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The upcoming centenary events concerning World War One (WWI) provide an opportunity to consider the historical lessons from this conflict including those related to nutrition and military planning. Part of this conflict involved the New Zealand Expeditionary Force in a multi-country campaign on the Gallipoli Peninsula in Turkey. This campaign ran from April 1915 to January 1916, at which time a withdrawal from the peninsula occurred.1 There were an estimated 7991 casualties (57% of the NZ military personnel) and 2779 died.2 (p275-378) At least 200 of the deaths were from infectious diseases such as dysentery and typhoid.2 (p263)In addition, the official New Zealand medical history of WWI refers to reports of scurvy among the troops (in three places in the report3 (p66, 106, 123)). Furthermore, as Christopher Pugsley notes in his seminal account of New Zealanders at Gallipoli,1 (p346) most of these soldiers ended the campaign too sick and too weak to continue soldiering.The importance of feeding an army properly has long been recognised as critical to its functioning. As Napoleon Bonaparte acknowledged: an army really does march on its stomach.4 (p274) Yet it is well known that military personnel have often suffered from nutritional deficiencies.For example, in the American Civil War, scurvy was diagnosed in 47,000 Union troops and ...by physicians in the field from all theatres of action throughout the war .5 Such cases of scurvy were often successfully treated with the provision of fresh vegetables. Scurvy was a major problem for both armies in the Crimean War5 and there was evidence for it in a number of other historical military settings such as Chinese garrisons and US military outposts.6Evidence of vitamin A deficiency (reports of night blindness ) was also reported for American Civil War troops on both sides and especially during the last year of the war.5 Other work considered night blindness in an Austrian naval crew in 1857-59, which was successfully treated with the provision of ox liver.7 Similarly, in 1863, night blind soldiers in a Paris garrison were successfully treated with cod-liver oil.7Given this background, we examined historical accounts and performed a retrospective analysis of military rations provided to the New Zealand troops involved in the Gallipoli campaign in 1915.MethodsHistorical context To provide context for food supply and consumption by military personnel in Gallipoli, we examined a number of documents written by contemporary authors,3 8-10 and by subsequent historians and researchers1 2 5 11-13 (including one of us14).Scenario development Table 1 details the specific scenarios we considered which included replicating the actual military food rations as best as possible (Scenario R-A ) but also to describe three possible alternatives. These were: (i) to slightly improve the amount of food variety in the 1915 rations by providing less corned beef and more fruit and vegetables (Scenario R-V ); (ii) to achieve modern nutritional recommendations for the lowest cost (optimised dietary pattern, Scenario R-O ); and (iii) to perform the latter but with more food variety (Scenario R-OV ).We suggest that it is very plausible that increased food variety and access to more vegetables and some fruit would have been desired by the soldiers (Scenario R-V), and that military planners could have considered this given prior evidence for problems with scurvy in the American Civil War, Crimean War and other preceding military situations (see Introduction). Nevertheless, it is acknowledged that the more optimised scenarios (R-O and R-OV) are completely hypothetical given the limitations of nutritional science in 1915.In Table A1 (see Appendix 1) we list the actual rations as used by the New Zealand Expeditionary Force and documented on 13 April 1915.3 (p543) The nearest equivalent modern foods used in the various scenarios are detailed in Tables A2 and A3.Nutrient requirements and data used For the scenarios involving optimisation of nutrients (R-O and R-OV in Table 1) we generally used the modern day estimated average requirements (EARs) of nutrients per day for adult men which are based on values set for Australia and New Zealand.15 But we also considered current nutrient intakes for men from the New Zealand Adult Nutrition Survey (NZANS).16 Further details are provided in Table 3. For food composition data we used the 2012 New Zealand food composition database (http://www.foodcomposition.co.nz/foodfiles).Food prices To estimate the likely costs of the different scenarios, we used current 2011/12 food prices. These came from the official food price index (average monthly data for New Zealand in 2011)17 or when not available, supermarket prices (as detailed in Tables A2 and A3 in the Appendix 1).Approach to mathematical modelling and uncertainty For the nutrient optimisation we used the simplex algorithm to solve this linear programming problem (see Briend et al18 for a detailed description of the latter). The scenarios were modelled in Microsoft Excel 2010 (Excel Solver, Simplex method). Details of the uncertainty analysis are in the Appendix 1. Table 1: Specific nutritional scenarios used for the analyses of the actual military rations of 1915 and alternatives Name and aim of specific scenario Additional details Scenario R-A : To replicate the actual military food rations We used the nearest-equivalent modern foods, see Table A2 for further details of these rations. The modern food nearest equivalents we used are detailed in Table A3. Scenario R-V : To slightly improve variety of the 1915 rations In this Scenario we simulated a better attempt by the planners of military rations to approximate the typical NZ diet at the time i.e., more vegetables and fruit. So we halved the amount of corned beef (down to 227 g) and added: 1 cup each of the two cheapest canned vegetables (tomatoes [240 g], and peas [248 g] - both canned products were available in 1915, see Table A3 in the Appendix 1). 1 cup of the cheapest canned fruit (apricots with syrup [240 g], also available in 1915). Scenario R-O : To achieve modern nutritional recommendations for the lowest cost (optimised dietary pattern) To achieve this optimised diet with the type of dried and canned foods available at the time, while also: (i) achieving the same level of dietary energy as Scenario R-A; (ii) to ignore the modern recommendations on sodium levels (given the food preservation value of high sodium levels in a military field setting). See text and Table 3 for further details on the specific nutrient recommendations. Scenario R-OV : As for Scenario R-O but with more variety As for Scenario R-O above but with progressively lowering the maximum amount of the highest individual food item (by weight) until the variety in the original ration increased the number of foods reaching over 50 g per day to up to 10 different foods. Results Historical reports of food issues That the majority of meals on Gallipoli consisted of corned beef (bully beef), hard biscuits and tea is especially significant to this study. For example, the first New Zealand historian of the campaign, Major Fred Waite, noted: Food was always plentiful (except just after the Great Blizzard in November when stocks ran very low). Tinned meat, jam and hard biscuits and a mug of tea provided 99 per cent of the meals10 (p161) (see Figure 1). On occasion (e.g., near the end of campaign2 (p267)) there were some improvements in the food provisioning. As one soldier remarked: We get very well fed here, considering, but we do miss the fresh vegetables and fruit. We get plenty of rice, tea, sugar, biscuits and bully beef, jam, onions etc and an adequate supply of milk [tinned condensed] and bread. Once or twice we have had an egg each, and yesterday actually had a little fresh mutton served out.14 (p202) Figure 1. Two signallers outside the Divisional Signal Office on the Gallipoli Peninsula (1915) enjoy a meal of bread and jam, washed down with a mug of tea. (The jam did provide a source of Vitamin C but it was not enough.) Source: Used with permission from National Army Museum, New Zealand (Number: 1992.742) An impression of some of the difficulties with food and water supply for the New Zealand military in Gallipoli is suggested by these commentators: After the first two days the battalion had a quiet time in the Walker\u2019s Ridge position. One of the greatest difficulties was in bringing up ammunition, water and food. The track up to the hill, 500 feet above the beach, was very narrow and steep, and exposed to sniping fire from the Turkish trenches; only small loads could be carried by each man, and each trip took a long time.8 With all these discomforts, the exhaustion of labour, the strain of unceasing vigil and shell fire, the lack of nourishing food, and little sleep, there was always a shortage of water and the possibility of no water at all. One pint of water a day was the usual issue9 (p38) (see Figure 2). Other conditions may have limited food intake and palatability: Owing to the annoyance of the flies some sections did not eat anything but a dry biscuit during the daytime. To eat biscuit and jam in the daytime a man had to keep moving the hand that held the food.9 (p37) .... however palatable in a temperate climate, any form of tinned food becomes distasteful in a semi-tropical summer unless ice is available. ... Not only was the clothing inadequate but the food and the feeding of the troops was unsatisfactory.3(p113) In commenting mainly on sanitation, the difficult circumstances for food preparation were described: It is questionable whether any alterations in the dietary - and some were made - could have improved the sanitary situation. The baneful system of individual cooking, then prevalent, would have ruined any ration however good; every man cooked for himself, every dug-out became a midden of fly contaminated food and food refuse.3 (p114) Figure 2. A precious water point at Anzac Cove, Gallipoli Peninsula (1915). Two quarts a day was the normal ration for New Zealand soldiers and it had to be used for all purposes. Most went to make tea. As one New Zealand soldier wrote: \u2018water is worth its weight in gold here\u2019. Source: Used with permission from National Army Museum, New Zealand (Number: 2007.550) Finally, Carbery3 (p113) appears to support a quote in the final report of the Dardanelles Commission, which stated that: there was nothing actively injurious to health in the meat; but it was of poor quality, and, from being salt and stringy, it caused some intestinal irritation and so conduced to diarrhoea . The bulk of the food diet of the New Zealanders at Gallipoli was supplied via the United Kingdom through its Army Service Corps. Generally it was inferior in quality to similar food that originated from New Zealand. Most of the corned beef was supplied from Argentina and Fred Waite commented that it\u2019s poor quality and the fact that it was served for meals three times a day, becomes more than the constitution of a New Zealander can stand .10 (p163) When limited sources of food from New Zealand did arrive in at Gallipoli with the latest batch of Reinforcement drafts, it was much sought after and highly prized. This was especially true of the New Zealand army biscuit which was white, easy to eat and pleasant tasting. In contrast, British army biscuits were hard beyond belief . New Zealand soldiers at Gallipoli tended to nibble the edges of these hard slabs and throw their centres into No Man\u2019s Land.10 (p162) Nutritional analyses The calculated weights of the foods in the different scenarios are shown in Table 2 and the nutrient analysis in Table 3. Of note is that the military rations (Scenario R-A) were far below modern nutritional requirements for vitamin C intake, around a third of the current estimated average requirement (EAR). They were also below the EARs for: vitamin A (33% too low), vitamin E (11% too low), potassium (36% too low), selenium (20% too low) and dietary fibre (36% too low), (Table 3). Relative to modern requirements, the military diet was also excessively high in saturated fat (3.1 times too high) and sodium (5.2 times higher than the 2300 mg upper limit) (Table 3). If the planners of military rations had made these rations somewhat more like the typical New Zealand diet in terms of modest amounts of vegetables and fruit (i.e., one cup each per day of peas, tomatoes and apricots used in our Scenario R-V ), then this would have substantially improved the nutrient quality. In particular it would have eliminated the below EAR intakes of vitamins A, C and E and dietary fibre; improved intake of potassium, but would have made little change to selenium intake. It would also have partly reduced the high intakes of saturated fat and sodium, which is desirable from a health perspective. If the relative food prices are roughly equivalent between now and 1915, then this alternative ration would have been achieved with only a minor increase in cost above the original ration (NZ$ 11.43 per day vs 11.03, Table 3). However, the higher weight (an extra 501 g/day) would have increased transport costs (Table 2). In 1915 there was no possibility that a properly optimised diet could be developed as there was limited knowledge of nutrition and no capacity to apply mathematical techniques such as linear programming. Nevertheless, it is plausible that military planners could have made moderately more use of a variety of canned and dried foods that were available in New Zealand in 1915 and produced in other developed countries. It is also of interest to demonstrate how far modern knowledge and methods can allow for optimal military rations to be formulated. Hence we optimised the military rations using canned and dried foods available in 1915, and found that only six foods would technically be required to meet all nutritional requirements: bread, flour, cheese, rolled oats, dried peas and canned tomatoes (Scenario R-O in Tables 2 and 3). Indeed, this ration would have been healthier in all of the dimensions shown in Table 3. Furthermore, this ration would have cost under half the cost of the original ration and would be a similar weight. Expanding the variety of this optimised ration to include ten items (over 50 g each) as per Scenario R-OV would have probably resulted in additional cost compared to Scenario R-O. But this cost was still estimated to be likely to below that of the original ration (i.e., $9.54 vs $11.03 per day). However, the extra weight of the food (466 g/day) would have increased transport costs (Table 2). The results in Table A3 (see Appendix 1) indicate that cheese was the likely major contributor to vitamin A intake in the rations. For vitamin C it was either jam, followed by dried potatoes (using the USDA food composition data); or corned beef followed by jam (using NZ food composition data). In the uncertainty analysis (Table 5) the mean vitamin A intake was below half the EAR of 625 mcg and the 95% uncertainty interval (UI) never approached this requirement (using both food composition datasets). Similarly, for vitamin C intake with the mean below a quarter of the EAR and the upper limit of the 95%UI never exceeding a third of the EAR. Table 2. Foods (with weights in g/day) included in the various daily dietary scenarios with some of these (in Scenarios R-O and R-OV) selected automatically in the optimisation process Food items Scenario R-A (actual) Scenario R-V (extra variety) Optimised diets Scenario R-O Scenario R-OV Food in the military rations of 1915 (descending amounts) Corned beef (canned) 454 227 0 0 Alternatives: Bread (white) Or biscuit Or flour (white) 187 187 330 225 150 150 0 225 150 150 585 225 Bacon 113 113 0 29 Cheese (cheddar) 85 85 110 82 Jam 85 85 0 0 Sugar (white) 85 85 0 0 Alternatives: Dried peas Or dried beans Or dried potatoes 19 19 19 19 19 19 8 0 0 0 225 0 Salt 14 14 0 0 Mustard 1.4 1.4 0 0 Pepper 0.8 0.8 0 0 Additional foods that could have been used in 1915 (see Appendix 1) Peas (canned) - 248 0 0 Apricots (canned) - 240 0 107 Tomatoes (canned) - 240 353 225 Oats (rolled) - 0 337 225 Peaches (canned) - 0 0 225 Fish (canned) - 0 0 56 Other** - 0 0 0 Total food weight g/day 1382 1883 1724

Summary

Abstract

Aim

Amongst New Zealand soldiers in Gallipoli in 1915 there were reports of poor food quality and cases of scurvy. But no modern analysis of the military food rations has ever been conducted to better understand potential nutritional problems in this group.

Method

We analysed the foods in the military rations for 1915 using food composition data on the closest equivalents for modern foods. We compared these results with other plausible diets and various optimised ones using linear programming.

Results

Historical accounts provide evidence for poor food quality supplied to these soldiers. The nutrient analysis suggested that the military rations were below modern requirements for vitamins A, C and E; potassium; selenium; and dietary fibre. If military planners had used modest amounts of the canned vegetables and fruit available in 1915, this would probably have eliminated four of these six deficits. The results from the uncertainty analyses for vitamin C (e.g., 95% uncertainty interval [UI]: 5.5 to 6.7 mg per day), was compatible with the range known to cause scurvy, but the UI for vitamin A intake was only partly in the range for causing night blindness. To indicate the gap with the ideal, an optimised diet (using foods available in 1915), could have achieved all nutrient requirements for under half the estimated purchase cost of the 1915 military rations.

Conclusion

There is now both historical and analytic evidence that the military rations provided to these soldiers were nutritionally inadequate in vitamin C, and probably other nutrients such as vitamin A. These deficits are likely to have caused cases of scurvy and may have contributed to the high rates of other illnesses experienced at Gallipoli. Such problems could have been readily prevented by providing rations that included some canned fruit or vegetables (e.g., as manufactured by New Zealand at the time).

Author Information

Nick Wilson1; Nhung Nghiem1; Jennifer A Summers1; Mary-Ann Carter1; Glyn Harper2. 1. University of Otago, Wellington, New Zealand. 2. Professor of War Studies, Massey University, Palmerston North, New Zealand

Acknowledgements

Correspondence

Associate Professor Nick Wilson, Department of Public Health, University of Otago, Wellington, PO Box 7343 Wellington South, 6242 New Zealand.

Correspondence Email

nick.wilson@otago.ac.nz

Competing Interests

Nil.

For the PDF of this article,
contact nzmj@nzma.org.nz

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The upcoming centenary events concerning World War One (WWI) provide an opportunity to consider the historical lessons from this conflict including those related to nutrition and military planning. Part of this conflict involved the New Zealand Expeditionary Force in a multi-country campaign on the Gallipoli Peninsula in Turkey. This campaign ran from April 1915 to January 1916, at which time a withdrawal from the peninsula occurred.1 There were an estimated 7991 casualties (57% of the NZ military personnel) and 2779 died.2 (p275-378) At least 200 of the deaths were from infectious diseases such as dysentery and typhoid.2 (p263)In addition, the official New Zealand medical history of WWI refers to reports of scurvy among the troops (in three places in the report3 (p66, 106, 123)). Furthermore, as Christopher Pugsley notes in his seminal account of New Zealanders at Gallipoli,1 (p346) most of these soldiers ended the campaign too sick and too weak to continue soldiering.The importance of feeding an army properly has long been recognised as critical to its functioning. As Napoleon Bonaparte acknowledged: an army really does march on its stomach.4 (p274) Yet it is well known that military personnel have often suffered from nutritional deficiencies.For example, in the American Civil War, scurvy was diagnosed in 47,000 Union troops and ...by physicians in the field from all theatres of action throughout the war .5 Such cases of scurvy were often successfully treated with the provision of fresh vegetables. Scurvy was a major problem for both armies in the Crimean War5 and there was evidence for it in a number of other historical military settings such as Chinese garrisons and US military outposts.6Evidence of vitamin A deficiency (reports of night blindness ) was also reported for American Civil War troops on both sides and especially during the last year of the war.5 Other work considered night blindness in an Austrian naval crew in 1857-59, which was successfully treated with the provision of ox liver.7 Similarly, in 1863, night blind soldiers in a Paris garrison were successfully treated with cod-liver oil.7Given this background, we examined historical accounts and performed a retrospective analysis of military rations provided to the New Zealand troops involved in the Gallipoli campaign in 1915.MethodsHistorical context To provide context for food supply and consumption by military personnel in Gallipoli, we examined a number of documents written by contemporary authors,3 8-10 and by subsequent historians and researchers1 2 5 11-13 (including one of us14).Scenario development Table 1 details the specific scenarios we considered which included replicating the actual military food rations as best as possible (Scenario R-A ) but also to describe three possible alternatives. These were: (i) to slightly improve the amount of food variety in the 1915 rations by providing less corned beef and more fruit and vegetables (Scenario R-V ); (ii) to achieve modern nutritional recommendations for the lowest cost (optimised dietary pattern, Scenario R-O ); and (iii) to perform the latter but with more food variety (Scenario R-OV ).We suggest that it is very plausible that increased food variety and access to more vegetables and some fruit would have been desired by the soldiers (Scenario R-V), and that military planners could have considered this given prior evidence for problems with scurvy in the American Civil War, Crimean War and other preceding military situations (see Introduction). Nevertheless, it is acknowledged that the more optimised scenarios (R-O and R-OV) are completely hypothetical given the limitations of nutritional science in 1915.In Table A1 (see Appendix 1) we list the actual rations as used by the New Zealand Expeditionary Force and documented on 13 April 1915.3 (p543) The nearest equivalent modern foods used in the various scenarios are detailed in Tables A2 and A3.Nutrient requirements and data used For the scenarios involving optimisation of nutrients (R-O and R-OV in Table 1) we generally used the modern day estimated average requirements (EARs) of nutrients per day for adult men which are based on values set for Australia and New Zealand.15 But we also considered current nutrient intakes for men from the New Zealand Adult Nutrition Survey (NZANS).16 Further details are provided in Table 3. For food composition data we used the 2012 New Zealand food composition database (http://www.foodcomposition.co.nz/foodfiles).Food prices To estimate the likely costs of the different scenarios, we used current 2011/12 food prices. These came from the official food price index (average monthly data for New Zealand in 2011)17 or when not available, supermarket prices (as detailed in Tables A2 and A3 in the Appendix 1).Approach to mathematical modelling and uncertainty For the nutrient optimisation we used the simplex algorithm to solve this linear programming problem (see Briend et al18 for a detailed description of the latter). The scenarios were modelled in Microsoft Excel 2010 (Excel Solver, Simplex method). Details of the uncertainty analysis are in the Appendix 1. Table 1: Specific nutritional scenarios used for the analyses of the actual military rations of 1915 and alternatives Name and aim of specific scenario Additional details Scenario R-A : To replicate the actual military food rations We used the nearest-equivalent modern foods, see Table A2 for further details of these rations. The modern food nearest equivalents we used are detailed in Table A3. Scenario R-V : To slightly improve variety of the 1915 rations In this Scenario we simulated a better attempt by the planners of military rations to approximate the typical NZ diet at the time i.e., more vegetables and fruit. So we halved the amount of corned beef (down to 227 g) and added: 1 cup each of the two cheapest canned vegetables (tomatoes [240 g], and peas [248 g] - both canned products were available in 1915, see Table A3 in the Appendix 1). 1 cup of the cheapest canned fruit (apricots with syrup [240 g], also available in 1915). Scenario R-O : To achieve modern nutritional recommendations for the lowest cost (optimised dietary pattern) To achieve this optimised diet with the type of dried and canned foods available at the time, while also: (i) achieving the same level of dietary energy as Scenario R-A; (ii) to ignore the modern recommendations on sodium levels (given the food preservation value of high sodium levels in a military field setting). See text and Table 3 for further details on the specific nutrient recommendations. Scenario R-OV : As for Scenario R-O but with more variety As for Scenario R-O above but with progressively lowering the maximum amount of the highest individual food item (by weight) until the variety in the original ration increased the number of foods reaching over 50 g per day to up to 10 different foods. Results Historical reports of food issues That the majority of meals on Gallipoli consisted of corned beef (bully beef), hard biscuits and tea is especially significant to this study. For example, the first New Zealand historian of the campaign, Major Fred Waite, noted: Food was always plentiful (except just after the Great Blizzard in November when stocks ran very low). Tinned meat, jam and hard biscuits and a mug of tea provided 99 per cent of the meals10 (p161) (see Figure 1). On occasion (e.g., near the end of campaign2 (p267)) there were some improvements in the food provisioning. As one soldier remarked: We get very well fed here, considering, but we do miss the fresh vegetables and fruit. We get plenty of rice, tea, sugar, biscuits and bully beef, jam, onions etc and an adequate supply of milk [tinned condensed] and bread. Once or twice we have had an egg each, and yesterday actually had a little fresh mutton served out.14 (p202) Figure 1. Two signallers outside the Divisional Signal Office on the Gallipoli Peninsula (1915) enjoy a meal of bread and jam, washed down with a mug of tea. (The jam did provide a source of Vitamin C but it was not enough.) Source: Used with permission from National Army Museum, New Zealand (Number: 1992.742) An impression of some of the difficulties with food and water supply for the New Zealand military in Gallipoli is suggested by these commentators: After the first two days the battalion had a quiet time in the Walker\u2019s Ridge position. One of the greatest difficulties was in bringing up ammunition, water and food. The track up to the hill, 500 feet above the beach, was very narrow and steep, and exposed to sniping fire from the Turkish trenches; only small loads could be carried by each man, and each trip took a long time.8 With all these discomforts, the exhaustion of labour, the strain of unceasing vigil and shell fire, the lack of nourishing food, and little sleep, there was always a shortage of water and the possibility of no water at all. One pint of water a day was the usual issue9 (p38) (see Figure 2). Other conditions may have limited food intake and palatability: Owing to the annoyance of the flies some sections did not eat anything but a dry biscuit during the daytime. To eat biscuit and jam in the daytime a man had to keep moving the hand that held the food.9 (p37) .... however palatable in a temperate climate, any form of tinned food becomes distasteful in a semi-tropical summer unless ice is available. ... Not only was the clothing inadequate but the food and the feeding of the troops was unsatisfactory.3(p113) In commenting mainly on sanitation, the difficult circumstances for food preparation were described: It is questionable whether any alterations in the dietary - and some were made - could have improved the sanitary situation. The baneful system of individual cooking, then prevalent, would have ruined any ration however good; every man cooked for himself, every dug-out became a midden of fly contaminated food and food refuse.3 (p114) Figure 2. A precious water point at Anzac Cove, Gallipoli Peninsula (1915). Two quarts a day was the normal ration for New Zealand soldiers and it had to be used for all purposes. Most went to make tea. As one New Zealand soldier wrote: \u2018water is worth its weight in gold here\u2019. Source: Used with permission from National Army Museum, New Zealand (Number: 2007.550) Finally, Carbery3 (p113) appears to support a quote in the final report of the Dardanelles Commission, which stated that: there was nothing actively injurious to health in the meat; but it was of poor quality, and, from being salt and stringy, it caused some intestinal irritation and so conduced to diarrhoea . The bulk of the food diet of the New Zealanders at Gallipoli was supplied via the United Kingdom through its Army Service Corps. Generally it was inferior in quality to similar food that originated from New Zealand. Most of the corned beef was supplied from Argentina and Fred Waite commented that it\u2019s poor quality and the fact that it was served for meals three times a day, becomes more than the constitution of a New Zealander can stand .10 (p163) When limited sources of food from New Zealand did arrive in at Gallipoli with the latest batch of Reinforcement drafts, it was much sought after and highly prized. This was especially true of the New Zealand army biscuit which was white, easy to eat and pleasant tasting. In contrast, British army biscuits were hard beyond belief . New Zealand soldiers at Gallipoli tended to nibble the edges of these hard slabs and throw their centres into No Man\u2019s Land.10 (p162) Nutritional analyses The calculated weights of the foods in the different scenarios are shown in Table 2 and the nutrient analysis in Table 3. Of note is that the military rations (Scenario R-A) were far below modern nutritional requirements for vitamin C intake, around a third of the current estimated average requirement (EAR). They were also below the EARs for: vitamin A (33% too low), vitamin E (11% too low), potassium (36% too low), selenium (20% too low) and dietary fibre (36% too low), (Table 3). Relative to modern requirements, the military diet was also excessively high in saturated fat (3.1 times too high) and sodium (5.2 times higher than the 2300 mg upper limit) (Table 3). If the planners of military rations had made these rations somewhat more like the typical New Zealand diet in terms of modest amounts of vegetables and fruit (i.e., one cup each per day of peas, tomatoes and apricots used in our Scenario R-V ), then this would have substantially improved the nutrient quality. In particular it would have eliminated the below EAR intakes of vitamins A, C and E and dietary fibre; improved intake of potassium, but would have made little change to selenium intake. It would also have partly reduced the high intakes of saturated fat and sodium, which is desirable from a health perspective. If the relative food prices are roughly equivalent between now and 1915, then this alternative ration would have been achieved with only a minor increase in cost above the original ration (NZ$ 11.43 per day vs 11.03, Table 3). However, the higher weight (an extra 501 g/day) would have increased transport costs (Table 2). In 1915 there was no possibility that a properly optimised diet could be developed as there was limited knowledge of nutrition and no capacity to apply mathematical techniques such as linear programming. Nevertheless, it is plausible that military planners could have made moderately more use of a variety of canned and dried foods that were available in New Zealand in 1915 and produced in other developed countries. It is also of interest to demonstrate how far modern knowledge and methods can allow for optimal military rations to be formulated. Hence we optimised the military rations using canned and dried foods available in 1915, and found that only six foods would technically be required to meet all nutritional requirements: bread, flour, cheese, rolled oats, dried peas and canned tomatoes (Scenario R-O in Tables 2 and 3). Indeed, this ration would have been healthier in all of the dimensions shown in Table 3. Furthermore, this ration would have cost under half the cost of the original ration and would be a similar weight. Expanding the variety of this optimised ration to include ten items (over 50 g each) as per Scenario R-OV would have probably resulted in additional cost compared to Scenario R-O. But this cost was still estimated to be likely to below that of the original ration (i.e., $9.54 vs $11.03 per day). However, the extra weight of the food (466 g/day) would have increased transport costs (Table 2). The results in Table A3 (see Appendix 1) indicate that cheese was the likely major contributor to vitamin A intake in the rations. For vitamin C it was either jam, followed by dried potatoes (using the USDA food composition data); or corned beef followed by jam (using NZ food composition data). In the uncertainty analysis (Table 5) the mean vitamin A intake was below half the EAR of 625 mcg and the 95% uncertainty interval (UI) never approached this requirement (using both food composition datasets). Similarly, for vitamin C intake with the mean below a quarter of the EAR and the upper limit of the 95%UI never exceeding a third of the EAR. Table 2. Foods (with weights in g/day) included in the various daily dietary scenarios with some of these (in Scenarios R-O and R-OV) selected automatically in the optimisation process Food items Scenario R-A (actual) Scenario R-V (extra variety) Optimised diets Scenario R-O Scenario R-OV Food in the military rations of 1915 (descending amounts) Corned beef (canned) 454 227 0 0 Alternatives: Bread (white) Or biscuit Or flour (white) 187 187 330 225 150 150 0 225 150 150 585 225 Bacon 113 113 0 29 Cheese (cheddar) 85 85 110 82 Jam 85 85 0 0 Sugar (white) 85 85 0 0 Alternatives: Dried peas Or dried beans Or dried potatoes 19 19 19 19 19 19 8 0 0 0 225 0 Salt 14 14 0 0 Mustard 1.4 1.4 0 0 Pepper 0.8 0.8 0 0 Additional foods that could have been used in 1915 (see Appendix 1) Peas (canned) - 248 0 0 Apricots (canned) - 240 0 107 Tomatoes (canned) - 240 353 225 Oats (rolled) - 0 337 225 Peaches (canned) - 0 0 225 Fish (canned) - 0 0 56 Other** - 0 0 0 Total food weight g/day 1382 1883 1724

Summary

Abstract

Aim

Amongst New Zealand soldiers in Gallipoli in 1915 there were reports of poor food quality and cases of scurvy. But no modern analysis of the military food rations has ever been conducted to better understand potential nutritional problems in this group.

Method

We analysed the foods in the military rations for 1915 using food composition data on the closest equivalents for modern foods. We compared these results with other plausible diets and various optimised ones using linear programming.

Results

Historical accounts provide evidence for poor food quality supplied to these soldiers. The nutrient analysis suggested that the military rations were below modern requirements for vitamins A, C and E; potassium; selenium; and dietary fibre. If military planners had used modest amounts of the canned vegetables and fruit available in 1915, this would probably have eliminated four of these six deficits. The results from the uncertainty analyses for vitamin C (e.g., 95% uncertainty interval [UI]: 5.5 to 6.7 mg per day), was compatible with the range known to cause scurvy, but the UI for vitamin A intake was only partly in the range for causing night blindness. To indicate the gap with the ideal, an optimised diet (using foods available in 1915), could have achieved all nutrient requirements for under half the estimated purchase cost of the 1915 military rations.

Conclusion

There is now both historical and analytic evidence that the military rations provided to these soldiers were nutritionally inadequate in vitamin C, and probably other nutrients such as vitamin A. These deficits are likely to have caused cases of scurvy and may have contributed to the high rates of other illnesses experienced at Gallipoli. Such problems could have been readily prevented by providing rations that included some canned fruit or vegetables (e.g., as manufactured by New Zealand at the time).

Author Information

Nick Wilson1; Nhung Nghiem1; Jennifer A Summers1; Mary-Ann Carter1; Glyn Harper2. 1. University of Otago, Wellington, New Zealand. 2. Professor of War Studies, Massey University, Palmerston North, New Zealand

Acknowledgements

Correspondence

Associate Professor Nick Wilson, Department of Public Health, University of Otago, Wellington, PO Box 7343 Wellington South, 6242 New Zealand.

Correspondence Email

nick.wilson@otago.ac.nz

Competing Interests

Nil.

For the PDF of this article,
contact nzmj@nzma.org.nz

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The upcoming centenary events concerning World War One (WWI) provide an opportunity to consider the historical lessons from this conflict including those related to nutrition and military planning. Part of this conflict involved the New Zealand Expeditionary Force in a multi-country campaign on the Gallipoli Peninsula in Turkey. This campaign ran from April 1915 to January 1916, at which time a withdrawal from the peninsula occurred.1 There were an estimated 7991 casualties (57% of the NZ military personnel) and 2779 died.2 (p275-378) At least 200 of the deaths were from infectious diseases such as dysentery and typhoid.2 (p263)In addition, the official New Zealand medical history of WWI refers to reports of scurvy among the troops (in three places in the report3 (p66, 106, 123)). Furthermore, as Christopher Pugsley notes in his seminal account of New Zealanders at Gallipoli,1 (p346) most of these soldiers ended the campaign too sick and too weak to continue soldiering.The importance of feeding an army properly has long been recognised as critical to its functioning. As Napoleon Bonaparte acknowledged: an army really does march on its stomach.4 (p274) Yet it is well known that military personnel have often suffered from nutritional deficiencies.For example, in the American Civil War, scurvy was diagnosed in 47,000 Union troops and ...by physicians in the field from all theatres of action throughout the war .5 Such cases of scurvy were often successfully treated with the provision of fresh vegetables. Scurvy was a major problem for both armies in the Crimean War5 and there was evidence for it in a number of other historical military settings such as Chinese garrisons and US military outposts.6Evidence of vitamin A deficiency (reports of night blindness ) was also reported for American Civil War troops on both sides and especially during the last year of the war.5 Other work considered night blindness in an Austrian naval crew in 1857-59, which was successfully treated with the provision of ox liver.7 Similarly, in 1863, night blind soldiers in a Paris garrison were successfully treated with cod-liver oil.7Given this background, we examined historical accounts and performed a retrospective analysis of military rations provided to the New Zealand troops involved in the Gallipoli campaign in 1915.MethodsHistorical context To provide context for food supply and consumption by military personnel in Gallipoli, we examined a number of documents written by contemporary authors,3 8-10 and by subsequent historians and researchers1 2 5 11-13 (including one of us14).Scenario development Table 1 details the specific scenarios we considered which included replicating the actual military food rations as best as possible (Scenario R-A ) but also to describe three possible alternatives. These were: (i) to slightly improve the amount of food variety in the 1915 rations by providing less corned beef and more fruit and vegetables (Scenario R-V ); (ii) to achieve modern nutritional recommendations for the lowest cost (optimised dietary pattern, Scenario R-O ); and (iii) to perform the latter but with more food variety (Scenario R-OV ).We suggest that it is very plausible that increased food variety and access to more vegetables and some fruit would have been desired by the soldiers (Scenario R-V), and that military planners could have considered this given prior evidence for problems with scurvy in the American Civil War, Crimean War and other preceding military situations (see Introduction). Nevertheless, it is acknowledged that the more optimised scenarios (R-O and R-OV) are completely hypothetical given the limitations of nutritional science in 1915.In Table A1 (see Appendix 1) we list the actual rations as used by the New Zealand Expeditionary Force and documented on 13 April 1915.3 (p543) The nearest equivalent modern foods used in the various scenarios are detailed in Tables A2 and A3.Nutrient requirements and data used For the scenarios involving optimisation of nutrients (R-O and R-OV in Table 1) we generally used the modern day estimated average requirements (EARs) of nutrients per day for adult men which are based on values set for Australia and New Zealand.15 But we also considered current nutrient intakes for men from the New Zealand Adult Nutrition Survey (NZANS).16 Further details are provided in Table 3. For food composition data we used the 2012 New Zealand food composition database (http://www.foodcomposition.co.nz/foodfiles).Food prices To estimate the likely costs of the different scenarios, we used current 2011/12 food prices. These came from the official food price index (average monthly data for New Zealand in 2011)17 or when not available, supermarket prices (as detailed in Tables A2 and A3 in the Appendix 1).Approach to mathematical modelling and uncertainty For the nutrient optimisation we used the simplex algorithm to solve this linear programming problem (see Briend et al18 for a detailed description of the latter). The scenarios were modelled in Microsoft Excel 2010 (Excel Solver, Simplex method). Details of the uncertainty analysis are in the Appendix 1. Table 1: Specific nutritional scenarios used for the analyses of the actual military rations of 1915 and alternatives Name and aim of specific scenario Additional details Scenario R-A : To replicate the actual military food rations We used the nearest-equivalent modern foods, see Table A2 for further details of these rations. The modern food nearest equivalents we used are detailed in Table A3. Scenario R-V : To slightly improve variety of the 1915 rations In this Scenario we simulated a better attempt by the planners of military rations to approximate the typical NZ diet at the time i.e., more vegetables and fruit. So we halved the amount of corned beef (down to 227 g) and added: 1 cup each of the two cheapest canned vegetables (tomatoes [240 g], and peas [248 g] - both canned products were available in 1915, see Table A3 in the Appendix 1). 1 cup of the cheapest canned fruit (apricots with syrup [240 g], also available in 1915). Scenario R-O : To achieve modern nutritional recommendations for the lowest cost (optimised dietary pattern) To achieve this optimised diet with the type of dried and canned foods available at the time, while also: (i) achieving the same level of dietary energy as Scenario R-A; (ii) to ignore the modern recommendations on sodium levels (given the food preservation value of high sodium levels in a military field setting). See text and Table 3 for further details on the specific nutrient recommendations. Scenario R-OV : As for Scenario R-O but with more variety As for Scenario R-O above but with progressively lowering the maximum amount of the highest individual food item (by weight) until the variety in the original ration increased the number of foods reaching over 50 g per day to up to 10 different foods. Results Historical reports of food issues That the majority of meals on Gallipoli consisted of corned beef (bully beef), hard biscuits and tea is especially significant to this study. For example, the first New Zealand historian of the campaign, Major Fred Waite, noted: Food was always plentiful (except just after the Great Blizzard in November when stocks ran very low). Tinned meat, jam and hard biscuits and a mug of tea provided 99 per cent of the meals10 (p161) (see Figure 1). On occasion (e.g., near the end of campaign2 (p267)) there were some improvements in the food provisioning. As one soldier remarked: We get very well fed here, considering, but we do miss the fresh vegetables and fruit. We get plenty of rice, tea, sugar, biscuits and bully beef, jam, onions etc and an adequate supply of milk [tinned condensed] and bread. Once or twice we have had an egg each, and yesterday actually had a little fresh mutton served out.14 (p202) Figure 1. Two signallers outside the Divisional Signal Office on the Gallipoli Peninsula (1915) enjoy a meal of bread and jam, washed down with a mug of tea. (The jam did provide a source of Vitamin C but it was not enough.) Source: Used with permission from National Army Museum, New Zealand (Number: 1992.742) An impression of some of the difficulties with food and water supply for the New Zealand military in Gallipoli is suggested by these commentators: After the first two days the battalion had a quiet time in the Walker\u2019s Ridge position. One of the greatest difficulties was in bringing up ammunition, water and food. The track up to the hill, 500 feet above the beach, was very narrow and steep, and exposed to sniping fire from the Turkish trenches; only small loads could be carried by each man, and each trip took a long time.8 With all these discomforts, the exhaustion of labour, the strain of unceasing vigil and shell fire, the lack of nourishing food, and little sleep, there was always a shortage of water and the possibility of no water at all. One pint of water a day was the usual issue9 (p38) (see Figure 2). Other conditions may have limited food intake and palatability: Owing to the annoyance of the flies some sections did not eat anything but a dry biscuit during the daytime. To eat biscuit and jam in the daytime a man had to keep moving the hand that held the food.9 (p37) .... however palatable in a temperate climate, any form of tinned food becomes distasteful in a semi-tropical summer unless ice is available. ... Not only was the clothing inadequate but the food and the feeding of the troops was unsatisfactory.3(p113) In commenting mainly on sanitation, the difficult circumstances for food preparation were described: It is questionable whether any alterations in the dietary - and some were made - could have improved the sanitary situation. The baneful system of individual cooking, then prevalent, would have ruined any ration however good; every man cooked for himself, every dug-out became a midden of fly contaminated food and food refuse.3 (p114) Figure 2. A precious water point at Anzac Cove, Gallipoli Peninsula (1915). Two quarts a day was the normal ration for New Zealand soldiers and it had to be used for all purposes. Most went to make tea. As one New Zealand soldier wrote: \u2018water is worth its weight in gold here\u2019. Source: Used with permission from National Army Museum, New Zealand (Number: 2007.550) Finally, Carbery3 (p113) appears to support a quote in the final report of the Dardanelles Commission, which stated that: there was nothing actively injurious to health in the meat; but it was of poor quality, and, from being salt and stringy, it caused some intestinal irritation and so conduced to diarrhoea . The bulk of the food diet of the New Zealanders at Gallipoli was supplied via the United Kingdom through its Army Service Corps. Generally it was inferior in quality to similar food that originated from New Zealand. Most of the corned beef was supplied from Argentina and Fred Waite commented that it\u2019s poor quality and the fact that it was served for meals three times a day, becomes more than the constitution of a New Zealander can stand .10 (p163) When limited sources of food from New Zealand did arrive in at Gallipoli with the latest batch of Reinforcement drafts, it was much sought after and highly prized. This was especially true of the New Zealand army biscuit which was white, easy to eat and pleasant tasting. In contrast, British army biscuits were hard beyond belief . New Zealand soldiers at Gallipoli tended to nibble the edges of these hard slabs and throw their centres into No Man\u2019s Land.10 (p162) Nutritional analyses The calculated weights of the foods in the different scenarios are shown in Table 2 and the nutrient analysis in Table 3. Of note is that the military rations (Scenario R-A) were far below modern nutritional requirements for vitamin C intake, around a third of the current estimated average requirement (EAR). They were also below the EARs for: vitamin A (33% too low), vitamin E (11% too low), potassium (36% too low), selenium (20% too low) and dietary fibre (36% too low), (Table 3). Relative to modern requirements, the military diet was also excessively high in saturated fat (3.1 times too high) and sodium (5.2 times higher than the 2300 mg upper limit) (Table 3). If the planners of military rations had made these rations somewhat more like the typical New Zealand diet in terms of modest amounts of vegetables and fruit (i.e., one cup each per day of peas, tomatoes and apricots used in our Scenario R-V ), then this would have substantially improved the nutrient quality. In particular it would have eliminated the below EAR intakes of vitamins A, C and E and dietary fibre; improved intake of potassium, but would have made little change to selenium intake. It would also have partly reduced the high intakes of saturated fat and sodium, which is desirable from a health perspective. If the relative food prices are roughly equivalent between now and 1915, then this alternative ration would have been achieved with only a minor increase in cost above the original ration (NZ$ 11.43 per day vs 11.03, Table 3). However, the higher weight (an extra 501 g/day) would have increased transport costs (Table 2). In 1915 there was no possibility that a properly optimised diet could be developed as there was limited knowledge of nutrition and no capacity to apply mathematical techniques such as linear programming. Nevertheless, it is plausible that military planners could have made moderately more use of a variety of canned and dried foods that were available in New Zealand in 1915 and produced in other developed countries. It is also of interest to demonstrate how far modern knowledge and methods can allow for optimal military rations to be formulated. Hence we optimised the military rations using canned and dried foods available in 1915, and found that only six foods would technically be required to meet all nutritional requirements: bread, flour, cheese, rolled oats, dried peas and canned tomatoes (Scenario R-O in Tables 2 and 3). Indeed, this ration would have been healthier in all of the dimensions shown in Table 3. Furthermore, this ration would have cost under half the cost of the original ration and would be a similar weight. Expanding the variety of this optimised ration to include ten items (over 50 g each) as per Scenario R-OV would have probably resulted in additional cost compared to Scenario R-O. But this cost was still estimated to be likely to below that of the original ration (i.e., $9.54 vs $11.03 per day). However, the extra weight of the food (466 g/day) would have increased transport costs (Table 2). The results in Table A3 (see Appendix 1) indicate that cheese was the likely major contributor to vitamin A intake in the rations. For vitamin C it was either jam, followed by dried potatoes (using the USDA food composition data); or corned beef followed by jam (using NZ food composition data). In the uncertainty analysis (Table 5) the mean vitamin A intake was below half the EAR of 625 mcg and the 95% uncertainty interval (UI) never approached this requirement (using both food composition datasets). Similarly, for vitamin C intake with the mean below a quarter of the EAR and the upper limit of the 95%UI never exceeding a third of the EAR. Table 2. Foods (with weights in g/day) included in the various daily dietary scenarios with some of these (in Scenarios R-O and R-OV) selected automatically in the optimisation process Food items Scenario R-A (actual) Scenario R-V (extra variety) Optimised diets Scenario R-O Scenario R-OV Food in the military rations of 1915 (descending amounts) Corned beef (canned) 454 227 0 0 Alternatives: Bread (white) Or biscuit Or flour (white) 187 187 330 225 150 150 0 225 150 150 585 225 Bacon 113 113 0 29 Cheese (cheddar) 85 85 110 82 Jam 85 85 0 0 Sugar (white) 85 85 0 0 Alternatives: Dried peas Or dried beans Or dried potatoes 19 19 19 19 19 19 8 0 0 0 225 0 Salt 14 14 0 0 Mustard 1.4 1.4 0 0 Pepper 0.8 0.8 0 0 Additional foods that could have been used in 1915 (see Appendix 1) Peas (canned) - 248 0 0 Apricots (canned) - 240 0 107 Tomatoes (canned) - 240 353 225 Oats (rolled) - 0 337 225 Peaches (canned) - 0 0 225 Fish (canned) - 0 0 56 Other** - 0 0 0 Total food weight g/day 1382 1883 1724

Summary

Abstract

Aim

Amongst New Zealand soldiers in Gallipoli in 1915 there were reports of poor food quality and cases of scurvy. But no modern analysis of the military food rations has ever been conducted to better understand potential nutritional problems in this group.

Method

We analysed the foods in the military rations for 1915 using food composition data on the closest equivalents for modern foods. We compared these results with other plausible diets and various optimised ones using linear programming.

Results

Historical accounts provide evidence for poor food quality supplied to these soldiers. The nutrient analysis suggested that the military rations were below modern requirements for vitamins A, C and E; potassium; selenium; and dietary fibre. If military planners had used modest amounts of the canned vegetables and fruit available in 1915, this would probably have eliminated four of these six deficits. The results from the uncertainty analyses for vitamin C (e.g., 95% uncertainty interval [UI]: 5.5 to 6.7 mg per day), was compatible with the range known to cause scurvy, but the UI for vitamin A intake was only partly in the range for causing night blindness. To indicate the gap with the ideal, an optimised diet (using foods available in 1915), could have achieved all nutrient requirements for under half the estimated purchase cost of the 1915 military rations.

Conclusion

There is now both historical and analytic evidence that the military rations provided to these soldiers were nutritionally inadequate in vitamin C, and probably other nutrients such as vitamin A. These deficits are likely to have caused cases of scurvy and may have contributed to the high rates of other illnesses experienced at Gallipoli. Such problems could have been readily prevented by providing rations that included some canned fruit or vegetables (e.g., as manufactured by New Zealand at the time).

Author Information

Nick Wilson1; Nhung Nghiem1; Jennifer A Summers1; Mary-Ann Carter1; Glyn Harper2. 1. University of Otago, Wellington, New Zealand. 2. Professor of War Studies, Massey University, Palmerston North, New Zealand

Acknowledgements

Correspondence

Associate Professor Nick Wilson, Department of Public Health, University of Otago, Wellington, PO Box 7343 Wellington South, 6242 New Zealand.

Correspondence Email

nick.wilson@otago.ac.nz

Competing Interests

Nil.

Contact diana@nzma.org.nz
for the PDF of this article

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