The Re-emergence of Nutrition Related Diseases

Because of new eating patterns within the United States and England, a resurgence of preventable diseases such as goiters, rickets, scurvy, and gout is occurring. These diseases tend to develop after lengthy periods of dietary deficiencies; therefore, preventing this re-emergence may be as simple as consuming a balanced diet with a wide variety of nutrients from all food groups. Unfortunately, recent dietary trends, such as decreased iodized salt intake, paired with insufficient nutritional knowledge have caused these once eradicated diseases to return. This article will examine the re-emergence of four preventable diseases and discuss which deficiencies contribute to each nutrition-related illness.

Goiters

Goiters occur when the thyroid gland swells, which is caused by an iodine deficiency. In the 1920s, iodine was first added to table salt, eliminating the majority of cases by the 1940s. However, the government never standardized the process of adding iodine to sodium, and certain forms like sea salt and Kosher salt do not contain added iodine. While most American diets are high in sodium, iodine deficiencies and goiters are returning due to a high consumption of these alternative forms of sodium. Processed foods high in sodium make up a large proportion of the American diet as well, however most manufacturers do not use iodized salt in their products. Additionally, dairy products and seafood are good sources of iodine, but consumption of these foods is decreasing in part due to health or allergy reasons.

Rickets

Often called the "disease of English children," rickets is caused by poor bone mineralization. This makes the bones weaker and is predominately caused by a lack of vitamin D. Rickets is most often seen in children, with the legs looking as if they are "bowing" to the sides. Rickets was first studied in the 17th century, but it wasn't until the 1920s that scientists discovered sunlight and cod liver oil could prevent and cure the disease. A paper published in 1922 suggested that a vitamin helped to deposit calcium into the bones. Today we know this vitamin as vitamin D. Recently, cases of rickets have returned in higher numbers than in the past four decades. Mostly in children under 3 years old, this increase is thought to be caused by a lack of sun exposure and poor vitamin D intake.

Scurvy

Scurvy is the rarest of these four re-emerging diseases, but the number of cases has increased in high risk groups. Historically seen in sailors who went months without vitamin C, both early and late symptoms of scurvy can be found in those with a vitamin C deficiency. In 2012, 7.1% of the US population was found to be vitamin C deficient. High risk groups include those on a restrictive or fad diet that restrict the amount of sugar a person can consume, resulting in the avoidance of fruit. Additional high-risk populations include those who abuse alcohol, smoke or do drugs, the elderly, those with poor diets, and those with inflammatory bowel diseases.

Gout

In the past, gout was thought of as the disease of the wealthy and influential. It was not very common, but it was still well known. Today, over 8 million Americans suffer from this disease. Gout occurs when high levels of uric acid accumulate in the blood, causing extremely painful inflammation and arthritis. Research has shown the re-emergence of gout has been caused by unhealthy lifestyle factors such as obesity or an unhealthy diet. Additionally, genetics may predispose an individual to the disease. Anti-inflammatory foods can be included in the diet to help with gout symptoms, such as berries, omega-3s from fish, and green tea.

While goiters, rickets, scurvy, and gout have been re-emerging, these nutrition-related diseases are easily preventable simply by consuming a healthy, balanced diet, and although rare, they should not be overlooked.

Care should be taken to ensure consumption of :

• iodine from iodized table salt
• vitamin D from fortified milk or juice, salmon, tuna
• vitamin C from citrus fruit, broccoli, cauliflower, Brussels sprouts and strawberries
• anti-inflammatory foods such as leafy greens, fish and shellfish, nuts and olive oil

Additionally, lifestyle patterns should emphasize moderate sun exposure, about three days a week for fifteen minutes, and avoidance of excess weight. By remembering these simple factors when considering our diets and lifestyles, we can prevent further cases of these re-emerging diseases.

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