Protein Malnutrition

Not all attention was negative. In 1834, an advertisement for Graham bread appeared in New-York as 'It Is' , a manual and guide to living in New York City. The guide pointed interested parties to Pierce and Luke, bakers who sold the bread at their bakery located at the intersection of Broadway and Leonard Street. The first published recipe for Graham bread appeared in 1835, emphasizing the use of finely ground, pure wheat meal.  In that same year the Minnesota Farmers’ Institute’s Annual reported on the differences between Graham and white bread, recommending “the use of some graham bread in families of growing children,” though warning that the bran in the bread could be “irritating to a delicate digestive system.”

In the next place we must consider the purposes achieved by the class of fats or hydrocarbons in nutrition. Liebig's views with regard to this subject also have been shown to be erroneous. He considered the function of fats to be entirely respiratory, and that by combining with oxygen, admitted into the system in respiration, they were consumed in the production of heat, and that the completeness of this combustion depended on the amount of inspired oxygen. But it has been observed that when an exclusive diet of fat has been taken, there has been less fat metabolised and less oxygen absorbed than in fasting, and also that, in certain circumstances, the whole of the albumen in the food is metabolised in the body, and the fat is appropriated to increase the body-weight ; an inversion of the formerly assumed roles of hydrocarbons and albuminates. From which it would appear that, under certain conditions, fat is split up into simpler bodies with greater difficulty than albumen, and must not, therefore, be regarded as the same easily combustible substance in the organism that it is outside. 

It is not, then, through the direct action of oxygen that the non-nitrogenous foods any more than the nitrogenous ones are split up into simpler products, but by the agency of the cellular tissues, and the oxygen enters into these products "little by little." Indeed, under the influence of fat tissue-waste is lessened, and, therefore, less oxygen is taken into the system ; less oxygen being abstracted from the blood by the products of metabolism. 

We thus see that one of the great purposes served by fat in the food is to diminish albuminous metabolism, and it is, therefore, regarded as an "albumen-sparing" food. "If flesh alone be given, large quantities are required in order that nutrition and waste may balance one another, but if fat be added the demand for flesh is less." (Bauer.) 

But the fats have also an important relation in the body to the production of force and heat, to body-work and body-temperature. While, unlike the albuminates, the metabolism of hydrocarbons is independent of the amount taken in as food, it is notably affected by bodily exercise, which produces little effect on nitrogenous metabolism. The fats, therefore, undoubtedly minister to force-production, and undergo destruction and oxidation in the process ; so that the amount of carbonic acid given off" during exercise is much greater than during rest. 

External temperature also influences the meta- bolism of the hydrocarbons, and therefore the amount of carbonic acid excreted ; the lower the temperature, so long as that of the body itself is maintained, the greater the metabolism of non-nitrogenous foods, and the greater the amount of carbonic acid discharged from the body. This is one of the chief means of regulating the temperature of the body, and keeping it constant. 

When, however, the temperature of the body itself is disturbed, as in fever, then the higher the tempera- ture the greater the waste of the non-nitrogenous, as well as of the nitrogenous, constituents of the body, and the greater the excretion of carbonic acid, as well as of urea. 

It is probably through the nervous system that the exteiThil temperature influences the metabolic processes in the body, and especially through the peripheral sensory nerves.

 It would appear that albuminates and fats are, to a certain extent, opposed to one another in their action on the organism, as the former increase waste and promote oxidation, while the latter have the effect of diminishing them, and this they do prbably by affecting the metabolic activity of the cells of the tissues themselves. It is a matter of common observation that fat animals bear privation of food better than thin ones ; in the latter, their small store of fat is quickly consumed, and then the albumen is rapidly decomposed. It is for the same reason that corpulent persons, even on a very moderate amount of food, are apt to become still more corpulent. 

The influence of fat in the storage of albumen is exemplified by the fact that if 1,500 grammes of lean meat be given alone, it will be wholly decomposed ; but if 100 to 150 grammes of fat be added, then it will yield only 1,422 grammes of waste. It has also been shown that the balance of income and expenditure of albuminates, although the amount taken in the food may be very small, is readily established as soon as one adds a certain quantity of fat. A dog who took daily 1,200 grammes of lean meat was observed to be still losing some of the albuminous constituents of the body ; whereas, with only 500 grammes of flesh and 200 grammes of fat, the nutritive balance was rapidly re-established. The same has been observed in man. Rubncr found that an individual taking daily 1,435 grammes of meat, containing 48.8 grammes of nitrogen, lost by the kidneys 50.8 grammes of nitrogen ; whereas another taking meat and bread containing 23.5 grammes of nitrogen, to which were added 191 grammes of fat, only eliminated 19 grammes of nitrogen on the second day of the diet ; so that a small quantity of albumen, when combined with fat, is sufficient to maintain the albuminous structures of the body. As a practical conclusion from these considerations, we should note, that if we wish to increase the weight of the body and add to its con- stituents, we must not rely on an excess of albu- minates, as these given alone only lead to increased waste ; but if we combine fats with albuminates in proper proportions, an appreciable increase of both the nitrogenous and non-nitrogenous constituents of the body can be maintained for a considerable time. 

We see, then, how a proper use of fat economises the albuminous elements of food and checks the waste of the albuminous tissues. Fat enters into all the tissues. By its decomposition and oxidation it yields muscular force and heat, and it is therefore largely consumed in muscular exercise. By its capacity of being stored up in the body as adipose tissue, it provides a reserve store of force-producing and heat- generating material which can be utilised as required. 

The supporting influence of fat under great muscular fatigue is strongly maintained by Ebstei : and it is stated that the German Emperor, in the war of 1870, recognised this fact by requiring that each soldier should have served out to him daily 250 grammes of fat bacon!

There are many people in the Mackenzie district who have given me much valuable information about their country, the greater part of which , however, has to be omitted here, but few men perhaps know the country better than Father Giroux, formerly stationed at Arctic Red River but now in charge of Providence. He says it is true in the Mackenzie district, as it is among the Arctic Eskimo, that measles is the deadliest of all diseases. There have been several epidemics, so that it might be supposed that the most susceptible had been weeded out, and yet the last epidemic (1903) killed about one fifth of the entire population of the Mackenzie Valley . He had noticed also a distinct and universal difference in health between those who wear white men's clothing and who live in white men's houses, as opposed to those who keep the ancient customs in the matter of dress and dwellings. These same elements I have since found equally harmful among the Eskimo, although among them must be added the surely no less dangerous element, the white men's diet, which is no more suited to the people than white men's clothing or houses. 

Grains and vegetables of most kinds, and even strawberries, are successfully cultivated at Providence. North of that, the possible agricultural products get fewer and fewer, until finally the northern limit of successful potato growing is reached near Fort Good Hope, on the Arctic Circle. Potatoes are grown farther north, but they do not mature and are not of good quality. 

In certain things the Mackenzie district was more advanced the better part of a century ago than it is now; the explorers of Franklin's parties, for instance, found milk cows at every Hudson's Bay post and were able to get milk and cream as far north as the Arctic Circle and even beyond. At that time, too, every post had large stores of dried meat and pemmican, so that if you had the good-will of the Company you could always stock up with provisions anywhere. Now this is all changed. Game has become so scarce that it would be difficult for the Company, even if they tried, to keep large stores of meat on hand. The importation of foodstuffs from the outside, on the other hand, has not grown easy as yet, and it is therefore much more difficult to buy provisions now than it was in Franklin's time. The trading posts are located now exactly where Franklin found them, so that taking this into consideration, and the decrease of game all over the northern country, it is clear that exploration on such a plan as ours — that of living on the country —is more difficult now than it was a hundred years ago. Another element that makes the situation more risky is that while then you could count on finding Indians anywhere who could supply you with provisions, or at least give you information as to where game might be found, now there are so few of the Indians left alive , —and all of those left are so concentrated around the trading posts , —that you may go hundreds of miles without seeing a camp or a trail, where seventy-five or a hundred years ago you would have found the trails crossing each other and might have seen the camp smokes rising here and there. 

The food supplies of the different posts vary according to location . In general the trading stations are divided into "fish posts" and “meat posts.” Fort Smith is a typical meat post, for caribou are found in the neighborhood and moose also; and the Indians not only get meat enough for themselves and for the white men, but the fur traders even find the abundance of the meat supply a handicap in their business, - for the Indian who has plenty to eat does not trap so energetically as do others who must pay in fur for some of their food. Resolution, Hay River, and Providence, on the other hand, are fish posts, while at any of the northern trading stations potatoes nowadays play a considerable part in the food supply, even as far up as Good Hope. In certain places and in certain years rabbits are an important article of diet, but even when there is an abundance of this animal, the Indians consider themselves starving if they get nothing else, and fairly enough, as my own party can testify, for any one who is compelled in winter to live for a period of several weeks on lean-meat will actually starve, in this sense: that there are lacking from his diet certain necessary elements, notably fat, and it makes no difference how much he eats, he will be hungry at the end of each meal, and eventually he will lose strength or become actually ill. The Eskimo who have provided themselves in summer with bags of seal oil can carry them into a rabbit country and can live on rabbits satisfactorily for months. The Indian, unfortunately for him, has no animal in his country so richly supplied with fat as is the seal, and nowadays he will make an effort to buy a small quantity of bacon to eat with his rabbits, unless he has a little caribou or moose fat stored up from the previous autumn.

There are many things which happen during the course of a year when one lives face to face with the wilderness and must rely entirely upon his dogs and his gun. The first matter of interest is the caribou, for they represent food. We have all encountered them, have seen the herds streaming out across the country, beneath a forest of antlers; we have all gorged ourselves on their flesh, haunted by the possibility of a day when the country would be empty of them, and the cold press in upon us and squeeze the life from our wretched bodies. We piece our recollections together and build for ourselves a picture of the caribou and its migrations, but we never succeed in discovering the first clue to the solution of the riddle of this mysterious animal.

Klondike Bill tells us about the time he was almost trampled underfoot by a herd of many thousand caribou. He had to crouch behind his sled, he said, whilst the herd, terrified by wolves, rushed by on every side. Joe had a hand-to-hand encounter with wolves up in the vicinity of the Coppermine River and escaped by the skin of his teeth. Bablet relates how once he was on the point of losing his dogs up on the Barrens — the very worst situation which could have confronted him. They were just making off with the sled in chase of a band of caribou, and Bablet had had no other choice but to shoot his train-leader. " The best dog that ever worked in the traces," he concludes. We others are not so willing to take his word on the latter point, however, for what trapper will ever admit that any but his own are the best dogs in the land? And woe be unto the man who, by innuendo or otherwise, dares to belittle them! Such is even worse than to mention to a man his wife's imperfections! A trapper may curse at his dogs and flog them unmercifully, but he always stands ready to do battle for them. 

Price has had a tough time of it during the latter part of the winter. He was on a long journey east when the caribou vanished completely. The dogs starved and one of them •— one of the most powerful beasts I have ever seen — began to get nasty. A primitive struggle for supremacy developed between dog and man. The dog was harnessed at the time, but it had become so wild and violent that it dragged the rest of the team with it when it decided to launch a lunging, snapping attack. At length, hopping up on the sled, it continued to give battle from there. Price conquered after a time, but it was a victory dearly won, and he would rather have fought with a grizzly bear, he says. Later, on that same journey, he became snow-blind, was taken so whilst he was off looking to one of his traps and had to feel his way back over his own tracks in the snow in order to find his dogs. "Wasn't much fun," he adds dryly. 

But, just the same, the one who had had the toughest time of all was certainly old Klondike Bill. Last autumn he had set off into the country with five big strapping dogs, and this spring he returned with but two. The other three he had eaten about Christmas time when he was starving on the shores of Kasba Lake. We all know of the affair, but it is a matter which no one ever mentions.

The Nephropathic Effect in Man of a Diet High in Beef Muscle and Liver.

Author(s) : Newburgh, L. H. ;  Falcon-lesses, M. ;  Johnston, Margaret W.

Author Affiliation : Med. School, Univ. of Michigan, Ann Arbor.

Journal article : American Journal of Medical Sciences 1930 Vol.179 pp.305-10 ref.8

Abstract : The authors have previously shown that rats living on a diet rich in animal tissues (muscle and liver) gradually developed sclerosis of the kidney. In the present investigation a normal man, aged 32, was given a diet containing less than 100 gm. protein daily, for a preliminary period of 35 days. There was no albumen in the urine during this period and the number of urinary casts averaged 50 per hour (ADDIS gives the average figure in group of students as 87). During the next 6 months the man ate a diet containing 327 gm. of animal protein and with a total calorie value of 4, 177. Beef liver, veal round, beef tenderloin and dried beef were given, about one-quarter of the protein being liver. Only 31 per cent. of the calories of the diet represented animal protein. No clinical or subjective abnormalities appeared. There was a gradual increase in the urine albumen which reached 2 to 4 mgm. of protein per hour in the 6th month. The cast counts during the first 7 weeks were within the normal range. Afterwards the counts were definitely pathological and during the last 6 weeks the average count was 1, 283 (15 X normal average). At first the casts were hyaline; gradually more and more granular casts appeared, and during the last 6 weeks, some were cellular and the hyaline type were in the minority. After returning to a diet of his own choice, in which meat was avoided, the man's urine became normal in 10 days. A diet containing the same proportions of animal protein was found not to affect the kidney of the rat. There are a number of observations which appear to show that an exclusive meat diet is not harmful to the kidneys of man. The Eskimos are cited in this regard, but a recent survey of a number of middle-aged Eskimos shows a definitely higher degree of albuminuria than in the policy holders of a large American insurance company. Furthermore the Eskimos have presumably over many generations become adapted to their diet. The recent investigation on 2 arctic explorers (this Bulletin, 1929, v. 4, 829), showed no renal impairment with " an exclusive meat diet " for 12 months. This diet only contained 100-140 gm. protein daily and 80 per cent. of the energy was in the form of fat.
H. N. H. Green.