Niacin

 

Niacin. A no more dramatic disease has ever come to the medical profession than pellagra, according to Dr. Tom Spies, one of the world’s greatest medical authorities in the field of nutrition. Pellagra has been known throughout the world for centuries, yet, it was not until the early 1930s, that Dr. Spies and several others managed to cure severely ill pellagra patients. The cure was a simple one: enormous doses of brewer's yeast, combined with a diet “high in calories, protein, minerals and vitamins.” By 1935, Dr. Spies had found that the one ounce of brewer’s yeast he had been giving was not enough, and, when he doubled and tripled this amount, the cure was almost miraculous, symptoms of pellagra are a red, sore tongue, skin troubles, digestive troubles, along with diarrhea and nerve disorders so severe that patients may become insane, Said Dr. Spies: “No tissues of the body are entirely exempt if the disease is permitted to run its natural course, untreated.” Pellagra can be induced in laboratory animals by giving them a diet deficient in niacin. 

It can also be induced by giving them a diet consisting largely of corn products, because corn, although it is an excellent food in other respects, is deficient in one amino acid (tryptophan) and niacin. Although this does no harm in a diet including other protein-rich foods, someone who is living mostly on foods made from corn is risking pellagra. The disease was widespread during the Depression of the 1930s in the southern part of the U.S., where cornbread, hominy, grits, and other corn products formed a large part of the diet. Dr. Spies writes in Clinical Nutrition, that there are three groups of people who are most likely to be susceptible to pellagra. 

First, those who do not eat a nourishing diet, either because they do not have enough money to buy nourishing foods, because they do not know which foods to eat, or because they have peculiar notions about food and put themselves on diets that are deficient in the B vitamins. The second group consists of those who have organic diseases which have changed their eating habits or have made their needs for certain foods much greater. People with tuberculosis, disease of the digestive tract, cirrhosis of the liver, heart disease, certain. kinds of kidney disease, diabetes, amoebic dysentery, pneumonia, hookworm, influenza, typhoid fever, malaria, and other diseases interfering with the eating of foods containing the B vitamins and the absorption of these vitamins from foods. 

The third group are chronic alcoholics who neglect all food and try to live on alcohol. Often the sufferer from pellagra is piteously thin and starved-looking. But it is just as likely that he is overweight, for, if he is eating a diet high in refined carbohydrates and fats, he is not getting enough of the B vitamins to protect him from pellagra, although he may be getting enough calories to make him fat. Many modern American mothers who make little effort to study nutrition and allow their children to live on soft drinks, potato chips, and candy are guaranteeing a future for these children in which they will be threatened with pellagra—if they manage to escape such diseases as TB, diabetes and heart trouble. 

Mothers and children must be made aware of the overwhelming importance of foods high in protein, vitamins, and minerals. How can you cure pellagra? In the words of Dr. Tom Spies: “113 grams of wheat germ daily (about one-fourth pound), 57 grams of brewer’s yeast daily (about 4 tablespoons) or a concentrate of niacin which would, of course, have to be given by a physician.” In cases where the patient cannot absorb food effectively from his digestive tract, the B vitamin can be injected. Unfortunately, pellagra did not pass into oblivion in the 1930s. It is still very much with us in the 1970s. A headline in the Washington Post for April 2, 1971, read: “Mental patients hit by pellagra.” The article went on to say that “Maryland’s health chief said that he personally discovered in December that patients at state mental hospitals were receiving inadequate daily amounts of vitamins in their meals, causing many of them to contract pellagra. 

The deficiencies apparently had existed for years and years,” stated Dr. Neil Solomon. The patients were immediately given vitamins, but Dr. Solomon explained that, because of budget cutting, there would not be enough money to feed mental patients properly during the coming years. There were, at the time, 10 - 300 patients in mental hospitals in the state. Dr. Solomon, a specialist in nutrition, said he had noticed a tremendous number of patients “had red, swollen tongues and lesions (sores) on exposed parts of their bodies.” The hospital attendants—and presumably all the doctors and psychiatrists in attendance had not noticed anything wrong with the patients, the Post article continued. When Dr. Solomon visited the hospital Kitch ens and studied the menus, he found that meals were deficient not only in niacin but also protein, iron, and calcium, “An unspecified number of patients had pellagra,” he noted, He went on to say that he had no idea how many mental patients had gotten pellagra in the past or how many had died of it. 

The same could be said for other deficiency diseases. The state had been spending 72 cents per day per patient to feed the mentally ill in six institutions, and An additional 28 cents per day had brought the menus to at least a nutritionally sound basis. Dr. Solomon is, apparently, just one of a handful of doctors in the entire medical profession who is concerned about what patients eat Speaking at a symposium on hunger and malnutrition sponsored by the American Association for the Advancement of Science, Dr. Jes Mayer, professor of Nutrition at Harvard University, and President Nixon’s advisor on nutrition, said: “Our studies at Harvard among residents suf gests that the average physician knows a little more about nutrition than the average secretary —unless the secretary has a weight problem, and then she probably knows more than the average physician.” He said that only a half dozen or so medical schools in the country include a nutrition course for their students. 

Continued Dr. Mayer: “Nutrition education should be centered on foods—their size, shape, color, caloric value, etc. We must relate such vital information to the everyday uses of people.” In 1963, the Council on Foods and Nutrition of the American Medical Association issued a report on nutritional education in medical schools in which they opined that the medics were not really learning anything much about food and nutrition, and they suggested hiring one professor in each school whose main interest might be nutrition. Even Dr. Fredrick Stare of Harvard, writing in Nutrition Reviews, said that very little attention is directed to nutrition teaching in medical schools. In the American Journal of Public Health in June 1966, Dr. Robert Shank stated that the situation was very bad. In 1967, Dr. J. F. Mueller said that there is great dissatisfaction among nutritionists in general with “the quality of nutrition education in medical schools.” Dr. Robert H. Barnes of the University of Washington concurred. 

Writing in Nutrition Today, 1968, Dr.-Barnes, after studying what. went on in a local hospital, said that he found that the terms by which doctors order diets for their patients are completely meaningless and indicate that the doctors have no idea of what the diets are supposed to do for the patients or why they should be put on such diets. Said Dr, Barnes: “No portion of the human body seems to confound physicians more than the gastrointestinal tract, Writing a diet for a patient ailing in this dark and mysterious region seems to Fill us with bewilderment.” Cancer researchers bave often used vitamins A, C, and E in their search for a cure for this mysterious disorder. 

We now have a report from the University of California at Los Angeles, where six researchers have determined that the abnormal growth of cancer cells may be due to a lack of niacin. Dr. Robert A. Smith and his co-workers have not as yet used animals or humans in their research, however, they indicate that animal studies will be begun. Working in tissue culture with cells derived from colon and kidney cancers in humans, the UCLA team found that there is a marked difference between cancer and normal cells. The cancer cells were depleted of nicotinamide, the physiologically active form of niacin, they said. A Montreal, Canada professor believes that niacin is important for improving memory in af ing people, He also gave them carbon dioxide to inhale.

He is quoted in Science News for April 1966 as saying that impairment of the manufacture of new protein in the body may be responsible for badly functioning memories. The B vitamin may help to encourage this activity. In another vein, Dr. Grace A., Goldsmith of Tulane University reported in the Journal of the American Medical Association on October 11, 1965, that niacin appears to reduce the level of cholesterol in the blood, In experiments with rabbits, the B vitamin protected against hardening of the arteries and reduced its severity.  Two New York physicians, who treated 41 patients with large doses of niacin, reported similar results with respect to cholesterol. The patients were suffering from high levels of cholesterol in the blood and hardening of the arteries. 

In all cases, the Jarge doses of niacin brought about a reduction in cholesterol without any change in diet. If you are bothered by large amounts of cholesterol deposits, why not ask your doctor to investigate the use of niacin? Taking an isolated B vitamin on your own in large quantities sometimes produces slight side effects because it is being used as a drug. Idiopathic hypogeusia is the unlikely name given to a new condition that doctors have recently uncovered. It means the inability to taste anything. Several articles in medical journals have reported on this disorder, and they are mystified as to what could possibly cause such a condition, in a letter to the editor of the Journal of the American Medical Association, Dr. R. P Green of Saskatchewan, Canada announced thy the condition is “part of a very old disease which, causes the perception to change—perception dysfunction, as a result of a niacin deficiency. The disease produced is pellagra and “the cur is niacin.” 

Dr. Green goes on to point out that lack of taste is only one possible effect on sensation caused by a lack of this B vitamin. In his expert experience with 800 cases, impairment of the senses of taste and smell are problems, he said. He told his physician readers that many patients come to a doctor with complaints for which there seems to be no physical basis. Ask them questions about their sense of taste, smell, sight, hearing, and touch and you can diagnose the disorder, he said. He gives his patients a perceptual test that reveals their impairment of one sense or another. Then he suggests a diet, that includes plenty of niacin. “The results in cases of recent! onset is nothing short of miraculous,” he said “Patients whose aberrations have extended over! months and even years respond more slowly but yet very satisfactorily in the main.” 

Laboratories used to report considerable work with animals on the effects of vitamin dosage on the symptoms of old aye. But this kind of pre-season has rather gone out of style, especially since our official scientific bodies make pronouncements that old people need no more vitamins than younger folks, and taking more vitamins than you “need” will do nothing for health. We are, therefore, glad to find in a European scientific journal the account of some convincing research along these lines. The scientists used three groups of rats and placed all of them on the same diet. Then they gave the first group a vitamin preparation containing twice the minimum daily requirements for rats. The second group received only niacin. 

The third group got no vitamins at all. However, all these rats were eating the customary good, nourishing diet that is fed to valuable laboratory animals to maintain the best possible health. The first group of animals showed better food assimilation, better health, and growth than the rest of the rats. The first group and the group that got the B vitamin were more active physically than the others. The first group had a higher fertility rate and lowest blood cholesterol. Those who received the multiple-vitamin had the longest lifespan. Next came those who got only the niacin, while the rats that had no vitamin supplement had the shortest life span. After the animals died, their tissues were examined in the laboratory. 

Deposits in the blood vessels—the kind that leads to hardening of the arteries—were much less noticeable in the rats that got the vitamin supplement. Other organs, too, showed less degeneration than that of the non-supplement animals. To test their findings still further, the scientists gave a multiple-vitamin preparation to a group of 65 to 90-year-old people for a month. They report that, when the oldsters were tested, they showed an increase in oxidative processes and protein metabolism. 

There was also “improvement in their general condition,” even though 80 days is not a very long time for such a study. This research was reported by V. V. Efremov in the Journal Vestnil Akademii Meditsinskikh Nauk, USSR, Volume 21 (10), 1966. It was abstracted in Chemical Abstracts, 1968, on page 9111. As far back as 1925, J. Goldberger had determined that pellagra is a deficiency disease. In 1937, C. A. Elvehjem and his associates discovered that nicotinic acid (niacin) is involved in preventing the disease. In the chart on page 236, we give you the main sources of niacin in the human diet. The recommended dietary allowances are infants (5 to 8 mg, daily); children (8 to 15 mg, daily; males (17 to 20 mg. daily); and females (19 to 15 mg. daily). Pregnant women (15 mg daily); lactation (20 mg, daily).

Riboflavin

ON MARCH 9, 1972 the Congressional authors of the new cancer attack law introduced a $ 1.3 billion bill to intensify the battle against heart, lung, and blood vessel diseases. Sen. Edward Kennedy (D., Mass,) and Rep. Paul G. Rogers (D., Fla), the co-sponsors, said that the proposed legislation was aimed at arresting diseases which annually cause more than half the deaths in the United States. Under the legislation, there would be community-based centers for screening and education as part of a disease-control program. In addition, there would be 15 new clinical research facilities for pulmonary disease.  

In the past, too little attention has been paid to the prevention of diseases, rather than trying to cure the disease after the patient has contracted it. And there is every indication that most of our major ills may be nutritionally based. Such things as cancer, heart disease multiple sclerosis, alcoholism, cataracts, mental disorders —yes, even aging—may be due to an imbalance of nutrients in our bodies or perhaps a damaging shortage of one or more vitamins or minerals. Riboflavin, or vitamin B2, is only one of the substances that may turn out to be at the forefront of this fight. A yellowish nitrogenous polyhydroxy alcohol, B2 was isolated as a vitamin in 1933 by R. Kuhn, P. Gyorgy, and T. Wagner-Jauregg. It occurs in considerable portions in egg white and whole eggs, milk, whey, brewer yeast, liver, whole grains, and soybeans. Dr. Otto Heinrich Warburg, a physician, two-time Nobel Laureate, and a former director of the Max Planck Institute of Cell Physiology in Germany, was a pioneer in the investigation of oxidation and reduction. 

One of the works leading biochemists, Warburg theorized that cancer cells produce energy by the fermentation of sugar, rather than, as often suspected, by the normal respiratory process. He further believed that the key to cancer prevention was in the protection of cellular respiration through the utilization of riboflavin and niacin. Dr. Warburg, who died in August 1970 at the age of 86, was also one of the first to discover the high production of lactic acid (an acid found in the blood and connected with muscle fatigue) by cancer tissues.  Hopefully, other researchers are continuing Dr Warburg’s important research. Dr Albert B. Sabin, developer of the oral polio vaccine that bears his name, told the Fifth International Symposium on Comparative Leukemia Research at Padua, Italy in 1971, that more research is needed on the role of nutrition in the possible prevention of cancer. 

He told Congress that crash programs to develop a miraculous cancer vaccine cure, rather than a method of prevention, are doomed to failure. We usually think of anemia as having to do with a lack of iron in food. And there is more serious anemia caused by certain very toxic drugs. As we learn from medical journals, pernicious anemia can be prevented and cured by taking vitamin B12, along with certain substances that help the stomach absorb it. According to two Baylor University researchers in Texas, however, a deficiency of riboflavin can cause anemia, Eight volunteers were put on a diet from which all riboflavin was carefully excluded. Then they were given vitamin supplements to make sure that they had enough of all other vitamins and minerals, The volunteers rapidly developed anemia, resulting in disorders of the blood cells and of the bone marrow where certain blood cells are manufactured. 

When vitamin B2 was given again, the anemia was halted. Cataract, which is generally thought to be a disorder of old age, affects over five million Americans between the ages of 80 and 60, Cataract is a fogging of the eye lens and may eventually result in complete blindness, The medical treatment is an operation which removes the cataract; then special glasses are prescribed. Unfortunately, many of the operations are not successful. Cataracts can easily be produced in laboratory animals by depriving them of riboflavin. In one experiment all the rats whose diets contained no vitamin B2 got cataracts. But it was only early in life that the deficient diet produced the effect in other words, the rats were young when they got the diet that was lacking in the B vitamin. 

Guinea pigs and man are just a few of the animals that cannot manufacture their own vitamin C. So diets deficient in vitamin C can produce scurvy. These same diets can also produce cataracts. A diet low in protein has also been linked to this eye disorder. Adelle Davis, who has written many excellent books, including Let’s Get Well, stated: “My files contain dozens of unsolicited letters from persons who have recovered from cataracts after their diets were more adequate, often while they were preparing for surgery. People sometimes take only a riboflavin supplement and then wonder why their eyes fail to improve. An anti-stress diet high in protein, riboflavin, vitamin C, vitamin E, pantothenic acid, and all nutrients is essential before good results can be expected.” (Additional information on the relationship be. Tween Cataracts and Nutrition is published in Vitamin C, the Powerhouse Vitamin, Conquers More Than Just Colds, which is listed in the bibliography at the end of this book). 

Four important studies of aging people seem to demonstrate two related facts: 1. Lack of essential nutrients may be a very common cause of aging; and 2. Older folks may in truth be far less than they need of many essential food elements. Geriatrics for March 1968 published an article by three Chicago researchers on the actual circumstances of our approximately 20 million senior citizens where eating and nutrition are concerned. They asked questions about the kind of diet being eaten by the elderly and the reasons for it. Their conclusions are significant. First, they point out that, although babies differ greatly in their individual physiological make-up, old folks differ far more, since they have a lifetime to accumulate all kinds of damage from accidents, surgery, disease, poison’ from drugs, and pollution, along with bad habits such as smoking and eating unwisely. 

So, if we agree that each of us is different in our needs, we must go further with older folks and decide that each of them is even more varied from all other old folks in his present condition and needs. Then, too, we must admit that most old folks suffer from at least one chronic disorder. According to these scientists, about 75% of all people between 65 and 74 years of age have chronic conditions and the incidence is even higher in those over 75. And, as we learned at the White House Conference on Aging in 1971, disease is not the only problem our senior citizens face. Lack of money and means of transportation, loneliness, and inadequate nutrition are some of the others. A 1955 dietary survey revealed that homes with homemakers over 60 and older have poorer diets in regard to all nutrients than households with younger cooks. Riboflavin, calcium, and vitamin C were the essentials most often lacking. Iron and thiamine are also usually in short supply. As people age beyond 65, their diets become progressively worse. Tea, toast, cereals, and sweets are most often favored. Some of the results of such badly planned diets are widespread anemia due to lack of iron and a bone condition that is almost universal-osteoporosis-which many nutrition experts believe is caused chiefly by lack of calcium and vitamin D. 

Since obesity and overweight are rather common among old folks, it seems apparent that the day's calories which should be spent in high ten foods (rich in vitamins and minerals) are often wasted instead on non-nourishing foods which contribute little but excess weight. Those on reducing diets tend to lack vitamins and minerals since it is hard to plan such diets which will supply all the needed nutrients. The conclusion these authors came to was that perhaps one-third or more of all people 65 and over have diets containing less than the recommended amounts of essential nutrients, especially vitamin B2, vitamin C, and calcium. Another study, made by six physicians at a British hospital catering only to old people, was published in Gerontologica Clinica (Volume 10, 1968). 

They examined 80 elderly patients who had lived in the hospital for a long time, They looked for signs of vitamin deficiency in the majority of patients. Only seven of the 80 appeared to be relatively free of such symptoms. To make sure that the symptoms indicated vitamin deficiency and nothing else, they divided the group into two groups and gave one group a vitamin supplement, and the other a simple pill which contained nothing. The group getting the vitamin supplement showed improvement within six months, and much more improvement within a year. The group which received no vitamin supplement showed no improvement. Especially interesting was the fact that apparently unrelated symptoms of bed sores yielded to the vitamin supplement. Said the authors: “One feature that has been observed in this study is the slow rate at which certain of the pathological (disease) changes can be reversed by even high doses of vitamins. It would seem that, like many other conditions, early changes are reversible but that if these remain untreated for a sufficient length of time then irreversible changes occur”.

 In a third article bearing on this subject, three Connecticut doctors studied 50 men and women at a nursing home for the aged trying to discover whether they suffered from being unable to absorb the food they ate. These older folks suffered from what the doctors called “The usual diseases of old age, such as osteoporosis, arteriosclerosis (hardening of the arteries), general mental confusion, and so forth.” Nine of them showed symptoms of severe wasting. That is, they were excessively thin, apathetic, and suffering from severe mental abnormalities. Is it possible, the doctors asked in this study, that one reason for the condition of these old people is just that they do not absorb enough nutrients from their food to bring them good health? They found that this, indeed, was the case. Many of the patients were unable to absorb important essential nutrients like protein, vitamin A, and fat (which influences the absorption of all fat-soluble vitamins—A, D, E, and K). 

The investigators also found that all of them were suffering, to some degree, from an inability pie? 50 to handle starches and sugars. That is, their blood sugar levels were disordered. They tended {to be diabetic. The patients who appeared to be wasting away were found to be the least able to absorb their food properly. The fourth article that we refer to appeared in the April 1966 issue of the Journal of the American Geriatrics Society. Written by a Belgian physician, a specialist in the problems of hows older people, it takes the form of a new theory Diet on why we age. No one really knows, of course, just why or how we get old or why some people seem to age so much faster than others. Piecing together information from many different sources, Dr. H. LeComte presented his new theory of aging: that we age because we have serious deficiencies in essential nutrients. 

Severe premature aging is caused by serious deficiencies; less pronounced aging is caused by lesser deficiencies and so on. “From this, we conclude that the so-called ‘normal aging’ is caused by small (maybe not to be diagnosed, but, nevertheless, real) deficiencies,” he said, He tells us that the illness or illnesses of an elderly patient can be far more easily cured if he is amply supplied with all the things in which he has been deficient. Then he tells us that there is a large group of older folks who appear to be healthy but who complain of “all sorts of troubles of which fatigue is the most important.” These complaints, he said, are the results of one or several deficiencies and they can be treated by supplying the essential nutrients in plentiful amounts, (Another theory on why we grow old_ is explored in the book, Vitamin E, Wonder Worker of the ’70’s?”, listed in the bibliography). 

In order to determine how much of each vitamin and mineral we need each day, every household should have a copy of Recommended Dietary Allowances, 7th Edition, 1968, available from the Printing and Publishing Office, National Academy of Sciences, 2101 Constitution Ave., Washington, D. C. 20418. It costs $1.75. The next edition is due out in 1978. For example, how much riboflavin do you need each day? For infants, the official daily recommendation is from 0.4 to 0.6 milligrams; for children, from 0.6 to 1.2 milligrams; for males, it is 1.3 for boys up to 1.7 for adults; for women, the range is 1.3 milligrams for girls to 1.5 milligrams for adults; pregnancy requires 1.8 milligrams daily and for lactation 2 milligrams each day.  A chart on page 234 gives some of the major sources of riboflavin.