Past exam of the medicine course of the University of Oxford / 1864 / First examination / Anatomy and physiology / 3

What properties must a substance possess to justify you in speaking of it as a “Food ?” Classify such substances.

A food supplies material or usable chemical energy that contributes to the organism's maintenance, growth or normal function after ingestion and physiological processing. It must be usable in the amount and form supplied, without its harmful effects defeating that nutritive role. Mere combustibility, a pleasant taste, or the presence of carbon and nitrogen is insufficient.

An edible material may need digestion before its constituents can be absorbed. A protein need not enter the blood unchanged to nourish: hydrolysis supplies absorbable amino acids. Conversely, a substance can burn in a laboratory yet furnish little accessible energy to human metabolism. The nutritional value of a mixture depends on availability, proportions and the organism consuming it. No requirement says that each separate food must contain every constituent of a complete diet.

A useful nineteenth-century division separates nitrogenous or plastic foods from non-nitrogenous or respiratory foods. The first includes animal and plant proteins, which supply amino acids for tissue renewal. The second includes carbohydrates and fats, whose oxidation supplies much of the body's energy. But the division is functional rather than absolute: proteins can also be oxidized, and lipids and carbohydrates supply material for cellular structures as well as fuel. The modern account follows anabolism and catabolism rather than assigning each class one exclusive destination.^[ref]

A fuller classification includes proteins; carbohydrates, including sugars and starch; lipids, including fats and essential fatty components; water; and required mineral constituents. Water provides solvent, transport medium and a participant in many reactions. Mineral constituents supply, among other needs, ions for electrical and osmotic functions and material for mineralized tissues. Neither class has to supply combustible energy to be indispensable. Meat, milk, grain and legumes are mixtures spanning several classes, rather than chemically pure examples of just one.

In modern classification, vitamins and other required micronutrients must also be included. Their specific deficiency roles and present classification should not be attributed wholesale to 1864. Dietary fibre is not equivalent to digestible starch; it can have important intestinal functions, and fermentable fractions can contribute metabolites through the microbiota. The adequacy of a diet concerns the whole combination of nutrients and the person's requirements, not a single measure of heat released on burning it.^[ref]

Oxygen is essential to ordinary aerobic life, but in the usual dietary sense it is a respiratory input rather than an ingested food class. Likewise, a drug that changes appetite or stimulates a physiological response is not thereby a substitute for nutritive material. A convincing experiment on food value must distinguish failure to eat, failure to digest or absorb, and a genuine missing dietary constituent; maintaining equal gross food mass alone does not control those differences.