Deficiency Diseases
In November of 2006, the National Institutes of Health made this shocking announcement through a consensus statement among their physicians:
Use of multivitamins/minerals (MVMs) has grown rapidly over the past several decades, and dietary supplements are now used by more than half of the adult population in the United States. In general, MVMs are used by individuals who practice healthier lifestyles, thus making observational studies of the overall relationship between MVM use and general health outcomes difficult to interpret. Despite the widespread use of MVMs, we still have insufficient knowledge about the actual amount of total nutrients that Americans consume from diet and supplements. This is at least in part due to the fortification of foods with these nutrients, which adds to the effects of MVMs or single-vitamin or single-mineral supplements. Historically, fortification of foods has led to the remediation of vitamin and mineral deficits, but the cumulative effects of supplementation and fortification have also raised safety concerns about exceeding upper levels. Thus, there is a national need to improve the methods of obtaining accurate and current data on the public’s total intake of these nutrients in foods and dietary supplements.
In systematically evaluating the effectiveness and safety of MVMs in relation to chronic disease prevention, we found few rigorous studies on which to base clear conclusions and recommendations. Most of the studies we examined do not provide strong evidence for beneficial health-related effects of supplements taken singly, in pairs, or in combinations of three or more. Within some studies or subgroups of the study populations, there is encouraging evidence of health benefits, such as increased bone mineral density and decreased fractures in postmenopausal women who use calcium and vitamin D supplements. However, several other studies also provide disturbing evidence of risk, such as increased lung cancer risk with β-carotene use among smokers. 3
The current level of public assurance of the safety and quality of MVMs is inadequate, given the fact that manufacturers of these products are not required to report adverse events and the FDA has no regulatory authority to require labeling changes or to help inform the public of these issues and concerns. It is important that the FDA’s purview over these products be authorized and implemented.
Finally, the present evidence is insufficient to recommend either for or against the use of MVMs by the American public to prevent chronic disease. The resolution of this important issue will require advances in research and improved communication and collaboration among scientists, health care providers, patients, the pharmaceutical and supplement industries, and the public.
With chronic disease on the rise in this country, one would think that these vitamins would be protective but there really is no evidence that they work. We’re continually told that to ward off the diseases of civilization we should eat less, exercise more, get fresh air, and keep a positive outlook. If we gaze back through history, we might find a more productive cure.
For fifty years after William Banting, of “On Corpulence” fame, his high-fat reducing diet was seen as just that, a reducing diet. The notion of a high-fat, zero-carb diet was first publicized after World War II when the Arctic explorer Vilhjalmur Stefansson advocated its potential for health rather than weight loss. After living among the Northern Inuit of Canada and Alaska, he insisted that the Inuit and the other explorers and traders who lived on this diet were among the healthiest if not the most robust populations imaginable. He lived with a particular tribe of Inuit whose diet was primarily caribou meat but they might have some fish, some seal, and smaller amounts of polar bear, and rabbits, with the rare birds and eggs by some. The Inuit paid little attention to the plants in their environment because they added nothing to their food supply. It would be a mistake to conclude that their meals consisted of eggs for breakfast, fish for lunch and caribou for dinner. In isolated populations, if caribou were available, they ate non-stop until it was not available. Then they might take to fish until the caribou returned.
Canadian anthropologist Diamond Jenness spent from 1914-16 living with Inuit in the Coronation Gulf region of Canada’s Arctic coast and described the diet as,
“No fruit, no vegetables; morning and night nothing but seal washed down with ice-cold water or hot broth.”
Lawyer and abolitionist Richard Henry Dana, Jr. also wrote in 1840 about memoirs of life on a sailing ship, Two Years Before the Mast. He wrote:
“For sixteen months we lived upon almost nothing but fresh beef, fried beefsteaks, three times a day […] in perfect health, and without ailing and failings.”
We simply cannot understand what it was like to experience the terror of the frozen North, the dark for six months, the dreaded Arctic. Wintering over meant certain death for the majority of those who tried it. It was quite strange that people actually lived and thrived there. Surely, they must have had some sort of genetic advantage, right? What’s even more unnerving is that doctors at the time thought they knew how to prevent the death that occurred there. It is one thing to encounter something that everyone understands that man is powerless against, but it’s another thing entirely to come to the feeling of powerlessness against something you thought you understood.
Dr. James Lind
There were many superstitions but the fact remains that the most horrifying stories were absolutely true especially when it comes to scurvy, AKA “the Blackleg.” The Middle Age doctors were more familiar with the symptoms of scurvy but these included other diseases which were less serious but it confuses their descriptions. Scurvy started with a mental or temperamental change. As scurvy proceeded, the mental state changed from aggressive and argumentative to pessimism. The sufferer got more lethargic and they developed a “what’s the use” mode. The first real step was observed when a person jumped from a sitting or lying position they would stumble momentarily though not enough to feel it as a dizzy spell. After a few days, they just fall back down. Then there are bleeding gums and joint pain. The joint pain will be most acute with the most active joints until all of them eventually feel pain. The blood vessels die beneath the skin particularly in the legs and the dried blood turns black and the leg takes on this resemblance. The mental state deteriorates and the victim no longer argues. They just get gloomy and last about three or four more weeks before death. The gums would become as soft as cheese and the teeth could easily be removed. The appetite actually remained normal and may even increase but it didn’t change much until a few weeks before death. Once the body used up the protective antiscorbutic nutrients the patient deteriorated very rapidly. Death is from hemorrhage, usually of the digestive tract or lungs. Sudden death occurred from ruptured blood vessels in the brain.
The terms a “scurvy fellow” and “blackleg” came from the symptoms. The former refers to the early argumentative disposition and the latter from the physical feature. Many people felt as if scurvy was brought on by the character of the person, thus the classification. However, it was part and parcel of the disease. People acted “scurvy” because they had it. They didn’t get it by acting “scurvy.” This made a difference in terms of treatment. Doctors advised people to exercise, be cheerful, develop a love for the arts, and to get out and be entertained as preventive measures.
In 1928, Stefansson wrote a paper in the Journal of the American Medical Association (JAMA) on “Observations on Three Cases of Scurvy.” The observations did not change the further you go back in history. What is striking is that we are not told very often that fresh meat cured scurvy. We are constantly told that fresh vegetables are a cure. The idea of “fresh” did indeed grab hold of people’s imagination. In the nineteenth century, the usual view of lime juice or lemon juice as an anti-scorbutic was that the efficacy depended on acidity. Accordingly, in the reports of polar expeditions there is frequent reference to the acid content of the anti-scorbutic. There is usually no mention of the age or comparative freshness of the juice. In the seventeenth and eighteenth century, they were very ingenious. The leader of an expedition would see to it that his men were clean, that they exercised in clean air, that they had plenty of sunshine, and that they were kept in good spirits by suitable entertainment. These views are still held as necessary for good health and particularly relevant to scurvy.
Robert Falcon Scott
There were two other expeditions, one by Robert Falcon Scott and the other by Ernest Henry Shackleton. We can also rely on the one by Stefansson himself. Scott sought out the most orthodox scientists when outfitting his first Antarctic expedition. He carried lime juice and he picked up quantities of fruits as he passed New Zealand. He saw to it that the diet was “wholesome” that the men exercised, and that they bathed and had fresh air. Scurvy broke out anyway. Shakleton, an underling of Scott’s at the time, had the same problem. His crew pulled their own sledges so they had plenty of exercise. There was also plenty of sunlight, fresh air and they believed in the religion of lime juice. Scurvy continued to baffle.
Since Shackleton was an underling of Scott, the fact that he got scurvy was particularly troublesome and he became the “scurvy fellow” we talked about earlier. He was loud and brash and became more pessimistic by the day. He subsequently recovered from scurvy and wanted to clear his name so he organized his own expedition. Shackleton’s expedition was carefree and the exact opposite of Scott’s. They were so haphazard that they reached the Antarctic and then discovered they didn’t have enough food. They were not as clean nor did they exercise as much as Scott’s crew did. Either Shackleton had to secure meat out of necessity or out of good advice, but he secured penguin and seal. Half of their food ended up being fresh meat. Shackleton had much better success with his expedition than Scott despite the lack of careful planning and regard for the opinions of the experts. There was never a sign of scurvy and every man retained his full strength and they accomplished what most authorities felt was the greatest physical achievement of southern exploration. The men drug the sledges a considerable part of the way and they got within sight of the South Pole.
Stefansson argued that a high-fat, all-meat diet could sustain a person in good health indefinitely and he went on to advocate similarly for pemmican which was a staple of the diet of the Native American of the Great Plain. Authentic pemmican is made of lean beef, and an equal proportion of fat. He argued that this was sufficient to sustain a person in good health indefinitely and cited numerous examples in his many books, particularly, in Not by Bread Alone.
Elmer McCollum
None of his observations would have been controversial had not the conventional wisdom at the time been (as it still is) that a mixed diet is essential for good health. A healthy diet must contain protein, fats and carbohydrates, the latter because of the misconception that the brain and central nervous system require dietary glucose to function and the debatable assumption that fresh vegetables and fruit are essential to prevent deficiency diseases. The assumption dates back to the early decades of the twentieth century, the golden era of research on vitamins and vitamin-deficiency diseases as one disease after another, scurvy, pellagra, beriberi, rickets, anemia was found to be caused by a lack of essential vitamins and minerals. This was the New Knowledge of Nutrition as termed by Johns Hopkins nutritionist Elmer McCollum. This philosophy was based almost exclusively on studies of deficiency diseases, all of which were induced by diets high in refined carbohydrates and low in meat, fish, eggs, and dairy products.
When James Lind demonstrated in 1753 how to cure sailors with citrus juice, the sailors were eating the typical naval fare of water gruel sweetened with sugar, fresh mutton broth, light puddings, boiled biscuit with sugar, barley and raisins, rice, and currants. Pellagra was brought about by corn-rich diets, and beriberi with the eating of white rice rather than brown. The outbreak of beriberi was brought under control by replacing barley with meat and evaporated milk. Carl Voegtlin used meat, milk and eggs to stop Pellagra in 1914. The subjects were consuming wheat bread, cabbage, cornmeal, corn syrup, turnips, potatoes, and sugar. Nutritionists found that they could induce deficiency diseases in lab animals in the 1940s by feeding them diets of mostly crushed barley and chickpeas.
We certainly cannot blame Scott because he went out of his way to secure the best medical information he could find yet scurvy still appeared. The doctors were to blame and they should have compared the Shackleton and Scott expeditions which may have enlightened them about deficiency diseases in general. No matter how good the juice of limes or lemons it is difficult to carry in bulk and it deteriorates whether in bulk or in pill and it may be lost with shipwreck. The lesson was to find the antiscorbutics as you went along.
Sir Ernest Shackleton
On Stefansson’s expedition, they learned from Shackleton and decided to get meat as they went rather than relying on that easy to carry shipboard food of refined carbohydrates which was resistant to rats and spoilage. Three men came down with scurvy for disobeying the instructions of the commander and living without his knowledge on stored food when they were supposed to be living chiefly on fresh meat. One of these three was Karsten Anderson, one of the principles of Bellevue fame. It took anywhere from three weeks to three months of bad diet to induce scurvy. One had already advanced so rapidly that they had soft gums, and had to be carried on a sledge. They traveled to an island and hunted caribou and began the all-meat cure. The patients ate breakfast with a lot of water and finished the boiled meat while it was hot and drank some of the warm broth and kept the remainder to drink later in the day. For their other meals they ate slightly frozen raw meat with normal digestion and good appetite.
They divided the caribou in ordinary Eskimo style and the dogs got the organs, entrails, hams, shoulders, and tenderloin while the invalids and hunters got the briskets, ribs, pelvis, and marrow from the bones. This is obviously contrary to those so-called experts who claim that the Inuit ate the entire animal and that’s why they were in such good health. Stefansson relates in his book that the insides of an animal were only eaten in times of famine and if there came a time when the dogs did not get their parts, this was preceded by the eating of the dogs themselves soon afterwards.
“On the all-meat diet, all pain and gloom disappeared within four days. Within a week, the men had no realization of being ill as long as they lay still in bed. In two weeks, they were able to begin traveling, at first riding on the sledges and then walking. No signs of the scurvy remained except the gums which receded from the teeth and never quite regained their position.”
There is no doubt that the percentage of Vitamin C that everyone thinks is the scurvy preventing factor is higher in certain vegetable elements than in any meats, especially muscle meats. However, it is equally true that if one has considerable meat in the diet everyday, and they do not overcook it, (medium to medium-well at most) there will be enough of whatever prevents scurvy to do the preventing. It’s clear that if one lives on fresh meat, that they get enough vitamins not only to prevent scurvy but to prevent all other deficiency diseases as well. Stefansson had the audacity to announce that scurvy could be cured by an all-meat diet that supposedly had no curative value just as effectively as a diet containing any or all of the known antiscorbutics such as the juices of limes and lemons. Despite his considerable experience and peer-reviewed work, this did not dissuade doctors from their theories of deficiency disease and we continue to suffer to this very day.
Making Pemmican
Stefansson assumed and readers took for granted that this cure came about through fresh meat and if that meat was salt-preserved or dried, then perhaps it may not have worked. Stefansson is now certain that it could have worked with dried meat but not salt-preserved. This would probably only seem likely to students of the frontier or fur traders. One continually runs into striking contrasts as those between coastal Hudson’s Bay Company posts where scurvy was troublesome and inland posts were the disease was rare or absent. Most experts concluded that lime juice didn’t work on sailing ships because it was too old and the antiscorbutic must be fresh. To explain what happened with dried and salted meats, the excuse was that those inland ate fresh meat whereas those at the sea coasts ate salted. However, when we analyze the records, we find that this isn’t fully demonstrated because there were many periods of misfortune in the hunt or fishery that both Europeans and natives lived for months at a time with as little fresh meat to supplement their inland diet of pemmican and jerky as the coast dwellers had to supplement their imported salt meats and cereals.
Therefore, it seems very plain to me that if these individuals mentioned herein were able to live in outstanding health for such long periods of time they were consuming what is by definition, a healthy diet.
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