee of the Home and School League in Philadelphia is given below : Weekly Menu in School with Penny Lunches and Five-cent Noon Dinner Monday : (i) Baked beans and roll, 5 j^ (2) Cocoa or milk, 2 ^ ; crackers or ice cream, i ^ Tuesday : (i) Vegetable soup and roll, 5 ^ (2) Same choice as Monday- Wednesday : (i) Creamed beef on toast and roll, 5 ^ (2) See Monday. Dates i ^ Thursday : (i) Macaroni with tomato sauce and roll, 5 ff (2) See Monday. Jam sandwich, i i. Friday: (i) Creamed salmon and roll, 5^ (2) See Monday The following interesting description shows the mech- anism of the service in the New York City schools : ^ ^ The School Lunch Service, Dept. of Education, The City of New York: Division of Reference and Research. Bull. No. 3. 1914. p. la 156 FEEDING THE FAMILY At 1 1 : 45 in each of the seventeen schools squads of picked pupils set up the portable tables in preparation for serving the lunch. The children come from their classrooms, form lines, usually in the interior play yards, and as they pass a given point take up a tray, spoon, and whatever other utensils are necessary. The line goes by the large containers of soup, which is dispensed in half -pint portions to the children. The rule has been to have each child purchase first a half-pint bowl of soup, after which he may purchase any of the other items prepared for that day. After buying the soup the child passes along the table on which the other foods are dis- played, choosing those which appeal to him. Behind these tables the picked pupils, in white gloves and aprons, and, in the case of the girls, caps, hand to the children the desired articles. At the end of the line the associate manager stands to receive as many pennies as there are items of food on each child's tray. The child carries his lunch to one of the tables which have been set for that purpose, where the food is eaten. After finishing the meal, the child takes the tray and soiled dishes to a designated place, where any remaining food is scraped into a pail and the bowls, trays, and utensils are neatly placed in piles ready to be washed. This affords an opportunity for a lesson in practical domestic science. Analyses of the foods served establish the actual food values which the children receive for their money : ^ Calories per Calories per Penny Portion Penny Portion Soups — Half -pint Green pea . . . Cream of barley Cream of macaroni Lentil White bean . . . JMacaroni and tomato Split pea 128 Com 91 120 American vegetable . 85 114 Scotch broth ... 85 113 Clam chowder ... 82 III 105 Foods Other than loi Soups Tapioca and tomato 91 Rice pudding ... 109 iQp. cit., page 12. FOOD FOR CHILDREN EIGHT TO TWELVE 157 Calories per Calories per Penny Portion Penny Portion Baked macaroni ... 90 Jam sandwich . . 228 Potato salad . 117 Cheese sandwich 250 Vegetable salad 77 Pot cheese sandwich 212 Lentil salad . 189 Prune sandwich . . 243 Beet salad . . 58 Apple jelly sandwich 240 Apple sauce . 109 Jelly tarts . . . 84 Egg sandwich 236 Spice cakes . . . 109 Butter sandwich 247 Vanilla cakes . . 29 Bread pudding 131 Prunes 180 Chocolate pudding 102 Dates 200 Baked beans . . . 168 Average . . . 155 Some of the typical trays of food purchased, none of which aggregates a cost of more than three cents, are shown here : Green pea soup ... 128 Vegetable soup . . . 85 Bread, 2 slices . . . 200 Egg sandwich . . . 236 Apple sauce .... 109 Rice pudding . . . 109 437 430 Cream of barley . . 120 Clam chowder . . . 82 Cheese sandwich . . 250 Butter sandwich . . 247 Chocolate pudding . 102 Jelly tarts . . . . 84 472 413 Macaroni and tomato . 105 Bean soup III Apple jelly sa,ndwich . 240 Bread, 2 slices . . . 200 Cocoa .... . , 100 Prunes 180 445 491 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 put on his digestive powers. The food plan given be- low will show the general t5^e of food to be chosen.^ 1 For further suggestions regarding school luncheons see " School Lunches," Farmers' Bulletin No. 712, U. S. Department of Agriculture. 158 FEEDING THE FAMILY 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 dinner 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 Hght lunch, then the dinner as outlined should 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. For the normal body weight of children during this period, the reader is advised to consult the tables giving weight in relation to height in the Appendix. A healthy child of eight years may be anywhere from 45 to 51 inches in height and weigh from 45 to 59 pounds, and in later years even more individual variation is possible. 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-^ 10-12 3-4 30-35 28-32 7S-IOO Calories FOOD FOR CHILDREN EIGHT TO TWELVE 159 A Day's Food Plan for a Child Eight to Ten Years Old Fuel Requirement: 1700-2000 Calories Cost f-i^j^ per 100 Calories Breakfast : Mild fruit, fresh, 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 50- 75 Calories Milk, plain or flavored with cocoa . 100-150 Calories Dinner : Soft co6ked egg or very small 12-12 : 30 P.M. portion of baked or broiled fish, lamb, chicken, qr bacon ^ . . 50-75 Calories Potatoes or Rice or Baked banana 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 Breads rice, or other nutritious ] pudding I or ^ j . 150-200 Calories Stewed fruit, with plain cake J Supper ; Cream soup 5 : 30-6 P.M. or MUk toast or Rice and milk or Baked potato and milk to drink Bread 50-100 Calories Nutritious pudding or stewed fruit, as figs, raisins, dates, apples . . 100-200 Calories 200-300 Calories i6o FEEDING THE FAMILY A Day's Dietary for a Child Eight Years Old Fuel Value: 1783 Calories Cost: ij-15 ^ per 100 Calories MEASXmE Weight PfiOTEIN Total Oz. Calories Calories Breakfast : 7-7 : 30 A.M. Orange (large) ^ orange 4.7 3 SO Oatmeal . . . 1 cup 6.0 12 75 Cream, thin . . 2 tbsp. 0.9 2 50 Milk f cup 6.8 25 133 Toast .... I slice o.S 7 50 Butter .... 2 tsp. 0.3 66 424 Dinner : 12 : 30 P.M. Egg timbale . . ^cup 5.6 32 125 Baked potato . . I medium 3.0 II 100 Asparagus tips 5 stalks 1.9 2 II Bread .... 2 slices 1-3 14 100 Butter .... 2 tsp. 0.3 66 Peanut butter if tsp. 0.4 12 66 Stewed pears . . ^cup 4.0 I 100 Sugar cookies . . 2 cookies 0.9 6 100 Milk ^cup 6.8 25 133 801 Supper : 5 : 30-6 P.M. Cream of bean soup f cup 3.9 22 150 Bread sticks . . 12 sticks 0.4 10 75 Cornstarch blanc- mange . . . |cup 5-4 18 200 Milk 5 cup 6.8 25 ^33 558 Total for day . 227 1783 FOOD FOR CHILDREN EIGHT TO TWELVE i6i A Day's Dietary for a Child Ten Years Old Fuel Value : 1900 Calories Cost : ij-i^ ^ per 100 Calories Measure Weight Protein Total Oz. Calories Calories Breakfast : Orange .... I large 9-5 7 100 Flaked wheat . . . f cup 6.0 13 100 Top milk (10 oz.) icup 2.1 9 100 Milk f cup 6.4 24 125 Toast 2 sUces I.O 14 100 Butter 1 tbsp. 0-3 50 575 Dinner: Hamburg steak . . I ball 1-3 41 75 Baked sweet potato I potato 4-5 9 150 Bread 2 slices 1.3 14 100 Butter I tbsp. 0.5 100 Creamed peas and carrots .... f cup 5-0 14 75 Bread pudding (with ; raisins) . . . . fcup 6.0 18 200 Milk fcup 6.4 24 125 825 Supper : Potato soup . . . f cup 6.3 22 150 Whole wheat bread 2 slices 1.4 16 roo Butter 1 tbsp. 03 — 50 Stewed apples . . fcup 5.0 I ICX) Molasses cookies 6 very small 0.7 6 ICX> 500 Total for day 232 igoo CHAPTER X FOOD IN ADOLESCENCE AND YOUTH With the introduction of meat and raw vegetables into the diet in the preceding period, the range of food ma- terials available for the child is practically the same as for the adult. In other words, any wholesome natural food may now be made a part of the dietary, in right amounts, at the right time, and in easily digestible form. Emphasis should still be placed on foods carrying sub- stances for growth, such as milk, eggs, cereals, fruits, and vegetables. 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. Inadequate 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 women 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, 162 FOOD IN ADOLESCENCE AND YOUTH 163 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 essen- tial. In addition to keeping out of the menu dishes which are decidedly difficult of digestion, or limiting them to occasional use under the most favorable cir- cumstances for taking care of them, there should be such supervision of the food eaten that a very one-sided or insufficient diet is impossible. 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 Uked, 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 1 64 FEEDING THE FAMILY 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. The vegetables which serve the same purpose as fruit should be used as freely as possible, especially in the dietary of growing girls who need a rich supply of iron. Salads are usually popular if daintily prepared, and become a very useful part of the high school girFs menu. They should consist of crisp fresh or cooked vegetables, fresh fruit, or eggs, served with a simple cream or oil dressing without high seasoning. Strong condiments have no place in the dietary of youth, and rich salads of meat or fish with a heavy load of mayon- naise dressing are a severe tax even on the sturdy adult stomach. Meat should be provided in moderate amounts, two to four ounces a day. This is a part of good education for adult life as well as a wise provision for this particu- lar period. As an addition to the protein content of the diet, cheese may now be used in such dishes as cheese fondue, macaroni or hominy baked with cheese, com- binations of rice, cheese, and tomatoes, or as a filling for sandwiches. These are good meat substitutes, and much less expensive 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 FOOD IN ADOLESCENCE AND YOUTH 165 cinnamon 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 little soft center, and served for breakfast or 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 mufhns, 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 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 capac- ity severely. It is possible to overstrain the stomach muscles by too great distention and thus lay the foun- i66 FEEDING THE FAMILY dation for gastric trouble when the nervous strains oi 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, 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 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 difiicult 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 or crackers, 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. FOOD IN ADOLESCENCE AND YOUTH 167 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 the Menu Bulletin of the Julia Richman High School in iSTew York City.^ 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 <^o.o5 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 2PO .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 ^ Op. cit, p. 17. i68 FEEDING THE FAMILY Calories Price Candy : Sweet milk chocolate, large bars .... 5cx) .05 Almond bars 600 .05 Assorted penny candy 100 .01 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. FOOD IN ADOLESCENCE AND YOUTH 169 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- 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 14-17 3 25-30 20-25 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 2500 to 3000 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, lyo FEEDING THE FAMILY 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 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 somewhat — 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: 1800-3200 Calories Cost: i-i|jif per 100 Calories Breakfast : Fruit 50-100 Calories Cereal 100-150 Calories Milk 100-200 Calories Bread 100-200 Calories Butter 50-100 Calories 500-800 Calories FOOD IN ADOLESCENCE AND YOUTH 171 Luncheon : Macaroni and cheese or Hot roast beef sandwich or Bean soup and crackers Cocoa or milk . . . Bread Butter Baked custard or Rice pudding or Baked apple 200-300 Calories 100-150 Calories 100-300 Calories 100-200 Calories 150-200 Calories 600-1200 Calories Dinner: Meat or Bean or lentil loaf and potatoes or Scalloped eggs Potatoes or Macaroni or Rice or Baked banana , Green vegetable, cooked . . Fresh fruit or vegetable salad Bread Butter Ice cream or Tapioca cream or Charlotte russe Milk or cereal cafe au lait 200-300 Calories 50-100 Calories 25-100 Calories 100-150 Calories 100-300 Calories 100-300 Calories 150-200 Calories 100-200 Calories 800-1400 Calories 173 FEEDING THE FAMILY A Day's Dietary for a Boy aged Sixteen Years Fuel Value : 3000 Calories Cost : i -li ji per 100 Calories Measure Weight Oz. Protein Calories Total Calories Breakfast : Banana .... Oatmeal Milk 1 large 2 cups i^ cups 2 small muffins 2 tsp. I tbsp. (scant) I cup 3 shces f tbsp. 1 cup 1 cup 2 small pieces 2 sHces |cup f cup 4 sUces 1 tbsp. f cup icup 2 tsp. 5.5 15.8 12.7 3-2 0.3 0.5 4.2 1.4 0.3 7.6 2.5 2.2 2.2 6.2 6.7 2.7 0.5 4.2 4.2 0.3 5 34 48 36 34 14 32 I 14 70 14 9 28 8 2! 100 200 250 275 70 Commeal muffins Butter Sugar . . . SO Luncheon : Macaroni and che Graham bread Butter , . . Cocoa III . , Stewed rhubarb Gingerbread I ^ ese 945 200 100 66 200 150 200 Dinner: Swiss steak . . . Mashed potatoes Stewed tomatoes Bread ...... 916 200 200 120 200 Butter Brown Betty . . . Milk 100 200 85 Sugar "^4 1139 Total for day . . 364 3000 See Table III, Appendix, pp. 358 and 370. FOOD IN ADOLESCENCE AND YOUTH 173 A Day's Dietary for a Girl aged Sixteen Years Fuel Value: 2350 Calories Cost: ii-i| ji per 100 Calories Breakfast : Orange Oatmeal Top milk (12 oz.). . . Whole milk . . . . Toast Butter Sugar Cereal coffee . . . , Luncheon : Corn chowder . . . Date and cheese sahd- wich Cocoa I ^ with whipped cream Baked apple .... Dinner: Broiled Hamburg steak . . . Brown sauce . . Baked potatoes . Stuffed peppers ^ Banana salad . French rolls . . Butter. . , . Washington pie Cereal coffee (^ mi Sugar . . . Uk) Measure large cup cup cup slices tbsp. tbsp. (scant) cup 3 triangles 3 in. X 3^ in. X4 in. icup I small I large cake 3 tbsp. I medium I small 1 serving 2 small I tbsp. piece 3 in. X3in. X I in. 1 cup 2 tsp. Weight Oz. 4-7 7.9 3.0 5.1 i.o 0.5 o.S 6.6 3-0 7.0 3.2 2.6 1.7 3-0 2.6 3-0 1.9 0.5 2.1 8.0 0.3 Protein Calories 3 17 10 19 14 I 24 27 82 7 II 9 13 18 21 5 Total for day 298 ^ See Table HI, Appendix, pp. 358 and 424. 174 FEEDING THE FAMILY 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 ofifered 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 nervous system grows stronger, and that fine working machine — the adult man or woman — comes upon the scene. The influence of active and sedentary Ufe 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 and apple pie, provided they are sufficient in amounts to cover his fuel needs. Outdoor life and fresh air are sauce to his appetite and tonic to his diges- tion. On the other hand, the young bank clerk, sitting FOOD IN ADOLESCENCE AND YOUTH 175 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 do not foster keen appetite. Girls at sedentary occu- pations are more liable to suffer from the blunting effect on appetite than boys, and are tempted to eat foods of high flavor, like pickles and candy, with little regard to their after-effects. But the simple, nourishing food already suggested 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 commerical concerns realizing the relationship between good feeding and efficiency in their employees, and estabUshing their own lunch rooms, with experts in charge to provide good food at a moderate price. Very often, however, the boy or girl must patronize some public restaurant, and here we have as yet little guarantee as to quality of food and no guid- ance as to what to choose. Those lunch rooms which provide plain, clean food under sanitary conditions, but without 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 176 FEEDING THE FAMILY home.^ But the individual must still decide for himself what shall constitute 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 organ- ism. Similarly, a serving of baked macaroni and cheese, with its accompan3dng bread and butter, as the main part of the luncheon would be preferable to one of mince pie, though the cost of fuel value may be the same.^ Most young people need from 750 to 1000 Calories for luncheon, the exact amount depending, of course, upon many factors — the kind of breakfast, the size and 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 regu- lar meals, each fairly substantial. Some examples of simple luncheons in which the cost of the food materials at retail is about one cent per 100 Calories are given below. Inexpensive Luncheons I. Cream of tomato soup i cup 225 Calories Toast 2 slices 100 Calories Butter I tbsp. 100 Calories Rice pudding f cup 325 Calories 7 50 Calories ^Attention has already been called to the valuable publication by Gephart and Lusk on the Food Value and Cost of the portions of food served in Childs' Restaurants in New York City. This is worthy of study by all patronizing these restaurants. (Analysis and Cost of Ready to Serve Foods; Gephart and Lusk. American Medical Association, Chicago, 10 cts.) ^ Gephart and Lusk, op. cU. FOOD IN ADOLESCENCE AND YOUTH 177 II. Potato soup Croutons Cornmeal and pudding Sugar cookies raism f cup 15 cubes f cup 2 large 200 Calories 50 Calories 300 Calories 200 Calories 750 Calories II. Bean soup i^ cups 150 Calories Corn bread 2 in. X 4 in. X 4 in. 200 Calories Butter I tbsp. 100 Calories Chocolate blancmange ^cup 200 Calories with cream (thin) icup 100 Calories 750 Calories ^V. Cheese and nut sand- wiches 2 large 415 Calories Dates 10 200 Calories Buttermilk i| cups 135 Calories 750 Calories V. Milk I cup 175 Calories Date sandwiches 2 large 375 Calories Sliced orange (i) and banana (i) with 175 Calories Sugar J tbsp. 25 Calories 750 Calories VI. Grape nuts 7i tbsp. 250 Calories Sugar 2 tbsp. 100 Calories Milk if cups 300 Calories Banana I large 100 Calories Salted peanuts 12 nuts 50 Calories VII. Macaroni and cheese i cup Lettuce salad, French dressing small serving Graham bread 2 sHces 800 Calories 200 Calories 100 Calories 100 Calories 178 FEEDING THE FAMILY Butter I tbsp. Gingerbread 2 in. X 2 in. Whipped cream 2 tbsp. X2m. VIII. IX. X. loo Calories 200 Calories loo Calories 800 Calories Nut loaf, tomato sauce ^cup 200 Calories Graham mufl&ns 2 small 200 Calories Butter I tbsp. 100 Calories Lemon milk sherbet f cup 300 Calories 800 Calories Creamed dried beef ^cup 175 Calories Baked potato I large 150 Calories Baking powder biscuit 3 small 125 Calories Butter 2 tbsp. 200 Calories Sliced banana (i) with sugar (i tsp.) and thin cream (3 tbsp.) 175 Calories 825 Calories Cheese fondue f cup 200 Calories Brown bread 3 slices 150 Calories Butter I tbsp. 100 Calories Cocoa f cup 200 Calories Rice pudding (creamy) ^cup 200 Calories Whipped cream I tbsp. 50 Calories 900 Calories 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 la3dng the final stones in that foundation of physical health and strength which FOOD IN ADOLESCENCE AND YOUTH 179 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 modi- fied 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 knowl- edge 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 excusable. On the other hand, college students do not need expensive and elaborate fare ; and even the expert 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 i8o FEEDING THE FAMILY 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 $io per week, whereas they were paying $3.50! It is only by education and estabhshing 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- 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 FOOD IN ADOLESCENCE AND YOUTH i8i 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 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 l82 FEEDING THE FAMILY the dining-room managers. Nothing interferes with clear thinking more than constipation, and the seden- tary 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 as a part of their education the young people should be en- couraged to eat them. If they have been carefully trained in eating from their early years, this will be com- paratively easy, but there will be some who need con- stant encouragement to teach them rational eating habits. 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 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 FOOD IN adolp:scence and youth 183 higher expenditure of energy in proportion to size and the greater need for building materials, which are more costly than simple fuel. While we insist on economy in the use of food materials, it must be a wise economy which avoids waste, but recognizes 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 old 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. Poisons due to con- stipation and intestinal putrefaction insidiously under- mine the body resistance and may be the real cause of the wreck which follows a severe strain. The normal healthy body is wonderfully elastic, and admirably re- pays reasonable care. Though a man may not be ''old" at fifty — may still be vigorous in mind and body — it is likely that his 184 FOOD AFTER FIFTY 185 muscular activity has decreased from what it was at thirty. He is more content to watch a ball game than 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 observ- ing whether one is growing more than 10 to 15 per cent heavier than the normal weight for his height (see Tables V and VI, Appendix, pp. 429 and 430) is the best way for one to discover whether or not his food intake should be cut down. If the diet has been up to this time a well- balanced one, with meat in moderation, fruit and vege- tables 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. It must be remembered, too, that i86 FEEDING THE FAMILY if alcoholic beverages are drunk, the alcohol, besides its stimulating and other pecuHar effects, has a high fuel value ^ and must be counted in the day's food supply. Up to the age of sixty reductions in food are necessitated chiefly by lessened external muscular activity, and 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 proc- esses, 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 : Average Weight of Old Men and Women ^ Age in Years Men Pounds Women Pounds 60 70 80 90 144 139 135 127 125 ' 125 113 109 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 ^. Seven Calories per gram. 2 From Bulletin No. 223, Office of Experiment Stations, U. S. Depart- ment of Agriculture (calculated to pounds). FOOD AFTER FIFTY 187 thirty requires p.er 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 Hves are likely to be decidedly 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 breads tuffs, fermentation is likely to result. The sub- stitution of thoroughly crisp toast or zwiebach, 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 and the slight chemical change (principally conversion of starch to the more readily digested dextrin) being also advantageous. 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 i88 FEEDING THE FAMILY old people are fond of sweets and can eat considerable amounts to advantage. . 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 Uke, are much to be preferred, and then in modera- tion. 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 stimulants may be exerted in the form of beef and other kinds of broth. With the lowering of metabolism characteristic of senil- ity, coupled with sedentary Hving, 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 Httle which interferes with free elimination 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 life persists FOOD AFTER FIFTY 28$ 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 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. I90 FEEDING THE FAMILY 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 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 are usually a part of the aged person's menu. Moderation and sim- plicity are the passwords to health. A Day's Food Plan for an Elderly Person Age: 70-80 Fuel Requirement : 1 500-1 800 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 zwiebach 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 Rice, or baked or riced potato . . . 75-100 Calories Toast or zwiebach 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 7 5-100 Calories 5 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 FOOD AFTER FIFTY 191 Toast or zwiebach, or Huntley and Palmer 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 A Day's Food Plan for an Aged Person Age : 80 or over Fuel Requirement : 1 200-1 500 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 Zwiebach or toast 75-150 Calories Weak tea or coffee with hot rtiilk or cream 7 5-1 00 Calories 12:30 P.M. Cream soup or vegetable pur6e with croutons 100-200 Calories Broiled, baked or boiled fish, small serving 100-200 Calories or Cheese souffle or egg timbale Baked, riced, or mashed potato . . 50-100 Calories Stewed or baked fruit 1 100-150 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 Zwiebach 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 ^ 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. 192 FEEDING THE FAMILY A Day's Dietary for an Aged Person, Based on the Preceding Plan Fuel Value : 1614 Calories MEAStJRE Weight Protein Total Oz. Calories Calories 6. A.M. Buttermilk . . . f cup 7.4 25 75 ^ 75 8 A.M. Grape juice . . . ^ cup 3-5 — 100 Cream of wheat f cup 30 6 50 Milk (top 10 oz.) icup 2.1 9 100 Sugar I tsp. (scant) 0.1 — 16 Bread (toasted) . . 2 thin slices 0.5 7 50 Butter h tbsp. 0-3 50 Bacon 4-5 small pieces 0.5 13 100 Coffee with | cup milk and i tsp. sugar I cup 9 60 526 12.30 P.M. Bouillon .... f cup 5.0 13 IS Croutons (toasted) I doz. 0.7 7 so Minced lamb with gravy (2 tsp. flour) 2.4 (roast meat) 43 120 Baked potato . . I small 2-3 9 75 Butter i tbsp. 0-3 — 50 Tapioca cream . . f cup 2.8 12 100 410 4 P.M. Tea with i tsp. sugar I cup — — 16 Bread (toasted) . . 2 thin slices 0.5 7 50 66 FOOD AFTER FIFTY 193 Measure Weight Protein Total Oz. Calories Calories 6 P.M. Omelet (i egg, i tsp. butter) .... — — 25 100 Rice steamed with green peppers and tomato .... |cup 3.5 7 70 Baked squash (i tsp. butter) .... |cup 3-0 5 50 Pulled bread . . . I slice 0-5. 7 50 Coflfee jelly . . . ^cup 4.0 4 40 Whipped cream . . 2 tbsp. 0.9 2 100 Cereal coffee with J cup hot milk and I tsp. sugar . . I cup " 9 60 470 10 P.M. Hot malted milk 2 tbsp. in 1 cup water 0.6 9 67 67 Total for day . . 228 1614 CHAPTER XII D FOR THE FAMH^Y GROUP: MENUS Diversity of age ! 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 and to avoid dangerous combinations." To-day the profession of housewife demands knowledge of the needs of each member of her group and ability 194 FOOD FOR THE FAMILY GROUP: MENUS 195 to supply them under all sorts of 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 a watchful eye that understands the laws of health and holds them in the highest regard. They will repay patient mastery of the A B C's of nutri- tion a hundred fold. And some of the rewards will be immediate. One grandmother 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 confi- dence instead of uncertainty. We have to cope to-day with many new conditions upon which tradition throws no light. Package goods, ready-to-eat foods, hothouse products, strange wares from the ends of the earth — we must learn in these to recognize the old famihar food- stuffs (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 four 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 tq decide how much elaboration is worth while? 196 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 contem- plate. But routine (drudgery if you will) loses much of its depressing 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. The Construction of the Menu 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- FOOD FOR THE FAMILY GROUP: MENUS 197 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 in her mind, 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 ipS 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 lun- cheon and dinner, or for dinner and supper, as the case may be. As a general rule, digestion is better served by having 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. 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 attractive to sedentary women. For the active worker, especially if engaged out of doors, for whom food must be liberally provided, one or two hot dishes, a substantial dessert (as pie) and a hot beverage, with bread and butter, will give as satisfac- FOOD FOR THE FAMILY GROUP: MENUS 199 tory 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 furnishings 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 physio- logical. A green vegetable is a desirable part of any dinner menu, but two green vegetables offer no enhance- ment to each other and rarely add anything to the effect not already accomplished by one, while physiologically they serve the same purpose and one might just as well eat two servings of one as one serving of each of two kinds. Every duplication of this kind makes it so much the more difficult to provide the sauce of variety for the 200 FEEDING THE FAMILY next time. Potatoes, macaroni and rice are essentially equivalents in the menu, carbohydrate foods of mild flavor and of the same color and general texture ; hence they should be served one at a time and made to give variety to three days — never all, nor even two of them, at one meal. The same is true of any group of foods like sweet potatoes, cooked bananas, parsnips, and car- rots — all sweet carbohydrate foods so similar that they are both nutritively and artistically food equivalents, and where one values esthetic effects to be used one at a time. In this matter of food equivalents, minor adjustment to individual preferences can often be made through the use of leftovers. If macaroiii is the starchy dish to-day and John prefers rice, which was served yesterday, a leftover portion may be given to him ; he will be as well fed as if he ate the macaroni, and the cook will be relieved of the odd portion. Often the dessert furnishes the most energy of any single dish, amounting to as much as 300 or 400 Calories. 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 t^|^e 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 mealJIetter balanced. Lme*' ilJe Food Combinations fro • the Scientific Standpoint "What foods go well gether?" Many housewives seem to think that the^ are laws on this point as un- alterable as those of t t Medes and Persians, As a Jllil ^ qooqoq "S, 9 d d d d H ^ -Sib M « to 'i' tn FOOD FOR THE FAMILY GROUP: MENUS 201 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 in warmer regions. Altogether, man finds himself 202 FEEDING THE FAMILY better off with proteins, fats, and carbohydrates repre- sented in each meal, the carbohydrates where available (i.e. J in all but extremely cold cHmates) predominating. To see that these three foodstuffs are represented in good proportions in each meal is what is usually meant by serving a ''balanced" meal. We should go a step further and see that some foods furnishing iron, phos- phorus, and calcium and some giving ''ballast" in the form of cellulose are also included, and that the fuel value of the meal is approximately the same each day ; or, in other words, that we do 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 choco- late sauce — all dishes very high in fuel ; and to-morrow a bouillon, a lean fish, riced potatoes, sHced 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.^ ^^ods which are known to be difficult of digestion should not be massed in the same day, or more partic- ularly, in the same meal. Even though the family enjoys griddle cakes, pork chops, fried potatoes, and plum ^ 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 203 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 decreased, and 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 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 dough- 204 FEEDING THE FAMILY nuts, 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 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 FOOD FOR THE FAMILY GROUP: MENUS 205 together too concentrated foods. Acids taken with sweet milk tend to make the milk form hard curds in the stomach, which of course interferes with digestion. Catsups, pickles, and highly spiced or very sweet foods of all sorts are irritating to the deHcate walls of the alimentary tract and should be used sparingly by the robust, never by invalids, children, or any of deli- cate digestion. Food Combinations from the Esthetic Standpoint A balanced meal does not necessarily mean an artistic one. Graham bread and 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 favor- ites ; 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 coun- try as much as from lack of other familiar associations. Some one has said that acclimatization is largely a matter of getting used to the food, and certainly this is an important part. So we find a diet made up of cer- tain staples, Uke bread and butter and potatoes, wel- comed daily, along with variables of all sorts, which aelp to keep up the appetite as well as to insure the presence of the different 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 2o6 FEEDING THE FAMILY 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 whole- some, but a joy to all the senses. So long as beauty is a part of life, and the spirit more than meat, the house- wife 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 wel- fare to the eye and the palate. Not all have a natural gift for making happy 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. 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 FOOD FOR THE FAMILY GROUP: MENUS 207 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 facihties 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 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, or sherbet for dinner, and get a very different impression from the dishes. So the country housewife welcomes the little book of Apples in One Hundred Ways and others of its kind, 2o8 FEEDING THE FAMILY 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 fooHsh to spend time in making 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 flavored with onions, and perhaps onions served as a vegetable 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 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 FOOD FOR THE FAMILY GROUP: MENUS 209 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- berries ; apples are good with beef, and many combina- tions 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 surroundings from those in which they were first served ; in another 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 2IO FEEDING THE FAMILY 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 sur- veys," found the girls of a certain school refusing en masse a dessert served in a large baking dish. It was put away till the 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 t5^es of food are harmoniously represented, but not repeated, and in which food acces- sories, such as 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. Summer and Winter Menus Spells of hot weather have always been accounted disastrous to babies. The well-organized infant welfare FOOD FOR THE FAMILY GROUP: MENUS 211 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 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 212 FEEDING THE FAMILY 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 were not very well represented, the value of milk as a supplement to such a diet being quite unrealized. 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 Dothe- boys' Hall. To-day, with our vastly improved facili- ties 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 on as in cold weather, there is apt to be a lessened mus- cular 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 FOOD FOR THE FAMILY GROUP: MENUS 213 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 moderate allowance of lean meat, or its equivalent in eggs, cheese, milk, or other meat substitute ; vegetables very simply cooked, as baked potatoes, boiled onions; 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, tapioca, or frozen milk 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 tempta- tions, it is much better to take a plain soda or 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 warm, the problem of physical comfort in the summer time is 214 FEEDING THE FAMILY 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 total 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- 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 : FOOD FOR THE FAMILY GROUP: MENUS 215 Summer Menus Breakfast I Dinner Supper Raspberries Veal cutlet, brown Creamed macaroni Cooked cereal with sauce on toast cream Buttered beets Sliced tomatoes Toast Mashed potatoes Rolls Coffee Lettuce salad Tapioca fruit jelly Wafers with cream with whipped cheese cream Currant jelly II Dinner Lady fingers Breakfast Supper Fresh fruit Stewed chicken. Scalloped corn Cornflakes with String beans Baked potatoes cream Rice Stewed fruit Toasted muffins Red cabbage salad Gingerbread Coffee Shortcake m Breakfast Luncheon Dinner Fresh fruit Potato salad, may- Tomato soup Cooked cereal with onnaise dressing Saltines cream Graham bread Jellied tongue Toast sandwiches New potatoes with Coffee Fresh sponge cake parsley Chocolate Vegetable salad Junket ice cream, fruit sauce IV Breakfast Luncheon Dinner Fresh fruit Minced chicken on Vegetable soup toast Bread sticks 2l6 FEEDING THE FAMILY Cooked cereal and Bread and butter Salmon loaf, cream cream JeUy sauce Popovers Cocoa Peas Coffee Marguerites V BoUed potatoes Sliced cucumbers Fruit sponge with creamy sauce Breakfast Luncheon Dinner Stewed rhubarb Broiled sardines on Julienne soup Cooked cereal with toast Cold roast lamb cream Tomato and chive Currant mint sauce Mufl&ns salad Baked hominy and Coffee Brown bread and cheese butter Cottage pudding Fresh fruit with berry sauce Cocoa or tea VI Breakfast Luncheon Dinner Fresh berries Omelet with aspara- Cream of spinach Puffed rice gus tips soup Frizzled ham Creamed potatoes Croutons Graham toast French rolls, twice Nut loaf, cream Coffee baked sauce Macedoine of fruit Stuffed peppers Cocoa or tea 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 FOOD FOR THE FAMILY GROUP: MENUS 217 greater physical activity. This does not apply, of course, 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. 2l8 FEEDING THE FAMILY Some Winter Menus Breakfast Dinner Supper Stewed figs Baked ham, brown Corn chowder Oatmeal with cream sauce Toasted crackers Scrambled eggs Southern sweet Orange and date Golden comcake potatoes salad Coffee Spinach Bread and butter Apple pie pudding Coffee n Breakfast Dinner Supper Stewed dried Cream of com soup Cheese souffle peaches and Hamburg steak with Baked rice and raisins onions tomatoes Hominy with cream Mashed potatoes Hermits Bacon Dried Lima beans. Tea or cocoa Graham muffins stewed Coffee Steamed fig pudding, foamy sauce - III Breakfast Luncheon Dinner Cornmeal and cream Scalloped oysters Noodle soup of wheat, with Parkerhouse rolls Boiled mutton, jelly cream Celery sauce Baked sausages Stewed apricots Baked potatoes Waffles Ginger cookies Creamed onions Coffee Tea Cold slaw Chocolate bread pudding, creamy sauce FOOD FOR THE FAMILY GROUP: MENUS 219 IV Breakfast Luncheon Dinner Stewed prunes Minced lamb on Tomato bisque Wheatena and toast Boiled tongue, vin- cream Apple and nut salad aigrette sauce Boiled eggs Cream cheese Savory potatoes Toast Crackers Buttered parsnips Coffee Cocoa or tea V Luncheon Mince pie Breakfast Dinner Cream of wheat with Macaroni and cheese Potato soup dates Apple sauce Braised beef with Omelet with bacon Baking powder bis- vegetables Toast cuit Scalloped tomatoes Coffee Cocoa or tea VI Pineapple salad Pumpkin pie Breakfast Luncheon Dinner Sliced bananas Creamed oysters on Chicken soup with Shredded wheat bis- toast rice cuit Pickles or olives Beef loaf, brown Griddle cakes Jellied fruit with sauce Coffee whipped cream Mashed potatoes Cup cakes Creamed carrots and Tea peas Apple sauce Baked Indian pud- ding, 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 inartistic, 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 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 FOOD FOR THE FAMILY GROUP: COST OF FOOD 221 guide for the housewife 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 animals. But when grain has to be raised to feed cattle for beef, the cost of the animaFs food and care makes meat dear. In this country we have just recently felt the effect of the passing of the great western grazing fields in the increased 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, 222 FEEDING THE FAMILY olive oil from Spain — food products from almost every 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. FOOD FOR THE FAMILY GROUP: COST OF FOOD 223 The way in which goods are put up for the market will affect the cost. Package goods are more expensive 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 counterbalances 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 224 FEEDING THE FAMILY shape, color, flavor, and texture all play their parts in this appeal. Tender beef is preferred to tough, and, 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 tlie 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 five or six 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 eight or lo, preferably 12, cents a pound. A piece of corned beef at 18 cents a pound may have FOOD FOR THE FAMILY GROUP : COST OF FOOD 225 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 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 will not be as economical a purchase as the rump, 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 cheapest 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. If our food allowance is liberal and the fuel require- ments of our family low, we may indulge more freely in food materials for the sake of their esthetic appeal. But if we are trying to make every cent go as far as it will toward supplying actual nourishment, we must think, not only in terms of market conditions, but of nutritive value. As Professor Graham Lusk has so often earnestly pointed out, it would be a great ad- vantage to the purchaser if the manufacturers of all kinds of package goods would not only indicate the nature of the contents (as they are now required by law to do), but also say, "This package contains — Calories of which — are protein." The housewife, looking along the cereal shelf, would then see something like this : Q 226 FEEDING THE FAMILY Food Values and Cost of Cereals in Packages Total Calories Protein Calories Price of Package (Cents) Rolled oats Flaked wheat Cracked wheat Rice Shredded wheat Cornflakes Puffed rice Pufifed wheat 2475 2495 2325 1590 1551 1080 702 690 456 368 491 145 20s 66 64 102 10 13 10 9 13 10 10 12 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 dif- ferences in the amount of water used to fill up the can and in the amount of sugar in sweetened products. At pres- ent 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.^ ^ Cf. Canned Foods; Fruits and Vegetables. Florence R. Corbett. Teachers College Bulletin, No. 18. Also Net Weight of Foods Sold in Packages. ]. P. Street. Conn. Agr. Exper. Sta. FOOD FOR THE FAMILY GROUP: COST OF FOOD 227 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, nine cents, is the equivalent in fuel value of about one pound of lean round steak, costing over 20 cents, or of nine eggs, which would be cheap at 18 cents. Even more striking is the case of oysters. A quart of soKd oysters is equiva- lent in fuel to one quart of milk, but will cost from seven to eight times as much as milk at nine cents per quart. In the restaurant, a menu card indicating the fuel value of the different dishes would help the patron to choose his meal with better regard to his food needs and the state of his pocketbook. In the interesting and valuable study of 350 portions of food as sold to guests in Child s' Restaurants in New York City already re- ferred to (see page 176), the authors make the following summary of their investigations.^ Dishes are classified in the ordinary fashion as pastry, meats, soups, etc., and the first column of figures in the table gives the mean nutritional value for five cents for each class of dish. The succeeding columns state the particular dishes within the class which represent the maximum and minimum of fuel value for that group. ^ Adapted from Discussion of Results, pp. 60-61, Analysis and Cost oj Ready to Serve Foods. 228 FEEDING THE FAMILY Purchasing Power of Five Cents in Child s' Restaurants ^. ^ OH Pm H g Ocj ai a ^2 1 < M < Pastry 333.0 Beans 204.S Sand- 180.3 wiches Dairy 174.4 dishes Meats 174.1 Oysters 149.4 Eggs 140.7 Salads 135-9 Soups 116.0 Fruits 88.8 Highest of Class in Fuel Value go Lowest of Class in Fuel Value 91.8 133-7 78.1 63.0 83.0 18.6 65.6 99- S 36.6 Napoleon Boston baked Roast beef sandwich . . Milk crackers Lamb croquettes and mashed potatoes Oyster pie Plain omelet Potato salad Beef stew Baked apple with cream . . 453-6 307.6 357.8 317.1 291.4 220.4 231.5 217.0 251.0 196.0 Strawberry shortcake Boston "on the side" Sliced chicken sandwich Cream of wheat . . Deviled crab . . . Raw oysters . . . Poached eggs on toast Crab meat salad . . Tomato soup with rice Cantaloupe .... According to the above, 15 cents invested in a luncheon of beef stew, lamb croquettes and mashed potatoes, baked apple and cream, would give the fol- lowing return : Beef stew 251.0 Calories for five cents Lamb croquettes and mashed potato 291.4 Calories for five cents Baked apple and cream , . . 196.0 Calories for five cents 738.4 Calories for 15 cents On the other hand, selecting corresponding foods from those lowest of their class in fuel value, our 15 cents would only give about one-sixth as much fuel for the money spent : FOOD FOR THE FAMILY GROUP: COST OF FOOD 229 Tomato soup with rice . . , . 36.6 Calories for five cents Deviled crab 83.0 Calories for five cents Cantaloupe 12.1 Calories for five cents 1 3 1. 7 Calories for 15 cents The difference is nearly as striking when we compare these same foods on the basis of the portions actually served : Price of Por- tion Served (Cents) Total Calories Beef stew 15 15 10 641.4 918.4 393.7 Lamb croquettes and mashed potatoes . Baked apple with cream Total 40 1953.5 II Tomato soup with rice Deviled crab . . . Cantaloupe .... Total .... Price of Por- tion Served (Cents) Total Calories 77.5 386.6 37.4 45 501.5 In the first case, a man would get four-fifths of an ordinary day^s ration for 40 cents, while in the second case he would get only about one-sixth. These comparisons include, of course, cost of labor and service, and therefore differ from those which the housewife makes in purchasing raw materials, but they serve to show that cost offers no true criterion as to nutritive value. 230 FEEDING THE FAMILY For ordinary purposes of comparison, the loo-Calorie portion serves as a most convenient unit, and in the Appen- dix will be found tables (see pp. 332 and 355) classifying 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 one- third of a cent per 100 Calories. These are mostly cereal products, such as cornmeal, rolled oats, hominy, 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 half a cent per 100 Calories, including pearl barley and flaked wheat, dried beans, bread, and salt pork, while for from two-thirds to three-quarters of a cent we may extend our list to cornstarch, cornflakes, plain crackers, butter at 24 cents per pound, or oleo- margarine, lentils, macaroni, rice, tapioca, and dates. 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 one cent per 100 Calories we may add bacon, olive oil, cabbage, carrots, potatoes, peanuts, dried apples and prunes, and milk at six cents per quart. In the coun- try, where fruits and vegetables are comparatively cheap, it will be possible to have a greater variety of food materials than this without going beyond one cent per 100 Calories, but in the city fresh fruits and vege- tables will range from two cents per 100 Calories for FOOD FOR THE FAMILY GROUP: COST OF FOOD 231 apples, onions, and cabbage, to 20 or 30 cents for asparagus, celery, and choice melons. Most meats ex- ceed two cents per 100 Calories and choice cuts exceed four cents per 100 Calories. It is by study of these relative values and judicious combinations of the inex- pensive with the more costly foods that the housewife controls her expenditure and yet provides ^' meals that shall be at once gratifying, satisfying, and fundamentally right." Cost of Other Nutritive Factors 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,^ etc. ; and for base-forming and other regulat- ing factors in the diet. Sugar and oatmeal have the * See pages 21-25. 232 FEEDING THE FAMILY same fuel value per pound (1800 Calories) and can be bought for the same price. On the basis of Calories they are, therefore, equivalent. But a pound of sugar 3delds nothing but fuel, while a pound of oatmeal will furnish 300 of its Calories in the form of protein, and will also yield over half a gram of calcium oxide, or nearly the whole day's requirement for a man ; nearly four grams of phosphoric acid, 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. We shall realize what a very cheap food oatmeal is as com- pared 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 23.4 cents, estimating the market cost of the meat as 28 cents per pound. In buying 300 protein Calories from oatmeal for five cents we got 1500 additional Calories; from the meat for our 23 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 phosphorus, 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 them most cheaply. We shall find that the cheapest source of calcium is milk, and, as milk is also rich in protein and phosphorus, FOOD FOR THE FAMILY GROUP : COST OF FOOD 233 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 nine cents per quart, 20.7 cents. Since 300 protein Calories from beef cost 23.4 cents, we have saved 2.7 cents, or 11.5 per cent, on our investment for protein. At the same time we shall find that we have obtained over 1200 Calories in addi- tion 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 oxide, and over three times as much phosphoric acid. 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 supple- ment which we shall need to purchase calcium, phos- phorus, and iron, and probably Calories too.^ Protein foods are, as a rule, a more expensive item in ^ Data upon which these statements are based : Weight to Yield 300 Calories of Protein This Amount Will Yield Food Material Total Calories Calcium Oxide (Grams) Phosphoric Acid (Grams) Iron (Grams) Oatmeal . . . Beef, lean round (E.P.) . . Milk, whole . . lib. 0.78 lb. S.37 lb. 1800 555 1575 0.59 0.056 3.84 3.96 1.50 4.91 0.016 O.OII 0.005 234 FEEDING THE FAMILY the dietary than carbohydrates and fats. This is partly because we Kke 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 substi- tuted with real economy. The grains and breadstuffs can also be depended upon to a considerable extent, having about the same proportion of protein to total fuel value that we aim to have in a well-balanced diet, Table Showing the Cost of ioo Protein Calories from Different Sources Food Material Cost per Pound Cost of Por- tion Yielding IOO Protein Calories 1. Beans, dried navy . . , 2. Oatmeal 3. Cornmeal 4. Beans, dried Lima . . . 5. Bread, white 6. Salt cod 7. Milk (6 cents per quart) , 8. Cheese, American . . , 9. Peanuts, shelled . . . , 10. Macaroni 11. Mutton, leg 12. Beef, lean rump . . . . 13. Milk (9 cents per quart) , 14. Beef, lean round . . . . 15. Lamb, leg 16. Eggs (24 cents per dozen) 17. Halibut 18. Porterhouse steak . . . 19. Eggs (36 cents per dozen) 20. Almonds, shelled . . . $0.08 0.06 0.05 0,10 0.066 0.22 0.03 0.28 0.25 0.13 0.16 0.22 0.045 0.28 0.22 0.18 0.22 0.32 0.27 0.60 $0,019 0.020 0.030 0.030 0.038 0.044 0.047 O.OS3 0.053 0.053 0.053 0.063 0.070 0.073 0.076 0.077 0.080 0.092 0.116 0.158 FOOD FOR THE FAMILY GROUP : COST OF FOOD 235 i.e.y 10 to 15 per cent of their Calories in the form of protein. The dried legumes — beans, peas, lentils, peanuts — are always cheap sources of protein. We must bear in mind, of course, that proteins differ some- what in their nutritive properties, and that milk and eggs have a fuller quota of the proteins which promote growth than the cereals and legumes, so that we should not depend exclusively upon the latter in feeding chil- dren, nor, if we can afford to do otherwise, even in feed- ing adults. The table on page 234 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. 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 tliree 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, dried beans, costing half a cent per 100 Calories for fuel, are also the cheapest food for protein and for iron, next to the cheapest for phosphorus, and included in the cheapest 10 for calcium. Milk is a fairly economical source of fuel, protein, and phosphorus, exceptionally cheap for calcium, and dear only for iron, a condition compensated again in part by the fact that its iron is 236 FEEDING THE FAMILY I. Cost of Portions of Calcium-bearing Foods to Yield 0.7 Gram OF Calcium Oxide Food Material 1. Milk (6 cents per quart) . . 2. Buttermilk (6 cents per quart) 3. Milk (9 cents per quart) . . 4. Cheese, American .... 5. Cheese, cottage 6. Cabbage 7. Beans, dried navy .... 8. Beans, string 9. Peas, dried '. 10. Oatmeal 11. Onions 12. Celery 13. Carrots 14. Beans, dried Lima .... 15. Bread, graham 16. Eggs (24 cents per dozen) 17. Bread, white 18. Peanuts, shelled 19. Eggs (36 cents per dozen) 20. Cornmeal 21. Almonds, shelled .... 22. Salt cod 23. Beef, lean round .... 24. Halibut Cost per Pound $0.03 0.03 0.045 0.28 o.io 0.02 0.08 0.07 0.08 0.06 0.03 0.08 0.05 0.10 0.066 0.18 0.066 0.25 0.27 0.05 0.60 0.22 0.26 0.22 Cost of Por- tion Yielding 0.7 Gram of Calcium Oxide $0,026 0.029 0.039 0,040 0.046 0.046 0.057 0.060 0.075 0.076 0.087 0.126 0.127 0.158 0.215 0-3SI 0.364 0.390 0.526 0.543 0.570 1.419 3.341 3-367 specially good as far as it goes. Taking all these things into consideration, we must regard milk as inexpensive. This is particularly noticeable when we compare it with lean beef (round), which at 28 cents a pound is just as economical a source of protein as milk at nine cents per quart. The beef is not to be considered as a source of FOOD FOR THE FAMILY GROUP : COST OF FOOD 237 II. Cost of Portions of Phosphorus-bearing Foods to Yield 2.75 Grams of Phosphoric Acid Food Material 1. Oatmeal 2. Beans, dried navy .... 3. Peas, dried 4. Buttermilk (6 cents per quart) 5. Beans, dried Lima .... 6. Milk (6 cents per quart) . . 7. Bread, graham 8. Cornmeal 9. Cheese, American .... 10. Milk (9 cents per quart) . . 11. Cheese, cottage 12. Beans, string 13. Peanuts, shelled 14. Onions 15. Cod, salt 16. Bread, white 17. Raisins 18. Beef, lean round 19. Prunes 20. Eggs (24 cents per dozen) 21. Almonds, shelled .... 22. Celery 23. Halibut 24. Carrots 25. Eggs (36 cents per dozen) Cost per Pound $0.06 0.08 0.08 0.03 o.io 0.03 0.066 0.05 0.28 0.04s O.IO 0.07 0.25 0.03 0.22 0.066 0.12 0.28 0.12 0.18 0.60 0.08 0.22 0.05 0.27 Cost or Por- tion Yielding 2.75 Grams of Phosphoric Acid $0,042 0.043 0.047 0.077 0.079 0.080 0.084 0.103 0.119 0.120 0.137 0.146 O.171 0.172 0.195 0.209 0.271 0.282 0.341 0.344 0.426 0.433 0.438 0.450 0.516 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. The tables also show justification for the purchase of 238 FEEDING THE FAMILY III. Cost of Portions of Iron-bearing Foods to Yield 0.015 Gram OF Iron Food Material I. 2. 3- 4. 5- 6. 7. 8. 9. 10. II. 12. 13- 14. IS. 16. 17. 18. 19. 20. 21. 22. Beans, dried navy . . . Peas, dried Beans, dried Lima . . Oatmeal Beans, string . . . . Bread, graham . . . . Spinach Lettuce Raisins Cornmeal Prunes Beef, lean round . . . Onions Eggs (24 cents per dozen) Bread, white Carrots Eggs (36 cents per dozen) Peanuts, shelled . . . . Celery Milk (6 cents per quart) . Milk (9 cents per quart) . Almonds, shelled . . . Cost of Por- Cost per tion Yielding Pound 0.015 Gram of Iron $0.08 $0,038 0.08 0.043 O.IO 0.049 0.06 0.055 0.07 0.060 0.066 0.067 O.IO 0.104 0.08 0.113 0.12 0.123 0.05 0.150 0.12 0.171 0.28 0.202 0.03 0.205 0.18 0.235 0.066 0.285 0.05 0.291 0.27 0.3S3 0.25 0.429 0.08 0.472 0.03 0.556 0.045 0.821 0.60 1.025 some of the green vegetables, which in general are expen- sive sources of fuel and protein. String beans afford noticeably cheap calcium, iron, and phosphorus ; and spinach and lettuce compare very 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 evi- FOOD FOR THE FAMILY GROUP : COST OF FOOD 239 dent 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 36 cents per dozen they are, by the balancing of counts, cheaper than porterhouse steak and other expensive kinds of meat. We have also to bear in mind here that the pro- tein, iron, and phosphorus in eggs are considered un- usually available to the body, so that their use may be justified, even if they have strong rivals in the economic field. 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. They are especially valu- able in the diet for their pleasing flavors and for their tendency to counteract acidity in the blood or other body fluids. A food like oatmeal, cheap as a source of fuel, protein, calcium, phosphorus, and iron, cannot be used as the sole article of diet, because its tendency is to create an acid condition in the body, the alkalinity of its ash not being sufhcient to neutralize the acids formed from its proteins. So with oatmeal we need a fruit or a vegetable to supply this needed alkali in the best way. The same is true of other cereals, of eggs, meat, and other high protein foods, with the exception of milk. It must also be borne in mind that fruits are exceedingly useful in counteracting constipation and intestinal putrefaction. In the well-balanced diet, a40 FEEDING THE FAMILY therefore, fruits and vegetables have a real place, aside from their fuel and iron value, and at least as much money should be spent for them as for meat, eggs, and fish. CHAPTER XIV FOOD FOR THE FAMH^Y 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. The suggestions which^have been made in the preceding 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 nutri- tive 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 modify her table accordingly. She can also discover, if she will, whether she is getting a good return for the money invested in her table supplies. It is proposed, therefore, in this chapter, to describe a R 241 , 242 FEEDING THE FAMILY 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 the fundamental requirement in nutri- tion, we must have at the outset some idea of the fuel needs of our family group. 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 twelve, and a grandmother of ninety. From the data in preceding chapters we may estimate the requirements of the group as follows (assuming average body weights) : Fuel Requirements of the Family Member or Family Man . . Woman . Baby Boy . . Girl . . Girl . . Boy . . Woman . Total Age 40 37 I 3 6 9 12 90 Weight Pounds 154 125 21 35 41 S6 75 no Protein Calories ' 277-415 225-338 84-126 140-210 139-208 184-276 225-338 150 I 424-206 I Total Calories 2770 2250 840 1400 1394 1848 2250 1500 14,252 ^ Allowing 10 to 15 per cent of total fuel in the form of protein, which will be sufficient to cover all nitrogen requirements. FOOD PLANS AND DIETARIES 243 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 10,000 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, the requirement will range from 12,000 to 14,000 Calories as a rule. The exact 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. 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 the children — one quart apiece if possible Fruit juice for the one-year-old One kind of fruit for the others Cereal for all the children — preferably for all the family A mild green vegetable for the three- and six-year-olds One kind of green vegetable for all the others except the baby Eggs for at least the three younger children and some protein dish (meat or a meat substitute) for the rest 244 FEEDING THE FAMILY To this list may be added those staples which are likely to appear in every day's menu, such as bread and butter. An estimate can quickly be made of the fuel that will be supplied by these essentials of the diet. Milk (5 quarts for children, i for adults) Cereal for all Eggs (3 eggs and i yolk) Fruit and fruit juice Green vegetable Bread Butter Meat or meat substitute Calories 4050 600 260 525 225 1500 1500 800 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 key note. 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, w^hole- 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. FOOD PLANS AND DIETARIES 245 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 zwiebach 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 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, — a very important part of their education, for eating habits once formed are hard to break, and 246 FEEDING THE FAMILY good ones are a valuable hygienic and social 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 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 one or two tablespoons of orange juice (8 a.m.) and at ten o'clock both these youngest children will have their lunch : strained oatmeal jelly with top milk and milk to drink, — or milk modified with cereal gruel, — for the baby, a glass of milk and a piece of stale bread or hard cracker for the three-year-old. It is to be hoped FOOD PLANS AND DIETARIES 247 that the six-year-old will have a glass of milk and a cracker in the middle of the morning at school. Assuming that luncheon will be served for all the family except the two 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 the cream sauce only from the creamed chicken will be served on her toast. After the family luncheon the baby will have another meal (2 p.m.), consisting of milk, egg yolk, and possibly a Httle stale bread to chew; the three-year-old will at the same time have a soft-cooked egg, some toast, some strained 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, or milk modified with a cereal gruel; the three-year-old, cereal and milk, bread and butter, a little of the custard which is served with the apple snow for 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 24^ FEEDING THE FAMILY to arrange for baked potatoes for these two children's suppers, since potatoes on the half shell form part of the family dinner. Late in the evening (lo p.m.), the baby may require a bottle of warm milk, and the grandmother will enjoy a hot, nutritious beverage (such as hot milk, plain or flavored) and a cracker; but these meals entail 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 times during the day. Calculation of the Family Dietary 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 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 loo- 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 below : FOOD PLANS AND DIETAIUES 249 Family Dietary Number I Fuel Value: about 14,400 Calories Cost: if-2^ per 100 Calories Food Measukje Protein Calories Total Calories Breakfast : Milk for baby Milk for 3-year-old . . . Wheatena for 3-year-old ^ . Orange juice for baby . . Orange juice for 3-year-old Oranges for 6 Wheatena for 6 ^ . . . . Omelet for 6 eggs milk bacon Toast for 6 Butter for 6 Milk for older children . . Milk for coffee 2 and cereal . Sugar for coffee .... Coffee for adults . . . . I cup I cup 4 tbsp. 1 tbsp. 3 tbsp. 3 large 3I cups 4 eggs i cup 12 small pieces 10 slices bread 5 tbsp. 3 cups 3 cups 2 tbsp. (scant) 2 tbsp. icupj Icupj 5 cup 1 slice f cup 2 crackers 34 34 4 20 63 100 17 39 70 5 102 102 3 34 26 7 26 5 170 170 33 II 33 300 525 280 85 300 500 500 510 Sio 100 Lunches : 10 A.M. For baby : Oatmeal jelly Milk for jelly MUk to drink For 3-year-old : Milk Bread For 6-year-old : Milk Crackers 4027 16 170 127 50 127 50 540 ^ Cf . farina. 2 xhe 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. 250 FEEDING THE FAMILY Food Measure Protein Calories Family Luncheon (for 6) Creamed chicken on toast Baked bananas . . . Boston brown bread . Butter Rice pudding II ^ . . Milk for children . . Sugar for tea . . . Tea for adults . . . Afternoon Meals: 2 P.M. For baby : Egg yolk . . . . Bread Milk For 3-year-old : Egg Toast Butter Sifted pea pulp . . Rice pudding II ^ Milk S-30 P.M. For baby : Oatmeal jelly . . . Milk for cereal . . Milk to drink . . . For 3-year-old : Steamed rice . . . Milk for rice . . . Bread Butter Boiled custard . . Milk to drink . . . if cups 6 slices 6 bananas lo slices 5 tbsp. If cups 3 cups 2 tbsp. I yolk i slice I cup I egg I slice I tsp. I tbsp. i cup f cup 2 tbsp. ¥ cup I -I cup J i- cup I cup I slice I tsp. 144 30 50 5 72 102 I cup II 3 34 25 7 3 12 26 3 34 3 II 7 13 26 1 See Table III, Appendix, p. 383. FOOD PLANS AND DIETARIES 251 Food Measure Protein Calories For 6-year-old : Steamed rice .... Milk for rice .... Bread Apple snow .... Boiled custard . . . Lady fingers .... Milk to drink .... Family Dinner: Bouillon for 5 .... Baked halibut for 5 . . Egg sauce for 4 white sauce .... egg Potatoes on half shell for 4 potatoes butter milk Buttered string beans for 5 beans butter Bread for 5 Butter for 5 Tomato salad for 4 , . tomatoes lettuce French dressing . . . Apple snow for 5 . . . with boiled custard . . . Lady fingers for 4 . . . Night Lunches: 10 P.M. Milk for baby Hot milk Cracker for grandmother 2- cup icup 2 slices ¥ cup i cup 2 fingers § cup 3 cups 2ioz.(rawwt.) I cup I egg 2 very large 2 tbsp. i cup 2i cups I tbsp, 6 slices 3 tbsp. 4 medium 8 leaves 4^ tbsp.^ 2 cups if cups 8 fingers f cup I cup I cracker 6 17 2 13 10 26 63 366 57 56 23 42 3 65 40 Total for day 7^ tbsp. served ; 3 tbsp. lost on plates. 252 FEEDING THE FAMILY Comparing our totals with the estimated day^s re- quirements, we find that we have almost our full quota of fuel, and a very Kberal 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 possi- ble way. The adults will get their protein largely from the halibut, chicken, and eggs, supplemented by milk, cereals, and bread. Checking off the Est of essentials for the diet (see page 243) we find that we have used a little over six quarts of milk, nearly 600 Calories of cereal in the form of oatmeal and wheatena ; have sup- plied five eggs and one yolk in addition to those used in the egg sauce, apple snow, custard, and lady fingers; over 900 Calories in the form of fruit; 226 in green vegetables (string beans, tomatoes, lettuce, pea pulp) ; fully 1500 each in butter and bread; and a little more than 1000 in the halibut, eggs, and chicken. Hence, we have a good representation of the different kinds of food stuffs, so that without calculation we can safely say that the ash constituents are properly supplied, and the diet- ary shows that protein and total fuel are fully adequate. Thus, by following a simple general plan, and using our knowledge of food values to help in arranging an attrac- tive menu, we can get a good family dietary without great difficulty, if we do not have to count cost too closely. Cost of the Family Dietary The dietary just planned will probably cost from $2.50 to $2.85 per day, or from one and three-fourths to two cents per 100 Calories, depending upon the local- FOOD PLANS AND DIETARIES B55 ity, provided milk costs nine cents per quart and eggs about three cents apiece. With milk at six or seven 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 one and one- half cents per 100 Calories, but hardly for less. 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 scrap- ing ; 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 valu- able as sweet. Every Calorie thrown away either de- prives the family of nutriment which it needs or adds to the total cost of its food supply. At the table there is often much carelessness about leaving food on indi- vidual 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 children should be early trained to a sense of responsibility 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 ; consequently the table waste is often 254 FEEDING THE FAMILY great, but at the home table, where individual require- ments can easily be studied, there is little excuse for table waste. A food budget of $2.50 per day means $900 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. ^ 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 one and three-fourths to two cents per 100 Calories on their food in order to ha^^e money for decent clothing and shelter and any ''higher life" at all. Yet these fami- lies have need of being well nourished and wish to enjoy some of the esthetic pleasure of a well-set table. Sup- pose, for instance, that we wish to reduce the cost of the foregoing dietary to between one and one-fourth and one and one-half cents per 100 Calories, making a total cost of from $1.75 to $2.10 per day. In our first 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 255 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 may 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 the fresh. While the milk seems to occupy a large place, its value and economy has already been demonstrated, and as long as the average cost of the dietary is over one cent 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 expen- sive 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 essentials first laid out for this dietary (see page 243) and these possible changes, we may plan a second menu at lower cost,^ an illustration of which is given below. ^ The table in the Appendix showing groups of foods at different price will be helpful in this connection. See pp. 426-429. ^S6 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 Menu II Breakfast : Oranges (smaller) Wheatena with cream (top milk) 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 Luncheon : Creamed dried beef 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 dress- ing Apple snow with boiled cus- tard Lady fingers Dinner: Baked halibut, white sauce Potatoes on the half shell String beans, buttered Bread and butter Cold 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. FOOD PLANS AND DIETARIES 257 Family Dietary Number II Fuel Value : about 14,400 Calories Cost : ii-ii|if per 100 Calories Food Breakfast : Milk for baby .... Milk for 3-year-old . . Wheatena for 3-year-old . Orange juice for baby . . Orange juice for 3-year-old Oranges for 6 .... Wheatena for 6 ... Toast for 6 Butter Milk for older children . Milk for coffee and cereal . Sugar for coffee . . . Coffee for adults . . . Lunches : 10 A.M. For baby : Oatmeal jelly .... Milk for jelly .... Milk to drink .... For 3-year-old : Milk Bread For 6-year-old : Milk Crackers Family Luncheon (for 6) : Creamed dried beef II ^ on toast .... Baked bananas . . . Boston brown bread . Butter Rice pudding II ^ . . Measure I cup I cup 4 tbsp. 1 tbsp. 3 tbsp. 3 medium si cups 10 slices 5 tbsp. 3 cups 3 cups 2 tbsp. (scant) 2 tbsp. icupl I cup] I cup I slice 1 cup 2 crackers 3 cups 6 thin slices 6 bananas 10 slices 5 tbsp. i^ cups Protein CALORrES 34 34 4 14 63 70 5 102 102 3 34 34 7 26 S 212 36 30 so 5 72 ^ See Table III, Appendix, pp. 383 and 394. 258 FEEDING THE FAMILY Food Family Luncheon : Continued Milk for children . . . Sugar for tea .... Tea for adults .... Afternoon Meals: 2 P.M. For baby : Egg yolk Bread Milk For 3-year-old : Egg Toast Butter Sifted pea pulp . . . Rice pudding II ^ . . Milk 5 : 30 P.M. For baby : Oatmeal jelly .... Milk for jelly .... Milk to drink .... For 3-year-old : Steamed rice .... Milk for rice .... Bread Butter Boiled custard . . . Milk to drink .... For 6-year-old : Steamed rice .... Milk for rice .... Bread Chocolate blancmange Plain cookies .... Milk to drink .... Measure 3 cups 2 tbsp. I yolk \ slice I cup I egg I slice I tsp. I tbsp. i cup f cup 2 tbsp. ¥ CUp\ I cup/ icup icup I slice I tsp. 3 cup h cup 1 cup 2 slices \ cup 2 cookies I cup Protein Calories II 3 34 25 7 3 12 26 3 34 3 II 7 13 26 6 17 14 8 6 26 * See Table III, Appendix, p. 383. FOOD PLANS AND DIETARIES 259 Food Measure Protein Calories Total Calories Family Dinner: Baked halibut for 5 ... White sauce for 4 . . . . Potatoes on the half shell . String beans, buttered, for 5 Bread for 5 Butter for 5 Cold slaw for 4 .... Chocolate blancmange for 5 Top milk for blancmange . Plain cookies for 4 ... 21 oz. (raw wt.) 1 cup 4 halves 2 J cups 6 shces 3 tbsp. 2 cups 2^ cups 2 cups ID cookies f cup f cup I cracker 366 32 56 23 42 3 12 80 68 30 26 26 3 600 4cx> 556 200 300 300 200 1000 340 500 Night Lunches: 10 P.M. Milk for baby Cracto}f- grandmother 4396 127 127 25 279 Total for day 2106 14,414 The above dietary calculation makes it evident that the changes in the menu have not materially affected the fuel value of the diet ; all the items listed as essential to the family welfare (see page 243) have been included, so that a sufficient supply of ash constituents is assured, and the calculations also show that there has been no decrease in the amount of protein, though it is high enough that some reduction would not have been objec- tionable. The reason it remains high in spite of the fact that seven eggs used in the first dietary have been left out of the second — thus decreasing the cost con- siderably — is that a quart more milk has been used 26o FEEDING THE FAMILY and the creamed dried beef yields more protein than the creamed chicken, so that the final result is quite as satis- factory as if the seven eggs had been used. 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 omis- sion of the apples, is also in the nature of an economy, since fruits are always a relatively expensive source of energy. 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 cent per loo Calories, while the other dessert will cost about one and one-half cents per loo 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 one and one-half to two cents per ICO 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 from one to one and one-half cents per loo Calories FOOD PLANS AND DIETARIES 261 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 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 sub- stituted. Dietaries Costing One Cent per 100 Calories or Less If now we wish to reduce the cost of food to one cent or less 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 one- third of a cent to one cent per 100 Calories, and very sparing use will have to be made of meats and fresh or canned fruits and vegetables. In the family group under consideration, the children re- quire 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 relatively expensive building materials — protein and ash. 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 cent per 100 Calories. Milk at eight or nine 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 262 FEEDING THE FAMILY cost of the dietary is not under three-quarters of a cent per loo Calories. Sometimes economy can be effected by buying two grades of milk, the better reserved 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 nine cents a quart. When the dietary costs less than three-quarters of a cent per loo 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 cent per loo 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 in fuel to olive oil and costs much less. Dried fruits and vegetables must be very largely sub- stituted for fresh. Bananas are usually cheap, and at certain seasons so are apples and oranges. Other fresh frxiits must be purchased with care and only when their FOOD PLANS AND DIETARIES 263 cost is at its very lowest. Bananas may be regarded 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 difficulties usually arise from eating them too green or too fast. As they ripen, considerable starch is changed to sugar, so they have a higher flavor as well as greater digesti- bility when fully ripened. Baking the ripe banana in the skin, if properly done, produces a more succulent 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. The many and varied uses of apples 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 one and one-half cents per 100 Calories (dates for less than one cent), and their uses are many and varied. Dates, figs, raisins, and apples will make bread crumbs or flour and 264 FEEDING THE FAMILY 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 palat- able 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 sand- wiches ; or chopped dates, figs, and raisins may be com- bined. 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. 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 FOOD PLANS AND DIETARIES 265 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, onions, carrots, turnips, and parsnips. While tomatoes are expensive as fuel, they have almost as great value for flavor as onions. Man demands 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 an acceptable 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 most useful for flavor, but they lack the ash constituents and fuel value which the fruits and vegetables also contribute, and hence should not be exclusively depended upon. Too often children as well as adults make a breakfast of nothing but bread and coffee. Cereal and milk would be much more wholesome and *' staying." 266 FEEDING THE FAMILY 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 Uttle 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 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 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.^ 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- ^ Cheese and Us economical uses in the diet. Farmers' Bulletin, 487. FOOD PLANS AND DIETARIES 267 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 cent per 100 Calories, we shall find that we cannot afford much more than five quarts of milk if we have to pay seven or more cents per quart for it ; this will give a quart apiece for each of the tliree younger children, a 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 reduce the cost to three-quarters of a cent per 100 Calories it will be necessary to pay no more than 24 cents per pound — the usual city cost of oleomargarine, which may be sub- stituted for all the butter. To compensate for the re- duction in the amount of butter, some increase in the amount of bread, breakfast cereal, and sugar has been made. Prune pulp has been substituted for orange juice for breakfast for the little children, and bananas 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 cent per 100 Calories. Therefore . 268 FEEDING THE FAMILY a rice pudding without eggs has been chosen and cookies with very high fuel value in proportion to the number of eggs used. Oatmeal cookies fulfil this condition, though oatmeal wafers would be still cheaper, since they can be made without any eggs at all. 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 below : Menu II Breakfast : Granges (smaller) Wheatena with cream (top mHk) Toast Coffee for adults Milk for children Luncheon : Creamed dried beef on toast Baked bananas Boston brown bread Rice pudding II ^ Tea for adults Milk for children Dinner: Baked halibut, white sauce Potatoes on the half shell String beans, buttered Bread and butter 1 See Table III, Menu III Breakfast : Bananas (prune pulp 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 Gatmeal cookies Tea for adults Milk for youngest children Dinner : Creamed salt cod Baked potatoes Boiled onions Bread and butter Appendix, p. 383. FOOD PLANS AND DIETARIES 269 Cold slaw Chocolate blancmange with thin cream and sugar Plain cookies Rice pudding III ^ with milk and sugar Worked out in detail for the family, as shown in the die- tary below, this menu fulfills the requirements 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 substitution of prune pulp for breakfast, 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. Family Dietary Number III Fuel Value: about 14,300 Calories Cost: f-i^ per 100 Calories Food Measure Protein Calories Total Calories Breakfast : Milk for baby Milk for 3-year-old . . . Wheatena for 3-year-old Prune pulp for baby . . . Prune pulp for 3-year-old Bananas for 6 Wheatena for 6 .... Toast for 6 Butter for 6 Milk for cereal coffee for children aged 6, 9, 12 . . Milk 2 for coffee for adults . Sugar for coffee and cereal for adults, cereal coffee for children I cup I cup 4 tbsp. i tbsp. I tbsp. 6 bananas 4h cups 12 slices 3 tbsp. ih cups 3 cups 6 tbsp. 34 34 4 I 30 72 84 3 51 102 170 170 33 25 50 600 600 600 300 25s 510 360 3673 1 See Table III, Appendix, p. 383. ^ See note to Dietary No. I. 270 FEEDING THE FAMILY Food Measure Protein Calories Lunches : 10 A.M. For baby : Oatmeal jelly . Milk for jelly Milk to drink For 3-year-old : Milk . . . Bread . . For 6-year-old : Milk. . . Crackers . Family Luncheon (for 6) : Macaroni and cheese Boston brown bread Butter Stewed apricots . . Oatmeal cookies Milk for 6-year-old Sugar for adult's tea Tea for adults . . Afternoon Meals: 2 P.M. For baby : Egg yolk ....... Bread Milk For 3-year-old : Split pea soup .... Bread Butter ....... Finely chopped creamed macaroni with | egg . . Apple sauce 2 tbsp. J cup \ f cup / f cup I slice i cup 2 crackers 6 cups 10 slices 5 tbsp. i^ cups 6 cookies 1 cup 2 tbsp. (scant) I yolk ^ slice I cup f cup I slice I tsp. h cup I cup 3 34 26 7 26 5 204 50 5 24 88 26 II 3 34 26 7 30 I FOOD PLANS AND DIETARIES 271 Food 5 : 30 P.M. For baby : Oatmeal jelly . . Milk for jelly . . Milk to drink . . For 3-year-old : Cream toast . . Rice pudding III ^ Milk for pudding Sugar for pudding Milk to drink . . For 6-year-old : Cream toast . . Rice pudding III ^ . Milk for pudding Sugar for pudding . Family Dinner: Creamed salt cod for 5 Baked potatoes for 5 . Boiled onions for 4 Bread for 5 ... . Butter for 5 ... Rice pudding III ^ for 5 Milk for pudding . . Sugar for pudding . . Night Lunches: 10 P.M. Milk for baby Tea with | cup hot milk for grandmother . . . . Sugar for tea Cracker for grandmother Total for day Measure 2 tbsp. icup \ f cup / 1 1 slices toast 6 tbsp. sauce 5 cup i cup I tsp. f cup I I slices toast I cup sauce f cup 1 cup 2 tsp. 4 cups 8 medium 8 medium 10 slices 5 tbsp. 4 cups 1 1 cups 3 tbsp. f cup 1 cup 2 tsp. I cracker Protein Calories 3 34 19 33 12 17 243 88 26 70 5 80 SI 26 17 3 1791 1 See Table III, Appendix, p. 383. 272 FEEDING THE FAMILY The food values for the three different menus are Protein Calories Total Calories Menu I 2202 2106 1 791 1424-2061 14,410 14,414 14,330 14,252 Menu II Menu III Requirement of family The protein in the first two exceeds all demands of necessity, but not far enough to make it objectionable unless it be from the point of expense. In the third, reduction in the amount of milk and eggs brings the protein within desirable limits, and, since it it derived quite largely from milk, especially for the children, there can be no question of its being ample for all body needs. In fact, it is evident that in this last dietary we have not reached the lowest cost at which it is possible to maintain our family, though we have reached the lowest point at which it can be done easily with prices as high as those of New York City. In any further reduction especial care will have to be taken to keep the protein and ash constituents adequate, as these are expensive items in any dietary. It becomes increasingly difficult to provide variety of diet. Cereal products, dried beans and peas, a few staple fresh vegetables, 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 limited amount of milk must be the chief reliance of the housewife. The temptation is FOOD PLANS AND DIETARIES 273 often great to use large quantities of sugar and syrup or molasses rather than cereals, because of the 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. The needs of the children cannot be ideally met when the dietary falls to two- thirds of a cent per 100 Calories, ex- cept in districts where milk and 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 two-thirds of a cent 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 (prune pulp for baby) Cornmeal mush with milk and sugar (oatmeal for 3-year-old) Bread Pork fat Sausage for father and mother Cereal cofifee for older children and adults Milk for youngest children T 274 FEEDING THE FAMILY Luncheon : Baked samp with cheese Stewed raisms Brown bread Oleomargarine Oatmeal wafers Tea for adults Cocoa for children Dinner : Beef stew with vegetables Bread Oleomargarine Date pudding with liquid sauce Family Dietary Number IV Fuel Value : About 14,300 Calories Cost : |-|ff per 100 Calories Food Breakfast : Milk for baby Prune pulp for baby . . . Milk for 3-year-old . . . Oatmeal for 3-year-old . . Dried apple sauce for 3-year- old Cornmeal mush for 6 . . Dried apple sauce for 6 . . Sausage for 2 Bread for 6 Milk for cereal coffee for children aged 6, 9, 12 . . Milk for coffee for adults Milk for mush Sugar Measure I cup I tbsp. 1 cup h cup 2 tbsp. 31 cups 2 J cups i lb. (rawwt.)^ 12 slices 1 1 cups ^ cup 2 cups 8 tbsp. Protein Calories 34 34 9 50 6 100 84 SI 17 68 Total Calories 170 25 170 50 50 500 600 500 600 255 85 340 480 3825 ^ Fat used on bread. FOOD PLANS AND DIETARIES 275 Food Measure Protein Calories Lunches : 10 A.M. For baby : Oatmeal jelly Milk for jelly Milk to drink For 3-year-old : Milk . . . Bread . . For 6-year-old : Milk. . . Crackers . Family Luncheon (for 6) : Baked samp with cheese Boston brown bread Oleomargarine . . Stewed raisins . . Oatmeal wafers Cocoa I ^ for children Sugar for adults' tea Tea for adults . . Afternoon Meals: 2 P.M. For baby : Milk ... Bread . . , For 3-year-old : Split pea soup Bread . . Oleomargarine Baked potato Baked apple 2 tbsp i cup f cup f cup I slice h cup 4 crackers 4-2- cups 10 slices 5 tbsp. 2 cups 8 wafers 3 cups 2 tbsp. (scant) 1 cup 5 slice f cup 2 slices 2 tsp. I small I small 3 34 26 7 17 10 132 50 5 18 88 70 34 3 26 9 ■ I ^ See Table III, Appendix, p. 358. 276 FEEDING THE FAMILY Food Measure Protein Calories 130 P.M. For baby : Oatmeal jelly Milk for jelly Milk to drink For 3-year-old : Cream toast Bread .... Oleomargarine Rice pudding III * Sugar for pudding Milk for pudding Milk to drink . . For 6-year-old : Cream toast . . Rice pudding III^ Milk for pudding Sugar for pudding Family Dinner (for 5) : Beef stew with vegetables Bread Oleomargarine . . . . Date pudding I ^ ... Brown sugar sauce . . Night Ltinches: 10 P.M. Milk for baby Tea with ^ cup hot milk for grandmother Sugar for tea Cracker Total for day . 7~. '. T 3 tbsp. -3- cup I cup I slice 6 tbsp. sauce I slice I tsp. I cup I tsp, 4 cup f cup i^ slices 5 cup sauce t cup 1 cup 2 tsp. 4f cups 10 slices 5 tbsp. 5 servings 2 1 cups I cup 1 cup 2 tsp. I cracker 4 34 34 33 16 183 70 5 SO 34 17 3 1526 ^ See Table III, Appendix, pp. 380 and 383. FOOD PLANS AND DIETARIES 277 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 din- ner because it has more fat and also gives more flavor. 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 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. Prune pulp has been retained for the baby for the same reason. No 278 FEEDING THE FAMILY 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 pro- tein, 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 children would be advisable. If the dietary must be kept under a cost of two-thirds of a cent per loo Calories, not more than three quarts of milk can usually be allowed, and, if possible, one of these should be bought for six cents a quart, this 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 condi- tions are given below. Menus for Very Low-Priced Family Dietaries (allowing three quarts of milk per day) I. Breakfast: 1 V, I ^^^^^ ^^'^ served with corn syrup for adults 1 steamed and served with milk for children Bread Oleomargarine Coffee for adults Apple sauce or date pulp for 3-year-old ; orange juice for baby FOOD PLANS AND DIETARIES 279 Luncheon or Supper: Pork and beans — bean soup for young children Bread Oleomargarine Tea with milk and sugar for adults Milk for youngest children Cereal coffee or cocoa for older children Dinner: Lentil soup 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- ing the plan in Dietary IV. ^ 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 dirmer of the little ones. Baked potato and baked apple or stewed prunes may be used for the three-year-old, as in Dietary IV.^ 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 128-134). ^ Page 274. "^ Page 275, 28o FEEDING THE FAMILY Lentil soup with bread may here take the place of cream toast, and cornmeal mush, if cooked all day, may be substituted for the rice pudding. Little change can be made in the night lunches. 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 \^^^ ^^^^^ ^^^ ^j^^^^ ^^^ Baking powder biscuit Toast and milk for other children Cofifee 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 Dinner : Pork sausage baked with parsnips Baked potatoes Bread Oleomargarine Steamed cranberry pudding Everyday sauce ,^ flavored with nutmeg ^ Waterj cornstarch, sugar, and oleomargarine. FOOD PLANS AND DIETARIES 281 This menu can be quite easily adapted to the chil- dren's needs. Their breakfasts will be like those in Dietary TV/ 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 outlined in Dietary IV ^ 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: SpHt pea soup Bread Oleomargarine Sliced bananas with sugar Gingerbread Dinner: Lentil-meat loaf Tomato sauce Mashed potatoes Scalloped dried apples Cocoa for children Tea for adults ^ Page 274. 2 Page 276. 282 FEEDING THE FAMILY 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: ^ , , , f with corn syrup for adults Oatmeal mush j .. .„ / ,.,, [ 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 din- ner and the six-year-old's supper. Junket can easily be made for dessert for the children's half past five supper. FOOD PLANS AND DIETARIES 283 V. Breakfast: Flaked wheat with milk and sugar Buckwheat cakes with corn syrup Coffee for adults Cocoa for children Luncheon or Supper: Escalloped 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 Cornbread baked in a thin sheet Oleomargarine Coffee for adults Cereal coffee for children 284 FEEDING THE FAMILY Luncheon or Supper: Corn chowder with croutons Rye bread and oleomargarine Stew^ed 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 nutri- tion, such as sanitary and cheerful surroundings, free- dom 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 his 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, often, for in- stance, 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 28s 286 FEEDING THE FAMILY which to flourish. So, in one way and another, illness may enter the home where food is dispensed with intelli- gent 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 requires knowledge and experience to diagnose disease and prescribe suitable food, and no book can take the place of the skillful doctor. In sickness, even 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 pocket book, and some- times the three seem quite irreconcilable. Moreover, 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 287 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.^ 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 ^ Much practical information about feeding in disease is to be found in Diet in Health and Disease by Friedenwald and Ruhrah. a88 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 suppHed 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 phys- ically, 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 289 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 nutri- tious, or more attractive 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 100 Calories. Their chief virtues are that they are agreeable 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 nutri- ment 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 150° 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 (J 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 290 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,^ 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. The virtue lies in alla3dng hunger and thirst and furnishing a Uttle 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, if taken slowly, 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 (i) 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- ^ Cereal gruels are dextrinized by adding to the cooked gruel, when cooled to about 100'' 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 291 thing which prevents the formation of large or hard curds in the stomach. The general principles of milk modification have already been discussed in Chapter V. They are applicable in all cases where digestion and assimilation are concerned, as well as in the feeding of infants. 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 their flavor; malted milk not only changes the taste but adds to the fuel value and ease of digestion. With malted milk a number of different 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 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 292 FEEDING THE FAMILY called albumin) with various fluids, such as milk, broth, orange, lemon, pineapple, or grape juice, or even water alone to make a soothing drink of some nutritive value, to be taken when the irritability of the digestive tract is particularly great. The white of one egg has an aver- age fuel value of 13 or 14 Calories. One white com- bined 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.^ 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 table- spoonful 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 III, 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 ^ Recipes for various foods for invalids with their fuel value stated may be found in Pattee's Practical Dietetics, 1 ^ -? -si V - M d rt rt oSouuu S aaa3 ."X S-i S 3 3 rt 9<9< M 4 ON d w to K°6? c o E 5 5 3 ^pqpqCJUW FOOD FOR THE SICK AND CONVALESCENT 293 relieves sensations of hunger and thirst, and the dilute food has a better chance of digestion than more concen- trated would have, for, when one is not taking any exercise, body processes are apt to be sluggish. The fluid diet should 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 Typical Menu for a Fluid Diet 7 A.M. I cup coffee with i cup milk 9 A.M. Albuminized lemonade; 2 tbsp. lemon juice, sugar, egg white, i cup water 2 tbsp. II A.M. I cup broth I P.M. I cup gruel made with milk 3 P.M. Albuminized lemonade (as above) 5 P.M. I cup tea with J cup milk 7 P.M. I cup broth 9 P.M. I cup gruel made with milk II P.M. I 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 fuel 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 294 FEEDING THE Fx\MILY 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 adapted to convalescence or other cases of weakness, where diges- tion is not greatly impaired. 7 A.M. I cup milk 9 A.M. I cup milk flavored with coffee essence II A.M. Albimiinized orange juice ; ^ cup orange juice, 2 tsp. sugar, white of one egg, f cup water I P.M. Cream soup with one egg, or broth with one egg and j cup cream 3 P.M. Grape juice eggnog ; one egg, ^ cup milk, i tbsp. sugar, I cup grape juice, i tbsp. cream 5 P.M. Gruel made with milk 7 P.M. I cup tea made with ^ cup milk and 2 tbsp. cream 9 P.M. Gruel flavored with beef extract 11 P.M. I cup hot malted milk; i cup milk, 3 tbsp. malted milk Soft or Semi-Solid Diet The so-called soft or semi-soUd diet represents an intermediate step between fluid diet and a very simple, wholesome, mixed diet, the latter often designated in hospitals as Hght or convalescent diet. Soft diet is generally more acceptable to the patient than a wholly fluid diet, and has the advantage of less bulk in propor- tion 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 ; custards, baked, steamed or ''boiled"; whips, souflSes, * See page 305. FOOD FOR THE SICK AND CONVALESCENT 295 junkets, blancmange, gelatin jellies, ice creams, ices, and sherbets. Meats, fish, and green vegetables are omitted. The following menu will give some idea of what foods are permissible. It will yield from 2000 to 2200 Calories. 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 I cup thick farina gruel served with rich milk I thin sHce toast with butter 12 M. I cup beef broth with the white of i egg I thin slice toast with butter 2 : 30 P.M. f cup chicken souffle ^ thin slice toast I cup lemon jelly with i tbsp. whipped cream 5 P.M. I cup milk flavored with tea or cocoa I thin slice toast 7 : 30 P.M. I cup bouillon I -egg omelet ^ cup cocoa or caramel junket 10 P.M. I cup gruel or malted milk (made with milk) I thin slice toast Light or Convalescent Diet The treatment of convalescence depends, of course, upon the nature of the disease. The severity and dura- tion 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 296 FEEDING THE FAMILY 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 permissible to provide a fairly hberal 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 Hkely to disturb digestion, and to see that build- ing materials are generously represented. Some of the ways of adapting food to digestive difficulties have been discussed in Chapter II, and many of the suggestions made in regard to selection of food for children (Chap- ters VI-IX) can be applied to the convalescent. It is well to keep in mind also the following points : 1. 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 FOOD FOR THE SICK AND CONVALESCENT 297 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 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 Dinner: Meat broth or soup (rice, barley, potato, pea, as- paragus) Roast or broiled lean beef, chicken, mutton, lamb, or fish Potatoes baked, boiled, or mashed, or macaroni or rice 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 preferred 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. 298 FEEDING THE FAMILY 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 followed. 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 indiges- tion. 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 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 a 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. 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 FOOD FOR THE SICK AND CONVALESCENT 299 on a long time and even be the beginning of more serious troubles, such as chronic catarrh, bronchitis, pneu- monia, 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 pre- viously ^ Sugars, which are irritating to the Hning 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 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 quanti- ties should be taken at one time. The following menu illustrates what may well be taken as soon as compara- tive comfort has been secured by rest and fighter 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 ^ See also "The Part of the Stomach in Good Digestion," page 34. 300 FEEDING THE FAMILY II A.M. A glass of buttermilk or sweet milk (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 Plain or milk toast or omelet Bread, tapioca, or other cereal pudding Intestinal Putrefaction The control of intestinal putrefaction depends largely upon the diet. As indicated in Chapter 11/ 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 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 tendency to ferment a little actually hinder the action of the putrefactive bac- teria. Constipation is very likely to be associated with * See page 39. FOOD FOR THE SICK AND CONVALESCENT 301 putrefaction, and most of the measures used to combat it ^ 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 follow- ing suggestions may be helpful in planning a diet. A Suggestive Menu for Counteracting \ntestinal Putrefaction Ci^ 7 A.M. Glass of water or dilute fruit juice ^ ^ ^ Breakfast : Thoroughly cooked cereal, with cream [V \ Dry, crisp toast and butter Fresh or stewed fruit s.- Luncheon: Hot vegetable dish, as escalloped cauliflower, cab- bage, tomatoes, or potatoes; macaroni, rice, or hominy, with cheese; macaroni or rice with tomatoes ; or stuffed tomatoes or peppers • 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 * See page 42. 302 FEEDING THE FAMILY at all can be retained. No food should be given which 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 ehmina- tion 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. The raised temperature may increase the energy expenditure as much as one- fourth. Thus a bedridden man with fever, instead of requiring from 1800 to 2200 Calories per day, will need from 2200 to 2800 to keep from burning up his body tissues for fuel — or about the same amount as he would require if doing moderate muscular work in health. In some diseases characterized by fever even this extra allowance is not enough to maintain the patient's body weight. In typhoid fever, for instance, the bacteria responsible for the disease cause a great wasting of body substance, which can be prevented only by feeding a diet of very much higher fuel value than the patient would need if he were simply lying in bed free from fever.^ The administration of food in fever calls for the exer- .^ See discussion of " Diet in Typhoid Fever." FOOD FOR THE SICK AND CONVALESCENT 303 cise of skill and good judgment in deciding how far the patient^s energy needs can be met when the aUmentary 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 different devices for modifying milk for infants are appHcable here, but more attention should be paid to flavor for the adult, lest he tire of its monotony. 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 294, 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 Ufe of the patient depends upon absolute obedience to physician and nurse in regard to every mouthful that the patient receives. A single 304 FEEDING THE FAMILY indiscretion in diet may prove fatal, and no one but a 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 respon- sibility 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 her this background that the following sugges- tions 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 enter 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 FOOD FOR THE SICK AND CONVALESCENT 305 cellulose, seeds, or even large undigested food fragments. In the early stages, the digestion may be greatly dis- turbed and Httle 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 inevi- table 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 hkely that a fluid diet will be adhered to very strictly, one consisting prin- cipally 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 ^ Calories For iooo Calories a Day: Milk, IOOO c.c. (i 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. (i| dr.) 24 * Coleman, American Journal of Medical Sciences, January, 191 2. X 3o6 FEEDING THE FAMILY Calories For 20CX) Calories a Day: Milk, 1500 c.c. (i§ 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. (i oz.) 60 Lactose, 18 gm. (4^ dr.) 72 For 3000 Calories a Day: Milk, 1500 c.c. (i^ quarts) 1000 Cream, 480 c.c. (i 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. (i 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 fol- A Mixed Fluid Diet for Typhoid Fever Milk and coffee, each 120 c.c. (4 oz.) Milk, hot or cold, 240 c.c. (8 oz.) Oatmeal gruel, 120 c.c. (4 oz.), with milk, 60 c.c. (2 oz.) Junket with cane- and milk-sugar Oatmeal gruel, 120 c.c. (4 oz.) with mUk, 60 c.c. (2 oz.) Junket with cane- and milk-sugar Hot milk, 240 c.c. (8 oz.) Whey, 180 c.c, with one whole egg and sherry Oatmeal gruel, 120 c.c. (4 oz.), with milk, 60 c.c. (2 oz.) Junket with cane- and milk-sugar ^ F. P. Kinnicutt, Did Lists oj the Presbyterian Hospital, New York City, page 15. owing : 8 A.M. 10 A.M. 12 noon 2 P.M. 4 P.M. 6 P.M. 8 P.M. 10 P.M. 12 P.M. 2 A.M. FOOD FOR THE SICK AND CONVALESCENT 307 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. (2f oz.) ; carbo- hydrates, 160 gm. (5I oz.) ; Calories, 2300. A typhoid patient is not always limited to a fluid diet, though soHd 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.^ ^ Coleman, American Journal of Medical Sciences, January, 1912. 3o8 FEEDING THE FAMILY A Soft Diet for Typhoid or Typhoid Convalescence Calories 7 A.M. Egg, I 80 Toast, I slice 80 Butter, 20 grams 150 Coffee Cream, 2 ounces 120 Lactose, 20 grams 80 9 A.M. MUk, 6 ounces 123 Cream, 2 ounces 120 Lactose, 10 grams 40 II A.M. Egg, I - 80 Mashed potato, 20 grams 20 Custard, 4 ounces 250 Toast (or bread) i slice 80 Butter, 20 grams - . . 150 Coffee Cream, 2 ounces 120 Lactose, 20 grams 80 I P.M. Same as 9 a.m 283 3 P.M. 1 Same as 9 a.m 283 5 P.M. Egg, I 80 Cereal, 3 tablespoons 150 Cream, 2 ounces 120 Apple sauce, i ounce 30 Tea Cream, 3 ounces 180 Lactose, 20 grams 8c 7 P.M. Same as 9 a.m 283 10 P.M. Same as 9 a.m 283 ^ Lactose lemonade may be substituted for the milk mixture at three o'clock. See Table III, Appendix, page 360 FOOD FOR THE SICK AND CONVALESCENT 309 Calories I A.M. Same as 9 a.m 283 4 A.M. Same as 9 a.m 283 Total Calories for day 3911 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 great importance. But in tuberculosis the appetite is apt to be poor and fitful and is no guide whatever as to how much the patient should eat. Often he must con- tinue eating when he does not want food at all. But this does not mean that he should be indiscriminately "stuffed." The best dieting is that which keeps his digestive tract in as good condition as possible and yet brings about a gain in weight, until he attains the highest 3IO FEEDING THE FAMILY weight which he is known to have had before contracting the disease. Fattening beyond this point seems unde- sirable. The amount necessary to produce a satis- factory gain in weight will vary with the individual, but the best rule which seems to have been evolved by stu- dents of the problem is to add one-third more to the diet which would be normal for the same person, with the same degree of activity (usually at rest), but without tuberculosis. Thus, taking the average requirement for a man at rest as 2000 Calories, the provision for the same person when tubercular would be about 2700 Calories. Much care must be taken in the selection and preparation of food, to see that it is easy of digestion, and the amount of food to be eaten must be carefully measured. As to kind of food, the tubercular patient seems to profit by liberal protein and fat, but indiscriminate stuff- ing with these may defeat its own end. An allowance of about one- third more protein than what would be a liberal provision in a non- tubercular diet seems advisable. A man in health is abundantly supplied when he has 400 protein Calories per day: the tubercular man should, accordingly, have about 530 protein Calories per day. Since the protein is needed to reconstruct wasted tissues, the kinds best for growth should have preference — milk and eggs particularly — though other protein food can also be used to advantage, if prepared in ways easy of digestion.^ Fat by its high fuel value helps to keep the bulk of the day's diet within practical limits — a great ^ See Chapter II. FOOD FOR THE SICK AND CONVALESCENT 311 consideration when the appetite is feeble. Butter, cream, olive oil, cod-liver oil, bacon, oleomargarine, suet, and beef drippings can all be successfully used. A Moderate-priced Dietary for Tuberculosis Measure Weight Protein Total Oz. Cvlories Calories Breakfast : Cream of wheat .... f cup 6.0 12 100 Cream, thin h cup 3.6 10 200 Poached egg I egg 1.6 25 70 Toast I slice 0.7 7 50 Butter I tbsp. 0-5 I 100 Sugar 2 tbsp. (scant) I.O — 100 Milk I cup 8.5 34 170 Coffee — 790 Dinner : Roast beef 2 slices 3-2 92 200 Gravy i cup 1-7 7 50 Mashed potato .... f cup 4-7 II 150 Turnips, creamed . . . ^cup 1.4 10 100 Bread I slice 0.7 7 50 Butter I tbsp. 0.5 I 100 Apple tapioca .... |cup 7.2 2 200 Milk I cup 8.5 34 170 1020 Supper : Corned beef hash . . . large serving 6.0 64 250 Banana .... I large 5.5 5 100 Cream . . . icup 1.8 5 100 Bread . . . 2 slices 1-3 14 100 Butter . . . I tbsp. 0.5 I 100 Plain cake . . small piece 1.5 12 150 Cocoa with milk fcup 7.6 32 200 . Milk, extra . . 2 cups 17.0 68 340 1340 Total for day . . . 454 3150 312 FEEDING THE FAMILY A Low-priced Tuberculosis Dietary for a Working Man Measure Weight Oz. Protein Calories Breakfast : Oatmeal Bacon, broiled . . . . Bacon fat Bread (toast) Sugar Milk Coffee Dinner: Pot roast Baked potato . . . . Bread Butter Tapioca-cornmeal pudding Milk Supper : Pea soup Sausage Bread Sausage fat Cheese, American . . . Cocoa with milk .... Night Lunch: Bread Butter Peanut butter .... Milk 1 cup 5 large pieces 2 tbsp. 4 slices 4 tbsp. (scant) large serving 1 large 2 slices 1 tbsp. 2 cup I cup 1 cup 2 small 2 slices 2 tbsp. i-g- in. cube I cup 4 slices 2 tbsp. 2 tbsp. (scant) cup 7-9 i.o i.o 2.6 1.9 5-1 4.8 4-4 1-3 0.5 7.2 8.5 lO.O 2.2 1-3 I.o 0.8 7.6 2.6 I.o I.I 5-1 17 26 28 19 186 16 14 I 44 34 43 40 14 26 32 28 2 38 19 Total for day 627 FOOD FOR THE SICK AND CONVALESCENT 313 A tempting diet of high fuel value, with a generous proportion (15 to 20 per cent) in the form of protein, is likely to be expensive. Cream, butter, eggs, choice meats, and dainty cookery and service are beyond the reach of many tubercular 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 in this country and at those in Eng-' land under the supervision of the well-known authori- ties, Bardswell and Chapman. The day's dietary given on page 311, moderate in cost, is based on the day's menu served at the Loomis Sanatorium.^ Diets even less expensive are those of Bardswell and Chapman. The following modification of their plan, adapted to American conditions, is a very satisfactory basis for low-priced diets.^ 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, slice of bread and oleomargarine, dish of weU-cooked vegetables, 8 oz. of rice or tapioca pudding made with milk, glass of milk . * King, On the Construction of a Practical and Efficient Diet in Tuberculosis. 2 Gibbs, Food for the Invalid and Convalescent, page 8i, 314 FEEDING THE FAMILY Diet in Diabetes The regulation of the diet is the most important con- sideration in the treatment of diabetes melHtus. The most striking symptom of the disease is an impaired power of utilizing carbohydrates. These ordinarily cir- culate 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 infec- tion and invites numerous compKcations, 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 315 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. Dietetic treatment must be directed to the control of Courtesy of John Criaiilloti and Sons. A Convenient Food Scale acidosis, as well as to the elimination of sugar from the urine. The first step is fasting ^ till the urine is sugar free, then beginning with small amounts of carbohydrate, preferably in the form of green vegetables, and gradually * For details see Allen, Treaiment of Diabetes^ Boston Medical and Surgical Journal, 1915, Vol. 173, p. 241. 3i6 FEEDING THE FAMH^Y increasing till the person's '' tolerance " or sugar-burning capacity is learned. This is important because any excess over what the tissues can utilize acts as a poison and causes the ability to burn carbohydrates to diminish, the organs concerned in the process being weakened by the strain of trying to care for more than they are able. The treatment which follows aims to increase this toler- ance by supplying the patient with sufhcient nourishment without overtaxing the powers of sugar-burning. The patient should be provided with scales measuring grams for weighing food, and written instructions as to the exact amounts of different foods to be eaten. The matter is too critical to be left to the crude measure- ments of the eye. When a certain course is to be pursued for some time, — perhaps several months, — a general plan for the diet and a table of " carbohydrate equivalents," by means of which the menu can be varied, is most conveniently followed. Whoever has charge of the feeding of a dia- betic patient should learn from the physician exactly how much protein, fat, and carbohydrate is to be given, and how to estimate the amount of each food to be eaten. Such tables as those below ^ give a good general outline of the foods available. A Scheme for Planning Diabetic Diets " Tables A and B are made up of foods that are nearly carbo- hydrate-free and from these lists this sort of dietary may be con- structed according to the patient's preferences. These foods (Tables A and B), may be used without restriction of quantity imless there is a necessity of limiting the amount of protein con- ^ N. B. Foster, American Journal of Medical Sciences, February, 191 1. FOOD FOR THE SICK AND CONVALESCENT 317 sumed. In Tables C and D the foods all contain carbohydrate. These tables are to be used only when the carbohydrate tolerance of the patient is known, and then the total amount of starch- containing food should be kept well below the tolerance limit (by at least 10 grams of bread). For example, if 60 grams of white bread is assimilated without inducing glycosuria,^ then not more than 50 grams in equivalents should be allowed. Further, foods like potatoes and fruits should be separately tested with each patient in order to determine whether there is any peculiarity of reaction toward them respecting sugar excretion. " The order and number of meals requires consideration also ; four or five meals are better than three ; a second breakfast and afternoon tea may be interpolated. Half of the daily allowance of bread should be taken at the mid-day meal, and it is better that at least a third of the daily bread allowance be used as equivalents — vegetables and fruits. "Table A "Fresh Meats: All muscle parts of beef, veal, pork, lamb, mutton, domestic and wild fowl, either roasted, boiled, or broiled, in their juices, with butter, or with mayonnaise made without flour, either hot or cold. " Various Organs of Animals : Tongue, heart, brains, sweet- breads, kidneys, marrow, calves' liver, liver of game or poultry (pate de fois gras) up to 100 grams in weight, weighed after being prepared. "Preserved Meat: Smoked meat, dried meat, smoked or pickled tongue, ham or bacon, corned beef, sausage (containing no bread). Be sure that no flour is used in preparing pickled meats. " Meat Peptones of all kinds, jellies, or aspics prepared from calves' feet, or pure gelatin ; nutrose, tropon, plasmon, wheat gluten, etc. " Fresh Fish : AU fresh fish boiled, fried, or broiled. If the ^ Glycosuria means glucose in the urine. Glucose is the kind of sugar which circulates in the blood and appears in the urine in diabetes. 3i8 FEEDING THE FAMILY fish is fried in bread crumbs and eggs the crust should be removed before the fish is eaten. All sauces that contain no flour are allowed ; those that contain butter and lemon are the best. " Preserved Fish : Dried, salted, and smoked, such as haddock cod, herring, mackerel, flounder, sturgeon, eels, salmon, etc. Pickled herrings, sardines in oil, mackerel in oil, anchovy, timny- fish, etc. " Fish Products : Caviare, cod-liver oil. " Shellfish and Crustacea : Oysters, clams, and other shell- fish, lobsters, crabs, crawfish, shrimps, turtle, etc. "Table B " Foods Rich in Fats : Dairy products — cream, butter, yolks of eggs, cheese. " Animal Fats — bone marrow, fat of edible meats, lard, tallow (used in cooking), cod-liver oil, oleomargarine. Vegetable Fats — olive oil, cottonseed oil, peanut oil, peanut butter, nut butter. " Vegetables containing a slight amount of carbohydrate (less than 4 per cent). These may be taken in normal quantities unless otherwise directed: asparagus, beet greens, Brussels sprouts, cabbage, celery, chard, cucumbers, endive, lettuce, sauerkraut, spinach, string beans, tomatoes (fresh). "Table C FOODS containing CARBOHYDRATES AND TO BE USED ONLY IN RESTRICTED quantity Grams Grams Grams Grams White bread lO 20 30 SO Equiva- Equiva- Equiva- Equiva- lent to lent to lent to lent to Com bread 12 24 36 60 Graham bread .... ID 20 30 SO Gluten bread .... 13 26 39 6S Oatcakes 25 SO 75 I2S Wheat flour 8 16 24 40 Hominy (boiled) . . . 20 38 50 FOOD FOR THE SICK AND CONVALESCENT 319 Grams Grams Grams Grams Rice (boiled) .... 14 28 42 Tapioca (pudding) . . 15 30 45 Macaroni (cooked) . . 30 60 90 Spaghetti (cooked) . . 30 60 90 Cocoa (unsweetened) 12 Vegetables : Asparagus (cooked) . . 175 350 Beans, red kidney- 25 50 Beans, lima . . . 25 50 Beets (cooked) . . 55 100 Carrots (raw) . . 60 120 Celery 100 200 Corn, green, canned 25 50 Cauliflower (raw) 80 160 Dandelion greens 50 100 Egg plant (cooked) 90 180 Onions (boiled) 90 180 Peas, green (cooked) 30 60 90 Parsnips (raw) 40 80 Potato (boiled) . . 25 50 75 Fruits : Apples (raw) .... 35 70 Apricots (stewed) . 40 80 Bananas .... 25 50 Blackberries (fresh) 35 70 Cherries (fresh) 25 50 Currants (fresh) . 40 80 Gooseberries . . 75 150 Grapefruit . . . 200 Oranges .... 30 60 Peaches .... 50 100 Pears 40 80 Phims 27 54 Prunes (stewed) 25 50 Raspberries . . 42 84 Strawberries . . 60 120 When no equivalent amount is mentioned in the third column, it is to be understood that the amount given in the second column is the maximum allowable. 320 ' FEEDING THE FAMILY "Table D " This table consists of a list of food materials which are not entirely free of sugars. They are allowed in quantities stated unless the patient is on a " carbohydrate-free " diet, when they must be avoided. " Vegetables (cooked without flour or sweetening) : Dried peas and beans, either whole or in puree, turnips, carrots, salsify, green peas, lima beans, kidney beans, 2 tablespoonfuls. " Fresh Fruit : Apples, pears, apricots, peaches, 50 grams. Raspberries, strawberries, red currants, i large tablespoonful. Blackberries, 2 tablespoonfuls. " Stewed Fruit (with saccharine or crystallose) : Plums, apples, pears, apricots, peaches, sour cherries, prunes, i heaped teaspoonful. Raspberries, gooseberries, red currants, 2 heaped tablespoonfuls. "Dried Fruit: Plums, apricots, peaches, apples, prunes, 2 heaped tablespoonfuls. "Levulose Chocolate (Stollwerck's), up to 15 grams. " Cocoa (without sugar), up to 12 grams. "How TO Make Use of Table C "The food is divided into two parts: (i) That which is free from carbohydrates, the principal fare, Tables A and B; and (2) that which contains carbohydrates, the secondary fare, Tables C and D. For instance, the equivalent of 75 grams of wheat bread are allowed in courses from Table C. Breakfast: Principal fare, medium strong coffee or tea, cold meat, i egg and butter ; secondary fare, 50 grams of oatcakes, the equivalent of which = 20 grams of wheat bread. Second Breakfast : Two eggs in any form. Dinner (midday meal) : Principal fare, broth with egg, meat with green vegetables or salad (Table B), cheese, and butter. Secondary fare, 50 grams of potatoes ( = 20 grams of wheat bread), 60 grams of strawberries ( = 10 grams of wheat bread). Afternoon Meal : Tea, coffee, or consomme, with casoid cakes. FOOD FOR THE SICK AND CONVALESCENT 321 Supper : Principal fare, plenty of hot or cold meat, with vege- tables or salad, cheese and butter; secondary fare, 25 grams of Graham bread ( = 25 grams of wheat bread). Total, = 75 grams of wheat bread." 1590 1500 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 available for food. Since carbohydrates constitute the largest part of an ordinary diet, their withdrawal changes eating habits materially, and people find it difhcult to do without the familiar bread, potatoes, cereals, sugars, and fruits. Furthermore, the carbo- hydrate foods are relatively the cheapest part of the diet, so that a diabetic diet will always cost more than a mixed diet of the same general character. The large amount of fat is likely to prove disagreeable un- less introduced with care into the menu. Most books on invalid cookery give recipes for diabetic diets.^ These are very helpful because the cook is de- prived of her ordinary thickening agents, such as flour, ^.Farmer, Food for the Sick and Convalescent. Pattee, Practical Dietetics. y Normal diet 2300 Calories Diabetic diet 2500 Calories k>^i^ifd Protein l^t Csirbohydrata A Comparison of the Distribu- tion of Calories in a Typical Normal and a Severe Dia- betic Diet 322 FEEDING THE FAMILY also of sugar and milk, and special devices are necessary to make acceptable dishes. The best fats are butter, cream, cream cheese, oHve oil, bacon fat, meat fats of other kinds, bone marrow, fat and highly flavored fish (as canned sardines, salmon, mackerel, and whitefish). Green vegetables are the best fat carriers. Melted butter may be poured over those served hot and olive oil or cream dressing over salads. A small potato? according to Miss Farmer, may take up one-half its weight in butter, or one-fourth its weight in heavy cream. Potatoes, however, are not always permissible, while green vegetables such as lettuce and cabbage are. Cream can be used in place of milk in many dishes. In others, cream diluted with water, to which raw white of egg is added, will make a satisfactory 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 market are expensive and not always reliable. They should not be used without knowledge of their exact composition.^ 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, casoid,^ or pure gluten flour are useful occasionally for the sake of variety, even for mild cases, and are a help when the carbohydrate is very greatly restricted. ^ The composition of many diabetic foods may be found in a bulletin by Mendel and Street, Diabetic Foods, published by the Connecticut Agricultural Experiment Station, New Haven, Conn, 2 The manufacturers of casoid flour publish a cookbook with some excellent recipes for the use of this carbohydrate-free flour. FOOD FOR THE SICK AND CONVALESCENT 323 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 Hmitations, he should be 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. In severe diabetes protein is restricted as well as car- bohydrate, and the body must depend mainly on fat for fuel. Under such circumstances the fat-burning power also becomes weakened, and the general disturb- ance of metabolism is evidenced by acidosis. The treatment then must attempt to correct both sugar and acid excretion. No one diet will serve this pur- pose. Treatment can be best carried on in hospital or sanitarium — at any rate, under constant guidance of a physician. One device for resting the impaired functions and reducing sugar in the blood is to prescribe ** green" or 324 FEEDING THE FAMILY "vegetable'' days, when little food of any kind is taken. The following will serve as an illustration of this type of diet. Green Days^ Breakfast : i egg, boiled or poached Cupful of black coffee Dinner : Spinach, with hard-boiled egg Bacon, 15 gm. (| oz.) Salad with 15 gm. (| oz.) of oil White wine, j 1. (4 oz.), or whisky or bi ndy, 30 c.c. (i oz.) 4 : 30 P.M. : Cup of beef-tea or chicken broth Supper : i egg, scrambled with tomato and a little butter Bacon, 15 gm. (^ oz.) Cabbage, cauliflower, sauerkraut, string-beans, or asparagus White wine, 1 1. (4 oz.), or whisky or brandy, 30 c.c. (i oz.) In the home treatment of diabetes the problem of following the doctor's orders is often difficult because of expense. Carbohydrate foods are the cheapest class; the more they are excluded, the greater the cost of the diet. Some suggestions for low-priced diets are given below. They will not cost over two cents per 100 Cal- ories, and neither will the cost be raised much by the addition of a little more carbohydrate food when this is permitted. ^ T. C. Jane way in Musser and Kelly, Practical Therapeutics. FOOD FOR THE SICK AND CONVALESCENT 325 A Low-Priced Dietary for a Diabetic Allowed 50 Grams (200 Calories) of Carbohydrate per Day Measure Weight Oz. Pro- tein Calo- ries Carbo- hydrate Calo- ries Total Calo- ries Breakfast ; Scrambled eggs .... Bacon Soy bean muffins . . . Butter 1 Cream, thick .... Coffee 2 eggs 8 small pieces 2 muffins 2 tbsp. li tbsp. 1 cup 2 balls I serving I slice I tbsp. I serving 1 cup 2 slices I egg and 1 tsp. cream ih cups f cup 2 large nuts 4 tbsp. 4.0 I.O 2.1 1.0 0.9 4.0 0.7 0.5 3-9 2.5 2.3 34 4-3 0-5 1.8 45 26 . 50 2 2 29 3 150 200 167 200 100 Dinner : Hamburg steak .... Lentil puree .... Whole wheat bread . . Butter 1 Cottage cheese salad 2 . Coffee 125 170 30 8 I 82 32 68 41 19 817 200 175 50 100 250 Supper : Boiled ham Deviled egg Shredded cabbage ^ . . Lemon jelly ^ . . . , Brazil nuts Whipped cream .... 291 57 25 6 8 10 5 128 21 14 4 6 775 200 100 30 22 100 200 III 45 652 Total for day . . . . 527 205 2244 ^ If butter is over 25 cents per pound, oleomargarine must be itsed to make this dietary cheap. 2 Made from 52 tbsp. cottage cheese, i tbsp. oil, i tbsp. vinegar, 5 or 6 walnuts, and lettuce. ' Served with salt and vinegar. * Sweetened with saccharine. 326 FEEDING THE FAMILY A. Low-Priced Dietary' for a Diabetic Allowed 75 Grams (300 Calories) of Carbohydrate per Day Measure Weight Oz. Pro- tein Calo- Carbo- hydrate Calo- ries Breakfast : Gluten breakfast food . Milk Toast Butter 2 Bacon Egg Cream, thick . . , . Coffee Dinner : Pot roast Spinach Bacon fat for spinach Bread Butter 2 Coffee jelly 3 . . . . English walnuts . . . Supper : Canned salmon .... Lettuce and cucumber salad, French dressing Toast Butter 2 Cheese, American . . . t cup (uncooked)^ 8 cup I slice I tbsp. 4 small pieces I egg I I tbsp. I cup I servmg f cup 2 1 tbsp. I slice I tbsp. f cup 8 nuts 1 servmg 2 slices 2 tbsp. cube 5-1 0.6 0.5 0-5 2.0 0.9 3-2 4.0 1-3 0.7 0.5 4.9 0.5 3-5 5-5 1.2 i.o 0.8 68 19 7 I 13 26 136 124 5 7 I 22 II 170 90 4 14 2 26 136 69 29 40 141 15 40 62 14 80 97 Total for day 442 300 ^ Where absolute accuracy is required it is a good plan to measure or weigh cereals before cooking. 2 If butter is over 25 cents per pound, oleomargarine must be used to make this dietary cheap. ^ Sweetened with saccharine. FOOD FOR THE SICK AND CONVALESCENT 327 Diet in Gout Gout is a disease of the overfed rather than the under- nourished. Luxurious Hving, with its constant tempta- tion 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 eHmination 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 acid 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 328 FEEDING THE FAMILY 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, Uver, 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 below. FOOD FOR THE SICK AND CONVALESCENT 329 A Day's Dietary Suggested for Chronic Gout 7 A.M.: Hot water 8 A.M. : Orange Rice Cream, thick Sugar ....... Hot milk Bread ' . . Butter Peaches I P.M.: Soft-cooked eggs .... Baked potato Celery Bread Butter Peaches Tea, very weak and un- sweetened 6 P.M. Milk Bread Baked apple with whipped cream Sugar Butter Measure I cup I large f cup, I tbsp. (scant) I tbsp. (scant) ij cups 4 slices I tbsp. I I medium 2 eggs^ 2 medium 4 slices I tbsp. i^ medium i^ cups 6 slices I small apple I tbsp. (scant) I tbsp. Weight Oz. 9.5 2.0 o.S o.S 10.2 1-3 0.5 5-3 3.4 6.0 4.8 2.6 o.S 5.3 10.2 3-9 2.4 0.5 o-S Protein Calories 38 28 I 3 54 22 6 28 I 3 38 42 Total for day . 279 APPENDIX Table I. Table II. Table III. Table IV. Table V. Table VI. Table VII, Table VIII, Table IX. loo-Calorie portions of foods as we eat them Fuel values of food materials in terms of common measures Dietary recipes Fuel values in relation to cost Height and weight of men at different ages Height and weight of women at different ages Height and weight of boys at different ages Height and weight of girls at different ages Weight of children from birth to fifth year 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, pubKshed 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. 332 APPENDIX 333 ioo-Caloeie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Beverages Buttermilk (seeD^iry Products) '. . Chocolate I . . . i cup (scant) 4-1. ID 48 42 Chocolate II . . . 3- cup 3.1 13 49 38 Cocoa I . . . . 5 cup 5.5 14 39 47 Cocoa II . . . . fcup • 3.8 16 44 40 Cocoa III ... . 3 cup 2.9 12 34 54 Cream (se^ Dairy Products) . . Egg lemonade . . Icup 4.8 13 24 63 Eggnog ^ cup (scant) 3-7 21 48 31 Fruit punch . . . 1 cup (scant) 1.8 I I 98 Grape juice (see Fruits) Lactose lemonade . i cup (scant) 2.6 — 100 Lemonade .... if cups II.O — 100 Milk (see Dairy Prod- ucts) . . . ;♦ • Orange juice (see Fruits) Bread, Biscuit, and MUFPINS Baking powder biscuit 2 small biscuit 1.3 II 27 62 Bread, Boston brown f in. slice 3 in. diam. 1.8 10 10 80 Graham .... 3 slices 1 in. X 2 in. X 3* in. 1.4 14 6 80 Old New England corn .... piece 2^ in. x i in. ♦ X I in. I.O 8 30 62 White . . . . 2 slices 3 in. x 3h in. X 2- in. 1-3 14 6 80 Whole wheat . . 2 slices 2^ in. X 2f in. X i in. 1.4 16 3 81 Com cake .... slice 2 in. X 2 in. X I in. 1.2 10 24 66 334 FEEDING THE FAMILY ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Bread, etc. — Cont'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 0.9 10 20 70 Croutons (fried) 15 croutons, | in. cubes 0.8 7 49 44 Croutons (toasted) . 27 croutons, \ in. cubes 1.4 14 4 82 Griddle cakes . . . I cake 4I in. diam. 1.8 14 25 61 Muffins, cornmeal . J muffin 1.2 13 25 62 Graham .... f muffin 1.4 13 16 71 One egg . . . . 1 muffin 1.2 12 24 64 Twin mountain f muffin I.O 9 36 55 Popovers .... I popover 2.0 18 27 55 Rolls, French . . . iroU 1-3 12 8 80 Sandwich, club . . \ sandwich 1-5 IS ^69 16 Date I triangle 3 in. X 3I in. X 45 in. I.I 6 27 67 Date and cream . cheese .... I triangle 3 in. X 3I in. X 4t in. 1.0 10 39 51 Toast, cream . . . f slice toast and \ cup sauce 2.2 13 43 44 French .... shce 3 in. X 3 in. X |in. 1.4 10 48 42 Waffles 1 waffle 6 in. diam. 0.9 14 35 51 Zwiebach .... 3 pieces 2>\ in. X h in. X i\ in. 0.8 9 21 70 Cake and Cookies Angel cake .... piece I i in. X 2 in. X 2I in. 1.3 12 I 87 Apple sauce cake . . piece i^ in. X Hn. X 3I in. 0.8 5 II 84 Chocolate loaf cake . piece 2\ in. X 2^ in. X 1 in. 0.9 5 41 54 Chocolate drop . . i^ cookies 2 J in. cookies . . . diam. 0.8 8_ 52 40 APPENDIX 335 ioo-Calorie Portion Distribution or Caloriks Measure Weight Oz Pro- tein Fat Carbohy- drate Cake, etc. — Cont'd Cream puflf shells i^ puffs 0.8 10 68 22 Doughnuts .... 5 doughnut 0.8 6 45 49 Fruit cake .... piece i| in. X i| in. X 1 in. 0.9 6 26 68 Gingerbread I . . piece I in. X if in. X 2 in. I.I 7 21 72 Gingerbread II . . piece I in. X 2 in. X 2 in. 1.2 8 22 70 Hermits .... 2| cookies 2 in. diam. 0.9 6 29 65 Lady fingers . . . 2-4 fingers I.O 10 13 77 Macaroons . . . 2 macaroons 0.8 6 33 61 Marguerites . . . 2 crackers 0.9 10 41 49 Molasses cookies I . 3 cookies 2 in. diam. 0.7 6 34 60 Molasses cookies II 2\ cookies 2\ in. . diam. 0.9 6 32 62 Oatmeal cookies . . f cooky 3 in. diam. 0.7 II 21 68 Oatmeal wafers . . I wafer 2f in. diam. 0-5 II 23 -66 One egg cake . . . if in. cube 1.0 8 32 60 Peanut cookies . . i| cookies 2 in. diam. 0.8 II 43 46 Plain cookies . . . 2 cookies 2\ in. diam; 0.9 6 33 61 Sponge cake . . . piece i| in. X i| in. X 2 in. 0.9 II 19 70 Sponge cake, hot piece 2 in. X 2f in. water .... X|in. 0.9 7 7 86 White mountain icing 2\ tbsp. 1.0 I — 99 Candies, CoNFEcnoNS, AND Sugars Cherries, candied 10 medium cherries 1.0 I — 99 Chocolate fudge . . piece i^ in. x f in. ^ X I in. 0.9 2 20 78 Chocolate nut car- piece I in. X I in. amels .... X i in. 0.7 4 32 64 33^ FEEDING THE FAMILY ioo-Caloree Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Candies, etc. — Cont'd Chocolate, milk, piece 2i in. x i in. sweetened . . Xiin. 0.7 7 58 35 Coconut caramels . piece I in. X I in. X |in. 0.7 3 24 73 Corn syrup . . . if tbsp. 1.5 — — 100 Ginger, crystallized . 6 pieces i| in. X | in. X i in. I.O I 99 Honey I tbsp. I.I I 99 Maple sugir . . . 4tsp. I.I — — 100 Maple syrup . . . i^ tbsp. 1.2 — 100 Molasses .... i| tbsp. 1.2 3 97 Penouche .... piece I in. X I in. X^if in. 0.9 2 18 80 Sugar, white, granu- lated .... 2 tbsp. (scant) 0.9 — 100 White, loaf . . . 3^ lumps (full size) 0.9 — 100 White, powdered . 2 tbsp. - 0.9 — — 100 Brown .... 2 tbsp. 0.9 — — lOO Cereals Cornflakes .... li cups 1.0 6 4 90 Cornmeal, cooked ! cup 6.0 10 5 85 Farina, cooked . . f cup 6.0 12 4 84 Grapenuts* . . . 3 tbsp. 1.0 12 2 86 Hominy grits, cooked Icup 6.8 9 I 90 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 I cup 7.9 17 16 67 Popcorn, popped unpopped i^ cupsl icup J 0.6 II II 78 Puffed corn . . . I J cups 1.0 6 4 90 APPENDIX 337 ioo-Calorie Portion Distribution of Calortks Measure Weight Oz. Pro- tein Fat Carbohy- drate Cereals — Cow^'i^ Puflfedrice . . . li cups I.O 9 I 90 Pufifed wheat . . . if cups I.O 15 3 82 Rice, steamed . . fcup 4.0 9 I 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 fcup 6.0 13 3 84 Wheat, shredded . . I biscuit 0.9 13 5 82 Custards, Puddings, AND Ices Apple snow . . . I cup 2.1 6 2 92 Apple tapioca . . icup 3-6 I I 98 Boiled custard . . 1 cup (scant) 2.2 13 44 43 Brown Betty . . . icup 2.1 3 35 62 Chocolate blanc mange . . . I cup (scant) 1.9 8 33 59 Coffee jelly . . . li cups 9.9 II — 89 Cornstarch blanc mange . . . icup 2.7 9 24 67 Cottage pudding . . slice if in. X 2 in. X 2^ in. I.I 7 26 67 Cup custard . . . |cup 3-3 17 39 44 Date pudding I . . slice I in. X I in. X ii in. 0.8 5 30 65 Date pudding II . . slice 3 in. diam. | in. thick I.I 7 27 66 Lemon ice ... . ^ cup (scant) 3-1 — — 100 Lemon jelly . . . ^cup' 3-8 9 — 91 Lemon milk sherbet J cup 1.9 4 12 84 Peach ice cream icup 1.8 4 51 45 338 FEEDING THE FAMILY icxs-Calortk Portion Distribution of Cai-ortks Measure Weight Oz. Pro- tein Fat Carbohy- drate Custards, kixj. — Cont'd Prune souffle . . . fcup 1.8 10 — 90 Raspberry sherbet . 4 cup 2.1 I — 99 Rice pudding I . . 1 cup (scant) 3-1 18 32 50 Rice pudding II . jcup 2.2 12 27 61 (creamy) Rice pudding III fcup I-S 8 7 85 Snow pudding . . fcup 2.2 10 — 90 Spanish cream . . I cup 2.S 18. 28 54. Tapioca-cornmeal pudding . . . 2 tbsp. 1.8 II 20 69 Tapioca cream . . fcup 2.8 12 28 60 Vanilla ice cream I . 2I tbsp. 1.6 4 63 33 Vanilla ice cream II . icup 2.0 6 55 39 Dairy Products and Fats Bacon fat .... I tbsp. 0.4 — 100 — Beef drippings . . I tbsp. 0.4 — 100 — Butter I tbsp. (scant) o.S I 99 — *J Buttermilk . . . li- cups 9.9 33. 13 54 Cheese, American pale .... i| in. cube 0.8 26 71 3 Cottage .... 5I tbsp. 3-2 76 9 15 Full cream . . . piece 2 in. X I in. X t in. 0.9 25 72 3 Neufchatel . . . 2 tbsp. I.I 23 75 2 Swiss slice 4I in. x 3! in. X i in. (i^ cu. in.) 0.8 25 73 2 Cream, thin (i8% fat) icup 1.8 5 86 9 thick (40% fat) li tbsp. 0.9 2 95 3 whipped .... 2 tbsp. 0.9 2 95 3 "^Milk, condensed. sweetened , . 1 2 tbsp. I.I II 23 66 APPENDIX 339 ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Dairy Prod. — Cont'd Milk, condensed, un- sweetened . . 3f tbsp. 2.1 23 51 26 skim . . . i| cups^ 9.6 37 7 56 top lO oz. . icup 2.1 9 78 13 top 12 oz. . 1 cup 3-0 10 75 15 whole . . . f cup^ 5-1 19 52 29 Oleomargarine . I tbsp. o.S I 99 — ^ Olive oil . . • I tbsp. 0.4 — 100 — Eggs and Cheese Dishes Eggs, a la goldenrod \ serving 2.0 18 42 40 raw (in shell) . . li eggs 2.7 36 64 — scrambled . ¥ cup 2.1 20 76 4 whites . . 7 whites 6.9 97 3 — ^ yolks . . . 2 yolks I.O 17 83 — timbale . . f cup 4.2 26 55 19 Cheese souffle . Icup 1.7 18 70 12 Cheese straws 2f straws 5 in. X f in. X f in. 0.8 17 52 31 Macaroni and cheese ^cup 2.1 17 39 44 Rice fondue with crackers . . . i| saltines and 2^ tbsp. sauce 1.4 22 48 30 Rice with cheese and tomatoes . . . icup 2.1 19 42 39. Samp baked with cheese . . . ^cup 4.0 14 20 66 Welsh rarebit . . i^ tbsp. rarebit and 1 slice toast 1-3 22 57 21 Fruits Apple, baked, with 2 tbsp. sugar . . \ large apple 2.3 I 3 96. baked, with whipped cream .... \ serving 2.4 I 31 68 fresh I large fcup 7-S 3 5 92 Apple sauce . . . 3.5 I 3 96 340 FEEDING THE FAMILY ioo-Calorie Portion Distribution of Calories Measure Weight Oz. Pro- tein Fat Carbohy- drate Fruits — Cont'd Apricots, canned . . 3 large halves and 2 tbsp. juice 4.8 5 — 95 dried 9 halves 1.3 7 3 90 dried, stewed . . ¥ cup 2.7 4 2 94 Bananas .... I large 5.5 5 6 89 Blackberries, fresh 1 cup (50 berries) 6.1 9 16 75 stewed .... i cup 2.2 2 4 94 Cantaloupe . . . imelon4^in. diam. 18.0 ^ — 94 Cherries, stoned . . I cup 4.5 5 9 86 Cranberry jelly . . 2 tbsp. 1-5 I 99 Cranberries, fresh 2 cups 7.6 3 12 85 Cranberry sauce . . 1 cup (scant) 1-5 — I 99 Currants, fresh . . i| cups 6.2 II — 89 Dates, unstoned 3-4 dates I.I 2 7 91 Figs, dried .... i^ large I.I 5 I 94 Grapes, Concord . . I large bunch 4.9 5 15 80 Grape juice . . . ^cup 3.5 — — 100 Grapes, Malaga . . 22 grapes 3.7 5 15 80 Huckleberries, fresh I cup 4-7 3 7 90 Lemons 3 large 11.4 9 15 76 Lemon juice . . . i| cups 9.0 — — 100 Olives, green . . . 6-8 olives 1.6 I 83 16 ripe 6-8 olives 1-7 3 90 7 Oranges ..... I large 9-5 7 2 91 Orange juice . . , I cup 8.2 — — 100 Peaches, fresh . . 3 medium 10.5 6 3 91 canned .... 2 large halves and 3 tbsp. juice 7-5 6 2 92. stewed .... |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 90 Pineapple, canned . I slice and 3 tbsp. juice or \ cup \ shredded 2.3 I 4 95 fresh ..... 2 slices I in. thick 8.2 4 6 90 APPENDIX 341 ioo-Calorie Portion Distribution of Calortks Measure Weight Oz. Pro- tein Fat Carbohy- drate Fruits — Cont'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. 1.4 2 — 98 Raisins |cup I.I 3 9 88 Raspberries . . . li cups ^.3 10 14 76 Rhubarb, fresh . . 4 cups of I in. pieces 15.3 10 27 63 stewed .... |cup 1.7 I 2 97 Strawberries, fresh . i| cups 9.0 10 14 76 Watermelon (edible portion) . » . II. 7 5 6 89 Meats and Fish (Cooked) Beef, corned, boiled (less i fat con- tent)! .... slice 4I in. X i| in. X|in. 3-0 53 47 — corned, boiled (with fat) .... I.O 21 79 — dried 4 thin slices 4 in. x sin. ^ 2.0 67. 33- — dried, creamed I icup 2.4 16 65 19 dried, creamed II ^cup 2.3 20 62 18 . flank, fat, stewed ' 0.9 26 80 — Hamburg steak, broiled . . . cake 2^ in. diam. 1 in. thick 2.0 55 45 — heart, stuffed . . slice 2^ in. x 2^ in. X i in. 1.0 21 68 II loaf ..... slice 4 in. X 6 in. X i in. 1.4 40 60 — • pie \ serving 1.7 10 43 47 ^ 15 % 0^ weight lost in cooking. ' « Bull. 162, OflSce of Experiment Stations, U.S. Dept. Agriculture. 342 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 2^ in. X i in. 1.6 46 54 round, lean, boiled ^ 2.2 90 10 round, lean, pot \ roast ^ ... 1.6 62 38 — round steak, lean, pan broiled ^ slice 4 in. X 3 in. X li in. 2.0 48 52 — round steak, stuffed slice 3 in. diam. \ in. thick 1.7 39 49 12 round steak, Svsdss style .... slice 4 in. X I in. X f in. 1.2 35 48 17 sirloin steak, lean. ? \ broiled . . . slice 2 in. x i^ in. X f in. 2.0 47 53 sirloin steak, me- dium fat, broiled slice if in. x i^in. X f in. 1-3 31 69 stew with vege- tables .... 1 cup 3-0 16 45 39 Fish Bluefish . . . . medium serving 2.4 72 28 — Codfish, balls . . I ball 2 in. diam. 1-7 14 65 21 creamed . . . 5 cup 2-5 32 46 22 Halibut steak, broiled . . . piece 3 in. x 2\ in. X I in. 3-0 61 39 — Mackerel, Spanish, broiled . , . 2.6 56 44 — Salmon, canned . 2 cup (scant) 1.8 45 55 — creamed, on toast \ cup salmon and h slice toast 2.4 22 42 36 loaf .... \ cup 2.1 37 52 II * Bull. 162, Office of Experiment Stations, U. S. Dept. Agriculture. APPENDIX 343 ioo-Calorie Portion Distribution of Calortkr Measure Weight Oz. Pro- tein Fat Carbohy- drate Fish -^Cont'd Sardines, canned . 3-6 sardines 1-7 46 54 — Tunnyfish a la New- . burg .... ' canned . . . J cup (scant) 1.8 36 60 4 1 cup 2.8 70 30 — Frankforters . . . I sausage I.I 31 67 2 T,a,mb, chops, broiled I chop (piece 2 in. X 2 in. X ^ in.) 1.6 40 60 — leg, roast .... slice 3I in. x 4^ in. X |in. 1.8 41 59 — Mutton, leg, roast . slice 3 in. x 3I in. X|in. 1.2 33 67 — Pork, bacon . . . 4-5 small slices 0.5 13 87 — ham, boiled . . . slice 4I in. X 4 in. X i in. 1.3 29 71 — sausage . . . if sausages 3 in. long 1 in. diam. (after cooking) I.I 20 78 2 Poultry Capon, roast . . slice 4 in. X 2^ in. Xiin. 1.7 51 49 — » sauoj^O • •«-> Q (J .4.J ■«-) 3 H|PIrt|« W M ^ M o 3 Kjhe rtiw « \0 36o FEEDING THE FAMILY i u 8 S3UOIB3 -oqa^o 8 8 M M saiaoiTJ3 1 1 sauoi^O 1 1 (pajfooo) •zo 5q3i9A\ o q M ajnsB9H icup (scant) if cups Pi O 1 ;2 vO O vo OS PC S9U0p3 ajTJjpXq -oq«3 VO O lo 0\ sauofBO 1 1 S9UOIT33 1 1 (pa^ooD) •zo VO 00 d ams'Bdp^ ft a 3 3 M Hi-* Lactose Lemonade 1 tbsp, cane sugar 2 tbsp. lemon juice 6 tbsp. lactose f cup water Lemonade 1 cup water ij tbsp. sugar 2 tbsp. lemon juice APPENDIX 361 S3U0l'B3 a sauojBQ S3UOfB3 uia^ojj (pajfooo) •20 ains'Baj^ S3UO['B3 S S3UO\BJ -oqxBp M 00 S9IJOJ'B3 S31J0][B3 (pajjooD) •ZQ ainsBaj^ ".9 s a ••5 (U W rf M M M nW a a C^ o -, ti • tn a Q. :3 o Jn ci, m 3 2 "^-S ^ o, a- 362 FEEDING THE FAMILY S3lJO|B3 -oqivj S3U01'B3 (pajfooD) •20 iq3i3AV ajnsB3jV .s X .S.S Sx S3U01133 8^ sauoj'Bj sauopQ S3UOI'B3 (paijooa) •zo 5q3pA\ ajnsB3j^ O X .9-9 H ^ ^ 8 a 'Ti in 5 a X^ ^ S *^ O '^ T) '-' 8 00 10 5 M to ►-• VO M 00 CO VO ^ (N M fO tJ- t^ M VO cs Tf « CO Tl- M H ^ W fO M ^ M 364 FEEDING THE FAMILY sauoiBO 00 M « ^ -oqjBO sauopo Tf t^ o> 00 ? ^^J W CO Tt- S3UOIB3 ■* vO 1 u;ajoj 00 aiBjpXq CO 8 -1- c>» -oqiB3 sauoFD H 00 '4- 00 00 s ^^J M to § > Q 8 sauopo 00 10 1-- CO (p33[OOD) ^ ^ •zo '^ CO CO 00 M •S d-9 .a- (IH rH|e« coX tn ainsBajii CO ^ S X s.a 1 C CO 'B X .s M M M CO CO 55 "^ ^1 Is 1 < § X i^i. P M c" J^ ti (rt .jD w 12; c H-S-a i£8 -s; gU 5 CO w so ■«i: CO . M PO 00 t^ 00 VO 00 00 't ON H 10 ■^ 00 00 M c< CO H 00 VO 10 Tj- CO •^ w I I 3 ^ ^ ^ O ej J^ a o, fco a, a a o U U flj t_) U ■*-' (-M I ON 00 10 x.a « ,S •a w .a ft ",5;x -3 8 8 O vO O i^ i2 5 S 370 FEEDING THE FAMILY -oqjBO c« sauoiBO M CI S3UOIB3 t^ 00 (P331003) •zo M C4 amsBSjii Piece I in. X if in. X 2 in. Piece I in. X 2 in. X 2 in. > M M sauoi^o S3U0]B3 fO ►-• tJ- 00 H M (pgjjooo) •zo ^q3i9M uo O lo d ains^sH .a 2 X X. Sg-3 -Sx IX y Gingerbread I I cup molasses ^ cup water 2^ cups flour I tsp. soda i^ tsp. ginger 4 tbsp. melted butter 1 tsp. salt Gingerbread II I cup molasses 1 cup sour milk 25 cups flour if tsp. soda 2 tsp. ginger h tsp. salt i cup melted butter APPENDIX 371 ^ 9 s H vO M VO ? ? d -3 S O e« v§ 10 -I li ^ 5« . . . Jn ^ ^ -» ^ Qi CL CL • 0,0,0-3 onuooOQ, O (J O ^1^ "ti "iJ ti 4^3 M Hi-* Hi'* C^ W H M M >H y =3 S S ^ -c (rt C« O „ • »H ' ?^ o. a 3 'rt cu bO O4 O, O* Oi tiJD 3 3 3 3 U3 r^ fO «^ M fO M o o lO vd " M ..s I ■s ^ ^ ■*-■ sa «e 'o o fc; =3 3 O bO, qa 13 •C o §1 <^-S W) r^^is S3 Sg-g-isg-gtl o 374 FEEDING THE FAMILY 8 ajuipXq -oqjB3 S3U0IB3 S9U01B3 (pa^looD) •ZQ ajns^}^ .g sauoi'BQ 9q.'wpXq sauoiBO S9U0IB3 (p35|OOD) •zo ;qStaM ams'Bsp^ ,B .a 1? v8 M -3 O^ CO ^ a a, •Z d 13 I a u 44 bo a 0) u is bo 3 a 3 HC» M H H-i* Ci W APPENDIX 375 X - X CO 3jnS«3}\[ 3 I sauoiB^ sauoi'B3 -oqjBO sauoiB^ sauoi^Q (pa^iooD) •zo wnsBayi APPENDIX 379 vS ^ ^^ to CO CO ^ fO 00 O M r^O •<« CO H4 I I 38o FEEDING THE FAMILY sauoi^O a^BjpXn 5 VO -oqjB3 S3UOIB3 vO Os o o %^i CN to CO sauoi^O t^ t- to I Up^OJd^ h-l (paiiooa) •ZO M M CO CO 00 6 .a X B* .a M X ajnsBSJv .s.s g d.S "^1? Hea M yx 8 X C/2 CAI S3iaOIT23 8 a s I^ox M O ■^ M S3UOIVJ c< 00 o 3;uipXq -oqjBO CO M Vo M sauoi^o ^ 8 ^ 1 1-^d lO ^ t^ S3UOIB3 OS cs CO o Up;OJ<£ M M M (pajjooD) PO °° o > 10 ^ ?? 8 X B amsBoj^ . a a •'- •^ ml-* c« X 1 .5 ^ • H|C< > fl «o ^ c 03 .pH ,2 ^ r .. egg cup milk r cups flour tsp. baking powder tsp. salt M C3 ^ M .fl S TAGE Pud cup butte cup sugar > Custard cups milk eggs tbsp. suga CE Puddin f cups dat i cups flou cup sugar cup dripp tsp. cinna S-HNN|« M M W Th iH|C« P to coo ^ M H pHK»n|KHM 11 u u Q •a CO APPENDIX 381 1 1 M r- 1 Ov Tj- M M M CO M .S3 ^S 3 8 hN S3UOIB3 in lO o VO to F^ox M 00 M sauopo r^ o IH a:>BjpAii -* t^ ^ o > -oqjTJO M S3UOI^3 CO -' S3UOP3 s to 00 '* H (pa^ooD) « O to •zo ^qSi3AV ^ M ^ g b K K 1 sjnsBapi 3 8 8 ■* to -55 s ci U Ice Creai ches sugar thick crea milk SoUPFLE prunes (u ked) whites sugar RRY ShERB raspberries ps sugar water p. lemon ce white Peach 6pea icup I cup I cup r, . 2 bo a g ^ O (u o P H|«» lOHlN ^ M H H 04 H APPENDIX 383 a t^ 1 00 M M 00 M M CO w «< I 1 00 vo PI & « ^ 8: § ^ 10 M 00 M to ^ s M 4 q 06 M I . *3 • rj 1"^ p sugar g whites p lemon ups wate tl ssfs:: r M cOH* •-• 384 FEEDING THE FAMILY sauopo ajBjpXq to S vB -oqJ^O S3UOIB3 00 O 00 . l^d M O) sauoj^o 00 ^ N 1 Ul3}OJi M *"* M (pa^ooD) lO 00 OO 1 •ZQ N H cs ^ ainsBapi 1 M e» «|io S9UOP3 to c^r ;^ I^:>ox ^ «>. s3uo]t;3 HI "* VO 3;BjpXq to C4 to to -oqjB3 M sauo|B3 00 M Pj l^J CO c« rt S9U01B3 w M H > upiojd: M (paTjooo) to vO O •zo o\ « iqSpAV M c« s -oqj^O sauoi^O ON to O H 1 S3IIOIB3 1 ^ o\ H H (pa^iooD) fO 00 t^ (2 •zo ^q3PAV ^ H & ^ HN ajTiffBa^^i ^ u •ON H 00 1 M en 3 M fe n^ s 5 ROD 2 cups milk 4 tbsp. flou 4 tbsp. butt 8 eggs 8 slices brea Seasonings 1 1 I egg f cup milk Seasonings 1 5 eggs ^ cup milk 2 tbsp. butt Seasonings APPENDIX 387 R ^ PO 00 M 00 6 cj X 1 M f 10 IN 10 On M M 00 M M 10 H M 00 q M X CO 00 .a a, w c« a COHlNrHl-* COCO d S tfl a ti 5P i w - a 6 s^r^-' - Hn m <*) 388 FEEDING THE FAMILY o sauoi^O aiBjpAq -oqjBO J^ % sauoi^o S °^ s3iaop3 lO CI (P35I003) •zo ams^aK M X rt :g c75 tr I > sauoi^O 00 M lO » t^ VO M vO Tl- 00 rh r^ M ■* t^ cs 10 Tf CO 00 CO M M VO r^ t^ 00 CO CO M 'S ^ tfl ^ D *J {« CO J2 O u 4> -^ «« S W H* M M «N rt- CO 390 FEEDING THE FAMILY sauopo a^BjpXq s % S Ov -oqjB3 sauoj^O ro PO M . ;iJd <0 S3UOIB3 M M 1 1 up;oj H -oqj^O saiioiBO lO VO "* S3UOIB3 o PO ^0 W > (14 uprjojj (paijooD) o lO 00 q •ZQ fO Th 4 o tjqSpAV cs rO to wnsTOK ^ 1 1 3 H|« (2 S9U0p3 sauoi^p a^BjpXq -oqj^O 1 9 1 a M S3U01B3 M 00 (P35100D) •ZO o o amsBaj^ .S.S 3 g X Beef Loaf 2 lb. lean beef 1 egg 2 tbsp. melted butter Seasonings Beef- Stew with Vegetables \ lb. beef plate \ cup carrot cubes I onion 3 potatoes \ cup turnip cubes \ cup flour Water and season- ings Codfish Balls 1 cup codfish 2 cups potato APPENDIX 393 ^ ^ M M ON VO o M °^ M H ■i^ lO S S3UOIB3 O S3IJOIB3 -oqjBO H M S9UOIT33 M CO M CO (pailooD) •zo q ajnsBajij Pie 9 in. diam. 3^ in. deep or 8 large servings Meat Pie Pastry : i^ cups flour 1 cup c-risco i tsp. baking powder I tsp. salt Filling : ^ lb. beef rump 5 medium po- tatoes 1 Ib.carrots 2 large) J oz. salt pork I small onion 3 tbsp. corn- starch I tbsp. butter Seasonings APPENDIX 397 "^ 00 o o CO 00 d H cs* q t X3. -, « X ^ Th O 00 •zo CO M iq3pM c« w b a s i 1 •1 •1 ajns^aj^ .9 .9 00 .s g s 1 o-^ a a Pie pies p sugar er Q pastry r 2 crusts cup sugar cup water lain pastry undercrust a strip's over to H ^ a <: ERINGUE ps milk sp. flour p sugar i^ 35 3 a- M hmPh a «N lO'^IW APPENDIX 401 CO 03 8 o 8 1 O J3 8 CO t^ M v 3^8°° 8 gi^ ^ 2 -p s fc« o c 3 *J d 3 to ci< di. ^ £?« O4 &) 3 U W pL, P4 XJ d d 3 -3 -^ '^ Oj D< Q, Q, . Wi CO coH«^ 3^ 402 FEEDING THE FAMILY -oqj^D O sauoi^O 00 M S3UO|B3 fO »o (pa^ooD) •zo q h-l amswpii II I I o > S9UOIB3 1 saijopo a^BjpXq -oqa^O CO M oo S3UO]B3 o CO ^ On (P33100D) •zo q M to amsBajv a . 1 00 ■I isiN AND Cran- berry Pie [ cup cranberries [ cup raisins [ cup sugar [ tbsp. flour [ cup water ^lain pastry for 2 crusts Rhubarb Pie 2\ cups rhubarb i^ cups sugar I egg 2\ tbsp. flour Plain pastry for 2 crusts 1 s. APPENDIX 403 •M . a In 1 a => a 404 FEEDING THE FAMILY S3UOl'B3 S3UOIB3 S9UOp3 (p9;5I003) •zo ainsvaj^ t S3UOJB3 S3UO|'B3 -oqjB3 S9U0|'B3 (pa^looD) •zo amsBajiI 3 B M ^ d ^ ^t: S HflN WIN ^ ml-* H-* CO APPENDIX 405 00 S CO o< l-i NO M H ^ m 10 H 10 ON M « 5 « •«|- ■^ fO W 10 00 t^ t-^ W H . 4) ST 4o8 FEEDING THE FAMILY sauoiB3 sauofB3 S3UOJB3 (pa^jooD) •zo 3jnsBap\[ s3uore3 S3U0I'B3 -oqjBD SSUOJB^ 83110^3 (p35JOOD) •ZO »qgi3A\ amsiBsp^i ^95 APPENDIX S3UOf83 saiJO|'B3 (P93100D) •ZQ amsBaj^ I sauoi^3 S3UOIB3 -oqj^D sauofB3 (paTfooo) IP amsBsj^ 4IO FEEDING THE FAMILY S3UOIB3 1 aiTJjpXq ^ 00 Ov 1 -oqjBO sauopo ^ t^ 00 z i^J to 1 up;oj<£ (pa^ooD) 00 •zo M M !^ ainsBaj^ 1 1 sauopo R J2 I^ox M oo S3UOI'B3 CS lO VO SlBjpXq O io -oqj^D sauopo s 8" ^ ;^J c* a. io sauo|t;3 ^ « > ma^ojj (p33[OOD) t^ vO O •zo 00 r^ H 10 qSi3AV fO lO ajnsB3H 3 8 > CO »0 M 3:»BjpXq -oqiBO oo r^ sauopo 5 8 fO !>• (pajfooD) •zp ^q3i3A\ ^ q ajnsBaj^ 3 1 Cream of Corn Soup 2 cups canned corn 2 cups milk 2 tbsp. butter 2 tbsp. flour 2 cups water Seasonings Cream of Green Pea Soup i| cups peas I cup milk I cup water I tbsp. flour I tbsp. butter Seasonings APPENDIX 415 10 CO 00 M M . "* Tf « 3 « -a o t3 a . a cij -a as- J Q-.S Q ^ ci c< M C/3 4i6 FEEDING THE FAMILY 2; s a;Bipi{q -oqj^O ^ s S3UOJT33 ^ S9UOP3 t^ 00 (pa^ooa) •ZO q t-. amsTspi I cup f cup O > ^ o *^ CO S3UOIB3 a^-BjpAq -oqrej M ID S3UOIB3 tr> O M (P35JOOD) •ZO t>qai9AV q cj 00 "+ M CS ajnsTOH « CO Lentil Soup 2 tbsp. lentils (un- cooked) i^ tbsp. flour ^ tbsp. butter 1 tsp. sugar ^ tsp. salt 2 cups water Seasonings Lentil and Tomato Soup ^ cup lentils (cooked) I cup tomatoes i tsp. sugar i tsp. salt 5 onion 1 tsp. lemon rind 2 cups water Seasonings APPENDIX 417 (J a •^ ^ M VO 10 00 ■* M 00 CO g^ M < El l^J CO VO lO W P< sauopo o IT) VO s uta^ojj M (p31[OOD) 00 00 Tl- J •zo M Ti- CN ^q3i3M « M CJ § 04 K 1 §* 3inSB3K g s 3 i1l8 1 3 g §1 1 gill ■< lo cOH« M «N M «|«CO ^ '^ M M CO H« S 55 (^ APPENDIX 423 CO v§ to ON M 00 lip M a Q< Q. a 3 3 g s 3 lO t (N 1 S 00 M ^ 10 -8. M J fO 10 M CO PO vg H -s, ^0 00 CO s M Q s »« -^ -a 13 « .:: .2 -Q 2 3 c2 1^ .S-s-^.g t/3 g a, o g y5 9<2 aaS ^o^d^ ^^ ^ "3 en ^ Jr! S a v> O -2i 2 5 M r1 ■M 1 a. a f^.2 n 3 35 ^ ^ s. 5 £ vO 362. canned, 347, 352. chowder, 346, 412. fresh, 347, 352. on cob, 347. puffed, 336. soup, cream of, 346, 414. syrup, 336. Corned beef, 341. Cornflakes, 336. Commeal, 336, 352. and tapioca pudding, 338, 384. muflans, 334, 363. Cornstarch, 352. blanc mange, 337, 379. chocolate blanc mange, 337, 379. Correct attitude toward food, 147. Cost of calcium in food, 236. of cereals in packages, 226. of eggs, 239. of family dietary, 252. of food, 220. of food in Childs' Restaurants, 228. of food, effect of market factors on, 221. of iron in food, 239. of phosphorus in food, 237. of protein in food, 234. per 100 Calories of common foods, 426. reduction in family dietary, 254. relation to fuel value, 225, 426. Cottage cheese, 338. pudding, 337, 380. Cottolene, 352. Cottonseed compared with olive oil, 262. Courses in meals, value of, 208. Cracker crumbs, 352. Crackers, graham, 334. oyster, 334. saltine, 334. soda, 334. Cranberries, 340, 352. Cranberry and raisin pie, 345, 402. jelly, 340, 390- pie, 344, 400. sauce, 340, 391. Cream cheese, 338. cheese and date sandwiches, 334, 364- filling, 346, 410. of asparagus soup, 346, 413. of baked bean soup, 346, 413. of celery soup, 346, 413. of corn soup, 346, 414. of green pea soup, 346, 414. of peanut butter soup, 346, 415. of spinach soup, 346, 415. of tomato soup, 346, 415. pie, 344, 400. puff shells, 335, 369. sauce, 346, 410. Spanish, 338, 384. tapioca, 338, 384. thick, 338, 352. thin, 338, 352. toast, 334, 363- whipped, 338. Creamed chicken, 343, 393. dried beef, 341, 393, 394- peas, 348, 419, potatoes, 348, 419. salmon on toast, 342, 394. salt cod, 342, 393. turnips, 348, 419. Creamy rice pudding, 338, 383. Crisco, 352. Croquettes, macaroni, 336, 421 Croutons, fried, 334, 363. toasted, 334, 364. Crumbs, bread, 351. cracker, 352. INDEX 439 Crystallized ginger, 336. Cucumber and tomato salad, 345, 408. Cucumbers, 347. Cup custard, 337, 380. Currants, dried, 352. fresh, 340. Custard, boiled, 337, 378. cup, 337, 380. Custards, puddings, and ices, 337, 378. Cutlets, veal, 343, 399. Date and cream cheese sandwiches, 334, 364- pudding, 337, 380, 381. sandwiches, 334, 364. Dates, stoned, 352. unstoned, 340, 352. uses of, 264. Desserts, for adolescents, 165. for children, 137. fuel value of, 200. Diabetes, diet in, 314. green diets for, 324. Diabetic dietaries, 325, 326. diets, fat in, 321. saccharine in, 323. scheme for, 316. foods, use of, 322. Diet, fluid, 288, 293, 294. for acute indigestion, 299. for cold weather, 216. for colds, 298. for constipation, 42. for convalescence, 295. for diabetes, 314. for fat men, 60. for fat women, 84. for fever, 301. for gout, 327. for hot weather, 212. for minor illness, 298. for thin men, 58. for thin women, 85. for tuberculosis, 309. for typhoid fever, 303. green, for diabetics, 324. light, 295. mixed fluid, 306. semi-solid, 294. soft, 294. soft, for typhoid fever, 308. Dietary, for active woman, 79. for aged person, 192. for boy 16 years old, 172. for child i^ years old, 127. for child 3 to 4 years old, 134. for child 5 to 6 years old, 144. for child 8 years old, 160. for child 10 years old, 161. for diabetic, low-priced, 325, 326. for family, cost of, 252. for family, menu for, 256, 268, 273. for family. No. i, 249. for family. No. 2, 257. for family. No. 3, 269. for family. No. 4, 274. for family, reducing the cost of, 254- for fat man, 61. for fat woman, 84. for fattening, 59. for girl 16 years old, 173. for nursing mother, 97. for sedentary man, 52, 53, 59. for sedentary woman, 81, 82. for thin man, 59. for thin woman, 87. for tuberculosis, 311, 312, for working man, 57. for working man, tubercular, 312. recipes, 358. Digestion, effect of concentration on, 35. effect of food combinations on, 202. effect of food mixtures on, 36. effect of mastication on, 33. effect of regularity on, 34. in large intestine, 40. in mouth, 31. in small intestine, 38. in stomach, 34. Dinner, family, 245. types of, 199, 245. Doughnuts, 335. Dressing, boiled salad, 345, 404. French, 345, 406. mayonnaise, 345, 407. 440 INDEX Dried beef, 341. beef, creamed, 341, 393, fruits, uses of, 263. Drippings, beef, 338. 394- Egg lemonade, 333, 359. salad, 345, 406. timbale, 339, 386. Eggnog, 333, 359. Eggs, 339, 352. a la goldenrod, 339, 386. and cheese dishes, 339, 386. relative cost of, 227, 238. scrambled, 339, 386. Eight year old child, dietary for, 160. energy requirement of, 158. food for, 145. food plan for, 159. protein requirement of, 158. Elderly person, food plan for, 190. Energy, measurement in food, 8. requirement, adolescents, 169. requirement, aged persons, 186. requirement, baby, 102. requirement, child i§ to 2 years old, 126. requirement, child 3 to 4 years old, 132. reqviirement, child 5 to 7 years old, 141. requirement, child 8 to 12 years old, 158. requirement, child 12 to 13 years old, 169. requirement, family, 242. requirement, farmers, 16. requirement, in sickness, 287. requirement, in tuberculosis, 310. requirement, man, 47. requirement, man, active, 51. requirement, man, sedentary, 48. requirement, measurement of, 14. requirement, woman, 74. requirement, youth 14 to 17 years old, 169. sources of, 6. value of desserts, 200. value of food, 8, 333, 3Si- value of gruels, 289. value of luncheons, 156, 176. value of top milk formulas, 1 1 1 . value of whole milk formulas, 108. value, relation to market cost, 225, 426. EngUsh walnuts, 344, 354. Enzymes, description of, 32. Factors in market cost of food, 221. Family, breakfast menu, 246. breakfast plan, 197. dietary, calculation of, 248. dietary, cost of, 252. dietary, essentials of, 243, dietary, menus for, 256, 268, 273, 278. dietary No. i, 249. dietary No. 2, 257. dietary No. 3, 269. dietary No. 4, 274, dietary, reducing cost of, 254, 261, 267, 278. dinner, menu, 245. dinner, plan, 199. energy requirement of, 242. luncheon, menu, 247. luncheon, plan, 198. Farina, cooked, 336. uncooked, 352. Farmers, energy requirement of, 16. Fat, foods rich in, 11. in diabetic diets, 321. man, diet for, 60. man, dietary for, 61. sources of, 6. woman, diet for, 83. woman, dietary for, 84. Fattening dietary for a sedentary man, 59. for a woman, 87. Fermentation, influence of carbohy- drates on, 37. Fever, diet in, 301. energy requirement in, 302. typhoid, diet in, 303. typhoid, mixed fluid diet for, 306. typhoid, modified milk diets fcr, 305. typhoid, soft diet for, 308. INDEX 441 Figs, chopped, 352. whole, 340. Filberts, 344. Filling, cream, 346, 410. for charlotte russe, 346, 409. Fillings and sauces, 346, 409. Fish, bluefish, 342. codfish, 342, 392. haUbut steak, 342. mackerel, Spanish, 342. meats, and poultry, 341, 392. salmon, 342, 394, 397. sardines, 343, 345, 407. tunny, 343, 398. Five cents, purchasing power in Child's Restaurants, 228. Five year old child, dietary for, 144. energy requirement of, 141. food for, 135. food plan for, 143. protein requirement of, 141. Flaked wheat, cooked, 337. uncooked, 354. Flank, beef, stewed, 341. Flavor, value of, 265. Flour, barley, 351. buckwheat, 353. graham, 353. rice, 353. rye, 353- wheat, 353. Fluid diet, 288. menus for, 293, 294. Fondue, rice, 33Q. 388. Food after fifty, 184. after weaning, 115. amounts to yield 100 Calories, 13, 332. at end of first year, 116. calcium in, 25. classified according to cost, 426. classified according to foodstuff, 10. energy value of, in common meas- ures, 351. energy value of recipes, 358. for adolescents, 162. for baby, 98. for child i to 2 years old, 119. for child 3 to 4 years old, 128. for child S to 7 years old, 135. for child 8 to 12 years old, 145. for college youth, 178. for the aged, 184. for the family group, 194. for the nursing mother, 93. for the school lunch box, 152. for the sick and convalescent, 285. for typhoid fever, 307. from 17 th to 25 th year, 174. in pregnancy, 88. iron in, 23. one hundred Calorie portions of, 332. order in meals, 204. phosphorus in, 22. plan, aged person, 191. plan, child ij to 2 years old, 126. plan, child 3 to 4 years old, 133. plan, child s to 7 years old, 143. plan, child 8 to 10 years old, 159. plan, elderly person, 190. plan, man, active, 55. plan, man, sedentary, 50. plan, man, working, 55. plan, woman, active, 71. plan, woman, sedentary, 80. plan, youth 14 to 16 years old, 170. protein in {see also table of 100- Calorie portions), 21. value and cost of cereals in packages, 226. value of common measures, 351. value of recipes, 358. value of loo-Calorie portions, 332. warm, in old age, 188. Formulas, top milk, 109. top milk, fuel value of, iii. whole milk, 105. whole milk, fuel value of, 108. Four year old child, dietary for, 134. energy requirement of, 132. food for, 128. food plan for, X33. protein requirement of, 132. Fourteenth to sixteenth year, dietary for boy, 172. dietary for girl, 173. energy requirement of, 169. 442 INDEX Fourteenth to sixteenth year — Cont. food plan for, 170. protein requirement of, 169. Frankforters, 343. French dressing, 345, 406. rolls, 334. toast, 334, 364. Fried croutons, 334, 363. Fruit cake, 335. Fruit, for adolescents and youths, 163. for children, 121, 130, 138, 149. for college youth, 181. punch, 333, 359. salad, 345, 306. value in diet, 239. Fruits, 339, 390. Fudge, chocolate, 335, 376. Fuel requirement — see Energy Re- quirement. Fuel value — see Food values or Energy values. Gelatin, 353. Ginger, crystallized, 336. Gmgerbread, 335, 370. Girl 16 years old, dietary for, 173. Girls and boys, growth of, 146. height and weight of, 432. Glazed sweet potatoes, 348, 419. Gout, diet in, 327. Graham, bread, 333. crackers, 334. flour, 353. muflfins, 334, 365. Granulated sugar, 336, 354. Grape juice, 340. Grapenuts, 336. Grapes, Concord, 340. Malaga, 340. Green diet for diabetics, 324 . vegetables for children, 122, 131, 138, 149. Griddle cakes, 334. 365- Growth, chart of normal, 146. Gruels, food value of, 289. Halibut steak, 342. Ham, boiled, 343. Hamburg steak, 341. Hard sauce, 346, 411. Heart, beef, stuffed, 341, 397, Height and weight, boys, 431. girls, 432. men, 429. women, 430. Hermits, 335, 37i. Hickory nuts, 344. chopped, 353. High school luncheons, 166. Hominy grits, cooked, 336. uncooked, 353. Honey, 336. Hot food, value of, 198. water sponge cake, 335, 375. weather diet, 212. Hours for babies' meals, loi. for children's meals, 125, 141, 151. Huckleberries, 340. Ice cream, for children, 137. peach, 337, 382, vanilla, 338, 385. Ice, lemon, 337, 381. Ices, custards, and puddings, 337, 578. Icing, White Moimtain, 335, 375. Indigestion, acute, diet after, 299. Infant — see Baby. Intestinal putrefaction, diet for, 300. Intestine, large, digestion in, 40. small, digestion in, 38. Irish stew, 395. Iron, in children's diet, 115, 117, 120^ 123, 140. in food materials, 23. in restricted diets, 70. relative cost of, 238. Jelly, coffee, 337. cranberry, 340, 390. lemon, 337, 381. Kidney bean stew, 347, 420. Kidney, veal, 344. Lactose lemonade, 333, 360. Lady fingers, 335. INDEX 443 Lamb, chops, 343. roast leg, 343. Lard, 353. Large intestine, digestion in, 40. Leftovers, use of, 209. Lemon ice, 337, 381. jelly, 337, 381. juice, 353. milk sherbet, 337, 381. pie, 344, 401. sauce, 346, 411. Lemonade, 333, 360. egg, 333, 359- lactose, 333, 360. Lemons, 340. Lentil and tomato soup, 346, 416. meat loaf, 347, 420. soup, 346, 416, Lentils, baked, 347, 418. dried, 347. Lettuce, 347. and tomato salad, 345, 408. salad, 345, 407. Light diet, 295. Lima beans, buttered, 347, 421. dried, 347, 351, fresh, 347. Liver, veal, 344. Loaf, lentil meat, 347, 420. nut, 344, 422. salmon, 342, 397. sugar, 336. Lobster, 343. Lunch box, plan for, 152. Luncheon, family, menu for, 247. high school, 166. menus, with fuel values, 167, 176. school, menus for, 155. school, value of, 142, 154, types of, 198. Macaroni and cheese, 339, 387. cooked, 336. croquettes, 336, 421. uncooked, 353. with tomato sauce, 336, 421. Macaroons, 335. Mackerel, Spanish, 342. Man, active, dietary for, 57./ active, energy requirement of, 51. active, food plan for, 55. ash requirement of, 69. building material for, 62, energy requirement of, 47. fat, 60. fat, dietary for, 61. fattening dietary for, 59. protein requirement of, 63. sedentary, dietaries for, 52, 53. sedentary, energy requirement of, 48. sedentary, fattening dietary for, 59- sedentary, food plan for, 50. thin, 58. thin, dietary for, 59. Maple sugar, 336. syrup, 336. Marguerites, 335, 371. Market cost of food, factors influencing, 221. relation to fuel value, 225, 426. Mashed potatoes, 348, 422. Mastication, importance of, 33. Mayonnaise dressing, 345, 407. Meal hours for children, loi, 125, 141, 151- plans, types of, 197. Meals — see also Menus. balanced, 202. in courses, value of, 208. number in old age, 190. sequence of foods in, 204. value of variety in, 205. Meat, compared with milk and eggs, 67. loaf, lentil, 347, 420. pie, 341, 396. place in diet, of adults, 67. place in diet, of adolescents, 164. place in diet, of children, 139, 150. Meats, fish, and poultry, 341, 392. Men, aged, weight of, 186. height and weight of, 429. Menu, construction of, 196. for convalescents, 294, 297. for diet after acute indigestion, 299. for family dietary, 244, 245. 444 INDEX Menu — Cont. for fluid diet, 293, 294. for intestinal putrefaction, 301. for soft or semi-solid diet, 295. seasonal variation in, 207. value of contrast in, 209. value of variety in, 205. Menus, anti-constipation, 44. for cold days, 218. for convalescence, 294, 297. for family dietaries, 256, 268, 273, 278. for family group, 194. for hot days, 215. for prospective mother, 92. for school limcheons, 155, 167. for summer, 215. for winter, 218. types of, 197. Milk, as food in fever, 303. as source of calcium, 72. ash content of, 72. care of, 112. chocolate, 336. /compared with lean beef, 232, 236. compared with other high protein foods, 227, condensed, sweetened, 338, 352. condensed, unsweetened, 339, 352. for adolescents, 163. for children, 104, 120, 128, 136, 148. for college youth, 181. for the sick, 290. modified, for babies, 105, 109. modified, for typhoid fever, 305. pasteurized, how to supplement for babies, 112. relative cost of, 227. sherbet, 337, 381. skim, 339, 353. top, 339. whole, 339, 353. — why cheap food, 235. Mince pie, 345. Minor illness, diet in, 298. Mixed fluid diet for t3rphoid, 306. Mixtures of food, influence on digestion, 36. Modified milk, 105, 109, 305. Molasses, 336, 353. cookies, 335, 371, 372. Mother, nursing, dietary for, 97. nursing, food for, 93. prospective, food for, 88. prospective, menus for, 92. Muffins, biscuit, and bread, 333, 361. cornmeal, 334, 363. graham, 334, 365. one egg, 334, 366. twin mountain, 334, 367. Mushrooms, fresh, 347. stewed, 347, 423. Mutton, roast leg, 343. Navy beans, dried, 351. Neufchatel cheese, 338. Nitrogen, importance of, 18. occurrence in food {see also Protein), 21. requirement — sec Protein require- ment. Normal growth of boys and girls, chart of, 146. Nursing mother, dietary for, 97. food for, 93. Nut and cheese roast, 344, 388. loaf, 344, 422. Nuts, almonds, 344, 351. Brazil, 344. coconut, 344, 352. filberts, 344. for children, 151. hickory, 344, 353. peanuts, 344, 354- pecans, 344, 354- pine, 344- walnuts, English, 344, 354. Oatmeal, compared with sugar, 232. cooked, 336. cookies, 335, 372. uncooked, 353. wafers, 335, 373- Oats, rolled, 353. Occupation, influence on energy re- quirement, of men, 55. of women, 76. Oil, olive, 339, 353. INDEX 445 Old age — see the Aged. Old New England corn bread, 333, 366. Oleomargarine, 339, 353. compared with butter, 262. Olive oil, 339, 353- Olives, 340. One egg cake, 335, 373- miiffins, 334, 366, One hundred Calorie portions, 13. table of, 333. Onions, 347. scalloped, 347, 422. Orange juice, 340, 353. preventive of scurvy, 112. Oranges, 340. Oyster crackers, 334. stew, 346, 417. Oysters, 343. compared with milk, 227. Package cereals, fuel value and cost, 226. Parsnips, stewed, 347. Pasteurized milk, how to supplement for babies, 112. Pastry, plain, 345, 401. Peach ice cream, 337, 382, Peaches, canned, 340. fresh, 340. stewed, 340, 391. Peanut, butter, 344. butter soup, 346, 415. cookies, 335, 374. Peanuts, 344, 354. Peas, canned, 348, 354. creamed, 348, 419. dried, 354. green, 348. Pea soup, cream of green, 346, 414. split, 346, 417. Pecans, 344. shelled, 354. Penouche, 336, 377. Peppers, stuffed, 348, 424. Perishability, effect on cost of food, 222. Phosphorus, cost of, 237. in food, 22. in restricted diets, 70. Pie, apple, 344, 400. cranberry, 344, 400. cranberry and raisin, 345, 402. cream, 344, 400. lemon, 344, 401. meat, 341, 396. mince, 345. raisin and cranberry, 345, 402. rhubarb, 345, 402. squash, 345, 403. Pies, 344, 400, Pilaf, Turkish, 337, 425. Pineapple and cheese salad, 345, 405. canned, grated, 354. fresh, 340. Pine nuts, 344. Plain cookies, 335, 374. pastry, 345, 401. Plans for meals — see Meals, Menus, Food plans. Plums, 341. Popcorn, 336. Popovers, 334, 366. Pork, bacon, 343. ham, 343. sausage, 343. Portions, table of loo-Caloiie, 333. Potato chips, 348. salad, 345, 407. soup, 346, 417. Potatoes, creamed, 348, 419. mashed, 348, 422. scalloped, 348, 423. sweet, baked, 348. sweet, glazed, 348, 419, sweet, imcooked, 348. white, baked, 348. white, boiled, 348. white, mashed, 348, 422, white, uncooked, 348. Pot roast, 342. Poultry, meats, and fish, 341, 392^ stuffing, 343, 397. Powdered sugar, 354. Pregnancy, food during, 88. Proprietary infant foods, 113. Prospective mother, food for, 88 Protein, cheap sources of, 266. cost of, 234. foods rich in, 10, 11, 12, 446 INDEX Protein — Cont. in foods, amounts, 21, 333, 351. proportion in diet, 65. requirement, adolescence and youth, 169. requirement, aged persons, 189. requirement, child i to 2 years old, 126. requirement, child 3 to 4 years old, 132. requirement, child s to 7 years old, 141. requirement, child 8 to 12 years old, 158. requirement, in tuberculosis, 310. requirement, man, 63. requirement, woman, 86. sources of, 7. use, in cold weather, 65. use, in hot weather, 66. value of different kinds, 19. Proteins, purin-free, 68, 328. Prune pulp, 341. souffle, 338, 382. Prunes, 341. choice and preparation of, 264. stewed, 341, 391. Pudding, commeal-tapioca, 338, 384. cottage, 337, 380. date, 337, 380, 381. rice, 338, 383. snow, 338, 383. tapioca-commeal, 338, 384. Puddings, custards, and ices, 337, 378. use in adolescence and youth, 165. Puffed com, 336. rice, 337. wheat, 337. Pumpkins, cooked, 354. Punch, fruit, 333, 359. Purchasing power of five cents in Child's Restaurants, 228. Purins, foods containing, 68, 328. Putrefaction, intestinal, diet for, 300. Radishes, 348. Raisin and cranberry pie, 345, 402. Raisins, 341, 354. uses of, 264 Rarebit, Welsh, 339, 389. Raspberries, 341. Raspberry sherbet, 338, 382. Recipes, dietary, 358. Reducing cost of family dietary, 254. Reducing dietarj', for fat man, 61. for fat woman, 84. Requirement, for ash — see Ash con- stituents. for energy — see Energy. for fuel — see Energy. for protein — see Protein. Rhubarb, fresh, 341, 354. pie, 345, 402. stewed, 341, 391. Rice flour, 353. fondue, 339, 388. , pudding, 338, 383. puffed, 337. steamed, 337, 354. imcooked, 354. with cheese and tomatoes, 339, 389. Roast, beef, rib, 342. lamb, leg, 353. mutton, leg, 343. pot, 342. turkey, 343. veal, 344. Rolls, French, 334. Round of beef compared with milk, 227, 233. steak — see Steak. Saccharine, 323. Salad, banana, 345, 404. cheese and pineapple, 345, 405. chicken, 345, 405. cucumber and tomato, 345, 408. egg, 345, 406. fruit, 345, 406. lettuce, 345, 407. lettuce and tomato, 345, 408. pineapple and cheese, 345, 405. potato, 345, 407. sardine, 345, 407 tomato and cucumber, 345, 408. tomato and lettuce, 345, 408. Waldorf, 345, 408. Salads and dressings, 345, 404 . INDEX 447 Salmon, canned, 342. creamed on toast, 342, 394. loaf, 342, 397. Saltines, 334, 354. Samp with cheese, 339, 389, Sandwich, club, 334, 362. date, 334, 364. date and cream cheese, 334, 364. Sardines, canned, 343. salad, 345, 407. Sauce, apple, 339, 390. brown, 346, 409. brown sugar, 346, 409. cranberry, 340, 391. cream, 346, 410. hard, 346, 411. lemon, 346, 411. tomato, 346, 411. white, 346, 411. Sauces and fillings, 346, 409. Sausage, Frankfort, 343. pork, 343. Scalloped onions, 347, 422. potatoes, 348, 423. Scallops, 343. Schedule for children's meals, loi, 125, 141. Scheme for diabetic diets, 316. for whole milk feeding during first year, 105. School lunch box, 152. limcheons, 142, 152, 155, 166, 176. Science of food combinations, 200. Scrambled eggs, 339, 386. Seasonal variation in menus, 207. Second year, food for (see also Two year old child), 120. Sedentary man, dietaries for, 52, 53, 59- energy requirement of, 48, fattening dietary for, 59. food plan for, 50. protein requirement of, 63. Sedentary persons, type of luncheon for, 176, 198. Sedentary woman, dietary for, 81, 82. energy requirement of, 76. food plan for, 80. protein requirement of, 65. Semi-solid or soft diet, 394. menu for, 295. Shellfish, 343. Sherbet, lemon milk, 337, 381. raspberry, 338, 382. Shredded wheat, 337. Shrimp, 343. Sick, energy requirement of, 287. food for, 285. Sirloin steak, 342. Sixteen year old, boy, dietary for, 172. girl, dietary for, 173. Skim milk, 339, 353. Slaw, cold, 345, 405. Small intestine, digestion in, 38. Snow, apple, 337, 378. pudding, 338, 383. Soda crackers, 334. Soft or semi-soUd diet, 294. for typhoid fever, 308. Souffl6, cheese, 339, 387. prune, 338, 382. Soup, dear tomato, 346, 412. cream of asparagus, 346, 413. cream of baked bean, 346, 413. cream of celery, 346, 413. cream of com, 346, 414. cream of green pea, 346, 414. cream of peanut butter, 346, 415. cream of spinach, 346, 415. cream of tomato, 346, 415. lentil, 346, 416. lentil and tomato, 346, 416. pea, split, 346, 417. potato, 346, 417. Soups, 346, 412. Spanish cream, 338, 384. mackerel, 342. Special diabetic foods, use of, 322. Spinach, a la crgme, 348, 423. cooked, 348, 354. soup, 346, 415. with egg, 348, 423. Sponge cake, 335, 375. hot water, 335, 375. Squash, cooked, 354. , pie, 345» 403. Steak, halibut, 342. Hamburg, 341. 448 INDEX Steak — Co»/. round, pot roast, round, stuffed, 342, 398. sirloin, 342. stuffed, 342, 398. Swiss, 342, 398. Stew, beef with vegetables, 342, 392. Irish, 395. kidney bean, 347, 420. oyster, 346, 417. Stewed dried apricots, 340, 391. mushrooms, 347, 423. peaches, 340, 391. prunes, 341, 391. rhubarb, 341, 391. Strawberries, 341, String beans, 347. Stuffed beef heart, 341, 397. peppers, 348, 424. steak, 342, 398. tomato, 348, 425. Stuffing, poultry, 343, 397, Successful infant feeding, criteria of, III. Succotash, canned, 348. Suet, 354. Sugar, brown, 336, 354- compared with oatmeal, 232. for children, 150. granulated, 336, 354. loaf, 336, maple, 336. powdered, 336, 354. Sulphur in food, 21. Summer and winter diet, 210. menus, 215. Swiss cheese, 338. steak, 342, 398. Syrup, com, 336. maple, 336. Table of calcium in food materials, 24. cost of cereals in packages, 226. cost of food to yield 0.7 gram cal- cium, 236. cost of food to yield 0.015 gram iron, 238. cost of food to yield 2.75 grams phosphorus, 237. cost of one hundred Calorie portions of food, 426. cost of one hundred protein Calories from different sources, 234. dietary recipes, 355. food value and cost of cereals in packages, 226. food value in relation to cost, 426. food value in terms of common measures, 351. foods rich in carbohydrates, 11. foods rich in cellulose, 12. foods rich in fat, 11. foods rich in protein, 10. foods rich in protein and fat, 11. foods rich in water, 12. height and weight of children from birth to fifth year, 433. height and weight of boys, 431. height and weight of girls, 43a. height and weight of men, 429. height and weight of women, 430. iron in food, 23. nitrogen in food, 22. phosphorus in food, 21. protein in food — see table of 100 Calorfe portions, purchasing power of five cents in Child's Restaurants, 228. scheme for planning diabetic diets, 317. weight and height — see Height and weight. weight of old men and women, 186. Tapioca, 354. apple, 337, 378. cornmeal pudding, 338, 384. cream, 338, 384. Ten year old child, dietary for, 161. Thin men, 58. dietary for, 59. Thin women, 85. dietary for, 87. Three or four year old child, dietary for 134. energy requirement of, 132. food for, 128. INDEX 449 Three or four year old child — Cont. food plan for, 133. protein requirement of, 132. Timbale, egg, 339, 386. Toast, cream, 334, 363. French, 334, 364. Toasted croutons, 334, 364. Tomato and cucumber salad, 345, 408. and lentil soup, 346, 416. and lettuce salad, 345, 408. sauce, 346, 411. soup, clear, 346, 412. soup, cream of, 346, 415. stuffed, 348, 425. Tomatoes, canned, 348, 354. fresh, 348. Top milk, 339. formulas, 109. formulas, fuel value of, in. Transportation, influence on cost of food, 221. Tuberculosis, diet in, 309. dietaries for, 311, 312. energy requirement in, 310. food in, 310, low-priced diet plan for, 313. protein requirement in, 310. Tunny fish a la Newburg, 343, 398. canned, 343. Turkey, roast, 343. roast with stufl&ng, 343. Turkish pilaf, 337, 425. Tvirnips, 348, 354. creamed, 348, 419. Twin mountain muflSns, 334, 367. Two year old child, dietary for, 127. food for, 119. food plan for, 126. protein requirement of, 126. Types of meal plans, 197. Typhoid fever, diet in, 303. mixed fluid diet for, 306. modified milk diets for, 305. soft diet for, 308. Vanilla ice cream, 338, 385. Variety in meals, value of, 205. Veal cutlets, 343, 399. kidney, 344. leg, roast, 344. liver, 344. Vegetables, 346, 418. for adolescents, 164. for children, 122, 131, 138, 149. for college youth, 181. Wafers, oatmeal, 335, 373. Waffles, 334, 367. Waldorf salad, 345, 408. Walnuts, English, 344. chopped, 354. Warm food in old age, 188. Water, foods rich in, 12. Watermelon, 341. Weaning, food after, 115. Weight — see also Height and weight aged, 186. Wheat bread, 2>3,3' flaked, 337, 354. flour, 353, White Mountain icing, 335, 375. sauce, 346, 411. Whole milk, 339, 353. formulas for infants, 105. Winter and summer menus, 210. Woman, active, dietary for, 79. active, energy requirement of, 74. active, food plan for, 77. ash requirement of, 86. fat, diet for, 83. fat, dietary for, 84. fattening dietary for thin, 87. nursing, dietary for, 97. nursing, food for, 93. pregnant, food for, 88. protein requirement of, 86. sedentary, dietary for, 81. sedentary, food plan for, 80. thin, diet for, 85. thin, dietary for, 87. Women, aged, weight of, 186. height and weight of, 430. Youth, energy requirement of, 169. food for, 162. protein requirement in, 169. Zwiebach, 334. Printed in the United States of America. 14 DAY USE RETURN TO DESK FROM WHICH BORROWED LOAN DEPT. This book is due on the last date stamped below, or on the date to which renewed. 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