Niacin.

Nicotinic acid and nicotinamide, collectively referred to as niacin, are nutritional precursors of the bioactive molecules nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). NAD and NADP are important cofactors for most cellular redox reactions, and as such are essential to maintain cellular metabolism and respiration. NAD also serves as a cosubstrate for a large number of ADP-ribosylation enzymes with varied functions. Among the NAD-consuming enzymes identified to date are important genetic and epigenetic regulators, e.g., poly(ADP-ribose)polymerases and sirtuins. There is rapidly growing knowledge of the close connection between dietary niacin intake, NAD(P) availability, and the activity of NAD(P)-dependent epigenetic regulator enzymes. It points to an exciting role of dietary niacin intake as a central regulator of physiological processes, e.g., maintenance of genetic stability, and of epigenetic control mechanisms modulating metabolism and aging. Insight into the role of niacin and various NAD-related diseases ranging from cancer, aging, and metabolic diseases to cardiovascular problems has shifted our view of niacin as a vitamin to current views that explore its potential as a therapeutic.

Pellagra Pre-Goldberger: Rupert Blue, Fleming Sandwith, and The "Vitamine Hypothesis".

The conquest of pellagra is commonly associated with one name: Joseph Goldberger of the US Public Health Service, who in 1914 went south, concluded within 4 months that the cause was inadequate diet, spent the rest of his life researching the disease, and--before his death from cancer in 1929--found that brewer's yeast could prevent and treat it at nominal cost. It does Goldberger no discredit to emphasize that between 1907 and 1914 a patchwork coalition of asylum superintendents, practicing physicians, local health officials, and others established for the first time an English-language competence in pellagra, sifted through competing hypotheses, and narrowed the choices down to two: an insect-borne infection hypothesis, championed by the flamboyant European Louis Westerna Sambon, and the new "vitamine hypothesis," proffered by Casimir Funk in early 1912 and articulated later that year by two members of the American Clinical and Climatological Association, Fleming Mant Sandwith and Rupert Blue. Those who resisted Goldberger's inconvenient truth that the root cause was southern poverty drew their arguments largely from the Thompson-McFadden Pellagra Commission, which traces back to Sambon's unfortunate influence on American researchers. Thousands died as a result.

How four once common diseases were eliminated from the American South.

Four major diseases stigmatized the American South in the nineteenth and twentieth centuries: yellow fever, malaria, hookworm, and pellagra. Each disease contributed to the inhibition of economic growth in the South, and the latter three severely affected children's development and adult workers' productivity. However, all four had largely disappeared from the region by 1950. This paper analyzes the reasons for this disappearance. It describes the direct effects of public health interventions and the indirect effects of prosperity and other facets of economic development. It also offers insights into the invaluable benefits that could be gained if today's neglected diseases were also eliminated.

Nicotinamide: a double edged sword.

Enrichment of diet with Nicotinamide in the West was introduced in the 1940s to prevent the dietary deficiency disorder Pellagra. Pellagra was caused by a particular form of poor vegetarian diet leading to Nicotinamide and Tryptophan deficiency. Arguably Pellagra would have disappeared if dietary measures suggested at the time had been implemented before Nicotinamide was even discovered. Diets may sometimes now be too high in selected pyridines and inadvertently we have exchanged one neurodegenerative disease for another. Parkinson's disease triggered in contrast to Pellagra by a particular form of rich omnivorous diet. Moderation of Nicotinamide intake would be easy to begin with compared with other dietary manipulations as there is no behavior change necessary for individuals. A substantial amount of Nicotinamide can be removed when and where there is too much that has been introduced artificially and inserted where there is too little because meat is unaffordable.

Should calcium and vitamin D be added to the current enrichment program for cereal-grain products?

Mean dietary intakes of calcium and vitamin D in the US adult population are far below the adequate intake (AI) values recommended by the Food and Nutrition Board, Institute of Medicine of the National Academy of Sciences, and thus substantial segments of the American population have inadequate intakes and elevated risks of osteoporosis and colon cancer. The current Code of Federal Regulations, Title 21, sets standards for the optional addition of moderate amounts of calcium and vitamin D in the enrichment of cereal-grain products, a provision that is essentially not used. We propose that the addition of calcium and vitamin D to currently enriched cereal-grain products be mandated in the United States: this would result in an increase in mean daily dietary intakes in the United States of approximately 400 mg Ca and > or =50 IU (or possibly >200 IU) vitamin D. The benefits would be a significant reduction in the incidences of osteoporosis and colon cancer over time and overall improvement in health, with little risk and a modest financial cost because of the ability to capitalize on existing technology. We suggest a full scientific review of cereal-grain enrichment with calcium and vitamin D.

Effectiveness of food fortification in the United States: the case of pellagra.

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.

The contribution of nutrition research to the control of undernutrition: the Indian experience.

Since diseases directly related to undernutrition are the major public health problems of India, nutrition research in the country has been largely directed towards elucidating their causes and identifying the most feasible methods for their prevention and control. This effort is an interdisciplinary exercise carried out in the laboratory, the clinic, and the field, with close interaction among biochemists, clinicians, and epidemiologists. Some of the identified solutions have found practical application; but, as in other areas of scientific endeavor, a gap exists between the acquisition of knowledge in the laboratories and its application in the field. Today, thanks to research efforts of the last few decades, we have the knowledge with which most diseases related to undernutrition can be prevented. Unfortunately, however, we do not always have the means of applying this knowledge under real-life conditions in the field. Even so, nutrition research during the last few decades has contributed significantly to the amelioration of undernutrition among poor communities in India.

Synthesis and availability of niacin in roasted coffee.

The coffee bean contains about 1% of trigonelline that is demethylated at temperatures approaching 200 degrees C; it is partially converted into nicotinic acid. This operation is mainly proportional to the severity of dry heat treatment; various other physico-chemical factors also influence the synthesis of niacin during the roasting. The niacin content of weakly roasted commercial coffee is about 10 mg/100 g (American coffee) and it reaches 40 mg in heavy roasted coffees, i.e. Italian coffee. Caffeine-free coffee is lower in niacin than the corresponding raw coffee. The drinking retains 85% of the niacin formed during roasting; it is totally available for the organism and can constitute a noticeable part of the daily supply in niacin.

The prevention and conquest of scurvy, beri-beri, and pellagra.

I have described how many years of research were needed to overcome three nutritional diseases that occurred throughout the world. When human beings migrated from tropical and subtropical regions to the temperate zone, they lost their year-round supplies of vitamin C, and scurvy began to occur. The emergence of beri-beri had a mechanical basis; the introduction of milling, which prevented the rancidity of rice and wheat, also removed the essential vitamin B1. The circumstance leading to the third deficiency disease was reliance on maize, without supplementing it with "protective" foods, such as meat, milk, and vegetables. Under conditions of poverty, the protective foods became expensive, and pellagra appeared. Synthetic chemistry, together with improvements in the diet and in education, largely overcame scurvy, beri-beri, and pellagra, but deficiencies of vitamins A, C, and folic acid still occur widely in economically disadvantaged populations, and this is a challenge to those who wish to improve public health. The brilliant prophesies of Casimir Funk, made in 1912, were fulfilled within 25 years. Today, his word "vitamin" is universally familiar. The account of the discovery, identification and synthesis of the vitamins is the story of how human beings have overcome nutritional deficiencies that were imposed by cultural and economic disadvantages or just plain ignorance. These discoveries were a triumph of science and technology. Much of the research depended on the use of experimental animals: guinea-pigs, rats, dogs, monkeys, and chickens. Vitamins are now added to the diets of both animals and human beings.