WE ALL have some pet notions about -what makes us work well, be it the mid-morning pick-me-up of coffee and a plate of snacks or a chocolate bar or a heavy meal. But according to tastes and experiments made on the relation of food to work accomplishment, the merit in most of these theories comes more from habit or psychological reasons than the actual relation of nutrition to energy. This is obvious from the kind and amount of food the various mountaineering expeditions carry with them. All of these expeditions come from different parts of the world and even if they are going to climb the same area the food differs greatly in size, shape, taste and ingredient. Each of them have their own success stories and sense of satisfaction once the expedition is over as far as the food menus are concerned.
In comparison look at the diet of the Eskimos, possibly the most cruel and most demanding conditions anywhere in the world are those imposed on man by numbing cold and the empty wastes of the Arctic country. Most of us have difficulty imagining how the Eskimos manage to survive, especially since their diet is necessarily devoid of such seeming staples as greens and dairy products. However, their survival is not nearly the struggle we think it to be, they actually thrive on the rugged life they lead and the limited variety of foods available to them. They are much healthier and less troubled than their partially civilized brothers. They have almost no tooth decay and do not suffer from any modern man's contagious or degenerative diseases.
Similarly the Sherpas in the Himalaya thrive on the limited variety of food that is available to them. They move around freely without any of the side effects which are experienced by some of the members of the expedition going there. Similar revelations can be obtained from other primitive races. It is concluded that though most of the native diets are also based on tradition, they all show a keen knowledge of what the body needs to stand up against life in rugged lands. And the diets, limited as they are, still show more than sufficient nutritional values probably due to the fact that all foods are eaten intact with none of the ingrown nutrients disturbed. The activities, the food and the life-style being constant there are no extra nutritional demands. But let a tribe be near a trading post, let a government boat bring civilization to a group of these people, and the health and stamina are sure to break down. Dental caries flourish, tuberculosis becomes a major problem and in fact the mortality rate skyrockets.
Look at the diet of the Eskimos. A big staple is salmon which they catch and freeze at the height of the season and which is eaten dipped in seal oil, known to be rich in Vitamin A. Caribou, nuts and kelp round out the diet of these hardy people. Similarly the staple of rice and potatoes accompanied by millets give Sherpas their high carbohydrate requirements. These are again rich in all the amino-acids with an alkaline balance which is most needed. Millets like ragi are often fermented after soaking and grinding, to make a certain kind of drink. Organ meats are eaten which supply most of the vitamins otherwise available in fresh vegetables.
But to understand the implications of such statements a deeper insight into the workings of the nutrients and their relationship with the body is very necessary. The health-conscious person of today seeking information on diet which will guarantee the best possible health and protect him against nutritional deficiencies, is often told to eat a good, well-rounded diet. The well-rounded diet or the so-called balanced diet is never spelled out. A list of general categories of food is often handed out with general instructions like, 'Eat some of these every day and you can't help but be healthy'. The nutrition columnists, the women's magazines, TV programmes and even the documentaries are no different.
Fifty-odd years ago such advice was sound. Today the traditions and habits being the same the main ingredients are slowly changing. The focus is on soft drinks, commercially prepared candy, soft bakery products, etc., ice creams and fried savoury titbits. On the other hand cereals are refined to the point where no nutrients are left in them, e.g., rice, pulses, wheat, etc. The consumption of white sugar is soaring with each successive year. Fats these days invariably are denatured, refined, bleached, deodorized and hydrogenated. The deficiencies do not show overnight, neither are they of similar nature in each person. Biochemical individuality is the answer to this riddle.
There are some more reasons for the individual deficiencies— polluted air, insecticides, diseases of the digestive tract, consumption of antibiotics, sulfa drugs, pain-killers, antacids, mineral oils or tablets for constipation as well as mental stress and strain together with increased physical activity. Socio-economic factors and changing cooking methods also lead to increased demands of nutrients. All this is evident from the statistics of the degenerative diseases which are changing too fast to be accurate. One can imagine the state of health on the same type of food carried to the place where environment itself demands extra nutrients. Mountaineers should study these points. Most mountaineers lead a city life with all its ailments, pollution and unbalanced diets. Hence to perform well on an expedition the nutritional needs of the body must be strengthened before and during the climbing period. Any use of the body reserves must be replenished upon return by sensible diet. This will lead to a better performance on the mountains. It will also help to avoid any physiological imbalance on the mountains in the short-run and long contribute to a healthy and climbing career in the long run. To do some-thing about it, it is very necessary to learn the real concept of nutrition beyond the mere definition of a balanced meal.
According to a vast amount of research done on the subject of nutrition so far it is stated that the body needs some 40 odd nutrients to carry on the work of the cells which is essential to human life and health. These 40 nutrients cannot be made in the body. They are to be supplied through food and hence called 'essential nutrients'. These are as follows:
1 essential fatty acid called EFA
10 ammo-acids called Essential Amino-Acids
15 vitamins—A, B group, C + P, D, E and K
14 to 18 minerals including trace minerals.
According to Dr Roger Williams of the University of Texas there is probably only a handful of people who can do away with the daily recommended allowance stated by various nutritional authorities. The overwhelming majority of humans need much more than the recommended daily allowance (RDA) due to the various factors stated earlier. If these demands are not satisfied the body cells will fail to function properly. This is when diseases take over, may be slowly, but surely. All these nutrients work as a team in the body. They are known in general terms as proteins, carbohydrates, fats, vitamins and minerals accompanied by natural roughage and water.
Definition of 'individual functions' and 'daily requirements' are laid down in most books on nutrition and as such they are known to people interested in health in general. But the little known facts about these nutrients are extremely important for people who are interested in health for a sport like mountaineering in particular.
Proteins as we all know are the basic building blocks of our body. But unless all the 10 essential amino-acids are supplied at one and the same time, they will not function efficiently in the body. Many will argue that flesh foods always contain all the 10 essential amino- acids at one and the same time. But even these, unless accompanied by Vitamin A, have no way of getting together into the protein chain which the blood-stream then supplies to the cells where it becomes the body's building blocks. On the other hand vegetarian proteins are always incomplete in the sense that cereals, pulses, legumes and leafy vegetables by themselves are incomplete. A combination of all of them eaten at one and the same time only will give the benefit of all the 10 essential amino-acids. 'Togetherness' of protein and Vitamin-A deficiency and protein malnutrition frequently occur together. Just as the absorption of protein is impaired when there is not enough Vitamin A, so also the absorption of dietary Vitamin A is impaired when there is acute protein malnutrition. Daily requirements in everyday life are 50 g of Vitamin A. This remains constant in all physical activities and stages of life except in cases of growing age and pregnant and lactating mothers.
Fats are included in our diet mainly to supply 1 essential fatty acid (EFA) called linoieic acid. Like essential amino-acids this EFA can- not be made in the body but should be supplied through foods. If linoleic acid is present in the diet and all the other 39 necessary nutrients are also present the body can synthesize two other EFAs, namely linolenic and arachidonic acids, in the body. EFAs are nutritionally very important. Many processes involved in metabolism will not take place in the absence of EFAs.
Safflower seed, sunflower seed, sesame seed, walnut and soya oil contain more linoleic acid than corn, peanut or cottonseed oil and many times more than olive oil. But because peanut oil is rich in arachidonic, saffiower and sesame seeds in linoleic and soya oil in linolenic acid it is best to use a combination of all of these. A combination of seasame seed and peanut oil in unrefined filtered form is most recommended. The reason being the absence of Vitamin E in refined oils. This vitamin, which is supposed to give protection to EFA, is lost in the process of refining due to high heat. If this fact is overlooked, one essential fatty acid is missing from a so-called balanced diet if the fats used are refined. Even the polyunsaturated oils, if refined, cannot give the benefit of EFA. Margarine and hydro- genated fats are also unable to give EFA. Therefore the only answer is to use cold pressed unrefined (filtered) oils or respective oilseeds in their natural form. Care should be taken to see that none is rancid. The daily requirement is 40 g in all cases.
The forms in which carbohydrates are consumed are often misunderstood. All natural grains (cereals, pulses, legumes and millets) with the skin on, all tubers (potatoes, sweet potatoes, yams) with their skin on, all dry fruits especially dates, figs, currants and apricots etc., will provide vitamins of B group and most of the minerals while supplying the necessary energy. Honey and jaggery also perform the same function. It is only the refined sugar or glucose which provides instant empty calories (i.e. only calories without any vitamins and minerals). One major difference is that while sugar gives rise to acid reaction in the intestine all the other carbohydrates give alkaline reaction. The energy supplied by natural carbohydrates is of sustaining type whereas energy supplied by glucose and sugar is not only shortlived but it induces more desire to eat more sugar on each successive consumption.
Vitamins and minerals are not found in the sense that proteins, carbohydrates and fats are. They do not provide calories. Proteins, carbohydrates and fats are broken down into other substances which the body uses in the process of metabolism, thus providing energy. But this function is not possible unless assisted by respective vitamins with minerals acting as metallic co-enzymes. As we have seen earlier, proteins require Vitamin A; similarly carbohydrates require the entire group of Vitamin B and the fats require Vitamin E. Unlike proteins, carbohydrates and fats, vitamins and minerals retain their original form in the body and are built into the body structure, where they are important parts of the machinery of all cells. Just by their presence in the cells, they bring about certain changes and processes in the body.
Like hormones, vitamins regulate body processes. As in trace minerals, such as iodine, the presence or absence of vitamins and minerals in very small amounts means the difference between good and poor health. But remember that 15 odd vitamins and 14 odd minerals cannot be made in the body. They have to be supplied through food.
The basic functions of each individual vitamin and mineral are described in detail in most books on nutrition and even in the charts produced by nutritionists. They can be studied as they are given elsewhere but the little-known facts about the complementary and antagonistic nature of these vitamins need careful study.
Vitamin A comes in two forms, retinol as preformed and carotene as precursor. Retinol is available in eggs, liver of all animals and in all the oils of fish livers. Sea fish and river fish have slightly different composition whereas carotene, a yellow substance found in green and yellow or orange vegetables or fruits, is not available to the body unless the textures are unusually soft. Absence of Vitamin B Complex calcium, 10 essential amino-acids and certain other minerals and the efficient functioning of liver in the body together with gastro-intestinal disorders etc. does not allow many individuals to obtain enough of Vitamin A unless their diets are supplemented. When the need increases over and above daily requirements of 5000 I.U. carotene will not be of much help.
Vitamin D is also called sunshine vitamin, but winter sunshine is of not much help. In winter, or on heights, most of the body is heavily covered. Absence of Vitamin D will affect directly the efficient functioning of Vitamin A, calcium and indirectly many other minerals. In normal individuals blood levels of 25 HCC (the circulating type of Vitamin D) were found to be at their lowest. Winter, steroid therapies, rheumatism all increase the need for this vitamin and the recommended daily allowance of 400 I.U. falls far short of this increased demand from dietary sources.
Vitamin E, the most controversial vitamin, is labelled a life saver by many nutritionists and useless by many others. It was there in our diets when oils were cold pressed and not refined or hydrogenated, then wheat flour was stone-ground at slow speed. Simultaneously when the consumption of fully grown dark green leaves as vegetables was substantial. The need for Vitamin E increases with increased oil consumption, specially of PUFAS (polyunsaturated type), fried foods, high altitudes. High heat and chopping renders Vitamin E enzy- matically useless. In the absence of Vitamin E, protection to Vitamins A and D and to Vitamin C is lost with the result that calcium and iron also cannot function properly. Modern civilized ways of living and eating require much more Vitamin E than is contained in the daily recommended allowance of 30 I.U. With deficiency of Vitamin E the net result is that the cells are oxidized faster. Faster oxidization of cells leads to faster deterioration. This factor is particularly harmful to mountaineers.
Vitamin K, since much of our supply of Vitamin K is manufactured by bacteria in our intestines, it is extremely important that we maintain our colonies of benign intestinal flora in good condition. Unfortunately in an effort to keep us healthy the medical profession sometimes uses antibiotics or sulfa drugs so liberally as to make this task difficulty and sometimes impossible. Unfortunately deficiency sometimes might create hemorrhaging problems, especially in surgery. Although the problem is worldwide no definite daily allowance of Vitamin K has been established. Excess would induce faster than average clotting, which is as dangerous as hemorrhage. Maintaining the intestinal flora and including some foods like soya beans, potatoes, peas, lean meat, spinach, cabbage, cauliflower, tomatoes, and pork liver is a safe bet.
40. Climbing Meru North (6672 m) via north ridge. Photos: S. Friedleuber Note 10
41. Climbing Meru North (6672 m) Note 10
42. Meru North as seen from Meru West (6361 m) Note 10
Vitamins A, D, E, and K are oil-soluble and efforts at crash dieting on boiled food may lead to deficiencies in most of them.
B Complex Vitamins are water-soluble. They are lost in many cooking processes — soaking, and peeling .vegetables, heating and cooking, Antibiotics, sulfa drugs, oral contraceptives, pain-killers, steroid therapies, stress situations like pregnancy, surgery illness, extreme vegetarianisms as well as high-protein diets are all somewhat antagonistic to the B complex vitamins in one way or other. Complications arising from deficiencies in these vitamins will lead to many bad symptoms. Excessive refined carbohydrates such as sugar increase the demand for the group B of vitamins. One prominent side effect is on the teeth, because of disturbance of pH factor. It changes the saliva into acid reaction. The only good sources of B group vitamins are liver, yeast, and wheat germ. Meat, nuts, seeds and vegetables contain less but can lead to increased availability of these vitamins. Bacteria obtained from yogurt or acidophilus milk synthesize these vitamins in the intestine. But the quantities are not easily measured. The recommended daily allowance of individual vitamins in this group ranges from below 1 mg to 6 mg level. The supplementations are to be examined carefully as all are not the same in content. Natural sources from food are necessary along with supplementations.
Vitamin C (ascorbic acid) always works efficiently with bioflavonoids. Both are available in citrus fruits. The discarded white portion of citrus fruits and the stems of vegetables are particularly rich sources of bioflavonoids. Both are extremely volatile and water- soluble. Exposure and heat, air, soaking in water, juicing as well as aspirin, corticosteroids, fatigue, smoking, alcohol, diabetic state are all antagonistic to Vitamin C. In the absence of Vitamin E and without the help of calcium and bioflavonoids Vitamin C is lost. The daily recommended allowance is 75 mg. Without Vitamin C calcium will not function properly.
Mineral Elements. It is often said that valuable things come in small packages. About 14 to 16 mineral elements account for only 4% of the body weight. Yet the absence of any one of these elements can cause serious problems. An excess of some of them can be toxic. The best known are calcium, iron, zinc, copper, sodium and potassium. Again most of the functions of calcium, iron etc. .are known to many. What is to be known is the antagonistic nature of some nutrients which renders these mineral elements sometimes unavailable to the body. The important functions of the minerals together with the trace elements is to speed up enzymatic action of vitamins, maintenance of water balance as well as acid base balance in the body. All natural foodgrains including tubers and millets are good sources. Requirements are less than 1 g daily.
The minimum, daily recommended allowances are for a person who is in perfect health. But judging from, some of the factors so far discussed, it is clear that there are many conditions and circumstances which can cause a person either to lose nutrients or to need them more than the normal day's allowance. The symptoms which are experienced by different personnel on different expeditions may indicate that there is a need for some nutrients to be added in extra strength. Nausea, sensation of - vomiting, dementia, loss of appetite, sleeplessness are symptoms generally linked with deficiencies of vitamins of B-group. Dizziness, breathlessness, need more Vitamin E. Extreme .cold temperatures, glare from, snow and the diets which are based, on high proteins all increase the need for Vitamin A. Absence of sunlight increases the need, for Vitamin D. Cold temperatures increase the need for Vitamin C and so on. Some of the factors like processed foods, tinned foods, absence of fresh and green vegetables and fruits to which a civilized person is accustomed and the absence of dairy products, are also to be considered while planning the supplementation programme for an. expedition. Such diets are often based on refined sugars, starches, chocolates and generally on high carbohydrates. This manipulation in food ingredients to increase the instant calorie count, increases the demand for more B-group vitamins. The demand for minerals also increases. If not supplied these deficiencies will aggravate the problem of acidosis which already creates problems at high altitudes. Besides acid-base balance, the water balance is also disturbed. On the other hand high-protein diets also increase the need for more water consumption. Such diets are antagonistic to the functioning of calcium.
Other problems which might cause deficiencies of vitamins and even nutrients like proteins are the results of the existing inter-relationships of all the 40 nutrients. There are two unvarying rules that apply to all diets for all diseases and all abnormalities — mountaineering can be called one among them. The first is to improve nutrition as soon as the initial symptom is noticed. Enormous amount of suffering could be prevented if this simple rule is followed. The second is to see that each of the 40 body requirements is adequately supplied, erring on the side of taking too much rather than too little of the nutrients that meet the needs of stress. While most medications are effective alone no nutrient is of value unless accompanied by 39 others.
It is often stated and as shown earlier that capacity to do physical work does not necessarily depend upon the state of nutrition. It is possible that long-standing inadequacy of diet elicits available mechanisms of adaptation. But what if this adaptation is carried out at the expense of the body's reserves of nutrients in the cells? Thus a mountaineer who spends a long period in isolation may operate well even with bad nutrition diet. But the body reserves will be used. These should be stocked in advance and refilled upon return. And still why suffer nutritional imbalance while performing a vigorous activity like climbing?
It seems to be practical to have a check on oneself nutrition wise, many days prior to the programme of expeditions. During this period, and even after the expedition is over it is wiser to plan the diets based on most of the natural foodgrains, nuts, tubers and green leafy vegetables and fruits. Oils and fats should also be given a thought as stated earlier. So also to refrain from eating white sugar and flour and all the products prepared from, them for some days prior to departure seems a wise investment. Milk and other protein foods based on flesh foods eaten in moderation will pay dividends. During the expedition, fortifying the foods with necessary supplementation seems to be the only answer. Thus these factors must be considered while planning food for an expedition. These thoughts are purely based on the principles of nutrition which do not change whereas diets may change and vary.