Vitamins and Development

Stephen DeAngelis

May 29, 2009

Almost everyone knows that in the heyday of sailing ships, scurvy was the scourge of sailors. For those not familiar with the disease, Wikipedia reports: “Scurvy leads to the formation of spots on the skin, spongy gums, and bleeding from the mucous membranes. The spots are most abundant on the thighs and legs, and a person with the ailment looks pale, feels depressed, and is partially immobilized. In advanced scurvy there are open, suppurating wounds and loss of teeth.” I suspect it was difficult for those sailors to get a date once they returned from sea. Scurvy is caused by a lack of vitamin C in the diet. Because humans cannot synthesize their own vitamin C, we must obtain it through our diet. Vitamin C is widespread in plant tissues, with particularly high concentrations occurring in citrus fruits (oranges, lemons, limes, grapefruits); tomatoes, potatoes, cabbages, and green peppers. Fortunately, today most us have ready access to such foods. We all know that a proper diet is essential for healthy living. Inadequate diets always result in health problems. In a previous post [Iodine and Intelligence], I cited an article by Donald G. McNeil, Jr. (“In Raising the World’s I.Q., the Secret’s in the Salt,” 16 December 2006), in which he noted the negative health effects of a diet deficient in iodine:

“Worldwide, about two billion people — a third of the globe — get too little iodine, including hundreds of millions in India and China. Studies show that iodine deficiency is the leading preventable cause of mental retardation. Even moderate deficiency, especially in pregnant women and infants, lowers intelligence by 10 to 15 I.Q. points, shaving incalculable potential off a nation’s development. The most visible and severe effects — disabling goiters, cretinism and dwarfism — affect a tiny minority, usually in mountain villages. But 16 percent of the world’s people have at least mild goiter, a swollen thyroid gland in the neck.”

A more recent article by New York Times’ columnist Nicholas Kristof reports the serious consequences of having too little Vitamin A in one’s diet [“What a Little Vitamin A Could Do,” 13 May 2009]. Kristof’s interest in the subject of vitamin deficiency came on his most recent trip to western Africa.

“Americans pretty much take vitamin A for granted, but many of the world’s poorest people lack it. And as a result, it is estimated that more than half-a-million children die or go blind each year. There’s a simple fix: vitamin A capsules that cost about 2 cents each.”

Vitamin A can be found in fish and liver, green and yellow fruits and vegetables, apricots, asparagus, beets, broccoli, butter, cantaloupe, carrots, cheese, garlic, green olives, milk products, fresh mustard, papaya, parsley, peaches, prunes, red peppers, sweet potatoes, spinach, sweet potatoes, pumpkin and watercress. The world’s poor, however, often have little access to such fruits and vegetables. Kristof noted that a lack of vitamin A can cause blindness. In addition, vitamin A deficiency can affect bones, hair, the immune system, skin, soft tissues and teeth. The effects are bad enough for those afflicted with them, but there are broader consequences as well. Not only are the afflicted often removed as a productive part of society they can sideline caregivers as well. Kristof provides an example of how blindness can affect an entire family:

“A man named Amadou Bailo shuffled toward us, holding one end of a stick as his daughter held the other and walked ahead of him. In wealthy countries, the blind have seeing-eye dogs; in poor countries, the blind have seeing-eye children. The girl, Mariama, who thought she might be about 9 years old, has never been able to attend school because she spends her days guiding her father. Her older brother was the father’s guide before that, so he never went to school either.”

Mr. Bailo didn’t go blind because of a lack of vitamin A. He has river blindness, “which is caused by baby worms that infest the body and destroy the optic nerve.” Kristof reports that river blindness was once widespread throughout Africa, but efforts spearheaded by former U.S. President Jimmy Carter have”In one of the great triumphs of humanitarian workers, it is under control and perhaps close to being conquered. Credit goes to former President Jimmy Carter for helping to lead the fight against the disease, to a number of aid groups and to Merck, which donated the medicines to kill the baby worms. Mr. Bailo will never recover his vision, but these days, virtually no one in West Africa is going blind from the disease.”

For more about President Carter’s efforts, read my post entitled Carter’s War on Worms. Kristof also visited a school where “80 percent of the students had lost their sight for reasons related to vitamin A deficiency.” The consequences of their blindness are tragic. What makes their blindness even more tragic is that it could have been prevented.

“According to the United Nations, half of the children in many African countries are deficient in vitamin A (which comes from liver, mangos, orange-fleshed sweet potatoes and dark, green leafy vegetables), and a disease like measles will quickly deplete their supply further and trigger blindness. The upshot is that vitamin A deficiency is the leading cause of child blindness in the world today. Health wonks have found that vitamin A supplements reduce not only blindness, but also death from diarrhea and other diseases. A review by Unicef and Helen Keller International reports that in areas such as West Africa where many children lack the vitamin, child mortality drops by approximately 23 percent after vitamin A capsules are distributed to children.”

One of the prerequisites for sustainable development is a healthy and educated workforce. As Kristof notes, vitamin deficiencies can negatively impact both. Although the Enterra Solutions® Development-in-a-Box™ approach is primarily focused on business development, it is a holistic approach and touches on every sector including health care and education. The philosophy behind our approach to health care is the same as it is for businesses: implement best practices and standards. One best practice, of course, is ensuring that a developing population obtains proper amounts of vitamins and minerals in their diet so that they remain healthy. Prevention is always better than cure.