In The American South, Millions Of People In The Early 1900s Suffered From A Crippling Dietary Deficiency Of?
If you live outside the developing world, there’s a good chance that you’ve never heard of, let alone seen, the condition known as pellagra. The crippling condition is a result of a lack of niacin and tryptophan in the diet (or, in what is known as secondary pellagra, the inability to process said nutrients because of alcoholism, medication side effects, or other disease processes).
The effects of pellagra include skin scaling and lesions, heightened sensitivity to sunlight, aggression, insomnia, and, eventually, nerve damage and death. Fortunately, like most nutritional deficiencies, it takes a significant and extended period of deficiency to create serious problems and, if treated, the survival rate is high. Although unheard of in the United States today outside of isolated cases, pellagra was once an epidemic-sized problem in the American South where millions of people in the early 20th century were affected (with more than 100,000 deaths). Niacin deficiency has caused more deaths than any other nutrition-related disease in American history. Supplementation and food preparation methods that increased niacin consumption decreased, and then finally eradicated the disorder by the 1940s.
If you’re curious as to how Southerners ended up with such a niacin deficit, there are several competing and overlapping theories, the most interesting and compelling of which hinges on the manner in which the corn they consumed was prepared. Southerners have long used corn meal in a variety of meals (the association between the South and corn bread, for example, is well founded) and corn is high in niacin, so how then did so many Southerners end up niacin deficient? A change in preparation methods and a desire to preserve corn meal for longer periods was the turning point. Historically, corn was ground using a millstone, leaving the niacin content nutritionally available. Later, when milling was industrialized, the process stripped away more of the outer coating (grit) of the corn kernel (where most of the niacin was) in order to remove oils and keep the milled corn from spoiling.
Image courtesy of the Waring historical Library/Wikimedia.