Diet therapy in the U.S. in the past 200 years. A Bicentennial study.
Although diet therapy is a concept of the twentieth century, its foundations were laid by such men as Sanctorius in the sixteenth century, Lavoisier in the eighteenth century, and Beaumont in the nineteenth century, whose detailed notes reflected amazingly accurate observations. With the advent of scientific medicine, research provided the knowledge on which diet therapy was built. Data on food composition, which began to be available around the turn of the century, was important to the therapeutic dietitian, and, at mid-century, formed the basis for the development of the first Exchange Lists (only revised this year). Diets early in the century involved rigid routines, in contrast with the trend today to consider the individual. World War I marked the emergence of the trained dietitian and changes in diet therapy, as knowledge of the biologic sciences and the practice of medium expanded. Research on metabolism led to control of hemoglobin and the red cell anemias, while growing knowledge of the role of pancreatic secretions in metabolism made near-normal lives possible for those with diabetes. The dietitian today finds herself in the position of interpreter of scientific findings, developing meal patterns which not only correct poor food habits but are acceptable to patients. More recently, she has been concerned with problems in modification of fat intake in the interest of possible prevention of cardiovascular disease. Obesity and its prevention remain problems. The practice of diet therapy is subject to vogues, as is science, but the challenge to the dietitian remains: that of serving each patient through the best possible use of her education, skill, and sensitivity.