The Importance of Nutrition in Infection and Allergy

It is difficult to evaluate the role of nutrition in the prevention and treatment of allergic and infectious states. The results of animal experiments are often contradictory and clinical observations difficult to interpret. Nevertheless, a broad relationship does exist.

Cod liver oil and sunshine were used to heal rickets long before vitamin D was known, and the usefulness of the former in the treatment of tuberculosis has recently been reemphasized. Lime juice was not withheld from men dying of scurvy because its action was not understood.

In this modern age we must apply common sense to the problem while awaiting laboratory confirmation of empirically useful methods of treatment. The thesis presented here is based on theoretical, clinical and experimental observations. Most important of all, it works in practice–and that is the acid test.

A healthy body is an efficient chemical factory. Given the right raw materials and a good heredity it should be capable, except for accidents, of developing an efficient endocrine and nervous system, strong bones, muscles and sinews, healthy gums, hard teeth, and good resistance against most invasive bacteria, viruses, and other environmental impacts. Unfortunately, every physician knows that today such is far from being the case. We are dealing with many nutritional cripples. Inadequate food intake over several generations may help to explain not only the widespread incidence of allergy and dental caries, but the frequency of many other degenerative conditions as well.

Primary Nutrients

Not many decades ago, the problem of nutrition seemed relatively simple. At the turn of the century research was mainly concentrated on proteins, carbohydrates and fats, together with iron, calcium, and phosphorus.

Just before the First World War it was shown that unrefined foods contained substances other than the above that were necessary to sustain life. The discovery of vitamins led to the conception that numerous afflictions might be due to deficiencies rather than to toxins or infections. Since then, the discovery, isolation and even synthesis of these compounds has proceeded rapidly. Unfortunately, the practical application of this knowledge has not kept pace with the facts.

Vitamins

Vitamins may be defined as organic catalysts that are necessary in the daily diet of man or animals for normal growth and for the maintenance of health and life. They are known to be an indispensable part of certain enzyme systems.

The vitamin A group consists of several fractions and a number of carotenes (pro vitamin A) which are converted to A by the intestinal mucosa. Deficiency results in xerophthalmia, mucous membrane metaplasia to squamous type and dermal hyperkeratosis. Reduced resistance to bacterial invasion is one result of metaplasia.

The vitamin B complex has now been split into many components with as many as fifteen fractions suspected. The main ones are. thiamin, riboflavin, pyridoxine, cyanocobalamin or B12, nicotinamide, pantothenic acid, biotin, choline, inositol, p-aminobenzoic acid, folic acid and possibly B15 or pangamic acid. Since their functions are fairly well known, they will not be discussed. Only recently was evidence available to prove the necessity of pyridoxine in human nutrition.¹ This was fortuitous. Babies fed on a certain heat-processed milk substitute developed convulsions. The addition of pyridoxine relieved the condition. This product now contains adequate amounts of this vitamin.

Vitamin C is essential for capillary strength and for the formation of the adequate collagen and connective tissue ground substance.

Vitamin D is composed of several fractions. D2 is irradiate ergosterol; D3 is 7-dehydrocholesterol in irradiated form. The latter is the natural vitamin found in fish liver oils and the skin. It is considerably more active therapeutically than D2 and possibly less toxic.²

The Vitamin E group, which includes several tocopherols, acts as an antioxidant, and is important as an antisterility factor. In experimental animals it prevents muscular dystrophy. If cattle are fed a vitamin E deficient ration for one year, one-half of the group will die of heart failure within three years.³ Electrocardiographic studies of deficient animals have revealed definite indications of cardiac abnormalities.⁴

Essential unsaturated fatty acids such as linoleic, linolenic, arachidonic and clupanodonic (formerly called vitamin F), while not true vitamins, are important nutritional factors often lacking in the modern diet. They are partially destroyed during the hydrogenation of fats, and are necessary for growth, a healthy skin, and adequate gonadal function. In addition, they boost resistance to infection by their pyridoxine synergism.

The vitamin K group is necessary as a blood clotting factor.

The vitamin P group, or citrus bioflavonoids, include hesperidin, citrin and rutin. They decrease capillary fragility and are receiving increasing attention. These substances enhance the activity of ascorbic acid.

Other vitamins will undoubtedly be discovered in the future. The basic fact to remember is that they all exist in natural, unprocessed foods.

Trace Minerals

The importance of trace minerals for plants and animals has been known for some time. Only recently, except for iodine, has such knowledge been transferred to the body economy of man. These catalysts are a vital part of many enzymes. They are particularly important for adequate function of C and the B-complex.

Zinc seems to be a part of the insulin molecule and cobalt is inseparable from B12. The following minerals in trace amounts are necessary for plants and animals and probably for man: iodine, manganese, cobalt, zinc, molybdenum, boron, magnesium and copper.

Confusion Regarding Nutritious Foods

While there is widespread awareness both by physicians and the public of the basic importance of vitamins, as related to preventive medicine and good health, there is much confusion as well.

The enrichment program for white bread, while a tacit admission that white flour is an incomplete food, has lulled the public into a false sense of security. Only a few of the important nutritional substances removed in milling have been replaced.

Aggressive advertising has convinced not only the average housewife, but her offspring as well, that candy bars, cookies, ice cream, sweetened soft drinks, and cereal from guns, supply quick energy that is a must for active young bodies. They are not told that starches break down gradually into useful sugars and that unrefined starches, proteins and edible fruits supply all the sugars the body needs. These latter foods come complete with vitamins, minerals, and other valuable accessory food factors.

Mothers are not informed that their children’s bodies are best equipped to handle sugar at a slow rate from natural foods, rather than a sudden flood of sucrose or glucose; nor are they told that sugar consumption is the most potent cause of dental caries in the 95 per cent of children in this country who do not possess natural immunity to decay.⁵ Norman Jolliffe has coined the apt phrase, “empty calories” to describe such foods.

Instead, the average housewife relaxes in the knowledge that the miracle vitamins which science has discovered may be bought at the drugstore to overcome any possible deficiency in the diet. She is led to believe that one capsule a day will make restitution for all the nutrients that have been removed from her children’s food. They “can have their cake and eat it, too.” Unfortunately, this is not true, and the result is physical degeneration.

We are living in an age of technologic miracles. It is easy to lose sight of basic facts and natural laws, and the penalty may be racial extinction.

The past century has witnessed an industrial revolution which is still going on. With the advent of manufacturing machinery and the motor car, there has been an increasing shift of our population from the farm to the city. Mechanization of agriculture has enabled each farmer to produce food for more individuals than was ever dreamed possible. This move to the cities has necessitated transportation of food to these areas and has stimulated processing to improve the keeping qualities of perishables; in turn, nutritional values have suffered.

Freshly ground whole wheat flour, containing the germ and all parts of the kernel, unless refrigerated, soon becomes rancid from oxidation of the oil, as well as infested with insects. Patent flour keeps indefinitely and inferior grades can be bleached to a uniform whiteness. In processing, the endosperm and coating are removed and sold for cattle feed, or for the production of vitamins. They contain the greater part of the minerals, B complex vitamins, vitamin E, and protein found in the natural grain.

White sugar has taste appeal and needs no preservative. In the past century the annual per capita consumption of this product has increased from seventeen to over 100 pounds. Many people each year actually eat their weight in sugar. It has been conservatively estimated that more than half the caloric intake in the average American diet is in the form of white bread and white sugar.⁵ Canned foods, through heat sterilization, lose many of their nutritive qualities. Frozen foods are relatively unchanged. Vegetables and fruits are usually picked before complete ripening and lose vitamins in transportation. Cold storage meat is not the same as fresh. The increasing use of hydrogenated fats in our dietary reduces the intake of essential unsaturated fatty acids. This may be related to vascular degeneration. The pasteurization of milk, while essential in most areas for the prevention of disease, probably renders this fluid less nutritious. There is partial destruction of vitamins, inactivation of enzymes, denaturation of the protein, and the calcium seems to be less assimilable. Unless certified raw milk is available, other foods must supply the difference. Since the majority of modern mothers are either unwilling or unable to breast-feed their infants, many of our children are off to a poor start. As a rule, infants are placed on a formula of powdered milk and sugar, which may be lacking in important nutritional factors.

Most consumers dislike powdered or cold storage eggs. Their taste tells them such products are inferior. Present day efficiency has resulted in individual cages for laying hens; not only are such birds subjected to enforced celibacy, but they are prevented from exercising any choice in food and do not have access to grass and weeds that might round out their man-made diet. Naturally, if the feed is inadequate, the eggs reflect it. Paper-thin shells, so common these days, are obviously low in calcium.

Preservatives and Adulterants

The problem of preservatives and adulterants in foods is a long story and can only be mentioned in passing. After being used for many years to bleach flour, agene (NCI3) was recently found to produce denaturation of the protein sufficient to cause running fits in dogs.⁶ The effects on human metabolism have not been determined. Nitrogen dioxide, of proven toxicity, is now being used as a substitute. The chronic toxicity of chemical preservatives in foods, together with the newer wetting agents of the polyoxyethylene group, still await adequate investigation, and yet their use in our foods is permitted.⁷

Proteins

Growth, reproduction, antibody formation, enzyme function, and repair of body tissue require an adequate protein intake. The essential amino acids, which constitute protein building blocks, must be present in sufficient and balanced amounts at the same time in order to be utilized. An incomplete protein ration, lacking in only one essential amino acid, will not sustain the life of rats. Addition of the missing amino acid is effective only if fed within one hour of the balance of the food.⁸

This is a valid argument for physicians to advocate the use of complete proteins such as meat, fish, milk, eggs and cheese. Since vegetable proteins usually are deficient in one or more of the essential amino acids, a pure vegetarian diet must be scientifically balanced in order to be adequate.⁸

Stress situations and prolonged bed rest increase the need for protein. The latter produces muscular wasting and a negative nitrogen balance. Thus early ambulation following surgery and other traumatic conditions, plus a high protein intake, are logical procedures.

And yet, an extremely high protein intake is not only wasteful, but may strain eliminative processes in some patients. If digestion and elimination are defective, toxic amines from the colon may produce severe disturbances. One wonders how certain primitive tribes not only subsist, but develop and maintain superb physiques and perfect teeth on such monotonous fare as black rye bread, turnip soup, vegetables in season, roots, nuts and other foods seldom seen on American tables, wth animal protein once or twice a week as a luxury item. Science should answer this question by confirming, if possible, the observations of Dr Price.⁹ He found such diets (while vastly different) to be unusually high in vitamins, calcium, phosphorus, magnesium and trace minerals.

Enzymes and Biologic Antagonists

Life processes in each body cell are the result of chemical reactions sparked or catalyzed by enzymes. There is evidence that genes are enzymes with specific functions. Thousands of enzymatic reactions occur simultaneously in each cell and influence the rate and degree of activity of each other. Such complexity baffles the investigator and is indeed awe-inspiring.

Enzymes contain amino acids, vitamins and minerals. Effective function depends not only upon the presence of the necessary raw materials but upon the absence of interfering substances.

Obviously, nutritional deficiency will decrease the function of these catalysts. So will the presence of a variety of chemicals acting as anti enzymes. Cyanide inactivates the mineral component, others, such as sulfanilamide, because of an almost identical chemical structure, substitute for the necessary vitamin fraction. Most useful and harmful chemicals act in this way. For example, sedatives selectively block oxidative enzymes in nerve tissues, as do the anesthetics. The potent nerve gases and closely related organic phosphate group of insecticides, such as TEPP and parathion, rapidly inactivate cholinesterase, DDT and similar insecticides inactivate cytochrome oxidase, but their main mode of action is still unknown. Other drugs, such as aspirin and sedatives increase the excretion of vitamin C. High fever apparently destroys ascorbic acid quite rapidly.¹⁰

Hundreds of synthetic antimetabolites are now being synthesized in our research laboratories with the hope that one or more will be found to inactivate enzymes essential for neoplastic growth, while not affecting those vital for normal cells.¹⁰ This approach holds much promise, but ignores basic causes.

Modern living has exposed mankind to an increasing number of chemicals with antimetabolic activity, These include tobacco, alcohol, industrial wastes in the air we breathe, chemical softeners, coal tar dyes, estrogenic hormones, antibiotic and insecticide residues in our foods, antibiotics used in treatment, pain killers, sedatives and other therapeutic drugs; pesticide residues of DDT, chlordane, lindane, methoxycholor and others widely advocated for use in our homes and public buildings;^{11,12,13,14,15} and now in many cities the calculated addition of fluorides to our drinking water presents another serious hazard.^17,18,19 Physicians, dentists and the public should learn the facts about this dubious experiment.

Stilbestrol has been advocated for several years to increase the market weight of chickens. In addition, this potent chemical is now added to the feed consumed by more than half our beef cattle. A recent report indicates that the residue in the meat, while minute, is ten times the amount necessary to induce carcinoma of the uterus in small experimental animals.¹⁶

Fluorides

At this point it is pertinent to comment on a strange phenomenon that is adding one more toxic chemical to the load already borne by our bodies namely, the drive by the Public Health Service to persuade cities to fluoridate their water supplies. This action merits discussion not only because of the potential health hazard involved, but because of the not so obvious threat to the private practice of medicine and dentistry. A concerted and effective propaganda campaign has pressured most of our major medical and dental societies into endorsement of fluoridation without adequate knowledge or consideration of the whole subject.

The Public Health Service argues that fluoridation is a means of reducing dental caries and, being a preventive measure, lies within its sphere of influence–as does the chlorination of our water supply. Nevertheless, there is a vast difference–and one must not be confused by semantics. Chlorination treats the water to destroy harmful bacteria (chiefly typhoid) that might cause epidemics; fluoridation treats the consumer by inducing changes in the bodies of those drinking such chemically treated water. What is more, fluoridation exposes all those using a communal water supply to an unnecessary hazard. It is common knowledge that adults will derive no benefit from fluoridated water, and there is increasing evidence that some of them will be harmed.

One of the first observable signs of fluoride toxicity in children is hardening of the dental enamel, which shows as chalky-white patches that later turn brown, gray or black. After sufficiently prolonged exposure to fluorides (fifteen to twenty-five years) some individuals may develop disabling osteosclerosis or osteoporosis, pulp stones in their teeth, pyorrhea, and other manifestations of systemic fluorosis.¹⁷

Speaking solely as an individual, I will note some of the objections to fluoridation with the hope that those unfamiliar with the subject will seek more information. The vitality of our nation as well as our professional freedom may well depend upon the outcome of this controversy. If the principle involved is accepted, what is to stop the Public Health Service from adding Isoniazid® to our water for the prevention of tuberculosis? Or any other medication that they may deem advisable for the prevention or treatment of disease?

Exner¹⁸ has published a logical and comprehensive critique of the whole question. He considers fluoridation to be immoral, adulteration of the water supply, and mass medication. His studies indicate that the statistics purporting to show a significant reduction of tooth decay in those children drinking water artificially fluoridated at a concentration of one part per million are unreliable and conflicting. He believes there is no adequate evidence in support of claims that toxic effects do not occur.

Klerer¹⁹ in a recent exhaustive and well documented article reaches the same conclusions and stresses dental fluorosis and bone changes in humans living in areas where the water supply is high in natural fluorides He is convinced that artificial fluoridation is extremely hazardous.

Sodium fluoride is a very toxic chemical that accumulates in the body at any concentration. This has been proven by Wallace-Durbin²⁰ who used radioactive tracer studies for this purpose. Sodium fluoride inhibits most enzyme systems. It is a general protoplasmic poison and reacts with bones and tooth enamel to produce irreversible changes. Contrary to popular opinion it is not a trace element necessary for animal nutrition.

The dose of any drug dissolved in the water supply obviously cannot be controlled. Even proponents admit that 15 to 20 per cent of children drinking such water will develop mottled teeth.²² Individual susceptibility may be expected to vary with inheritance, the amount and hardness of the water consumed, the concentration of fluoride, the nutritional status, kidney function, allergy and other factors.

The experiences of Waldbott have been illuminating. He has not only studied the literature extensively, but has discovered clinical evidence of fluoride toxicity. He has personally observed and reported serious illness resulting from the consumption of artificially fluoridated water.^23,24 From the literature^25,26 he cites two fatal cases exhibiting marked generalized fluorosis. The latter drank naturally fluoridated water at a concentration of about 2 ppm. Kidney disease may have been a predisposing factor.

Forman²⁷ has effectively stated the practical and theoretical objections to artificial fluoridation.

Expert testimony heard before Congressional committees^28,29 presents an excellent picture of both sides of the question.

One may summarize by stating that artificial fluoridation is illogical and an invasion of personal rights. It is premature and based upon questionable statistical evidence. It is expensive, and the dosage uncontrollable. The indiscriminate treatment of all members of a community by the addition of a potent chemical to the water supply without regard for, or knowledge of, the state of health of each individual, is dangerous and totalitarian in nature. As Exner says. “We are entitled to pure water from the tap–not medicine or soup.”

Fluorides can be administered to children, whose parents request it, in accurate doses and at low cost in the form of drops or tablets. Why fluoridation? Almost all cases of dental caries can be controlled by the avoidance of sugar and refined carbohydrates together with an adequate diet.

Preparation of Food

Even excellent food of high nutritional quality can be and often is ruined in the kitchen.

Vitamin C is very unstable in the presence of oxygen. Vegetables and fruits begin to lose it right after harvest. Ascorbic acid is very vulnerable to heat, particularly in an alkaline medium. Finely shredded cole slaw will lose most of its vitamin C content in one hour.

The B-Complex vitamins are water soluble. When much cooking water is used and then discarded, more than half of the B group may go with it. That makes as much sense as throwing away fluid coffee and eating the grounds. Vegetables should be steamed or cooked in a small amount of water, and the residual cooking water, if any, consumed with them or added to soup or tomato juice. This method also conserves the valuable minerals.

Soil Conservation

In the exploitation of this country’s vast natural resources, man has been criminally careless of the soil. Until recently, there was always virgin land to the west, and many farms were abandoned to the weather once the original fertility was used up. Indiscriminate destruction of our forest watersheds has led to recurrent floods and droughts, and has hastened the movement of topsoil to the sea. The deep-rooted grasses and plants of the western plains have been replaced by less hardy wheat and corn, unable to hive through a dry cycle. The wind has dissipated hundreds of thousands of tons of fertile soil as a result. So now we have reached the stage when many areas have lost the few inches of precious topsoil that mean the difference between life and death.

In recent decades, the demands of war and the spur of price supports have induced farmers to produce bumper crops in quick succession without replenishing the soil by means of crop rotation and the addition of organic material. Commercial fertilizer has not supplied the needed organic matter nor the important trace elements.

The newer pesticides have upset the balance of nature, killing natural insect enemies as well as the insects themselves and by contamination of the soil may have upset the teeming billions of soil organisms necessary to release plant nutrients and to produce natural antibiotics.

The end result of all these factors is a steadily declining protein content of our grains, grasses and vegetables, which thus weakened, seem to be increasingly less resistant to the insect hordes.³⁰ Deficient soils produce deficient plants, and poor fodder does not foster strong animals. And so we come full circle to man who must now pay for his blindness: For we are what we eat.

Evidence of Nutritional Deficiency

There has been in the past considerable argument concerning the incidence of nutritional deficiency in the United States. It has been difficult for many to accept the idea that in “the best fed nation in the world” such a condition might be widespread. However, our high draft rejection rate and our poor showing in the recent Olympic Games leave little room for doubt. A study of primitive races in their native environments is quite illuminating.

The late Weston A. Price, a dentist with original ideas, through extensive travels discovered that natives in all parts of the world on their natural tribal diets were not afflicted with dental caries, and enjoyed excellent general health. Contact with civilization and the resultant consumption of white flour, sugar and canned goods produced not only tooth decay, but deformed dental arches in the second generation, together with a marked increase in infectious and degenerative diseases. His book contains numerous photographs dramatically supporting his thesis.⁹

Sir Robert MCarrison, in his classic book Studies in Deficiency Diseases,³¹ recorded some very interesting experiments. Several varieties of animals were fed diets of autoclaved white rice with occasional supplements. Careful postmortem studies were done. The most significant gross findings in the gastrointestinal tract were dilatation of the stomach, and thinning of the wall, muscular atrophy and distention of the small bowel or colon. Microscopic examination revealed congestion and hemorrhage, atrophy of the muscular coat, degenerative changes in Auerbach’s plexus of nerve ganglia, atrophy and inflammation of the mucous membrane and lymphoid structures, fibrosis and lowered resistance to bacterial invasion of the bowel wall (mostly cocci).

Chronic passive congestion of the liver with slight atrophy and necrosis accompanied atrophy of the pancreas which was often extensive. The endocrine glands revealed atrophy of the thyroid, spleen and thymus in contrast to hypertrophy of the adrenals and pituitary. (Hans Selye has since termed this the “Alarm Reaction.”) The central nervous system and autonomic ganglia showed degeneration.

In another study, when rats were fed the average diet of the English and Americans, including white flour and sugar, the animals developed sinusitis, otitis media, abscesses, arthritis, pyelonephritis and other infectious and degenerative ailments akin to those afflicting the human race.

The observations of F. M. Pottenger, Jr.³² substantiate these findings. He noted that raw meat and raw milk produced generations of alert cats in excellent health and full of feline exuberance, The other half of this same litter, when fed on cooked meat and pasteurized milk only, developed osteomalacia, pyorrhea, sinus infections, pneumonia, and a great increase in allergic manifestations, up to 90 per cent of those surviving. Degeneration was so rapid that reproduction was seldom possible beyond the third generation. It took another three generations on raw food to breed the few survivors back to normal.

Morton Biskind, Roger Williams, N. Philip Norman, Tom Spies. Gillman and Gillman, and Jonathan Forman, together with many others have stressed the importance of malnutrition in the production of disease.^32,33

Surveys conducted by the National Research Council and other groups have shown that only a small percentage of families in this country are consuming a diet meeting with Council’s recommendations.³⁹ The figures of Canadian investigators are similar.

Nutrition and Infection

The results of animal experimentation to determine the effects of single vitamin deficiencies upon resistance to infection are often contradictory and confusing.^40-43 On the whole, there is evidence that malnutrition decreases resistance to bacterial infection, but in some instances may increase resistance to the invasion of viruses. Apparently, the virus competes with the body cell for certain essential nutrients and fails to multiply if these are not available in sufficient amounts. However the opposite is also true, and in clinical practice at least, improved nutrition raises resistance against viruses as well as bacteria. Recently, Axelrod⁴⁴ has reported that pantothenic acid, folic acid and pyridoxine are essential for antibody formation in the rat. It has been definitely proven that vitamin A deficiency lowers resistance to bacterial infection in many parts of the body.

Vitamin C deficiency delays solid wound healing. It also interferes with the localization of staphylococcus infections; collagen fails to form and the reticular ground substance is disorganized.⁴⁵

Nutrition and Allergy

Many asthmatic children and adults develop severe attacks concurrent with upper respiratory infections. An unknown number of cases of chronic allergic rhinitis and intrinsic asthma are thought to be due to bacterial allergy. It is therefore vitally important to reduce the incidence of respiratory infections. The regime to be outlined later is very effective in this respect.

Specific vitamin therapy in allergy has centered mainly around vitamin C. Simon Ruskin^46,47 has reported favorably on the use of calcium ascorbate in the treatment of hay fever. Ethan Allan Brown⁴⁸ has also worked along these lines. Results seem to be equivocal but the writer has observed that large doses (1-3 gm) daily of ascorbic acid are useful adjuncts in both allergic and infectious states. Larger amounts may be indicated. Intensive parenteral therapy has been reported to produce dramatic improvement in acute virus infections, including poliomyelitis.⁴⁹

Since most deficiencies are multiple, it would seem of paramount importance to attempt to supply each patient with the optimum amount of all nutrients needed by that individual. Such requirements vary widely depending among other things upon inheritance, past nutritional habits, liver pathology, state of the gastrointestinal tract, including hypochlorhydria and colitis, chronic illnesses, such as allergic states, diabetes, tuberculosis, arthritis, and, lastly, emotional disturbances.

Many deficiency states, in addition to an adequate diet, require vitamin supplements in therapeutic amounts. Except for vitamin D this means ten or more times the estimated minimum daily requirements. Some individuals, perhaps as a result of partial genetic blocks involving enzyme systems,³⁴ may always need nutritional supplements, since they cannot satisfy abnormally large vitamin needs from food alone. It has been observed that animals once severely deficient require excessively large amounts of vitamins thereafter to keep them in nutritional balance. This is also true for human beings. Give Nature the raw materials and she can often perform wonders.

Personal Observations

In the past fifteen years, recorded observations reveal that between 60 and 90 per cent of all patients coming to my office with allergic, or ear, nose and throat complaints have shown clinical evidence of vitamin B complex deficiency. Diet histories in almost all cases have revealed an excessive intake of refined foods and a paucity of the protective ones. About 20 per cent have shown signs of deficiency in vitamin A. Many have had gingivitis and almost all have had obviously deformed dental arches with a crowded and irregular dentition, in addition to evidence of caries or filled teeth.

Allergic states, recurrent sinus infection, otitis media, tonsillitis and stubborn external otitis responded poorly until dietary correction was made. Vitamin supplements were almost always necessary but not curative in themselves. It is of interest to note that on a good nutritional regime allergic individuals seldom develop new sensitivities.

Before outlining the basic nutritional suggestions made in all cases, one case report will illustrate the problem and the results to be anticipated.

Case Report

A six-year-old girl was brought to the office with a history of repeated tonsillitis and acute otitis media recurring every ten days or two weeks over a two year period. During that time her parents had spent in excess of $2,000.00 for her medical care, most of which represented the purchase of antibiotics. The mother was frantic and worn out by constant nursing care, as well as by worry about her daughter’s health.

Except for enlarged, red tonsils, scarred ear drums, a red tongue, hyperkeratotic changes of the skin typical of vitamin A deficiency, numerous fillings in her teeth and a secondary anemia, examination was not remarkable. The child’s diet was fairly good (for the mother was conscientious), except for the inclusion of dried cereals, white bread, homogenized milk and a sweet dessert once daily plus several cookies in the afternoon.

Correction of her diet according to the basic regime to be described later, plus the addition of vitamin supplements including A, C, B-complex, unsaturated fatty acids and a multivitamin preparation, worked wonders.

One more infection, requiring an antibiotic, occurred twelve days after the first visit. A second, two weeks later, was surmounted without such aid. Since then, her health has shown marked improvement in spite of exposure to virulent infections.

While therapy must be tailored to fit each case, this result is typical of the response to be expected from the application of practical nutritional knowledge. Many more cases could be cited but time does not permit.

Recommendations

The following recommendations with modifications as indicated are made to my patients. These stress the vitamin and mineral rich foods:

1. Avoid white bread and commercial whole wheat bread unless freshly ground and baked. Local bakers will co-operate if assured of a demand; otherwise, home baking is advised. A high protein, hard wheat should be used. The result is not only nutritious but delicious.
2. If available, use certified raw milk except for cooking.
3. At first, eliminate sugar in all forms, such as pastries, ice cream, soft drinks, candy, jams, jellies and sugar as such. Later, sweets may be permitted once or twice weekly or at parties.
4. Change from processed cereals to stone ground or steel cut oatmeal and freshly ground whole wheat.
5. Use brown rice instead of white.
6. Bake or boil potatoes and eat the jackets: mashed potato has lost its ascorbic acid.
7. Eat plenty of fish, beef and other high protein foods, including liver, kidneys, sweetbreads, brains and tripe. Animal organs are high in vitamins and trace minerals. Learn to like rare beef, lamb and beef liver. (Cook pork well because of the danger of trichinosis.)
8. Increase the intake of raw fruits and green and yellow vegetables. Vegetables should be steamed and the cooking water, if any, consumed. Vegetables, when possible, should be home grown or free from spray residues. Peel all fruit because of the danger of DDT and other new insecticides. Washing will not remove them.
9. Eat one or two eggs daily and purchase fertile ranch eggs when possible.
10. Serve fruits or cheese for dessert.
11. Take vitamin supplements as directed. In addition to concentrates, yeast, wheat germ and raw liver must usually be consumed to supply a balanced ration of the known and unknown fractions of the B complex group.

In severe deficiencies, poor absorption may necessitate injections of vitamin B complex and/or liver for a few weeks.

Progress is frequently slow, for deficiencies have usually developed over a period of years. Patients should be informed of this, so that they will not become discouraged and revert to their old habits. Full benefit of the new routine may not be obtained for six months or a year, but in obvious B-complex depletion increased appetite and a feeling of well being are often noticeable within a week. Tooth decay in cooperative patients usually may be eliminated.

George Herbert once made the remark, “Whatsoever is the father of disease, an ill diet was its mother.” To me, there is no greater satisfaction in the practice of medicine than to have a patient say, “Doctor, l feel ten years younger!”

Any attempt to change ingrained food habits and customs meets with marked resistance. The desire to conform is especially strong in teenagers. This adolescent group, because of rapid growth, is particularly vulnerable to dietary deficiencies and prone to consume large quantities of refined carbohydrates. Psychologie rapport is difficult, for this age group is naturally defiant of all authority. Tact and diplomacy are essential for success.

Summary and Conclusions

In spite of an adequate caloric intake, there is widespread evidence of nutritional deficiency in the United States. This statement is supported both by reliable statistics and by personal observations.

Theoretically, malnutrition may be the result of our mechanical age. Population moves from farms to cities have created problems of food preservation and transport. Food processing has decreased the vitamin, mineral and protein values of many staple foods, already low because many such foods were raised on depleted soil.

Chemical additives and contaminants in our foods, air and water may seriously interfere with vital chemical reactions in the body, thus predisposing to or inducing the development of disease, The campaign to fluoridate domestic water supplies adds one more chemical to the vast number which the body must detoxicate.

The high intake of refined carbohydrates so typical of most diets, together with poor food selection, wasteful cooking methods and other stresses, gradually lead to malnutrition in many individuals. Adequate nutrition is of the greatest importance for the production and maintenance of healthy tissues. Deficiency states lower resistance to infection and indirectly predispose to allergic states, perhaps over several generations.

Vitamin supplements are not enough. We must produce food not primarily for quantity, but for quality. Better food as the result of improved farming practices, uncontaminated by insecticides and other chemicals, must be combined with new food habits if a healthy race is to be preserved. Tooth decay in 90 per cent of co-operative individuals can be controlled by means of a good diet and the avoidance of sugar. It is probable that the answer to our degenerative diseases lies not in more medical facilities, vaccines or wonder drugs, but in the application of nutritional knowledge to prevention and treatment. The global implications are obvious.

 

Editor’s note: Since the era in which this article was written, society’s understanding of respectful terminology when referring to ethnic and cultural groups has evolved, and some readers may be offended by references to “primitive” people and other out-of-date terminology. However, this article has been archived as a historical document, and so we have chosen to use Knight’s exact words in the interest of authenticity.  No disrespect to any cultural or ethnic group is intended.

 

References Cited:

1. Council on Pharmacy and Chemistry: “Pyridoxine hydrochloride (Vitamin B6), a status report.” J.A.M.A., 147:322-325 (Sept. 22) 1951.
2. Bicknell & Prescott: The Vitamins in Medicine. London: William Heinemann, 1948.
3. Gullickson, T. W.: “The relation of vitamin E to reproduction in cattle.” Annals New York Acad. Sc., 52:256-259, 1949-1950.
4. Gullickson, T. W., and Calverley, C. E.: “Cardiac failure in cattle on vitamin E-free rations as revealed by electrocardiograms.” Science, 104:2701, 1946.
5. Joint Report of the Council on Dental Therapeutics of the Am. Dental Assn.: “Sugar and dental caries.” J. Am. Dent. Assn., 47 (Oct.) 1953.
6. Silvers, M. L., Johnson, R. E., et al: “White bread and epilepsy in animals.” J.A.M.A., 135:12, 1947.
7. Chemicals in Foods and Cosmetics: Hearings before the House Select Committee to investigate the use of chemicals in foods and cosmetics. Parts 1, 2, 3, U. S. Govt. Printing Office, Wash., D. C, 1951-52.
8. Pollack, H., and Halpern, S. L.. with collaboration of the Committee on Therapeutic, Nutrition of the Food and Nutrition Board, National Research Council: Therapeutic Nutrition, Pub. 234, Nat. Acad. Sc., Nat., Research Council, Wash, D. C, 1952.
9. Price, W. A.: Nutrition and Physical Degeneration. Los Angeles: American Academy of Nutrition, 1946.
10. Martin, G. J.: Biological Antagonism. Philadelphia: The Blakiston Co., 1951.
11. Biskind, M. S.: “Chemical intoxication with DDT and other new insecticides. Chemicals in Food Products.” Hearings before the House Select Committee to Investigate the Use of Chemicals in Food Products, pp. 700-722. U. S. Govt. Printing Office, 1951.
12. Biskind, M. S.: “Public health aspects of the new insecticides.” Am. J. Digest. Dis., 20:11 (Nov.) 1953.
13. Knight, G. F.: “What are pesticides doing to human beings?” Modern Nutrition, 5:4-7 (April); 11-16 (Sept); 10-14 (Dec.) 1952.
14. Pottenger, F. M., Jr., and Krohn, B.: “Poisoning from DDT and other chlorinated hydrocarbon pesticides–pathogenesis, diagnosis and treatment. Chemicals in foods and cosmetics, pt. 2” (Nov.) 1951, Wash., U. S. Gov’t. Printing Office, 1952.
15. Brown, A. W. A.: Insect Control by Chemicals. New York: John Wiley and Sons, 1951.
16. Knight, G. F., Martin, W. C., Iglesias, R., and Smith, W. E.: “Possible cancer hazard presented by feeding diethylstilbestrol to cattle.” Symposium on Medicated Feeds. Food and Drug Administration, Washington, D. C., January 24, 1956.
17. Pandit, C. G.; Raghavachari, T. N, S.; Subba, R.; and Krishnamurti, V.: “Endemic fluorosis in South India.” Indian J. M. Research, 25:553-568 (Oct) 1940.
18. Exner, F. B.: “Fluoridation.” Northwest Med., 54: (July, Oct., Nov.) 1955.
19. Klerer, M.: “The fluoridation experiment.” Contemporary Issues, 7: 119-167 (Feb.-Mar.) 1956.
20. Wallace-Durbin, P.: “The metabolism of fluorine in the rat using F18 as a tracer.” J. Dent. Research, 33:797 (Dec.) 1954.
21. McClure, F. J.: “Fluorine and other trace elements in nutrition.” J.A.M.A. 139:711-714 (Mar. 12) 1949.
22. Arnold, F. A.: “Fluoride in drinking water; its effect on dental caries.” J.A.D.A., 36:28-36 (Jan.) 1948.
23. Waldbott, G. L.: “Chronic fluorine intoxication from drinking water at the 1 ppm concentration: An epidemic in Saginaw, Mich.” Folia Clin. Internac., 4:26 (April) 1955.
24. Waldbott, G. L.: “Chronic fluorine intoxication from drinking water at the 1 ppm concentration; a case report.” Int. Arch. Allergy and Immunol., 7:70-74, 1955.
25. Linsman, J. F., and McMurray, C. H.: “Fluoride osteosclerosis from drinking water.” Radiology, 40:474-84, 1943. Misprint corrected in 41:497, 1943.
26. Mascheroni, H. A.; Munoz, J. M.; and Renssi, C.: “Bone manifestation of endemic fluorosis.” Rev. Soc. argent. de biol., 15:417-19, 1939.
27. Forman, J.: “Fluoride on tap: The case against it.” The Land, 12:1 (Spring) 1953.
28. “Fluoridation of water.” Hearings before the Committee on Interstate and Foreign Commerce, House of Representatives, 83rd Congress, 2nd session. Gov’t. Printing Office, Washington, D. C. (1 May 25, 26, and 27) 1954.
29. “Fluoridation of public drinking water.” Delaney Report Hearings Before the House Select Committee to investigate the use of chemicals in foods and cosmetics 82nd Congress, 2nd Session, Union Calendar No. 787, Report No. 2500, Government Printing Office, Washington, D. C. (July 10) 1952.
30. Albrecht, W A.: “Protein deficiencies via soil deficiencies.” (Dept. of Soils, College of Agriculture, University of Missouri.) Paper read before the Eighth Annual Seminar for the Study and Practice of Dental Medicine, Palm Springs, California, October 31, 1951.
31. McCarrson, Sir R.: Studies in Deficiency Diseases. London Frowde, Hodder and Stoughton, 1921 Reproduced by photo lithography Milwaukee: Lee Foundation for Nutritional Research, 1945.
32. Pottenger, F. M., Jr.: “The effect of heat-processed foods and metabolized vitamin D milk on the dentofacial structures of experimental animals.” Am. J. Orthodontics and Oral Surg., 328 (Aug.) 1946.
33. Biskind, M S.: “Nutritional aspects of certain cardiovascular disorders.” J. Insurance Med., 6:1 (May) 1951.
34. Williams, R. J.: “Individual Metabolic Patterns and Human Disease: An exploratory study utilizing predominantly paper chromatographic methods.” Austin Univ. of Texas, 1951.
35. Norman, N P: “Ulcerative Colitis,” Milwaukee Lee Foundation for Nutritional Research, 1950.
36. Spies, T.D. et al: “Detection and treatment of nutritive failure in children.” J.A.M.A., 148:16 (April) 1952.
37. Gillman & Gillman: Perspectives in Human Malnutrition. New York: Grune & Stratton, 1951.
38. Forman, J.: “Soils, Food and Health,” Columbus: Friends of the Land, 1949.
39. National Research Council: “Inadequate diets and nutritional deficiencies in the United States.” Am. J. Dig. Diseases, 11:19-32 (May) 1944.
40. Rasmussen, A. F: “Influence of thiamin and riboflavin deficiencies on resistance to Theiler’s virus and to Lansing strain of poliomyelitis in mice.” J. Bacteriology, 45:1, 1943.
41. Leftwich, W. B.: “Effect of diet on the susceptibility of the mouse to pneumonia virus of mice.” L. J. Exp. Med., 124:5, 1946.
42. Aycock, W. L.: “Vitamin deficiency as an epidemiological principle.” Am. J. Med. Sciences, 208:3, 1944.
43. Farher, J. E.: “Niacin and riboflavin deficiency in tuberculosis.” Am. Rev Tuberculosis, 48:6, 1943.
44. Axelrod, A. E.: “Symposium on protein metabolism.” Univ. of Toronto, Canada, 1953.
45. Meyer, E., and Meyer, M. B.: “The pathology of staphylococcus abscesses in vitamin C-deficient guinea pigs.” Bull. Johns Hopkins Hosp., 74:2, 1944.
46. Ruskin, S. L.: “High dosage vitamin C in allergy.” Am. J. Dig. Dis., 12:281- 313 (Sept) 1945.
47. Ruskin, S. L.: “Influence of vitamin C on the anti-histaminic action of various drugs.” Arch. Otolaryg., 36:853-873, 1942.
48. Browu, E. A., and Ruskin, S. L.: “The use of cevitamic acid in the symptomatic and coseasonal treatment of pollinosis.” Ann. Allergy, 7:65 (Jan.-Feb.) 1949.
49. Kennet, F. R.: “The use of vitamin C as an antibiotic.” J. Applied Nutrition, 6:274-278, 1953.