Despite our nostalgia for Christmases past, as recently as 200 years ago the winter feast must have been a challenge for cooks - even in rich families. Without refrigeration or canning, the only ways to preserve foods were drying, salting, spicing and smoking in various combinations. A few fruits such as apples could be kept throughout the winter, preserved by their own sugar content, but in northern Europe many people were, by Easter, suffering symptoms of scurvy - loose teeth, bleeding gums, br uised skin - due to lack of vitamin C. Many of our familiar vegetables are not native to Europe. Potatoes (an important source of vitamin C), most beans, and tomatoes, all came from the Americas and did not become popular and cheap until around 1750. Bef ore then, the main carbohydrate staples were grains and the poor lived on bread (with enough grit in it to wear down their teeth), dumplings, porridge, gruel and, in southern Europe, pasta.

The rich got through the winter by eating prodigious quantities of protein and fat. Historians have plenty of evidence of the vast numbers of fish, birds, game animals and domestic meats eaten at the succession of banquets that marked the Christmas season, but it was not only on special occasions that the affluent gorged themselves on meat. Up to Edwardian times, hotels offered standard dinners at which people would eat their way through oysters, soup, sole, fillet of beef, wild duck or perhaps a chicken, and a pudding.

Game birds - pheasants, partridges, duck, snipe, woodcock, and grouse - were shot throughout the winter months and provided fresh meat. Fresh meat contains plenty of B vitamins and minerals, especially in its juices. But the high protein content of the affluent northern European's diet had its drawbacks. The most obvious was gout, a potentially crippling type of arthritis. Nowadays people who suffer from gout mostly have an inborn abnormality of their body chemistry, but a couple of hundred years ago, satirical cartoonists were well aware that many victims had brought the disease upon themselves by years of overeating protein washed down with large amounts of alcohol.

Our self-indulgent ancestors feared gout and were also terrified of the formation of a stone in the kidneys and the bladder. A stone that became stuck in the outflow passage from the kidney would cause renal colic, one of the worst pains known. Bladder stones caused problems with passing urine and often led to repeated attacks of painful cystitis. The symptoms were severe enough for victims to be prepared to undergo the primitive operation of cutting for stone without anaesthesia. A quick cut was made into the bladder and the stone removed. The mortality of the operation was at least one third of those treated, and the survivors (including the diarist Samuel Pepys) often gave thanks on the anniversary for the rest of their lives.

Argument continues as to why bladder stones were so common up to the late 19th century and then disappeared, but diet seems likely to have been the most important factor. We may look back with envy to the great Tudor feasts, but their consequences for health were worse than the coronary heart disease that threatens 20th-century gluttons.