American raw materials, and many of them resemble our dishes so closely that only slight changes in our recipes are necessary to produce a welcome diet for these people.

A study of this kind should be extended to more race groups than the four which we have taken up as examples. It would be useful to enter into more details in many respects, for success in dietary work is largely a matter of applying certain general principles to special problems. However, a study of the diets of the Italians, Jews, Poles, and certain Near East races may serve as an example of what can be done in adapting immigrant tastes to American foods. Recipes for each nationality are to be found in the Appendix.

REPLACING ITALIAN FOOD

The Italians who come to America are the peasants or country land workers. They are heavily taxed at home; ready money is scarce, and saving is a slow process. The needs of the family are supplied directly or by exchange with neighboring farmers. Italy has a climate much like that of California, which gives the people a long farming season. But in the hottest part of the summer in southern Italy very little work is done during the middle of the day.

Wheat, corn, and other cereals, vegetables, fruit, chickens, pigs, and goats' milk, constitute the food products of the farms. A greater variety is found on some farms than on others, depending on the ambition and energy of the farmer. The Italians make their own cheese from goats' milk; they lay in a store of dried peppers and strings of garlic for

the winter, and they make enough tomato paste to last during the season. Here and there one finds

olives raised for family use. These are pickled, both ripe and green, and used not only as a relish, but cooked with macaroni or, in northern Italy, with corn meal.

The country people of northern and central Italy have a well-balanced diet, with protein from milk, cheese, eggs, and meat; carbohydrates from bread, and various forms of macaroni; mineral matter from fruits and vegetables; fat from olive oil; and vitamines from milk, vegetables, and egg yolks. Southern Italians obtain a more varied diet than the other two groups, by the addition of innumerable kinds of fish. The Italians in the cities use more pastry and cake than the country people, and have altogether a more expensive and varied diet.

In the United States the Italians find plenty of the foodstuffs to which they are accustomed, but everything is very expensive, notwithstanding the higher wage scale. More meat can be had than in Italy, and they enjoy that. The high price of eggs is almost completely prohibitive. They like vegetables, but to use enough of them to get the amount of satisfaction and bulk to which they are accustomed, costs too much. Milk is considered a drink, and is purchased only after the solid food is bought.

These conditions result in one of two compromises: either they leave out both milk and meat and live largely on starches-bread, macaroni, and potatoes --and vegetables; or meat is used at the sacrifice of both vegetables and milk. The health of the family naturally suffers through this change of diet.

The Italian woman, when she cooks a meal, spends much time and care, and the results are very appetizing. This fact shows what an apt pupil she would be if taught early on her arrival how to market, what familiar foodstuffs can be secured, what substitutes can be used, and what a day's dietary, breakfast, dinner, and supper, should contain, and why.

In furnishing this instruction, native dishes and raw-food materials should be included wherever possible. If olive oil is a luxury, other vegetable oils, of which we have several, may be introduced. Soups may be given the Italian flavor of tomato or garlic or both. To them may be added macaroni in one of its various forms, or rice, and this will furnish thickening in place of eggs. Milk soups will be acceptable only when highly flavored or after the family have learned to like white sauces. Vegetables the Italians have always liked, and when their value is explained they are often willing to substitute them for meat.

The Italian children are put on the adults' diet as soon as they are out of swaddling clothes. The larger the abdomen the stronger and healthier the mother considers the child. A diet of milk, strained cereal, and fruit juices is unknown to an Italian mother. The children learn to take tea or black coffee and bread without butter, for breakfast. Usually this means a meal of 200 to 250 calories, composed of carbohydrates, instead of one of 500 calories, combining protein, carbohydrates, mineral matter, and fats. At noon the meal often consists again, as with the adults, of bread with a piece of bologna and more tea or coffee. At supper time comes the big meal of the day. Too large an amount of macaroni

or rice, and lard, is usually included in the diet, with few vegetables and little fruit, and often the children suffer from constipation because of this excess of starch.

Very often bringing a child back to normal health and development is only a matter of readjusting diet. With a slight knowledge of their predilections this can be done. They do not need to be encouraged to eat macaroni, vermicelli, or spaghetti. They are quite ready to eat oatmeal or rolled oats if these are cooked in milk and with raisins. Undernourished children should be given soups and milk, plain or in custards. Other recipes for children may be found in the Appendix.3

A constipation diet includes vegetables, cooked in any of their many different appetizing ways, and fresh fruit or fruit juices. When constipation is found among Italians it is usually because they have been financially unable to secure vegetables, fruit, and olive oil, and have lived exclusively on macaroni, rice, and lentils.

If any protein is to be allowed to an Italian with nephritis, cheese should be selected. He does not miss the other forms of protein so much. He uses very little meat at any time; eggs are used as thickening and would not be missed if another thickening were used, but cheese furnishes flavor for many dishes.

Tuberculosis patients may be given milk in the forms prescribed for undernourished children, and eggs in soups. The Italian people are not in the habit 2 Ibid., recipes 5, 6.

1 See Appendix, recipes 1, 2, 3, 4. 3 Ibid., recipes 7, 8, 9, 10, 11.

of using soft eggs, although they have many recipes for using hard-boiled eggs. Patients can be taught to eat them poached or dropped, and served with a little grated cheese. Sugar may be prescribed in fruit compotes or in stewed fruits, made of either fresh or dried fruits. Raisins and almond paste are

other forms of sweets.

Diabetic patients find it very hard to go without pasta or macaroni. Among the poorer people it has been the staple at every meal. Vegetables, used by them in many combinations, are prescribed for this disease. Tomatoes may be scooped out and have an egg dropped in each, then placed in a small dish and baked until the eggs are set. Mushrooms are often chopped and baked in tomatoes. Beans of all kinds must be forbidden. Often the use of mushrooms may be encouraged in their place. Endive is enjoyed, as are dandelions and spinach.

If Italians can secure the diet they prefer, it is usually well balanced, and the women are naturally good cooks. A person who knows the native dietaries can help them to adjust themselves successfully to the conditions in this country.

JEWISH RELIGIOUS RESTRICTIONS

The wanderings of the Children of Israel since Bible times have made them an international race. They have known all countries, and adapted themselves to different climates and products. Because of these conditions they have a more varied dietary than any other people. They know the Russian, Polish, German, Spanish, and Italian foods, and have adapted them to their dietary laws.