PROJECT REPORT ON FOOD RESEARCH QUARTERMASTER FOOD AND CONTAINER INSTITUTE FOR THE ARMED FORCES CHICAGO ILLINOIS RESEARCH AND DEVELOPMENT BRANCH MILITARY PLANNING DIVISION OFFICE OF THE QUARTERMASTER GENERAL COOPERATING INSTITUTION New York Medical College Metropolitan Hospital Research Unit LOCALITY Welfare Island, New York City, Ni» Y* DIVISION DEP ARTM ENT , . , Medicine OFFICIAL INVESTIGATOR David Schwimmcr, M, D, COLLABORATES, MoQavack> M# D# li Droktor, B.S* REPORT NO. 2 PILE NO. NU-9 CON TRACI ¥44-109-qm-771.. FOR PERIOD COVERING 1 July to 31 1945 mT,r!ftiiyEi94:5 T,TLE! I I PROGRESS REPORT [* I PHASE REPORT C 1 ANNUAL REPORT f 1 TERMINATION REPORT protein Metabolism Studies on Reduced Caloric and Water Intake NUMMARY During August and September, 1945, metabolic studio: wore made on ten healthy volunteer Conscientious Objectors receiving 800 cc. and 200 Gnu food (850 calorics) daily for ten consecutive days# One group of five men ate a -protein-free diet composed (by weight) of 90$ carbohydrate and 10$ fat; the other, a diet consisting of 80$ carbohydrate, 10$ fat, and 10$ protein derived from malted milk. In October, these studios were duplicated with the same subjects, with the exception that dried or:g albumin was used instead of the malted milk protein- The daily ration was again 200 Gm., but a difference in moisture content resulted in a caloric value of 800. By comparison with the proto in-free regime serving as control, the diet containing 10$ malted milk protein produced a slightly greater weight loss, significantly higher urinary volume, total urinary solutes, and'total urinary nitrogen. There was also a definite increase in the daily output of urinary sodium and potassium, end seme docrease in the urinary ammonia nitrogen. In contrast with the malted milk protein, the dried egg albumin ration produced very little increase lin tVfcal weight less end in urinary volume- Although the total s 'lutes'.end nitrogen of the urine exceeded somewhat those found with the accompanying pretein- frcc/regimo, these differences wore much smaller RB,6 12-121 than with the malted milk protein. Positive nitrogen balance was not attained, but of the s.g Gm. nitrogen fed daily, 1.4,Gm. was retained.. Averaged group data are detailed in the accompanying tables and figures. It appears, then, that dried egg albumin is superior to malted milk protein in the 800-850 calorie range in the presence of limited water intake.• Further dietary studies are now in progress, and additional reports on completed work ere now in preparation. INTRODUCTION Tho object of these experiments is the study of the basic human physiology under conditions of specific limitation of food and water. • Originally the work was directed primarily towards Life Raft Rations, but more recently the outlook has been broad- ened to include general .survival rations. Emphasis is being placed on the variations in protein, fat, and carbohydrate content, and in caloric intake, which will afford maximal chances not only for survival, but also for maintenance of fit- ness in normal human beings.* Special attention is being paid to the advisability of including protein in the rations. If found feasible, the inclusion of protein may be of great value to men suffering from injury, blood loss, or shock. Protein could also make rations more palatable. A major problem in this respect is the question of retention of protein by the body and maintenance of nitrogen equilibrium. Since the nitrogenous end-products of protein metabolism classically require additional'urine water for excretion, it would be unoconomica 1, with a limited water intake, to feed a protein which would not be retained. It would be distinctly advantageous, then, if a type or form of protein were found which, perhaps under certain conditions, would promote a retention of nitrogen by tho tissues. Preliminary experimentation mth animals has indicated that such an objective may not be un- attainable . NU-9, Rept. #Z The investigations here reported (Experimental Diets #9, 10, 11, and 12) are a continuation of studies begun in January, 1945. The latter included Experimentgtl Diets #1-8, inclusive, of our numerical series, and were reported to the Committee on Food Research in June, 1945.- Since these data were never mimeographed for general distribution by the Committee, and since they comprise an integral part of the studies to be reported now and in the future, we include the follow- ing summation of our'earlier work: SUMMARY OF FINDINGS WITH EXPERIMENTAL DIETS # 1-8. INCLUSIVE * 1. Ten normal adult males were divided into groups and subjected to a series of five experimental dietary regimens for five days, and to throe experimental regimens for ten days* 2* The daily diet per man weighed 100 Gm., and supplied from 400 to 525 calories* 3* The intake of water was standardized at 800 cck per man per day* During the ten- day experimental period, 1 Gm* of Nad was added to each man's daily ration of water* 4. Despite weakness, dehydration, and ' loss of weight, all subjects were in relatively good physical and mental condition at the end of both the five and ten day testing periods, regardless of which of the eight experimental diets had been consumed* 5* Severe muscular pains occurred during the first testing period of five days. These muscular pains did not appear during the ten day experiment, when 1 Gm* of Ne.Cl was added to the daily ration of water* There were also less nausea, headache, insomnia, and general malaise during these longer experiments. 6. Constipation occurred as a result of the general limitation of food and water; this was independent of the composition of ‘the individual diet* The diet containing 25$ fat caused abdominal distress, including gaseous distension, cramps, flatulence, and nausea* 7* As measured by psychological and * See Table #4A page 3A , NU-9, Kept. #2 tabu: #4=a § PERCENTAGE COMPOSITION OF EXPERXMENTAL DIETS ,/ 1 - 8. INCLUSIVE DIET CHO PROT. FAT 1 100 — 2 90 10 3 80 20 — 4 65 10 25 5 100 — -- 6 86 4 10 7 90 — 10 8 78 12 10 Dehydrated (uncoagulated) egg white was the source of protein in Diets #2, 3, 4, and 8; malted milk powder was used in Diet #6. NU-9, Kept* #4 3A performance tests, capacity for muscular work was decreased in all subjects, but neural functions were not significantly disturbed. Psychological tests were of limited use- fulness in differentiating between the small groups of subjects because of large individual variations in response* / . 8. During "deprivation", fatigue and thirst increased rapidly, abdominal discomfort and dizziness, slowly. Hunger increased rapidly for three days, after which it was progressively less intense. 9. Loss of weight occurred in all subjects; the greatest rate of decrease was noted during the first two days. There was less loss of weight during the first five days of the ten day experiment than during the initial five day experiment. Losses in water (urine) paralleled changes in weight. 10. Urinary volume decreased in all cases, but never to critical levels. 11. The addition of protein or fat to the diet lessened the decrease in urinary volume. 12. • The addition of even the smallest amount of protein (4$) to the diet produced an increase in the total solutes of the urine. 13. Dehydration caused the appearance of albumen, casts, leucocytes, and erythrocytes in the urine of certain subjects who may have had some previously unrecognized diminution of renal reserve. 14. All experimental groups exhibited a general increase in hematocrit, erythrocyte, and hemoglobin values during the first throe to four of the experimental days, after which they returned to and remained normal. NU-9, Kept. #8 4 15. Tests of heprtic function indicated no Impairment of the liver through ’’deprivation.” 16. Under the experimental conditions used, there was no alteration in the pH, the specific gravity, or in the creatinine of the urine. No acetone bodies appeared in the urine at any ttime. . 17. The white blood count and the rate of sedimentation of the erythrocytes were un- affected by the respective experimental regime n&-*. 18. Changes in the basal metabolic rate, (capillary permeability, fluorescein excretion, and ascorbic acid levels (tissue and plasma) shewed no changes which were traceable to the experimental conditions. 19. In one subject, a pre-existing bigeminal rhythm disappeared during salt deprivation. 20. The total non-protein nitrogen in the blood rose as ’’deprivation” progressed, the highest levels being reached by the fifth to seventh days. No clinical symptoms whatsoever were present which could be attributed to accumulation of nitrogenous substances in the blood. 21. The urinary nitrogen decreased sharply during the experimental periods. The greatest drop occurred in the first two days. The addition of protein to the diet lessoned this decrease. The inclusion of fat counteracted this effect of protein somewhat. Salt may have had a similar effect. 22. The excretion of urea nitrogen paralleled . that of total nitrogen. 23. There was a phasic variation in the excretion of creatine in the urine, with incretases until the fourth and fifth days, followed by decreases. Secondary elevations occurred in the subjects on Diets 7 and 8. The addition of NU-9, Kept. #2 snail amounts of protein to the diet produced some decrease in creatinuria. Addition of salt delayed the rise in croatinuim 24. Blood and'urinary sodium values dropped during both experimental periods, but the fall was much slower and less marked when 1-Gm. of Nr.Cl was included in the rations. 25. Chloride levels in the blood decreased during the five-day ’’deprivation", and were still subnormal on the sixth recovery day. When NaCl was provided, the sodium concentration had returned to normal between the third and seventh experimental days. The excretion of chlorides in the urine dropped sharply in the first five days of both testing periods. . The urinary chloride levels remained low throughout the latter half of the ten-day experiment. The decrease in urinary chlorides was somewhat less in the subjects receiving protein than in those who were not. 26. Potassium concentration in the blood rose in all subjects, but the rise was less . when they were receiving Nad than when they were not. 27. Urinary potassium values dropped rapidly in the first two days of the five-day testing period, and thereafter rose again. In the ten-day period, when NaCl was added, tho urinary potassium did not reach its lowest level until the seventh experimental day, after which it rose gradually. In these first eight experimental diets, the daily ration was sot at 100 Gm. to conform with the level present in the standard Army Air Forces Life Raft Ration. The 800 cc. figure for the daily water allotment was determined as the average amount expected to be available to a Life Raft passenger from the combined use of sun still, desalination kit, and rain water. NU-9, Rept. #2 Tho 200 Gm. f-'cd level in Diets #9, 10, 11, and x2 herein reported was originally chosen as approaching 50 per cent cf minima 1 caloric requirement. (The influence of caloric levels will he discussed in greater detail in a forthcoming report). The use cf such higher caloric intake was encouraged hy the animal work of Swanson and of Allison (1), who reported that they promoted increased nitrogen retention. It was also hoped that the Air Force would provide tho small additional space required if such rations proved definitely superior. METHODS AND MATERIALS The general plan of this study has included three consecutive periods in each experiment;' 1. A seven-day standardization and control period 2. A ten-day testing (’’deprivation”) period 3. A five-day recovery period I Subjects Ten volunteer Conscientious Objectors were used as subjects* They ranged in age from 20 to 37, and in weight from 137 to 178 pounds. These men were considered to be in good health. All had passed Army Induction physical examinations before assignment to Civilian Public Service Camps. Preliminary to acceptance as a test subject, the physical status of each man was thoroughly checked by a careful history, physical examination, electrocardiogram, chest roentgenogram, blood count, uninalysis, erythrocyte sedimentation rate, blood sugar, urea nitrogen, and Wasserman test. II Environmental Conditions The subjects were confined, during control as Yirell as experimental periods, to Ward K of the Research Unit as regular patients. They wore allo?/ed be ambulatory•on the premises, but at no time were they permitted to leave the ward. The subjects rested or NU-9, Rept. #2 slept whenever they wished during the day, except for feeding and testing times; at night they were in bed by 11 o’clock. Records wore kept of the quantity and quality of sleep. Brushing the teeth, shaving, showering, smoking, and chewing gum were prohibited during test periods. Readings of temperature, barometric pressure, and relative humidity were taken regularly at 8 A.M,, 12 Noon, and 8 P.M* The ranges of these readings were as follows: Temperature: 70-85 degrees Fahrenheit * Barometric Pressure: 29.78” - 20.46” Hg Relative Humidity: 65$ - 88$ III Dietary Regimes All food and fluid was carefully weighed, measured, checked, and charted. This included the renfeighing of seme items previously packeted and labelled for weight. a. Standardization period: The subjects were standardized for a preliminary seven day period on regular Army 10-in-l Rations; during the last five days of this period, control clinical and laboratory data were collected. Equal servings of food wore weighed for each man, with slight variations in biscuit and sugar intake to allow for differences in individual caloric requirements. The caloric Intakes during this period ranged from 2500 to 3700 calories per day. Analysis of a typical subject-day’s consumption of 10-in-l Rations was as follows: / Carbohydrate: 330.9 Grams Protein: 99.5 Grams Fat: 96.1 Grams. Calories: 2654.0 Calcium: 464.0 Mg. Iron: 24.2 Mg. Vitamin A: 2242.0 Units Vitamin Bp: 1606.0 Meg. Vitamin C: 73.1. Mg. Vitamin : 1316*0 Meg, Niacin: 16*3 Mg. Sodium: 6.1 Gm, Potassium: 2.9 Gm. t ' , . , NTJ-9 , Ropt. #2 Water was taken ad libitum during the standard- ization period, the amount varying from 1800 to 2700 cc. per man per day* b. Testing Period: l The testing periods ("deprivation") were ten days in length. Experimental Diets #9 and 10 were employed in August and- September, 1945; Diets #11 and 12y in September and October. The subjects were divided into two groups of five each in such a manner as to afford similar total weight and range of weight in each group. The groupings and detailed composition of the test rations are indicated in Table 4B. TABLE 4B COMPOSITION OF EXPERIMENTAL DIETS 9-12, INCLUSIVE Diet # Subjects % CHO t PROT. % FAT CAL. 9 C,K,E,P,B 86.1 . — 9.3 4.6 856 10 J,D,A,H,M 75.4 . 9.7 9.2 5i7 846 11 C,K,E,P,B 75.8 10.0 14.2 790 12 J,D,A.H,M 68.5 ■ 9.2 10.0 12 *5 816 As originally planned, Diets # 9 and 11 were to contain 90% carbohydrate and 10% fat, while Diets #10 and 12 were to contain 80% carbohydrate, 10% fat, and 10% protein; the caloric value of each then would have been 900. However, because of technical factors and resulting high moisture contents, the actual values attained are those listed in Table 4B. In all exper- iments subsequent to these, aberrations in percentual content and in caloric intake have been eliminated by determining moisture content first, then calculating percentual composition on the actual dry Yreight of the components. The basic constituent materials of the present diets wore: NTJ-9, Rept. #2 <* Diet #0 ’’Charms” (Chafcms Co*, Bloomfield,N*J.) Sucrose-lipid tablets C0QMG-) Diet #10 .’’Charms” Sucrose-lipid tablets Malted Milk tablets (Horlick) Diet #11 Wheat Starch Honey Hydrogenated Fat Diet #12 Wheat Starch Honey Hydrogenated Fat Powdered Dried Egg Albumin It should be noted that Diets #9 and 10 consisted of properly weighed amounts of the listed constituents as previously prepared; diets #11 and 12, on the other hand, were baked into unifoim biscuits by the Quarter- master laboratory in Chicago; On each of the ton deysoflf deprivation, every subject received 200 Gm; of test ration and 600 Gm. of tap water containing 1 Gm. NaCl; These were fed on the following schedule: $ A»M; - - 33 Gm. ration and 200 Gm. Water 1 P*M; - - 67 ” ” ” ” ” !t 5 P;M* - - 67 ” ” ” ” tT 9 P*M; 33 ” ” ” ” ” ” In addition, one multivatimin tablet per man per day was given at the 9 A.M. feeding* Each of these tablets contained: Vitamin A - 2300 USP Units - Fish Liver Oil Vitamin D - 200 USP Units - Viosterol Vitamin B1- 1.0 mg; - Thiamin Hydrochloride Vitamin Bg- 1.5 mg; - Riboflavin Vitamin C - 37.5 mg; - Ascorbic Acid 10.Q mg. - Niacinamide c. Recovery Period Recovery from deprivation was carefully observed for five days. As in the preliminary standardization phase, the men were again fed Army 10-in-l Rations.' On the first recovery day, they were limited to 1200 calories of food and 2500 cc. of water; thereafter, calories and water were allowed to be taken ad libitum. NU*-9, Hept. #2 10 IV Laboratory Procedures Fasting venous blood samples were drawn between 8:00 and 8:30 A.M., preceding the first morning feed- ing. Pre-sealed vacuumatic tubes were used to insure against contamination. Urinary determinations were all made on aliquots of 24-hour collections covering periods from 8:00 A.M. of one day to 8:00 A.M. of the next. The specimens were preserved with toluene. The following tests and procedures were carried out: * 1. Total Nitrogen in urine - Pregl, F. , Die Quant. Organisch. Mikreansl., Berlin, 1923, 2nd ed. Brecher, A., Wien. Clin. Wech., 49_:1228, 1936. 2. Urea Nitrogen in blood and urine - Van Slyke, D.D., and Cullen, C.E., 1. Biol. Chem., 24:117, 1916. 3. Ammonia in blood and urine - idem. 4. Creatine and Creatinine in urine - Folin, 0., Lab, Manual of Biol. Chem., 5th ed., D. Appleton-Century Company, New York, 1934. 5. Sodium in blood and urine - Barnes, R.B., Richardson, David, Berry, J.W., and Hood, R.L., Ind. and Eng. Chem., ‘Analytic ed., 17:605-11, 1945. 6. Potassium in blood and urine - idem. 7. Chlorides in blood and urine - Van slyke, D.D., and Sendroy, I., Jr., J. Biol. Chem., §63:523, 1923. 8. Depression of Freezing Point of urine - Beckmann, F., Zoit, phys. Chem., Rept% jf2 TOTi I MILLl iS^ClVSISNTS Day Sodium Potassium Chlorides HHs Nitrogen Urine Blood Urine Blood Urine Blood Urine Control 194 145 76 3.54 212 104 61 -' Aver. ■ D 1 153 64 130 34 2 77 144 54 4.22 81 103 24 P 3 40 143 60 4.56 39 101 24 i i ■\* 4 37 141 82 5.07 26 99 19 5 37 140 106 5.45 30 99 19 a + 6 47 140 108 8.95 28 107 19 7 45 137 110 7.33 24 105 18 U i 8 48 140 84 6.85 30 111 17 9 52 139 94 6.59 36 103 19 U n 10 57 138 82 6.43 28 103 20 Recover r 1 52 140 90 6.38 30 103 30 * ' 2 48 141 90 5.55 47 104 40 3 120 144 54 4.04 111 105 49 4 202 144 50 3.79 174 104 88 5 266 144 56 3.43 225 104 78 TABLE 7B GROUP AVER. - DIET 10 • CHO - Q0$ PROT 10fc (Milk Protein) e;t io $ NEW YORK MEDIC L COLIEGEm METROPOLITAN HOSPITAL RESEARCH UNIT WEEF-RS ISL/ND, NEW YORK CITY NU-9, Kept* FA STING BLOOD Day Sodium Potassium Chlorides ■ Sugar npn UN Tot cl chol. Control liyaTv 1 333 13.7 612 78.3 35.1 17.1 172 D £ e 1 s' 331 16*5 605 75.9 34.5 16.6 238 P 3 329 17.8 ' 593 244 f 4 325 19.8 583 79.0 37.7 18.8 229 1 5 321 21.5 585 227 v 6 321 34.9 631 239 f 7 316 28.6 617 85.6 45.7 23.0 251 J 8 321 26.7 652 71.3 50.3 24.7 205 1 9 320 25*7 608 205 0 10 n 318 25.1 605 77.3 51.3 25; 5 179 RECOVERY 1 323 24.9 606 165 2 325 21.5 615 74.6 32 ;4 15.7 137 3 332 15.8 622 • 129 4 331 14*8 616 78.8 29.5 15.0 142 5 332 13.5 614 158 TABLE 6C GROUP /VAR. - PI T 10 CHC - 80$~ PROT - 10$ (Milk Protein) FAT - 10$ NSW YORIC MEDICAL COLLEGE, METROPOLITAN HOSPITAL RASA. RCH UNIT WELFARE I3L ND, NEW YORK CITY. NU-9, Kept. )'}Z FIGURE 10 DIET NO.- OHO. FAT proti 9 90$ 1055 10 80'5- 10$ 10$ EXESRIMENTAi DAYS DAILY UEIGHT RECORD (Kllogrsms) R 3 C 0 V E R y NU-9, Kept. fZ FIGURE 10A CUMULATIVE UEIGHT LOSS (Kilograms* EXPERIMENTAL DAYS DIET NO. CHO. FAT FRO. (Milk),,.. iS3£ 9 90$ 10$ rrw.i 10 80$ 10$ 10$ NU-9, Hop t. #2 FIGURE 10B DAILY '"SIGHT LOSS (Kilograms) EXPERIMENTAL DAYS DIET NO. CHO. FAT PRO. (Milk ) 3P5u 9 90% 10% ClS'i 10 80% 10% 10% NU-9, Ropt, #2 FIGURE 11 CONTROL EXPERIMENTAL D'YS TOTAL URINARY VOLUME ( CC.) DIET NO. CHO. FAT PRO, 9 903 10$ - - -10 803 10-3 10% {Milk Protein) RECOVERY NU-9., Rept. ffe 40 FIGURE 11A CONTROL TOTAL MILLIOSHOLS IN URINE EXPERIMENTAL DAYS DIET NO. OHO. FAT I PRO. 9 90$ 10$ 10 80$ 10$ 10$ (Milk Protein) RECOVERY Ntr-9, Rept. #2 15 14 13 IE 11 10 9 8 7 6 5 Gm. FIGURE 12 12 3 CONTROL 123456789 10 EXPERIMENTAL D/YS TOTAL NITROGEN IN URINE (G-rams) DIET NO. CHO. PAT? PRO. 9 90% 10% - - -10 80fb 10$ 10% (Milk Protein 1 2 3 4 5 R E C 0 Y S :: 7 NU-9, Rept. #2 FIGURE; 12A NEGATIVE NITROGEN BALANCE (Grams) EXPERIMENTAL DAYS Gr. DIET NO. CHO. FAT PRO. (Milk Pro.) 9 90$ 10$ 10 80$ 10$ 10$ DIET NO. AVERAGE DAILY N2 BALANCE 9 Minus "g. g 10 Minus g, 3g NU-9, Ropt. #2 FIGURE 13 CONTROL EXPERIMENTAL DAYS . TOTAL CRTATININE IN URINE (Mil'.VAiris' • DIRT NO. CHO. FAT i PRC. 9 90$ 10$ - - -10 80$ 10$ 10$ (Milk Protein) R .9 C G V L R Y NU-9, Ropt. $2 FIGURE 14 CONTROL EXPERIMENTAL DAYS TOTAL CREATINE IN URINE DIET NO. CHO. FAT PRO. — 9 90# 10% 10 80# 10# 10# (Milk Protein) RECOVERY NU-9, Ropt; #2 FIGURE 15 CONTHOi TOTAL NH5 NITROGEN IN URINE (Milliequivalents per 24 Hour) 5HTW) %OT £01 $08 01 $01 $06 6 •0EH IVi OHO »0N XEia EXPERIMENTAL DAYS RECOVERY NU-9, RspU j'2 FIGURE 16 CONTROL DIET NO. CHO. FAT PRO. 9 90$ 10$ - - -10 80$ 10$ 10$ (Milk Protein) BLOOD NON-PROTSIN NITROGEN (Milligrams per 100 cc) E XPER ILCNTEL PI. YS ? 2 C 0 V 2 R T MU-9, Rept. #2 FIGURE 17 CONTROL SERUM SODIUM (Milliequivalents Per Liter) DIET NO. CEO. FLT' PRO* 9 90$. 10% 10 80$ 10% 10% (Milk Protein) EXPERIMENT!.! D;.Y3 R E G 0 V L G: Y NU-9, Rep t* ifZ CONTROL FIGURE V 17A DIET NO, CHO, FAT PRO.. 1 9 90$ 10$ 10 80$ J£$ 10$ (Milk Protein) EXPERIMICNTAL DAYS TOTAL SODIUM IN URINE (Milliequivalents Per 24 Hours) RECOVERY NU-9, Ropt. jjZ FIGURE 18 hA O « Eh Js; o o SERUM POTASSIUM (Milliequivalents Per Liter) EXP'MIOVTAL D'YS DIET NO. CHO. FAT PRO. 9 90$ 10$ ~ - -10 80$ 10$ 10$ (Milk Portein) RECOVERY NU-9, Rept. #2 CONTROL FIGURE 18A POTASSIUM IN URTNE (Mi Hi equivalents Per 24 Hours) EXPERIMENTAL DAYS DIET NO. CHO. FAT PRO. ' 9 90% 10% 10 80% 10% 10% (Milk Protein) RECOVERY NU-9 Kept )f2 FIGURE 19 CONTROL EXPSRIMEM1 AL DAYS SERUM CHLORITES (Milliequivalents Per Liter) I DIET NO, CHO. FAT PRO.^ 9 90$ 10$ - - - -10 80$ 10$ 10$ (Milk Protein) R ECO VSR Y NU-9, Kept, #Z FIGURE 19A CONTROL TOTAL CHLORIDES IN URINE (Milliequivalents Per 24 Hours) EXPERIMENTAL DIYS DIET NO, CHO. FAT PRC). *—9 90% 10% j 10 80% 10% 10% (Milk ProetinJ RECOVERY NO-9 , pt. #2 FIGURE 21 C 0 N T R 0 L I 0^ > DIET NO. CHO. FAT PRO. 9 50% 10% - - -10 80% 10% 10% (Milk Proilein) TOT/L SERUM CHOLESTEROL (Milligrams per 100 cc. ) EXPERIMENTAL D/AS RECOVERY NU-9, Ropt. 42 ■ FIGURE 22 CONTROL EXPERIMENTAL DAYS TOTiX SERUM PROTEINS (Grams per 100 oc.) -I DIET NO. CHO. FAT PRO. 9 90 % 1056 - - -10 80% 10% 10% (Milk Protein) RECOVERY DAYS xTU—S j Rg pt • jfC, Day Weight Water Volume Minimal Depr. Total Sodium Potass Chlorides Intake Urine jTr.P. Mill!- (kg) ( cc) (cc) Volume degree osmols . i ( cc) cent. (gm) (gm) (gm) Control Aver, n $D.4 2316 1287 703 1.45 987 4.54 3.65 12.4fc- • e 1 '7(2.3 800 1226 455 0.98 637 2.41 3.56 6.94 P 2 69.4 800 722 300 1.08 419 1.31 3.08 3.74 r 3 '69.0 800 472 247 1.41 '345 0.66 3.05 2.16 i 4 €6.5 6&.5 800 416 180 1.31 280 0.61 2.58 *1.57 V 5 800 422 214 1.42 297 0.28 1.21 0.99 a 6 6®.0 800 534 , 215 1.10 298 C.29 0.89 0.87 t 7 67.7 800 387 184 1.29 258 0.27 1.02 ■ 0.86 i 8 676 5 80© 394 179 1.23 250 0.34 1.06 0.74 c o 9 6T.1 800 366 ■172 1.29 240 0.33 1.06 v/ # / v. 0.69 ' n 10 6^9 800 329 167 1.37 234 0.24 0-97 0.74 H Recovery 67.2 ) 1 2196 1275 250 0.54 266 0.42 0.93 0 -57 f 2 3 6@.6 6&.2 2034 2096 668 1154 365 505 1.53 1.38 510 708 1.34 3.63 1.63 1.96 v kj f 2.82 c 8.56 1 4 cr £0.8 1988 1032 635 1.69 855 4.27 1.76 w • o w h- 11.54 E 13.6© 5 65,6 1752 . 978 681 1.59 952 5.95 2.64 TA3L~ 6A GWT ATPR. DIET XI ~~3E!U ~TO$ FAT 10^c HE* TOWC MLDICAL COLLEGE, KSTHOPOUTAH HOSPIT.'L HLSCAXCL UNIT' TCTLEARC ISLAND, NSV'YOR” CITY 24 HOUR UHINL COLLECTION NU~9 y Ropt. jfZ Day T#tal Urea nh3 Nitrogen Creatine Creatinine Nitrogen Nitrogen (gm) (gm) (gm) (gm) (gm) Control 1 ver. 12.09 9.87 0.71 0#01 1.05 D rs 1 8.03 5.97 0.97 0.01 1.03 © 2 5.91 4.66 0.46 0.02 1.02 P 3 5.50 4.38 0.45 0.01 0.94 r i •XT 4 5.28 4.18 0.37 0.19 0.81 5 5.31 4.04 0.36 0.05 0.84 V 6 5.26 4.38 0.36 0.12 0.97 d f 7 4,46 3.39 0.33 0.08 0.80 I 8 4.41 3.53 0.30 0.08 0.75 -L 9 4.27 3.20 0.35 0.02 0.89 O n 10 4.21 3.13 0.39 0.08 0.84 Recovery 1 6.70 5.80 0.52 0.08 1.12 2 8.42 6.81 0.52 0.03 1.14 3 9.02 7.54 0.57 0.09 1.05 4 10.42 8.37 0.77 0.08 0.75 5 10.89 8.96 0.70 0.03 0.68 GROUP AVER. DLaTJX CHO ' ' 90$ PAT Lj.0$ TABLE 8B NEW YORK MEDIC L COLLEGE, METROPOLITAN HOSPITAL RESEARCH UNIT WELFARE ISLAND, NEW YORK CITY 24 HOUR URINE COLLECTION NU-9, Kept. #2 Water Minimal Depr. Total Day Weight Intake Volume Urine Fr.P. Mini- Sodium Potass Chlorides Volume degree osmols Ckg) ( cc) ( cc) ( CC ) ' cent. (gm) (gm) (gm) Control Aver. 72*0 2577 1425 664 1.42 971 4.46 . 2.87 12.28 D Q 1 70. 7 800 1868 475 1.00 664 2.68 3.33 7.18 n 2 €0 *9 800 723 354 1.33 495 1.76 3.16 4.18 y •p 3 69.6 800 591 313 1.52 438 0.98 3.28 2.66 JL 1 4 66.8 800 433 217 1*39 303 * 0.53 2.74 1.88 V 5 66.5 800 466 264 1.65 370 0.36 1.45 1.12 a 6 66.2 800 473 254 1.61 355 0.42 1.39 1.04 t 7 66.0 800 373 239 1.72 335 0.33 1.37 0.84 i 8 67.6 800 420 240 1.64 335 0.40 1.34, 0.73 JL o 9 67.4 800 380 221 1.64 309 0.39 1.22 0.72 n 10 67.2 800 335 207 1.67 289 0.35 * 1.43 . 0.84 Recovery • \ 1 ■■67.7 2234 987 302 0.89 423 0.54 1.04 0.62 2 «* 6 2464 674 404 1.67 565 1.53 1.03 2.46 3 :>69.6 2148 1129 581 1.45 812 4.22 2.42 10.49 4 7 0*0 2064 1236 619 1.48 865 4.58 1.97 12.12 5 70.0 1998 1009 667 1.79 934 5.94 2.16 11.55 TABIE 8C GROUP AVER. - DIET 12 CHO" 80% ~ FAT 10% PROT 10% (Egg white) SETT YORK MEDIC/L COLLEGE, METROPOLITAN HOSPITAL RESEARCH UNIT 'ELF RE ISLAND. KET" YORK CITY 24 HOUR URINE COLLECTION NU-9, Hop t. #2 Pay • Total Urea nk3 Creatine Creatinine Nitrogen Nitrogen Nitrogen ( : Tl) (gmT (gm) - (gm) Cgm) Control Ave r. 11.62 9.27 «S.72 0.01 0.96 D e 1 8.48 6.61 0.57 0.00 1.01 •n 2 7.34 6.15 0.46 o.Ol 1.01 Jr r 3 7.36 6,24 0.47 0.01 0.98 i 4 6*85 5.42 0,40 0.16 0.80 V 5 6.89 5.69 0.40 o. 07 0.84 a t i 6 • 7 8 6.70 6.38 6.44 5*49 5.02 5.22 0.38 0.34 0.37 0.14 0.12 0.03 0.89 0.79 0.72 o 9 6.03 4.83 0.37 0.09 0.78 n 10 5.77 4.64 0.40 0.11 0.87 Recovery 1 7*97 6.76 0.53 0 .vi/wi 1.12 2 8*58 6.96 0.52 0.06 1.04 3 9.20 7.41 0.74 0.06 1.17 4 9.67 7.63 0.84 0.08 0.71 5 10.77 8.70 0.70 0.03 0.68 T/BLS 8D GROUP AVER.- DIET 12 GKO 80 fo FAT 10$ PHOT 10$ (Egg white) NSW YORK MEDICAL COLLIDE, METROPOLITAN HOSPITAL RESEARCH UNIT WELFARE ISLAND, NEW YORK CITY 24 HOUR URINE COLLSCTICN 11,-9, Kept. ■ FASTING BLOOD D ay Sodium Potassium Chlorides Sugar NPN UN Total Choi. Control 332 Aver, 332 15.9 608 78.8 31.2 15.2 179 D 1 328 16.9 582 229- e 2 328 21.8 612 78.4 32.6 15.9 21w' P 3 327 21.0 577 207 r i 4 317 19.5 582 82.0 33.9 16.5 214 5 326 29.6 602 232 V 6 326 20.8 590 80.6 32.3 16,3 195 a 7 322 20.6 591 198 t i e 321 20.1 601 80.5 32.9 16.3 186 9 322 22.0 .502 168 o n 10 313 19.4 582 89.6 35.4 17.9 200 Recovery 1 328 15.8 602 183 2 340 20,6 606 191 3 335 16.7 604 80.2 30.5 15.5 156 4 326 14.2 582 152 5 334 14.9 601 83.9 29.2 14.6' 177 Table 9A GROUP AVAR. DETJi_ CEO 90/T EAT 10 io nat york medical (sqliagl , metropolitan hospital rlslarch unit T.’ALFARA ISLAND, NATJ YORK CITY NU-9 , Rep t. jf:2 FASTING BLOOD Day TSP ALB GLOB A/G Kemat RBC HGB Control Aver. , 7.6 6.8 l.B 4.4 - 40 4.50 15 % 1 e 1 6.3 7.0 1.3 6.9 41 4.40 14t9 p s 8.2 6.3 1.9 3.6 39 4.19 14.3 v 3 8.2 6.2 2.0 3.1 41 4.27 14,2 1 4 7.0 5.2 1.8 3.0 36 4.29 14.7 : 1 7.7 7.8 5.4 5.5 2.3 2.3 2.3 2.5 39 4.15 14.4 t i 7. 7' 6.3 1.6 4.1 38 3.92 13.5 i ® 7.6 6.4 1.3 6.9 38 3,64 13.2 o 7.9 5.0 2.9 1.8 40 3.76 13.3 10 n 8.1 6.1 a.s 3.2 38 4.01 14.0 • Recovery 1 7.3 5.2 2.1 2*5 37 3.79 13.3 2 3 7.5 7.9 5.6 5.3 1.8 2.5 3.2 2.2 37 39 4.33 14.5 4 7.4 5.5 1.9 3.3 37 4.22 14.4 5 8.3 6.5 1.8 3.9 42 TABE 9B GROUP AVBR. PET 11 CHO 90;5” FAT 10/i NBW YORK MUDICAL COLEGU, MCTROPOLITAN HOSPITAL RESEARCH UNIT 'ELFAR3 ISLAND, HUU YORK CITY NU-9 , R® t. 'JfZ FASTING BLOOD Day Sodium Potassium Chlorides Sugar ' npn tjN Total chol. Control Aver. 332. 17.3 605 77.1 ■50.3 14.9 199 D 574 o 1 328 18.1 240 2 330 22.2 607 75.4 31.9 15.7 222 P 3 327 21.6 580 215 r • 4 321 21.4 SO .'i> 85.5 53.4 16.3 240 • ± 5 3M 30.9 594 242 V a 6 323 24.6 589 79.9 31.9 16.1 219 7 325 23.9 582 - 216 u * 8 327 21.5 580 82.5 32.7 16.0 191 i 9 324 21,1 610 173 0 110 319 21.8 B&S 85.7 35.9 17.2 2666 n Hecovery 195 1 334 16.5 582 2 352 19.3 • 625 195 3 322 15.3 626 77.4 30.0 15.3 171 4 324 12.8 610 167 5 330 14.8 606 81.7 27.7 14.2 171 d r # TABLS 9C CTOOP AVER. DIPT 12 CTO 80^ Fst 10% PRCT 10# (Egg white) N3¥ YORK MCDICAL COLIAGL, METROPOLITAN HOSPITAL RESEARCH UNIT ¥SLFARE ISLAND, NEW YORK CITY NU-9, Re t. #2 ' FiSTING BLOOD Day $8Blu ALB GLOB a/ g Hemat BBC HGB Control Aver. 8.0 6.0 2.0 3.4 42 4.51 15.3 D 1 8*1 7*0 1.1 6.0 42 4.18 15.1 e 2 8.4 666 1.8 3.7 40 4.00 13. 5 P 3 8.1 7.7 1.9 3.8 42 4.10 14.0 r 4 7.3 5.0 2.4 2.3 39 4.03 14,3 i 5 8*0 5.6 2.3 2.5 - V 6 8.3 5.6 2.7 2.1 41 4.06 13.8 a 7 8.1 6.0 2.0 3.6 39 4.01 13.7 t 8 8.0 5.6 2.5 2,3 40 3.89 13.4 i 9 7.8 5.9 2.9 1.9 37 3,85 13,3 t?o 10 8.0 6.0 2.0 3.4 38 3.99 13,1 n ■ Rea»very 1 7.5 5.4 2.1 2.9 38 3.9b 13«0 2 7.3 ■ 5.3 2.0 2.9 39 3 7.6 - 5.3 2.3 2.5 43 4.47 14.C 4 7.4 5.6 1.8 3.1 39 4.46 14.1 5 8.3 *.4 2.0 3.4 42 GROUP AVER. PET 13 CHO so;l FAT XO% PHOT 10/5 (Egg white) TABIS9D NEW YORK MEDICAL COLLEGE, METROPOLITAN HOSPIT.X RESEARCH UNIT tCLFAIC ISLAND, NEU YORK CITY NU-9, Rcpt. #2 TOTAL MILLI “SQUIVALUNTS Da y Sodium Potassium Chlorides NH3 Nitrogen Urine Bleed Urine Blood Urine Blood Urine Control 197 145 94 3.47 214 105 51 D 1 105 143 91 4.34 120 100 69 G 2 57 143 79 5.59 65 105 33 P 3 29 142 78 5.39 37 100 32 r * 4 27 138 66 5.00 27 100 26 i 5 12 142 31 775S9 17 104 26 V 6 13 142 23 5.34 15 100 26 a 7 12 140 26 5228 15 100 24 t i 8 15 140 27 * 5.16 13 loai- 21 9 14 140 27 5.64 12 IDG 25 c n 10 10 136 25 4.98 13 100 28 Recovery 1 18 143 24 4.05 10 104 37 2 58 148 42 5.29 '49 104 37 3 158 146 50 4.28 148 104 41 4 186 142 * 45 3,64 / 199 100 55 5 259 145 68 3.82 235 103 50 GROUP AVSR. DIET 11 CHO FIT 103 TABU 10A 1C,7 YORK MEDICAL COLLEGE, METROPOLITAN HOSPITAL RESEARCH UNIT 7SLFAR2 ISLAND, NS7 YORK CITY NU~9, Ropt*. Uz TOTAL MILLI -SqpiVAISNTS Day Sodium Potas slum Chlorides NHg Nitrogen Urine Blood Urine Blood Urine Blood Urine Control 194 145 73 3.83 212 104 52 Aver. D 1 117 143 85 4.64 124 99 41 e 2 77 144 81 5.69 72 104 33 P 3 43 142 84 5.54 46 100 33 r 4 23 140 70 5.49 32 iei 29 i 5 16 140 37 7.92 19 102 29 V 6 18 140 36 6.30 18 101 27 a 7 14 141 35 6.13 14 100 24 t 8 ir 142 35 • 5.51 13 100 26 i 9 17 141 31 5'. 42 12 105 26 o n 10 15 139 37 5.60 14 1CU 29 Recovery 1 24 145 27 4.24 11 100 38 2 67 144 26 4.95 42 108 37 3 • 180 140 62 3.93 181 108 53 4 199 141 50 3.29 209 105 60 • 5 258 144 55 p 3.60 199 104 50 Table 103 GROUP AVER. DIET 12 CllO" QC/o FAT 101o PHOT 1055 (2gg white) NEW YORK MEDICAL COLLEGE , METROPOLITAN HOSPITAL RESEARCH UNIT WELFARE ISLAND, NEW YORK CITY MJ-9 , Ropt . #2 FIGURE 23 DBT NO. CHO. FAT EGG ’’HITE 11 90$ 10$ 12 60$ 10$ 10$ DAILY ''EIGHT RECORD ’Kilograms) NU-9, Ropt. #2 FIGURE 23A CUMULATIVE WEIGHT LOSS (Kilograms) EXPERIMENTAL DAYS DIET NO. CHO. FIT PRO. (EGG T/HITE) 3330 IX 90j5 10$ SSXM 12 80$ 10$ 10$ Nu9-, Ropt. #Z FIGURE 23B DAILY LEIGHT LOSS (Kilograms) EXPERIMENTAL DA^S DIET NO* CHO. FAT PRO.(EGG T/HITE) tmm 11 90% 10% fETSSj 12 8 0% 10% 10% NU-9, Rcpt. #2 CONTROL FIGURE 24 EXPERIMENTAL DAYS TOTAL URINARY VOLUME '(cc. ) DDT NO. CEO. FAT EGG WHITE 11 90% 10% 12 80% 10% 10% RECOVERY NU-9, Ropt. #2 r CONTROL FIGURE 25 S XHSRIMSNTAL DAYS TOTAL SOLUTES IN URINE (Milliosmols) DIET NO. CHO. FAT WHITS 11 90 $ 10 % 12 80io 10 Jo RECOVERY Ropt. it-2, NU-9 FIGURE 26 CONTROL DAYS TOTAL NITROGEN IN URINE (Grams) EXPERIMENTAL DAYS ! DI-jT NO. OHO, FAT EGG UNITE 11 90/S 10/b - - - 12 80 /0 10/S 10A RECOVERY NU-9, Rept. #2 FIGURE 26A NEGATIVE NITROGEN B: LANCE (Grans ) EXPERIMENTAL DAYS DIET NO. CHO. FIT PSO. (Egg Ttoite) -— 11 90$ 10$ 12 80$ 10$ 10$ DIET NO. AVERAGE DAILY N BALANCE . 11 Minus 9.3 ‘ 2 12 _ Minus 3.9' Ro pt. #2 FIGURE 20 CONTROL TOTAL CREATININE IN URINE (Milligrams) EXPERIMENTAL DAYS DIET NO. CHO. FAT EGG WHITE II 90% 10% 12 80% 10% 10% NU-9, Kept, #2 FIGURE 28 CONTROL DIET NO. CHC. FAT EGG WHITE 11 90% ■ 10% 12 BO% 1010% EXPERIMENTAL DAYS TOTAL CREATINE IN URINE (Miligrams) RECOVERY NU-9, Rcpt• #2 CONTROL FIGURE '29 DIET NO. OHO. FAT EGG TOTES 11 90% 10 % 12 80% 10% 10% EXPERIMENTAL DAYS TOTAL NEU NITROGEN IN URINE (MUlloquivalonts Per 24 Hours) RiCO V E R Y NIT-9, Rept. #2 FIOJB3 30 C 0 NT BO X BLOOD NON-PROTLIN NITROGLN (Milligrams Per 100 cc. ) DIET NO. CHO. FAT EGG fiI[X 11 90$ 10$ 12 80v5 10/S 10/S experimental dais 33 C OTS a T NU-9, Kept, #2 FIGUHS 31 CONTROL DET NO. CHO. FAT AGO WHITE 11 ’ S0% 1C% - - - 12 80% 10% ' 10% SSRUM SODIUM (Milliequivalents Per Liter) EXPERIMENTAL DAYS RECOVERY NU-9, Rgpt* #2 FIGURE 51A C ON T R C L DIET NO. OHO. FAT EGG NTIITE ll 9055 1055 12 80$ 10$ 10$ TOTAL SODIUM IN URINE (Milliequlvalents For 24 Hours) "experimental days' REG 0 (ST S R Y MU-9, Kept, jf2 FIGURE 32 CONTROL EXPERIMENTAL DAYS SERUM POTASSIUM (MllHequivalonts Per Liter) DIET NO. CHO. FAT EGG WHITE 11 90$ 10$ - - - 1§ 80$ 10$ 10$ RECOVERY .j-9, Rept. #Z FIGURE 32A CONTROL POTASSIUM IN URINE ( Milliequivalents per 24 Hours ) Diet No. CHO FAT &GG WHITE li 90$ 10 12 80$ 10$ 10$ EXPERIMENTAL DAYS RE C 0 V E R Y NTJ-9, Rcpt. #2 CONTROL FIGURE 33 DIET HO. CHO. FAT EGG WHITE 11 90$ 10 fo 12 80,1 10$ 10$ SERUM CHLORIDES (Milllequivalents per Liter) EXPERIMENTAL DAYS RECOVERY NU-9, Ropt. #2 FIGURE 33A CONTROL DIET NO. CHO. FAT EGG WHITE 11' 90% 10% 12 80% 10% 10% TOTAL CHLORIDES IN URINE (Milliequivalents Per 24 Hours) EXPERIMENTAL DAYS RECOVERY NU-9, Ropt• 2 FIGURE 35 C 0 N T R 0 L TOTAL SERUM CHOLESTEROL (Milligram Per 100 co.) E XFER IMENTAL DATS DIET NO. CHO, EAT EGG UHITE 11 90/= 10/= ' - - - 12 '80& 10/ 10/ yC0T25Y NU-91 Rept* #2 _C C N T R 0 Li FIGURE 36 EXPERIMENTAL DAYS TOTAL SERUM PROTEIN (Groms per ICO co.) Diet No. CHO FAT EGG WHITE: 11 90% 10% ,1.° 80$ 10$ 10$ RE C 0 VERY NU-9, Kept, #2