Forewordby Sir Heneage Ogilvie, KBE, DM, M CH, FRCS
Consultant Surgeon, Guy's Hospital; Editor of
; Late: Vice-President of the Royal College of Surgeons
THE STATISTICIAN looks on nutrition as a mater of calories, and on obesity as aquestion of upset caloric equilibrium. A calorie is a unit of heat, a unit of potentialenergy, but not a unit of nutrition. Prison governors, school superintendents, dictatorswhether of a nation or of a small community, talk in calories to prove that they arefeeding their charges or their victims adequately. Fellows of the
, anddoctors with political leanings, talk in calories as if the human body were a machinerequiring a certain amount of fuel to enable it to do a certain amount of work.A motor-car needs calories, and we give it calories in the form of petrol. If we give itgood petrol it will do good work for quite a long time. But even a Rolls-Royce cannotfind its own fuel. It cannot separate motor spirit and lubricating oil from the crudemixture brought by a tanker from the wells of Kuwait. It cannot clean its own pipes,clear its own choked jets, grind its own valves, re-line its own bearings when they areworn, and replace defective parts as they need renewal. The body can do all thesethings. but the body is not a machine, and to do them it needs food not fuel.There are three kinds of food: fats, proteins and carbohydrates. All of these providecalories; the fats 9.3 calories per gramme, the proteins and the carbohydrates 4.1 each.But the carbohydrates provide calories and nothing else.They have none of the essential elements to build up or to repair the tissues of the body. A man given carbohydrates alone, however liberally, would starve to death oncalories, While he was dying he would break down his own proteins to providematerials for the repair of his key organs. He would use what calories were needed to provide energy, and he would lay down the carbohydrate surplus to his caloricrequirements as fat.Proteins are the essential food of the body. They provide not merely carbon, nitrogen,sulphur, phosphorus, sodium, potassium, calcium and iron, chlorine and iodine, butthose trace elements such as boron, manganese, zinc, copper, and cobalt that areessential to life. They provide many prefabricated molecules that the body is unable to build up from simple elements.Fat is the caloric reserve material of nature. The whale stores fat in his subcutaneouslayers against the rigours of life at the Pole, the camel stores it in his hump against hardtimes in the desert, the African sheep stores it in his tail and his buttocks against theday when even the parched grass shall have withered away. But fats are more thanstores of reserve caloric material. They are heat insulators, they are fillers of deadspaces, and they are facilitators of movement in rigid compartments such as the orbit,the pelvis, and the capsules of joints. They are also essential building materials. Animalfats contain three groups of substances: the neutral fats which are chiefly energy providers, the lipids containing phosphorus that enter into most tissues and bulk largelyin the brain and the central nervous system, and the sterols that are the basis of mosthormones.