By L. Stambovsky
Summary: In this article, written amidst the Great Depression and the outset of World War II, the author describes the vitamin-poor state of the typical American citizen in terms that still apply today. “Quantitatively, most Americans get enough calories in the form of [refined] carbohydrates…But refined sugar and starch, while they are energy sources, provide little or no accessory or vital food factors [i.e., vitamins and minerals].” This basic message sums up the work of many of the early nutritionists, who tried in vain to communicate the fact that nutrient deficiencies are at the root of most modern degenerative illness. Includes an illuminating chart listing various vitamin deficiencies and their associated diseases. From Drug and Cosmetic Industry magazine, 1942. Lee Foundation for Nutritional Research reprint 31.[The following is a transcription of the original Archives document. To view or download the original document, click here.]
The Need for Vitamins
The recent phenomenal disclosures in the field of nutrition are changing our concepts of health and disease. It can now be said that comprehensive nutrition is the keystone upon which is dependent the normal development and efficient maintenance of the skeletal, muscular, glandular, and neurologic systems. Optimum function is manifest by well-developed bodies, good muscle tone, youthfulness, stamina, longevity, freedom from disease, and a full capacity for life in general. Inversely, nutritional deficiencies and errors are, directly or indirectly, in a major degree etiologic in the production of nearly all pathology—irrespective of whether such be evidenced as neoplastic disease, bacterial invasion, toxemia, functional disbalance, or just an untimely wearing out of one or more organs.
Admittedly, the above statements cover a lot of ground and quite frankly are coldly received by many members of the medical fraternity. It is beyond the scope of this discussion to present, even in briefest abstract, the vast amount of existent clinical and experimental proof of the above. Convincing and amazing confirmation may be found in the thousands of nutritional references (8,000 as of October 1940) published in Quarterly Cumulative Medicus, Chemical Abstracts, Biological Abstracts, and Nutritional Abstracts and Reviews. A review of this immense amount of clinical and experimental research cannot fail to imbue one with at least a dawning realization that herein lie the cause and cure of most of the ills of man.
Widespread Deficiency and Deterioration of Public Health
According to the U.S. Public Health Service [USPHS], 40 percent of the country’s population suffers from inadequate nutrition. Quantitatively, most Americans get enough calories in the form of carbohydrates, which incidentally constitute 50 percent of our food intake. But refined sugar and starch, while they are energy sources, provide little or no accessory or vital food factors. Much more important than mere calories are the proteins, fats, vitamins, and minerals. Since half of our food intake consists of white flour and sugar, it is clearly apparent that the most vital phase of nutrition—the proteins, fats, vitamins, and minerals—has been in a great measure displaced by a nonvital dietary.
Neil and Bloomfield of the U.S. Public Health Service estimated that 350 million man-days were lost last year among industrial workers because of illness and accident. Certainly, not more than 10 percent of this figure is attributable to accident, leaving a staggering number of days of unproductivity that may be laid at the door of colds, constipation, headaches, exhaustion, and a number of other clinical and subclinical syndromes. This industrial loss becomes still more plausible upon focusing our attention on the common cold. Four-hundred-million colds annually cost America $500,000,000 (Bruce Bliven, New Republic, December 15, 1941). Even though this claim may be somewhat exaggerated, it must be remembered that colds are but one of a number of debilitative disorders that account for the industrial losses mentioned above. The colossal technical and medical literature is replete with irrefutable evidence that these very pathologies that exact such a grievous toll among America’s workers can be prevented, mitigated, and cured by comprehensive nutrition. Why shouldn’t we employ now this forward march in the realm of preventive medicine?
McCormac (Med. Rec., 152: 439) conducted in vivo experiments along these lines with vitamin B1. Athletes in better than average condition were given optimum doses of thiamine a few days prior to the tests. In every instance there was a strong increase in physical output—as high as 200 to 300 percent—as evaluated by breath-holding ability, swimming stamina, and other forms of physical endurance. This reference is industrially significant. If these college athletes, who unquestionably are in better condition than the average worker, responded so markedly to but one of a number of interdependent nutritional biochemicals, it is logical to conclude that the population in general, and industry in particular, would favorably respond to an increase in dietary adequacy—artificially or naturally supplied. Enriched bread is a feeble but nonetheless forward step in this direction. Much more can be and should be immediately done.
Further Evidence of Widespread Deficiency
Many general practitioners and even medical leaders in high places still ridicule the USPHS statistics regarding the prevalence of incompetent dietary. With decreasing intensity are heard the familiar echoes, “American diets are all inclusive,” “Vitamins are a transient fancy,” “It is impossible for the rich American table to be deficient,” etc. There is some justification for the above attitude. The practicing physician is so absorbed with the problem of diagnosis and treatment that he does not have the time nor energy to keep immediately abreast of developments in all fields of science, especially the commonplace subject of foodstuffs. We sympathize with the general practitioner. The mass of medical literature by itself absorbs his few free moments, and to expect him to wade through endless nutritional references is out of the question. However, the physician must increase his interest in nutrition or permit the public to seek elsewhere information on the subject.
There are still other reasons for medical indifference. Specific or acute at avitaminosis such as scurvy, beriberi, pellagra, rickets, osteomalacia, and tetany are comparatively rare. Illustrative of their infrequency is the report of the U.S. Census Bureau, wherein it is stated that the total deaths in 1938 from these causes was but 3,637. If the general practitioner judges the prevalence of nutritional disease from these rare cases, then naturally he is of the opinion that all is well with our diet. But what of the millions of subclinical cases—persons who are not sufficiently ill to require medical aid yet who are really not well? This condition is aptly termed “suboptimum” health and does not fall within the range of the physician. The reason therefore is very human—why go to a doctor unless forced to? Why not wait until subclinical symptoms eventuate into real distress or incapacity and then visit Dr. Jones? Such is the reasoning of the average person.
We list below, in tabular form, the mild and extreme deficiency symptoms of the more common nutritional biochemicals and essentials. It becomes obvious from this tabulation that everyone has at one time or another experienced or continues to tolerate some of these states. Combined or acute avitaminosis assists in the development of or results in the run of the mill pathologies, from alopecia to xerophthalmia. As we have already outlined, because of the cyclonic speed with which the science of nutrition has grown and because of the inherent but regrettable tendency on the part of medicine to resist new and simple facts that did not emanate from the AMA [American Medical Association], medicine as a whole is not yet sufficiently schooled or even willing to concede the possibility of a nutritional ideology for much of the disease with which its efforts are concerned.
Vitamin B1 (Thiamine)
Vitamin B2 (Riboflavin)
Cheilosis (lesions at corner of mouth)
Vitamin B6 (Pyridoxine)
Vitamin E (alpha-Tocopherol)
Failure of male germ cells to develop
|Prolonged coagulation time|
Vitamin P-P (Nicotinic Acid [Vitamin B3])
Vitamin C (Ascorbic Acid, Cevitamic Acid)
Poor assimilation of calcium and phosphorous
Pantothenic Acid [Vitamin B5]
Deficiency state not [yet] proven in man. Presence in many foods suggests it as a supplement in deficient diet. Thought to be essential for growth and life. [Note: Proven essential since time of publication of article.]
Anti-alopecia factor for mice
Poor development of skeletal structure
Poor development of bones and teeth
Essential Fatty Unsaturates [Essential Fatty Acids]
Further Demonstration of Widespread Deficiencies
The USPHS statistics covering the extent of malnutrition are very conservative. Overwhelming evidence to this effect may be found in the existence of the gigantic proprietary drug business or the business of self-medication. Non-secret and well-known medicines such as cascara, brown mixture, baking soda, etc., should be included in this classification inasmuch as they are usually employed without the advice of a physician. America’s total drug bill for 1929 (Cost of Medicine, Rorer and Fischelis) was $715,000,000. Only 27 percent of this total was spent for physicians’ prescriptions. The balance or $525,000,000 was obtained from customers who did not feel the necessity to seek medical aid. These persons, judging from the figures cited, must run into many millions. Consequently, we have here a vast army of people who, while not acutely ill, are certainly not 100 percent well and whom the physician never contacts and is therefore in ignorance of. Obviously, medicine is not qualified to state in any degree the absence or prevalence of suboptimum health.
It would be interesting to break down the expenditures for different types of medication, but unfortunately such figures are not available. Yet any drug clerk knows that millions are spent for analgesics in the treatment of countless headaches. Many more millions are annually exchanged for laxatives and the treatment of not occasional but chronic constipation. Still more millions are expended for cough mixtures, nasal preparations, throat lozenges, and other products for the symptomatic relief of colds. Tonics also get their share of America’s income, from an effort to get rid of “that tired feeling.” Possibly the most important of all is the incalculable bill engendered by dental caries, which more and more are being viewed as of dietary origin—primarily carbohydrate excess. The gastrointestinal tract is instrumental in the conversion of further millions into antacids, digestants, and other acids.
The foregoing is not a tirade against the drug business or retail pharmacy. The correction of those maladies for which these patent and home remedies are sold constitutes a public service of no little magnitude and of which the industry might well be proud. But the essence of this exposition is the question, “Why was it necessary for the American people to spend the unbelievable sum of $525,000,000 for self-medication?” No one can say that the myriad daily headaches are normal or that man’s sewage system was so imperfectly designed as to require constant outside assistance to function. Anemia, with its telltale fatigue and pallor, is certainly not a part of nature’s design—nor are colds, coughs, coryza, impaired digestion, poor skin, nervousness, and other of the complex syndromes characteristic of ill health. It is admitted that the wear and tear of civilization, with its perversions and distortions of natural laws, is partly, but only in minor degree, accountable for some of our modern pathology. In the light of newer knowledge, we now know that the real culprit is inadequate nutrition—more specifically excess of carbohydrates and insufficient fats, proteins, vitamins, and minerals.
Why Impoverish Food?
There is no longer the question of whether or not our dietary is comprehensive. We have briefly proven that it is not. To what factor or factors is attributable our inadequate dietary? Fundamentally, certain evolutionary changes are herein concerned. Man was born omnivorous. For those who are doubtful of same, it is but necessary to point out that diabetes, an appreciably common disease, is merely the abuse and subsequent exhaustion of a comparatively limited property—the power to digest carbohydrates, which is the basis of all herbivorous foods. Man’s ability to consume proteins and fats is, within reasonable limits, continuous throughout life. This seems to indicate a physiology that was constructed for omnivorous and not herbivorous foods.
However, as time went on, [our] species of Homo genus increased to such an extent that there was no longer enough animal food to go around. With characteristic ingenuity, man turned directly to the earth for food, which was plentiful and easy to obtain. The birth of agriculture ensued—dating back about 7,000 years. But man’s physiologic evolution has not kept up with this change in food habits. The herbivorous animals have large stomach capacity, for the consumption of voluminous quantities of grains, fruits, and vegetables. The capacity of carnivorous animals, including man, was geared to the relatively concentrated fats and meats of animals. On the basis of equal volumes, unconcentrated nutriment of vegetable origin contains but half the energy value of animal fats, none of the structural value of animal proteins, and on the average but a fraction of the vitamin and mineral content of carnivorous foods in general. This changeover from carnivorous habits is a first step in the explanation of the modern paradox—malnutrition in an oasis of plenty.
Why and Where Does Qualitative Depletion Occur?
American foods are the richest and most plentiful on Earth. The factors responsible for impoverishment are manifold and complex. We have already discussed the transition from carnivorous to omnivorous habits. It becomes even more relevant in view of the following: Vegetables, fruits, and grains are at best, as compared with foodstuffs of animal origin, an inferior source of minerals, vitamins, energy, and repair substance. But vegetable foodstuffs under modern conditions are subject to still further depreciation. The time required for long distance transportation necessitates the marketing of unripe fruit that, of course, does not possess the mineral and vitamin content of naturally matured fruit. Large scale distribution forces the employment of cold storage, permitting oxidation and time to wreak still further destruction. Exhausted soil—the matrix of fruits and vegetables—cannot do otherwise than yield low vitamin and mineral content. Sun-dried fruits, by virtue of heat, oxidation, and actinic effects, undergo high vitamin losses. Animal foodstuffs withstand deleterious conditions much better and are not subject to as many as the above.
Canning, a necessary phase of modern living, is another source of vitamin deterioration. According to Drs. L.B. Pelta and M.M. Cantor, Department of Biochemistry, University of Alberta, Edmonton, the following losses occur:
- Vitamin A: 10–50 percent.
- Vitamin B1: Appreciably destroyed in all canning and cooking. Loss in acid media 5–15 percent; in alkaline media up to 80 percent.
- Vitamin C: Variable: stable in some foods, completely destroyed in others.
- Vitamin D: Not important in canned foods.
- Riboflavin, nicotinic acid: 5–15 percent.
- Calcium, phosphorus: Precipitate during canning. Lost through adherence to metal or insolubility in gastrointestinal tract.
These authors further state that increased destruction must occur inasmuch as the foods must be again heated before serving.
A limited economic status is worthy of a place in the dietary picture. Thirty-two percent of America’s families have an annual income of less than $750 (a summary in Yearbook of Agriculture, U.S. Deptartment of Agriculture, 1939). This means that three out of ten families do not have sufficient funds to permit the consumption of the barest minimum of protective foods such as visceral organs, meats, milk, eggs, and vegetables. In the more favored socioeconomic strata, excess candy, pastry, and other ultrarefined gastronomic temptations displace the more simple but fundamental foods. The substitution of natural fats such as butter, corn oil, and animal fats with cheaper, synthetic, non-vitamin and non-assimilable fats is one of the main causes of fat starvation, with resultant dermatologic repercussions [occurring].
Destructive culinary practices are guilty of extensive damage to what was originally good food. Heat and the presence of alkali inactivate vitamins C, B1, and B2. Fruits and vegetables cooked in water lose nutrients both through heat and solution in discarded cooking media. Frying and other heat treatments of meats reduce the B complex content by about half. The multiple processes involved in producing dishes of ultimate visual appeal as well as the creation of exotic concoctions divorced of any relationship to the original foodstuff and the constant striving for maximum taste stimulation concertedly devitaminize and denature nutriment so treated. Modern milling practices and bleaching remove or destroy carotene, B complex, and other vitamins and minerals contained in the cereals. White flour and white sugar—as already stated, constituting 50 percent of America’s caloric intake—are totally devoid of any mineral or vitamin content.
Still other factors involved in the production of nutritional disturbances are personal idiosyncrasies, faddist diets, weight reduction, psychotic aberration, impaired digestion, and a number of other syndromes such as pregnancy, fever, glandular dysfunction, toxemia, and so on. Another but recently recognized source of depletion is the common mineral oil habit. Vitamins A and D are more freely soluble in this hydrocarbon than in the bowel content, resulting in their transfer to the oil and subsequent loss [to the body]. High carbohydrate intake creates increased demands for B complex for the carbohydrate’s metabolism, which serves still further to deplete the body of the B factor, which should have been but was not supplied simultaneously with the carbohydrate ingestion.
Elimination of Nutritional Diseases
We have briefly depicted the extent and cause of nutritional deficiencies and errors. What is the quickest and most feasible method of eliminating this insidious detriment to our national health? A thorough reform of those culinary practices accountable for destruction and removal of food accessories would eventually result in a substantial improvement. However, an appalling amount of education and time will be necessary to achieve much success along this line. The increased consumption of animal products would be a distinct advance, but unfortunately economic limitations prohibit more than a minor relief by this means. Any appreciable transition from animal to other classes of foods becomes doubly difficult when it is realized that per calorie the cereals cost one-half to two-thirds less than any other source of energy. Wider consumption of vitamin-bearing vegetables would unquestionably be of worthwhile benefit. Authorities claim that a good diet should contain at least 200 grams of vitamin-bearing vegetables. This is impossible since the present supply in the United States could apportion only 70 grams per capita (Stiebling, H.K., and Clark, F., “Planning for Good Nutrition,” USDA, Food and Life, page 28).
Education as to more efficient food selection—along the lines of, figuratively, “less cake and more cheese”—would be a powerful influence but again would require precious time. The present emergency has produced almost universal increased mental and physical stress, which in turn are being manifest in the form of tension, gastrointestinal impairment, and other dyscrasia—all factors demanding increased vitamin intake. For the immediate present and as a national service, supplementing the American dietary with those nutritional biochemicals and minerals of known deficiency is a positive necessity and would be a long step towards the rapid completion of our national defense.
By L. Stambovsky. Reprinted by the Lee Foundation for Nutritional Research from Drug and Cosmetic Industry, 1942. [This source, listed by the Lee Foundation, is unconfirmed. Other references list Consumer’s Research Bulletin, April 1942, as the original source of publication.]
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