Abstract
OBJECTIVES: We evaluated the possible role of niacin fortification of the US food supply and other concurrent influences in eliminating the nutritional deficiency disease pellagra. METHODS: We traced chronological changes in pellagra mortality and morbidity and compared them with the development of federal regulations, state laws, and other national activities pertaining to the fortification of cereal-grain products with niacin and other B vitamins. We also compared these changes with other concurrent changes that would have affected pellagra mortality or morbidity. RESULTS: The results show the difficulty of evaluating the effectiveness of a single public health initiative such as food fortification without controlled experimental trials. Nonetheless, the results provide support for the belief that food fortification played a significant role in the elimination of pellagra in the United States. CONCLUSIONS: Food fortification that is designed to restore amounts of nutrients lost through grain milling was an effective tool in preventing pellagra, a classical nutritional deficiency disease, during the 1930s and 1940s, when food availability and variety were considerably less than are currently found in the United States.
Full Text
The Full Text of this article is available as a PDF (203.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- BROCKETT J. E., Jr, CROWLEY L. V., POLLACK H. Studies on nutrition in the Far East. IX. Correlations between clinical signs and biochemical findings. Metabolism. 1956 May;5(3):283–286. [PubMed] [Google Scholar]
- FIGUEROA W. G., SARGENT F., IMPERIALE L., MOREY G. R., PAYNTER C. R., VORHAUS L. J., KARK R. M. Lack of avitaminosis among alcoholics: its relation to fortification of cereal products and the general nutritional status of the population. J Clin Nutr. 1953 Mar-Apr;1(3):179–199. [PubMed] [Google Scholar]
- GOLDSMITH G. A., DARBY W. J. Resurvey of nutritional status in Norris Point, Newfoundland. J Nutr. 1950 Jan;40(1):41–69. doi: 10.1093/jn/40.1.41. [DOI] [PubMed] [Google Scholar]
- Miller D. F. Pellagra deaths in the United States. Am J Clin Nutr. 1978 Apr;31(4):558–559. doi: 10.1093/ajcn/31.4.558. [DOI] [PubMed] [Google Scholar]
- POLLACK H. Studies on nutrition in the Far East. III. Clinical indicator signs of nutritional insufficiencies before and after enrichment of rice with synthetic vitamins. Metabolism. 1956 May;5(3):231–244. [PubMed] [Google Scholar]
- SEBRELL W. H., Jr Enrichment; a public health approach to better nutrition. Public Health Rep. 1953 Aug;68(8):741–746. [PMC free article] [PubMed] [Google Scholar]
- SYDENSTRICKER V. P. The history of pellagra, its recognition as a disorder of nutrition and its conquest. Am J Clin Nutr. 1958 Jul-Aug;6(4):409–414. doi: 10.1093/ajcn/6.4.409. [DOI] [PubMed] [Google Scholar]
- Sebrell W. H., Jr History of pellagra. Fed Proc. 1981 Apr;40(5):1520–1522. [PubMed] [Google Scholar]
- Spivak J. L., Jackson D. L. Pellagra: an analysis of 18 patients and a review of the literature. Johns Hopkins Med J. 1977 Jun;140(6):295–309. [PubMed] [Google Scholar]
- Stratigos J. D., Katsambas A. Pellagra: a still existing disease. Br J Dermatol. 1977 Jan;96(1):99–106. doi: 10.1111/j.1365-2133.1977.tb05197.x. [DOI] [PubMed] [Google Scholar]