DIETARY PRACTICES AND

NUTRITEONAL STATUS OF STUDENT
NURSES AT SPARROW HOSPITAL,

LANSBNG, MICHIGAN

Thesis for H19 Degree of M. S.
MlflHiGAN STATE COLLEGE

Rufh Miriam Marin
1‘94?

This is to ccrtiig that the
lhvsis cntillml
"Dietary Practices and Nutritional Status
of Student Nurses at Sparrow Hospital,

Lansing, Michigan"

presented In]

Ruth Miriam Marin

has been am‘eptvd tomamls fulfillmvnt

Hi the requirements for

Master of Science dmprcin Foods & Nutrition

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Infic October 21, 1949

 

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DIETARY PRACTICES AND NUTRITIONAL STATUS
OF STUDENT NURSES AT SPARROW HOSPITAL,
LANSING, MICHIGAN

By

RUTH 1-11 RIAMi‘fRIN

A THESIS

Submitted to the School of Graduate Studies of Michigan
State College of Agriculture and Applied Science
in partial fulfillment of the requirements
for the degree of

MASTER OF SCIENCE

Department of Foods and Nutrition
School of Home Economics

l9h9

TH E9?

ACKNOWLEDGMENTS

The writer wishes to express her sincere appreciation to
Miss Mabel L. McNeel and Miss Juliet George of the Edward‘w. Sparrow
Hospital School of Nursing for their permission to conduct this study and
for their interest throughout; to the 71 student nurses whose cooperation
made this study possible; to members of the hospital staff Who so kindly
assisted in numerous ways; to Dr. Dena Cederquist and Miss Wilma.Brewer
for their assistance and advice; and to Dr. Margaret A. Ohlson for her

helpful suggestions, guidance and encouragement throughout the study.

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liasma Ascorhic Acid . . . . . . . . . . . . . . . . . . 9
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Diet RecoraLS 0 o o o o o O 0 o O o o O o o o 0 o o o o o 12

Heigh and Yeigfit Records . . . . . . . . . . . . . . . . 13
1:060:1013111 o o o o o o o o o o o o o o o o o o s o s o o 1LIv
Plasmsx Ascorbic Acid . . . . . . . . . . . . . . . . . . l5
322::17IPLT T -CIT CF D:1T..IL JIknrn T): 50,38: 13‘], o o o o o o o o o o o o 18

r Histories and Food Intake Records . . . . . . . 13

HUMIOCloIbiII o o o o o o o o o o o o o o o o o o o o o o o a:
Plasma ASCOT‘CiC ACi\L o o o o o o o o o o o o o o o o s o :1:
H1? ”1th. Histories o 0 o o o o o o o o o o o o o o o o o o 33

Heizhts and Mei :hts . . . . . . . . . . . . . . . . . . .

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I-I‘Edicé‘l iYiStory o o o o o o o o o o o o o o o o o o
Fecord of Meals ior One “”v . . . . . . . . . . . .

Cq alculate d Average Daily Intake of Food Iutrients by
e

68 St \1. {ant ::‘I-1r S s O O O O O O O O O I O O O O O

Intake of Dietar'r Single ants bgr S cudent fiurses During
e

Period of Recorded Food Inta}
Composition of Dietary Supplements . . . . . . . .

Individ 51 31001 Finof nrc Heights and Weights . .

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sunber

12.

13.

Effect of Precipitation and Storage Time on Recovery
of Reduced A3001tic Acid from Elood Plasma

Da Lv Diets ry Intakes of Cal. , Protein, Calcic:.,
Vitamin A an 16 Vitamir t t
Hunter of Heels Kissed Per Week ‘y 68 Student Hurses

Comcarison of Coffee Intake with Amount of Kilk
Cons amei

Comparison of Studs ext 5 Opinion of Averede Ii k Intake
mith Actual Amount of Milk Consumed

Cnanées in F0011 Ma its During Trainin“ as Reportel ty
70 Student Lurses

Iite res cf litomin C at Ir.cree:in; Levels of Plasma
Ascorbic Acid Concentra ion

Degree of Menst1*al Difficulty Reportei by .1 Student
Yurses

on to Height of 71 Student Nurses
2 Years

Averrre Daily Diet ry Intakes of Student Nurse 8
ing from Lozmal 32-; ected ”ei: -:hts

U
(D 00
q
p.
9‘.)
Cr

seieht Chan"e of Student Lurses by Six- Honth and
Year r-3 Intervals

Comparison of Entrance Weight with Gram ation Height
of 19 Student fiurses

AC (.3 \—

Ave “Tge Daily Di to rV Intakes of Stuients Changing
or fia1ntaining Their @ts Durirg the Week of
Study

Page

16

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(I)

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111

#2

131mb er

LIiT OF FIGURES

HemOglobin Concentrations of 71 Stui9nt Yurses

Concentrations of Plasma Ascor%ic Aci‘ of 70
Student Iursos

INTRODUCTION

Surveys of various population groups have been conducted in
recent years in an effort to appraise nutritional status. Methods used
have been varied. Dietary histories, records of food intake, physical
examinations, anthropometric measurements, and biochemical analyses have
been employed in various combinations. Although the information obtained
from nutrition surveys is largely presumptive, such surveys do provide a
means for estimating relative nutritional status of a group.

Nutrition studies of young women.have been reported recently.

In 1937, in a discussion of present-day problems in nutrition, Todhunter (1)
expressed concern over the "tendency of many young women to be more inter-
ested in a slender figure than in a well-nourished body" in the light of
knowledge that lowered caloric intakes have usually been accompanied‘by re-
duced intakes of specific nutrients. College students have served as
subjects in most of the studies of young women. Such research has been
stimulated by establishment of cooperative projects among colleges (2, 3).

A review of recent literature reveals a paucity of nutrition
studies of student nurses as a group. That such information might be of
value was noted during the time that the writer served as health nurse in
the school of nursing selected for study. It was observed that many of the
students had at some time during training received multi-vitamin or iron
medication, that some students were apparently selecting inadequate diets,

and that missing of meals occurred with some frequency.

This study of dietary practices and nutritional status of student
nurses was planned with these objectives:

1. To explore dietary habits and actual food consumption
patterns, as reported in dietary histories and food intake records;

2. To attempt to discover the general nutritional level, as
shown by health histories, biochemical tests and maintenance of weight;

3. To compare calculated intake of food nutrients with findings
in the literature, and with recommended allowances of the National Research
Council (4);

4. To learn whether or not a group which had received instruction
in health practices and in the principles of nutrition appeared to be apply—
ing such knowledge to actual practice;

5. To determine, if possible, the influence on dietary practices
of adaptation to certain factors in the nursing situation such as changing
hours of duty; and

6. To add to present information certain data obtained from a

study of a group of apparently healthy young women.

REVIEW OF LITERATURE
Dietary Survey Methods

The use of several methods simultaneously in the evaluation of
the food intake of a group yields a more complete picture than does the use
of any single determination yet developed. Each method of appraisal has
certain values and limitations, and data obtained.through its use must be
viewed in the light of such limiting factors.

Burke (5) expresses the belief that a detailed dietary history is
of value as a tool in nutrition research, since nutritional status reflects
the average dietary intake for the period of observation or for the period
preceding a study. Such a dietary history should attempt to discover the
average or representative food intake as carefully as possible. The amount
of food nutrients in the average dietary can then be calculated and a rat-
ing scale of relative nutritional status developed. This evaluation should
not, however, go beyond its limits of dependability. Since a one-day or
even a seven-day period may not be representative of the usual intake,
Burke feels that diet records are the least valuable part of the information
obtained.

An opposite view is taken by Huenemann and Turner (6), who com—
pared dietary histories with food intake records of 25 children, ages six
to 16 years. In their study no history was found to agree with a 10- to
lb-day weighed diet record.within 20 per cent for all constituents.
Approximately one-half differed significantly in five or six nutrients.
These investigators conclude that the dietary history has little quantita~

tive value and its use is questionable in research on a small number of cases

In repeated records of food intake, variations were found in all nus
trients, indicating that diets may differ from time to time, making
several investigations necessary in a longer study.

In reviewing nutrition surveys conducted in Tennessee and
North Carolina, Darby (7) states that seven, or three-day food records
gave mean results that were "reasonable if not viewed with a background
conditioned by the expectation of deficiencies". Agreement was found be-
tween calculated and chemically determined food values in sample meals,
especially when mean values were considered. The best agreement occurred
in the low—intake group. Darby concludes that "this method yields useful
information regarding the mean level of intakes of a population group. It
has less value for assessing the intake of an individual".

Leverton and Marsh (8) found a significant variation in food
intakes for week days and for Saturday and Sunday of 2h college girls on
self-selected diets. They conclude that studies should be conducted for
at least one week, or preferably for 10 days. Although student nurses do
not regularly have free week-ends, a seven-day period usually covers the

days off duty, when dietary patterns may be changed.

Reported Food Intakes of Young Women

A review of studies of the food intakes of young women, chiefly
college students, shows considerable variation in data reported. Coons and
Schiefelbusch (9) report results of a study in which self-selected diets of
17 subjects provided a mean daily intake of 1990 Calories, 56 grams of
protein, and.0.93 grams of calcium. The range of intakes was from l7b7
to 221k Calories, #1 to 71 grams protein, and 0.h9 to 1.55 grams calcium.
Another study, reported in 193s by Latzke (D3, shows that 31 students
selected diets from a college cafeteria, which furnished an average

of 167a Calories, 50.9 grams of protein, and 0.613 grams of calcium

per day. Individual intakes varied from 1010 to 2529 Calories, 32.88 to
78.84 grams protein, and 0.266 to 1.213 grams of calcium. Pittman et al.
(11) report that 27 college women from Ohio and Kansas ingested a daily
average of 2038 Calories, individual intakes varying from 1119 to 3267
Calories. Students from Ohio showed a mean intake of calories which was
significantly lower than that for Kansas.

The work of Morris and Bowers (12) in Utah reveals that 100
college women were eating an average of 0.71? grams calcium, 60.71 grams
protein, and 1805 Calories each day. Greenwood and Lonsinger (13, 14),
who calculated dietary components from seven-day food records of 203 stu-
dents, report average daily intakes as follows: 2016 Calories (range
1089-3082), 64.6 grams protein (range 39.6—91.0) , and 0.8288 grams calcium
(range 0.350—1.551). Studies of 124 college women from four north central
states, reported by McKay et a1. (15) in 1942, show that students on self—
selected diets consumed 34.69.to 109.56 grams of protein and 0.322 to
2.323 grams of calcium daily. Mean intakes of protein and calcium were
63.18 and 0.941 grams, respectively.

Thirty-eight college women were studied as freshmen and as
seniors by Ohlson and others (16). These students had an average daily
intake of 2178 Calories, 69.5 grams protein, and 0.94 grams calcium for
the two periods of study. Morris and Bowers (12) report daily average in—
takes of 7793 International Units of vitamin A and 44.? milligrams of
vitamin C. Intake of ascorbic acid by 345 women averaged 84.6 milligrams
daily during the period of a study by Dodds and I-IacLeod (17).

In summary, results of several studies of food intakes of young
women show that mean intakes of Calories ranged from 1674 to 2178, average
intakes of protein ranged from 50.9 to 69.5 grams, and daily intakes of

calcium averaged from 0.613 to 0.941 grams. Two studies record ascorbic

acid intakes of 44.7 and 84.6 milligrams daily, and in one study an
average intake of 7793 International Units of vitamin A was found.

Dietary practices are related to food intake, and a study of
food habits provides information substantiating or explaining certain of
the findings of food consumption studies. Shaw (18) reports food habits
of 80 college students, as such practices were revealed by two-day diet
records. One pint of milk was consumed daily by nearly one—half of the
students, but about one-fourth drank no milk. Forty-two per cent chose
no green leafy vegetables, 10 per cent ate no fruit, and approximately
one-half had no citrus fruit during the two—day period. Nearly all students
ate between meals. One-third of all breakfasts were omitted or inadequate.
For six per cent of the group, all meals were inadequate.

Reynolds et a1. (19) studied seven-day food records of 3432
subjects. Thqrfound high protein foods, such as meat and meat substitutes,
to be most often selected, followed.by milk, green and.yellow vegetables
and citrus fruits, with whole-grain cereals chosen least often. Two
periods of seven—day food records furnished the information which is re—
ported by Young (20). It was found that weekly-average intakes of all
nutrients for a group of Cornell University women were within the minimum
requirement of two-thirds of the National Research Council allowances.

Milk intake was higher than that reported in the Shaw study, 93 per cent
drinking at least one glass daily, over one-half drinking two glasses, and
more than one-fourth consuming three or more glasses of milk each day.
Lower intakes were reported for eggs and whole-grain cereals. All students
ate between meals. One—half of the women never missed.breakfast, and no
student missed breakfast consistently. '

Using inventories of food purchased as a‘basis for the survey of

dietary practices of 213 college women, Lamb and McPherson (21) arrive at

the conclusion that no generalized deficiencies of food groups or nut—
rients were present. The recommended milk allowance was met. Consumption
of citrus fruits and green and yellow vegetables was higher than expected.
One—half of cereal products eaten were whole—grain. The number of eggs
consumed was low in most cases. A high consumption of fat and sugar was

found.
Anthropometric Data

Jackson (22) found the mean height of a group of 1022 women
students at the University of Minnesota to be 63.657 inches. Average
body weight for the group was 119.87 pounds. Records of 1000 Smith College
students were examined by Gordon (23), who reports median heights of 63.5
to 65.4 inches for students grouped by age and body build. Heights ranged
from 58 to 70.9 inches. The median weight at 19 years was 126 pounds, and
at 20 years, 124 pounds. Measurements made on 17,127 college women between
the ages of 16 and 21 years were analyzed by Diehl (24). The means of
height and weight for the total group were 63.75 inches and 120.69 pounds,
respectively. Heights varied from 48 to 73 inches, and weights ranged
from 64 to 245 pounds. Findings in this study showed the weights of col-
lege women to be uniformly lower than weights given in life-insurance
tables, except for the 16—year age group. These findings raise a question
concerning the use of such tables as a.basis for determining "normal"
weights of college women. Diehl concludes, after this report, that no
significant increase in height or weight occurs after the age of 16 in a
group of college women.

Several studies, in which measurements of the same subjects were
repeated over a period of several years, show that there is a small in-

crease in height during college. Such an increase was not observed in

Diehl's study, where single measurements of a large number of subjects
furnished the data. In such a study individual differences in total
height would tend to mask any increases which had occurred. Barker and
Stone (25) of Stanford University analyzed records of heights and weights
of 1290 women in that school. The mean height at 20 years was found to
be 64.63 inches, with an average weight of 120.90 pounds. A small but
significant increment in height and.weight was found to have occurred
during the years spent in college. Increase in stature during this period
has also been noted by Gould (26) and Donelson et a1. (27).

A study by Gutowska and Ellms (28) shows an average height of
64.45 inches and a mean weight of 130.69 pounds for a group of Massachue
setts students. Greenwood and Lonsinger (13) found an average in height
of 164.07 centimeters and an average in weight of 58.40 kilograms fer 203
Oklahoma women. In a study of 1013 college freshmen from four of the
Iorth Central States reported by Donelson and others (29), when subjects
were grouped.by states, mean heights ranged from 161.4 to 164.8 centime-
ters, and mean weights ranged from 55.8 to 58.4 kilograms. Students from
Ohio were found to be significantly shorter than were students from the
other states studied. College women in this study exceeded in height and

weight previous measurements of women from the North Central States.

Hemoglobin

Osgood (30) reports an average value for the hemoglobin concen-
tration of the blood of 369 young women as 13.9 grams per 100 milliliters.
For 100 women, Sachs et a1. (31) found an average hemoglobin value of
12.96 grams and for 10 women, a mean value of 13.5 grams, with a range of
12.4 to 14.3 grams per cent. Ohlson and others (32) report a mean hemo-

globin of 13.4 grams in a study of 4550 students from the North Central

 

‘Wr+

States. Although a range in values from 8.5 to 17.5 grams was recorded,
72 per cent of all tests were within one standard deviation of the mean,
or between 12.2 and 14.6 grams per 100 milliliters. These investigators
conclude that the normal standard for hemoglobin concentrations must be
interpreted as a range of values, this range being wider than those re-
ported in previous studies.

Of 604 women studied.by Sheets and Barrentine (33) at Mississippi
State College, 76.4 per cent had hemoglobin values between 11.5 and 14.0
grams. The complete range was 8.8 to 15.7 grams, with a mean of 12.4 grams
per 100 milliliters. This average value is lower than the mean values re-
ported by most investigators. Gutowska and Ellms (28) found a hemoglobin
range of 9.5 to 16.0 grams per cent, with a mean value of 13.8 grams in a
study of 161 Massachusetts students. MacMillan and Todhunter (34) report
hemoglobin values for young women which range from 9.2 to 15.8 grams, with
a mean of 13.9 grams. A mean hemoglobin concentration of 14.20 grams was
found for 30 college women studied by McAllister and Molsberry (35). The

concentrations ranged from 12.01 to 15.52 grams per 100 milliliters.
Plasma Ascorbic Acid

The blood plasma is a carrier of ascorbic acid to the various
body tissues and is influenced by diet. Laboratory tests of reduced as-
corbic acid content of the plasma have been used in nutrition surveys to
add objective information in attempts to appraise nutritional status.

Seven young women were studied by Todhunter and Fatzer (36), and
were found to have ascorbic acid concentrations of 0.86 to 1.66 milligrams
per 100 milliliters plasma during a period when they were eating their
usual diets. Dodds and MacLeod (17) report a mean plasma ascorbic acid

concentration of 0.67 milligrams per cent for 345 college women in

10

Tennessee. An average fasting plasma ascorbic acid value of 0.66 milli»
grams per cent is reported for 582 women by Donelson et a1. (37).
MacMillan and Todhunter (34) report plasma ascorbic acid values for 174
young women which range from 0.11 to 1.65 with a mean value of 0.65

milligrams per 100 milliliters.
Summary

A review of the recent literature reveals that certain infor-
mation concerning dietary practices and nutritional status of a popula-
tion group can be secured through dietary histories, food intake records,
height and weight measurements, and biochemical tests for determination of
blood hemoglobin and plasma ascorbic acid concentrations. These various
methods tend to supplement rather than replace one another in the deter-
mination of nutritional status, and therefore all have been employed in
this study.

College students have served as subjects for many of the recent
nutrition studies of young women. Since nurses in training are within the
age range of college students and live under some of the same conditions,
it was felt that results of college studies could be used for comparison

with the findings of the present study.

EXPERII-{ENTAL PRO 031707713
subjects

Students enrolled in the Edward W. Sparrow Hospital School of
Nursing served as experimental subjects for this survey of nutritional
status and dietary practices. Data were obtained from 71 of the 99 stu-
dents in that school. Thossnot included in the study were omitted.because
of vacations, affiliations, or working hours which made scheduling diffi-
cult. The 71 young women ranged in age from 19 to 32 years and were all
in apparent good health. They lived in the nurses' dormitory and ate
most of their meals in the hospital cafeteria.

Before the survey was begun, an explanatory notice was posted
on the students' bulletin board. This letter stated the purpose of the
project, told what would be expected of persons serving as subjects, and
expressed a desire for the cooperation of the students. A sample diet
record form was also posted, with instructions for completing it. Sub-
jects were individually informed of the time of their blood tests.

The study was begun on February 17, 1949 and information was

obtained at intervals throughout the four—month period ending June 14, 1949.
Questionnaires

Because of varying time schedules, personal interviews were not
arranged. It was felt that, since this was a group of students, satis—
factory information could be obtained through questionnaires. Two sets of
questions were developed, one to obtain general information on family back»

ground and history of dietary practices, and the other form to secure data

12

on general health conditions, past and present. A copy of each questionnaire
may be found in the Appendix. Additional or verifying information about the
health of the subjects was available from medical records kept by the school
health nurse.

Subjects received copies of the two questionnaires at the time of
blood testing, and were asked to return the completed forms with their food

intake records. Seventy subjects returned completed questionnaires.
Diet Records

On the day of blood testing, subjects were given seven c0pies of
a form for reporting daily food intake. They were asked to record all
food eaten on the day preceding the examination, and to keep such daily
diet records for a total of seven consecutive days. Subjects were on un-
restricted self-selected diets with the exception of two who were following
prescribed low-caloric reducing diets.

Records of food intake were obtained from 68 of the subjects.
From these records the number of servings per period of each type of food
was determined and entered on a calculation form. COpies of the forms
used for recording food intake and for calculating diets may be found in
the Appendix. Intakes of calories, protein, calcium, vitamin A and vitamin
C for the period were calculated.by use of the short method of Donelson
and Leichsenring (38). Average daily intake of each was then found by
dividing total intake by the number of days for which food records were
kept.

The Donelson and Leichsenring table is a.usefu1 tool for rapid
calculation of the components of a mixed dietary. The authors report close
agreement between the values secured with short and long methods of compue

tation of food values of 30 three-day records. They found no deviation

13

greater than 2.5 per cent in the results obtained by use of the two methods.
Studies of usual dietaries in the North Central States served as the basis
for food values included in the table. The figures, therefore, are repre—
sentative of foods eaten in this section of the country. One period of
study of the food consumption of an individual can serve only as an indi-
cation of the average or usual intake. Variations in the composition of
various foods would also tend to decrease the assumed greater accuracy of
a long method of computation. The use of the short method of calculation
in this study was felt to be justified on the basis of these observations.
For purposes of information and validation, menus of foods
served in the hospital cafeteria during the period of study were obtained

from the hospital dietitians.
Height and Weight Records

Heights and weights of subjects were obtained during the week of
recorded food intake. Subjects were weighed without shoes and while wear-
ing ordinary clothing. Heavy coats or jackets were removed. The scales
used were those in the office of the school health nurse. A sliding rule
attached to the scales was employed in measurement of heights, which were
taken without shoes while the subject stood on the platform of the scales.

Records of entrance weights and monthly weights throughout train—
ing were obtained from the health nurse. These weights were taken on the
same scales and under conditions similar to those described above. Since
individuals had spent varying amounts of time in the school, the same in-
formation was not obtained for all subjects. Twenty-five students included
in this study had been enrolled for about six months, while 11 had been in
training for over 30 months. Eight subjects had been enrolled for 24

months, 16 for 18 months, and 11 of the students for 12 months.

14

Findings were compared with Wood's Table of Height and Weight
for Women of Different Ages (39), and with figures reported in the

literature.
Hemoglobin

The hemoglobin concentration of the blood was determined once
for each subject. The sample for this test was taken at the same time and
under the same conditions as was the specimen for determining plasma as-
corbic acid, described later.

After the finger and knife-blade were sponged with alcohol, a
small cut was made near the tip of the finger. The first drop of blood
was wiped away, then several drops were collected in a paraffin cup con-
taining a small amount of heparin, which was used to prevent coagulation.
The Sheard-Sanford method (to) of hemoglobin determination was then fol-
lowed. A 0.02 cubic centimeter sample of the whole capillary blood was
laked in 10 cubic centimeters of 0.1 per cent sodium carbonate. Sodium
carbonate, rather than distilled water, was used in the conversion of hemo-
globin to oxyhemoglobin to prevent possible clouding caused by precipita-
tion of globulin, and to prevent the formation of acid hematin. Since
little change in the reading occurs for several hours, the sample was
transported from the nurses' residence to the laboratory in this form.
Duplicate readings were made in a Cenco—SheardrSanford.Photelometer (#1)
using Cenco Filter Number 525P. Distilled water set at 100 was used as
a standard. I

The hemoglobin concentration of the blood was calculated from a

calibration chart supplied with the instrument and filter. Swansonl has

 

1. Personal Communication, Dr. Pearl Swanson, Iowa State College,
June l9u9.

15

recently reported results of a study of the concentrations of hemoglobin
found in samples of heparinized and non—heparinized blood. Higher values
were obtained when heparin was added, with a mean increase of 0.59 grams.
0n the basis of these findings, all hemoglobin values reported in this
paper have been corrected.by subtracting 0.5 grams from the values
obtained on heparinized blood.

Hemoglobin values found in this study were analyzed for mean,
standard deviation and probable error of the mean, and were compared with

reports of other studies of young women.

Plasma Ascorbic Acid

Blood.plasma concentration of reduced ascorbic acid was deter-
mined once for each experimental subject. The sample was obtained at the
nurses' residence before the subject had eaten.breakfast, which, in most
cases, was at 6:30 o'clock. All of the subjects appeared to be in good
health at the time of examination.

Analysis for ascorbic acid followed the micromethod of Farmer
and Abt (b2,43). Two 1.0 milliliter samples of capillary blood from a
finger out were collected into vials containing dried two per cent lithium
oxalate. In some cases a second cut was necessary to provide sufficient
blood. The vials of oxalated blood were then immediately centrifuged for
five minutes to separate the plasma.

Plasma proteins were precipitated by the addition of 0.2 milli—
liters glass-distilled water and 0.4 milliliters five per cent metaphos-
phoric acid to 0.2 milliliter sample of the plasme. Since removal to the
laboratory for the titration procedure was desired, this stage was chosen
as the most satisfactory time for transportation on the basis of data pre—
sented in Table 1. To determine the effects of precipitation and storage

time on loss of ascorbic acid from plasma, intravenous blood from one

and

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stored for fou

subject ‘as treated in three way 3: h—thoi 1, precipitate
centrif‘ ged and titrated immediately; Hethod 2, precipite
centrifuged, refrigerated for four hours, then titrated;
precipitated plasma was refrig;rated for frur hours, then
titrated immediately. Results showed no appreciab

acid from the precipitreted elasma samples which here

hours before centrifu in'.

There was a possible s;.;a11 lcs

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amples

 

 

 

stored for four hours after s epa wr ti on of the precipitate by centrifugi 5.
Table l. Effec t of Precipitation and Storage Tin.e on Recovery
of Fe di‘;ced Ascorbic Acid from Blood Plasma
Sa ple Kl. Dye Used to Titre‘e Plasma
unfitqr i-f‘f‘ACA- l vocf‘kca ’.‘ rnthcw '3,
l 01:-0 0117 012‘.)
2 .117 .113 .121
3 .110 .113
. .113 .118
Average .1185 .113 .118
After samples were aken to the laboratory, they were centrifuged
for five minutes to se arat e the plasma protein precipitate. Two 0.2
milliliter samples of the deproteinized plasma were then tit ated im-
mediately with a standardized solution of 2,6—sodiun dichlorobeirenenein-
dophenol to an end—point of the first faint pink which persisted for 20

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PRESENTATION OF DATA AND DISCUSSION

Dietary Histories and Food Intake Records

Sixty—eight student nurses kept records of their daily food
intakes for a.period of one week each. Amounts of foods eaten were esti-
mated, except in certain cases, such as the half—pint bottle of milk, which
could be measured. The amounts reported, therefore, should be somewhat
more accurate than if the quantities reported were all estimated. Average
daily intakes of calories, protein, calcium, vitamin A and vitamin C were
calculated from these diet records by use of The Food Composition Table for
Short Method of Dietary Analysis (Revised), prepared by Donelson and
Leichsenring (38). A table of average daily dietary intakes of the 68
subjects may be found in the Appendix.

A summary of the calculated average daily dietary intakes of
this group of student nurses is presented in Table 2. Intakes of Calories
ranged from 858 to 2&81, with an average of 1699 Calories per dn . Only
two values below 1000 Calories were found. One of these girls was follow-
ing a prescribed low-calorie reducing diet, and the other missed six meals
during the week of study. One-fourth of the subjects ingested 1000 to
1500 Calories, over one-half ate food furnishing 1500 to 2000 Calories,

and about one—fifth consumed more than 2000 Calories.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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The average caloric intake of this group of young women for
the period studied was lower than in most studies reported. It agrees
most closely with the reports of Latzke (10), who found students select-
ing foods supplying an average of l67h Calories, and Morris and Bowers
(12), who found an average intake of 1805 Calories for a group of Utah
students. Most other studies of food consumption have reported an
average intake of about 2000 Calories for women of this age range.

In the present study a prOgressive increase in mean intakes
of specific nutrients occurred with increasing caloric intakes. The
average daily protein intake of this group of student nurses was 60.1
grams, with a range of 32.6 to 89.1 grams. The mean intake of protein
was higher than the 50.9 and 56 grams reported.by Latzke (10) and Coons
and Schiefelbusch (9) respectively. It most closely agrees with the)
60.71 grams reported by Morris and.Bowers (12). Values found by other
investigators have been somewhat higher, ranging from 63 to 70 grams of
protein.per day (14,15,16).

Calcium intake for the group averaged 0.78 grams per day, and
ranged from 0.18 to 1.85 grams. This mean intake compares with findings
of 0.717 grams daily by Morris and Bowers (12) and 0.8288 grams per day
by Greenwood and Lonsinger (14). Except for the intake of 0.613 grams
found by Latzke, calcium consumptions observed by other investigators
have been higher, averaging 0.93 to 0.94 grams per person daily (9,15,165

The mean intake of vitamin A was computed to be 5476 Inter-
national Units per day, but individuals within the group varied from
1171 to 13,280 International Units per day. Since intake of vitamin A
is dependent upon choice of specific foods, there was found to be less

consistent increase with calories eaten than was shown by certain other

nutrients. The average vitamin C content of diets tended to rise with

increasing calories, although much individual variation occurred. The
calculated amount of ascorbic acid ingested ranged from 19 to 130 milli-
grams per day, and averaged 59 milligrams. These figures do not include
ascorbic acid intakes from dietary supplements, which will be discussed
later. Such additional vitamin C would have raised the figures reported
in Table 2. It is of interest to note that dietary sources of ascorbic
acid provided an average of about 60 milligrams per day, an amount which
probably meets the needs of many of the subjects.

0n the basis of data obtained, only a few observations on
dietary adequacy appear justified. In the comparison of survey findings
with dietary standards or allowances, it must be remembered that
"inasmuch as variability is a fundamental attribute in biology, it be-
comes impossible to fix a single figure as the requirement for a substance‘
(7). Standardization of requirements is difficult, also, because of
changing knowledge and inadequacies of present measures and means of
detecting mild deficiencies (12). As emphasized by Sherman and Atwater
(#5), "a dietary standard is only an indication, not a rule". The recom—
mended allowances of the National Research Council were planned to serve
as a guide in the planning of adequate diets for a normal population.
Balance studies and other chemical measures of nutritional status (46)
have shown that these allowances are greater than the needs of many indi-
viduals. It appears, therefore, that persons whose intakes equal or
exceed these allowances are presumable adequately nourished, but it does
not necessarily follow that all people failing to reach these goals are
malnourished. (1+)

It would seem that student nurses, in general should be classi-
fied as moderately active individuals. hational Research Council

recommended allowances for a moderately active, 123-pound woman are:

2&00 Calories, 60 grams protein, 1.0 grams calcium, 5000 International
Units vitamin A and 70 milligrams ascorbic acid daily. Since many of
the subjects were in the 19-20 year age groups, the above allowances
were compared with recommendations for girls 16 to 20 years of age.

The protein allowance for post adolescent girls is 75 grams, and an
ascorbic acid intake of 80 milligrams is recommended. Other recommenda-
tions are the same as those for a moderately active voman.

In comparison with the above allowances, the average intake of
calories appears to be low. Calcium and vitamin C intakes also are
somewhat below allowances. The average protein intake is within that
recommended for women, but is low for girls 16 to 20 years. Whether or
not the actual requirements of these students for maintenance of normal
nutrition are being met Cannot be determined from the present study. It
would appear, however, that if satisfactory nutritional states are being
maintained by present calculated dietary intakes, requirements of certain
specific nutrients by some individuals are lower than those generalhy
found.

As mentioned earlier, low-caloric diets tended to be low in
other nutrients. 0f the 19 subjects ingesting less than 1500 Calories
only two had 60 or more grams of protein, and only one averaged one gram
of calcium daily. Intake of the specific nutrients studied reached or
exceeded allowances in nearly all cases where the energy intake was over
2000 Calories. It was observed that calcium intake did not reach one
gram per day until more than two glasses of milk were included in the
daily dietary. Thirty—five per cent of the group ingested the recommended
daily amount of calcium.

0f eSpecial interest for the partial explanation of low dietary
intakes is the record of meals missed during the week of study. Table 3

summarizes these data. A meal was defined more in terms of time of eating

than in terms of quality. For instance, black coffee and fruit juice

at breakfast-time served as a meal for some of the subjects. If Judged
in terms of nutrients supplied, the number of meals which were missed or
grossly inadequate would have been increased. Meals for students working
evenings were interpreted as the corresponding deyatime meals. Jackson
and Schuck (U7), in a study of Purdue University women, found that
omissions or inadequacies of breakfasts were not compensated by the rest
of the meals for the day and caused a low intake of whole and enriched
grain products, milk and fruits.for the week. Because of our usual menu
patterns, the missing of any meal is likely to result in the omission of
certain foods from the day's dietary. For example, cereals and citrus
fruits are usually eaten at breakfast, while meats or other high protein
foods are most frequently served at dinner. A consistent omission of
breakfast would lead to a low consumption of citrus fruits for the week,
and the missing of dinner would lower the protein food intake.

In this study breakfast was omitted by one-half of the students
one to three times, supper by one—third of the girls one to five times,
and the noon meal by eight individuals one to two times during the week.
Meals missed on days off duty accounted for about one—third of the meals
omitted. The large number of suppers missed can be explained in part
by the fact that many students who worked evenings did not eat at
11:00 o'clock when reporting off duty. In other words, there was a
tendency for students working the evening shift to eat only two meals a

day.

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l7 drank two to four cups per day, and three averaged five or six cups
each day. Table 4 shows that there was a tendency for coffee intake to
decrease with increased milk intake.

Table 4. Comparison of Coffee Intake with
Amount of Milk Consumed

 

 

 

Glasses Milk Ho. of Cuts Coffee Per Day
Per Day Cases Averige Range
0-1 13 2.1 0-6
1-2 31 1.1; 0.5
Over 2 24 0.5 0‘3

 

Between-meal and bedtime snacks were fairly frequent. Over
one-half of the group reported occasional snacks, and more than one-third
ate between meals often or regularly. Only five students indicated that
they ate only at mealtime. Twenty-nine of the 70 girls reported eating
meals away from the hospital or nurses' residence once a week or more.
Nearly one~half stated that they ate out only about once a month. Since
many leave the hospital on days off duty, the latter figure seems high.
Perhaps meals eaten at home were not considered "eating out".

A check-list was included in the general questionnaire in an
attempt to discover changes in food habits which had occurred during the
period since the student enrolled in the school. Responses to such a
list are necessarily subjective, and are influenced.by forgetting and
various factors of personal bias, so must be viewed within the limita-
tions of such information. Opinions of usual food consumption often vary
from actual amounts of food consumed. Ohlson and others (U8) found that
subjects consistently thought their milk consumption to be higher than

was found when actual dietary records were checked. Such a comparison

was made in the present study, with somewhat similar findings. Results

of this analysis are shown in Table 5.

Table 5. Comparison of Student's Opinion of Average
Milk Intake with Actual Amount of Milk Consumed

 

 

Students Reporting Number
Actual intake 18
More than actually consumed £2
Less than actually consumed 7

 

Table 6 presents a summary of changes in food habits, as re-
ported by 70 student nurses. Of especial interest are the reports of
lowered intakes of eggs, citrus fruits, cheese and fresh meats. Custards
and butter or margarine were also eaten less frequently by several persons

With the exception of butter and perhaps fresh meats, reductions in in—

Ill.

take of these various foods was probably influenced.by lesser availability"
in the hospital cafeteria. During the period of study, eggs and custards
were seldom served. Sufficient high vitamin C foods were eaten by some

of the students, so these needs could have been met by careful choice of
foods. The possibility of serving more cheese on the hospital menu is
indiCated.

Since students did not pay for their meals, cost should not
have influenced the choice of foods. Several students commented on the
fact that they received more starchy foods in the hospital cafeteria
than in their usual home dietaries. This probably was true. In view of
the apparently low caloric intakes of many of the subjects, perhaps the
use of some of the combination dishes was indicated. The use of eggs at

other meals, in addition to breakfast, is suggested, especially since

individuals working evenings usually omit breakfast. Devilled eggs, served
as a salad or a garnish, are often accepted more easily than a breakfast

egg not done to taste. Leafy green vegetables which are not well-accepted
when cooked might be offered in a fresh crisp salad.with a tart dressing.
Such small changes in methods of food preparation might increase consumption
of certain foods.

Changes in milk intake varied, with about the same number re-
porting increased and decreased intakes. Milk was available at all meals,
and also between meals in the nurses' residence. Potatoes and whole-
grain breads were other foods for which a fairly large number of students
reported lowered intakes. An increase in the amount of macaroni products
and rice eaten could partially replace calories lost by lessened potato
and bread intakes. The total findings may inficate that certain indivi-
duals were eating smaller quantities of food than they had been consuming
before they enrolled in the school. Comments were made by several of the
students that they ate less now than they did at home. Thirty students
reported increased coffee intakes. This was the largest single change
in food habits reported. More favorable changes included increased con-
sumption of liver by 10 individuals, and a decrease in the amount of

candy eaten by lh.

Table 6. Changes in Food Habits During Training
as Reported by 70 Student Nurses

 

 

 

Husker of Students Reporting
Food More now Learned Less now Does not

to eat eat
Milk 10 l 12 5
Eggs 4 20 5
Custards 2 l 7 17
American cheese 2 ll 8
Liver 6 u 5 16
Fresh meats b 1 lb
Oranges and grapefruit 6 l 18 l
Tomatoes 7 1 7 5
Fresh vegetable salads 9 5 9
Spinach 8 3 5 8
Carrots 2 2 5 7
Potatoes 2 19 b
Ereakfast cereals 6 5 9 15
Whole-grain bread 7 l 12 7
Macaroni, rice, etc. 1h 1 5
Navy and lima beans N 5 3 l6
Butter and margarine 3 8
cake 3 1h
Candy 7 14 4
Coffee 16 in 5 10

 

Hemoglobin

Results of a si n le determination of he noglobin concentration

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71 student nurses showed a mean of 13.7 grams
8, with a range of 11.5 to 15.8 grams per hundred
milliliters. Figure 1 presents a frequency dis otribution of the values
obtained. Seventy per cent of all cases fell within one standard de-
viation of the mean, or between 12.9 and IL. 5 grams, and all were within
three standard deviations above or below the mean. Hemoglobin concentra—
tions of the individual subjects may be found in a table in the Appendix.
The average concentration of 13.7 grams found in this study is
near the mean value of 13.’1 grams reported for #550 women from the North
Central States (32). The mean of this study also ap1roaches the average
values of 13.8 and 13.9 grams per cent which h ave been reported.by sever 1

other investigators (28, %,3h). The range of values in this study was

not as gr eat as have been the var:iations reported in several other

J

studies. This can probably be explained.by the fact that the subjects
were exar1ined routinely throughout their tre in 113, and any very low
hemoglobin concentrations would have been found and treated.

Hemoglobin values have been found to vary within, as well as
among, individuals. Therefore, results of single determinations should
not be accepted as absolute values. Such results can be used as indi-
cations of probably hemoglobin concentrations of individuals studied.
Findings for this group of student nurses show that hemoglobin concentra-
tions of these subjects aopear to be within the no .al range.

No consistent relationships 13ers foux id between the observed
iemoglobin values and intake of specific dietary nutrients. Low
concentrations of plasma ascorbic acid occurred at random throughout

the range of hemoglobin values.

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Plasma Ascorbic Acid

Concentration of reduced ascorbic acid in blood plasma of 70
student nurses averaged 0.9 milli- ams per hundred milliliters plasma.
The range of values was found to be from 0.26 to 2.05 milligrams per
cent. Fifty—three values, or 75.7 per cent of all cases were within one
standard deviation of the mean or between 0.69 and 1.25 milligrams per
cent. Only or e value vas more than three mt ndard deviations from the
mean. This was the high concentration of 2.05 milligrams per 00 ill -
liters for a student tak ng 500 milligrams of crystalline ascorbic acid
do i1;r in addition to t1 At received in food. Figure 2 shows the distri-
buti n of plasma ascorbic acid values for this group. A table in the
Appendix lists plasma ascorbic acid concentrations for the individual
subjects.

The mean plasma ascorbic acid value found in this study is
hi Dher tr an the 0. 66 milli rams per cent reported for women from the
North Central States (37). It is also higher than th e average 0.797
milligrams per cent recorded by Dodds and MacLeod (l7) and the mean of
0.65 milligrams per 100 nilliliters found by Machillan and Todhunter (3b).

There was an apparent limited correlation found.between intake
of vitamin C and plasma ascorbic acid concentration. Table 7 shows an

e ascorbic acid con-

U

increasing mean intake of vitamin C with increasin
centrations of blood plasma. This table includes six individuals who
received 75 to 500 millig‘ams of supplementary vitamin C each day. These
additiorm l amounts have been included in the intake ra nges recorded in
the table. A wide ran.e of int shes was observed for each plasma level.
The low inte ices of vita 31in C recorded for certain Siwbject :hose plasma

ascorbic acid concentrations appeared satisfactory, suggest that the

vitamin 0 requirements of some indi v1’duals mav be much lower than the

amounts usually considered to be necessarv.

Table 7. Intakes of Vitamin C at Increasin3 Levels
Plasma Ascorbic Acid Concentration

 

 

Plasma Ascorbic 30. of Inta me of Vitamin C
Acid Con en tretion Cases Mean Intake Range of Intake
mg./100 ml. mg. mg.
0.20-0.39 1 27 -
o.uo_o.59 5 57.6* 31-9u*
0.60-0.79 9 bu.3 31—8h
0.80-0.99 23 61.0* 2h-107*
1.00-1.19 19 73.5* 31-190*
1.20—1.39 7 102.1* 51-212*
l.h0 and over 3 gun,3* 53_562*

*Fig ures include intake of vitamin su333, ilements.

 

Health Histories

Good health is a requirement for entranc einto, and is necessary
for remaining in, nurses' training. This process of selection rules out
dividuals with poor health records. An examination of medical records
for this group gave a ge eral picture ofq app arently good pr sent he 21 ...
The chief illnesses of these students during training were upper respira—
tory infections, gastrointestinal upsets, and surgical operations, such
as appendectomies and tonsillectomies, which were of short duration and

probably had little effect on the nutritional states of the individuals

concerned.

Food allergies result in the restriction of those foods which

~*

rave been found to produce allergic responses. oi nce such sllerg es

were reported.by nine of the students dietary records of these individuals

were examined for the possible effects on food intake. The average
dietary intake of this group was found to me close to the ne1: for all the
su-jects studied. The allergv-group ate foods providing an average of
1697 Calories, 59.3 grams protein, 1.79 grams calcium, 5183 .U. vitamin
A and 55 milligrams ascorbic acid daily. However, about one—half of
these subjects had low intakes of several or all of the nutrients calcu—
lated. Allergy lists of these students ShOVJed ti at adequate diets could
be selected from the food served, if the individuals so desired.

Since menstrual difficulty ma;r be a health yroblen for some
youn3 women and may influence dietary intake during period 5 of catane nia
certafi n data reveals d 0" this study are included in this report. The
average age of onset of menstruation was found to be 12.6 years, with a
re: 3c of 10 to 16 vears. This is the menarcheal age reported by Simmons
and Greulich (L?) from t1e analvsis of records of 230 girls. Other in-
vestigators (23,53) resort that menstruation begins most often during
the thirteenth yea .

Table 8 presents a distribution of the de3ree of menstrual dif
ficulty reported by these sxcjects. About one~half reported no diffi—
culty, about one-third had some disconfor , while about one-sixth had
moderately severe difficulty or incapacity with periods. A higher number
of cases of menstrual discomfort Ler 9 found to occur in the gir ls \610
started to me istruate between ll and 13 vea rs of age. Whether or not
this finding is associated with age of onset, with stature, or both, is

uestioned, since it was also discovered that students of shorter pre se .t

q
hei3ht -ad tented to reach he menarche earlier than had girls of greater

35

oresent stature. A clasSification of degree of menstrual difficulty by

hei3ht showed a mean oresent height of 62.3 inches for students report—

.-

2.;

f

ing severe difficulty ant an average height of 6h.b inc.es for those

0

Table 8. Degree of Menstrual Difficulty
Resorted by 71 Student Eurses

 

 

 

 

 

 

 

 

Age of No. of Present Height Degree of “enstruol Diffi ultg

Onset gases Egan; Range ngire ‘31.ch;_ Mod. .flone
yr. in. in. no. no. no. no.
10 1 6h.5 l
11 16 63.3 62.0-65.0 1 4 8

13 2h 64.4 61.0-71.5 2 1

it 11 6u.9 61.0—69.0

U‘ \0 0\ W
H
0\ T0

15 3 65.5 64.0—67.0 1 2

Total 71 5 6 24 36

 

Heights and Weights

For this group of 71 young women an average height of 6M.O
inches, or 162.6 centimeters, was found, with a range of 59 to 71.5 inches,
or 1&9.9 to 181.6 centimeters. Weights ranged from 103 to 162 pounds
(#6.8 to 73.6 kilograms), with an average weight of 128.h pounds (58.h
kilograms). Table 9 presents the average weight and the range of weights
:

ior girls of different heights, as found in this study and as compared

with a standard table. The range of expected weights is recorded as 10

per cent below the mean expected weight to 15 per cent above that we

\ 1.)
O\

xau+

*b.LU.

The average actual weights were somewhat higher than the mean expected

weights for students between 6M.0 and 66.5 inches.

Heights and weights

of the individual subjects are recorded in a table which may be found

in the Atpendix.

‘

 

 

 

 

Table 9. Weight in Relation to Height of 71
Student Iurses Ages 19 to 32 Years
Lo. of ‘_' Actualflfieigbt Egpected Weight* “——
Eeigkt ”sees Kean Range Fean Range
in. 1b. lb.’ 1b. lb.
59.0 1 110 109 99-125
61.0 5 113 106-118 116 lOU-l33
61.5 1 103 117 105-139
62.0 6 115 103—126 118 106-136
62.5 3 13M 126-1u7 119 107-137
63.0 5 113 10b-130 120 108-138
63.5 6 11 103—12! 22 110—1b0
6u.0 16 13a 113-156 125 112—1uu
64.5 6 133 120-1u8 126 113—1&5
65.0 5 135 llZ-lhé 127 llh-lh6
65.5 h 135 l31-1b0 130 117-1h9
66.0 h 13h 12h—151 132 119-152
66.5 2 155 1&8—162 134 121-15h
67.0 2 29 128-130 135 122-155
67.5 1 145 137 123-157
68.0 1 155 138 12u-158
69.0 1 138 150 135-172
70.5 1 1&5 106 131-168
71.5 1 1M5 1&8 133-170
*Besed 0n the Table of E-ight and Weight for Women of Different Ages
by Thomas D. flood, M. D (39)

 

’T"?

-.
Couiarlsoz‘; zit“. fix-Tints if. the litant'w‘e shot's this f_:.‘o'1_;
2.1ients to is some htt shorter on the average tir: 1”?” college women
studied.hy Greenwood an” Loreinger (13), Gutowsks "id films 38), an-
D'SII?.L::‘"‘I‘. t‘: al. (29). '2 es“ i_.‘.':?t1;{‘-131’"5 regorted risen statures of
7‘21. 1 If: "vs" “I"? ” .11-‘~'-":-+.~.-q “Co- nfiff’ws‘l'r “—.-fi+‘.« ”'Tl~-}g c+“'11“+lr"
—. -. ., v T. ‘*&A\‘— *\.z ..( .--J.A.... u A y. ‘L C ,.-\.1 .L- -4...‘ . D......~'-~ VJ.- \L‘-< ~~ .. .u... D
(23) and Stanford Ynivsrzitr students (L5) were Cleo found to he teller
than this gran; of stulent nerses. The mean heigfit regorted free tee

1 r 'x A“ +‘ (1" V ' f‘ “ ‘
01 CS ~— ' U 0 l .lcio 1* ~-& . -- \. I . —- \4 LL
‘ a
A“? CC)“ 1 r ‘fl 1‘,‘:).-3v‘ ,0.“ . L1 _. _ 5' C ., 1",: ’5‘ l 4“!- \ 'H. ’2“ ‘ A: ‘54- C: \ «‘4’: 'JV' '5'; .n ‘avr
‘- _ . no .V“ 9 a- J-‘\. .. .. .4 A .a“ L". [I . I.--L“ --‘. _... v.. .r .v , _ .5 ‘ (Ivy ‘. LC- ~- y; 5:
g, I V J '4
4. 4.- 3.- t “.1 .- .u. - 4.: .. 1 , . ..- 4.. t - o 1
- l ‘h 1 ‘ 5“» _ ~ Pfi fl, s~f‘) (7v- ‘ ~r . _‘ Q1 < vry-l an o,-
EU14L~ s: -.5 est} _..I 4 I \3.. “V‘.-.'\‘- .6 ..»-J ..,V x. J (.vb \2-5 .Kdu ~~§§ 41.9.: UC~1¢vJ

'0 " L * —. w". h as 4", Vf‘ a “,0 ~ 4-,
1ron 161.~ to 1ve. c “t16~ “ 0; tne stat

»_.;~ .1 L o...

o 1 . J 0 'V.
e “*0 4a.d 1n t1

M - , ins-“ 1.1. . - .1.“ 4. - ‘ - ..- "J- 3-. I‘ 1 .2
on: 2‘s pro...1y 0-, “0.0 can gr. -3 to “10-1V5n. a u-ents iron o;-e
.-. - 4. 1., - i. 4 .-‘. t 'r. '4" .431 - . +y .9 +3
2.:e -0"u1 to “'"e a .>'n nelvn s1q41-1cuntl; loner uihn any 01 .ne
u 2 . .. 4- 1: a "r- -'.--° + 1». —- 1.-- t :- .. - a . t“
.ner states studied. -.e s; ch s of two fires»; study exceeded he
... a1 . - 4 j t I. ‘ ' v V ‘ ' '3" ." '1‘ " 1 "" ‘ "‘
0‘110 0111.5 U113: 5‘ v." a 302.1 "telf o. e ce..-:..e-. 1‘, "ct Lei: 1123333?
\
a Q o I ,N‘!_ i _ fl I. . ‘ _- .
tne he: Hts of tne onio 32‘ sets tnnn tP° stwtares eirrtei for y uh?
‘
. w. -- I. ‘ * a a”
a new 1son tee o.h;r stutes.
I s 3 s‘. + 1A - , .‘ 1'". I ‘- a<;
lite avexpe z": ‘33.. lecor.‘_.. :1. . .1 s st1 ,’ C4.)I.').'ir“;‘-a. lost
-. .‘L 1-1. -. +.. ' a --n 1? ..:...- ls“ xxan
closel" ' lbf‘. 43.1: . reiorus’rl h," u‘M-enno), an dp:-::-_-q r .1, , . n . Lher
r“"\-\(- ”*A ‘rA‘. ‘1'L cl n -'|",- ‘fi‘fi‘q :fi A o+-1‘.‘~V I fin\ 7y~~5+ C‘ \Yr—xrrq +/\ A14. t. ‘1. A .
L'v..-g, ..L.LJ.-U "(‘b _.'.'."3. up- .1. 0.1"; Jung. ~-I’ I..- g'»'-p~L 0._‘ Sr,“ ___:

height and sge, eight ov:rreigit enl eight Ud’ervei ht. Fi"s of the
eiQh. olese suhj=cts were six to 15 gonads verve: “t, while serve cf
the 51;”t find? “Sight er J’cts r3re one to Ti": 30"n*s 1‘elow the’r
lowest nornal exgected Lei fits. Severn; stuffints ct the Forderlin1 verc

38

T ble 10 shows the average dietarr intake for the grouo of

OVf-‘weieht gi rls to be considerntly lower than is the mean intake of the
underweight girls. This finding is in line with the report by Erown and
thson (52 th5¢ obese young women were found to he maintaining their body

weivhts on less ce‘ories than those consunal by average young women of
normal weight. Sever51 of the obese students in a present study were re—

strictiig their intakes in an effort to lose weight. Two were t:11:ing

- 0 v 1‘ - r~ , 3- *r r. n w . h s 1 -'
thyroid entroct and benucirine gregaretions under red1c.l Slpervls-on.
.‘ A . a . . A ‘VOA‘Q‘ A. ‘4'! 1a 9v v A ‘
They still rena1ned 1n thr o.s1Maeiott along, “3u€f:l.

Studies of the weight changes of subjects in this survey pro-

. a, .‘ A. 1 ~-‘ A «L4-v- .n:‘ .~-. ~- m - . ‘ ‘
diced ssveial irt res.1 r llflllnbsg lphle 11 yresents tne pnttern of

"eight char'e during the period of tra mino. "Pi‘ht fi:“r°s Vere ohtrinei
for total time in trainin;, and changes were determined for six—month and
yearl" intervrls. The fi;“”es for the first year in training inc'r‘e all
stuients in the stuly, "hile second "ezr figures inclide onlv trose who
were in, or had completed, their second yerr in the school. Figures

given for tre t? wird e5r regresent the 11 senior students studled. Over
one-half of the students gained weight during heir first six months in
training, while only about 10 per cent lost weight during the saune period.
During the next year and one-half, wei hts tezided to remain f5ir1y con-

Stant or to decrease. In the small sum 1e of senior students studied,

L

+1

a pattern of increased weight loss was not e1 durinx tne last year of

training, esoecially in the last six month

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able 12. Comparison of Entrance W.ei it With
a aduation Height of 19 Student Iurses

 

 

H 4 ‘ ‘ no. of Amount of Change
ae1gnt Cfia~oe Cases 1-9 lb. lC-l9 lb.
I10 0 n0 0

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Average intakes of food nutrients by groups of stud nts

apnarently geir.ing :naintair -irg, or losing weight during the period of
study are reported in Ta is 13. The lowest mean dietary intake was
found 1or the gr ou13 losing wei‘.t, and the highest average intake for

the gaining group. The reputed ve lue of 858 Calories daily is low for

a studen -t apparently main ai in 5 bodv wei att. 1ne next loxest caloric
intake by an inoit id w.l maintaining weight was 12 53. Since the effects
of increased or decreased aloric intake are not immediate, figures re-
ported.here may reflect diets Hr es of sever5l we ee‘s past, or in the on se
of the very low caloric diet, weight changes may h ave been measured lEtc r

if the diet had been followed for a limited numbw of days at the time of

study.

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Slxndicta I'y
Calculated daily dietary intakes of many of the student nurses
studied 1*eered someHHat lo” when comje red "it“ 1‘"c “rded allo'arces.

In soite of their assercntly low inteaee

’ D
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9
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good health at the time of study. Their average h

r - . I‘ ~ ‘ ‘ ~ a” 1A : 1 2,". a T. ‘0 ~ ‘4‘ Al

ascorbic acid values Wrc: sitlin no real rcu :72. Height ch.naes tenied to
. ._‘ N a. -<" ' p - r . l\ «D QQ - p-g -. . r-
sisjects -aininb wei. t w s nigher than taut oi the b:roup l0:ing wejékt.

‘! L ‘ 1 c 1 7" —. “" " -‘ N - q' t' I“ v p '

nu caen;es “”131 occuired were, in MOLD cases, desiralle. These

C"‘oup was good at the tine of stud'. It should be notgj ttat intakes Of

all the sutjects were not low. Some students were eating at high levels,

I '1' a r 't 4“!- . g ‘
ani,c en at lower level 1:, fewe :gtremelv low intanes meie recorded.
A‘ I‘.‘ e \ '1': "'V -!-’ x a 1* - ‘ “ ‘0 4A wr - a 1. ‘ -.Qv
several qu c.i an alias as tne r-s t c- iiilinbs oi tuis stu1;.
“ ‘ -, L I ‘.H .x q * ‘L‘ . g Q : ‘ ‘A ‘ ‘ Q
are tne intaues cl tnese surgects meetin~ tne-r needs, and if so, are tne

actual eneréy and nitrient requirements of this group lower than those

usually ex)ected for indivi(il wls of this age ranwe and type of activity?

\J

If present inta”;s of the‘e ti'ent are not meeting their individ 31
needs, what will te the long time effect of such def cits?

These studezit nurses had rec 1V rel instruction in the orinciples

L

of nutritior and diet therasy in addition to courses concerned with

general health. From the data presented it can he concluded t.at me.ny of
the students were not Lakinr )'liCPt on of theoretical kntwledse to
actual practice. The findings of this study imply s.need for more effec—

tive education in the field of Versonal food requirements ani 1"ooh. dietpry

hatit 5. Sin nee food consunption was found to be influenced ty changing

hours of duty, e:.3 hasis Should.be placei on the fulfilling of daily
requirements re5erdless of the time of neals.

Findin5s of this studv indicate thrt nee ls serve to tiw
student nurses were nutritionally ade'unte. The adequacy of individual
dietaries was degenuent uyon the foodc hoices mode ty the subjects. In
sis on educet on su55ested above, students

mi5ht be encoure 5ed to eat more of certain nutritionally important foods

. V y r g- :I -‘ I I- , A .' r “g F.
1f son s-1ll mo difications were to Us mpde in m tnods of pr eoari;15 and

.-

serving t.131.

l. Seventy—one student nurses, who r.e n1; ed in age from 19 to

32 years, were studied.
health histories, keno

record.s, and hei5zt and

r‘ a
4. hean daily

Tirorluoion obtained include i dietary histories,
Ilasna escortic acid analyse , diet
-5nt measurenants.

'.,'.".
81-.

calculated intakes were estimated as 1699

Calories, 60.1 grams protein, 0.78 grams Calcium, 5h67 Internn tionnl Units

vitamin A, and 59 milli

iction in individual

5rans asc corbic acid. There was found to he a ride

'1 *fi‘rcc 7" 6
1‘1J(~.-,~J J"...

, ranging from 858 to 2L°1 Calories,

89.1 grams protein, 0.18 to 1.85 grams calcium, 1171 to 13,280 Inter-

national Units vitamin A and 19 to 130 milligmr ms ascorbic acid. Higher

intakes of specific nutrients tended to parallel increased caloric

3. A number

students reoorted eating less e‘cc custerds,

Q“_)L‘ .

fresh meats, potatoes and whole-grain trends

-5. Meals were missed fairly freouently. Most

students ate between motile. One -th ird dreni: more tlm.n two glasses of

milk daily. Coffee in t21:e tended to be high, esgecially in cases of

lower milk consumluiot.

lowered food intakes.

‘ h. Avera5 3 he

be 13.7 grams, with a re

tion and dietary intake

Irre5ular hours of work pgeared to result in

moglobin concentration of the blood was found to

5e of 11.5 to 15.8 5rams per 190 milliliters

21001. No apparent relationship was found between hemoglobin concentra-

of nutrients studied.

L56

5. Rzesults of one detei m1 'netion of reduced ascorhic acid con-
centretion of t21e blood plasma showed a ran5e of 0.26 to 2.05 n111i5rans

per 100 milliliters, with an average value of 0.9 milli5rans

d
*1
o
m
:3
<+
0

There was a positive relationship demonstrnted between plasma ascorbic
acid values and mean intakes of vitamin C

, althou5h individual variation us

6. heights of these youn5 women ran5 ed from 59 to 71. 5 in& 1

m

(1L9.9 to 131.6 entimeters) and wei_§ Wt varied from 103 to 162 pounds
(

(162.6 centimeters), with a mean weignt of 23.9 pounds (58.h kilogrems).

-

I

3.8 to 73.6 kilograns). Avera5e stature was found to be 6h.0 inches

li5ht s 1-mj cts w'ere found to be over 10 per cent below their expected
weights for hei5nt and age, and eight were more ti an 15 per cent shove
their expects ed Mei“ nts. There appeared to be a pattern of weight gain
during the first six I1onths in training, . ollowed.hv a 5rpdua1 return to
entrance wei5ht for manv students.

7. Avera5e food intake of the overt; ei5ht students was found
to be lower than that of m1deruei 5ht subjects. Those students losing
weight were eating fes'er calories, and those 5ainin5 weight were eatin5

T11 L a. .n— '. .u. v S U." (I. V‘i v :a ~I S x. ‘ S kl“; Sud VJ VA C n C o b r n
ore c 1orie *h'n ere tie t1 ent o e ei 1ts re: 11 ed n t t

durin5 the period of study.

COITCLUSIOITS

Tie student nurses studied showed variations in their
a;7 lication of knowledge of recommended dietery practices to insiVidual
intal.es. I'viany seemed. to be eating at lower levels than might be ex-
pected in View of h-alth ed‘lcetion 0‘.) ained in nurses' training.

Althouzb " od intakes of many of these su‘ojects 'mpe e‘d

p

be somewhat low, their average ”11921051313171 and ascorbic acid concentra-
tions were within normal ran‘es, and nearly four—fifths w ere mninta inii .5;
or increasing their i-zeiguts. Tie present general health of the. group

2;p:a.rently wns good.

9.

13.

13.

lb.

‘7

Todhunter, 3. n. 1937 Some present day nroblems in nutrition.
%

J. Am. B et. Assoc., 1:235.

Fisher, G. 1736 Cooperet1ve research anonb coile5es. J. none icon.,
no ,.A
LustJO

Fincke M. L. 1950 The as corDi c acid vit 3mg n0) metabolism of
D
college students. A COD perative study. J. 3A1. Piet. Assoc.,
1£077C
AWOIRJ.

Food an. Nutrition Eonrd lQHB Recommended Die tarv Allowances.
Notional Research Council, Reprint and Circ.1lar Series no. 129,

Washington.
Eurke, B. S. 17Q7 The dietery history as a.tcol in research.
J. All. giet. ASS 0C0. azloul.

Huener ann, R. L. and D. Turner l9h2 Methods of dietary investigxt on
J. Am. Diet. ASSOCO. 19:562.

Darby, '.'.'. J. 19

inte pretst o

47 The influence of some recent studies on the
i i
Assoc., ;;:20'

ngs of nutrition surveys. J. Am. Diet.

Leverton, R. M. an d A. G. Hersh 19°C ComJarison of food intakes

J//

for w,-nieve and for Snturdov and Su11nv. J. Home Econ., 11:111.

Coons C. M. and A. T. Schiefelbusch 1932 The diets of college
wor en in relation to their basal me abolism. J. Yutrition, j5'59.

Latzke, E. 193h A study of the diets selected by college students
selected from a college cafeteria. J. Home Econ., ;£:107.

Pittman, 1:. 3., H. 11¢sz ,13. L. Kuner tn, 2:. 3. Patton, Ede
and G. Cox 19h2 The mloric intekes of twentV—seven coll
women. J. Am. Diet. Assoc., ;§;~b9.

Morris, S. O. and M. Powers 1 39 A stu ' of the diets of one hundred
colle5 e women students. J. Am. Diet. Assoc., 15:358.

Greenwood, M. L. and B. N. Lonsinger 19Uh Food intam of college
women: caloric intake and energy requirement. J. Am. Diet. Assoc,

£93 5214'.

l,LL Food intake of college women: protein, calcium,
pho osphorus, and iron. J. Am. Diet. Assoc., 20:671.

17o

18.

19.

h)
«a
O

A)
C.)
o

L o

LZcKav, H., M. P. Patton, M. A. Ohlson, H. S.
A. G. Marsh, G. Stearns and G. Cox 1441
nitr

ltt 'mdwn Pb.
alcium, phos
ogen metabolis.1 of young college women. J. Nutrition, 1 :°c .

1
o
C)h_1

hlson, M. A., Y. D. Brewer, D C. Ced mist, L. Jackson, 3. G. Brown
and P. H. Roberts 19L8 Studies of the protein requ uirements of

women. J. Am. Diet. ASSOC., é£37uw

Dodds, M. L. and F. L. HecLeod 19Gb A survey of the ascorbic acid
status of college students. J. Nutrition 12:315

Shaw, M. M. 1940 A study of the food habits of eighty college
students. J. Home Econ., 32:61M

Reynolds, M. S., M. A. Ohlson, F. S. Pittman, H. KcKny, M. E. Patton,
E. Donelso n, R. Leverton, E. J. Meiller and M. d. hitting 19U2
The dietary habits of college students. J. Home Econ., 3£;379.

You-g, C. M. 19fl6 Dietary study of Cornell University women.
“n. Diet. Assoc., ;§:25.

Lamb, bh W. and C. K. McPherson 19GB Trends in dietary pre ctices
of college women. J. Home Econ., 32:19.

Jackson, C. M. 1929 Porsical measurements of the fen ale students
at the Universitv of fi~innesota, with special reference to body
build ar nd Vito 1 ca oacity. Am. J. Phgrs. Anthron 12 363.

Gordon, F. F. 1930 Physical measurements of one thousand Smith
College students. Am. J. Pub. Health, g91963.

Diehl, H. S. 1933 The heights and weights of American college
wome.. Human Biolo”", 55600.

32 ”her, R. G. and C. P. Stone 1936 Growth in height and weight in
college and university wome1. Science, 22:59.

Gould, H. N. 1939 The pr Q’sique of women students at lfewcomb College
of Tulane University. V. Increase in stature at college, based
on reoeated measurements of the same individuals. Human Biology,
11: 220.

Donelson, E. G., M. A. Ohlson, B. K. ”att, IL D. Patton and G. M.
Kinsman 19“3 Physical measures ents of col.lege women. Am. J.
Dis. Child., §§:21.

Gutowska, M. S. and E. B. Ellms 1956 Nutritional status of women
students. J. m. Diet. Assoc., §§:763.

Done lson, E. G., II .A. Ohlson, B. Kune rth, I-L B. Pzt onrti and G. Kinsman
19UO Anthropometric data on colle5e women of t‘ne Id ddle States.
Am. J. Phys. Anthrop., 22:319.

Osgood 7. 3. 193 Hormel hematologic s tanderd.s. Arch. Int. hed.,
4

37.

39.

#0.

£1.

an.

50

Sachs, A., V. 3. Levine, F. C. Hill and R. Hughes 19h3 Cooper and
iron in human blood. Arch. Int. Med., leb89.

Ohlson, M. A., U. Cederquist, E. J. Uonelson, :. M. Leverton,
G. K. Lewis, . .Q. Iiim is and H. S. Feynolds 19th Hemoglobin
concentre tions: red cell counts and erythrocyte volumes of college
wonen of the Lorth Central States. Am. J. Physiol., __§: 72 7.

Sheets, 0. and M. H. 33 rrentine 19th Hemoglobin concentrations and
erythrocyte counts of the blood of college men and women. J. Am.

MacMillan, T. J. and E. E. Todhunter 19U6 Plasma ascorbic acid and
hemoe :-obin values J. Am. Diet. Assoc., §§;503

McAllister, G. and D. Molsbsrry 19L '7 Hemoglobin values of college
women. J. Am. Diet. Assoc., 22; %Q7
Todhunter, E. H. and A. S. Fatzer 19u0 A comparison of the utili—
zation.by college women of equivalent amounts of ascorbic acid
(vitamin C) in red raspberries and in crystalline form. J.
Nutrition, 12:1

Donelson, 3., P. M. Eelson, M. A. Ohlson, M. Pittman, R. Leverton,.
H. I-‘cKay, G. Kinsman, Y. Armstrong a.n d M. Reynolds 1945 Uutri—
tional ste tus of I'id\.estern college women. J. Am. Diet. 'ssoc.,

2331145.

Donelson, E. G. and J. M. Leichsenring 19”5 Food composition table

for short method of dietary ana lysis (r evised). J. Am. Diet.
Assoc., gizuuo.

McLeod, G. and C. M. Tevlor 19h5 Pose's Foundations of “utrition.
Four h- Edi tion, The liacmili an Companv, flew York, p. 571.

Loffman, W. S. 191'1 otelotetric Clinical Che:.istry. William
Lorrow and Congany,r Lew York, pp b8-62.

Sanford, A. 3., C. Sheard and A. E. Osterberg 1933 The photelometer
and its use in the clinical 1 abor retory. Am. J. Clin. Path., 35b05,

Farmer, C. J. and A. F. Alt 1936 Determination of reduced ascorbi
acid in small amounts of blood” Proc. Soc. 2; . Biol. Med., lgglbéo

1938 Titration of plasma ascorbic acid as a test for
letentavitaminosis C, in Nutrition: The Fewer Dia5.ostic Methods,
Milbank Me morial Fund, New York, pp. lie—137.

 

Pessey, O. A. 1938 A method for th e determination of small qL denti—
ties of ascorbic acid and dehydro—ascorlic acid in turbid and
colored solutions in the presence of other reducing substances.
J. Biol. Chem., 126:771.

She Hrian, H. C. 19b6 Chemistrv of Food an.d fiutrition. Seventh
Edition, The Macmille LU Company, New York, p. 511.

#6.

Fincke, M. L. and V. L. Landquist 19b2 The daily intake of
ascorbic acid required to maintain adequate and optimal levels
of this vitamin in.blood plasma. J. Nutrition, g2:h83.

Jackson, P. and C. Schuck 19b? Dietary habits of Purine University
women. J. Home Econ., 23:33u.

Ohlson, H. A., P. H. Roberts, 5. A. Joseph and P. R. Nelson l9h8
Dietary practices of 100 women from #0 to 75 years of age.
J. Am. Diet. Assoc., 23:286.

Simm~ns, K. and W. V. Greulich 19b3 Fenarcheal age an the height,
weight and skeletal age of girls age 7 to 1? years. J. Pedia rics,
I‘f‘. (10
L ~o'14.\.,.

u
' I
'7’
U)
H.
H

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3&3
.9
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.C
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OO
0

Brown, 3. G. and E. A. Ohlson lQhé Weigrt refluction of obese women
of college age. I. Clinical results anfl basal neteholism.
J. Am. Diet. Assoc., 22:939.

L LA‘< .LJ

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A:

NUTRITIONAL SURVEY - SPARROW HOSPITAL
Spring 1949

Name Class Date
Home address If you live in a town give its size

Do you, or have you ever lived on a farm?

 

Birth date Age Sex

 

Place of birth
Nationality Are you a citizen of the U.S.?
Father's birthplace
Mother's birthplace

How many generations has your family lived in the U.S.?

 

How many members are there in your family? At home?

 

Father
Mother

Brothers Younger? Older?

 

Sisters Younger? Older?

 

Are all members of your family living?

 

If not, give cause of death age at death relation

Who is wage earner in your family? Occupation?

 

Has he worked steadily during the past 5 years?

 

If not, give reasons
Do any other members of your family contribute to your support?
Father's education: Grade completed College Degree

Mother's education: Grade completed College Degree

 

How many rooms are there in your home?

 

Does your family own your home? Rent it?

 

Approximate rent
(below $30, $30-$60, over $60)

 

Page two

Have your eating habits changed since entering training?

 

Check ( ) the foods that you eat now but did not eat at home. Mark (1)
the foods you do not eat. Also indicate by "more" or "less" any changes
in amounts of foods eaten since entering training.

 

 

 

 

 

 

 

 

 

 

Milk Macaroni, rice, etc.
Coffee Carrots

Liver Navy or lima beans
Eggs Butter or margarine
Cake Meat (fresh)
Breakfast cereals Potatoes

 

 

Oranges and grapefruit Whole grain bread

 

 

 

 

Spinach Candy
American cheese Tomatoes
Custards Fresh vegetable salad

 

 

Others, or comments:

How often do you eat out?

Do you eat between-meal snacks? Often? Seldom? Regularly?___

Do you eat at bedtime? Often? Seldom? Regularly?__

Does your home have electricity?

 

running‘water?

 

bathroom?

 

Does your family have an automobile?

 

radio?

 

refrigerator? mechanical ice

 

How many hours of sleep do you get When on day duty? 3-11?

Nights?

 

How much sleep have you had in the past 2h hours?

 

Page three

 

Did you work before entering training? Occupation?

 

Method of financing education
Do you.participate in sports: actively? occasionally?

never?

 

What sports do you.particularly like?

 

 

When did you last have ice cream

candy

gum
soft drinks

 

tea, coffee

Do you.take vitamin preparations? What kind?

 

Do you take iron medication? What kind?

 

Do you take laxatives? How often? What kind?

 

How many glasses of milk do you drink daily?

 

How many glasses of water do you drink daily?

 

What foods do you usually eat for breakfast?

Dinner?

Supper?

‘ R
Q\

MEDICAL HISTORY
Name Date

Check once the conditions which you have had and give approximate dates.
Check twice those you now have.

Acne
Bronchitis
Chickenpox
Measles
Whooping Cough
Diarrhea
Diphtheria
Scarlet Fever
Tuberculosis
Typhoid Fever
Rheumatic Fever

Joint pains

Jaundice

Allergies (specify)
Tonsillitis

Colds, frequent
Pneumonia

Migraine headaches
Infantile Paralysis
Smallpox
Appendicitis

Mumps

Other (specify)

Have you ever had any surgical operations? Explain
Have you ever had.any broken bones? Explain

Have you ever been confined to bed for longer than 2 weeks?

 

If so, why and how long?

 

Do you have a family doctor? Dentist?

 

When did.you last see a dentist?

 

When were you last under the care of a doctor?

 

Are you taking any medications now?

 

Is any member of your family now under doctor's care?

 

 

Why?
Do you ever have: Shortness of breath Sore mouth
Loss of appetite Chest pain Swellings Nausea or vomiting

Fainting spells Cramps Boils

Page two
Menstrual history:

Age of menarche

Length of cycle

 

Duration of period

How many napkins do you use?

 

Pain (describe)

 

Is medication necessary?

 

Has either of your parents or any brother or sister had:

 

 

 

 

 

 

Tuberculosis Diabetes
Insanity Cancer
Epilepsy Heart Disease
Gout

 

Any significant loss or gain in weight before entering training?

Since enrolled in the school?

 

Weight upon entrance

 

Date Height Weight Hemoglobin. Plasma ascorbic
acid

Record of illness during study.

in
L0

RECORD OF MEALS FOR ONE DAY
Name Day Date

DIRECTIONS:

List gll_the foods that you have eaten in the last 24 hours, including
butter, sugar and cream, and beverages.

Tell whether food was raw or cooked, and if cooked tell how, as raw ap-
ple or baked apple. Describe mixed dishes such as salads, stews, sand-
wishes, etc.

Tell whether bread was made of corn, rye, whole wheat or white flour, as
corn muffins. .

Give approximate measure (e.g. 1 slice, 1 cup, etc.) for each food.

FOODS EATEN FOR.BREAKEAST

 

 

 

 

 

 

1. h. 7.
2. ___5. 8.
3. 6. 9.

 

 

 

What foods did.you eat or drink between breakfast and noon?

 

FOODS EATEN AT NOON

 

 

 

 

 

1. u. 7.
2. A5. 80
3. 6. 9.

 

 

 

What foods did you eat or drink between the noon and evening meal?

FOODS EATEN AT EVENING MEAL

 

 

 

 

 

 

 

 

 

 

l. 45. 9.
2. 6. 10.
3. 7. ll.
h. 8. 12.

 

 

 

What foods did you eat or drink before you went to bed?

 

 

 

 

 

Vitamin preparations Amount
Iron medications Amount
Other medications Amount

 

 

Time of duty (e.g. 7-3 P.M.) Ward

59

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CALCULATED AVERAGE DAILY INTAKE OF FOOD NUTRIENTS BY 68 STUDENT NURSES

 

 

Subj . Calori es Protein Calcium Vitamin A Vitamin 0
N01 IG'QL Gmg LU. is
1 1964 66.7 0.89 5127 62
2 1493 “8.9 0.54 3049 53
3 2274 76.5 0.86 7660 63
u;
5 1984 75.9 1.14 4681 62
6 1863 65.1 1.16 4706 27
7*
8 1448 52.1 0.84 1463 31
9 1897 49.7 0.30 1857 21
10 2481 89.1 1.85 9160 130
11 1612 60.8 0.89 2737 65
12 1951 73.2 1.11 4330 62
13 877 41.2 0.18 7607 115
14 1958 73.3 1.08 7025 46
15 2085 66.7 0.76 2818 33
16 1831 68 . 2 0 . 97 3743 47
17 1936 66.5 1.08 7288 60
18 1593 51.2 0.64 6849 89
19 1976 72.2 1.21 8142 49
20 2038 70.2 1.06 11015 67
21 1644 61.9 0.80 4421 70
22 1380 54.0 0.68 5017 51
23 2305 83.0 1.29 7451 97
24 1981 74.0 1.16 9002 84
25 2188 80.3 1.19 3260 75
26 1604 53.9 0.68 4960 31
27 1673 57.0 0.61 6901 39
28 2108 76.5 1.29 3091 63
29 1309 36.8 0.38 3667 53
30 1353 46.9 0.20 3557 51
31 1564 68.1 0.93 5335 31
32 2103 74.2 1.17 7997 84
33*
34 1580 49.5 0.55 5436 68
35 1743 65.0 0.72 6740 52
36 1941 69.6 0.68 3674 83
37 1304 38.0 0.30 2725 58
38 1884 65.0 0.76 6147 63
39 1461 47.2 0.43 3082 38
40 2067 78.4 1.27 5448 83
41 1253 35.1 0.37 1687 24
42 2045 64.7 0.77 3350 107
43 1850 58.6 0.85 6247 60
44** 1522 45.2 0.42 10934 74
45 1636 57.7 0.74 3721 34
46** 1714 65.2 1.10 2496 48
47 1783 57.0 1.03 6164 72
48 1268 49.9 0.61 4088 39
“9 2173 78.1 1.09 6575 75

Calculated Average Daily Intake of Food Nutrients by 68 Student Nurses
(Continued)

 

 

Subj. Calories Protein Calcium Vitamin A Vitamin C
No. Gm.. Gm. I.U. ems
50 1374 45.6 0.39 3211 27
51 858 32.6 0.25 3697 47
52 1580 61.1 0.81 5792 79
53 1719 62.9 0.87 7199 49
54 1687 67.2 0.98 7484 19
55 1763 63.2 0.58 2133 34
56 1827 61.6 0.86 13280 56
57 1339 36.0 0.20 1171 36
58 1302 56.8 0.67 9842 48
59 1612 50.4 0.67 3044 46
60 1428 51.2 0.28 10850 108
61*** 1473 60.1 0.77 2055 37
62 1270 51.8 0.77 3892 34
63 1131 65.8 0.97 11078 39
64 1753 69.9 0.83 8556 46
65 1709 54.3 0.21 4573 40
66 1656 65.5 0.97 5224 93
67 1503 53.6 0.74 4247 62
68 2043 65.8 1.07 9632 94
69 1120 57.5 0.79 7313 99
70 1913 52.9 0.43 2235 80
71 1769 47.8 0.61 3448 70

 

* Food records not returned
** Six—day period
*** Five-day period

INTAKE OF DIETARY SUPPLEMENTS BY STUDENT NURSES DURING PERIOD OF
RECORDED FOOD INTAKE

 

 

 

 

 

sub ect Name of
Hunger Supplement Amount Taken
5 Ascorbic Acid 500 mg. daily
6 Ferrous Sulfate 15 grains for 3 days
9 Ascorbic Acid 250 mg. one day
Multicebrin 2 gelseals for 2 days
12 Multicebrin 2 gelseals daily
13 Multicebrin l gelseal daily
27 Mal-Iron 3 capsules one day
54 Multicebrin 1 daily
56 Ferrous Sulfate 5 grains one day
69 Multicebrin 1 daily
COHPOSITION 0F DIETARY SUPPLEMENTS
Name Manufacturer Composition
Gelseals Eli Lilly Thiamin Chloride 3 mg.
No. 100 Mul- & Company Riboflavin 3 mg.
ticebrin Pyridoxine Hydrochloride 1.5 mg.
Pantothenic Acid (as
Calcium Pantothenate) 5 mg.
Nicotinamide 25 mg.
Ascorbic Acid 75 mg.
Vitamin A 10,000 I.U.
Vitamin D 1,000 I.U.
White's White Labora— Ferrous Sulfate (3 gr.) 195 mg.
Mel-Iron tories, Inc. Mohfbdenum Oxide (1/20 gr.) 3 mg.

 

63

INDIVIDUAL BLOOD FINDINGS, HEIGHTS AND WEIGHTS

 

 

subject Hemogiobin Ascorbic Acid Height Weight
W300 ml. 111- lb -
1 20 13.2 1.27 63.0 104
2 21 13.0 1.17 63.5 109
3 20 13.2 1.52 65.0 134
4 20 15.8** 1.13*** 61.0 118
5 21 12.6 2.05 62.0 120
6 21 14.0 0.26 64.0 151
7 21 13.8 1.47 65.0 138
8 20 13.9 1.12 67.0 130
9 21 12.9 0.92 64.0 129
10 20 14.4** 1.03 61.5 103
11 20 12.2 1.28 66.0 127
12 21 12.6 1.33 61.0 108
13 22 13.9 1.10 66.5 162
14 23 12.8 0.78 66.0 124
15 19 14.6 0.73 62.5 126
16 ‘ 19 13.5 1.00 63.5 103
17 19 14.8 0.97 65.0 145
18 20 14.6 1.00 62.0 126
19 20 14.0 0.57 63.0 108
20 26 14.0 0.92 65.5 133
21 19 12.8 1.05*** 61.0 118
22 19 15.3 1.22 63.0 130
23 19 13.0 0.89 71.5 145
24 19 14.0 0.78 63.5 128
25 19 13.2 0.47 62.0 105
26 19 14.0 0.65 62.0 112
27 19 12.6 0.44 64.0 123
28 19 13.9 0.84*** 63.0 113
29 24 14.8 1.07 65.5 140
30 19 13.6 0.92 64.0 139
31 21 13.2 0.48 59.0 110
32 25 15.1 1.01*** 64.0 125
33 21 13.1 1.03 65.0 112
34 21 12.5 1.24 64.0 113
35 32 13.0 0.70 69.0 138
36 21 13.6 1.25 67.5 145
37 19 14.6 1.01 66.5 148
38 20 13.6 » 0.90 64.0 156
39 20 14.0 1.01 61.0 115
40 23 13.2 1.12 64.0 118
41 20 15.1 0.80 63.5 122
42 19 14.8 0.93 65.0 146
43 22 13.0 0.90 64.5 128
44 22 15.4 0.81 64.0 137
45 19 13.4 0.62 64.5 130
:3 1; 12.2 1.00 64.0 130
1 1 .2 0.87*** 6 . 12
48 19 13.2 0.62 63.6 116

64

Individual Blood Findings, Heights and Weights (Continued)

 

 

subject Hemogdobin. Ascorbic Acid Height Weight
Number Age‘ 92.11Q9m1. mg,[100 m1. inn 1b.
49 20 13.8 0.95 62.0 103
50 20 14.0 0.91 64.0 130
51 20 14.0 1.04 62.5 147
52 21 14.0 1.04 - 64.0 138
53 19 13.5 0.92*** 64.0 122
54 19 13.8 0.58 63.5 112
55 19 13.5 0.94 64.5 120
56 28 12.1 0.94 64.0 142
57 20 13.9 0.88 65.5 134
58 21 13.2 0.94 62.0 125
59 20 14.2 1.05*** 66.0 151
60 20 13.8 1.52 68.0 155
61 20 14.0 0.99*** 64.5 148
62 21 13.9 0.75 64.0 125
63 21 14.2 1.17 64.0 156
64 20 13.5 0.64 66.0 134
65 22 13.9 0.92 67.0 128
66 20 12.6 1.14 64.5 126
67 19 13.9 1.06**‘ 65.5 131
68 19 11.5 0.89 62.5 131
69 19 13.8 1.25*‘* 64.5 148
70 20 13.5 hemolyzed 70.5 145
71 19 13.5 0.91 61.0 106

 

* Age of nearest birthday
** Based on single value (no duplicate) .
*** Based on 2 determinations on single sample (no duplicate)

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