APPLICATIONS TO HEALTH WORK AND TO INSTITUTIONAL SERVICE
From our studies of dietary backgrounds it has become apparent:
That a family coming to this country from a wholly different environment is under an enormous handicap in attaining a satisfactory diet, particularly when the income is small.
That doctors, nurses, social workers, and even dietitians generally lack knowledge of the native diets and usual food habits of the foreign-born.
That a large number of the foods of foreign-bom peoples are well adapted to their physical needs. That most of these foods can be obtained in this country.
That the dietary errors arising in this country are largely due to disturbance of the balance in the diet because of change of environment, new scales of prices, etc.; and that the problem before the dietitian is not so much to introduce a complete "American" dietary, as it is to restore the former dietary balance by supplying lost elements.
That knowledge of foods of the foreign-born and of their native dietaries is the foundation of all success in this endeavor; it is a necessity in dealing with many specific problems of health or of disease; and is invaluable as a means of mutual understanding and sympathy between the American-born and the immigrant. "The way to a man's heart is through his stomach." The soul of a family may be reached through the daily chores of the household.
There is need for enlightenment among Americans regarding the practical utility and enjoyability of many foreign foods. A study of "Foreign Foods Which Would Improve the American Dietary" would be an Americanizing agent of practical value for the use of Home Economic sections of Women's Clubs and similar organizations. American diet would be improved and (psychologically speaking) be enriched; and many Americans would be given a sympathetic appreciation and understanding of our foreign-born population through the practical medium of the kitchen and the dinner table.
An International Menu is needed for use in institutions of all kinds receiving any number of foreign-born. An "International Menu" is one which is not confined to "American" dishes, but which contains each day at least one dish especially adapted to at least one of the nationalities or races represented among the patients. This would demonstrate to the patients that the dietitian had considered them and would have a good psychological effect which would of itself help them physically. Thus in a menu for an institution with many different race groups, a characteristic Italian dish might be included one day, a Polish dish at another meal, or on another day soon thereafter, and similarly the next day might remember the Jewish or Russian patients. So during each week they would all be better satisfied, both physically and mentally. Such an "International Menu" need not make the diet less acceptable to the native-born Americans. It would give greater variety and would help the dietitians in their endless search for something new. As must be borne in mind, the practical value of such a menu is its psychological effect upon the immigrant, almost if not quite as much as its physiological. The work of making up such an International Menu is a matter of practical and not difficult detail. The dietitians, or other persons responsible in hospitals, sanitoria, convalescent homes, restaurants in industrial plants, etc., should (wherever the racial constitution of their people requires it) be made responsible for developing something of this sort.
The diet lists used by medical institutions such as hospitals and dispensaries should be adapted to the people, as well as to the diseases which are treated. The habitual foods of the nationality or race dealt with must be in the mind of the person who prepares the diet list, if it is to be of much real service. This means that the dietary problems of patients need to be handled by dietitians, visiting nurses, or social workers who have some knowledge of foreign as well as of the characteristic American diet. The average visiting nurse or medical-social service worker cannot become an expert in dietetics, and must depend upon the advisory dietitian or the visiting housekeeper. It may be expected that dispensary and visiting nursing associations should provide themselves directly, or through the cooperation of some other organization, with at least the advisory services of such a dietitian. Food Clinics, in which dietitians can be consulted by nurses or general workers, and to which patients can be sent when necessary, are needed in the large dispensaries and in connection with the Health Centers which are now being established so rapidly throughout the country.