Fitness

Although one could argue endlessly as to the differences between experimental animals and humans, the fact remains that almost everything learned about positive health has first been found in experimental animals and its counterpart later recognized in humans. I know of no exception. In our present state of ignorance concerning the B vitamins, it seems to me we must have caution in believing that the cheap B vitamins supply all the body requirements, that bacterial synthesis in the intestines takes care of the other B-vitamin needs of each individual, and that the B vitamins still little known or unknown are not important.

Let us consider, for example, heart disease. Heart failure is not produced in animals when they are deficient in vitamins A, C, D, and K, in any of the minerals, or in sugar, protein, or fat. Heart damage or collapse or failure is produced when animals are undersupplied with almost anyone of the B vitamins. The thousands of persons who have died from the B-complex-deficiency disease, beriberi, have died of heart failure. In Denmark during World War I and in England during World War II, when wheat germ remained in all breadstuffs and decreased calories reduced the B-vitamin requirements, the incidence of deaths from heart disease dropped markedly. Dr. Morrison’s spectacular results in treating coronary occlusion and coronary thrombosis with B vitamins cannot be ignored. Animals under stress not given the anti-stress B vitamins die of heart collapse, often while still having all the appearances of health. There is absolutely no proof that the human counterpart of these deaths is not widespread.

Six times more men than women die of heart attacks. It is recognized that men, as a rule, need much larger amounts of B vitamins than women do; men are usually larger, have more muscle tissue, do harder physical work, take more vigorous exercise, are submitted to greater and more numerous stresses, and often drink larger amounts of coffee and alcohol, each of which increases the need for the B vitamins. Perhaps men’s greater need for these vitamins has caused more men than women to die of heart disease.

The scientist working with deficient animals for years learns to predict when death will occur. Similarly, those of us in clinical nutrition can sometimes predict death with depressing accuracy. One has only to watch an individual, learn of his dietary habits, and estimate his vitamin-B requirements to guess the severity of his deficiencies. He may appear to be healthy, but usually many telltale signs are obvious.

Not long ago a friend invited me to a lecture on psychology. She was much annoyed afterward because I commented that I could not listen to what the lecturer said for observing his numerous symptoms of multiple B-vitamin deficiencies and especially the way he breathed. I told her that unless he improved his diet, he would die soon of a bad heart.

“Oh, you” she exclaimed in disgust. “All you can think of is nutrition I” the following week, when this man actually dropped dead, her disgust changed to amazement. I recently watched another seemingly healthy man who sneered at the idea of adequate nutrition but whose requirements for the B vitamins were extremely high; some 10 days after I had predicted that he could not live long, he died of heart disease. Anyone working in clinical nutrition could cite similar examples. Try it yourself. You will find it so easy as to be frightening. A man who has had warning in the form of a heart attack is lucky indeed because he usually takes more rest and thus decreases his vitamin requirements and/or improves his nutrition so that his body needs are met.

The statistics, “885,190 men died of heart failure last year,” are cold and meaningless. But after you have known dozens of these men and seen the sadness of their children and the loneliness of their widows, these statistics become cruelly and tragically alive. You find you care not one iota that the findings proved by animal research are not yet accepted as proved with humans. If the work with animals indicates that lives can be saved, we should apply this knowledge and let the proof come later. A doctor friend, as intolerant as I with the purely scientific attitude, asks persons who defend it, “Have you yet time?”

What kind of men are they who are being taken off by heart failure? They are not the lumberjacks, the ditch diggers, or others who can eat large amounts of food and in so doing obtain at least a certain amount of nutrients. Rather, they are our leaders, our executives, our outstanding men, whose lives are largely sedentary. A friend of mine especially interested in this phase of nutrition has kept hundreds of clippings from newspapers: “Stettinius Collapses of Heart Failure,” “General Arnold Dies from Heart Attack,” and on and on.

At the height of Wendell Willkie’s career he died of pneumonia, although physicians have prevented such deaths since the sulfonamides came into use; the real cause was the coronary attack which preceded the infection. Within recent years other important figures have died of heart disease: Maurice J. Tobin. former Secretary of Labor; John H. Paxton, American Consul; Stephen Early and Joseph H. Short, White House press secretaries; Francis A. Truslow, appointed Minister to Brazil; and Beauford H. Jester, Governor of Texas. Outstanding men in all fields have recently died of heart attacks when still young: fhe Reverend Joseph P. Connor, priest and composer; Dr. Donald A. Stauffer, educator, poet, critic, and novelist; Horace Underwood, educator; Michel Licht, poet and translator; William J. Conners, Jr., publisher of the Buffalo Courier; Roger Riis, Readers Digest roving editor; Fulton Oursler, author of best sellers; Dr. Louis Wirth, sociologist; Edwin Leland James, managing editor of the New York Times; Joseph K. Howard, editor, author, and historian; Albert L. Baker, wartime leader of the Manhattan Project; Arthur Szuk, miniature painter and caricaturist; Leo Pasvolsky, economics expert; David L. Behncke, president of Air Line Pilots’ Association; Walter Geist, president of Allis-Chahners Manufacturing Company; and Lewis Brown, president of the Johns-Manville Corporation. The Army and Navy have been saddened by untimely deaths from heart disease: Captain W. R. Edsall, skipper of the battleship Missouri; Admiral Forrest Sherman, U. S. Chief of Naval Operations; Major General Bryant Moore, Commander of the U. S. Ninth Corps; Major General Robert A. Soule, former division commander in Korea; Dr. Walter Van Dyke Bingham, the Army’s chief psychologist; and Major Samuel Woodfill, Medal of Honor winner. Sports fans grieved on hearing that heart attacks had taken Joseph Jackson, baseball’s great hitter; Norman Ross, former Olympic swimming champion; “Big Bill” Tilden, the tennis champion; Joe H. Palmer, sports writer; and Jacob J. Galomb, of the nation’s largest sports equipment enterprise. Entertainers felt little like entertaining after the news that their colleagues were gone: Al Jolson, singer and comedian; John Garfield, actor of stage and screen; J. Edward Bromberg, character actor; Val Lewton, movie producer, Lamar Trotti, oscar-winning screen writer and producer; and young Hank Williams, singer and composer, who died when only twenty-nine. Not one man among these was old when a heart attack stopped his career. The average age of this group was only fifty-five years when death came. More than one-fourth of these outstanding people did not live to celebrate their fiftieth birthday. My friend adds another clipping from almost every newspaper he picks up.

Brilliant men are often taken at their very prime of life, perhaps in their early forties, after they have gained the education and experience which qualify them for splendid leadership. The years they should have lived would have been the years when their contribution would have been greatest. No country can afford the loss of such a tremendous asset.

Recently I had the opportunity to study such a person, a man of fifty-five years, 190 pounds, with a magnificent physique so rare in middle-aged men. This man is brilliant; moral strength, character, and integrity show in every line of his face. As an international leader, he is making no small contribution toward world peace, but the pressure he is under is unrelenting. Like so many leaders, his work keeps him traveling constantly. He must eat in restaurants where it is literally impossible to obtain adequate B vitamins; he is being entertained by hostesses from coast to coast, and guest meals, as a rule, are even nutritionally inferior to restaurant meals. Women who ordinarily serve whole-wheat breads, milk, perhaps fruit for dessert at family meals substitute white rolls, wine, coffee, and some oversweet pastry when entertaining. A psychologist friend says that when one offers food to one’s guests, one is really offering love; if this be love, I say that it lacks depth. Since graciousness demands that such food be eaten, this man has gained 20 hated pounds during the last year. He tries to maintain his health and normal weight by vigorous exercise. In this case it is tennis, not ordinary tennis but hard games played with professionals.

Although one might consider this man to be in perfect health, close scrutiny and conversation revealed many signs of deficiencies: attacks of gout, showing rapid tissue destruction brought on by stress; concern over elimination; fatigue from exertion which should have caused no fatigue; nervous twitches when extremely exhausted; such exhaustion being fought off with coffee, and tension relaxed by whisky and soda. Although this man expressed the desire for 25 more years of useful, active life, my reaction was, thinking of his large frame, his added pounds, the tremendous pressure of his work, the intensity of his athletics, and the dire inadequacy of his food, that he would be lucky indeed to live another five years. Never in my life have I wanted so much to help another human being; yet this brilliant person knows so little about the needs of his body and I so little about psychology that I failed to do anything more than to antagonize him. One can only pray to God that this man and the thousands of wonderful men like him can learn the rudiments of nutrition before it is too late.

The circumstances in the lives of our leaders who have died at their prime in recent years are frighteningly similar to this man’s. Yet few persons, if any, can study nutrition without obtaining the conviction that everyone of these men could have enjoyed 20 or 5O more productive years.

It will be long before our state of ignorance can be changed to one of enlightenment. In the meantime, let us be open-minded, remembering that the experimental work with animals does eventually find its human counterpart and that the counterpart of the scientist’s report, “The animals died apparently of heart congestion although they still had the appearance of good health,” may be found in the widow’s anguished cry, “He was never sick a day in his life.”

Let us be cautious in feeling secure that a mere capsule of mixed B vitamins will supply the body’s requirements. Let us realize that, in respect to the B vitamins at least, our needs must be met largely by wholesome foods chosen with utmost care. Let us keep on the alert for new findings, being aware that the nutrients which may have the greatest effect upon our health are still to be discovered. Let us stay open-minded to the fact that although nutrition is known to be important in maintaining health, the extent of that importance is still to be learned.

Since these vitamins are concerned with the production of energy, the more exercise you take and/or the harder you work, the more of these vitamins you need. Obviously, your requirement will be higher on the days you work hard than when you are vacationing. Also the less sleep you get, the more of these vitamins you need.
The requirement of all vitamins appears to be greatly increased by stress. Your need, therefore, will depend upon the number and severity of stresses you are under. A person might be upset over a pending divorce (stress 1), working long hours under pressure (stress 2), getting too little sleep (stress 3), taking thyroid tablets and benzedrine to keep going (stresses 4 and 5) and sleeping tablets to relax (stress (3), worrying over a sick child (stress 7), and suffering from a sinus infection (stress 8); his requirements for these vitamins are tremendous indeed. I frequently find persons harassed by as many as 15 or 20 different stressor agents at one time. If you are such a person, it seems to me you have three possibilities: live on yeast, liver, yogurt, wheat germ, and even B-vitamin tablets; or remove the stresses; or look forward to ill health.

Your need for these vitamins also appears to be in proportion to the amount of liquid you drink. Years ago, Dr. George R. Cowgill of Yale University produced B-vitamin deficiencies in animals by force-feeding them water. Alcoholic drinks of all varieties increase the need for the B vitamins; these vitamins are needed in utilizing the alcohol in the body and are washed through the body by the liquid. Recently-I am sincerely sorry to write this-scientists at the University of Wisconsin have produced multiple B-vitamin deficiencies merely by feeding animals coffee. Animals thrived when given caffeine without water. It would appear that caffeine, by stimulating the heart beat, increases the flow of blood plasma through the kidneys and thus causes more of the B vitamins to be lost in the urine. So far no one seems to have investigated tea, but it is a fairly safe bet that the effect will be the same as that of coffee.

Heavy coffee drinkers almost invariably show symptoms of B-vitamin deficiencies even when their diets are excellent. I strongly suspect drinking large amounts of coffee is one factor contributing to the graying of hair and perhaps to baldness. Even drinking too much water may be unwise. This problem of liquid intake is probably more important than is appreciated.

Through the years I have been consulted by many persons who make a fetish of building health. For example, a woman recently told me that her breakfast was whole-grain cereal, hand ground immediately before it was cooked, on which she put powdered whey, bone meal, sunflower seeds, powdered milk, yeast, rice polish, cream, and “raw” sugar. Her husband commented that it was like compiling a compost heat>; he was (understandably) intolerant of her ideas (an understatement). Even with such carefully selected foods, this woman and others not unlike her showed symptoms of severe B-vitamin deficiencies. Invariably I find these people not only believe that one should drink eight glasses of water daily but actually do it. Large amounts of water, coffee, beer, soft drinks, or any liquid wash these vitamins out of your body. On very hot days when B vitamins are lost in perspiration and you drink large amounts of liquids, your need for these vitamins is tremendously increased.

It seems to me there is only one way to determine the quantity of these vitamins which will make you feel your best: find your own dosage. Learn how to vary the amounts from day to day depending upon your own body structure, the quantity and type of food you eat, the strain of your work and exercise, the stresses you are under, and the amount of liquid you drink. For example, during the summer when I vacation in the mountains, I eat yogurt occasionally and take only a tablespoon of yeast daily, usually in juice. When working moderately hard, I drink 1 or 2 glasses of tiger’s milk made with 112 cup of yeast and have some yogurt daily. If under stress, I eat 1 cup of yogurt and % pound of fresh liver or take 2 tablespoons of desiccated liver in addition to the tiger’s milk; on the days when the going is really tough, I have liver and yogurt and drink a quart of tiger’s milk containing 1 cup of yeast.

The one day when I experienced the most exuberant feeling of well-being and felt that my mind was clearest was a time when I was under considerable strain. I was asked to give an intensive post-graduate course in nutrition to physicians and dentists. The procedure was to lecture from 9 A.M. until 5 P.M. with a five-minute break every hour. I was told that the last lecturer to give such a course had blacked out from exhaustion at the end of the day. I realized that if I were to sell nutrition, I had to stay rested and my mind alert. Frankly, I was frightened. I therefore had fruit with yogurt, liver and tiger’s milk at breakfast; milk and a huge serving of lobster for lunch, chosen because lobster is rich in glycogen which would be changed slowly to sugar as the protein digested and would thus give a sustained pickup; and tiger’s milk at 10 A.M. and 2 and 4 P.M. Although I stood except during lunch and spoke without a microphone, I did not experience one second of fatigue throughout the day or evening or even the next day when I kept expecting a letdown. This experience convinced me that, for the relatively healthy person, fatigue can be completely prevented.

The real test, I believe, is this: if you are never tired, the chances are that your intake of B vitamins is adequate or that your intestinal bacteria are pretty efficient. If you experience fatigue, your intake is probably too low. A man said to me recently, “You never realize how terribly tired you were until you’ve found out you don’t need to be tired at all.”

Perhaps a hundred times each year I am asked, “Is it all right to take tablets of B vitamins?” I simply do not know the answer. I wish I did.

There are times when such tablets are of value; I have recommended their use for short periods and have taken them myself. No one knows the harm they may do, however, when used as the only source of B vitamins, especially if continued over a long period. When they are taken together with liver, yeast, wheat germ, yogurt, and the most carefully selected diet possible, they probably do little or no harm. In this case they may not be needed unless your requirements are unusually high.

Such tablets generally contain a day’s requirement of the cheap vitamins B1, B2, and niacin; a small amount of pantothenic acid and just enough vitamin B6 to permit a statement of its content on the label. A vitamin catalogue reveals the reason: vitamin u., $3.50 per kilogram; vitamin B6, $55.00 per kilogram. A few other B vitamins may be included but usually are not. Misleading labels often state that such tablets contain 200 to 500 milligrams of liver or yeast; one serving of liver, or less than % pound, is 100,000 milligrams; a heaping tablespoon of yeast is approximately 45,000 milligrams. What earthly value could 500 milligrams, or 1/50 ounce, of either is?

The proportions of each vitamin found in animal and human tissues and the amounts of each excreted daily in the urine of a healthy person on an adequate diet have been carefully studied. These proportions should apparently be maintained if health is to result. In case you take a tablet of mixed B vitamins, examine the label for the following: if your tablet supplies 2 milligrams of vitamin B1, it should also contain equal amounts, or 2 milligrams, of vitamins B2, B6, and folic acid; 10 times more pantothenic acid and niacin than B1 or 20 milligrams of each; approximately 20 times more PABA, or 40 milligrams; 500 times more inositol and cholin, or 1,000 milligrams of each of these two. I know of no studies of the amount of biotin required. Only 1 to 3 micrograms of vitamin B12 appear to be needed daily and possibly even less of the anti-stress vitamins. Does your tablet contain these proportions? I have never seen one which did.

I believe that these preparations are dangerous unless they are taken only temporarily and with foods naturally rich in these vitamins; even then they should be recommended for you by a person who is thoroughly trained in nutrition. If you take one or more B vitamins, you increase your need for all the other vitamins in the B group. The increased need for the ones you do not take may cause you to develop deficiencies of them; these deficiencies may cause far more harm than the vitamins which you take can do good. For example. during World War II when defense plants were selling tablets of cheap B vitamins and urging workers to take them, dozens of persons with eczema consulted me. Invariably these persons were interested in their health and figured that if one tablet daily was good, three or four would be better. I told them to discontinue the tablets immediately. Usually it took a few days before they purchased the foods I recommended, and in this interval the eczema often cleared up. I became convinced that the B vitamins they were taking had increased their need for pantothenic acid, vitamin Be, PABA,and/or biotin, a lack of anyone of which could have caused the eczema. These people not only suffered from eczema but also from fatigue, constipation, and multiple symptoms which these very tablets are supposed to prevent.

The problem of obtaining adequate amounts of all the B vitamins largely from natural sources when living in a hotel or traveling is a challenging one. I travel a fair amount and often must live in hotels. At such times my requirements for these vitamins are unusually high because I am lecturing or rushing from one engagement to the next or interviewing patients for physicians, often talking 10 hours without a break. For me, fatigue prevention at such times is paramount. I carry tablets of mixed B vitamins; wooden spoons, yeast and/or desiccated liver or yeast mix 2 which I take stirred into water before leaving the hotel room in the morning and perhaps again at noon and/or in the evening. At most hotels, liver and yogurt are available; if not, I ask the maitre d’h6tel to order them for me. Wonderful people from coast to coast simplify my travel problem by inviting me to their homes. I doubt that there is another person in this entire United States who is served such marvelous meals of nutritious and delicious foods, although one hostess told me recently that the thought of my coming made her as nervous as if she were entertaining Socrates. Had she known that I washed my face in a granite wash pan until I was nearly old enough to vote, she might have relaxed.
The question of the quantity of B vitamins which should be taken daily is impossible to answer. The foods themselves vary widely. No two people have the same requirement, and every individual’s requirement changes from day to day. For these reasons, the daily allowances suggested by the National Research Council have been purposely omitted from this book.

Since all the B vitamins appear to be needed by every cell in your body, the amount required depends on how many cells you have. If you are small boned and short, you have relatively few cells, and your B-vitamin needs are probably moderate. Stored fat, of course, has no nutritional requirements. Your need for these vitamins, therefore, is in proportion to your ideal weight rather than to your actual weight. The larger your body structure and especially the more pounds of actual muscle you have, the larger the quantity of these vitamins you need.

Vitamin B1 is used in changing sugar into energy or fat; hence the more starches and sugar you eat, the more of this vitamin you need. Similarly, if your diet is high in fat, you need more inositol and cholin. In one way or another, all B vitamins appear to be concerned with the utilization of foods. The person who eats large amounts of food, therefore, needs far greater quantities of these vitamins than do persons with small food intakes.

I serve kidneys frequently; kidney creole is hard to beat. Brains I bake in bacon rings, steam and then cream with ham or tuna, or serve liquefied in milk and added to scrambled eggs and soups; I have finally discovered they can be delicious. When liquefied, they have a texture similar to that of whipping cream and are amazingly palatable in ice cream and eggnogs. Unhydrogenated peanut butter and other nut butters are good old stand-bys; the untoasted varieties obtained from health-food stores are nutritionally superior to others. I keep peanuts, almonds, cashew nuts, and walnuts in the house at all times for children’s lunches and afternoon snacks; they are excellent if the budget can take it. The cumulative amounts of B vitamins obtained from all of these foods is worthwhile indeed. Many of them are too high in calories, however, for those of us who are forced to lead sedentary lives.

If I am working under pressure, which seems to be most of the time, I eat liver daily for breakfast. Fortunately it is my favorite meat and has become the children’s favorite, too. I saute it, using the least fat possible to keep it from sticking, sear it on both sides, then turn off the heat, and let it cook slowly, uncovered, from the heat in the pan. If the liver is not the best, I roll it in flour or wheat germ before cooking it or eat it covered with catsup so that I cannot taste it. Raw liver is nutritionally superior to well done because enzymes, which can help you digest it, are not destroyed; I prefer mine medium well and rationalize that I can produce my own enzymes. Every type of liver, be it rabbit, lamb, pork, beef, or giraffe, supplies B vitamins.

If you are one of those people who hate liver yet truly desire the best health you can obtain, desiccated liver, dried under vacuum at below body temperature, is available; not by the farthest stretch of the imagination, however, could one call it palatable; 2 heaping tablespoons are equivalent to one serving, or 1/4 pound, of fresh liver. I often tell people about it, saying they might try it if they want to. I have been surprised at the number of people who not only take it daily but claim it makes them feel so much better that nothing could make them give it up. I use it, stirred into water or tomato juice, when I cannot get fresh liver. Tablets of dried liver are expensive; 30 tablets are usually equivalent to a serving, or 1;4 pound, of fresh liver. Concentrates of liver or yeast are available but have not been tested for the anti-stress vitamins; certainly none contains the marvelous protein of powdered yeast or fresh or desiccated liver.

For all practical purposes, brewers’ yeast is the cheapest and best source of the B vitamins for a person not under stress. In fact, more nutrients are more concentrated in yeast than in any other known food. The use of yeast alone could correct the majority of the world’s nutritional problems: the proteinless meals of China and India; the B-vitamin needs in the Orient and the tropics; the iron starvation of women the world over; and the trace-mineral deficiencies of both sexes of all ages of every nationality. Yeast can be grown in a few hours without acres of land or sweat of a laborer’s brow, its nutritive value increased by the touch of a chemist’s hand. It is said that three hundred years have been required to introduce most new foods, for example, potatoes and tomatoes. Perhaps by the year 2250, yeast will save our overpopulated planet from famine.

Yeast contains almost no fat, starch, or sugar; its excellent protein sticks to your ribs, satisfies the appetite, increases your basal metabolism, and gives you pep to work off unwanted pounds. If any food could be said to be “reducing,” yeast is that food. Powdered yeast is preferable to flaked yeast which usually has a lower vitamin content, weight for weight. Moreover, 1 tablespoon of powdered yeast is the equivalent of 5 to 9 tablespoons of the light flaked. Yeast tablets are quite all right; 90 tablets are equivalent in mineral, protein, and vitamin content to 1 heaping tablespoon of powdered yeast. Uncooked bakers’ yeast grows in the intestine, grabs the B vitamins supplied by other foods, and refuses to give them up; it is dangerous to take.

Just as you may not have enjoyed your first taste of coffee, you may not enjoy your introduction to yeast. The best way for a beginner to take it is to add no more than 1 teaspoon to a large glass of fruit juice; increase the amount very gradually as you become accustomed to it. I must warn you, however, that there are yeasts and yeasts. Some taste so bad that no human being should be expected to swallow them. If you dislike the yeast you have, feed it to the cat and/or dog, and buy a different brand. Some varieties, to one who is used to yeast at least, are quite palatable. The flavor is, of course, a matter of personal preference.

Despite the fact that these abnormalities are numerous and varied, vitamin B1 appears to have only one function. As part of an enzyme, it helps to change glucose into energy or fat. During the breakdown of sugar to produce energy, pyruvic and lactic acids are formed. By the help of enzymes containing vitamin Bi, pyruvic acid is quickly broken down still further into carbon dioxide and water; lactic acid is rebuilt into glycogen. If the vitamin is undersupplied, these changes cannot take place, and the acids remain in the tissues; they accumulate, especially in the brain, nerves, heart, and blood; eventually they are thrown off in the urine. The production of energy from sugar slows down, coming only from half-burned sugar or from fat; the acids irritate the tissues. Since energy cannot be produced efficiently from fat alone, the result is fatigue, lassitude, and a general laziness throughout the body,

When people deficient in vitamin B1 are supplied with it, the relief of fatigue is often dramatic. Frequently they exclaim in amazement, “I can work twice as hard without getting tired!” In an experiment, subjects were given a minimum amount of vitamin Bi daily; then that amount was doubled and tripled, and their work capacity was tested by weight lifting; it was found they could work twice and then three times as long without tiring. The first thing I do when I employ help to work in the garden or house is to feed them B vitamins; they not only work three times as hard for the same amount of money but work three times as cheerfully.

The reason for personality changes and such symptoms as mental depression, confused thinking, and forgetfulness which occur when vitamin B1 is undersupplied is twofold: first, brain cells derive their energy only from sugar, and glucose cannot be converted into energy without this vitamin; second, the! accumulation of pyruvic and lactic acids in the brain cells is somewhat toxic. At a Philadelphia hospital persons who had eaten foods inadequate in the B vitamins were given a battery of psychological tests before dietary improvement, after vitamin Bi was given, and again after all the B vitamins were supplied. When vitamin Bi was injected, clarity and quickness of thinking, ability to remember, foresight and judgment somewhat improved. The improvement was far more marked when all the B vitamins were supplied by natural foods. Unfortunately, intelligence as such remained the same under all three conditions.

A deficiency of vitamin B1 causes digestive disturbances in a number of ways. Energy production is so faulty that muscular contractions of the stomach and intestinal walls slow down; food can no longer be well mixed with digestive juices and enzymes; and the already digested food cannot be brought into frequent contact with the absorbing surface where it can pass into the blood. A partial or complete lack of hydrochloric acid allows several vitamins to be destroyed, proteins to be incompletely digested, and many minerals to stay insoluble. Gas pain and flatulence are inevitable. If the nutrition is not improved, more serious deviations from health can be expected.

Interference with energy production so limits the contractions of the walls of the large intestine that waste material remains in the large bowel longer than it should. The purpose {If the large intestine is to conserve water by absorbing it back into the blood; the longer the wastes remain, therefore, the harder and drier the stools become. This condition is constipation. Poor elimination can be corrected by a diet adequate in the B vitamins. Except in cases of diarrhea or severe psychological disturbances, your elimination is a fair index of your energy production. Whenever energy is not produced as it should be, constipation occurs; when energy is readily produced, elimination is usually normal.

Heart abnormalities are also caused by the body’s inability to burn sugar efficiently without vitamin B1. Since the heart must work from birth until death, it must be continuously supplied with energy. In a mild deficiency a resting pulse may drop to 50 or even 40 beats per minute instead of the normal 72. As the vitamin deficiency becomes progressively more severe, the pulse alternates between slow during relaxation and rapid during exertion. Eventually it remains rapid, sometimes reaching 180 beats per minute or more. Irritation of the heart muscles by the accumulated lactic and pyruvic acids is believed to cause both the rapid beat and the enlarged waterlogged heart. I recall a sixteen-year-old girl, suffering from exophthalmic goiter, whose resting pulse dropped from 180 to 80 beats per minute during the first week after she added yeast to her diet. If adequate B vitamins are not given, the condition can increase in severity; the almost complete lack of vitamin B1 can quickly result in death.

Neuritis frequently develops when vitamin B, is inadequately supplied. Like the brain cells, the nerves are particularly affected by this deficiency because they are exclusive sugar burners. Neuritis, which may take the form of trifacial neuralgia, shingles, sciatica, or lumbago, is characterized by a sliding scale varying from a dull ache to excruciating pain following the nerve channels. Such pain is thought to result first from the accumulation of acids and later from actual damage to the nerve cells. Headaches and nerve irritation which bring about nausea and vomiting may likewise be caused by these acids.

Neither persons nor experimental animals undersupplied with vitamin Br show all the symptoms of the deficiency. Symptoms of any deficiency vary in endless degrees among individuals and even in the same person from day to day. These same symptoms, however, occur again and again in both people and animals.

Any woman who reads about the experiments conducted at the Mayo Foundation must surely come to the conclusion that it is selfish wisdom to see that her family is given daily foods rich in the B vitamins; if she does not, she herself must be too deficient in these vitamins to think clearly.

When volunteers have stayed on diets lacking vitamin B2, the skin of the nose, chin, and forehead has taken on an oily appearance; tiny fatty deposits, like whiteheads, have accumulated under the skin. Cracks and fissures, like those formed at the corners of the mouth, have sometimes appeared in the corners of the eyelids; the lashes may stick together with an oily secretion, particularly on waking in the morning. Cracks and oily scabs may form at the base of the nose. I have rarely seen these symptoms or perhaps have failed to recognize them.

Such widely different animals as dogs, ducks, rats, chickens, monkeys, geese, and even fish, when put on diets lacking vitamin B2, develop cataracts. If the vitamin is given early enough, the cataracts disappear. When the deficiency is allowed to progress until it becomes severe, however, the damage can be arrested but not repaired. Blindness results if no vitamin is given. Whether or not an undersupply of vitamin B2 causes cataract in humans is controversial. Dr. Sydenstricker of the University of Alabama Medical School studied cataracts and opacities in the eyes of persons showing symptoms of multiple vitamin-B deficiency. When vitamin B2 was given in generous amounts together with an adequate diet, the eyes became normal, usually in about two weeks.

Bloodshot eyes and lip and tongue. abnormalities, characteristic of vitamin-B2 deficiency, have been produced in persons deficient in anyone of several amino acids or in vitamin Be. Animals lacking any one of these nutrients develop cataracts. These conditions can be corrected by supplying, not vitamin B2, but the missing nutrient. At first these facts were puzzling indeed. It must be remembered, however, that vitamin B2 in itself is of no importance; it is merely part of the structure of a number of enzymes. These same enzymes are largely protein made of essential amino acids, the lack of anyone of which can limit their production. It is now known that vitamin B6 is necessary to help combine the amino acids into the protein part of these enzymes. The reason symptoms usually disappear when vitamin Bs is given is that this vitamin is more often lacking than is adequate protein; vitamin B6 is usually given with the vitamin Bs. Conversely, if the symptoms do not disappear after vitamin Bs is made adequate, deficiencies of protein and/or vitamin B6 should be suspected. The deficiency symptoms are caused by a lack of enzymes rather than of any single nutrient. Such is the intricate relationship of many nutrients in the body and of multiple overlapping deficiencies. Milk or yogurt, supplying vitamin Bs, also furnishes vitamin B6 and essential amino acids; the yogurt offers protein in predigested form and a “factory” of hardworking bacteria willing to produce B vitamins for future needs.

I have had many persons report that, after their nutrition was improved, their glasses seemed no longer suited to their needs. On going to an oculist, they have been told that their eyes were much stronger than formerly. Such an improvement can be brought about only by a completely adequate diet, although vitamin Bs undoubtedly plays an important role. Good nutrition, however, cannot correct conditions for which glasses are needed.

Among elderly persons visual difficulties caused by multiple nutritional deficiencies are almost the rule rather than the exception. In all probability, such deficiencies are often responsible for failing vision so frequently accepted as .an inevitable part of growing older. I gave a series of lectures at a Women’s Club where most of the audience consisted of women sixty to eighty years old. On several occasions I tried without success to find one person in the audience who did not show symptoms of vitamin-Be deficiency. In this group was a sweet old lady of eighty whom I shall remember; her lower eyelids were so swollen that there appeared to be a half teaspoon of tears poised on each. She had given up reading, sewing, movies, and even television. Only two days after she improved her diet, she could read the newspaper. Later her delight at being able to sew for her grandchildren was touching.

It is important to realize that eyes can be improved during the later years when many activities are denied elderly persons. Under no circumstances should dim vision be accepted without making every effort to keep the nutrition adequate. Years ago Dr. Spies made a study of children whose families were too poor to buy milk. He found marked “oldage” symptoms including watery and burning eyes and failing vision which cleared quickly when the nutrition was made adequate and milk was supplied. The worst case I have seen was that of a three-year-old who had been given only soy milk. These visual symptoms are usually corrected in young and old alike by an increased intake of yogurt and/or milk, yeast, and liver. In cases of severely bloodshot eyes, it may be wise to ask your physician about taking vitamin B2 temporarily. Milk sugar, or lactose, appears to increase the need for vitamin B2 unless fat is adequate in the diet (p. 45). If a fat-free diet must be adhered to, the use of powdered milk and especially powdered whey should be restricted, particularly when symptoms of a vitamin-Be deficiency occur.

The signs of multiple nutritional deficiencies, perhaps most often caused by lack of vitamin B2, should not be taken lightly. The woman who may be proud of such high color that she need not wear rouge would be wise to inspect herself carefully in the mirror. Probably she should improve her diet with all possible speed.

Vitamins B1, B2, and niacin have long been made synthetically and are the cheap B vitamins. Liver is the richest natural source of vitamin B2, or riboflavin; yeast runs a close second. Since these foods are rarely eaten, for all practical purposes milk is the most reliable source. This vitamin is found in leafy vegetables but can be absorbed only after they are cooked; it is not available from salads.

According to many authorities, a lack of vitamin B2 is the most widespread deficiency in America. Dr. Henry Borsook, studying workers in defense plants during World War II, found approximately 60 per cent showing advanced deficiency symptoms. It has been my experience that symptoms of this deficiency are to be found in almost every person who drinks less than one quart of milk a day.

The symptoms of vitamin-Be deficiency are fairly well understood; studies have been made of human volunteers living on diets adequate in all nutrients except this vitamin. The most universal sign is a magenta or purplish tongue, caused by stagnant blood held in the taste buds. Changes in the lips, however, usually occur earlier, the lower lip apparently being affected first. Perpendicular lines or tiny wrinkles may be seen; later these disappear, and the lip becomes crinkled and rough, often feeling as if it were chapped; tiny Hakes of skin may peel from it. All too often these symptoms can be seen merely by studying yourself in the mirror.

When the deficiency becomes acute, the corners of the mouth split or crack. These cracks do not heal readily and repeatedly break open; although they do not bleed, they become quite sore. They may extend half an inch into the outer cheek and an equal length or more on the inside of the mouth. These cracks appear or disappear depending upon the vitamin-Be intake.

In case the deficiency continues, wrinkles appear radiating from the mouth in much the same direction as is seen when the mouth is puckered for whistling. These wrinkles, which I call whistle marks, may extend half way to the nose. Lipstick gradually creeps up these whistle marks, giving an irregular and ridiculous appearance. Since most of us are vain enough to smile pleasantly at ourselves in the mirror, whistle marks are rarely noticed by the individual who has them; they are visible only when the face is relaxed.

If the deficiency is slight but of long standing, cracks may never appear; instead, the upper lip becomes progressively smaller. In many cases, the upper lip practically disappears. ‘Women with this symptom usually wear their lipstick far above their upper-lip line. The disappearance of the upper lip is common among elderly persons, who invariably blame their false teeth; persons having their own teeth, however, show the same symptoms. I see whistle marks and atrophied upper lips daily, often in persons thirty years of age or even younger.

An early symptom of vitamin-Be deficiency is that the eyes become sensitive to light; like persons deficient in vitamin A, such people usually feel more comfortable wearing dark glasses. If the nutrition is adequate in vitamins A and E, a person’s night vision will be normal, but his vision in dim light or twilight is faulty; he feels confused in dim light. If he comes into a room where others are enjoying the twilight, he usually demands irritably, “Why are you sitting in the dark?” and quickly snaps on the lights. Even though his eyes are sensitive to bright light, he cannot work or write with ease unless the lights are bright. As the deficiency becomes more severe, his eyes may water, the lids may itch and burn and he occasionally feels as if grains of sand are under the lids or particles of dirt are in his eyes. You can notice such a person frequently rubbing or wiping his eyes.

If the eyes are severely strained, they become bloodshot.

Enzymes containing vitamin B2 normally combine with oxygen from the air to supply the cells in the cornea, or tissue covering the eye; when this vitamin is inadequate, the body forms tiny blood vessels in this tissue, thus supplying it with oxygen. After these blood vessels are formed, the blood will drain from them when vitamin B2 is adequate and they are not needed, but the blood vessels remain; hence blood can . quickly enter them again whenever a deficiency recurs. The person whose eyes have once been bloodshot, therefore, often suffers quick recurrences whenever his diet becomes deficient.

A condition similar to bloodshot eyes frequently occurs in the skin of the cheeks. Tiny blood vessels are formed in the outer layers of skin which normally would not contain blood vessels. Such blood vessels can be seen on close examination with the naked eye, and even at a distance they give the cheeks a high color. This abnormal coloring, called acne rosacea, may occur high in the cheeks under the eyes, over the lower jaw or far back on the face in the lateral line near the ears. In severe cases, most often seen in alcoholics, these blood vessels form in the skin over the nose and sometimes the entire face.

These symptoms disappear when the nutrition is completely adequate, the length of time depending upon the severity of the condition, the amount of vitamins given, and the completeness of absorption. I have seen severely bloodshot eyes appear normal again in 24 hours. The tiny blood vessels in the cheeks usually become invisible within two to four weeks after dietary improvement, but they are sometimes maddeningly persistent.

There is still much to be learned concerning the relation of cholin to the utilization of cholesterol in the body. An undersupply of this vitamin, however, appears to be responsible for dim vision resulting when arteries in the eyes become so plugged by cholesterol that circulation can no longer be normal. Circulation to the legs and feet may be so decreased by cholesterol being deposited in the blood-vessel walls that pain and leg cramps occur. In diabetics, where a high-fat diet without cholin or any good source of B vitamins may be adhered to for years, cholesterol deposits may shut off circulation to the legs so completely that gangrene and death occur. “Senile softening of the brain” is probably the result of decreased circulation caused by cholesterol deposits in the blood vessels in the brain. Studies have shown that men put on high-fat diets (unintentionally lacking in B vitamins) because of diabetes, stomach ulcers, or a desire to gain weight 1 often develop fatal coronary occlusion or thrombosis in so short a time as three months; some of the men studied were only thirty-five years old. Persons kept on high-fat diets because of diabetes have been reported dying from atherosclerosis when as young as eighteen years of age. Atherosclerosis, therefore, is not a disease of the aged only. Cirrhosis of the liver in humans, or so-called fatty degeneration of the liver, has been treated successfully with cholin. This disease is also becoming increasingly common 8 as our national diet becomes increasingly deficient in cholin.

The assumption is that we get all the vitamin B6 we need from our diets too. Only recently have vitamin-B, deficiencies been produced in humans.” Hospital patients, given a diet adequate except for vitamin B6, developed mental depression, sore mouths, lips, and tongues and, in time, insomnia, extreme weakness, nervousness, dizziness, nausea, and vomiting. The most striking abnormality, however, ‘was eczema (seborrheic dermatitis) which appeared first in the scalp and the eyebrows, around the nose, and behind the ears. One patient, already suffering from eczema, rapidly became worse. When vitamin B6 was given these patients, their condition quickly became normal. The investigators were then surprised to discover that similar eczemas had appeared in other patients during their hospitalization, while they were eating the “adequate” hospital diet. Since vitamin B6 is known to be part of enzymes necessary for the utilization of both fat and protein, these investigators suggest that eczema appears because the oil glands of the skin cannot function normally without the vitamin.

When experimental animals have been kept on diets adequate except for vitamin B6, eczema does not occur readily unless the diet is also deficient in linoleic acid. However, the animals do develop anemia, extreme irritability, nervousness and insomnia; they often have convulsions not unlike epilepsy. Many animals develop tremors and have difficulty in walking; if the diet is not improved, they eventually become paralyzed. When vitamin B6 is given early enough, health is regained; if not, nerve damage occurs, and the tremors, convulsions, or paralysis cannot be corrected. On autopsy, the heart muscles of these animals are found to be severely damaged.

Dr. Tom D. Spies studied a group of patients who had been given vitamins Bi, B2, and niacin but still complained of extreme nervousness, weakness, excitability, insomnia, irritability, and difficulty in walking. The relief was dramatic when vitamin B6 was given. The patients felt unusually relaxed; they slept soundly; their strength so increased that several, formerly unable to walk more than a few steps, walked a mile or more the day the vitamin was given. Persons with anemia which had not responded to iron, adequate protein, or the B vitamins already given showed marked improvement in five days.

Since animals develop tremors and epileptic-like seizures, physicians have given vitamin B6 in the treatment of paralysis agitans (popularly called palsy), epilepsy, and chorea, or St. Vitus’ dance. Excellent results have been obtained in some cases, despite the fact that epilepsy and paralysis agitans have been considered incurable. In other cases, especially when vitamin Be has been given without a dependable source of the remaining B vitamins, the results have been disappointing. Chorea, however, has been completely cured, the seizures of epilepsy have decreased, and palsy has been corrected except in cases where irreparable nerve damage appears already to have been done.

I have yet to see eczema which has not cleared up when the diet was made adequate and especially rich in linoleic acid and all of the B vitamins. A most spectacular case was that of a man fifty-three years old who had suffered from eczema since he was twenty. His entire body was covered; the eczema was so sore and weepy that, on the extremely hot day when I first saw him, he not only wore long underwear, but his arms and legs were wrapped in yards of gauze, like a mummy. I planned an adequate diet for him and asked him to take a heaping tablespoon of yeast with each meal and between meals. Two weeks later, his skin had completely cleared; in the 10 years since that time, the eczema has not returned.

Through the years I have been consulted by persons so depressed that they were panicky; sometimes they could think of little except a desire to destroy themselves. On their records I have often written, “Problem definitely psychological.” Later they came in so cheerful that I was amazed and puzzled, wondering what had brought about such a change. Since biotin deficiencies have been produced in volunteers, I ask panicky persons if they ever wished to commit suicide. The stories I have been told are so incredible that I hesitate to write them. A minister’s wife cried heartbrokenly, repeating again and again, “I’m a Christian, Miss Davis. I would never take my life,” but her words showed her underlying fear. One young girl had a compulsion to commit suicide so great that she felt safe only around people; since she was ashamed to discuss her problem with her family or friends, she spent most of her time in a cafeteria sitting at tables with strangers. Another was a father who sobbed out his fear that he would lull not only himself but his three children. Still another was a wealthy woman who kept crying, “Why? Why? Why?” Between sobs she explained that she had a marvelous husband, wonderful children, and everything to live for.

Each of these persons and several not unlike them I have known for at least three years. Although most had suffered from depression for months, in no case did the depression return after their nutrition was improved. Their histories, however, show several interesting facts. In most cases they had been given antibiotics which had destroyed valuable intestinal bacteria, perhaps their only source of biotin. Several were taking mixed vitamin preparations; the other B vitamins may have increased their need for biotin, which was not supplied. Some were taking raw eggs beaten into orange juice, thus preventing biotin from being absorbed. Multiple nutritional deficiencies they certainly had, but panic was their outstanding symptom. Improved nutrition apparently gave them strength to cope with their psychological problems. It is said that there are no biotin deficiencies in America; I wonder every time I read of a suicide in the newspaper.

Inositol is another B vitamin about which too little is known. The assumption is that we get all of this vitamin we need from food. In addition to liver, yeast, and wheat germ, its sources are whole-wheat bread, oatmeal, and corn. The richest source is blacks trap molasses. This vitamin is a byproduct of cornstarch manufacture; tons of it are added to the gray paint used by our Navy. Since inositol is not cheap, this paint may account for part of our high taxes.

When animals are put on a diet lacking inositol, their hair falls out. If the vitamin is then added to the diet, their hair grows in again. Male animals lose their hair twice as quickly as do females, indicating that the male requirement is higher than that of the female. A deficiency also causes constipation, eczema (dermatitis) and abnormalities of the eyes. Inositol is particularly concentrated in the lens of the human eye and in the heart muscles, perhaps indicating that it plays some role in normal vision and in heart action. A hundred times more inositol than any other vitamin except niacin is found in the human body.

Dr. Gustav Martin and co-workers at the Warner Institute of Therapeutic Research studied the effects of different B vitamins on the intestinal tract. Separate vitamins were given with barium, and contractions of the stomach and intestines were studied by fluoroscope. Only inositol caused a marked increase in the movements; poor appetites became normal, and previously existing constipation was relieved. Greater activity in the intestine is known to increase absorption. Blackstrap molasses is certainly more laxative than any other food. The millions of dollars spent annually on cathartics in America may result from inositol deficiency.

A few years ago I became interested in the possibility that a lack of inositol might be one cause of baldness in men. For a time I recommended inositol together with other sources of B vitamins to all the bald men who consulted me. In almost every case they soon reported that their hair was no longer falling out. Wives or mothers particularly mentioned that, whereas loose hair had formerly covered pillows and washbasins, they now had no loose hair to clean up. In some cases new hair growth was obvious in a month. One man of forty-eight, who had been bald for years, grew hair so thick that it looked like rabbit fur; surprisingly enough, he was extremely proud of it. One white-haired man of sixty-five had a bald spot far back on his head; the entire spot filled in with black hair, and a distinguished streak of black hair in the white appeared above his forehead. One man, who had been bald since he was twenty, grew so much hair that no bald spot remained. Some of the men, however, grew not one encouraging wisp.

Loss of hair often occurs in animals deficient in anyone of several B vitamins or certain amino acids. Since I recommended for baldness a teaspoon of pure inositol daily added to a quart of tiger’s milk (p. 114) unusually rich in all these vitamins and proteins, new hair growth may have been brought about by increased amounts of nutrients other than inositol. At each meeting of the American Academy of Nutrition I am impressed that most of the doctors who have been active in the organization for years have healthy luxuriant hair, in marked contrast to the sparse strands of younger men whose diets are less adequate. Hereditary tendencies and other causes of baldness undoubtedly exist. Family albums showing our elderly forefathers with luxuriant hair growth makes me suspect, however, that baldness is becoming more common and is developing at a younger age than it did a hundred years ago.

So much is known about the B vitamins that entire volumes are written about them. If the known facts were universally applied, the improvement in world health would probably be beyond imagination. Yet knowledge of many of these vitamins is so limited that it can only be described as a state of ignorance.

This group of perhaps 20 or more vitamins is called the vitamin-B complex because it is complex. Every month or two a new substance is separated from liver, yeast, and/or wheat germ. One, pan gamic acid, spoken of by some investigators as vitamin B15, promises to be important in energy production. Another, lipoic acid, is being written about. Vitamins B13 and B14 are now reported. Others can be expected.

The last three B vitamins to be well established are variously called the anti-fatigue, antitoxic, or anti-stress vitamins. These three appear to be unnecessary under normal conditions or to be needed in such small amounts that they can be made in the body or perhaps by bacteria in the intestines. Even though a diet contains all previously known nutrients and is adequate to support health under normal conditions, it can still be inadequate during conditions of stress unless these anti-stress vitamins are supplied. Stress is anything which puts an extra load on the body. Conditions of stress are produced by drugs, chemicals, infections, surgery, noise, excessive fatigue, psychological upsets, resentments, hatreds, and. hundreds of other factors. It now appears that all nutrients are needed in larger amounts during stress than under normal circumstances.

When animals on seemingly adequate diets are submitted to stress, widespread damage occurs in their bodies. If these animals, however, are given fresh or dried liver or a crude liver concentrate, little harm is done. For example, when the strength of animals was tested by making them swim in ice water, the animals on “normal” diets could swim only three to ten minutes before drowning; animals given the same diet fortified with liver swam two hours or longer and lived to swim again.

When liver is given, the harmful effects of such stressor agents as atabrine, excessive amounts of the thyroid hormone or milk sugar, extreme heat or cold, lack of oxygen, X-rays, and various drugs have been prevented or decreased. Animals subjected to stress but not given liver often die unexpectedly, apparently of heart failure,’ although they may have all the outward appearances of good health. Liver of all varieties appears to be the richest source of the anti-stress vitamins; kidney, soybean flour, and brewers’ yeast contain some.

A number of other B vitamins have been so little studied that their distribution in foods is largely unknown, the amount needed is a mystery and, if deficiencies of them commonly occur, they are not recognized. Since the deficiencies produced experimentally are not recognized in humans, the assumption is that these vitamins are amply supplied by food or by intestinal bacteria, an assumption which I believe is not always true.

The richest source of the B vitamin, biotin, is yeast. Animals lacking this vitamin develop eczema, or dermatitis; their hair falls out; they are particularly susceptible to heart abnormalities and lung infections. If cancers are transplanted, they grow rapidly in biotin-deficient animals. Growth is extremely stunted in young animals; adults become emaciated; death comes quickly to both.

A substance in egg white, avidin, can combine with biotin in the intestinal tract and prevent it from reaching the blood. Dr. V. P. Sydenstricker of the University of Alabama studied, biotin deficiencies produced in human volunteers on adequate diets containing egg white. The first symptom noticed was mental depression. In time the subjects developed dry peeling skin, extreme fatigue, muscular pain, nausea, and distress around the heart. The mental depression became intensified to what Dr. Sydenstricker described as “panic.” All the symptoms disappeared in three to five days after biotin was added to the diet.

I know a physician, too overworked to follow nutritional research, who tells mothers to add beaten raw egg to their baby’s formula, starting at the third month. I have seen nine of these children covered with severe eczema which promptly cleared when the egg was withdrawn, and yeast and yogurt were added to the diet. The many recipes calling for uncooked egg white should be discarded. Eggs should be cooked until the white is firm, especially for persons “allergic to eggs.”

In a general way you can tell how adequate your intake of B vitamins has been by looking at your tongue.” It should be moderate in size, an even pink in color, and smooth around the edges without coating or indentations showing where it has rested against your teeth. The taste buds should be uniformly small and cover the entire surface and edges. If you can find a healthy child, you may see what the normal tongue should look like.

When the B vitamins are undersupplied, many changes take place in this organ. The first change appears to be enlargement of the buds at the front and sides of the tongue. Later these buds become small or even disappear, making the tip and sides smooth, whereas the buds farther back will progressively enlarge. These buds have a fiat appearance, like button mushrooms. As the deficiencies of these vitamins become more severe, clumps of taste buds fuse and grow together, pulling apart from other clumps and thus forming grooves or fissures. The first groove usually forms down the center of the tongue. In a severe B-vitamin deficiency, the tongue may be so cut by grooves and fissures that it looks ‘like a relief map of the Grand Canyon and the surrounding territory or a Hank steak run through a tenderizing machine.

When the deficiencies are still more severe, the taste buds literally disappear. First the tip and edges become smooth and shiny; then the buds disappear progressively from front to back. This extreme condition is found most often in elderly persons whose diets have been inadequate for years; they complain that their food has little flavor. In some cases such tongues are intensely sore. In other cases, persons having extremely abnormal tongues are surprised to find that they differ from normal.

The size of the tongue also indicates deficiencies of these vitamins. The tongue may be large, beefy, and full of water (edematous). Often such a tongue shows scallops around the edges where it has rested against the teeth. The beefy tongue is so named because it has the appearance of beef and is usually an intense deep red. On the other hand, it may become too small, or atrophied. Other tongues may have a purplish, or magenta, cast, and still others may be a brilliant red. Often the tongue shows a combination of colors with perhaps a red tip and a magenta center. The color and texture vary depending upon which B-vitamin lack is most prominent. For example, a magenta tongue (the color seen most often) indicates that a deficiency of vitamin Bs predominates over the other B-vitamin deficiencies. A beefy tongue is thought to show that pantothenic acid is particularly undersupplied. When deficiencies of vitamin B12 and folic acid are most prominent, the tongue becomes strawberry red and smooth at the tip and sides; it is often shiny and not coated. If the deficiency is predominantly the B vitamin, niacin, the tongue may be fiery red at the tip and may appear to be either too small or too large and so coated that it is fuzzy with debris. The heavy coating is caused by the growth of undesirable bacteria; it usually indicates much putrefaction in the intestine. Since valuable bacteria in the intestine produce B vitamins, such coating probably never occurs if bacteria growth is normal.

I asked a professor in medical school if he thought it wise to include a description of abnormal tongues in this book; I feared that people would worry excessively about their tongues. To my amazement he answered, “You never see them anyway. I’d omit it.” He does not see them because he does research, but I have examined hundreds of tongues and have found only three normal ones in two years. I still chuckle every time I remember an occasion when, lecturing before a small group, I was requested to examine the tongue of everyone present; not one normal tongue had come to the lecture. The group sat like so many panting collies, astonished at each other’s deficiencies. When the diet is made adequate, however, the tongue gradually becomes normal again, the recovery time depending upon the severity of the deficiency and the completeness of absorption.

Studies indicate that 60 to 100 per cent of the persons showing severe tongue changes are unable to produce sufficient amounts of hydrochloric acid in their stomachs; their output of digestive enzymes is far below normal. In such cases, digestion is so faulty that unless tablets of hydrochloric acid and digestive enzymes are taken temporarily (p. 233), much gas, flatulence, digestive disturbances, and discomfort may be experienced. In fact, if your digestion is so faulty that you have intestinal gas after you add foods rich in the B vitamins to your diet, you can be sure you have been deficient in these vitamins.

All the B vitamins dissolve in water and for this reason cannot be stored in the body. Just as a sponge can be slightly moist or dripping wet, however, so can the cells hold little or much of each B vitamin, depending on the amount offered. To maintain ideal health, the offering of B vitamins should be sufficient for each cell to take all it can use to advantage. Any B vitamins not needed are excreted in the urine.
It appears that all B vitamins work together; this cooperation is called the synergistic action of the B vitamins.

The taking of one or more B vitamins increases the need for the others not supplied, probably because anyone B vitamin alone can increase the activity of each body cell. The group in its entirety can be obtained only from such foods as liver, yeast, and wheat germ.

To discuss the deficiencies of the B vitamins separately is as unrealistic as to believe in men from Mars. Such deficiencies exist only in an experimental laboratory. A deficiency of one, however, often predominates over others. If the first symptoms of that deficiency are recognized, they can serve as a warning that unless your nutrition is improved, greater deviations from health can be expected.

The 15 or more B vitamins are so meagerly supplied in our American diet that almost every person lacks them.

Dr. Norman Jolliffe has pointed out that a few generations ago even the paupers received a diet rich in these vitamins. They were better off than the wealthiest are today.

The reasons for this drastic decrease are numerous. Formerly every bite of bread, cereal, and foods prepared from grain supplied B vitamins. Since there was no refrigeration or canning and there were few fruits and vegetables, the mainstay of the diet was breadstuffs. In 1862 machinery was invented which refined grains in such a way that most of the nutrients were discarded. Molasses, rich in certain B vitamins, was once the only sweetening. No refined foods and few sweets of any kind were available. Now the consumption of sugar has increased tremendously; all the original nutrients are discarded; it quickly destroys the appetite and greatly augments the need for certain B vitamins. Whereas no nutrients were formerly discarded, two-thirds of our calories are now supplied by foods from which the original nutrients are largely or wholly discarded. Furthermore, we lead such sedentary lives that our food intake is small compared with that of our grandparents. Seventy years ago, men consumed approximately 6,000 to 6,500 calories daily; women 4,000 to 4,500. Today the average is 2,400 to 2,800 for men and 1,800 to 2,200 for women.

The advantage of using whole-grain breads and cereals was shown during World War I when shortages caused the Danish government to forbid the milling of grains; nutrition in Denmark was so improved that during the war years the death rate fell 34 per cent. The incidence of cancer, diabetes, high blood pressure, and heart and kidney diseases dropped markedly, and evidences of positive health greatly increased. Much the same improvement occurred in England during and after World War II when grains were only slightly milled. Although the English diet was deficient in many respects, surveys showed that the national health did not suffer during this period.

Now that our breadstuffs are refined, no food rich in the B vitamins is ordinarily eaten daily. In fact, there are only four good sources of these vitamins: liver, brewers’ yeast, wheat germ, and rice polish. A few foods are high in one or two B vitamins, but to obtain our daily requirement of all of them from such foods is impossible.

A source of B vitamins perhaps more important than any other is that synthesized by valuable bacteria in the intestine; the amount from this source cannot be easily measured. Studies of B vitamins found in the blood and urine of persons on diets lacking these vitamins show that intestinal bacteria can produce large amounts of certain B vitamins, which disappear from the blood and urine if the bacteria are destroyed. For reasons not understood, other persons on a B-vitamin-deficient diet have been found to have little or none of these vitamins in their blood and urine.

It appears that these bacteria grow best on milk sugar and cannot grow unless fat is supplied them; milk-free and/or fat-free diets, therefore, may be dangerous. The taking of sulfonamides and antibiotics, such as streptomycin and aureomycin, completely destroys these valuable bacteria; symptoms of multiple B-vitamin deficiencies may quickly appear unless food which promotes the growth of desirable intestinal bacteria, such as yogurt, is eaten. This food, sometimes spoken of in America as a fad, has been eaten for centuries in countries from Turkey to Lapland, Iceland to China. A study made by Dr. Seneca 1 of the College of Physicians and Surgeons of Columbia University points out that when yogurt is eaten over a long period, no other bacteria except those from yogurt are found in the stools.

The B vitamins appear to be needed equally by every cell in the body. For example, if a well-fed animal is killed and its tissues are analyzed separately, these vitamins are found to be evenly distributed throughout the tissues. Conversely when animals are kept on a deficient diet, then killed, and separate tissues are analyzed, each tissue is uniformly deficient. Most of the other vitamins are needed more by certain tissues than by others. Dr. Roger J. Williams (ref. 1, p. 35) has pointed out that because these vitamins are needed equally by all cells, a deficiency can produce severe damage before the condition can be noticed. The damage is nevertheless real. Instead of one organ showing abnormalities, as do the eyes during a vitamin-A deficiency, the entire body degenerates into a one-hoss-shay collapse. This overall abnormality is difficult to recognize in an adult, but severely stunted growth makes it markedly noticeable in the young.

Dr. Williams also points out that only when the deficiency becomes quite severe does one group of cells show greater damage than another. For example, when a person feels below par, he automatically decreases his activity and may spend much time sleeping; thus most of his cells do less work, and their need for B vitamins decreases. The heart, however, works continuously from birth until death; even though the deficiency is already severe and every cell has been equally damaged up to this point, the first deficiency signs may now appear in the heart.

It has become increasingly clear that since the B vitamins occur together in food, no person is deficient in anyone B vitamin without being deficient in all of them. There are, however, as many degrees and variations of B-vitamin deficiencies as there are different individuals. Formerly the disease beriberi was thought to be caused by a deficiency of vitamin B1, and pellagra by lack of the B vitamin, niacin. When human volunteers have stayed on diets lacking vitamin B1 or niacin, however, neither beriberi nor pellagra has been produced. These diseases actually result from multiple deficiencies of all the B vitamins, the lack of vitamin B1 or niacin being only more prominent.