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Fairfax Throckmorton Proudfit.

Dietetics for nurses

. (page 32 of 37)

and which will be at the same time one on which the patient



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CONDITIONS AFFECTED BY DIET 457

can gradually be built up, and in this way benefit, as far
as possible, under the circumstances. The diet used in the
treatment of anemia seems to be the one best suited to
meet the requirements of the patient suffering with pel-
lagra; changes may be made in this diet, however, by the
physician, who will be able to judge the need of the indi-
vidual under his care. Whether pellagra can be cured by
dietetic treatment is very uncertain, but the condition of
the patient can undoubtedly be materially improved, pro-
vided the treatment is begun sufficiently early; that is,
before the disease has progressed to such an extent that
neither diet nor anything else can bring about a cure.

The above dietetic treatment is not claimed to be in-
fallible. It is merely given as a suggestion to be used at the
discretion of the physician.

In all probability the treatment of pellagra will undergo
a definite change in the near future, but at present our best
results accrue from the giving of an adequate, well-bal-
anced diet. The extent of the relief of such dietetic meas-
ures depends, as has already been stated, upon taking the
disease in its early stage.

SUMMARY

Food Poisoning is more or less common, being induced
by polluted water, milk, or other foods, bad sanitation, and
imperfect canning, as well as by certain obscure substances
known as ptomaines.

Shellfish have often been found to cause poisoning in
certain individuals. Stale fish may cause the most violent
t3T)e of poisoning in any individual.

Chicken Salad which has been kept overnight in tin
receptacles has been known to cause violent attacks of
poisoning.

Ice Cream which is melted and re-frozen is likewise a
source of a number of the cases reported,



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458 DIETETICS FOR NURSES

Symptoms. — Very like those of auto-intoxication, and
violent intestinal disturbances are manifested.

Prostration may be great, according to the violence and
duration of the attack.

Anemia follows many cases of poisoning as a result not
only of the impairment and lack of nutrition of the blood-
making organs, but also on account of the other symptoms,
especially diarrhea occurring in the disease.

ACIDOSIS

This condition is more or less common, especially in the
disturbances manifested by children.

Cause of acidosis is believed to be an impairment of
metabolism, especially in regard to the fats.

Starvation or Malnutrition is believed to produce many
cases of acidosis in childhood and adults sufiFering from dis-
eases in which certain foods have been limited.

Dietetic Treatment like that used in acute gastro-intes-
tinal disturbances begins with a starvation period and is fol-
lowed by a simple fluid diet until violent symptoms subside.
Examination of the stools and the material vomited will,
at times, furnish an insight as to the source of the poison.

Convalescent Diet is begun after the violent symptoms
have subsided, but care must be taken not to increase the
diet too rapidly, owing to the danger from relapse.

Method of Administering Diet. — First: a period of
total abstinence from food.

Second: fluid diet consisting of broth, buttermilk, or
some of the predigested liquid beef preparations which fur-
nish both food and stimulation necessary in such cases.

Rectal Feeding may be found necessary when the pros-
tration is great.

Personal Idiosyncrasies should be taken into account
and effort made to find whether or not the attack is caused
by any one food material or by bad sanitation or unclean



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CONDITIONS AFFECTED BY DIET 459

food. The patient should be warned against the danger of
taking a food which has caused a previous attack of poison-
ing, especially in cases where a personal idiosyncrasy against
a food h3S been manifested.

PELLAGRA

The cause and cure for this disease are still a matter of
discussion. Whether it is due to the presence or absence of
certain substances in the food materials, is as yet to be
determined.

Diet in Pellagra is most important. It is impossible to
say that pellagra is a nutritional disease, but it is certain
that m balancing the diet much has been done toward re-
lieving the condition.

Diarrhea is one of the chief symptoms of the disease and
great care is needed in formulating the dietary in order not
to increase this condition.

Conclusion. — The diet is thus shown to be directed
toward overcoming the emaciation and anemia and relieving
or preventing the gastro-intestinal disturbances which are
so apt to occur. It must be remembered that even a well-
balanced diet will not materially relieve the condition unless
it is instituted sufficiently early.

PROBLEMS

(a) Formulate a diet for an adult in which the base form-
ing elements predominate.

(6) Formulate a diet for child suffering from acidosis.

(c) Arrange a well balanced diet for pellagra in which forty
grams of protein shall come from milk, meat or eggs.



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APPENDIX

TABLE I'
Edible Organic Nutrients and Fuel Values of Foods*













Fuel


^/v>


Food




Protein

(NX6.25)

Per Cent


Fat
Per Cent


Carbo-
hydrate
Per Cent


Value

per
Pound
Calories


100
Calorie
Portion
Grams


Almonds . .


E.P.t


21.0


54.9


17.3


2940


15




A.P.t


11.5


30.2


9.5


1615


28


Apples . .


E.P.


.4


.5


14.2


285


159




A. P.


.3


.3


10.8


214


212


Apricots . .


E.P.


1.1


—


13.4


263


174




A. P.


1.0


—


12.6


247


184


Artichoke,














French . .


E.P.


3.4


.6


12.0


300


151




A. P.


1.7


.3


6.0


150


302


Asparagus, fresh E. P.


1.8


.2


3.3


100


450


cooked . . .


A. P.


2.1


3.3


2.2


213


213


Avocado . .


E.P.


2.1


20.1


7.4


993


46




A. P.


1.4


13.2


4.8


652


70


Bacon, smoked


E.P.


10.6


64.8


—


2840


16




A. P.


9.5


59.4


—


2372


19


Bananas . .


E.P.


1.3


.6


22.0


447


101




A. P.


.8


.4


14.3


290


156


Barley, pearled




8.5


1.1


77.8


1615


28


Beans, dried .




22.5


1.8


59.6


1565


29


Lima, dried .




18.1


1.5


65.9


1586


29


Lima, fresh .


E.P.


7.1


.7


22.0


557


82




A. P.


3.2


.3


9.9


250


182


string, fresh


E.P.


2.3


3.


7.4


184


241




A. P.


2.1


3.


6.9


176


259


baked, canned


A. P.


6.9


2.5


19.6


583


78


red kidney.














canned




7.0


.2


18'5


471


96



* Courtesy of Dr. Henry Sherman.

* The percentages of nutrients are taken from Bull. 28, Office of Experi-
ment Stations, U. S. Department of Agriculture. The fuel values are cal-
culated from these percentages by the use of the factors explained in
Chapter II, viz. — protein, 4 calories; fat, 9 calories; carbohydrate, 4 calories
per gram.

tE.P. signifies edible portion; A. P. signifies as purchased.

461



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462



DIETETICS FOR NURSES

TABLE I — Continued











Fuel






Protein


Fat
Per Cent


Carbo-


Value


100


Food


(NX 6.25)

Per Cent


hydrate
Percent


per
Pound


Calorie
Portion


9








Calories


Grams


Beef, brisket,












medium fat E. P.


15.8


28.5


—


1449


31


A. P.


12.0


22.3


—


1130


40


chuck, average E. P.


19.2


15.4


—


978


46


A. P.


15.8


12.5


—


797


58


corned, aver-












age . . E.P.


15.6


26.2


—


1353


34


A. P.


14.3


23.8


—


1230


37


cross ribs,












average . E. P.


15.9


28.2


—


1440


32


A. P.


13.8


24.8


—


1262


36


dried, salted,












and smoked E.P.


30.0


6.5


.4


817


56


A. P.


26.4


6.9


—


760


60


flank, lean . E. P.


20.8


11.3


—


838


54


A. P.


20.5


11.0


—


821


55


fore quarter.












lean . . E.P.


18.9


12.2


_—


842


54


A. P.


14.7


9.5


—


655


69


fore shank, lean E. P.


22.0


6.1


—


647


70


A. P.


14.0


3.9


—


414


110


heart . . . E. P.


16.0


20.4


1.0


1140


40


A. P.


14.8


24.7


.9


1292


35


hind quarter,












lean . . E. P.


20.0


13.4





907


50


A. P.


16.7


11.2


— .


757


60


hind shank, lean E. P.


21.9


5.4


.


617


75


A. P.


9.1


2.2


.


255


179


hind shank, fat E. P.


20.4


J8.8


.


1171


40


A. P.


9.9


9.1


.


552


83


liver . . .E.P.


20.4


4.5


1.7


584


78


A. P.


20.2


3.1


2.6


537


85


loin . . .E.P.


19.7


12.7




877


52


A. P.


17.1


11.1


.


764


60


neck, lean . E.P.


21.4


8.4


_


732


62


A. P.


15.1


5.9


__


493


93


neck, medium












fat . . '. E.P.


20.1


16.5


—.


1040


44


A. P.


14.5


11.9





749


61


plate, lean . E. P.


15.6


18.8





1051


43


A. P.


13.0


15.5





867


52



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APPENDIX
TABLE I — Continued



463













Fuel








Protein


Fat
Per Cent


Carbo-


Value


100


Food




(NX 6.25)

Per Cent


hydrate
Per Cent


per
Pound


CcUorte
Portion












Calories


Oramt


Porterhouse














steak . .


E.P.


21.9


20.4


—


1230


37




A. P.


19.1


17.9


-.-


1077


42


rib rolls, lean


A. P.


20.2


10.5


—


795


57


ribs, lean


E.P.


19.6


12.0


—


845


54




A. P.


15.2


9.3


—


654


69


ribs, fat . .


E.P.


15.0


35.6


—


1721


26




A. P.


12.7


30.6





1480


31


round, lean .


E.P.


21.3


7.9


—


709


64




A. P.


19.5


7.3


—


649


70


round, free from












visible fat


,


23,2


2.5


—


512


87


rump, lean .


E.P.


20.9


13.7


—


940


49




A. P.


19.1


11.0


—


796


67


rump, fat


E.P.


16.8


35.7


—


1763


26




A. P.


12.9


27.6


—


1361


33


sides, lean .


E.P.


19.3


13.2


—


890


61




A. P.


15.5


10.6


—


716


64


sirloin steak .


E.P.


18.9


18.5


—


1099


41




A. P.


16.5


16.1


—


960


48


sweetbreads .


A. P.


16.8


12.1


_


799


57


tenderloin


A. P.


16.2


24.4


—


1290


36


ton^e . .


E.P.


•18.9


9.2


—


717


63




A. P.


14.1


6.7


—


529


86


Beets, cooked .


E.P.


2.3


.1


7.4


180


252


fresh . . .


E.P.


1.6


.1


9.7


209


217




A. P.


1.3


.1


7.7


167


271


Blackberries


A. P.


1.3


1.0


10.9


262


173


Blackfish . .


E.P.


18.7


1.3


—


393


116




A. P.


7.4


.7


—


163


279


Bluefish . .


E.P.


19.4


1.2





402


113




A. P.


10.0


.6





206


220


Boston crackers




11.0


8.5


71.1


1835


26


Brazil nuts . .


E.P.


17.0


66.8


7.0


3162


14




A. P.


8.6


33.7


3.5


1591


28


Bread, Boston














brown . .




6.0


6.3


54.0


1345


34


graham




8.9


1.8


52.1


1189


38


rolls, water .




9.0


3.0


54.2


1268


36


toasted . .




11.5


1.6


61.2


1385


33



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464



DIETETICS FOR NURSES
TABLE I — Continued













Fuel








Protein


Fat
Per Cent


Carbo-


Value


100


Food




(NX6.25)

Per Cent


hydrate
Per Cent


per
Pound


Calorie
Portion












Calories


Orams


white, home-














made . .




9.1


1.6


53.3


1199


38


milk . . .




9.6


1.4


51.1


1158


39


Vienna . .




9.4


1.2


54.1


1199


38


average white




9.2


1.3


53.1


1182


38


whole wheat .




9.7


.9


49.7


1113


41


Buckwheat flour




6.4


1.2


77.9


1580


29


Butter . . .




1.0


85.0


—


3491


13


Buttermilk . .




3.0


.5


4.8


162


280


Butternuts . .


E.P.


27.9


61.2


3.5


3065


15




A. P.


3.8


8.3


.5


417


109


Cabbage . .


E.P.


1.6


.3


6.6


143


317




A. P.


1.4


.2


4.8


121


376


Calf 8 foot jelly




4.3


—


17.4


394


115


Carrots, fresh .


E.P.


1.1


.4


9.3


204


221




A. P.


.9


.2


7.4


158


286


Cauliflower


A. P.


1.8


.5


4.7


139


328


Celery . . .


E.P.


1.1


.1


3.3


84


542




A. P.


.9


.1


2.6


68


672


Celery soup.














canned . .




2.1


2.8


5.0


243


187


Cerealine . .




9.6


1.1


78.3


1640


28


Chard . . .


E.P.


3.2


.6


5.0


173


262


Cheese, Amer-














ican pale .




28.8


35.9


.3


1990


23


American red




29.6


38.3


—


2102


22


Cheddar . .




27.7


36.8


4.1


2080


22


cottage . .




20.9


1.0


4.3


499


91


full cream .




25.9


33.7


2.4


1890


24


Fromage de














Brie . .




15.9


21.0


1.4


1170


39


Neufchatel .




18.7


27.4


1.5


1484


31


pineapple




29.9


38.9


2.6


2180


21


Roquefort




22.6


29.5


1.8


1645


28


Swiss . .




27.6


34.9


1.3


1945


23


Cherries, fresh .


E.P.


1.0


.8


16.7


354


128




A. P.


.9


.8


15.9


337


134


canned . .


A. P.


1.1


.1


21.1


407


112


Chestnuts, fresh


E.P.


6.2


5.4


42.1


1098


41




A. P.


6.2


4.5


35.4


920


49



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APPENDIX
TABLE I — Continued



465













Fuel








Protein


17f ±


Carbo-


Value


100


Food




(NX6.25)

Per Cent


Fat
Per Cent


hydrate
Per Cent


per
Pound
Calories


Calorie
Portion
Orams


Chicken, broilers


E.P.


21.5


2.5





493


92




A. P.


12.8


1.4





289


157


Chocolate . .




12.9


48.7


30.3


2768


16


Cocoa . . .




21.6


28.9


37.7


2258


20


Cod, dressed .


A. P.


11.1


.2




209


217


salt . . .


E.P.


25.4


.3





473


96




A. P.


19.0


.4





361


126


Consomm^,














canned . .


A. P.


2.5


—


.4


53


862


Com, green.














canned . .




2.8


1.2


19.0


455


102


sweet, fresh .


E.P.


3.1


1.1


19.7


459


99




A. P.


1.2


.4


7.7


178


255


Com meal . .




9.2


1.9


75.4


1620


28


Cowpeas, dried




21.4


1.4


60.8


1550


29


green . . .


E.P.


9.4


.6


22.7


603


76


Crackers, butter


A. P.


9.6


10.1


71.6


1887


23


cream . .


A. P.


9.7


12.1


69.7


1938


23


graham


A. P.


10.0


9.4


73.8


1905


24


soda . . .


A. P.


9.8


9.1


73.1


1875


24


water . . .


A. P.


10.7


8.8


71.9


1855


24


Cranberries


A. P.


.4


.6


9.9


212


212


Cream . . .




2.6


18.5


4.6


883


50


Cucumbers . .


E.P.


.8


.2


3.1


79


575




A. P.


.7


.2


2.6


68


666


Currants, fresh




1.6





12.8


259


175


dried Zante .




2.4


1.7


74.2


1455


31


Dandelion greens




2.4


1.0


10.6


277


164


Dates, dried .


E.P.


2.1


2.8


78.4


1575


29




A. P.


1.9


2.5


70.6


1416


32


Doughnuts . .




6.7


21.0


63.1


1941


23


Eggplant . .


E.P.


1.2


.3


6.1


126


349


Eggs, uncooked


E.P.


13.4


10.5




672


68




A. P.


11.9


9.3





594


76


Farina . . .




11.0


1.4


76.8


1640


28


Figs, dried . .




4.3


.3


74.2


1437


32


Flounder . .


A. P.


6.4


.3





110


412




E.P.


14.2


.6





282


161


Flour, rye . .




6.8


.9


78.7


1590


29



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466



DIETETICS FOR NURSES

TABLE I — Continued











Fuel






Protein


Fat
PerCent


Carbo-


Value


100


Food


(NX0.25)

PerCent


hydrate
PerCent


per
Pound


Calorie
Portion










Calories


Grams


Flour, continued












wheat, Cali-












fornia fine .


7.9


1.4


76.4


1585


29


wheat, entire


13.8


1.9


71.9


1630


28


wheat, graham


13.3


2.2


71.4


1628


28


wheat, patent












baker's grade


13.3


1.5


72.7


1623


28


wheat, straight












grade . .


10.8


1.1


74.8


1608


28


wheat, average












high and












medium


11.4


1.0


75.1


1610


28


wheat, average












low grade .


14.0


1.9


71.2


1625


28


Fowls . . . E.P.


19.3


16.3





1017


45


A. P.


13.7


12.3





752


60


Gelatin . . .


91.4


.1


—


1660


27


Grape butter .


1.2


.1


58.5


1088


42


Grapes ... E.P.


1.3


1.6


19.2


437


104


A. P.


1.0


1.2


14.4


328


138


Grapefruit . . E. P.


.6


.1


12.2


235


193


A. P.


.4


.1


8.9


172


264


Haddock . . E.P.


17.2


.3


—


324


140


A. P.


8.4


.2





160


283


Halibut steaks . E. P.


18.6


5.2





550


83


A. P.


15.3


4.4


—


457


100


Ham, fresh lean E.P.


25.0


14.4


—


1042


44


A. P.


24.8


14.2


—


1030


44


fresh, medium E. P.


15.3


28.9


—


1458


31


A. P.


13.5


25.9


.^ .


1303


35


smoked, lean . E.P.


19.8


20.8


—


1209


38


A. P.


17.5


18.5


—


1073


42


Herring, whole E. P.


19.5


7.1


—


644


70


A. P.


11.2


3.9


—


362


125


smoked . . E. P.


36.9


15.8


—


1315


35


A. P.


20.5


8.8


—


731


62


Hominy . .


8.3


.6


79.0


1609


28


Honey . . .


.4


—


81.2


1481


31


Huckleberries .


.6


.6


m.fi


336


135


Kohl-rabi . .E.P.


2.0


.1


5.5


- 140


324


Koumiss . . .


2.8


2.1


5.4


234


194



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APPENDIX






467




TABLE ]


'. — Contintted
















Fuel








Protein


Fat
Per Cent


Carbo-


Value


100


Food




(NX6.25)

Per Cent


hydrate
Per Cent


per
Pound


Calorie
Portion












Calories


Orams


Lamb, breast


E.P.


19.1


23.6


—


1311


35




A. P.


15.4


19.1


—


1058


43


chops, broiled .


E,P.


21.7


29.9


—


1614


28


fore quarter .


E.P.


18.3


25.8


—


1385


33




A. P.


14.9


21.0


-^


1127


40


hind quarter .


E.P.


19.6


19.1


—


1149


40




A. P.


16.5


16.1


—


953


48


leg, roast . .




19.7


12.7


—


876


52


side . . .


E,P,


17.6


23.1


—


1263


36




A. P.


14.1


18.7


-^


1015


45


Lard, refined




—


100.0


-^


4080


11


Lemon juice . .




—


—


9.8


178


255


Lemons . . .


E.P.


1.0


.7


8.5


201


226




A. P.


.7


.5


5.9


140


323


Lettuce . . .


E.P.


1.2


.3


2.9


87


525




A. P.


1.0


.2


2.5


72


633


Liver, beef . .


E.P.


20.4


4.5


1.7


583


78




A. P.


20.2


3.1


2.5


538


84


veal . . .


E.P.


19.0


5.3


—


562


81


Lobster, whole .


E.P.


16.4


1.8


.4


379


120




A. P.


5.9


.7


.2


139


326


canned . . .


A. P.


18.1


1.1


.5


382


119


Macaroni . .




13.4


.9


74.1


1625


28


Macaroons . .




6.5


15.2


65.2


1922


24


Mackerel . .


E.P.


18.7


7.1


—


629


72




A. P.


10.2


4.2


—


356


127


salt . . . .


E.P.


21.1


22.6


—


1305


35




A. P.


16.3


17.4


—


1005


45


Marmalade, orange


.6


,1


84.5


1548


29


Milk, condensed














sweetened . .




8.8


8.3


54.1


1480


31


skimmed . .




3.4


.3


5.1


167


273


whole . . .




3.3


4.0


5.0


314


145


Mince meat, com














mercial .




6.7


1.4


60.2


1280


36


home made




4.8


6.7


32.1


942


48


Molasses, cane




2.4


—


69.3


1302


35


Mushrooms .


A. P.


3.5


.4


6.8


204


223


Muskmelons .


. E.P.


.6


—


9.3


180


252




A. P.


.3


—


4.6


89


510



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468



DIETETICS FOR NURSES
TABLE I — Continued













Fuel


100
Calorie
Portion
Orams


Food




Protein

(NX6.25)

PerCent


Fat
PerCent


Carbo-
hydrate
PerCent


Value

per
Pound
Calories


Mutton, fore quar-












ter ... .


E.P.


15.6


30.9


—


1543


29




A. P.


12.3


24.5


—


1223


37


hind quarter .


E.P.


16.7


28.1


—


1450


31




A. P.


13.8


23.2


—


1197


38


leg ....


E.P.


19.8


12.4


—


863


52




A. P.


16.5


10.3


—


718


63


side . . .


A. P.


13.0


24.0


—


1215


37




E.P.


16.2


29.8


—


1512


30


Nectarines


E.P.


.6


—


15.9


299


152




A. P.


.6


—


14.8


280


162


Oatmeal . . .




16.1


7.2


67.5


1811


25


Okra ....


E.P.


1.6


.2


7.4


172


264




A. P.


1.4


.2


6.5


152


300


Olives, green .


E.P.


1.1


27.6


11.6


1357


33




A. P.


.8


20.2


8.5


995


46


ripe . • .


E.P.


1.7


25.0


4.3


1130


40




A. P.


1.4


21.0


3.5


947


48


Onions, fresh .


E.P.


1.6


.3


9.9


220


206




A. P.


1.4


.3


8.9


199


228


Oranges . . .


E.P.


.8


.2


11.6


233


195




A. P.


.6


.1


8.5


169


268


Oxtail soup.














canned . . .


A. P.


3.8


.5


4.2


166


274


Oysters . . .


E.P.


6.2


1.2


3.7


228


199


in shell . .


A. P.


1.2


.2


.7


43


1065


canned . .


A. P.


8.8


2.4


3.9


328


138


Parsnips . . .


E.P.


1.6


.6


13.5


294


154




A. P.


1.3


.4


10.8


236


192


Pea soup, canned


A. P.


3.6


.7


7.6


232


196


Peaches, canned


A. P.


.7


.1


10.8


213


213


fresh . . .


E.P.


.7


.1


9.4


188


242




A. P.


.5


.1


7.7


153


297


Peanuts . . .


E.P.


25.8


38.6


24.4


2490


18




A. P.


19.5


29.1


18.5


1877


24


Pears, fresh . .


E.P.


.6


.5


14.1


288


158




A. P.


.6


.4


12.7


256


177


Peas, canned


A. P.


3.6


.2


9.8


252


180


dried . . .




24.6


1.0


62.0


1611


28


green . . .


E.P.


7.0


.5


16.9


454


100




A. P.


3.6


.2


9.8


252


180



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APPENDIX
TABLE I — Continued



469











Fuel


•i/\/\


Food


Protein
(NX6.26)
PerCent


Fat
PerCent


Carbo-
hydrate
PerCent


Value

per
Pound
Calorie}^


100
Calorie
Portion
Orams


Peppers, green . E. P.


1.1


.1


4.6


109


417


PersiniTnonB . . E. P.


.8


.7


31.5


615


74


Pies, apple . .


3.1


0.8


42.8


1233


37


CQSt&rd • •


4.2


6.3


26.1


806


56


lemon . . .


3.6


10.1


37.4


1156


39


mince . . .


6.8


12.3


38.1


1300


35


squash . . •


4.4


8.4


21.7


817


56


Pineapples, fresh E. P.


.4


.3


9.7


196


232


canned . . A. P.


.4


.7


36.4


695


65


Pine nuts (pig-












nolias) . .


33.9


49.4


6.9


2757


16


Pistachios,












sheUed . . .


22.3


54.0


16.3


2900


16


Plums . . . E.P.


1.0


—


20.1


383


118


A. P.


.9


—


19.1


363


125


Pomegranates . E.P.


1.5


1.6


19.6


447


102


Pork chops.












medium . .E.P.


16.6


30.1


■—


1530


30


A. P.


13.4


24.2


—


1230


37


chuck ribs and












shoulder . E.P.


17.3


31.1


—


1585


29


A. P.


14.1


25.5


—


1298


35


fat, salt . . A.P.


1.9


86.2


—


3555


13


sausage . . A. P.


13.0


44.2


1.1


2030


22


side . . .E.P.


9.1


55.3


—


2423


19



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