Vitamin C : The protective vitamin

Citation preview

ure

1

‘vent anemia and miscz ‘iage,

tic

ul

the common

cold, pre-

heal wounds after surgery,

7605,

and much more!

Webster

hivoduction aa nadie cance i

|

Robert L. Rowan, M.D.

RECENT FINDINGS HAVE UNCOVERED SOME AMAZING POSSIBILITIES FOR VITAMIN € Experts have found that, unlike other vitamins, the more Vitamin C ree consume, the more effective it is. Here is the natural way to health and well-being. Here is the only known cure for the common cold. Here is the miracle medicine that is becoming #1 in the home of the careful American. The many ways that you can use Vitamin C as

a cure and a preventative, to keep yourself and your family in top shape, are explained in this comprehensive, authoritative volume.

READ IT NOW! START YOUR VITAMIN € CAMPAIGN TODAY!

VITAMIN ¢

THE PROTECTIVE VITAMIN James Webster

Foreword by Robert L. Rowan, M.D.

AWARD BOOKS TANDEM

BOC KS

Titles are also available at discounts in quantity lots for industrial or sales-promotional use. For details write to Special Projects Division, Award Books, 235 East 45th Street, New York, N.Y. 10017,

Copyright @ 1971 by Universal-Award House, Inc. All rights reserved,

AWARD BOOKS are Srerradiraie UniversalMig sie ByA, is ty ern and aa busing ci Coxporatton, TANDEM BOOKS are Universal andom Pub Som mpi, 14 Gloucester Road, Lon

a

Manufactured in the United States i yeaa

CONTENTS Foreword, by Robert L. Rowan, M.D,

Chapter I. Introduction

Il.

7

17

How The Body Uses Vitamin C

24

III. Some Of This Vitamin’s Benefits

60

IV. V.

A Look At Attitudes The Curative Power Of Vitamin C

" 92 117

FOREWORD Robert L. Rowan, M.D. Robert L. Rowan, M.D., is a practicing urologist and surgeon at New York's St. Vincent's Hospital. He is a diplomate of the American Board of Urol-

ogy, and a fellow of the American College of Surgeons. Dr. Rowan has had experience in the field of drug research and has been a consultant in this field. _

- Vitamin C is essential to human life. This is a univer-

sally accepted fact. There are, however, many aspects of Vitamin C use and function that are the subject of both debate and controversy, the various sides backed by wellknown names in the field of science. This book presents a broad picture of the various aspects of Vitamin C that have developed throughout theears. It will give you an opportunity to learn many e facts involved so that you will be aware of some ofthe problems and possible answers. The Beginning

|

The story of Vitamin C really starts on the British Naval ship Salisbury in the summer of 1750. Here Vitamin C was essentially discovered. _ The Salisbury was ober: of British sailing ships of that era. It idle spend long months at sea because it was at the mercy of the winds. After three or four months at sea, signs of scurvy (the result of a Vitamin C deficiency) would begin to appear, more often among the ship’s crew than among the officers. The signs of scurvy were all too familiar to the doctor aboard the Salisbury, Dr. jones Lind. Sailors would appear in sick bay first complaining of weakness, fatigue. nd Bresisiess then progressed to ep being irritable Bes, 7

8

VITAMIN

C—THE

PROTECTIVE

VITAMIN

and feeling sick. Then aches and pains in muscles and joints developed. As a sailor’s condition worsened, he became short of breath; his skin turned dark and rough; the hair of his body became infected; hemorrhage areas under

the skin developed; his body joints swelled; his gums bled; his teeth fell out. Death would occur when the body temperature rose and breathing became difficult and then impossible. But fortunately, Dr. Lind, a captain and a Scotsman,

didn’t accept the disease as had doctors before him. He took the approach that characterizes the true genius— he began to reason out the problem. Lind noted that scurvy didn’t occur aboard ships that sailed the coastline or on local fishing ships, But scurvy did occur on long sea voyages. Far ahead of his time, Lind undertook exoo aeseda that would prove eventually that scurvy could € prevented and cured by “salad, summer fruits, ete.” Lind actually recognized Vitamin C, but it was an era too soon—no one would accept his findings. But he was. persistent with the British Admiralty, and in 1795, his persistence paid off. Limes were included as a dietary staple for British sailors (hence, their nickname, limeys). Limes were used in this manner as late as the First. World War. _

Vitamins Get Their Start In 1912, a chemist, Casimir Funk, isolated a vitamin material. He called all vitamins known at that time

“vitamine,” probably because of his chemistry background. He chose *‘vita” to indicate a vital material for _ life and “amine” because he believed all vitamins belong _ to this chemical group. In 1920, the word vitamin was established because it was indicated that not all vitamin materials were chemically related, if related at all. _ Today the definition of vitamin includes all organic _

is a epoands that are essential to life ware: in ee

5

VITAMIN C—THE

PROTECTIVE VITAMIN

9

amounts of one or more of the animal species. They are essential for good health. : The

__

Human

Need

for Vitamin

C

This vitamin has the unique quality of being an essential dietary requirement of man, the monkey, the guinea pig and the bulbul. This small group of creatures re-

quires an external supply of Vitamin C whereas a large number of species do not. Humans and the others men- tioned are lacking a material in the liver that allows for the manufacture of Vitamin C from a commonly found body chemical—the body sugar, glucose. Those animals that don’t need an outside supply have an enzyme in the liver that can convert a stage of glucose metabolism into a final step—the production of ascorbic acid (Vitamin C). Vitamin C Deficiency—The Variables _ What happens to a person who is deprived of Vitamin -C in his diet? The answer depends on many factors, _ among which are: the degree of deprivation, the length ofthe deprivation, the person’s body reserve of C, the

_ rare possibility that the person can produce some C internally, the extent of their need for C. In an adult who is kept on a diet free of ascorbic acid,

_ after about six weeks the blood levels of C will fall to zero, If you continue the withholding of C, in about ten _ weeks symptoms of scurvy, previously described, will _ start to appear.

When you have scurvy, you will always have a zero C blood level. You can, however, have a zero C blood level

and not show signs of scurvy. Why is this latter condition possible? One possibility is that there are occasional humans who have some of the chemical necessary for the internal manufacture of Vitamin C. These people - might possibly be able to produce enough C to prevent _ scurvy though the blood level is zero and no outside C is supplied. bi

10

VITAMIN C—THE PROTECTIVE VITAMIN

C’s Storage

Compartments

The ascorbic acid within the body is distributed :into

what might be considered compartments.

These areas,

the blood, tissues and buffy coat, vary in amounts of C but not necessarily in relationship to one another. It’s believed that when the_tissue level falls to 50 percent of normal saturation, the blood level decreases, and when

the tissue level falls to 20 percent of normal, the disease scurvy begins to prevent symptoms. Testing for the Body’s Vitamin C Testing for Vitamin C levels can be done by many different methods. This produces a wide variety of results —

and leads to confusion. The results will often vary with the type of test used, such as a color test, a chemical reducing test, various electronically controlled tests. Tissues such as the retina of the eye (which holds the s

greatest concentration)

are tested, as well as various

‘active glands. The more active the tissue, the more C it

holds. Vitamin C can also be in a part of the blood called is that part of the blood that clot which forms when blood

tested for in the blood and the buffy coat. This “coat” settles in a layer above the is placed in a test tube.

Deficiencies

Aside from poverty, which can be a cause of poor nutrition, there can be other causes for a Vitamin C defi-

_ ciency in the general population. © Many people eat the wrong foods because of a lack of adequate nutritional knowledge. They eat a poor choice of foods and prepare them in an improper man_ ner, This lack of knowledge can be due to nee

edu-

- cation.

_© Many people in the United States dict to prevent a weight gain or to remove excess weight. In the: processnt

VITAMIN O—THE PROTECTIVE VITAMIN

11

i dieting they lack the vitamin consumption, minerals, and

proteins that are required for good health. _® Alcoholics are notoriously inadequately supplied with essential vitamins. The alcoholic consumes his _

calories in the form of whiskey and thereby unbalances

his dietary needs. ® The bachelor who is too busy to consider the correct

diet will state that he always eats a hot lunch—meaning, perhaps, a hot fudge sundae. He is a candidate for vitamin deficiency. i

The

Need

for Increased

Ascorbic

Acid

- There are some conditions that have been proven to _ require an increase in Vitamin C intake for prevention - or correction. There are other situations that have been said to “improve” with an increase in Vitamin C. There are some in which the possibility of improvement by

increased C has stimulated a great deal of disagreement. _ A wide representation of these will be presented in this

_ book. Not everyone will agree with the findings. The

_ following are a few of the conditions that will be pre-

sented:

® Surgical procedures definitely require an increase in ascorbic acid intake, This has been carefully documented in studies done on surgical patients both before and after the surgery. It is well known that in patients deficient in _ G, there will be poor wound healing and possibly wound ‘breakdown.

® Pregnancy is a state of sudden increase in growth.

- It requires adequate supplies of Vitamin C.

® Some disease processes are believed to be aided by ‘an increase in Vitamin C—allergy, rheumatic fever, hep-

_ atitis, and arthritis.

‘ The Common Cold _ Can ascorbic acid intake prevent or cure the common

cold? You would think this a simple questionto answer.

12

VITAMIN C—THE PROTECTIVE VITAMIN

It is not. I don’t believe the answer will be forthcoming for a long time. There are many factors that we do not understand. Is the common cold always due to a vineDo we at times mistake a common cold for an allergic reaction, a reaction to the smog, an anxiety response, or a bacterial

infection? Are there some viruses that cause the common cold that we have not as yet been able to identify? What are the factors of natural resistance to a coldP You see,

we are working with a disease that is not easily identified — on a scientific basis.

f

Were we able to definitely establish who has a cold and who does not, what would be required next in the Vitamin C study? We would have to establish three groups of patients for study. One group would be the control, one group would receive the Vitamin C and one oup, unknowingly, would receive a placebo identical to the C. Each group would be studied and followed for » a long period of time. The frequency of colds in each “group would have to be determined. It would be necessary to show that the difference in the groups had a statistical significance. An example of this type of study was the one done to determine if fluoridation prevented tooth decay. Two cities of equal size, location, and population were compared. One city received the fluoride in the water, the other did not. Careful records were kept as to the fre-

quency of cavities in the teeth of respective groups in ‘the two cities. A fairly accurate determination

can be

_ made by this method. For a Vitamin C cold study to be of value, it would

have to be similar to the fluoride study—only with the _ cold study, the number

of variable factors would

be

greater than with the fluoride study, so that even when the study was over, the results might not be conclusive, _

VITAMIN

The ‘Safety and of Vitamin C

|

C—THE

PROTECTIVE

Danger

of an

VITAMIN

Increased

13

Intake

The group in favor of an increased intake of C claims that you can take up to 1000 mg of C a day for three months and there will be no adverse effects on the patient’s clinical condition nor will there be any ill effects upon the blood or buffy coat levels of ascorbic acid. The group who claim that there are dangers in the

overuse of Vitamin C have their side presented in the _ Medical Letter of December 25, 1970, Vol. 12, No. 26. It indicates that Vitamin C (ascorbic acid) passes out

of the body in the urine. The word acid explains the effect of the vitamin upon the urine, It makes it chemically acid. This increased acidity causes certain types _ of kidney stone to precipitate out of the urine. The stones are cystine stones and urate stones.

_ Patients with gout or a tendency to gout should not receive the extra C because of this, as should not dia_betics

(patients with increased

blood

sugar disease).

- These patients test their urine for the presence of sugar and determine in this manner the amount of antisugar drug (insulin) needed to keep their body in balance. In patients who are receiving the extra C, the urine change . _ resulting may affect the test they use for sugar evaluation.

Their diabetic contro] would thus be endangered. _.

Obtaining

the C Your

Body

Needs

Where can I obtain the C my body needs and how do I prepare the food that contains this vitamin so that it is not destroyed? The common foods that are most important and valuable as the dietary source of ascorbic acid are liver, fruits and vegetables. Citrus fruits and fresh tomatoes provide the best source in this group. Unfortunately, _ storage and food processing decreases the amount of C

14

VITAMIN

C—THE

PROTECTIVE

VITAMIN

in various foods. There are two general rules that are of help in protecting the C in foods. 1, Storage of foods ina cool environment protects the C. 2. Boiling foods for any length of time destroys the C. Vitamin C is water soluble and boiling the food containing it draws the vitamin out into the water used and

the heat destroys it. Boiling can bring the C content of food down to zero milligrams. To preserve Vitamin C in cooked foods, Richard W. Vilter, M.D., Professor of Medicine, University of Cin-

cinnati Medical Center in the book Modern Nutrition in Health and Disease, says that vegetables should be cooked only to the point of nalatability. This process will allow roughly 50 percent of the C to remain intact. Those of you familiar with Oriental cooking will be aware that in this style of food preparation, a rapid heating of short duration is used. This is the ideal type of preparation for protection of Vitamin C. Bee

‘How Much C and Where? The two most common questions asked about Vitamin C are: 1. How much C do I need each day?

2. What foods have the Vitamin and in what amounts? The answer to the first question can be obtained from the following chart that was prepared by the Food and ~ Nutrition Board, National Research Council in 1963: Vitamin C daily requirements listed by age, sex, and. pregnancy; figures are in milligrams of ascorbic acid Men—alll agg oso sictcccsacliw sssncucseseesstnersoes mares eee 70 Women—all: ‘agess ani kes PAS ec ceenerpen nena 70 Pregnant 3rd trimester) . . ........... Thea Lactating (850 ml daily) 0.0.0...

100 100

;

Infants —up to 1 year 0 oececeeescseeeeeeteeese Beeae 30 Children— 173 years) sieve tceesscesaicscetatscanetpesneateeetee 40 SHG VOATS eae actas tase aah steered a 50 ToQ' Years’ iiusts camseyeaa oct eee - 60— Ft 5

VITAMIN

C—THE

BOVSe— LOUD

PROTECTIVE

VITAMIN

15

Years, |caicais. ca dyeovarteleipsceasssohovarennce> 70

13-15 years ........000.... ... 80 LOR20) VOaTs ih cclcssetmiannctivseecestetepianed «... 80

GES LO V2 VEATS 8csi esos: cat eeel ce eek coat savec ees 80 UG--ESUVOATS: Mites awsicc aeecto we laescsects 80 TG—ZOVeATS

piece chy Aivsiatitatceseieanectte 70

The answer to the second question can be found in part in the following chart from Bulletin No. 27, US. Department of Agriculture: The following are a few foods and their ascorbic acid content. *mg. ascorbic acid Asparagus, cut spears, cooked—1 cup ................ 46 Lima beans,cteh CUP Shui heats mechae= OS Broccoli spears, eked CUD YES rede reese! 135

Brussels sprouts, cooked—1 cup .........:..s-sseseeee 113

Mustard greens, cooked—I

cup ..........:ceee

68

Green peas, cooked—L cup o....tc..csseceeeceessseeeeeees 33 Sweet peppers, red pod, hah tai pod ssid; 122 Spinach, cooked—1 cup ......:...cescceceseeesseseeseeeees 50 Tomato juice, canned—1 cup ... eee 39 Cantaloupe, raw, med. size—one half ................ 63 Grapefruit juice, frozen conc. unsweet.—6 fl. oz. 286

Lemon juice, fresh—1 Cup .u..s.....ccee eee eeeeees 113 Orange juice, fresh—1 cup .......0...c.eccceeeeeeee 122 Strawberries, frozen, not thawed—16 oz. can . 1 2A0ETomato SOW PLS CUP) crit trssbactevesscivios sarctustiathees

* Nutritive Value of Foods—Home U.S. Department of Agriculture

12

and Garden Bulletin No. 72

Note: Remember to take into account the method you

use to prepare these foods. Improper preparation will destroy Vitamin C.

Should

I Take

Vitamin

C Tablets?

_ The answer to this question like most medica! questions,is specific for each individual human being. The very best method to determine this answer is to have

your doctor answer it for you, specifically.

AGS:

The

VITAMIN

Need

C—THE

PROTECTIVE

for Continuing

VITAMIN

Research

‘One is made aware of the necessity for research when one notes an article that appeared in the June 9, 1971 Medical Tribune. — Two Get A.M.A. Prize for Joint Research on

Vitamin Deficit ; “Chicago—An Iowa university professor and the com‘mander of an Army medical research laboratory have been named by the American Medical Association to. share the 1971 Joseph Goldberger Award in Clinical Nutrition. “They are Dr. Robert E. Hodges, Professor of Internal Medicine at the University of Iowa Medical School, in Iowa City, and Col. John E. Canham, commanding officer

of the U.S. Army Medical Research and Nutrition Laboratory at Fitzsimons General Hospital in Denver. “The award is in recognition of their joint experiments *. with human volunteers into deficiencies of Vitamin A and ~ C, as well as for outstanding research each has done

separately...” > “They collaborated in projects to further define the minimum dietary requirement in human beings for Vita' mins A and C and to get deeper insight into how the body responds both to decreasing body supplies of the vitamins and to restoring them. Using prison volunteers,

they studied physiologic, biochemical and anatomical changes and their relationship, first while the patients were fed diets lacking in the two vitamins and then as the vitamins were restored.” You can see that from 1750 until today we are still struggling with a need and desire to understand the

functions and the basic requirements of the human body for vitamins. —Robert L. Rowan, M.D. New York City

INTRODUCTION The winter of 1971 brought an unprecedented run on retail pharmacies for supplies of Vitamin C in massive doses. Not since the days of sea-going wooden ships had the anti-scurvy element seemed so wanted. Why? A considerable number of physicians, nutritionists and

biochemists seem to agree that massive doses of powdered Vitamin C can cure or prevent colds and other upper respiratory infections. A great many other medical people do not agree—in fact, some claim that Vitamin C in massive doses can cause gastric disturbances and

that other possible side effects are unknown. What is the truth of the matter? And how does it affect you, the publicP Let’s sample the record. Fern Marja Eckman, writing for the New York Post of February 6, 1971, said that the first controlled test since the controversy began was about to be taunched _by the University of Maryland Medical School. The test was to be limited in scope. 17

18

VITAMIN

“Dr. Richard

C—-THE

PROTECTIVE

B. Hornick,

VITAMIN

director of the Infectious

Disease Division, said that on February 1 his research

unit began a month-long experiment on forty prisoner volunteers at the Maryland House of Corrections,” Mrs.

Eckman wrote. Four grams of Vitamin C were to be administered each day to half the participants. Placebos—harmless and inert substitutes—went to the other twenty. As is usual in a double-blind test, neither doctors nor sub-

jects were to know who was in each group. At the end of the second week, live cold viruses were

to be injected into all forty men, with their conditions closely monitored for the final two weeks. Blood and urine specimens were to be checked at regwiar intervals for antibody protection to the virus. Hornick said the results could not be tabulated for several months but did not discount the seriousness of checking for such side effects as diarrhea and insomnia. This writer, no medical researcher, merely a fallible

human, tested Vitamin C and could not get past more

_ than 250 mg of the product. I had what can only be described as gastric reactions. A friend of mine, a Californian, has’ taken; Vitamin C every day for years. But the practice is no longer common sense with him—it’s a religion. ")

A

number of other newspapers had comments. The

_ Dayton

(Ohio)

News

of November

22, 1970, had a

humorous observation: “If you want to prevent colds,

_ start with either fifty-two oranges or fifty-two grapefruit a day. That’s what it would take in citrus fruit to match the Vitamin C in the four ape of baertnns acid _

vocated by enthusiasts.”

gh

eee

VITAMIN C—THE PROTECTIVE VITAMIN

19

_ This bit of information was supplied by Karen Living_ ston, a Miami Valley hospital dietitian. She further told the newspaper’s readership that if they tired of citrus » fruits, leafy vegetables and new potatoes were also important sources of natural Vitamin C. On short no_ tice, The Daily News couldn't find out how many pounds _ of, say, spinach or head lettuce would have to be consumed daily to meet recommendations. A minimum of 60 milligrams daily of Vitamin C is set by the food and _ nutrition board of the National Research Council but

_ many say that is too low. Jim Hyatt of The Wall Street Journal felt light-hearted about the subject in a front-page article on December

4, 1970.

- “Does your throat feel like a clumsy carpenter has _ just run his rasp across it? Is your nose running so fast _ that you had to buy. it a pair of track shoes?. Does your chest feel like you're being squeezed by a notso-lovable gorilla? _ “Then, friend, you have a cold. (Here he went on to _ describe the massive-dose recommendations. ) _ “There's just one problem . . . there has been a run on Vitamin C and your friendly neighborhood druggist ~ may well be out. “Not everyone agrees that massive doses of Vitamin Care good for a person; some medical authorities re_ main quite skeptical. But most people stopped listening as soon as they heard that Vitamin C could cure colds. _ They stopped listening and started running to the drugstore.

“We're not’ selling twice as much Vitamin C—it’s _ more like twenty times as much,’ says a re at os Leader Drug Store in downtown Cleveland..

20

VITAMIN

C—THE

PROTECTIVE

VITAMIN

“Some physicians and health food advocates have for years been urging heavy intake of Vitamin C, which is commonly found in citrus fruit, some leafy green vegetables and potatoes. Although it isn’t clear yet if large doses are good for a person, all medical authorities agree that everyone should take some Vitamin C regularly. Without it, a person gets scurvy—the oncedread disease producing abnormal bone growth, Biko ribs, pain, fever and infections.” ; Medical authorities do not agree on cures fou oe common cold! “But anyone with a cold will go to great lengths to get rid of it,” the newspaper continued. “Sam Hersh, a twenty-four-year-old from Cleveland, recently tried to buy some Vitamin C, but it took him a week — to find some. And

what happened

while he was

rac-

ing in and out of the cold, from one suburban drugstore to another? ra

“Sam Hersh caught a cold.” The Medical Letter, a non-profit industry newsletter that discusses pharmaceutical products, came out on

December 25, 1970, with specific warnings against indiscriminate massive

doses of Vitamin C without pre-

vious large-scale testing of its efficacy. Among the observations in The Medical Letter were: “Differences in the natural history of an infection — ‘and in. natural immunity have an important bearing on the apparent effects of a proposed remedy, and a

controlled trial of the effectiveness of Vitamin C against _ upper respiratory infections must be conducted over a long period and include many hundreds gt persons to _ give meaningful results.” _

On the other hand, Medical World PBS, the presti-

VITAMIN

C—THE

PROTECTIVE VITAMIN

21

gious professional magazine for doctors, did not go along with this guarded opinion. In its February 26, 1971, issue, in an article entitled

“Vitamin

C:

How

-Much Is Too Much?” MWN stated: “The possibility of overuse was first raised in the December 25 issue of Medical Letter, which cautioned

that Vitamin C in large doses can have adverse effects and that ‘when four to twelve grams of Vitamin C are taken daily for acidification of the urine, as in the management of some chronic urinary-tract infections, precipitation. of urate and cystine stones in the urinary tract can occur.’

. Medical. Letter was asked to cite the medical literature supporting its warning about urate and cystine stones. Of the three papers cited, none mentioned any precipitation of stones. And one stated: ‘In no patient were any side effects noted from the administration -of either

[ascorbic

acid or methanamine

mandelate]

drug.’ _

“Dr. Harold Aaron, chairman of ML’s editorial board,

later explained that the studies pose only: to establish that the by high dosages of ascorbic acid of precipitation of urate and

were cited for one pururine could be acidified . . . As for the possibility cystine stones at such

levels of acidification, he said: “That, you'll find in any

textbook of medicine.’ “The Newsletter, when asked, refused to identify the

writer of the article...”

MWN also quoted Dr. Frederick Stare, chief nutri-

tionist at Harvard’s School of Public Health, as stating

that a Russian study showed that six gm of ascorbic acid a day for three days had been used to abort, ee ecect success, in sixteen of twenty women. 2ro

he

Pee" ‘a3 Ara

= h

‘ lS,i Aoi ds ai ALi oe

22

VITAMIN

C—THE

PROTECTIVE

VITAMIN

What is the cost of the massive-dose therapy to the cold sufferer? One pound of the crystalline-powdered form of ascorbic acid equals 453.6 grams. A level teaspoon of ascorbic acid is 4.4 grams. Dr. Linus Pauling recommends three grams a day for “many people,” the dosage he takes, but he does say that some people may need only 250 milligrams and others as much as ten grams to knock out a cold once it starts.

Retail prices for 1000-tablet bottles in 500-milligram strength in the three large area chains in Washington, D. C., jumped sharply from the beginning of the fad, ' ranging from $1.59 to $2.27, and in New York City local pharmaceutical retailers complained that they were forced to raise the usually low prices of Vitamin C in tablets because their suppliers were putting the squeeze on price, thanks to increased demand. But even at rates oo as high as $4 per hundred for the 500-milligram bottle, the 3-gram dose recommended by Dr. Pauling would only cost each customer

ten to twenty-four cents a

day.

Pauling himself, according to the Washington Post News Service, in a story that appeared on December . 20, 1970, in the New

:

Haven Register, prefers Vitamin

C in powdered form, mixed with fruit juice, to avoid swallowing a great many pills daily. Most customers seem to prefer tablets, however, say pharmacists. Vitamin C comes in dosages ranging from 50 to 500 ; milligrams. The most common

tablet size is 250 milli-.

grams, yet pharmacists report bottles of one hundred tablets of 500-milligram strength have been the biggest sellers recently, compared with the 100-milligram dosage _ that was the popular seller a few years ago.

VITAMIN

C——-THE

PROTECTIVE

VITAMIN

23

The Register story quoted Alan Fishman, a pharmacist. *T usually tell (customers) to wash it down with bour-

bon,” he said. “The drug won't help their cough, but they won't give a damn if they drink (alcohol)

with

it.

One of the three leading manufacturers

of ascorbic

_ acid was quoted as calling the Vitamin C fad “a flash in the pan” and predicted sales would amount to “peanuts.” Another, however, has been building a new plant

in Belvedere, New Jersey, since long before this fad _ Started, which will be capable of producing 12,000 tons

_of Vitamin C a year when demand warrants. When asked by a news service if the current fad was a factor, a company spokesman scoffed at the idea. The new plant, he said, had been projected on the basis of

a long-term trend toward nutrient enrichment. - Production of Vitamin C already has increased considerably since 1968, the latest year for which official figures are available. According to the U.S. Tariff Commission, U. S. bulk production of Vitamin C—for food, animal feed, export, pharmaceuticals, et cetera

-—amounted to 4,280 tons, with a value of ten million dollars. In that same year (1968) over 1,000 tons were

imported, much of it from Japan, at a cost of three million dollars. Ascorbic acid now sells for about $3000 a ton.

il

HOW

THE BODY

The Washington

USES VITAMIN C

Post service pointed out that no

breakdown seems available on the amount of Vitamin

C sold in tablet form, since only a fraction of the bulk » production ends on the drugstore shelf. The Pharmaceutical Manufacturers Association esti-mates approximately 1/7 of all bulk vitamins manufactured are ascorbic acid. However, the percentage of retail sales (which amounted to $304,460,000 in 1969)

represented by Vitamin C remains unknown. This is because much of it is sold in multi-vitamin form. Up to now, the amount of pure Vitamin C sold in tablet

—

form has been considered too insignificant to warrant — _ Separate tabulation—but it may have to be considered separately in the future on the basis of sales alone. Certainly, if you read through this book, you will learn more truths about Vitamin C than anything it~ may have to do with cold cure and prevention. Because _ Vitamin C is good for so many things—and has been © known to be so for far longer than the public realizes— _ its about time the wraps were taken off this hardy ~ i

:

24

oie

‘0.

dle

ao

VITAMIN

C—THE

PROTECTIVE VITAMIN

25

and helpful factor in our lives, and you were given the whole story. : _ Vitamin C is something you need—with or without a cold! So reaadon... | Back in June 1968, not enough people heard of an

excellent delineation given at a seminar for science editors and writers by Dr. Elmer Severinghaus, Medical Consultant to the Vitamin Information Bureau at 575 Lexington Avenue, New York, New York 10022. Dr. Sev-

-eringhaus is a graduate of Harvard University and of _the University of Wisconsin, and is the former vice-

_ president for Clinical Research of Hoffman-La Roche -Inc., as well as having served at Columbia University and on the National Research Council. In addition, he is a past president of the Endocrine Society, so we

might very well admit that he knows his field. - With the kind permission of Dr. Severinghaus and the Vitamin Information Bureau, I am repeating the information this nutritional/gland expert gave on the program. The material follows. It should help you understand the controversy which would come two years later and which still goes on. _ ‘The interest in Vitamin C, or ascorbic acid, as it is known technically, is relatively recent. Even primitive people, however, knew that it was necessary to have

fresh plant foods to maintain health and to avoid what - we now know as scurvy. However, the actual discovery of the chemical nature of Vitamin C and its synthesis did not occur until the early thirties of this century. A surprising fact about ourselves came to light at _ about this time. _ Vitamin C is necessary to many cell functions in

plants and animals alike. We find it produced in ger-

26

VITAMIN

C—THE

PROTECTIVE

VITAMIN

minating seeds and also by the action of enzymes on simple carbohydrates in animals. But this universal vitamin must be pre-formed for man because his cells cannot manufacture it as those of plants and most ani-

mals can. The only other animals as handicapped as man are the guinea pig, many primates and a few Oriental birds. This small group lacks a certain enzyme which can complete the synthesis of Vitamin C and must have it pre-formed in food. Concentration of Vitamin C in the cellular liquids of all life forms is remarkably similar, indicating a normal or optimum level which tissues make for their own needs. This gives us a clue to the desirable concentration that we must attempt to maintain through the only means available to us.

Cow’s milk is low in Vitamin C. Human milk is said to be higher than cow’s milk, but to vary in Vitamin C content according to the dietary intake of the nursing mother. When Vitamin C intake is impaired for any reason, some body tissue, such as the plasma part of blood, shows a rapid drop in content. The amount lost in the urine also drops rapidly. The concentration in the blood corpuscles, however, drops slowly—and even more slowly in non-circulating (fixed) tissue. Certain symptoms become apparent after prolonged _ Vitamin C deprivation. They are weakness and lassi4

—

tude, a decreased appetite, retardation in growth and anemia. There is increased risk of infection. Tender-

ness in general, not localized to some particular place, —

becomes evident, as does swelling of the gums and loosening of teeth. Swelling around the wrists and an- —

VITAMIN

C—-THE.

PROTECTIVE

VITAMIN

27

Kles, shortness of breath and fevers may appear. Tiny hemorrhages,

often microscopic

in size but tending to

be confluent, may occur under the skin, giving the appearance of a big bruise. A grave symptom is the so- . called beading of the ribs. In this condition, swelling occurs between the cartilaginous and bony sections of the rib, resulting in.a chain of bead-like swellings up and down the front of the chest wall. _ X-ray will show progressive damage to bone struc_ ture at the growing ends, or epipheses. Massive hemor-

_ rhages may follow deep in the tissues and on the lin- ing outside the bones called the periosteum. These symptoms may be classified together in general terms of failure in maintaining

a normal

amount

of

- collagen, protein from which gelatin is made in com-— merce. This soft structural protein is present in cartilage, and is also found in diffused form in most of body tissues. This collagen protein is unique in its content of an amino acid called hydroxyprolone. A combined activity of oxygen, Vitamin C and enzymes, is necessary for the conversion of proline into hydroxyproline. _A sufficient supply of Vitamin C is therefore necessary for normal collagen. Without Vitamin C we have an _ abnormal

protein, the collagen that is not normal in

character and not normal in amount, and this is the

_ fundamental cause of characteristic disorders in gums,

teeth and bones. Some impairment in clotting mechanism also occurs,

so that there may be a tendency to exaggerated bleeding. Any deficiency of collagen in the lining of the blood ' vessels will allow ruptures. __ While anemia is one of the symptoms in the ache

©

/

28

VITAMIN C—THE

PROTECTIVE

VITAMIN

of Vitamin C or ascorbic acid, anemia can also be caused

by other deficiencies and therefore is not evidence ‘ ; Vitamin C deficiency only.

One of the early discoveries about Vitamin C was its intimate relation to oxidation—that is, a combination of

biological compounds

with oxygen.

I mentioned

its

need in the hydroxylation of proline to make hydroxy-

proline. Vitamin C also’ protects against oxidation of other sensitive materials such as thiamine or Vitamin B; and riboflavin (or Vitamin Bz), of -folic acid and pantothenic acid. It even helps to protect some of the fat-soluble vitamins like A and E. Vitamin C also has an effect on the production of flora, those bacteria to which we are all hosts in our own digestive tracts, and which there create some of

the other vitamins that we absorb. What happens to Vitamin C if we have an excess beyond our needs? We can ingest large amounts of Vitamin C without harm. In excess as well as in ordinary intake, Vitamin C is excreted through the kidneys into the urine, part of it oxidized in the same way that sugar is oxidized to carbon dioxide to appear as oxalic acid. The Vitamin C content of the body tissues is found to be rapidly and markedly depleted by such situations

as severe burns, toxicity from infection or poison—and — even by profound shock. The shock may be from a physiological cause like hemorrhage or accident; or may be a psychological shock. Either way, a shock situation can reduce Vitamin C. . We do not know exactly what happens in this connection. The vitamin content may be lowered by utiliza-

VITAMIN

C—THE

PROTECTIVE

VITAMIN

29

tion, in some way reappearing later—or it may be destroyed. Vitamin C is quite stable chemically if protected in _an acid solution. In a neutral or alkaline solution, the vitamin is destroyed quite easily. It is also destroyed by oxygen and is particularly susceptible to contact with copper. The latter fact has become important in the whole matter of pasteurization and other food processing. Copper tubing and copper equipment, which are technically ' very desirable, are hazards to the Vitamin C content of food processed through them. This factor is important when the food is considered a source of Vitamin C.

The human need for, Vitamin C is probably in the _ neighborhood of 10 mg per day if the criterion is merely prevention of florid scurvy. Florid scurvy is the late evidence of marked and persistent deficiency. If one uses

as a criterion not the prevention of disaster but

_ the maintenance of good health, the concentration of _ Vitamin C would have to be much higher, something _ like five to fifteen times as much as the scurvy prevention minimum—or 50 to 150 mg per day instead of 10. _

This choice of criterion—cure or prevention of demonstrable vitamin deficiency disease as opposed to op_timum concentration—affects almost all of the vitamin _ studies currently under way. A small need exists to prevent overt disease. A much _ larger goal is to prevent any diminution in functional _ capacity One ot the easiest ways of measuring optimum _ functiona! capacity is to observe fertility and the main_ tenance of reproductive capacity in animals known to

_ manufacture their own Vitamin C, The amount found in the tissues of sexually vigorous specimens. would sup-

30

VITAMIN

C—THE

PROTECTIVE

VITAMIN

port the argument for the top daily requirement in humans. The Food and Nutrition Board of the National Research Council has for a period of some thirty years been concerned with a recommended daily allowance of different nutrients including vitamins. In their recent publication, they are still adhering to a figure of 70 mg of Vitamin C for the average healthy adult. For nursing women

they advise

100 instead

of 70; for infants, a i

proportionately larger amount, 50 mg, and for adolescents, 80 instead of 70, These figures are in proportion to growing processes, particularly production of new protein.

F

These amounts are average and they are also merely suggestions to help maintenance of good health in someone who is already well supplied with Vitamin C—not someone who has been deficient in this vitamin. There is no doubt that individuals vary, that some people need more Vitamin C than others. Inferentially,

some need less than others. The Nutrition Board figures are for the usual person.

Let study of the States to 117

us look at data compiled through a broad-scale of the food purchases and probable food intake population of this country. The average United citizen is assumed to have been taking from 60 mg of Vitamin C per day. Once this trend was

going up, but in recent years.there has been a definite

decrease in consumption of fresh fruit and vegetables as more use is made of prepared, processed materials. We are currently in part of a cycle of decreasing the use of the fresh foods which are the obvious sources of Vitamin

C in our diet. This brings up the whole question of — food fortification and the use of vitamin concentrates as supplements.

:

\ hae

VITAMIN C—THE PROTECTIVE VITAMIN

31

If you are interested in this sort of material, look at the February 1968 issue of Nutrition Review, the month-

ly journal of the Nutrition Foundation. This information is very ably summarized by Dr. Glen King, years ago one of the discoverers of how to synthesize Vitamin C. Some duibottois and answers, addressed to and replied to by an expert, now follow. Question: With regard to the use of Vitamin C in ‘upper respiratory infections, I wonder if you could give me the benefit of your thinking. Answer:

(Dr. Severinghaus)

It has been difficult to

demonstrate this with any kind of statistical validity. Many physicians are convinced that Vitamin C does help. The evidence

is, of course, that with deficiency

of Vitamin C, susceptibility increases to infections in general. But to pin it down to prevention or abortion— that is the short-term cure of upper respiratory infections—I think, is premature. Question: What are your thoughts on the combination _of Vitamin C with other so-called, and I use this word in quotes, “impurities’—the bioflavanoids, you know,

that may be of particular benefit through the use of Vitamin C? Dr. Severinghaus: I have never been convinced that there was any significant value to such addition to Vitamin C. I don’t see any reason to change my feeling which has developed over a period of decades.

- Question: This question applies not only to Vitamin C but to all vitamins. We are always given as you pointed out, this business of the average dosage, minimun aversee erie for ent so much for lactating

a

vag ‘ arg 4

32

VITAMIN

C—THE

PROTECTIVE

VITAMIN

women, so much for adolescents and so much for adults.

Why has no one looked into the geriatric possibilitiesP Might there not be an additional requirement on the part of the elderly as much as there might be an additional requirement on the part of the adolescent? Why has no one looked into the changing needs of the elderly as a possibility? _ Dr. Severinghaus: I think that it has been looked into. In Vitamin C, there would be little reason to suspect

V4

increased need because one of the important functions involved is the formation of new collagen, not an active process in older people. The same cannot be said for each individual vitamin. There may be individual needs. There has been a fair amount of study in this field. There’s room for more. Question: What is the evidence for Vitamin C deficiency in clinical collagen-type diseases? Answer: The so-called collagen-type are rheumatoid

arthritis and similar diseases. We have not established a relationship. Question: Since Vitamin C is depleted by severe burns and shock, is there a relationship between the adrenal

glands and Vitamin C? Dr. Severinghaus:

Yes, there certainly is a rather in-

—

volved relationship. Any vigorous stimulation of the adrenal glands to secrete the adrenal cortical hormones is associated with rapid depletion in Vitamin C in the © adrenals and in turn in the body. This is part of the shock mechanism. Question: Vitamin C is sometimes recommended for herpes simplex lesions, the cold sore. It would seem to be effective. Is this because of increased integrity of — the tissue or does the vitamin affect the virus too?

VITAMIN

C—THE

PROTECTIVE

VITAMIN

Dr. Severinghaus: I don’t think any answer to that question.

Ive

ever

33

heard

A Woman: The fact that it works, is this rie?

Dr. Severinghaus: I don’t know. This problem would ‘be perhaps as difficult to solve as the first question about upper respiratory infections. An adequate number of cases would be needed to establish the facts. Question: You mentioned that the consumption of fresh fruits and vegetables has been going down. Do you think there is consequently a case for prophylactic concentrate of Vitamin C for children? Answer: I think this is the logic that many of us immediately turn to. Since there is a decrease in the use of fruits and vegetables, there’s increasing reason

to ad-

vise the use of Vitamin C concentrates as routine with people who are not sure that they are getting enough . fruit and vegetable foods. Question: How does the irradiation of foods affect Vitamin C content? Answer: It doesn’t. ‘Historical Information About Vitamin C Before further discussion about Vitamin C, we should _ establish what a vitamin is. _ The word “vitamine” was coined in 1911 by Casimir Funk, a Polish chemist, to designate certain protec-

tive substances which he believed were present in food —but the fascinating properties of vitamins were at least

partly recognized over two hundred years before “vitamins” had a name.

_ Initially it was thought that each vitamin was a protective substance

Be a

which

prevented

a specific disease.

34

VITAMIN

C—THE

PROTECTIVE VITAMIN

However, while it is true that specific disease can result from the lack of specific vitamins, it is also true

that vitamins are essential in maintaining general health. Babies, for example, are customarily given supplementary vitamins from the time they are born until they are at least a year old and sometimes older. Many people of all ages take supplemental vitamins regularly on the recommendation of their family doctors. According to an information booklet published by the

Vitamin

Information

Bureau,

one

definition

of

vitamins is that they are complex organic substances, required in small amounts for the maintenance of life and health, which the body cannot manufacture. Although they themselves are not burned for energy or used as “building blocks” they act as catalysts that help natural body processes to proceed normally—the absorption, digestion and utilization of food for energy, for

example, and the development of tissues peered for

growth, reproduction and repair. Pure vitamins

are very disappointing to ive at, ac-

cording to an article in Today's Health, January 1963, by Donald G. Cooley. They look like powders, oils, salts and other prosaic chemicals,

although under

a micro-_

scope some of their delicate crystals are very beautiful. Vitamins have nothing in common chemically. Some are acids, some are alcohols, some are amines and other molecules that are quite simple, compared to the complex structure of proteins. Nothing in the make-up of -a molecule tells a researcher that it is a vitamin, Mr. Cooley explains. Nicotinic acid was a known chemical compound for twenty-five years before scientists found — it to be the vitamin that prevents pellagra._ The Vitamin Jerounetes Bureau says that vitamins

VITAMIN C—THE

PROTECTIVE VITAMIN

35

are not foods, but chemicals contained in foods. They furnish no calories or building materials for body parts. Vitamins take part in chains of fleeting chemical reactions which release energy from foods and _participate in vital processes within our bones, blood, eyes, heart, skin, glands, nerves, circulation, and minds. These

intricate processes need many kinds of specific chemical help. Many must be ignited, or kept going at some step of the way, with the help of vitamins. Vitamins never work single-handedly, but in partnership with each other, with hormones, enzymes, and many other sub' stances.

In 1963 the scientific world paid special tribute to James Lind. Two centuries earlier, in 1753, he had written his famous “Treatise of the Scurvy,” a short book that not only helped conquer the scourge of scurvy among seamen but also pointed the way to the discovery of _ ascorbic acid, or Vitamin C. However, despite Lind’s findings, it took nearly fifty years for his recommendations

to be put into effect.

Not until 1795 did the British Admiralty issue that each seaman and marine be issued lemon juice daily. As a result, scurvy disappeared Royal Navy as if by magic. Much more than a century later, the true Vitamin C was only beginning to be realized.

the order or orange from the

nature of Not until 1932 was it first isolated from lemons by researchers Waugh and King, according to an article by Milton A. Lesser, in the May and June 1954 issues of Drug and Cosmetic Industry. Following year it was synthesized by scientist Reichstein and his associates, Soon, large-scale synthesis was developed to permit the commercial production of the first crystalline vitamin. ~

yy Bia? >

ee

VITAMIN

C—THE

PROTECTIVE

VITAMIN

Only man, monkeys, the guinea pig, the Indian fruit

fly and an oriental animal called the red-vented bulbul develop scurvy, the nutritional deficiency disease, because they alone are unable to produce their own internal supply of ascorbic acid (Vitamin C). The Vitamin Information Bureau advises that other animals—as far

as is now known—are not dependent on outside sources. Due to a genetic defect, the absence of one liver enzyme,

L-gulono-lactone oxidase, man like the bulbul must consume ascorbic acid and is susceptible to scurvy when his diet is deficient in it. In 1928 Szent-Gyorgi had isolated from oranges, cabbage, the adrenals of oxen and later, from paprika, a substance he named hexuronic acid, which was demon-

strated in 1932 to be identical to the Waugh/King _ material isolated from lemons. Ascorbic acid, in addition to its fundamental action as the antiscorbutic vitamin, is an essential factor in normal growth, development and nutrition. Later we shall go into each of these categories with more defini-

tive examples, but now it is enough to say that Vitamin Cis a prerequisite, not only for the formation of collagen, but for intercellular cement, dentine, cartilage, callus, osteoid tissue of the bones, blood vessel walls and connective tissue. It is indispensable in the healing of wounds and the union of fractures. ;

Ascorbic acid is important in tooth development and is a factor

in resistance

to infection.

It is actively

involved in certain vital functions of the body, such as carbohydrate and protein metabolism, cellular oxidation, and particular focus has been placed in recent years on its function in the adrenal cortex because of i

VITAMIN

C—THE

PROTECTIVE

VITAMIN

37

Vitamin C’s high concentration in the adrenal gland. This vitamin is also believed a regulator of the rate at which cholesterol is formed in the body and a help in problems of aging. Because of these functions, Vitamin C must be considered more than a cure for colds. It is a factor of enormous importance to the human organism, from infancy y on. To understand any one vitamin, we must know a little

more of what they all do and how they support each other in keeping the human body healthy. Donald Cooley’s article on vitamins in the January, 1963, issue of Today's Health, monthly magazine for the public published by the American Medical Association, still seems one of the best summaries of the subject. Cooley stressed that while scientists do not know

in complete detail how a single vitamin works, they have been able to map many biochemical actions with - great accuracy—for instance, the role of vitamins in energy transformation. “Chemical energy of foods must be changed to forms the body can use. This is a matter of burning carbohydrate and fat in the cell to make a molecule called ATP (adenosine triphosphate). This power-packed organic molecule is a source of energy for all living things—men, microbes, plants. “, . Not that vitamins are miraculous packets of com_ pressed energy. We don’t swallow energy per se when _ we swallow vitamins. The notion that one particular vitamin is ‘good for’ energy, another for nerves, another for the skin and another for preventing

a

infections

is

an unfortunate holdover from early days of vitamin re_ search when it was discovered that Vitamin C_prevents scurvy, Vitamin D prevents rickets and Vitamin

38

VITAMIN

C—THE

PROTECTIVE

VITAMIN

B, prevents beriberi. . . . Vitamins are so multi-faceted, so interdependent, so interlinked with hormones, enzymes, and other molecules, that their effects are mani-

fested in i every function of the body. . How certain foods prevent certain diseases was a mystery until around the beginning of our century. This ‘magic’ was most spectacular in treating classic deficiency diseases that took a high toll in disability and death. Nutrition studies began to show that unknown elements in foods, called ‘accessory factors’ were

essential to health in totally unexpected ways. When the word ‘vitamin’ was adopted, mysterious factors were given alphabetical labels. Different investigators discovered the same factor and each gave it a different letter.” . That is why the major “alphabetical” vitamins (A through D) remind us that their benefits were known ~~ before their names,

According to the National Vitamin Foundation, the story of vitamins is, in its way, a kind of detective story

_—complete with clues, developments, discoveries, theo-

ries, evidence, analysis—and a cast which literally numbers thousands, The story of vitamins, however, isn’t complete as yet,

and research is still going on. Also, each of us is personally involved in the vitamin story—not merely as an onlooker, but as a participant—whether or not we realize it.

All of us in America like to think of ourselves as being the best fed, most generally health-conscious nation in the world, True, we are better fed than people

in many countries. Chances are that most of us cam re-

VITAMIN C—THE

PROTECTIVE VITAMIN

39

cite the staples of what the National Dairy Council would _ consider a sound daily diet—milk, eggs, fresh fruits and vegetables, meat and fish, whole-grain bread and cereals.

The trouble is that we neglect or ignore the rules. Although an abundance of good food is available, many of us have fallen into poor eating habits which deprive us _ of the nutrition we need every day of our lives. Do you think this has nothing to do with you? Well, let's take a look at some typical Americans. There’s the city dweller or commuter who either skips breakfast entirely or who settles for a container of coffee and a ‘sweet roll when he reaches the office. His teenage children virtually live on “snacks” at home and a diet of hamburgers, hot dogs and soft drinks when they're out with the gang. As for Mother, how many women do you know who breakfast on coffee and a piece of toast after the family has gone its way, and who nibble at a leftover or a lettuce leaf for lunch? Calorie counters (except those who scrupulously fol-

low doctors’ menus and Weight Watcher Club menus specifically made out for their individual needs) add millions more to the growing number of otherwise intelligent individuals who regularly short-change themselves on the essential vitamins and nutrients they need, Add the thousands of bachelors—and bachelorettes—who live alone (and it’s no fun to cook for just yourself!) and the growing number of older people who suffer from poor appetites and poor teeth and perhaps you'll agree that, from a nutrition point of view, millions of Americans aren’t being fair to themselves. Everybody knows that the foods we eat supposedly supply necessary elements for growth and health; among ‘these are carbohydrates, fats, proteins, minerals, water

40

VITAMIN

C-——-THE

PROTECTIVE

VITAMIN

and vitamins. Generally speaking, our nutrition problems occur most frequently in the areas of too much fat and carbohydrate—sugars and starches—and in too little of certain minerals and vitamins. Now, “too much” or “too little” of some food elements

may soon show up on the bathroom scale, as we note with surprise that we've gained or lost a pound or two. A lack of vitamins, on the other hand, isn’t so immediate-

ly recognized. Many people who feel vaguely that they're “not quite up to par” may walk around for months and even years without realizing a possible cause of the trouble—they’ve let themselves run low on their body's essential vitamin supply. Physicians, of course, are the only. people to consult about illness or unusual fatigue, but the essential role of vitamins in maintaining health is something which everyone should understand. Think of the body as a complex chemical plant which operates twenty-four hours a day, seven days a week, as long as you live. It’s easy to grasp that in order to function smoothly, without breakdown along the line, your body needs a continuous flow of basic raw materials and supplies—food, air, water and sleep—four examples, the Vitamin Information Bureau tells us, of basic “supplies” without which our complex systems would refuse to operate. Given adequate amounts of such essentials,

- our individual chemical plants go to work—converting, manufacturing, repairing, producing literally hundreds

of different products—blood, tissue, bones, antibodies to. resist infection, hair, nails . . . the list is tremendous.

(And have you noticed how many of these you already recognize as being related to the functions of Vitamin: CP) | The first and most obvious source of vitamins is foal: —and some foods ips a higher vitamin content t than

VITAMIN C—THE PROTECTIVE VITAMIN

41

others. Now, after years of research by specialists all over the world, it has been established that a steady diet of certain key foods would provide a normal (notice that

- word “normal”) human being with all the vitamins he needs—if he could stick to it! _. However, the choice of vitamin-rich foods need not

be so limited as one might think. Cereals, leafy green vegetables, liver, citrus fruits and dairy products all con-

tain generous amounts of different vitamins, and many brands of packaged foods contain some assortment of vi_ tamins which have been added by the food processor or . manufacturer. Unfortunately, many of the nutrients nat-

urally present in foods can be lost by improper storage or cooking, so that by the time they reach the table much of their value may have disappeared. _ That is why responsible pharmaceutical companies do us a favor by bringing out supplementary vitamin prep- arations

which

are uniform

in size and

content,

al-

though the specific make-up of different brands does vary. Manufactured vitamins fall into two categories. “Supplementa]” vitamins might be likened to diet insurance— people, particularly those who have irregular eating hab_ its, take them simply to be sure that they are getting

enough vitamins each day. “Therapeutic” vitamins, on the other hand, while not prescription items, should be taken only on the recommendation of physicians to help correct particular physical conditions. Sometimes a doctor will recommend therapeutic vitamins until the condition has been corrected, and will then suggest that supplementary vitamins be taken from there on. As for how much of the various vitamins are needed, this varies with individuals. How old you are, the kind of

42,

VITAMIN

C—THE

PROTECTIVE

VITAMIN

work you do, your general physical condition and other factors, all affect your personal needs.

However,

nu-

tritionists have spent years of study in establishing (approximate)

recommended

daily

allowances,

and

government health agencies as well as hospitals and physicians have lists and charts which outline the various

important vitamins by name, listing the areas in which they are believed to be particularly helpful. Only Vitamin C and Vitamin E have not yet been accurately | figured out for a minimum or maximum daily recommended allowance. That is why their use is still a hap-

penchance thing dependent on each individual's health and reactions, more than happens with the other vita-

mins where definite recommended daily allowances seem to be known at both the minimum and maximum levels. Vitamin A affects the “lining cells” of the body—the skin, the eyes, the urinary tract, the bones and teeth and

gastrointestinal tract. Night vision, or the ability of eyes to adjust to darkness or dim light is one example of conditions affected by Vitamin A, which is largely found in foods of animal origin—whole milk, butter, eggs, liver and kidney, and in certain Vitamin A fortified foods _ such as margarine. The body also makes its own Vitamin A from carotene, found in leafy dark green and yellow vegetables. In general, the deeper or more intense the color, the higher is the natural carotene content— spinach, kale, lettuce and cabbage are in this group, as

are good yellow vegetables such as carrots, squash and yellow turnips.

Vitamin B; (thiamine) helps the body convert sugars and starches into fuel. An inadequate supply of

VITAMIN

thiamine

C—THE

PROTECTIVE

VITAMIN

results in irritability, constipation,

43

insomnia,

loss of appetite and a variety of signs and symptoms . related to disturbances in the functioning of the nervous system. Since the nerve cells use carbohydrate as practically their only source of energy, they are among the first cells in the body to suffer from a lack of thiamine. - If you happen to be fond of dried brewers’ yeast, grilled _ pork chops (well done!) or roast pork or ham, you're

probably often in rich thiamine territory. The same is true of Canadian bacon. As a matter of fact, you'll get a certain amount of thiamine in most other meat, whole grain or enriched cereals and breads; peanuts, eggs,

green peas and oranges. Vitamin

Bz (Riboflavin),

if not in your diet, can

make its absence known in ways that will make you feel distinctly unattractive. Open sores at the corners of the mouth, a red scaly area about the nose, or an unusual _ sensitivity of your eyes to light—these are just a few of _.the results of missing riboflavin. However, it often hap-

_ pens that a lack of riboflavin in the diet is not easily _ recognizable; only your doctor has the knowledge and _ experience to know the difference. If you drink at least a pint of milk a day and eat enriched bread, if you ~ nibble on dried yeast or enjoy kidney, heart or liver, chances are that you're reasonably safe in the riboflavin department. Riboflavin is available from other good _ sources—meat, fish and poultry; eggs, green leafy vegetables and whole wheat bread. An important thing to remember—riboflavin is readily destroyed by light. A bottle of milk, if left standing in the sunlight, loses much of its riboflavin content very quickly. Scientists are not sure exactly how much vitamin Be

44

;

VITAMIN

C—THE

PROTECTIVE

VITAMIN

is required daily. Recent medical studies of a group of expectant mothers indicate that this vitamin is a factor in the prevention or slowing of tooth decay. However, Be deficiency imitates deficiencies of some of the other B vitamins

as well.

Sleepiness,

irritability,

increased

susceptibility to infection, inflammatory lesions of the tongue, mouth

and lips, a dry, scaly skin—these

are

also symptoms of Bg deficiency. Interestingly enough, it has also been found that some laboratory animals, ' when deprived of Be, develop arteriosclerosis (hardening

of the arteries). This vitamin is widely distributed in commonly available foods. Among the best sources are muscle meat, liver, vegetables, whole grain cereals, dried

yeast and whole grain breads. Vitamin By2, although required in extremely small amounts, still is essential for the proper function of the

‘blood-forming organs of the bone marrow. It is also necessary for the health of the nervous system. Usually, deficiency of this vitamin is a result of stomach or intesti- . nal disorders which prevent proper absorption of Biz by the body. Vitamin B,2 is found almost exclusively in animal foods and is stored in the liver. One of the first signs of Bis deficiency is anemia; however, if the deficiency is severe or prolonged, it can result in abnormalities of the spinal cord, peripheral nerves and even the brain. Main sources of Bie are liver, kidney, milk, saltwater fish, oysters, lean

meat and foods of animal origin in general. Although folic acid, pantothenic acid, niacin (nicotinic

acid) and biotin do not have any “B” titles, they too belong to the “B--complex family.” Folic acid therapy is especially good for tropical area disorders of the blood (macrocytic or large cell anemias)

VITAMIN

C—-THE

PROTECTIVE

VITAMIN

45

and of the intestines. In temperate climates, expectant

mothers and infants particularly may suffer from one or another of these ailments due to inadequate folic acid in the diet. There’s some indication that, while folic acid is present in small amounts in most common foods, it

is affected by storage and cooking. Keeping vegetables in the refrigerator will protect their folic acid content— particularly such rich sources as deep green leafy vegetables. Meats, particularly liver, are other good sources. Food yeast is another. Pantothenic acid is found in all living things. So far, no tests have shown that a spontaneous dietary deficiency has occurred in man, but when experimental defi-

ciencies were

induced

in laboratory animals, distur-

bance was noted in the secretion of adrenal hormones

and in the nervous system. —which are necessary to _ pantothenic acid to function Meat, yeast, eggs, nuts, tables contain pantothenic

The production of antibodies fight infections—also needs successfully. and deep green leafy vegeacid. If exposure to air and

high temperatures is avoided, pantothenic acid will re-

main relatively stable in foods that are stored for long periods of time. Niacin (Nicotinic Acid) works with the other B vita-

mins in the utilization of carbohydrates

(sugars and

_ starches) and is also a factor in the prevention of pella_ gra. In the presence of Vitamin Bg and other B vitamins,

the body can convert an “amino acid,” tryptophan, to ~ niacin. Most animal protein foods are high in tryptophan

and will protect against niacin deficiency. Liver, eggs, yeast, enriched cereals and lean meats, including fish

and poultry, are good sources. If you eat little meat or _ enriched and whole grain cereal products, you might do -

46

VITAMIN

C—THE

PROTECTIVE

VITAMIN

well to check with your doctor on a B-complex vitamin supplement. — Biotin is the one vitamin in the B family that is unlikely to give you trouble. Biotin is widely distributed in foods and is also synthesized by micro-organisms in the intestine. Liver, kidney, eggs and most fresh vegetables are good sources. Vitamin D, as you probably know, is called the “sunshine” vitamin. This is the vitamin which the human. body manufactures with help from ultraviolet rays. It seems to have a direct effect on the formation of bone and for this reason, Vitamin D is a must for growing

children.

Expectant

mothers

also

need

additional

amounts of Vitamin D, as do people who have little or

no direct exposure to sunlight. The only rich food sources of this vitamin are fish-liver oils and their ~. concentrates and Vitamin-D fortified milk, although small amounts are present in eggs, herring, sardines, tuna and salmon.

Vitamin E had a role established a little over a decade

ago. At that time, an abnormality of the red blood cells in premature babies was corrected with Vitamin E. Later, a number of full-term babies with the same abnormality were found to make a more rapid and complete

recovery when fed with human milk rather than with cow's milk; and laboratory tests showed that human milk contains from two to four times as much Vitamin E as cow’s milk, Vitamin E also occurs in plant oils such as corn oil, cottonseed oil and wheat germ oils, Lettuce and whole grain cereals contain it and small amounts are present in animal tissues.

VITAMIN. C—THE

PROTECTIVE VITAMIN

47.

Vitamin K is widely present in nature, and can be made by bacteria in the intestines. Leafy vegetables are the main dietary source. Expectant mothers often are given Vitamin K prior to delivery because the newborn child is deficient in _ it. A deficiency of Vitamin K can produce an increase

in the clotting time of the blood and lead to hemorrhage, For most adults, the requirement is about a half milligram per day. The foregoing information about vitamins is in striking contrast to an effort by the Food and Drug Administra-

tion in Washington, D. C., to have all vitamins labeled with a statement that, “except for persons with special

- medical needs, there is no scientific basis for recom-

mending routine use of dietary supplements.” How can a large government agency unilaterally decide what is a special need? In April, 1968, when this _ FDA pronouncement first was made, newspaper writer _ John Chamberlain stated: “, .. this is all very funny, for the Department of Agriculture . . . has recently put out a statement that half the families in America subsist on a diet deficient

in recommended amounts of vitamins and minerals. Is the FDA going to direct them to the right foods? “Consulting a report put out by a third body of ex- perts, the American Medical Association, you get a gris_ ly story of what happens to the average woman of child_ bearing age on a normal . . . 2100 calories a day. A child-bearing woman needs twenty daily milligrams of iron, but a regimen of 2100 calories contains only thir‘teen milligrams. The result, according to the AMA, is _ that ten percent of the women of child-bearing age are iW anemic.

‘

48

VITAMIN

C—THE

PROTECTIVE

VITAMIN

“The Food and Drug Administration might counter with an argument that child-bearing women are ‘persons with special medical needs, but they must add up to between a fourth and a third of the population [at any given time]. If they aren’t getting enough iron, the pro-

posed Food and Drug Administration label telling people that ‘vitamins and minerals are supplied in abundant amounts by commonly available foods’ would be a plain lie for a big portion of the human race. . I asked a nutritionist if a special supplement of spinach might save those anemic women. The answer shed a curious light on the FDA statement that ‘vitamins and minerals are supplied in abundant amounts in commonly available foods.’ “True,

there’s

iron

in

spinach,

But

.

.

.

other

elements in green leafy vegetables can ‘lock the iron up’ so that it can’t be extracted for nutritive purposes . . “Still seeking clarification, I asked the nutritionist, ‘What about liver? That has iron.’ Oh yes, said my expert, you can get enough iron from three-quarters of a pound of liver a day for each of our child-bearing women, but

ifthey were to eat this much there wouldn't be any left for the regular

diets

of males,

who

in turn

would

become anemic...” However, statements by other nutritional groups and experts, including the Department of Health, Education -

and Welfare, agrees with the National Vitamin Board that vitamin supplements are not superfluous.

When food budgets start decreasing, what are the items people try to save on? Those they consider superfluous or luxuries can include fresh fruit or imitation fruit

products, such as orange juice or breakfast juices fortified

with Vitamin C. Many will cut out fresh vegetables and

eae :

concentrate on cheap filling food such as bread, they may try to depend, for vitamins and minerals, on eggs. But like man himself, eggs do not naturally contain Vitamin C. The solution would appear to be a supplement.

In man, the missing factor essential to internal manufacture of Vitamin C is the enzyme that catalyzes the chemical change of gulunolactone to ascorbic acid. The specific genetic defect must have occurred as a mutation over 20 million years ago in the common ancestor of man and other primates, according to the Vitamin Information Bureau, which supplied this particular rundown,

A similar event presumably took place in the ancestors of the other species known to share our handicap. The VIB states that this metabolic defect was apparently not a serious deterrent in the struggle for life—at least not among primates. Vitamin C is abundantly present in plant food. Only when man tried to subsist on a _ diet lacking fresh citrus fruits or vegetables did he experience the full impact of his inability to synthesize ascorbic acid. A person with an ample tissue store of Vitamin C is said to have a plasma ascorbic acid level of 0.8 to 1.0 mg percent. The level is higher in the whole blood (1 to 1.2 mg percent) and much higher in the white blood cells (25 to 38 mg precent). The latter reading is easily obtained by spinning a blood sample in a centrifuge, according to the Vitamin Information Bureau's _ explanation, and siphoning the “buffy coat” that collects between the red cells and plasma. The Vitamin C level in the buffy coat presumably reflects the general tissue concentrations of the vitamin and is considered the best index of ascorbic acid nutriture. On a Vitamin-C-free diet, concentration of this vitaSag

ae

aR

re

50

VITAMIN

C—THE

PROTECTIVE

VITAMIN

min falls to zero in about forty days for the plasma level, in eighty to ninety days for whole blood, and in about 120 days for the buffy coat. The clinical signs of scurvy in various depletion studies did not show up visually until several weeks after Vitamin C disappeared from the buffy coat, following about 160 days of deprivation.

In a recent study, a diet completely free of Vitamin C was used. Some early signs of scurvy began to ap-' pear before one hundred days. The volunteer subjects, however, had few complaints save mild fatigue and muscle cramps. Actual symptoms of scurvy did not appear until the total body pool of ascorbic acid was depleted to 300 mg, about ten percent of the estimated pretrial amount. As with most nutrients, the body conserves scarce . material. One of the tests to determine the amount of

tissue saturation of Vitamin.C is to give 100 mg of ascorbic acid by intravenous injection. Normally, a person well-saturated with Vitamin C will excrete fifty percent of the dose in the urine within three hours; a de-. pleted person will excrete less than fifteen percent; a scorbutic person, less than five percent. In the trial mentioned above, the urinary excretion of ascorbic acid

came back only when the total body pool of the vitamin was restored to about 1500 milligrams. Direct evidence is lacking to support the desirability of high Vitamin C saturation in man. Indirect evidence to this effect, however, is fairly convincing. Guinea pigs

are protected against scurvy by point-five mg of ascorbic acid a day. But up to twentyfold this amount is necessary, says Dr. Charles Glen King, “for optimal pro-_ tection against demands for lactation and reproduction, — ae

te

sa

VITAMIN

C—THE

PROTECTIVE VITAMIN

51

resistance to bacterial toxins, survival under stress, such

as exposure

to cold infections,

and severe

trauma.”

Furthermore, healthy human beings on a mixed diet con-

taining adequate amounts of fresh food consume 50 to 150 mg of Vitamin C daily. These individuals maintain tissue storage equivalent to that seen in animals that synthesize ascorbic acid and presumably keep the vita_min under natural physiological control. The usual American diet is said amply to meet the high requirements of the National Research Council. Dr. King says that the average daily intake of Vitamin C has risen from 69 to 117 mg. In a report published in 1961, a study of high cost, low cost and poor diets

found the daily Vitamin C content to be 147, 134 and 55 mg. Yet there are many indications that substandard intake of Vitamin C is prevalent in America, in spite of statements to the contrary and even though overt clini-_ cal deficiency is seldom seen. Moreover, the situation may have worsened in recent years. The U. S. Department of Agriculture’s survey of 1965 showed American diets to be poorer in calcium, Vitamin A and Vitamin

C than the diets of 1955. A comprehensive review of ninety-one nutrition surveys in the U. S. between 1950 | and 1968 turned up indications of further deterioration. The findings suggest that Vitamin C deficiency usualTy occurs in association with other deficiencies, as part of a general poor nutrition picture. _ The viewers concluded that although the amount of data on nutrient intakes of infants was inadequate for sweeping generalizations, available reports suggested that appreciable percentages of infants were poorly nour-— ished and that, paradoxically, infants from high socio-

peer

52

VITAMIN

C—THE

PROTECTIVE

VITAMIN

economic groups may receive less adequate diets than those from low socio-economic groups.

It is difficult to correlate these findings with the prevalence of clinical or subclinical vitamin deficiency. Most nutrition surveys in this country have been of the dietary intake type, usually without accompanying biochemical measurements or medical examination. Indeed, _ according -to the authors of the review, “Worthwhile

clinical evaluations have been so rare in the studies of Americans that we did not review them”. Thus we know relatively little about the kind and degree of deficiency symptoms present in individuals with low intake of Vitamin C, singly or in combination with other deficiencies. One of the most provocative unanswered questions, the Vitamin Information Bureau says, is how much people differ in their requirements of Vitamin C and, possi-

bly,in the way they metabolize it. Experimental induction of scurvy in man has shown some variations in the time required for the symptoms to appear and in their severity. Generally these variations have not been striking. But other indications suggest a wide variation in individual needs for the vitamin. : The accounts of long voyages from Magellan to Richard Henry Dana show that scurvy seldom if ever affected the entire crew of a vessel. While some sailors

were dying of scurvy, others seemed unaffected—at

least, they were able to carry out hard physical labor. One of the chroniclers of Magellan’s voyage, Antonio Pigafetta, who gave us our account of scurvy in the fleet,

was apparently quite free from physical or mental signs of the disease. This may have been due to differences in taste; some

crew

members

ate better or more wisely

VITAMIN C—THE PROTECTIVE VITAMIN

53

than others. Scurvy was much more common among sailors than officers, reflecting no doubt a felatively greater abundance of fresh food at the officers’ mess. The impression still remains that some individuals are innately less likely to develop scurvy than others. This impression is backed up by certain other data. It has been shown that the Vitamin C requirement of guinea pigs varies by a twentyfold range. If this is so with a laboratory animal like the guinea pig, the chances are that man,

an even

more

variable

species, would

have a far greater range of optimum daily requirements. In this connection, there was an instructive discovery in an early 1960 English study of Vitamin C supplementation in an old age home. The subjects had low Vitamin C levels in their white blood cells. With the addition of 40 or 80 mg of Vitamin C a day, their average vitamin level rose gradually over a nine-month period to that of normal healthy adults. But there was a marked _ variation in individual responses. At the end of the trial (which was carried on for seventeen months) the amount of increase in Vitamin C concentration ranged

from 5 percent at the low end to over 100 percent at the high end—a twentyfold difference. The reason for the differential response was not ascertained. _ Some evidence indicates that animals which synthesize their own Vitamin C are capable of producing large amounts on short notice. The data from rat experiments suggests that, if man belonged to this species, an average _150-pound man would produce 1800 to 4000 mg of Vitamin C daily and, in stress, over 15,000 mg per day! This is a magnitude of vitamin concentration far exceeding any therapeutic regimen used in man, even for the cure of scurvy. It is interesting that overdosage of Vita-

54

VITAMIN

C—-THE.

PROTECTIVE

VITAMIN

min C has not been detected up to now even in the daily intake of 1000-2000 mg over several months. Most nutritionists would consider such consumption as probably harmless but wasteful. Dr. Linus Pauling considers it helpful. Doctors are concerned about its effect on various

tissues

in excretion.

In this writer's

opinion,

it would be worthwhile to research individual reaction and receptivity to any massive overdose.

It might be mentioned here that we know Be genetic conditions due to inborn errors of metabolism in which individuals require a vitamin in amounts far exceeding what is considered the optimum intake, the

Vitamin Information Board advises. One involves Vitamin Bg; the other, Vitamin Bi2. Without

supplemental

vitamins, certain people develop a definite set of symp. toms and some have died. Dr. Leon Rosenberg reviewed these rare “vitamin dependency syndromes” and said such abnormal requirements due to a hereditary defect may exist for all vitamins and other nutrients. Children with a hereditary disease known as Hurler’s syndrome may represent the other end of the spectrum —i.e., people who

need

less vitamin

C than normal

people. In a year or two after birth, the Hurler patient _ develops skeletal abnormalities, coarse and grotesque facial features, visual and/or hearing defects and men-

tal retardation. The primary metabolic fault is apparently an overabundance of the connective tissue cementing substances (mucopolysaccharides ). The cells from Hurlers patients in tissue culture were found to produce and retain more of the cementing substances when Vitamin C was added to the culture. On the hunch that restrictionof Vitamin C might lessen the production of _ such substances, a group of workers at Stanford carried —

VITAMIN

C—THE

PROTECTIVE

VITAMIN

55

out a detailed study of a baby girl with the Hurler’s syndrome who was given a Vitamin C deficient diet. The baby’s level of Vitamin C in the buffy coat was reduced to zero by the thirty-second week of the diet. She was on the diet for over a year, yet showed no signs or symptoms of scurvy. This is an unusual example and the significance of the findings is not clear. But it does point to the possibility that some persons could be relatively resistent to the scorbutic effect of Vitamin C depletion.

It has been suggested that some individuals have re-tained a vestigial power to manufacture Vitamin C in trace amounts. If so, the amount must be very small since the tissue is drained of the vitamin after a few months of restricted diet. The suggestion, however, is in line’

with what has been found in many hereditary metabolic diseases in which patients are capable of making small amounts of the presumably totally “missing” enzyme. Viewing man’s need for preformed Vitamin C—‘“hypoascorbemia”—Irwin Stone wrote, “This genetic disease concept provides the necessary rationale for the use of large doses of ascorbic acid in diseases other than scurvy and opens wide areas of clinical research, previously inadequately explored, for the therapeutic use of high levels of ascorbic acid in infectious diseases, collagen diseases, cardiovascular conditions, cancer, and the aging processes.” Pauling suggests doing likewise in some mental diseases, but other scientists were

ahead

of both

Stone and Pauling, as you will see from research reports we use further on. However, it is important to bear in mind that Stone and Pauling were talking about possibilities, not proba-

bilities. To determine a therapeutic or prophylactic effect of Vitamin C in any one of these conditions requires a

56

VITAMIN

C—THE

PROTECTIVE

VITAMIN

series of well-controlled studies over many years involying different population groups, and requiring much effort and time of the planners, sears

and inter-

preters of the data. There are many unanswered questions about Vitamin C. It is possible that many of its functions are of marginal importance. It seems often to serve as an enhancer of © metabolic reaction but seldom as a limiting factor; i.e., its

absence does not stop the reactions. Experimental and natural scurvy in man, monkeys and guinea pigs seems to follow a predictable, stereotyped pattern. The wide variety of clinical diseases produced in different species by Vitamin E shortage is not seen in Vitamin C deficienoY: The medical journals are filled with clinical findings about the combining of Vitamin C with other vitamins. For instance, some dermatologists have long given their

aging patients a combination of Vitamin C and Vitamin E to keep them mentally alert and their skins young in texture. Some studies indicate improvement in the men-

tal state of the aged after combining dosage forms of Vitamin B Complex with Vitamin C. _ Vitamin C and Vitamin K are often given to patients with nosebleed because research has proven the majority of such patients have a deficiency of ascorbic acid in their bodies. Some researchers have found that next to Vitamin D,

Vitamin C is most lacking in children from four to twelve years of age. In other studies, however, the diets of older children were more deficient in Vitamin C than were the diets of younger children. Where the climate is very warm, scientists believe Vi-

tamin C deficiency will be high. One reason may be that Sa