Vitamin B1 (Thiamine) and Beriberi
Beriberi is a disabling and potentially deadly disease that occurred mainly in societies where people depended heavily on white rice as a staple food. The disease had been known in East Asia for centuries, but serious outbreaks of it started in the 1880s, when steam-powered machines for milling rice were introduced.
Most people in East Asia had always preferred white rice, which is produced by polishing the bran and germ off the kernels of brown rice. Although white rice is not as nutritious as brown rice, it keeps better.
Because of the tiny amount of fat in the rice germ, brown rice easily goes rancid. Also, many people simply prefer the look and taste of white rice.
Unfortunately, nearly all of the thiamine in a rice kernel is in the bran and germ. When people eat a diet based too heavily on white rice, which lacks this bran and germ, they are at risk for thiamine deficiency.
Beriberi is horrible disabling. In fact, the name beriberi came from a Sinhalese word meaning “I can’t, I can’t.”
At first, beriberi was mistakenly believed to result from protein deficiency, because people who were wealthy enough to eat some meat or fish didn’t get beriberi. When millers started adding back the vitamins that were being lost in the milling process, beriberi was practically wiped out.
Beriberi is rare nowadays. However, people can still end up with a thiamine deficiency if they have trouble absorbing vitamins from their food. Examples include people with celiac disease and people who have had intestinal surgery.
Thiamine deficiency is a particular problem in alcoholics, partly because alcoholics are often generally malnourished and partly because alcohol makes it harder to absorb thiamine from food.
Many scientific authorities believe that a devastating, incurable brain disorder called Wernicke-Korsakoff syndrome (“wet brain”) that occurs in alcoholics could be prevented if an effective vitamin B1 supplement were added to alcoholic beverages.
Unfortunately, the Bureau of Alcohol, Tobacco, and Firearms has the final say on that issue, and they have refused to allow any alcoholic beverages to be fortified with any vitamins for any reason. The American Medical Association has tried to reason with them, but to no avail.
Thiamine is easily available from a wide variety of plant-based foods. Unless you have an intestinal disease or are a malnourished alcoholic, you are almost certainly getting enough in your diet. On the other hand, a fat-soluble thiamine analogue called benfotiamine might be useful for helping to prevent the complications of diabetes.
It may also be useful in preventing the progression of Alzheimer’s disease, which is sometimes called type 3 diabetes. As we’ll see, however, type 2 diabetes is easily reversed through a switch to a low-fat, plant-based diet, and most cases of type 1 diabetes could be prevented if people stopped giving cow’s milk to children and made sure that the children got enough vitamin D from exposure to natural sunshine.
I am normally skeptical of the value of vitamin supplements. However, I think that there should be more research on the use of benfotiamine for the prevention and management of Alzheimer’s disease and the complications of diabetes.
Vitamin B2 (Riboflavin)
Although riboflavin (vitamin B2) is one of the essential nutrients, it was never associated with a major deficiency syndrome, like scurvy or beriberi. Vitamin B2 is so widespread in foods that it is hard to get a vitamin B2 deficiency, unless you are having trouble absorbing vitamins from your food.
The most obvious sign of riboflavin deficiency is chapping of the lips, with cracking at the corners of the mouth. Other signs include a sore, red tongue and an oily, scaly rash on the genitals and the upper lip.
Riboflavin deficiency during pregnancy can cause birth defects, such as cleft lip or defects of the arms or legs.
Some people may need more riboflavin than others do, because of genetic differences in how their bodies handle riboflavin.
One preliminary study found that people with Parkinson’s disease tended to have abnormally low levels of riboflavin, even though they were eating a normal diet. Correcting the riboflavin deficiency and eliminating red meat from the diet actually helped to reverse the symptoms of Parkinson’s disease.
Some critics of this study complained that the riboflavin treatment was not being compared with a placebo treatment. Yet the riboflavin was being used to correct a documented deficiency.
Thus, it would have been unethical to have a placebo group.
The only morally acceptable comparator would have been some sort of historical control group. It would be interesting to see whether other researchers also find a high incidence of riboflavin deficiency in people with Parkinson’s disease.
Yet even before that research is done, doctors can order a simple and inexpensive blood test to see whether their patients with Parkinson’s disease have a riboflavin deficiency that needs to be corrected.
Vitamin B3 (Niacin) and Pellagra
During the first half of the 20th century, a severe epidemic of pellagra, which results from deficiency of niacin (vitamin B3), raged in the United States, particularly in the South. It sickened as many as three million people, killing perhaps 100,000 of them.
The epidemic ended abruptly in the 1940s, when food processing companies started “enriching” their refined grain products. “Enrichment” means that the manufacturer adds vitamins to compensate for the nutrient losses that occur when a whole-grain product is refined, such as when whole-grain corn is turned into degerminated cornmeal.
Pellagra causes the “Four D’s”: dermatitis (skin disorder), diarrhea, dementia (loss of memory and thinking skills), and death. Although small outbreaks of pellagra had been occurring in the United States for many years, the Great Pellagra Epidemic broke out after new machinery for processing corn (maize) was introduced.
This machinery produced large corn grits that were lower in fat and fiber but also extremely low in niacin. Among people who were eating virtually nothing other than cornmeal, flavored with molasses and a little bit of fatback, the decrease in the niacin content of their cornmeal was a disaster. Although pellagra was common among people who couldn’t afford to eat much meat or milk, it was not caused by protein deficiency.
At first, many people thought that pellagra was contagious because there were severe outbreaks of it in prisons and mental institutions. However, the staff who worked at these institutions never caught the disease from the inmates, because the staff members were eating a better diet.
People who could afford to eat meat or milk or eggs didn’t get pellagra. That’s because these foods contain niacin or at least some disease from the inmates, because the staff members were eating a better diet. People who could afford to eat meat or milk or eggs didn’t get pellagra.
That’s because these foods contain niacin or at least some tryptophan, which the body can convert to niacin. However, you don’t need to eat animal-based foods in order to get enough niacin or enough tryptophan.
The diet in Mexico and Central America has always been based heavily on corn. Nevertheless, pellagra is rare in those countries, even among the poor, because of the traditional way in which corn is processed. The dried corn is soaked in an alkaline solution, which makes it smell and taste better and makes it easier to grind.
This process also makes the corn easier to digest (so that people absorb more of the niacin) and helps to destroy common toxins produced by mold.
Today, niacin deficiency is rare in the developed countries. It tends to happen only in people who cannot or will not eat a normal diet, or who cannot absorb nutrients from their food.
Niacin is easily available from a wide variety of plant-based foods and is added to refined grain products. So unless you have an intestinal disease or are getting most of your calories from booze, you are probably getting enough niacin from your diet, even if you don’t eat any animal products.
Abnormally high doses of niacin are sometimes used as a drug to boost the levels of “good” HDL cholesterol in the blood. Unfortunately such hi doses of niacin can cause side effects ranging from skin flushing and itching to severe liver damage.
It’s odd that people are willing to take potentially dangerous doses of niacin to deal with a problem that could easily be solved by taking the fat and animal-based foods out of the diet.