REPORT ON NUTRITION

Two years ago in Advisory Committee on Nutrition was appointed by the British Government. The terms of reference were: “To inquire into the facts, quantitative and qualitative, in relation to the diet of the people, and to report as to any changes there-in which appear desirable in the light of modern advances in the knowledge of nutrition.” Three standing sub-committees were also appointed, namely, Statistical, Economic and Social and Physiological. The sub-committee appointed further sub-committees for special purposes. The first report has been issued. It merely gives the result of a preliminary survey of the whole field.

The report seeks to indicate in what directions changes in the nation’s diet are desirable rather than to show how these can be affected. Attention is called at the outset to the fact that recent discoveries have shown that various mineral elements and vitamins play roles as essential in the bodily economy as those played by proteins, fats and carbohydrates. Reference is made to the modern term “protective” in relation to foods. Such foods correct the commoner deficiencies of diet, and so protect the individual against the effects of such deficiencies. The most important protective foods are said to be milk and milk products, green vegetables, fruit and eggs. Inclusion of adequate amounts of these in the diet will, it is stated, ensure correct nutrition.

The report maintains that the diet of the people is now more in conformity with physiological principles that it was in pre-war years. One of the reasons for this advance is said to be the educational work on nutrition carried out in health clinics and in schools throughout the country. As the report goes on to state there is ample room for further progress. Such an airily cheerful view of the situation as the framers of this report appear to take is not justified. The food of thousands of the population is at present their attention to the question of the adulteration of our foodstuffs it would have been better for all concerned. Today, more so even than in pre-war times, our food materials are often far from pure. Certain products are absolutely misnamed. Sausages may contain any kind of meat along with diverse ingredients. Custard powders many not contain eggs, and so on. In this respect the report is disappointing. The Committee were duly appointed to enquire into the qualitative facts in relation to diet. Surely, therefore, this should have included the question of adulteration.

A curious statement is made to the effect that the consumption of cereals has fallen by nearly 10 percent since the five-year period before the war. “This fact.” says the repot, “taken in conjunction with the increased consumption of other foods, is evidence of improvement in the national dietary and of a rise in the standard of living.” But is it evidence of improvement? We know that Professor Mellanby, who is a member of this Committee, condemned oatmeal after feeding experiments on puppies. Let us humbly remind this experimental pharmacologist that humans are not dogs. As a matter of fact, oatmeal is an excellent foodstuff. The sturdy Scottish highlander has lived and thrived on it for years. Oatmeal porridge is a dish of which every hardy Scot is proud. He considers Professor Mellanby’s dictum as a grave personal libel. This report perpetuates this experimentalism’s views on the subject. Speaking of course form clinical and not from laboratory experience, to do so is a serious error, calculated to do much harm.

Another fault we have to find with this report is that it is too much inclined to put milk in the foreground as a food. Again we say Nature never intended milk to be an adult’s food. The Committee deplore the fact that the consumption of milk in this country falls short even of the minimum amount of seven-eights of a pint daily as laid down by the League of Nation’s Commission on Nutrition. The present national consumption of milk is even less than one half of this amount. “We regard this deficiency with special concern,” says the report. Now why all this fuss about milk? It seems to have become a kind of bogey to be dragged out on all occasions before the public eye. For adults half a pint of milk daily is the Committee’s recommendation. In the following sentence, however, if we are clever enough to read between the lines, we get the real reason for this boosting of milk. “That under consumption of a foodstuff so important as milk should exist in a country so eminently suited for milk production (the italics are ours) is a matter towards which we cannot remain indifferent.” In other words, behind all this milk propaganda is an attempt to improve the agricultural condition of the country.

Another sentence from the report deserves quotation and criticism. “From the health standpoint there is no other single measure which would do more to improve the health, development and resistance to disease of the rising generation, than a largely increased consumption of safe milk by mothers, children and adolescents.” Now this is sheer nonsense. There are other measures. We know them only too well, but it is not our business to instruct dictators of our health and well-being. It is interesting to learn that the consumption per head of most foodstuffs has increased since before the war, and that the greatest increases have been noted with regard to condensed milk, fruit, butter, vegetables, eggs, tea, margarine and cheese. The consumption of cereals and of milk and cream, however, has fallen. Sugar, we are told, should not be taken in large amounts in the fasting state. What about the value of milk-chocolate as a stand-by for the busy doctor who cannot get a meal at any particular time? Apparently the Committee would condemn it. For our own part we commend the practice.

In an appendix the Committee have much to say on the nutritive value of milk. Consumption of a sufficient quantity of milk is regarded by the Committee as “the key to proper nutrition.” Milk is stated, on the authority of certain experiments conducted by Mrs. Mellanby and others, to be all-important for the development of normal teeth resistant to dental caries. “From many other experiments on man and animals it can be predicted that important beneficial effects would result from an increase in the consumption of milk above that at present prevailing in this country.” To our mind these experiments never proved very convincing at any time. In some respects they have led to an entirely misleading view as to the value of milk as a food. We are told that its few disadvantages are easily overcome. An adult is enjoined to drink at least half a pint of milk daily. What about those who cannot take milk? They constitute by no means a negligible portion of the population. How sad it is to read that “herds in which all the cows are perfectly healthy are at present relatively few.” Is his not a serious reflection on the work of the Board of Agriculture? Why have we such a state of affairs in this so-called advanced age? it is because, as usual, those in authority begin at the wrong end. Before recommending an increased consumption of milk we should have thought it would have been a wise precaution to see to it that al milk, as it comes from the cow, is really safe for human consumption.

Skimmed milk is stated to stand next to whole milk in order of nutritive value. The Committee, in fact, express regret that little of this “valuable food” is available for sale in liquid form in this country. It is said that there is a wide scope for the use of skimmed milk in preparing puddings, bread and cakes. This, of course, is a fact which every experienced housewife knows already. It does not require a Government Committee included some ladies; perhaps the latter gave this hint to the less well-informed male members. The fact that there has been a marked increase in the consumption of fats in recent years is taken as a suggestion that there is no aggregate deficiency of this in the national diet, although there is some such deficiency among the very poorest of our population. It is suggested that an increase in the consumption of potatoes would prove advantageous. Again we seem to hear the voice of Agriculture speaking to us through the medium of this report. The inclusion of a certain amount of sea-fish in the diet is also a more fish” will therefore, have to be added to the slogans “Drink more milk” and “Eat more fruit.”

On the whole we think this preliminary report is disappointing. It is very one-sided, and based to much, we fear, on experimental work by pure scientists rather than on observations made by experienced clinicians and dietetic specialists. It is no use trying to make practical physicians, who are face to face every day with dietetic problems., believe that the results of feeding animals in experimental laboratories can be safely applied to humans. Rats and puppies may not thrive on oatmeal; but that does not prove that human beings cannot do so. The sooner we get away from such delusions the better.

Medical World.