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LIBRARY
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PLACE IN RETURN Box to remove this checkout from your record.
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DATE DUE DATE DUE DATE DUE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6/01 cJCIRCIDIteDuest-p. 1 5

 

/moomBIN CONCENTRATIONS AND PROTEIN, CALORIE,
AND IRON INTAKES or STUDENT mes
AT ST. JOSEPH'S HOSPITAL
IN FLINT, MICHIGAV

BY

ADELAIDE TIIEKELL

FOOIB AND NUTRITION 8138
DR. DENA CEDERQUIST

1961

I57
5w
THS

.._-V—<¢ -. .4 _

TABLE

INIRODUCTION O O O O O O O O 0
REVIEW OF LITERATURE . . . . .

Dietary Survey Mathods . .

OF C ONTE N “l‘S

Reported Food Intakes of Young Women . .

Hemoglobin . . . . . . . .
Summary . . . . . . . . .
EXPERIMENTAL PROCEDURE . . . .
Subjects . . . . . . . . .
Diet Records . . . . . . .
Height and Weight Records .

Hemoglobin . . . . . . . .

PRESENTATION OF DATA AND DISCUSSION . . . . . .

Food Intake Records J . . .
Caloric Intakes . . . ... .
Protein Intakes . . . . . .
Iron Intakes and Hemoglobin
Heights and Weights . . . .
Summary . . . . . . . . . .
SUTMARY.............
CONCLUSIONS . . . . . . . . . .

LITERATURE CITED . . . . . . .

O O C O O O O 0

Concentrations

Page

10

12

13
14
17
19

21

24

25

TABLE 013' comms (cont.)
Page
APPENDIX . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Record of Meals For One Day . . . . . . . . . . . . . . . . . 28
Form For Calculating Diets . . . . . . . . . . . . . . . . . 29
Individual Blood Findings, Height and Weight . . . . . . . . 33
; Calculated Intake of Some Food Nutrients by 38 Student Nurses 31

Weight In Relation To Height and Caloric Intake of 38 Student
Nurses Ages 17 to 28 Years . . . . . . . . . . . . . . . 32

Number of Students Whose Intakes Were Two-thirds or More of
the Recommended Allowances . . . . . . . . . . . . . . . 33

LIST OF TABLES

TITLE Page
Average Calories, Iron, and Protein . . . . . . . . . . . . 12
Average Heights, Weights, and Hemoglobin Concentrations . . 18
Changes In Hemoglobin Concentrations From September To May 18

Average Caloric and Protein Intake of Student nurses
Deviating 101 or More From Normal Expected Heights . . . 19

Caloric Intake and Hemoglobin Concentrations of Underweight
and Overweight Students - Period I . . . . . . . . . . 20

Number
1.

2.

LIST 0? FIGURES

TITIE
Relationship Between Protein Intake and Caloric Intake. .

Relationship Between Iron Intake and Pretein Intake . . .

INTRODUCTION

Surveys of eating habits of teenage young women have been made in recent

years to appraise nutritional status. There is growing concern for the

nutritional status of this group since many girls marry before they are out

of their teens and may be subject to the extra nutritional needs of pregnancy

while still in their teens.

Intakes of protein and iron are of special interest during late

adolescence and pregnancy. Nutrition studies of college women have been

reported, and some studies have been made of student nurses. Cursory studies

of the diet habits of student nurses have been made over the past three years

by the writer- involving students enrolled in nutrition classes. It was

observed that many of these students had poor nutrition patterns. This study

of dietary practices and nutritional status of student nurses was planned with

these Objectives:

1.

2.

To explore dietary habits and actual food consumption as reported in
two separate one-day recall records made within a three month interval.
To learn whether there were any changes in the students dietary habits
as the result of a semester course in foundations of nutrition and
other phases of health education.

To attempt to discover the general nutritional level as shown by
height, weight, and hemogldbin concentration.

To determine, if possible, the effect of iron and protein intake on
hemoglobin concentration.

To compare calculated intake of some food nutrients (protein and iron)
with findings in literature, and with recommended allowances of the
National Research Council.

To add to present information certain data obtained from a study of

healthy student nurses.

,.
4v .

REVIEW OF LITERATURE
Dietary Survey'lethods

The use of several methods simultaneously in the evaluation of a group
yields a more complete picture than does the use of a single determination.
For a group it is possible to use the 2h-hour recall method to determine a
representative food intake. In assessing individual food intake, the more
detailed three or seven day dietary records or dietary histories reveal a
more accurate picture.

Charlotte Young (1) and others using data gathered from 191:7 - 1958
from five northeastern states representing seventh, eighth, and ninth grade:
high school and college students, pregnant women and.male industrial workers,
made a comparison between dietary intakes as obtained by dietary histories
and by seven-day records for the same subJects. It was found that the dietary
history did not give the same estimate of intake for an individual as the
seven-day record.but differences between methods when applied to college
home economic students were much smaller.

The same group (2) made a comparison of the use of the dietary history
versus 2h-hour recall, and the seven-day record versus 2h-hour recall, as
:methods of estimating the nutrient intake of an individual and a group.

Data for these comparisions were obtained fromtthree different population

groups: grade school children, high school and college students, and pregnant

WM.

For an individual in any of the three population groups studied, the
2h-hour recall did not give the same estimate of intake as the dietary
history, nor the same estimate of dietary intake as the seven-day record.
The history and 2h-hour recall gave results which were in better agreement

for the college group studied. For the mean of a group, the sevenqday

 

 

 

~_-.—_. * _.-__‘___......_ . . V
_ n‘

 

 

 

record and the Qh-hour recall tended to give the same estimate for the
dietary intake for most nutrients. Under certain circumstances, it is
possible to substitute the 21t-hour recall for the seven-day record in
estimating £922 intakes. When an estimate of the mean intake of a group
of roughly fifty persons is desired, and when an error of 10% can be
tolerated, the shorter simpler 24-hour recall may he used.

Faith Chalmers and others (3), used the same study of the nutritional
status in the northeastern part of the United States and attempted to answer
the question of how many and which days should be used in a dietary record.
For characterizing a group by its mean intake, a one-day record we found to
be the most efficient. No "day effect" could be discerned except in the
college group which had a lower intake over the weekend.

Three papers in the American Journal of Public Health (1+)(5)(.=3) analyzed

the present status of dietary surveys and suggested improvements 3: presently

1‘
used methods.

Young and Trulson (it) came to the conclusion that because 0;" the doubtful
validity of current methods of dietary surveys it was difficult Jo evaluate
their usefulness. Secondly, it was evident that new methods word-it snve a
useful purpose.

In further iscussion of the (5) sec racy of current methods Whiting
and Leverton have compared results of collecting and processing; ietazgr data
by two methods: laboratory analysis and calculation from food-Vélue tables.
Laboratory analysis is expensive and time consuming but the most accurate.

For the food tables, if reliable results are to he obtained, cation or usual
foods simply prepared must be used, descriptions must be accuser-33 and adequate

times of study and adequate numbers of individuals nmst be us 4-.

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-- -4“ w“ -‘..__... “w ..-.‘-_.- irv-‘~_—‘~_—-—._—— a-

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As a partial solution to some of these problems, Wiehl and Ried (6)
have considered the development of new and improved methods of obtaining
dietary information. The suggested a short schedule of simple questions
to be developed and field tested in an effort to find a practical means for
obtaining information needed to classify individuals according to dietary
practices. .

The record would not be designed for analysis of quantative estimate
but would permit grading of items into four or five categories. The short
questionaire for this study/would be identified by simple nondtechnical

I

questions and planned so that broad differences could be recopvized.

There was a chance for error in the 2h-hour recall method in assuming
that the subjects could estimate the size of portions eaten. In the study
made by Charlotte Young and others (7), as a report of one of a series
growing out of the Nbrtheastern regional Research Project Nfuh, it was
determined that on a group basis calculated nutritive value; of estimated
and measured food intakes showed small and inconsistent differences in

most cases.

.3)

\n

REVIEW OF LITERATURE

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. Odland (8) and
others reported in 1955 the results of a study of seven day food records made
by 100 Freshmen women at Montana State College. Their records showed a mean
daily intake of 2,060 calories, 7% grams of protein, and 10 milligrams of iron.
The range of intakes was from 560 to h,980 calories, 27 to 15h grams of protein,
6 to 25”milligrams of iron. Another study reported by Fry (9) in 1959 showed
that lhh dental hygienists, ranging in age between 18 and.25 years (BEA lfiln 20
years old), who completed a seven day record of their daily food intake, had a
mean caloric intake of 202% calories, 71 grams of protein and 11.05 milligrams
of iron. Scoular and Fosters (10) reported in 19h6 the results of a study of
106 college women from Texas whose mean age was 13.2 years. Data was collect-
ed.by means of fourteen day food records covering two periods. The study
showed a mean caloric intake of ehhs calories, 93.9 grams of protein and 18.20
milligrams of iron for the first period, and a mean intake of 2th calories,
99 grams of protein, and 22 milligrams of iron for the second period. Fourteen
college girls were studies in Rhode Island (7) for one day, during which they
recorded their food intake at the college crfeteria. The mean of their measured
caloric intake was 1,670 calories, the mean protein intake 56.7 grams, the mean
iron intake 8.1 milligrams. Marin (11) studied a group of 71 student nurses who
compiled seven day food records. Their mean caloric intake was reported as 1699
calories, the mean protein intake 60.1 grams. Fortynfive student nurses from

Flint (12) who studied at Flint JUnior College in 1960, used the twenty-four

A_—._.."-

- ‘0--4--~(

o "“‘“'1-’VI"AO‘ -- - -—
.
,.

hour recall method and rec.orded their food intalce in a nutrition lab ratory
class session. Their caloric intake ranged from 1600 to 2&5; calories with

a mean of 2100 calories, the protein intake ranged from 58 to 1&2 grams, with
a mean of 95 grams, the iron intake ranged from 7.5 milligrams to 21.6 milli-
grams, with a mean of 12 mdlligrans. ietary stud: es of young women of college
age, 10 - 20 years, in new Yerk, Maine, Rhode Island, West VL ginia, and
Mantana as reported by the tste Agriedltaral Erper- -men cSta+ one ( 2) from
19h? through 1958 revealed a mean intake of 2000 ca1.ori es, 75 trams of protein
and 11 milligram.of iron.

Hemoglobin

 

'Estimations of hemoglobin concentration and erythrocyte count are common
laboratory procedures used in the assessment of the s catus of nutritzon.
Donelson (it) reported in 1915 on "one matrinodai status of 1+ 50 college women
in the Midwestern stat es, Iowa, Kansas, Minna fits , Nebraska, Oklahoma, and
Wisconsin. The mean hemoglntln concentration was 13.h grams per 100cc with a
mean range of 13.0 grams to H3. grams. ‘Women college students 16 - 20 years
in (13) Maine, Rhode Island, and West Virginia had mean hemoglobins of 13 grams
per cent, 12.5 grams per cent and 13 grams per c.ent rc-spect vely per 100cc of
blood. Maria’s study (11) showed a mean hemogM :in concentration oi‘ 13. 7 grams
with a range of 11.5 grams to 15.8 grams per 100 m1.

Odland and es le (15) reported in 1956t he results of clinical and bioches-
ical studies of 112 Mbntana fifteen year old girls. Mean huocgloain lava 1.» were
13.5 grams and 1h.6 grams per 1000c respectively for two reg: no. Iron intake
and hemoglobin level were correlated at the gar can level oi' igni:_canc
(r :0. 300) for all studs .nts. McAllister and Holsberry (16) reported in 19h?

hemogldbin concentrations rare ging from 12.Cltc 15.52 grams per 106cc of blood,

1',

U

‘1}

with a mean of 1h.20 ' 0.79 gram for thirty college women studied. These
women were students at Virginia Polytechnic Institute. Their ages ranged
from 17 to 26 years with a mean of 19 years. Gutowska and Ellms (17) studied
161 girls ranging from 17 to 22 years. Data on hemoglobin concentration,
determined by the acid hematin method showed the range of hemoglobin varied
from 9.5 to 16.0 grams per 100 ml. of blood, with a mean value of 13.8 grams.
Sheets and Barretine (18) studied the hemoglobin concentration of 60h Missis-
sippi college women ranging in age from 16 to 20 years in l9hh. USing the
acid hematin method of Newcomer for the determination of hemoglobin, concen~
trations ranged from 8.8 to 15.7 grams per 100cc of blood, with a mean of 12.h
grams.
Summary

A review of the literature of the last fifteen years reveals that infor-
mation concerning dietary practices and nutritional status of a population
group can be obtained by using dietary history, food intake records, and a
twentynfour hour recall method. For a group, the last method, which is less
time consuming can serve to identify food intakes reprseznting a group pattern.
If the record does not include a Saturday or Sunday for college girls studied,
any other day may be chosen for the study. Estimating hue food intake is as
accurate as weighing the food intake in obtaining a grocg mean for nutrients.

At least fifty subjects and preferably one hundred subjects are needed
to study a groups dietary intake. The group in this strty is small and so
may not be representative. College students have serve'.as subjects for many

of the recent nutrition studies of young women. Since :arses in training are

within the age range of college students and engage in gcderate activity,

'1'

results of collage studies were used for comparison with findings of the
mount study along with two (11) (12) other studies of student nurses and

one study of dental hygienists. (9)

tax

a.)

EXPERIMENTAL PROCEDURE

Subgects

Students enrolled in St. Josephs Respital School of Nursing, Flint,
served as experimental subjects for this survey of nutritional status and
dietary patterns. Data were obtained from 38 students who 1ived in the
nurses dormitory and ate most of their meals in the hospital cafeteria.

Diet Records

 

In February, students were asked to fill out a food intake form, using
the 2h-hour recall method, during the first nutrition laboratory class period
of the semester. In May, a second one-day intake was recorded. From these
records the calories, iron, and protein were calculated and entered on a
form. For additional information, menus and recipes of foods served on the
day studies were made were obtained from the hospital dietitions.

Height & waight Records

Heights and weights of subjects were obtained during the weeks of the
recorded food intakes. Subjects were weighed without shoes and while wear»
ing ordinary clothing. A sliding rule attached to the scale was used in

‘

measurement of heights which were taken also without shoes. Records of
entrance weights and monthly weights through the first year of training were

Obtained from the school records.

i“.

 

*9“..- dI-n - M'vn-v “Au—w-

10

Hemogldbin

 

The hemoglobin concentration of the blood was determined twice for each
subject. One sample was taken in September when the student entered the school,
and a second sample was taken in JUne at the end of the school year.

The samples for the tests were drawn from a ch tube of blood taken for
general hematology from the vein in the laboratory. Tests for hemoglobin were
determined the same day.

The cyanmethemoglobin method (19) for determining the grams per cent of
hemoglobin in 100 ml of blood was used. In using this method, an accurately
measured volume of blood (0.02 ml) was diluted in an accurately measured volume
of the diluent (h.m1). The diluent, Drabkin's diluent solution, consists of
Na HC03 3 gm., potassium cyanide (KEN) 150mg., potassium ferricyanide (K3Fe(CN)6)
600 mg., and distilled water to three liters. The hospital laboratory made up
its own solution, it was discarded when it became turbid, stored in a brown
bottle and a fresh solution was made up each month.

Ferricyanide converted the hemoglobin iron from the ferrous to the ferric
state to form methemoglobin, which then combined with potassium cyanide to
produce the stable pigment, cyanmethemoglobin. These two reactions were rapid
and staichiometric.

The diluent was used in the amount of h.0 ml to 0.02 ml of blood, a 1:201
dilution. In this method there WES;£'1% accuracy, .5 gram reproducibility, 98%
accuracy to answer the obJectivity cf the test, and the test is specific since
it measured total hemoglobin (19‘.

The optical density of this unknown solution was then compared with that
of the standard using an electrophotometer. The Optical density was taken to

be directly proportional to the concentration of the pigment. The color

I

i

intensity was measured in Bausch and Lomb electrophotometer set at the 5&0 mu
band. Cyanmethemoglobin because of its broad absorbtion band in the region of
5&0 mu is adaptable to photometry and solutions if the pigment are stable.

The determination of the optical density at various wave lengths of a dilute
solution of a hemolysed normal blood (standard) and the repetition of this same
procedure in the unknown sample gave the grams % of hemoblobin in the sample.

The standard of reference was crystalline human hemoglobin prepared by the
method of Darabkin (20). This was a solut on containing 1 milliatom of hemo-
globin iron per liter which has a millimolar extinction coefficient of 11.5 in
a one centimeter absorbtion cell at a wave length of 5&0 mu when measured as
cyanmethemoglobin. The iron content of hemoglobin is assumed to be 0.335 per
cent, which corresponds to an equivalent weight for hemoglobin of 16,700 per

atom of iron.

12

PRESENTATION OF DATA AND DISCUSSION

Food Intake Records

In February at the beginning of the semester course in nutrition, 38
student nurses were asked to record all food eaten in the previous 24 hours;
using the recall method. Amounts of food eaten were estimated except for milk
which was available in half pint and pint cartons.

The daily intake of calories, proteins, and iron was calculated by use of
C osition of Foods, the United States Department of Agriculture, Handbook # 8.

A second 24-hour recall was made in May following four months of nutrition
education to see if there had been any changes in intake or dietary patterns.

The subjects were divided into three groups according to height;

Short (58-61"), Medium (62-64"), and Tall (64.5 - 68.5")-

TABIE 1 - AVERAGE CALORIES+ IROL AND PROTEIN

 

 

 

 

 

 

 

 

mamas CALORIES 120:1 mos 220mm PROTEIN
Awmm Awmm mmmsAmum wmmzAwum
11mm 11mm. 11mm: muss INIAE INTAKE
982100 1 11 1 11 1 __;;___
02002 I (a) 1622 1838 8.3 9.6 67.8 75.6
saosr- 61"
on IBSS
RANGE 1048- 1297- 5.3- 6.9- 40.7- 62.4-
2242 2864 15.9 13.1 100.0 112.0
GROUP II (10) 1957 1811 10.4 “9.4 69.0 74.0
MEDIUM-
62 - 64"
RANGE 1265- 1402- 6.6- 7.0- 50.8- 47.2-
2972 2417 15.8 13.3 87.0 90.4
02002 111 (20) 1925 1819 9.08 9.61 73.5 76.0
TALL-
64.5 - 68.5"
asses 1038- 1101- 7.2- 3.4- 48.4- 41.1-

3122 3923 13.1 14.9 112.2 125.9

a .

 

13

CALORIC INTAKES

Intake of calories ranged from 1100 to 3925, with a mean of 1886 the first
period and 1914 the second period for the whole group. Average caloric intakes
in the first period ranged from 1622 for the short girls to 1957 for the girls
of medium height and 1925 for the girls of tall height. The second period the
mean for all groups was much the same, for the short girls 1838, the mediuer
girls 1811, and the tall girls 1819. Students from all three groups were ”'
represented by high and low calorie intakes. The nine girls who were overweight
in the first period had a mean intake of 1721 calories while the five who were
underweight had a mean intake of 1264 calories.

In the second period the nine overweight giris had a mean intake of 1634
calories while the five who were underweight had a mean intake of 1731 calories.
These are small numbers for a sampling but the overweight girls lost a total of
26 pounds in the four months, the underweight girls gained only 5 pounds.

The average caloric intake of this group of young women for the period
studied was lower than in most studies reported, except for the group of nurses
studied by Maria, whose mean intake was 1699 calories. Most other studies of
food consumption have reported an average intake of about 2000 calories for
college students in this age range.

Recommended dietary allowances for this group are higher than the mean
intake found for this moderately active group of girls, the recommended intake
is 2400 calories.

A summary of the calculated average dietary intake of this group of

student nurses is presented in Table l.

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14

PROTBIR’INTAIES

Protein intakes ranged from 40.7 grams reported by one student in the
short group to 125 grams reported by a student in the tall group. Average
intakes ranged from 67.8 grams for the short group to 76 grams for the tall
group. The mean protein intake in the first period for the whole group was
69.5 grams, in the second period the mean was 75.3 grams. In the first period
921 of the 38 students had a protein intake which was two-thirds or more of
the reco-ended allowance. In the second period 891 of the students had a
protein intake that represented twat-thirds or more of the reeonended allowance
of 75 grams of protein daily.

It is particularly unfortunate when protein intakes are low for this group
of girls, for they are a group who need an adequate protein reserve in prep-
aration for possible early marriage and pregnancy. Of more importance is the
percentage of calories yielded by protein. These 38 students in all cases
derived over fifteen per cent of their calories from dietary protein as
race-ended by some nutritionists.

hotein intake was adequate and sometimes high for this group because
expensive protein foods were available to than at the hospital at no extra
cost to them. Also milk was available and most of the girls liked milk and
drank at least two glasses or more daily, at mealtime and between meals.

In the present study a progressive increase in protein oceured with
increasing calorie intake. The mean intake of 69.5 grams for these students

coqares with the findings of 71 grams daily by Fry (12) and 74 grams by
Odland (ll).

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Relationship Between Iron Intake and Protein Intake

 

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17

IRON INTAKES AND HEMOGLOBIN CONCENTRATIGNS

Iron intakes for the student nurses studied were very low. Only 31 Z of
the whole group reported intakes that were two-thirds of the recommended allow-
ances. Iron intakes ranged from 3.4 milligrams as reported by a student in the
tall group in the second period to 15.8 milligrams as reported by a student in
the medium group. Mean intake was 8.3 milligrams in the first period for the
short group with an increase to a mean of 9.6 milligrame for the same group in
the second period. The Medium group did not show a corresponding increase from
period I to period II, the mean for period I was 10.4 and it dropped to 9.4
during the second period. The tall group reported a mean intake of 9.08 milli-
grams the first period and 9.61 milligrams the second period.

The mean intake for the whole group was 9.1 milligrams for the first period
and 9.78 milligrams for the second period. These mean intakes agree most closely
with the 10.0 milligrams reported by Odland (11), although they are lower than
those found by most other investigators, with the exception of the 8.1 milligrams
reported by 14 college students in Rhode Island (14).

The group of students studied very seldom chose to eat eggs for breakfast
or at other meals. Green leafy vegetables, peas, beans and lentils were not
popular foods, nor were cereals a popular item.

The nurses studied were necessarily a selected group since applicants for
nursing school would not have been accepted if they showed evidence of very low
hemoglobin. These student nurses had hemoglobiusthat ranged from 11.8 grams per
cent to 14.9 grams per cent in period I, and 11.8 - 14.5 grams per cent in the
second period. The mean value was 13.1 in the first period with a slight drop
to a value of 13.0 in the second period. These mean values are similar to those
found by other investigators ranging from the mean value - 12.4 (23) reported by
Sheets and Barrentine to a mean value of 14.0 reported by MtAllister and

Molsberry (21).

«.5?

18

TABLE 2 - AVERAGE HEIGHTS, WEIGHTS. AND HEMDGLOBIN CONCENTRATIONS

 

 

 

 

 

 

HENOGL HENOGL HEIGHT HEIGfi WEIGHT HEIGHT" '
GRANS z GRANS z INGHES INCHES POUNDS POUNDS
AVE RAGE AVE RAGE , AVERAGE AVE RAGE AVERAGE AVERAGE
PERIOD I II I II I II
GROUP I (8) 12.9 12.5 59.9 59.9 109.7 109.0
SHORT
61" or Less
W 12.0- 11.8- 58"- 58"- 95- 93-
13.7 13.3 61" 61" 125 117
GROUP II (10) 13.3 13.4 62.8 63.0 124.0 123.0
NEDIUN
62 - 64"
RANGE 12.0- 12.2- 61"- 61"- 105- 105-
14.1 14.5 64" 64" 135 138
GROUP 111 (20) 13.1 12.9 65.7 65.7 134.6 134.6
TALL
64.5 - 68.5"
RANGE 11.8- 11.8- 64.5"- 64.5"- 114- 114-
14.9 14.5 68.5" 68.5" 166 160

 

TABIE 3 - CHANGES IN HEMOGLOBIN

CONCENTRATIONS FROM SEPTEMBER TO HAY

 

 

HENOGL HEMOGL IRON INIARE

% SEPT. HAY SEPI. MAY
Subject 2 12.3 12.9 I .6 grams 1 15.8 8.6 -
Subject 5 14.9 12.4 -2.5 8.4 8.5 0
Subject 12 12.9 13.7 7 .8 10.0 9.9 0
Subject 18 12.5 11.9 - .6 7.7 9.0 }
Subject 21 13.7 12.2 -1.5 9.5 11.4 ¥
Subject 24 13.3 12.4 - .9 7.6 6.4 -
Subject 25 12.9 12.2 - .7 5.3 9.1 I
Subject 32 11.8 12.5 i .7 10.0 9.0 -
Subject 34 13.3 12.4 - .9 9.9 9.3 - ‘

19

EQTQHTS AND WEIGHTS

The students studied were divided into three groups according to height.
There were eight girls under 61", ten girls 62" to 64" tall, and twenty girls
between 64.59 and 68.5" tall. There was no clear relationship between hemo-
globin values and weights of the students. There were fourteen students whose
weights deviated 101 or more from the expected weight. Of these, nine students
wore overweight, and five students were underweight. The overweight students
who lost a total of twenty-six pounds in the four month period of the study had
a mean caloric intake of 1721 calories the first period, and 1634 the second
period. Their protein intake increased the second period along with a decrease
in calories. The group of girls who were underweight gained a total of five
pounds and reported a mean intake of calories of 1264 in the first period with
an increase to 1731 for the second period. The mean protein intake for the
underweight group increased from a mean of 61.8 grams daily to 75.3 grams daily.
This is a small sampling and so it may not he at all significant as far as
individual differences are concerned.

TABLE 4 - AVERAGE CALGFZIC AND PEWTER} HEART: OF STUDENT N" 323
DEVZATING 107. (‘3. MORE FR-‘Ci‘i 1102915.}. EXE’ECTED WE IGHTS

PERIOD I NO. OF ‘hLCREWS PRCTEIR CRANE

 

 

 

 

 

_QA.SE S WAN 1315551133 MEAN ngg
‘OVERWEIGHT 9 1721 1035 - 232 60.4 48.4 - 75.7
UNDERWEIGET 5 1264 1848 - 2213 61.8 45.7 - 79.8

PERIOD 1!

OVERWEIGHT 9 1634 1101 - 2417 66.6 47.0 - 90.4

UNDERWEIGHT 5 1731 1384 - 2239 75.3 62.0 -119.0

‘1

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POUNDS

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EEMQGLOBIN
GRAMS Z

 

 

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21

Summary

Calculated dietary intakes of many of the student nurses studied appeared to
be low in calories and in iron when compared with recommended dietary allowances.
Only 31% of the students had hemogldbin concentrations which were within normal
ranges, between 11.0 and 13.0 grams per cent. Donelson (1h) found in metabolic
balance studies that "in the case of iron the adequacy of the remainder of the diet
was of signal importance and that with a good diet an intake of only 7.21 milli-
grams of iron daily is sufficient". Protein intake compared favorably with the
amounts recommended and were adequate because the students drank large amounts of
milk. The students reported a mean intake of calories that was more than 500 less
than that recommended for girls 16 to 19 years old. In spite of this difference
nine of the students were overweight, twenty four students had weights within the
normal expected range, and only five students were underweight.

These students had the opportunity to be well fed but individual problems
existed and food choices were not always wise. The meals served the students were
nutritionally adequate, but the students did not always choose’énough servings of
green or yellow vegetables, citrus fruits, whole grain cereals and meat to provide
the amounts of vitamin A, vitamin C and iron needed to furnish 2/3 of the recoms
mended dietary allowances.

There were no distinct changes or improvement in dietary patterns as a result
of four months of nutrition education. The weight changes that resulted were
probably the result of changes in dietary patterns that took place before nutrition
classes began. These students as part of a post adolescent group carry on the same
food habits as they did as younger adolescents. Stearns (21) stated that the teen
age group is the group least amenable to nutrition education. Motivation to change

diet habits for this post adolescent group stem from a desire to improve appearance,

not for reasons of good health.

hrgaret Head (22) indicated that adolescents are more literate and very
much more sophisticated than their elders and can learn a great many more general-
isatim than their elders . She saw the need for the development of a changing
pattern that will be fitted to our increased knowledge of nutrition and to the

presence or absence of particular foods. In addition through education she saw

the need for the develoment of individuals who have flexibility and variability

enough to eat anywhere, any time if it's necessary, in any part of the world,
”any food which might be dictated by the exigencies of war or peace or migration
or shortage or change."

.J

23

SW

The 38 student nurses studied showed no changes in dietary habits as a result
of nutrition education over a four month period.

As the students increased their calorie intakes their protein intakes also in-
creased.

As protein intakes increased the students iron intaka increased.

There was no apparent relationship between hemoglobin concentrations and
iron intakes. Hemoglobin concentrations fell within the norml range 11.0 to
13.9 grams per cent, wath‘means of 13.1 3:53.134).

Protein intakes for the students were adequate, the mean intakes were 69. 5- and
75.3 grams. Iron intakes were lower than recommended, mean intern-s were 9.1
milligrams and 9.78 milligrams. calorie intakes were lower than room-ended,
but the students maintained or lost weight on mean intakes of 1866 and 191’4

calories .

w‘ ‘

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'24

OOKCEUSIONS

The student nurses studied showed variations in their knowledge of recom-
mended dietary patterns. They can apparently maintain normal weight with less
than 2000 calories. They can get along with a smaller amount or iron than 2/3 of
the recommended dietary allowances because the remainder of the diet is good.

The present form of nutrition education did not motivate the student to
change her eating habits to include eating more servings of neat, citrus fruits

or yellow and green leafy vegetables.

y.

10.

ll.

12.

13.

1h.

15.

LITERATURE CITED

Young, C. M., F. Chalmers, H. Church, M. Clayton, R. Tucker, A. Wertz,
W. Foster 1952 A comparison of dietary study methods. I dietary
history versus seven day records. J. Am. Diet. Assoc., g§;12h

Young, C., G. Huzan, A. Tucker, W. Foster 1952 A comparison of dietary
study methods II Dietary history versus seven day record versus
twenty-four hour recall. J. Am. Diet. Assoc., g§3218

Chalmers, F., M. Clayton, L. Gates, R. Tucker, A. Wertz, C. Young, W. Foster
1952 The dietary records how many and which days. J. Am. Diet. Assoc.
28:71?

Young, 0., M. Trulson 1960 Methodology for dietary studies. Am. J. Pub.
Health 59;803

Whiting, M. G., R. Leverton 1960 Reliability of Dietary appraisal. Am. J.
Tub. Health 29;815

Wiehl, D., A. Ried 1960 Development of n04 and improved dietary methods.
Am. J. Pub. Health 59;82h

Young, 0., F. Chalmers, H. Church, M. Clayton 1953 Subjects estimate of
food intake and calculated nutritive VLJIG of the diet. J. Am. Diet.
Assoc. 22;1216

Odland, L. M., L. Page, L. Guild 1955 Hui ient intakes and food habits
of Mentana students. J. Am. Diet Assoc. 31:113h

 

Fry, Peggy, 1959 Diets of post adolescenfi young women. J. Am. Diet.
Assoc. 353687

Scoular, F., L. B. Foster 19M6 Food inteic of college women. J. Am. Diet.
Assoc. ggghOl '

Marin, Ruth, l9h9 Dietary Practices and Nutritional status of student nurses
at Sparrow Hospital 1949 unpublinled thesis Michigan State University
for M. S.

writerh own studies made in 1960 at Efint Junior College

Mbrgan, Agnes, 1959 Nutritional st..us USA California Agricultural
Experimental Station Bulletin 709

Donelson, Eva G., P. Nelson, M. hlsrn, M. Pittman, R. Leverton 19h5 Nutri-
tional status of Midwestern coll:;e women. J. Am. Diet Assoc. glclh5

Odland, L., Ruth Ostle 1956 Nutritional status of Montana adolescents.
J. Am. Diet. Assoc. 325823

16.

17.

18.

19.
2o.

21.

22.

' ‘ ' q 0-o-- v A; J: 1'- ..r r? a.“ ~ '1'! . -‘ .h‘ ~
McAlliSte_, G., D. iolsoe.r: 1;¢o demagluuia salues of co. sue women.
.. n I ‘,r\
J. Am. 1319 o AQS?'\:O 23:?j7
Gutowska, M., E. Ellms, 19%5 Hutritional status of women students. J} Am.
r.-
Diet. Assoc. 92:?0j

Sheets, 0., M. Barrentine 1
men and WOTJ'ZC’II 0 Jo 1‘11: 0 Di .0

Connor, C. 1955 Hemoglobincmetry. Clinical Chemistry 3zh02
Wintrobe, Maxwell Clinical Hematology Lea and Fibinge' 1956 Phila. Rs.

Stearns, G., 1958 H tritionai state of the mother prior to conception
J. Am. Mad. Assoc. 68:555

Mead, Margaret, 1949 Cultural pattern
J: Am. Diet. Assoc. 2526??

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27

APPENDIX

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NAME:

28

DAY:11 DATE:

 

 

DIRECTIONS: List all the foods that you ate in 24 hours, including

butter, sugar, cream and beverages. Tell whether the
foods were raw or cooked; and if cooked, how (example -
raw apple or baked apple or applesauce). Describe
mixed dishes such as salads, stews sandwitches, etc.
Tell whether bread was made of corn, rye, whole wheat
or white flour. Give approximate amounts of each food
(example - 1 slice bread, 1 cup of milk, etc).

 

HEAL

roan HOUSEHOLD FOOD HOUSEHOLD
MEASURE MEASURE

 

 

 

BREAKFAST

 

SNACK

 

' fumes

 

SNACK

 

' DINNER

 

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29

 

 

 

 

 

 

 

 

 

 

 

 

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30

IIDIVInuAL snoop PIIDIICS usxcnr AND wzxcur

 

 

 

KIWI. B1061. HE 10111 RE I 6111' WE IGHT WE I 0171‘
P3810- I GB 1 II on 1 I II I U

1 18 12.0 12.5 60.0 In 60.0 In 112 Lb 112 Lb
2 18 12.3 12.9 62.5 63.0 132 135
3 18 12.9 12.7 66.0 66.0 135 135
4 18 13.6 13.5 65.5 65.5 145 143
5 18 14.9 12.4 65.5 65.5 117 118
6 18 14.1 14.1 68.0 68.0 138 140
7 21 13.3 13.3 62.0 62.0 112 114
8 18 12.0 12.2 62.0 62.0 120 118
'9 18 14.1 14.1 64.0 64.0 140 138
10 18 12.0 11.8 65.0 65.0 115 118
11 20 13.7 14.1 64.0 64.0 140 140
12 18 12.9 13.7 65.5 65.5 124 124
13 18‘ 13.3 13.3 64.5 64.5 114 114
14 18 12.2 12.2 61.0 61.0 110 108
15 18 12.2 12.4 65.0 65.0 134 133
. 16 18‘ 13.7 13.6 64.0 64.0 115 119
17 18 13.1 12.9 59.0 59.0 125 121
18 21 12.5 11.9 68.5 68.5 166 160
19 17 13.6 14.0 64.5 65.0 116 120
20 18 14.0 14.5 62.0 62.0 115 115
21 28 13.7 12.2 59.5 59.5 95 93
22 18 13.3 13.7 62.0 62.0 105 105
23 18 13.3 12.9 64.5 64.5 145 144
24 16 13.3 12.4 66.75 66.7 136 138
25 13. 12.9 12.2 61.0 61.0 100 104
26 19 12.4 12.7 67.0 67.0 143 146
27 18 14.1 13.7 64.0 64.0 135 132
28 19 14.1 14.5 68.5 68.5 152 150
29. 18 12.5 12.2 65.5 65.5 154 146
30 18 13.3 13.3 61.0 61.0 118 117
31 18 12.7 12.9 58.0 58.0 108 108
32 18 11.8 12.5 65.0 65.0 130 130
33 18 13.3 11.8 61.0 61.0 110 107
34 18 13.3 12.4 68.0 68.0 141 140
35 18 12.9 13.3 67.0 67.0 129 127
36 18 11.9 12.2 ”65.0 65.0 133 132
37 18 12.5 12.2 62.0 62.0 126 119

* Age of nearest birthday

—____—_. _. _ _

_ .— _- *3..g". ——._ .

31

CAMULATED INTAEE 01" SM FOG) NUTRIENTS BY 38 STUDENT NURSES

 

 

 

SUBJECT CALORIES CALORIES PROTEIN PROTEIN IRON IRON
PERIOD- 1 II I Gms II Gms I mgs II mgs

1 2099 1914 69.50 73.9 7.40 10.0
2 1803 1402 59.40 47.2 15.75 8.6
3 1985 1109 77.20 41.1 8.10 3.4
4 2046 1491 72.60 59.9 7.80 9.3
5 1711 1426 64.50 67.4 8.40 8.5
6 2828 2483 112.20 113.3 9.40 9.7
7 1964 1771 87.00 76.1 12.30 7.0
8 1798 1648‘ 71.40 78.4 6.60 9.9
9 1527 1734» 53.70 68.2 9.25 10.3
10 1893 2848 73.80 125.9 10.13 14.9
11 1992 2307 66.20 88.5 10.40 13.3
12 2289 2109 94.90 75.7 10.00 9.9
13 1949 2259 79.80 119.7 7.20 12.4
14 1702 2864 60.00 112.0 5.76 13.1
15 1750 1712 68.80 82.4 8.90 8.8
16 2972 1877 81.90 71.7 13.10 7.7
17 1356 1297 68.60 62.5 7.30 6.9
18 1736 1638 55.60 62.2 7.70 9.0
19 3132 1672 91.20 70.6 8.30 6.4
20 1715 1547 71.00 68.9 6.90 9.0
21 1643 1855 57.70 80.2 9.50 11.4
22 2216 1904 72.70 65.4 8.30 7.3
23 1674 1334 48.40 49.3 8.16 7.6
24 1714 1055 50.00 50.3 7.60 6.4
25 1399 1685 51.30 62.5 5.30 9.1
26 1445 3923 69.60 83.0 8.90 14.0
27 2322 2417 75.70 90.4 13.00 11.5
28 1334 1357 74.70 49.6 10.20 10.0
29 1038 1101 49.50 61.5 7.60 7.8
30 2089 2372 94.60 88.3 9.03 9.0
31 2242 1337 200.00 63.3 15.90 9.1
32 2191 1865 96.70 71.5 10.00 9.0
33 1048 1384 40.70 62.4 6.50 8.4
34 2287 2572 71.40 83.3 9.90 9.3
35 2026 2342 87.70 110.0 8.75 16.0
36' 1362 2251 49.40 68.3 11.45 10.1
37 1265 1504 50.80 87.0 8.65 9.4
38 2123 2498 87.10 75.2 13.10 9.7

WEIGHT IN R872T10N 1:0 Z—?EIGHT A531) CALORIC INTAKE

0F 33" "C.“FDENT 1'3"T£3.81"LSJ1 ACES 17 to 28 “11.43.53

 

 

 

 

PE R101) I
SUBJECT HElSHT WEIGHT EXPECTED DEVIATEON ENIAKE 0F CALORIES
Inches Pounds WEIGHT Pounds

1 60 112 111 f 1 2099
2 62 132 120 f 12 1803
3 66 135 130 fi 5 1985
4 65 145 13 i 15 204
$3 65 117 130 - 13 1711
6‘ 68 138 142 - 4 2828
7 62 112 118 - 6 1964
8 62 12 118 f 2 1798
9 64 140 123 f 17 152’
10 65 115 126 - 11 1833
11 64 140 123 f 17 1992
12 65 124 130 - 6 2289
13 64 11 126 - 2 1939
14 61 110 116 m 6 1702
15 65 134 126 é 8 1750
16 64 115 123 - 8 2972
17 59 125 104 f 21 1336
18 68 166 142 f 24 1736
19 64 116 126 ~ 10 3132
20 62 115 118 - 3 1715
21 58 95 104 - 9 1643
22 62 105 118 - 13 2216
23 64 I 3 123 i 32 1674
24 67 136 135 f 1 1714
25 61 100 116 - 16 1399
26 67 143 135 % 8 1445
27 64 135 123 f 12 2322
28 68 132 142 f 10 1334
29 65 154 130 I 24 1038
30 61 118 116 i 2 2089
31 58 103 101 f 7 2242
32 65 130 126 f 4 2191
33 65 110 126 - 16 1048
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