Tuesday, 14 November 2017

Dietary Study in the Island of Lewis: MRC Report, 1940

"You'll get porridge and brose for your breakfast in the madainn

It will make you a braw Hieland laddie!"

Notes and comments from:
Studies in Nutrition. An inquiry into the diet of families in the Highlands and Islands of Scotland (Medical Research Council. Special Reports Series. no. 242.) 1940 37pp. By Prof. Edward Provan Cathcart (Glasgow), (Mrs.) Annabel Mary Tough Murray, J. B. Beveridge. 

(This may be found in the National Archives, reference FD 4/242, although not a public record as such).

The rate of publication and range of coverage of the MRC's "Green Books" was impressive

Among the many subjects addressed by the UK Medical Research Council (MRC) in its long-running and wide-ranging Special Reports Series (SRS, known as the Green Books, from their covers) that of nutrition occurred early and repeatedly: for example, SRS 13, published in 1918, was “An enquiry into the composition of dietaries, with special reference to the dietaries of munition workers”. It was more unusual for biomedical researchers to turn their attention to the far north and west of the country, but this did happen in time for the results of the study looked at here to be published early in the Second World War. Previous studies, SRS 151 1931 (St. Andrews) and SRS 165 1932 (Cardiff, Reading) had focused on different places. Nutrition was of course a key area of government concern during the war, and it may be inferred that some of the findings in these reports may well have influenced policy.

The authors’ method was to select a number of families in the Scottish Highlands on the mainland, and on the Isle of Lewis, and to record their food intake during one week. This was done first in summer, then some of the studies were duplicated in winter. The average intake was standardised as that for an adult male, deduced by formula. They pointed out (Introduction, p.5) that while much information was available about urban settings, the task of obtaining data on the Highlands presented some difficulty. Referring to the Department of Health (Scotland) Committee on Scottish Health Services, 1936, they noted how witnesses deplored the passing of old staple foods – porridge, salt herring and potatoes – and the use of more shop bread, tinned goods, tea, sweets etc. bought from shops and traders’ vans. Deficiencies in diet they reckoned were probably due to economic circumstances, as in the “dismal picture” painted by the Dewar Committee in 1912 (which had led to the setting up of the Highlands & Islands Medical Service). Now, however, they found doctors saying most families were reasonably well fed.

Comments turned up in a historical survey comparing the current situation with the past included:

  • Diet may lack variety; less oatmeal; but “very sound… and I doubt that there is a great difference from that of our forefathers.” 
  • More tea, shop bread, but plenty oatmeal, milk. 
  • More meat, fruits, veg. 

A minority of health professionals apparently believed diet was on a down-grade, but the authors query whether the conditions in the past were so very bright, going into an diverting digression about the 18th century and the controversial introduction of potatoes (denounced by some as “foolish roots”, whilst in one case compulsorily planted on pain of imprisonment).

The Highland subjects comprised (p.11) 58 families, living in the counties of Ross-shire (Ross & Cromarty), Sutherland, and Inverness-shire. Most were occupied in crofting, many with additional work such as fishing or labouring. It was found impossible to obtain much trustworthy information for the majority as to their economic status, in terms of income, but this was felt to be no great loss to the study. A total of 349 people were included, 118 of them under 12 years of age. As noted, the original studies were done in spring or early summer; seasonal variations were not in practice thought to be a major factor (44 families agreed to a re-study in autumn/winter). Children made up 36.4% of the summer, 37.5% of the winter samples.

Among the findings were that some items would be prepared in larger amounts than immediately required, to allow for leftovers to be given to hens and so on, “the actual waste of edible calories by the various households [being] very small”.  Compared with previous studies, a slight but definite increase was observed in the percentage of calories derived from protein, less came from fat, intake of carbohydrate substantially higher (Lewis was different – see below) and it was concluded that (p.16): “It is clear that, so far as gross quantities are concerned, these rural Highland diets are superior to the earlier urban ones.” 50% of the protein consumed was rated “first class”.  No definite increase in food intake was observed (as might have been expected) in winter, a possible explanation being that energy expenditure was less, because of weather conditions hampering activity. Intakes of vitamins A, B, C might “be seen as adequate”. Food common to all included butter, white bread, potatoes, and “tea” bread (which from the context probably means baked bannocks, oatcakes, scones and similar items eaten at tea-time). Eggs were scarce in winter. Beef, ham, bacon, cheese, and root veg were common to about ¾ of the sample (Further statistical details of the comparison are given in a Table). More fresh than tinned fruit was eaten, and consumption of fresh fish, perhaps surprisingly, not high. Brown bread was not appreciated by everyone, eating it “almost indicative of social standing”; green leafy veg was similarly undervalued, and it was suggested that the Women’s Rural Institute (WRI) could be mobilised to educate people (housewives) as to its benefits, favourable reference being made here to a similar initiative in the USSR.

Section III, beginning on p. 29, is specifically on the Dietary Study in the Island of Lewis. “Just as the dietary study of the highland families was drawing to a close,” the authors tell us, “we undertook, at the suggestion of Sir Edward Mellanby [then Secretary of the MRC, special interest nutrition with particular reference to vitamin deficiency] an investigation of a small group of families living in an isolated area in the Island of Lewis.” These too were engaged mainly in crofting, most men having in addition other, often seasonal work especially fishing. This study was done in summer.
A Lewis family, transitional between rural and town life.
(Slightly earlier than the date of the study),
Compared with Wester Ross (19 families), thought to be the closest and most useful comparitor set, the 23 Lewis families’ percentage of total calories derived from protein and fat was very definitely higher, and the percentage of protein rated first-class about 10% more. Their intake of 3 minerals (calcium, phosphorus, iron) was definitely above, plus slightly more lime and more vitamin A, but less B & C; oatmeal figured largely in the diet. Marked differences were noted in actual foodstuffs: on Lewis more mutton than beef was consumed, and all ate fresh fish, especially fatty varieties (herring, mackerel); they got more cheese/crowdie (fine-grained creamy ‘cottage’ cheese). No leaf veg was eaten, but 74% ate root veg. along with slightly more fresh fruit, and less sugar, jam, eggs, and whole milk. Dental condition in relation to diet is mentioned on p.32, referencing SRS 241 (see below).

Overall, the Report’s Conclusions (p.34) were favourable:
“It may be noted that both in Lewis and in the Highlands generally the standard of maternal efficiency is remarkably high... We have included a summary (Table XX) which suggests that the children both on the island and on the mainland are well up to standard in both height and weight.”

The phrase “maternal efficiency”, given inverted commas at one point in the Report (a raised eyebrow on the part of the female author, perhaps?), was evidently current usage among pundits of the time. Although deployed in commendation here, albeit with a tinge of patronising surprise, it carries the judgmental assumption that a mother should be able to raise healthy children in whatever conditions prevailed. Acknowledgements, after the practitioners and district nurses among others who helped, wind up “... and finally to the many long-suffering housewives who so graciously permitted us to investigate their household economy.”

The preceding Special Report, No.241, had also looked at the Isle of Lewis
(and drawn some similar conclusions about health benefits versus lack of variety of the rural diet).
A later generation of island housewives, being encouraged to cater for tourists.

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