Scurvy Reappears in Australia

[alicec]

Here is a report making the news today in Australia.

These are not people living in some remote location where fruit and vegetables are prohibitively expensive. They live in the largest city of a very wealthy country which produces an abundance of fruit and vegetables year round and where public health campaigns promoting inclusion of fruit and vegetables in the diet are very common.

Apart from having diabetes, there doesn't seem to be anything unusual about the group.

They came to the attention of their treating doctors because of wounds which didn't heal - wounds which the doctors expected should heal. Eventually lack of vitamin C was considered as a possible explanation, blood tests confirmed this and sure enough, supplementation soon fixed the problem.

The patients tended to avoid fruit because of the diabetes but most of them did eat reasonable amounts of vegetables. The doctors concluded that their poor vit C status was due to their overcooking the vegetables.

They also canvassed the possibility that vitamin C deficiency could be widespread in the population.

How did these people end up with such a compromised vit C status that overcooking of vegetables could send them into scurvy?

I thought this was an interesting question, particularly in light of the widespread and complacent assertion by many in the health professions that we get plenty of vitamins/minerals from our food and supplements are unnecessary.

I am interested in the notion that different health conditions and circumstances can change demands for nutrients. The recent metabolomics studies in CFS/ME confirm widespread metabolic derangement which could dramatically alter nutrient status and indeed one studied concluded that it is akin to a starvation state.

This report on the diabetics made me think there must be some derangement of vit C metabolism going on. A quick google suggests that there is at least some evidence for increased demand for vit C.

Maybe it is time for more questioning of the notion that diet alone is sufficient to supply nutrients.

 

[Cheesus]

A boy recently died in the UK because of scurvy. There is a resurgence of 19th Century disease here, largely because of declining standards of living. Doctors are diagnosing things like malnutrition, TB and Cholera.

These are not people living in some remote location where fruit and vegetables are prohibitively expensive. They live in the largest city of a very wealthy country which produces an abundance of fruit and vegetables year round and where public health campaigns promoting inclusion of fruit and vegetables in the diet are very common.

They live in a wealthy country, but the gap between rich and poor is widening. I suspect Australia is much like the UK in that the lower echelons of the socioeconomic strata are getting poorer and poorer. There is a clear connection in the developed world between levels of poverty and the kind of food people eat. There are kids around here who wouldn't be able to recognise a piece of broccoli. They eat baked beans, chips and turkey dinosaurs. It's cheap and easy, and the parents do not realise the damage they are doing to their children because the social structures they are surrounded by are often fatalistic and do not pay any heed to health and wellbeing.

 

[taniaaust1]

They live in a wealthy country, but the gap between rich and poor is widening. I suspect Australia is much like the UK in that the lower echelons of the socioeconomic strata are getting poorer and poorer. There is a clear connection in the developed world between levels of poverty and the kind of food people eat. There are kids around here who wouldn't be able to recognise a piece of broccoli. They eat baked beans, chips and turkey dinosaurs. It's cheap and easy, and the parents do not realise the damage they are doing to their children because the social structures they are surrounded by are often fatalistic and do not pay any heed to health and wellbeing.

Takeaway food including things like just chips, is expensive here in Australia compared to buying fresh fruit and veg. Back when I was child my mother used to be about to buy just chips cheaply but not now.

As an Australian, Ive neer heard of turkey dinosaurs.
...........

One thing I was taught in nutrition at collage is that things like fruit and veg can contain less vitamin C then one supposes they would cause supermarket foods are picked while still green and then allowed to ripen. Fruit and Veg develop their vitamin C with the riper they get and don't have their full vit C until they are fully ripe. They don't give much if the food is picked early with something ripening off a tree. (hence why some orange juice companies actually aid vit C to orange juice cause those oranges have been picked while still green).

 

[Cheesus]

@taniaaust1

Chips aren't usually considered solely takeaway food here in the UK. But that isn't important, my example was only intended to illustrate a typical nutrient-poor meal of oven-cooked frozen food. I am sure Australians eat such meals.

It may be the case that Australians all eat equal quantities of vegetables regardless of socioeconomics, unlike the UK. But the expense of the food is not necessarily the determining factor when considering why socioeconomic status might influence decision-making. There is a statistical relationship between poor education and socioeconomic status, so it might be that people are less capable of making informed decisions. Moreover, not all fruit and vegetables are created equal, and those with cheaper production techniques tend to have lower nutrient density.

There are almost certainly cultural influences at play. The food industry is enormously important in determining what ends up on people's plates, and they commonly do not have an interest in promoting foods dense in micronutrients (the combinations of macronutrients are what will make the customers come back). It is possibly also caused by changing methods of food production, as you rightly say.

Anyway, the key question here is, I think, why is there a sudden and apparently global resurgence of these types of diseases? Is it the case that people across the globe are suddenly changing how they cook vegetables? That seems unlikely to me. There is something changing behind the scenes, and I would be very interested to know exactly what.

 

[hixxy]

@taniaaust1 Supermarkets here are full of varieties of frozen chips and you can easily substitute frozen chicken nuggets for turkey dinosaurs. There's no way that fruit and vegetables are cheaper than this kind of nutritionless food.

 

[alicec]

They live in a wealthy country, but the gap between rich and poor is widening. I suspect Australia is much like the UK in that the lower echelons of the socioeconomic strata are getting poorer and poorer

In general that does seem to be an important element in the very poor diet phenomenon but in the case of these diabetics, the report specifically ruled out SES. The affected people seemed to cover the range.

 

[alicec]

Anyway, the key question here is, I think, why is there a sudden and apparently global resurgence of these types of diseases? Is it the case that people across the globe are suddenly changing how they cook vegetables? That seems unlikely to me. There is something changing behind the scenes, and I would be very interested to know exactly what

Yes I agree. We seem to have lost some dietary fundamentals and the link to health and well being.

 

[taniaaust1]

Maybe its more so that people eat less salads then they used to do and go more for cooked veg. It only takes 10 mins of heat to destroy vitamin C so a salad can make a big difference over a cooked meal. (I don't think the shift has anything to do do with money or richer or poorer but to do with something else.. peoples dietary preferences shifting for other reasons).

...
Australia hasn't gone like the UK where some disabled people are offered far less then others as payments etc and hence not getting enough to survive (everyone on disability has same standard disability rate here in Australia). From what Ive heard some people seem to be far more disadvantaged in the UK.

 

[Little Bluestem]

I have read about a resurgence of scurvy in the US, as well. Poor neighborhoods often do not have grocery stores, so the people get most of their food at convenience stores. This food is not necessarily inexpensive, but they do not the the time and/or transportation to get to grocery stores.

 

[Cheesus]

From what Ive heard some people seem to be far more disadvantaged in the UK

That certainly wouldn't surprise me. People are really suffering here.