It is almost to the day ten years since I had the honour of delivering before your Society the third of the Cantor Lectures for 1932. It is no less wise for the scientist than for the politician to remind himself of what he has said on previous occasions, so I read again what I had written then. Although it is part of my job in life to keep myself acquainted with advances in the study of nutrition I found myself wondering that so much had been learnt in these ten years. I was surprised to be reminded that nutrition experts at that time were unable to indicate more precisely than by a series of plus and minus signs what amounts of the more important vitamins are present in our common foods. Many other matters I discussed in those lectures brought home forcibly to me how inadequately prepared we would have been on what I may term the “ nutritional front,” had plans for feeding the people of this country for several years of war been called for in 1929. Comparisons between conditions prevailing during the warof 1914–18 and those existing to‐day constantly come to the mind of those whose experience covers both. But I will remind you of one great difference which is curiously rarely appreciated. In the last struggle the food position in Great Britain did not materially deteriorate until the latter part of 1917—after three years of war—and it was not found necessary to introduce rationing until February of 1918—a mere nine months before the Armistice. We are apt complacently to think our people were reasonably well fed for the latter part of that war period, and to point to the contrast with terrible conditions in Germany and Central Europe. What we often fail to recognise or even, perhaps, admit, is that, had the submarine campaign of 1918 continued for another year and become intensified to an extent comparable with what is being faced to‐day, we would probably have run into serious nutritional troubles because we had not then the scientific knowledge either to foresee them or to devise protective measures. The outbreak of the second world war in 1939 found us in an incomparably stronger position. It is true there were still disconcerting gaps in our knowledge, such, for example, as the lack of any trustworthy data as to the protein requirements of the adult man and woman, but, by and large, it was possible to draw up a basic plan for providing all categories of the population with food suitable for their nutritional requirements. The foundations of this plan were quantitative data, much of which had been acquired in very recent years. The importance of this basic plan lay in the fact that, whereas it was constructed in the first instance from these quantitative data concerning proteins, calories, vitamins and other nutrients, it could be developed in a variety of ways when it came to translation in terms of actual commodities. This gave it the quality of flexibility so essential if the plan were to be adaptable to changes in the quantities of individual foodstuffs available. We had something more than the estimates of requirements on which this basic plan was built. We had the invaluable information which Sir John Orr and others had collected from the surveys they had conducted during the four or five years before the war. This gave us a measure of the extent to which diets consumed in this country were nutritionally defective and in need of improvement. Moreover, it indicated quite clearly how important it would be to control the distribution of essential foods so that gross nutritional inequalities, revealed by these surveys, should be redressed as far as possible. The striking example of the success that has been achieved in this latter direction concerns the distribution of the liquid milk supply. Nutrition experts agree that the average consumption per head of the population ought to be not less than a pint a day. Before the war we drank about about half that quantity, but the curve relating volume consumed to income spent on food was disturbingly steep. Families spending more than 18s. a week per head on food were able to purchase nearly six pints a week for each member. Those who were unable to spare more than 5s. a week on their diet could not afford to purchase more than 1½ pints. It was clear at the beginning of the war, and even more obvious after the fall of Denmark and Holland, that there would be very great difficulties in the way of raising significantly the total milk consumption, much as that was to be desired. On the other hand, there was everything to be said for distributing more equably such supplies as were available. By one measure or another this has been achieved. The Milk in Schools Scheme, the National Milk Scheme, the Special Category Priority Scheme, each has served to flatten out the steep consumption income curve of pre‐war years. To‐day, we find that the poorest families covered by our surveys are drinking nearly 3½ pints of milk per head per week; the well‐to‐do families, scarcely more than 4½ pints. This naturally has raised a few grumbles from those who were fortunate enough before restrictions were imposed to be able to purchase all they wished to have, but we regard their troubles as trivial when we look at the benefits gained by the poorer people who have thus been enabled to get a fairer share of a food that has been aptly described as the keystone of the nutritional structure. If we look to the post‐war years—and it is one of the most heartening signs of the spirit in which we are waging this struggle against barbarism that so much attention is being paid to questions of reconstruction—we cannot see ourselves reverting to a state in which the consumption of milk can be seriously restricted by lack of purchasing power. The consumption of milk in one form or another must be raised. Our post‐war target should be a level 100 per cent. higher than the present figures, which, it may surprise you to learn, are actually higher than in 1939. But the curve must not be allowed to become steep again. Nearly a horizontal line, as it now is, its level must be raised without changing in shape. I believe that will be done. If it is, it will be a direct outcome of our nutrition policy during the present war. Those of us who have for many years studied experimental animals have long known of the profound effects of pre‐natal diet on the welfare of the mother and her offspring. Although there was every reason to believe that the same conditions would influence a woman and her child, precise information was curiously scanty. Here and there in the medical literature, suggestive records or observations could be gleaned, but there was not a convincing picture and much remained mere surmise. Largely as a result of the enthusiasm and enterprise of Miss Olga Nethersole, founder of the People's League of Health, an investigation was begun in London a year or so before the outbreak of war. I was privileged to serve on the Committee that directed the work. In all, no less than 5,000 women, typical of those coming for their confinements to the large London hospitals, were covered by the investigation. Approximately half the number of women were given vitamin and mineral supplements during the latter half of pregnancy; the supplements being in quantities likely to bring their total intake up to what scientists regard as desirable for that condition. The remainder were not so treated and served as controls. I will not give you the results in detail of this very comprehensive test, for they are about to be published in the medical press, but the chief finding was that the treated group showed a reduction in the incidence of toxæmic conditions and their sequelæ of such an order that, had the figures been applicable to the country as a whole—and, may I remind you that London has a relatively low toxæmia incidence by comparison with some other large towns?—the lives of no less than 10,000 women a year would have been saved.
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