View report page

16
Dietaries.
Accordingly, Dr. Alexander Livingston, the then consulting dental surgeon of the
Council, was asked to prepare schemes for these two homes, both of which were for
the accommodation of children under 5. In the case of Cumberlow Lodge (which is
outside the county) a local dental surgeon was appointed to inspect all children at
the Lodge at half-yearly intervals and to deal with any cases requiring treatment at
his surgery. With regard to Hornsey Rise, advantage was taken of its proximity
to the Holloway treatment centre, where the Council had made arrangements for
the dental treatment of day school children from neighbouring schools, to arrange
for one of the dental surgeons working at this centre to visit the home at six-monthly
intervals and to treat at the Holloway centre all cases requiring attention.
In the last annual report it was stated that a uniform dietary for these institutions
was considered desirable as an early measure of reform. During 1931 all the dietaries
in use were carefully examined, and the character and suitability of the meals noted.
Perhaps the greatest difficulty to be met in feeding children in institutions in
this country is that of ensuring a sufficient supply of water soluable anti-scorbutic
vitamin C during the winter months. This vitamin is destroyed by cooking, and
winter milk cannot be relied upon to provide it. It is found in fresh fruit and raw
vegetables, especially swede j uice and in tinned tomatoes. At one important children's
institution the difficulty had in the main been surmounted by giving raw salads
during the winter. These consist of raw cabbage, beetroot, carrots, turnips and other
produce of the garden passed through the mincing machine and served (all raw)
mixed with sauce. Salads such as described are found to be most acceptable to all
the boys, and they had also been successfully given to children of all ages and both
sexes in the Leytonstone school.
Undoubtedly, occasional meals with butter not only add to the interest of the
meals and the taste of the food, but also give the necessary amount of vitamin D.
Generally the supply of fresh fruit was inadequate. Some fresh fruit should be given
to every child every day, especially the young ones. Also the calcium content of the
food was often poor and, with so much carbohydrate given, calcium metabolism is
interfered with.
As a result of the investigation a new dietary was approved for use at the
residential institutions under the control of the Education Committee.
The diet is presented in the form of a table of foods for each separate meal of
the day, but the choice of menu for any one day is left to the authority at each school,
so that a very great field is left for variety in the selection of the daily menu and also
in the methods of cooking and serving the food ; above all, it is pointed out that the
regular recurrence of one particularly uninteresting item on the same day every week
throughout the year should be avoided.
As margarine, while useful as a source of heat, has ordinarily no vitamin value,
butter is introduced into the dietary twice a week, both at breakfast and tea time.
Deficiency in vitamin C is made up by the introduction of a daily fruit ration in
addition to the provision of raw salads throughout the year. In view of the fact
that apples are our best medicofuge and have the property of leaving the mouth in
a clean and wholesome state, the fruit ration is prescribed in a form of a definite
amount of apple to be taken every day as the last item of food. An addition of cheese
at tea time twice a week has been introduced as a correction of the calcium deficiency
in the dietaries generally.
The caloric value of the dietary for children of 10-15 years is about 3,000 per
24 hours, an average of 35 calories per pound body weight. The protein, fat and
carbohydrate value will be approximately 100 grms., 110 grms., and 425 grms.
respectively.
The new scale thus provides at a reasonable cost a well-balanced dietary, giving
ample quantities of the proximate food principles, and meets the necessities in regard
to vitamin content.
Notwithstanding anything in the dietary table the children are to be fed according
to appetite and the superintendents of the institutions have been requested to
observe the heights and weights of the children, in order that the whole question