Doctor's Complete Guide to Vitamins and Minerals

SECTION I Understanding Vitamins Notes VITAMINS: A HISTORICAL PERSPECTIVE Nutrition, or the lack of it, has shaped the world. The pages of history record human suffering, disease, and the disability occasioned by malnourishment through the millennia. From the first description of beriberi in ancient Chinese writings (2500 b.c.) to the blight of scurvy that crippled or destroyed armies and navies from the time of Hippocrates to the Crusades, nutritional deficiency played a role. And it didn't end then. Human suffering from malnutrition followed us straight into the early twentieth century, when physicians filled mental institutions of the post-Civil War American South to overflowing with the hopelessly insane and disabled, many of whom suffered only from lack of the B vitamin niacin. How different a history humankind might have recorded were it not for the diseases occasioned by epidemic vitamin and mineral malnourishment. Although throughout history medical investigators struggled to discover the link between illness and certain food habits, the concept of dietary deficiency causing disease did not become widely accepted until the late nineteenth century. Prior to that time, the prevailing scientific wisdom held that the diseases called scurvy, beriberi, pellagra, and rickets--which modern nutritional and medical science now accept without question as being caused solely by vitamin deficiencies--were caused by an unknown infectious agent or a toxin or poison in the food. At the turn of the twentieth century, several researchers began to believe that perhaps certain foods contained an "accessory food factor" that prevented disease. Based on early investigations, researchers believed that the critical "accessory food factor" belonged to a group of organic nitrogen-containing compounds called amines. They named their discovery "vital amines" (from the Latin vita for life, and the chemical class of amines) or vitamines. Continued study would ultimately prove that the compounds were not amines at all, but the name for the food factors stuck. In deference to accuracy or to avoid confusion, the pioneers of nutritional research decided to drop the final "e," creating the name by which we call them today: vitamins.1 Each disorder and the vitamin deficiency that causes it has a unique and interesting place in medical history, replete with the missed clues, false trails, and serendipity with which the advancement of medical knowledge often stumbles and bumbles forward. I ask you to thumb through the pages of nutritional history with me now as we examine the Big Four dietary deficiency disorders in turn. The Classic Vitamin Deficiency Diseases Beriberi: Thiamine (Vitamin B1) Deficiency Over 4000 years ago, the ancient Chinese first described the disorder we recognize today as thiamine deficiency. This disorder, with the unusual name beriberi, strikes a wide assortment of body systems. Impairment of the nervous system and muscles from insufficient thiamine in the diet causes symptoms ranging from pain and weakness to paralysis and wasting; in the gastrointestinal tract, lack of thiamine may cause nausea, vomiting, bowel sluggishness, and constipation; and mental aberrations from mild irritability to frank depression, dementia, and paranoia can occur as well. Carried to its extreme, thiamine deficiency proves fatal. It is not surprising that the ancient Chinese, in their voluminous writings on medicine, would have identified and first recorded the symptoms of this vitamin deficiency disease, since thiamine is found in the husks or bran of rice, a main staple in the Orient. Once the rice has been milled to remove the bran, however, most of the thiamine is lost. And so, with the advent of milling processes, the incidence of beriberi among the Chinese increased. Modern food manufacturers add thiamine back into milled rice productsEades, Mary Dan is the author of 'Doctor's Complete Guide to Vitamins and Minerals' with ISBN 9780440236450 and ISBN 0440236452.