November 22, 2015
In the United States, the prevalence of nutrient deficiencies is pretty stark: nine out of 10 Americans fell short of key nutrients in their diet in a 2011 study for the National Milk Mustache Campaign.
While that proportion is alarming, remedies are plentiful. Pairing vitamins and supplements with a more balanced diet to address a particular nutrient deficiency enables most people to reverse harmful health effects in due time.
Those with fewer resources or a dependable support network are not as fortunate, however, and with an abundance of cheap, low-nutrient food, one disease thought to be a thing of pirate tales could be making a comeback.
Eric Churchill, a physician at Baystate Medical Center in Springfield, Massachusetts, first considered the possibility of a modern day scurvy diagnosis in 2009, when a middle-aged man came to his office with bleeding gums, swelling, bruises, and general malaise, Slate reports.
Churchill learned that the man, who suffered from mental illness, had subsisted on nothing but bread and cheese for years in an impoverished food desert.
Known historically to affect sailors in the 1700's who lacked access to fresh produce, scurvy had largely dropped from medical consciousness until Churchill – visited by multiple patients with critically low vitamin C levels – decided to conduct a 5-year study.
In the rare cases that have popped up, the disease has generally been associated with alcoholics, the elderly and severely malnourished children. Churchill's study of 120 individuals revealed that 29 had vitamin C deficiencies low enough to qualify for a scurvy diagnose, a surprise given the low threshold (Churchill said a handful of McDonald's ketchup packets contain enough vitamin C to stave off scurvy).
Extrapolating from the study in Springfield, Churchill realized that the condition, which often surfaces with mysterious symptoms, may be far more common than thought in American cities. What's worse, he said, is that it's going undiagnosed.
The Springfield findings are supported by a 2003-2004 CDC study that found 6-8 percent of the U.S. population, primarily males, had deficiencies that qualify as scurvy. Among low-income individuals, the range jumped to 10-17 percent.
An epidemiologist at the University of Massachusetts-Amherst said that the lack of attention to scurvy in recent decades is probably attributable to the ease of treatment. Those who have it are in many cases consuming no fruits or vegetables at all.
“I think it’s not a sexy topic from a research point of view,” said Elizabeth Bertone-Johnson. “We've understood what causes [scurvy] for several hundred years and we know how to reverse scurvy. We know how to improve vitamin C deficiency with fruits and vegetables and supplements. So it's old news.”
Still, Churchill and his colleagues plan to write up the results of their study and map out scurvy cases to illustrate the effects of the disease among vulnerable populations. Later, he hopes, public health researchers will pick up the cause and pursue further studies that emphasize the consequences of food deserts and the need to offer nutrition education to those at risk.
