“Metabolic Kitchen” To Aid Medical Research

Press, Volume CII, Issue 30154, 11 June 1963, Page 10

“Metabolic Kitchen” To Aid Medical Research

A “metabolic kitchen” due to start operating every soon in the Medical Unit at the Princess Margaret Hospital would lead to new possibilities in research into, and treatment of metabolic disorders, the director of the unit (Dr. D. W. Beaven) said yesterday. Metabolic disorders are those in which something is wrong with the body’s metabolism —the series of chemical changes by which life is maintained. Diabetes and goitre are typical examples. The object of the special kitchen is to enable an exact measurement of the food intake of certain patients. Their urine and faeces will also be collected and analysed, and in this way checks can be made on their bodies’ metabolic capacity.

“We have been trying for some time to make these measurements using food supplied by the ordinary hospital kitchen, but there have been very great difficulties,” Dr. Beaven said.

“We have found it essential that the dietitian who plans the meals and the staff -member who cooks and serves them shall have close contact with the doctor and ward sister and other staff in charge of the patient. It is a matter for team work.” The team work extended to the patient, or he or she must know exactly what was needed and be prepared to carry out instructions to the letter. "If a patient goes to the toilet other than in the special containers provided, or eats a sweet or a piece of fruit brought m by a friend, all our work is for nothing, and may even mislead us seriously as to the patient's condition,” Dr. Beaven said. Careful Planning The meals to be served to each patient were planned to the last detail even before he or she entered hospital. Wherever possible, the dietitian or some other member of the staff visited the patient at home to explain what was going to happen and to find out the patient’s likes and dislikes and the ordinary home diet; alternatively, the patient was asked to visit the dietitian at this stage. It was necessary to conform as far as possible to a patient’s ordinary eating-habits, as otherwise food was likely to be refused; refusal led to undesirable complications in

measurement, and if repeated could ruin the investigation. Moreover, the meals were kept as uniform as possible to simplify analysis, and it would be too hard on patients to ask them to eat something they did not particularly like, for what might be three weeks on end. The kitchen procedure was to divide each meal exactly into two. One half went to the patient, the other half was mixed thoroughly in a homogeniser and then sampled for analysis. If a patient could not eat the whole helping, the remains had to be homogenised and a further analysis made. A piece of bread was provided as part of the meal so that the patient could wipe round the plate to prevent loss of any of the food. As an extra precaution to make sure no patient used the wrong food or toilet container by accident, all utensils were soon to be coloured distinctively. Initially, only one or two patients would be studied at any one time, but it was hoped that eventually numbers would be built up to three or four. Some of these might be ordinary healthy persons used as “controls” to see what happened to food elements in normal subjects under the conditions of the investigation unit The first work would be on the calcium balance of the metabolism of certain patients, but sodium and potassium balance studies were also planned. The kitchen was created by minor alterations at small cost in under-used space in Ward 83.