Physiological economy in nutrition, with special reference to the minimal proteid requirement of the healthy man / an experimental study

by R. H. Chittenden

I. EXPERIMENTS WITH PROFESSIONAL MEN.

Before proceeding with a detailed account of the experimental work, it may be well again to emphasize that what is especially desired is to ascertain how far, if any, the intake of proteid food can be diminished without detriment to the body, i. e., with maintenance of nitrogen and body equilibrium and without impairment of bodily and mental vigor. Further, if a lower proteid standard than that generally adopted can be established, it is desirable to ascertain whether it can be maintained indefinitely, or for a long period of time, without loss of strength and vigor. Obviously, it is of primary importance that we should know quite definitely what the minimal proteid requirement of the healthy man per kilo of body-weight really is, and the experimental work about to be detailed has aimed especially to determine whether it is possible to materially lower the amount of daily proteid food, without detriment to the bodily health and with maintenance of physical and mental vigor.

The writer, fully impressed with his responsibility in the conduct of an experiment of this kind, began with himself in November, 1902. At that time he weighed 65 kilos, was nearly 47 years of age, and accustomed to eating daily an amount of food approximately equal to the so-called dietary standards. Recognizing that the habits of a lifetime should not be too suddenly changed, a gradual reduction was made in the amount of proteid or albuminous food taken each day. In the writer’s case, this resulted in the course of a month or two in the complete abolition of breakfast, except for a small cup of coffee. A light lunch was taken at 1.30 P. M., followed by a heavier dinner at 6.30 P. M. Occasionally, however, the heartier meal was taken at noontime, as the appetite suggested. It should be added that the total intake of food was gradually diminished, as well as the proteid constituents. There was no change, however, to a vegetable diet, but a simple introduction of physiological economy. Still, there was and is now a distinct tendency toward the exclusion of meat in some measure, the appetite not calling for this form of food in the same degree as formerly. At first, this change to a smaller amount of food daily was attended with some discomfort, but this soon passed away, and the writer’s interest in the subject was augmented by the discovery that he was unquestionably in improved physical condition. A rheumatic trouble in the knee joint, which had persisted for a year and a half and which only partially responded to treatment, entirely disappeared (and has never recurred since). Minor troubles, such as “sick headaches” and bilious attacks, no longer appeared periodically as before. There was greater appreciation of such food as was eaten; a keener appetite and a more acute taste seemed to be developed, with a more thorough liking for simple foods. By June, 1903, the body-weight had fallen to 58 kilos.

During the summer the same simple diet was persisted in—a small cup of coffee for breakfast, a fairly substantial dinner at midday and a light supper at night. Two months were spent in Maine at an inland fishing resort, and during a part of this time a guide was dispensed with and the boat rowed by the writer frequently six to ten miles in a forenoon, sometimes against head winds (without breakfast), and with much greater freedom from fatigue and muscular soreness than in previous years on a fuller dietary. The test of endurance and fitness for physical work which the writer thus carried out “on an empty stomach” tended to strengthen the opinion that it is a mistake to assume the necessity for a hearty meal because heavy work is about to be done. It is certainly far more rational from a physiological standpoint to leave the hearty meal until the day’s work is accomplished. We seemingly forget that the energy of muscular contraction comes not from the food-stuffs present at the time in the stomach and intestinal tract, but rather from the absorbed material stored up in the muscles and which was digested and absorbed a day or two before. Further, it is to be remembered that the very process of digestion draws to the gastro-intestinal tract a large supply of blood, and that a large amount of energy is needed for the processes of secretion, digestion, absorption, and peristalsis, which are of necessity incited by the presence of food in the stomach and intestine, thereby actually diminishing the amount of energy available at the place where it is most needed. Why, then, draw upon the resources of the body just at a time, or slightly prior to the time, when the work we desire to perform, either muscular or mental, calls for a copious blood supply in muscle or brain, and when all available energy is needed for the task that is to be accomplished?

We are too wont to compare the working body with a machine, the boiler, engine, etc., overlooking the fact that the animal mechanism differs from the machine in at least one important respect. When we desire to set machinery in operation we must get up steam, and so a fire is started under the boiler and steam is generated in proportion as fuel is burned. The source of the energy made use of in moving the machinery is the extraneous combustible material introduced into the fire-box, but the energy of muscular contraction, for example, comes not from the oxidizable food material in the stomach, but from the material of the muscle itself. In other words, in the animal body it is a part of the tissue framework, or material that is closely incorporated with the framework, that is burned up, and the ability to endure continued muscular strain depends upon the nutritive condition of the muscles involved, and not upon the amount of food contained in, or introduced into, the stomach. All physiologists will, I think, acknowledge the soundness of this reasoning, but how few of us apply the principle in practice. It is perfectly logical to begin the work of the day with a comparatively empty stomach,—after we have once freed ourselves from the habit of a hearty breakfast,—and in the writer’s experience both mental and physical work have become the easier from this change of habit. The muscle and the brain are given opportunity to repair the waste they have undergone, by the taking of food at times when the digestive processes will not draw upon the energy that in activity is needed elsewhere.

Further, it is easy to understand why on a restricted diet, especially of proteid foods, there should be a diminished sense of fatigue in connection with vigorous or continued muscular work, and why at the same time there should be an increased power of endurance, with actual increase of strength. With a diminished intake of proteid food there is a decreased formation of crystalline nitrogenous waste products, such as uric acid and the purin bases, to say nothing of other bodies less fully known, which circulating through the system are undoubtedly responsible, in part at least, for what we term fatigue. We need not consider here whether the sense of fatigue is due to an action of these substances upon the muscles themselves, upon the motor nerves or their end-plates, or upon the central nervous system; it is enough for the present purpose to emphasize the probable results of their presence in undue amount. Lastly, we may emphasize what is pretty clearly evident to-day, viz., that the energy of muscular contraction comes preferably from the oxidation, not of the nitrogenous or proteid constituents of the muscles, but of the non-nitrogenous components of the tissue; another reason why excess of proteid food may be advantageously avoided. Moreover, proteid food stimulates body metabolism in general, and hence undue amounts of proteid in the diet augment unnecessarily the metabolism or combustion of the non-nitrogenous material of the muscle, thereby destroying what would otherwise be preserved as a source of energy in muscular contraction, when the muscles are called upon for the performance of their daily functions.

On the writer’s return to New Haven in the fall of 1903, he was surprised to find that his body-weight was practically the same as early in July. In the period between November, 1902, and July, 1903, the body had lost 8 kilos under the gradual change of diet, but from July to October, 1903, the weight had apparently remained stationary, from which it might fairly be assumed that the body had finally adjusted itself to the new conditions.

What now was the condition of the body as regards nitrogen metabolism? To answer this question the entire twenty-four hours’ urine was collected practically every day, from October 13, 1903, to June 28, 1904, representing a period of nearly nine months. This daily output through the kidneys was analyzed each day with special reference to the total nitrogen,[31] as a measure of the amount of proteid material metabolized. Total volume of the urine, specific gravity, uric acid, phosphoric acid, indican, and other points were also considered, the more important results being indicated in the following tables.