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A STUDY OF THE PROTEIN

REQUIREMENTS OF NORMAL
FOUR YEAR OLD CHILDREN

THESIS FOR THE DEBBIE OF M. 8.

Margaret j Nunn
1931

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A S T U D Y
OF THE
P R O T E I N R E Q U I R E M E N T S
OF
N O R M A L F O U R Y E A R O L D

C H I L D R E N

A Thesis submitted
to the Faculty of
Michigan State College
in Partial Fulfillment
of the Requirements for the
Degree of Master of Science

by
Margaret J. Dunn

Department of Food and Nutrition
Division of Home Economics

1951

THESWfl

 

 

Object of Experiment
Review of Literature

«

Procedure
Discussion of Results

Summary and Conclusions

Bibliography

113$- 19’?"

Acknowledgment

For the helpful suggestions given during
this study, the writer is very grateful to Dr.
Marie Dye, under whose general supervision the
problem was done. She also greatly appreciates
the kindly advice and criticisms given by Miss
Whittaker.

Special appreciation is due, also, to the
mothers of the children used as subjects and to
Miss Miller and her assistants, whose Splendid

cooperation made the work pleasant.

A STUDY OF THE PROTEIR REUJIREHRNTS
OF

NORMAL FOUR YEAR OLD CHILDREN

Introduction:

 

In the field of metabolism studies through dietary

3

experiments upon human beings, considerrblo work has

}

been done with adult subjects and some with infants,

but very little with individuals of the early growth

q

ards nave been set up

9...!

period or pre-school age. Stan(
showing the optimum proportions of protein, calories,.
and minerals for adults, then these values have been
reduced proportionately and allowances made to meet
the needs of younger people.

The object of this study was to determine the
level on which normal four year old children maintained

the most efficient nitrogen retention.

Review of Literature:

 

A study of the literature shows that different
methods have been used.(l) The earliest investigators
considered the needs of two children equivalent to the
needs of one adult. In 1866, Atwater (1) proposed a
scale with the adult male as the standard, and cal-
culated the needs of the other individuals in prOpor-
tion. Engel, a Saxon statistician, nine years later
took an infant during the first year of age as the
unit, and calculated on the basis of height—weight
statistics that an increase of one—tenth over the de—
mands for the first year was needed for each additional
year. The plan, however, was not extensively accepted.
Atwater used the energy standards of Voit and inter—
polated an assumed value for children of two to six
years, arranging his table in terms of a man's need.

A review of the literature shoes that little
thoroughly controlled res-arch was don; before the
latter part of the nineteenth century. Most of the
early work was done in Germany, and was of a purely
clinical type. The conclusions were not warranted by
either the number of children studied or the conditions

I
f

under which they lived. Len" of the sub ects were

(J

l...“

abnormal. Var ations are great in normal children,

but are greater in abnormal. Therefore many misleading
deductions were made, but they were used because they
were the only ones availzble. Among the German authors
:hose conclusions we find much quoted in Spite of their
inaccuracies are Hrsse, Herbst, Huller, Uflemann,
Camerer, Baginsky and Sterling. These investigators
studied the caloric reeuirenent of children as well

as the protein, yet many of the subjects under ob-
servation proved to be under-fed. In their summary of
caloric schedules proposed by various authors, Holt

and Fales (2) show by comparison the great variations

among data that have previously been accepted as standg

ards. This summary is as follows:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Holt and Fales (2) recommend that, in calculating
the total caloric r Cuirement of children, the component
parts of that total be considered. These are: basal meta-
bolism, growth, musculer activity, and the food values
lost in the excreta. The basal requirements used by them
are the ones determined by Benedict and Talbot. The
latter studied a large number of children in Boston and
furnished most of the data on which all the modern meta—

bolism curves are based (5). They have found basal needs

highest per kilogram of body weight at 9 months and
steadily falling from then to adult life. The excreta
loss is about 10 per cent for all ages after infancy.
The growth requirement is greatest when growth is most
active, or during the first year and adolescence. It
is nearly uniform from four to ten years. Activity is
the only factor that varies widely with the individual,
the other three being nearly uniform for children of
the same weight under similar conditions. Holt and
Fales give as the total caloric requirement of child—
ren: 100 calories per kilogram at 1 year (9.5 kilograms).
For boys, this falls to 80 calories per kilogram at
6 years (20 kilograms) and remains constant to 15
years. The activity increase is met by basal reduc—
tion. After 50 kilograms are reached, the energy
value is reduced to the adult standard of 48 calories
per kilogram. For girls, the requirement falls to 76
calories per kilogram at 6 years (20 kilograms) and
continues to fall until 10 years, At this age it rises,
and remains at 80 calories per kilogram until grow h
is complete; when it falls to the adult standard of
48 calories per kilogram.

Various dietary scales and standards have been

used to measure the nutritive needs of the members of

the family. Edith Hawley reviews these in her develop-
ment of the scale used by the U. S. Department of Agri-
culture. (1) Her description of the scales of Atwater
and Engel has already been reviewed. From 1886 to 1915,
the increase in nutrition studies gave new light on
metabolic needs. In View of this, and because of the
inconsistent use of dietary scales for the reiuirements
of the various members of the family, Sherman felt it
necessary to study the energy reouirements of children
and eXpress them in calories instead of the percentage
of a man's need. In his introduction to Gillett's

study (4), he says, "In our opinion, the food require-
ment for each member of the family should be determined
on his own merits rather than in terns of the man's
requirement." This was the first real step towards
attention to the child's individual needs, and as a
result of it, Gillett (4) brought together all the
dietary studies and metabolism exneriments that con-
tained data on the energy requirements of healthy child-
ren. On the evidence of 564 studies, she made the

following table of standards:

 

 

 

 

 

 

 

 

.Aee vears)_ Ca ories day LBovs)tJCalories day (Girls)

  

Legit; a_ 900 :u1200 a_ J 800 — 1200

 

 

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The energy allowances for children of 5 - 5 years
may be summarized in the following table. (This is
the Specific age period of the present study and is

therefore used in this table).

 

 

 

 

 

 

 

 

 

 

 

 

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The total protein reouirement during the growth
period depends upon the character of the protein and
the total caloric intake.

In estimating a child's protein requirement, two
equally important factors must be considered; first,
tissue maintenance; and second, growth.

Sherman (5) states that, on the basis of adult
needs, a child's requirement for maintenance is about
1 to 1.5 grams per kilogram per day, from either animal
or vegetable source. In addition to this, growth re-
quirements must be met. This should be done largely
with animal protein. It is difficult to estimate the
amount required.

Little wor; has been reported on the protein need
and the effect of protein upon the growth of children.
Osborne and Mendel's (6) experiments on rats and the
work of Newburgh and his associates (7) on rats and
rabbits indicate that growth is affected by the kind
and amount of protein. One of the best ways to deter-
mine the protein need of normal children is through a
metabolism study, whereby the nitrogen balance will
indicate the efficiency with which the body is using
its protein supply.

There is little scientific data on the composition

of the diet of children over one year of age. Lucy
Gillett (4) summarizes studies made from 146 cases of
18 authors whose work was large observational, and
includes the values of protein intake as indicated by

various authors up to 1917.

 

 

 

 

 

 

 

 

 

 

 

 

 

Age (years)Ifio1 caseszotal proEEinTProteim‘intake.~q
__ _ ‘h_gmslday‘4 av'_EELE;lQ._
2 — 5 fl; -_ 51 55 5.5g
6 — 9 44gg 57 215
10 - 15 55 13 2.0
14 - 17__ 18 #94 ____ M 2.2 g

 

 

 

 

 

 

 

 

The total range in all of the cases over one year, as
studied by Miss Gillett, was from 1.57 to 4.86 gms. of
protein per kilogram of body weight.

Camerer (8), in 1896, recommended over 4 grams of
protein per kilogram of body weight for the first year,
5 to 4 grams per kilogram up to 8 years of awe, then
over 2 grams per kilogram until 14 years, and 1.7 grams
per kilogram at the end of the growth period.

J. P. Parsons, in his report on the nitrogen meta-
bolism of children (9), gives a comprehensive survey
of the work on protein reouirements done by foreign
workers since 1900. Several of his comments are inter-

esting.

-10...

Siegert, 1916 (9), showed that nursing children
require one gram of protein per kilogram of body weight
per day, while children of three to six years require
three to four grams per kilogram per day.

Muller (9) made a metabolism study of 52 children
in an orphan asylum. This was done during the cool
part of the year, using from 5 to 7 preliminary days
with the ordinary diet and 6 days with the Special
diet. He found the average of protein calories to be
15.8 per cent of the total. The average nitrogen in—
take was 0.55 grams per kilogram or about 5.4 grams per
day. The daily nitrogen output was about 5.18 grams.
Holt and Fales (8) criticize this work because much of
it was done on underweight, undernourished children.

Schlossmen and Murschhauser, in 1910, (9) worked
on a study of the oxygen exchange of individuals of
various ages. They decided that the difference between
the metabolism of children and adults is due to the
added growth needs of Children.

A study of food and protein requirements of three
children was made by Stargardter in 1912. (9) His
results are not of great value, however, because he
varied the caloric intake from day to day.

Ruotsalainen (9), in 1921, made a study of protein

requirements, keeping the total caloric value constant

- 11 -

from day to day and varying only one type of food. On
a diet with sufficient basal protein intake, he added
isodynamic quantities of fat, protein and carbohydrate.
He found a nitrogen balance maintained on two to three
grams of protein per kilogram per day. The nitrogen
retention was greatest when protein was added to the
constant diet. He found that the nitrogen retention
seemed to be the expression of an actual protein addi-
tion. More recent workers have found a greater nitrogen
retention when carbohydrate is added to the diet.
Practical use is made of this fact in feeding during
disease where there is a toxic destruction of protein.
Gephart (10), in 1917, made an observational
dietary study in a more reliable way than much of the
work reviewed by Parsons. He studied the diet of 350
boys through adolescence at St. Paul's boarding school,
Concord, N. H. He found the protein intake very high.
The daily average was 160 grams or 2.6 to 5.8 grams of
protein per kilogram of body weight. His children were
beyond pre-school age, however, and were very active.
Holt and Fales (8), in 1921, collected the food
consumption data for more than.lOO health normal
children from 1 to 16 years of age and found that their
figures agreed rather well with the average for the

various age groups. The urinary excretion was 4 to 6

-12...

grams of nitrogen per day for all ages. This figure

is hi her than was found by either Muller or Rubner.

U")

The average total protein intake during the second year
was 44 grams; in the sixth and seventh year, 60 grams;
in the twelfth year, 80 grams; in the fourteenth to
sixteenth years, 130 grams; and at eighteen years, 115
grams. The protein intake of children under 6 years
averaged over 3 gra s per kilogram. For older child—
ren, the average was 2 grams per kilogram. This indi-
cates a reduction with age. These children received
about two thirds of their protein from animal sources
and one third froa vegetable sources.

Fleming and Hutchi.son (11), in 1924, found the
normal absorption of nitrogen to be 60 — 95 per cent of
the intake.

From 1926 to 1929, Chi Che Wang and her associates
(12) made a series of studies on the metabolisn of
undernourished children. They used normal children
as controls. Their resalts indicate that the per cent
of absorption of nitrogen is about the same in both
normal and underweight children (99 - 92 per cent).

The nitrogen retention, however, increases with the
degree of undernutrition. Dr. Wang has also found that

high protein diets do not spear to have any harmful

1

effects on children. She found that the nitrogen re-
tention for all children is directly proportioned to
the nitrOgen intake.

Other investigators who have differed in the per

cent allowance of protein for adults or children are

Voit, Playfair and Gautier - 16 per cent of
total fuel value (high)

Atwater - 15 per cent of total fuel value

Landworthy — 12 per cent of total fuel value

Chittenden - 8.5 per cent of total fuel value
advocates low protein intake

Benedict - liberal allowance

Meltzer - allow for storage of protein as a

factor of safety.

The dietary standards of the past tend to indicate
a liberal intake of protein.

Sherman (15) claims that it is inadvisable to use
as a standard the least amount to which the body can
adjust itself, but rather to regard as the normal re—

quirement an anount which will enable the body to

(1

maintain not only its equilibrium, Lut 150 some such

J
reserve store of protein as we are accumstomed to

carry.

-14..

Parsons, in 1950 (9), studied protein maintenance
levels for the pre-school child, finding a nitrogen
balance possible on 1.1 grams of protein per kilogram
of body weight.

An allowance of one gram of protein ncily per
kilogram of body weight, or 50 per cent above the pre-
sent estimate of actual re uiroments seems a reasonable
standard to use as a general guide for adults.

Little can be said with confidence regarding the
optimum amount of protein for children after the nursing
period (15). Hell planned dietaries generally contain
12 to 15 per cent of the total energy in the form of
protein calories. During the period of rapid growth,
much of the protein of the food is used to synthesize
body protein. The amount of protein needed to produce
one gram of body protein varies with the amino acid
content of the food. Therefore, the specific anino
acids supplied are of great importance.

Hoobler, B. R. (9), in 1915, found that infants
utilize their protein most efficiently when the calories
from this source represent 10 per cent of the total
caloric intake. Sherman placed this figure at 9 per
cent to meet the needs of an adult.

To allow for varying conditions and for individual

D
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preferences, as well as to provide a liberal margin 0

- 15 _

Ho

safety, t is customary to consider from 10 to 15 per

1‘

cent of the total calories in the form 01 protein

calories. Mary Swartz Rose (14) says that it is ap—
parent that an allowance of 15 per cent of the total
calories in the forn of protein calories gives the

growing child at all ag s a surplus of 0.75 to 1.35

('0

grams of protein per kilogram of body weight above the
probable requirement. Any intermediate value should

be adequate when the proteins are of good quality and
the diet as a whole meet all other nutritive re mire-

ments.

Procedure:

 

The purpose of this study was to determine the
level on which normal four year old children maintained
the most efficient nitrogen retention. Three seearate
-eriods were planned, with about six or eight weeks
time elausing between them. It was exoected that the
optinum level would be between 2 and 4 grams of pro-
tein per kilogram of body weight. During the first
period, therefore, 2 grams per kilogram were taken as

the 1 wer level. The intermediate level during the

(0

second period mas on the basi. of 3 grams per kilogram,

1

.ms per kilosren formed

|\

and on the third period, 4 gr
the hisher level.

C.)

A quantitative metabolisn stufiy involves the

{Q

planninv o: a diet adequate for experimental purpose ,
the feedinf of this diet to the subject for a given
preparatory period, followed by a period of collection

of urine and fecal samples. Then, by a chemical analr-

(A

sis of an accurately measured sen le of the food intake
as Well as analysis of the excreta, the amount used by
the body for metabolic purposes may be determined.

One or more of the food constituents may be verisc
amount or ouality, and the results thus deternined. In

general this was the plan followed in this study. The

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-13-

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ca oric intake remained constant throughout the series
of studies at the value best suited to each child ac—
cording to accepted standards. The protein intake was
varied in each study, first on an estimated low level,
supposed to be just above maintenance, then on the ex-
pected normal level, and lastly, on a high levcl.

Table No. I summarizes these requirements and variations
for the children studied. From the data secured from
the analysis of the food and excreta, he optimum
intake for nitrogen balance and adequate metabolism was
determined.

The difficulties met in such a study are great,
and eXplain to a certain degree the absence of exten-
sive data. Care is necessary to prevent contamination
of samples. In order to keep the child's daily routine
just as normal as possible during the study, the
attention of at least one person is constantly required
to be sure food habits are properly observed and no
excrete lost.

The sutjects for this experiment were three
normal, healthy, active, nursery school children, two
boys and one girl. Their ages, weights, and heights
are given in Table II. The children Spent each 63*

according to usual schedule in the nursery scnool,

where the splendid cooperation of the instructor and

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her assistants made it possible for the children to
follow their usual life. Eoually splendid cooperation
was obtained from the mothers of the children who took
charge of collection of samples over night.

The general health of the subjects during the
experimental periods was satisfactory. The prevalence
of colds during the early part of the first and second
stuies interfered somewhat. The children were urged
to drink all the water they could in order to prevent
constipation whicn occurred to some extent during the
second period, but not seriously enough to interfere
with the completion of the metabolism study. Special
precautions were taken to prevent this before the sub-
jects began the high—protein diet. Since constipation
seemed to be so easily caused, each child was given a
small amount of mineral oil on the first and second
days of the preliminary period. The children were
also kept out of doors in the fresh air and sunlight
as much as possible. The meals were prepared and
served in a separate room at the college. The menu
and calculated value of the diet (Rose Handbook of
Dietetics) are given in Tables III and IV.

A three day‘s preliminary period on each level
was followed by a three day collection period. During

the last three days; duplicate samples of the daily

 

 

 

 

 

 

 

 

 

 

Table II;
Daily_§ppusr -_* __.
Exp. I Exp. II Exp. III
Approx.2gm.Prplkg.Aoprox.§gn.Perkg

 

 

 

 

 

 

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breakfast brange juice Orange juice juice
Farina Cream of Wheat Cream of theat
Cream ream Cream
Sugar sugar Sugar
Buttered toast Buttered tafst Buttered toast
Milk “Willi L’Lilk

l0:50 A.M. Oraxge jfiice Orange juice Orange juice
Cod liver oil Cod liver oil Cod liver oil r
p- -i __ ... _._.--,,r-__i-,-

 

 

 

 

 

 

 

 

instead of soup.
Ice cream or
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stead of baked
custard.
Peaches in custa

 

instead of plain

Spinach soup.
Ice cream
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Buttered potatoes Buttered potatoes Meat with mcat I
Scrambled egg Scrambled egg loaf '
Milk Milk Tom to juice 1
Peaches Peaches Lettuce & cottage'
cheese sandwich i
Milk
Baked custard
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5 P. M. Milk Milk Milk
Peanut butter
sandwich a
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Supper Cre"med carrots Buttered carrots (Scrambled egg
Thickened tomato Tomato juice 'Buttered carrots
juice (liver Spinach puree 1Spinach
extract) 'Baked custard Milk
Baked custard Milk Peaches
Variations Creamed potatoes Creamed carrots Tomato sauce tith
in & buttered carrots&:buttered pota meat loaf.
Preparation Iced tomato juice' toes. Tomato & Creamed carrots. ,

 

r‘
L?-

8.

Lettuce vege- !
table and plain

cheese sandwiches
Spinach sandwichs

Ice cream

 

 

 

diet were kept for analysis. Pure fat and pure car~
bohydrate were eliminated from the sample for analysis.

The e analysis portions were dried in the oven at a

U)

low temperature, ground and pulverized and reserved
for chemical analysiS.

The addition of liver extract to the low protein
diet brought the very low iron value up to the re Hired
amount. Spinach was used for this purpose on the

medium and higher protein level dieteriee, since less

OJ

supplementary iron was needed an en extra vegetable
was of added value. Since the filtered butter, cod
liver oil, sugar, and corn starch were considered pure
fat and carbohydrate, fu nisning only calories, they
were not included in the sample to he used for analysis.
The content of the low and medium protein diets was
changed very little except in the amounts of the
protein—rich foods, but several changes more made in
the high protein diet. One half the milk used con—
sisted of skimmed milk and the other half whole milk
in order to keep the fat content at its normal level
of thirty—five per cent of the total calories. Lean
beef, finely ground, cottage cheese, and peanut butter
were added to raise the protein value. In the first
dietary, a whole grain cereal, Reldbns, was used be-

cause it would aid materially in increasing the iron

content. It was found, hovev;r, that the bran

...

particles were not digested and aipeared in the feces,

..
4

interfering considerably with analysis. Cream of
Wheat was used, therefore, in the medium and high
protein dietaries. The additie a1 protein iceded to
meet individual requirements ahove the basal allowance
was in the form of egg white. Additional calories
were made up with sugar.

The urine and feces vere collected separately.

A

DJ

aily record was kept of the volume, Specific gravity,
acidity,(by the Folin method} and creatinine,(hy the
Folin micro chemical method) content of the urine. The
creatinine value indicated the accuracy in collecting
24 hour samples (15). The iaily samples were then com—
bined, and further analyses were made on the three day
portion. The nitrogen content of the urine was deter-
mined by the Folin-Dennis micro Kjeldahl method and

the amount of protein calculated. The feces were

marked for collection by charcoal, civen to the sut-

(W

jects in capsule form on the morning when the col-

lection period began and the evening when it closed.

3

The feces were washed in o c flask with 10 per cent

I

H?SO4 and gently boiled in this solution until com-

pletely disintegrated. This solution was made up to

volume and aliquot portions used for determining
nitrogen according to the standard chldahl method.
The caloric value of the food was determined by

the oxycalorimeter (16).

 

 

Dr. Amy Daniels and her associate workers (17)
have made studies on the relation of the rate of
growth of infants to diet. One of her conclusions is
that the accepted standards of growth for infants are
too low. In Table II the weight of each child used in
this eXperiment has been compared with the accepted
stanlards of the Baldwin-hood Tables (18) and the
Holt and Fales tables (19). The variations from the
normal weights according to age ranges from 11.9 to

I -‘ o

18.5 per cent above these standards, ineicating that
these children are juite overweight according to their
ages. When the weights are compared with the heights,
the range for the boys is 1.5% to 5.9 per cent and for
the girl , E. J. is 16.5 per cent above the accepted
value. E. J., however, was about average height, and
was very solidly built. She was a very active child,
but not of a nervous temperament. B. L. was a tall,
slender, apidly growing boy. He was very active with
a great deal of nervous energy. J. B. was chubby,
fairly solidly built child, very deliberate in all of
his actions. All three of the children were of average

height or taller, therefore these figures coincide with

Dr. Daniels results with younger children.

 

 

 

ISL.

91.5.

J .B.

Therefore, Since these children were above the
normal weight and height for their age group, the daily
allowance of protein and calories was increased accord—
ingly. The variations thus made are shown in Table I.
That the children were growing rapidly is shown in
the differences in their heights and weights at the
first period and at the last.

A typical, adequate, daily diet was selected for
each eXperiment containing amounts to meet the needs
of the lowest individual protein level and caloric
requirement. Throughout the three eXperimen s, the
energy intake was kept at approximately 80 calories
per kilogram (2). The children were increasing in
weight, therefore the total calories increased from
experiment to eXperiment, but the proportion was kept

constant. The analys1s sample is referred to in

(‘0

section (1) of Table IV as the minimum individual ne d,
and section (2) of the 33m: table gives the additions
to this basal menu which were used to raise the caloric
intake to the minimum amount needed by any one of the
children. If these additions did not meet the reouire-
ments, further additions of carbohydrate or protein
were made as shown in section (5) of Table IV.

It w's a bit difficult for the children to eat

all of the food c*ivon them, especially at the evening

 

 

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27

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I

meal, for the amounts did seem larger than those to
which they were accustomed. Many ways were devised to
make the meals interesting and full of fun. Small
tables, chairs, and some of the dishes were brought

to the apartment from the nursery school. A colored
oil cloth cover was used on the table, adding both
attractiveness and ease of recovering any Spilledgnrt-
icles. The Spirit of competition was great. Even
though E. J. was a girl, she "wasn't going to let a
pair of boys beat her getting done". When individual
preferences were learned, attempts were made to meet
them. For example, J. B. much preferred his Spinach
combined with the tomato juice and served in a cup to
be drunk as a bouillon, whereas B. L. ate his much
more willingly if it were served on his plate as a
separate vegetable, and his tomato juice sweetened and
served in his orange juice cup. Different colored
glass cups were borrowed from the nursery school,

but it was a delightful treat if one might drink his
milk from a measuring cup. Ice cream, of course, was

a constant request and delight. Any meal was a "party"

if "pink" ice cream were the dessert. If some Special

(D

naughtiness arose, one of the children was moved to

another table to eat alone, but when conversation was
interesting, a meal would go quite rapidly. A story
or account of some exciting adventure told by one of
the adults who ate with the children would often mean

that the children were finished eating before they

(‘3

re lized it. They did not seem to tire eSpecially of
eating the same type of food day after day, and only
once did J. B. ask if "maybe by tomorrow won't we have
all the tomatoes eaten up". The best of table manners
could not be emphasized, but one mother told us, after
the eXperiments were finished, that her only objection
to what we had taught her son was that he still in-
sisted on scraping the flowers off the dishes.

After the food for each dietary was analyzed, the
total intake for each child was computed, and the cal-
culrted and analysis values were compared. This com-
parison is shown in Table V. Analysis proved the cal—
culated values to vary considerably from the levels
planned for them. For example, the total daily protein
content of the diet for J. B. in the first period was,
according to the analys's figures, three grams over
the daily protein according to the calculated figures.
During the second and third periods, however, the

analysis figure was five grams short of the amount

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Table VI

Comparison of Calculated

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

and Analvsis Figures
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J.B, 80.6 75.4 1625 166
ggg. 85. 84.4 172; 167

 

 

 

 

 

 

 

 

 

planned by calculation from Rose's (20) Handbook. Dr.
Wang (12) reports this same situation during a study on
high and low protein levels. She says, "this variation
was due partly to the discrepancy between the publish-
ed figures and the actual nitrogen content of the food
as analyzed, and partly to the fact that some of the
children refused to eat all of the amount planned". In
this case, however, it may be said with confidence

that each child ate all of the amount planned for him.
A possible eXplanation of the variation is indicated in
the analysis figures on egg white. Egg white was the
only food in the diet to be analyzed separately for
protein. It was done because it was used to supple-
ment the basal or minimum individual needs (Table IV)
in the case of E. J. and B. L. According to the
analysis, the protein content of the egg white was
0.10694, 0.10450, 0.10778 gm. per gram of material.
Rose gives the protein content as 0.1230 gm. per gram
of material. On the first eXperiment, there were only
15 grams of egg white used, while on the second and
third experiments, 50 grams and 40 grams reSpectively
were required. By comparing the two values of egg
white, the second and third periods would be lower

proportionately in protein than the first, thus giving

a possible eXplanation for the drop in the last two
periods. Variations in the analyzed and calculated
figures may have occurred in other foods of the diet
as well as the egg white.

In the determination of the caloric content of
the diet by means of the oxycalorimeter, no difficul—
ties were met in the analysis of the mixed sample of
food. When the dried egg white representing the
supplementary protein was run, however, it proved to
be impossible to obtain complete burning of the sample.
Even when 0.5 gram of egg white was mixed with 2 grams
of sugar, the mixture charred rather than burned.

This was due, it seems, to the excess of nitrogen gas
formed when the high nitrogen material began to burn.
Nitrogen gas does not support combustion and prevented
the complete burning of the sample. Since the use of
a smaller amount of egg white would allow for so great
a percentage error, it seemed advisable, in order to
obtain complete analysis results for the caloric value
of the diets in which supplementary egg white had been
used, to calculate the calories from protein and fat
determinations. The protein value of the egg white used
in the three reapective periods had varied so greatly
from the figures given by Rose that it was advisable

to do fat analysis of the samples, because in most

foods that Cont in large amounts of protein, vhen the

.rotein runs lower the fat tends ta run higher. This

r

J
O

was found ta hold true, although the FIW;;
white used did not hrve rs high a fat Contrnt as Rose
gives. The percent 5c” of fat in tne egg white were
found to be 0.371, 0.086, and 0.065 respectiVely, as
compared with Rose's figure of 0.2 per ceni. This
value made the caloric value of egg white to be 0.434,

0.424, and 0.458 calories per gram for the three r

(’3
m
I

pective periods, as comparrd with Rose's caloric v lue
of 0.510 calories per gram.

The shortage of protein and the fact th't J. B.
and B. L. had colds during the first and second series:
would account in part for the irregilcr continuity in
the nitrogen balance that they have shown in Tables
VII and VIII. B. L. and J. B. had rather slight colds

at the beginning of the first experiment, tut they were

C,

quite well by the end of the three day preliminary

period. During the seemnd experiment, however, E. L.

‘

had cad tr utle with constipftion and cold just before

oeriod bcgfln. An enema during the

‘

the preliminary

a neccsve 3, hut during the

f“

preliminary period as

collection period, he seemed ouite all rl :t. J. E.

m
'D
0

showed signs of a severe cold on the ond day of the
collection period durinr the second CXjOTiHEJt. During

the third experiment, however, all thrre of the sutjects

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  

  

 

 

 

 

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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-57-

were in excellent condition. E. J. had been in good
health during all of the eXperimental periods.

It was eXpected that, if the caloric intake were
adequate, the nitrogen retention would be in direct
proportion to the nitrogen intake (12). This proved
true in the case of E- J., but with B. L. and J. B.,
the second period does not show a consistent increase
over the first in the amount of nitrogen retained.
Parsons (9) states that it is doubtful if a negative
balance always means tissue destruction. He found
that one of his subjects went into a negative balance
during the time she had an infection of the upper
respiratory tract. During the acute phase of such an
infection, a patient is more or less toxic. Consider-
able water may be bound in the tissues. Protéin, un—
like carbohydrate and fat, requirwi ample "free"
water for complete metabolism. If the free water is
not available, the rezuired protein cannot be utilized
and the stored nitrogen may be Spilled. Thus a
negative balance may serve as a protective mechanism,
just as refuhal of food by a patient may be a protective
mechanism. The situation is different from a chronic
condition where the patient becomes accustomed to
functioning on less free water. DuBois (E) discussed

this point from a somewhat different angle than Parsons.

0.)]

O.)
I

1

He state

'f

9 that “toyie destruction of protein" occurs in
infectious diseases vith torem a, cancer, and other
wasting illnesses. This condition m", Le prevented if
a sufficient increase is made in the caloric int Ye,
but th“t increas must be about diuble the number of
calories actvally produced ty the fiftient's metabolism.
Protein metabolisl i: usually elevated in seere in—

fections and nitroren balance can be more easily

L

“ 1

obtained when the csloric int He is greatly increased.
It is CLite possible that the colds that the lays had

were not severe enough to cause any great variation

.40

in protein metstolesn, but since their esloric intake

(+-
I
H.
C+
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’1

was not raised above their norw:l rcoiiremen-;

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The General inhiCafgon iron the refvlt? in Tables
VII and VIII are that nitrogen retention is in direct
proportion to the nitrogen infrke than the c:lories

are adeouate; that i", on a higher level oi

(‘3

such as 4 Grams per kilogram of rod: weight daily
greater amount of niirsgeu rill Ft stored or ret fined
is? the budy than +herr~vmnflx§lxecn1 ; gran? or a {r:ts
of pretcin arr kilocrrn err egg.

- -

Dr. Fun” :33 her assaci‘tes (If) used c

4 — 12 years of age.

those of the present stwdy i

table. The results cited ar

Dr. hang pM ces in her normal,

 

 

 

 

 

 
 

 

 

 

 

 

 

The relation

of her
s

seen in

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vigorous clas

fljldirlg S ‘to
the following

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It is

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interesting to note, however, that this child at 5 years

of age is i

PI
3

of 4 to 5 years used in thi

n

study .

weight than the children

Children of the pre—school age are facing a long

period of re )id growth,

nitrogen as possible to make

and successful. Result

view of Dr.

the ones used do not appear
on children when the criteri

behavior, and relation betwe

the children seened in the b

and physically during the la

the process

to have any
a used are
an intake

est condition

st

and output,

period when the

and need as much reserve
efficient
study confirm the

hang (12) that protein diets as high as
harmful effects

appearances,

for

hoth mentally

diet con—

-40-

teined the largest amount of protein. It would seem
logical therefore to recommend a higher level of
protein intake for children of pre-school age, rather

than a lower level.

Summqu afld Conclusions:

 

1.

~»..—-—.—-.._...—.

The accepted standards of growth for children of

the pre—school age are too low.

Nitrogen retention varies in direct proportion to

the nitrogen intake when the calories are adequate.

An indication of a lower nitrogen retention on a
higher protein level may be due to the discrepancy
between the calculated values according to pub—
lished figures and the actual analyzed values of
the diet. This variation is also found in the

caloric content of the diet.

A condition interfering with general metabolic
processes, such as a cold, will affect the nitrogen

retention, tending to reduce it.

As high a level of protein as 4 grams per kilogram
of body weight per day does not appear to have any

harmful effects on rapidly growing children of

From 3 - 4 grams of protein per kilogram of body
weight are to be recommended for children of the

pre-school age rather than lower levels.

7. At least 80 calories per kilogram of body weight
per day are to be recommended for active, normal

children of 4 - 5 years of age.

 

BIBLIOGRAPHX

(1) Hawle , E U. S. Dept. Agr., Tech. Bul. g)

Y - 2
1 — so, (1927)

(2) Holt, E. and Fales, B., A. J. D. C. £;,(l)
l - 29 (1921)

(5) DuBois, Basal Metabolism in Health and Disease

(4) Gillett, L., N. Y. Assoc. for Improving the
Condition of the Poor, Pub. 115

(S) Sherman, H. C., J. B. C. 31 77 - 109

(6) Holt, E., Food Health and Growth

01

o
’

(7) Newburgh, L. H., Arch. Int. Med. g2, 850, 192
fig, 682, 1925

(8) Holt, E. and Fales, H., A. J. D. c. gg_(4)
871, 1921

(9) Parsons, J., A. J. D. c. §;_(6) 1221, 1930

(10) Gephart, F. G., Boston Med. and Surg. Journ.
176, 17, 1917

(11) Fleming, G- B. and Hutchinson, H. 8., Quart. J.
Med. fig, 589, 1924

(12) Wang, c. C., A- J. D. c. gs (6) 1161, 1928

(15) Sherman, H0 C., Chemistry of Food and Nutrition,
3rd Edition.

(14 Rose, M. 8., The Foundations of nutrition
(15) Wang, c. C., A. J. D. 0. £2 (6) 560, 1926

(16) Benedict, F. G. and Fox, E. L., J. Ind. and Eng.
Chem. _1_(9) 912, 1925

(17) Daniels, 1., A. J. D. 0. £1 (6) 1177, 1929

(18) Baldwin-Wood Tables, American Child Health Assoc-
iation

(19) Holt, E., and Fales, B., Science of Nutrition in
Infancy and Early Childhood

(20) Rose, M. 8., Laboratory Handbook for Dietetics,
5rd Edition

 

  
 
 
    

    
    
  

 
  
  

 

  

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