I found you, Antiscorbutic…

Look at that guy. He’s ready for this flight. Are you? It’s mid-flu season and you’re about to spend several hours in a flying, sealed tube with a lot of other people. How many shameless, no-mask-wearing, selfish monsters do you think will sneeze during the flight? How much snot will be wiped? Did you take your airborne? Did you even drink a glass of orange juice before you left the house? Well, godspeed because your seat is beside that talkative, coughing, Kindergartner over there. Bet you wished you had a nice little Vitamin C blanket like my smart, furry friend up there. And oh yeah he just got bumped to first class.

What you forgot.

Better get orange juice from that drink cart that comes around in an hour and just hold your breath till then. Even though they’re giving you that cheap OJ from concentrate it’ll still have Vitamin C in it aka Ascorbic Acid. It’s a pretty small, simple molecule and in the world of living things seems to be almost ubiquitous ( in other words you could have easily gotten it and you have only yourself to blame). It’s important to us humans because it’s a necessary ingredient for our bodies to produce collagen. Collagen is a protein that makes up much of our connective tissue. It is about 30% of all the protein in our bodies. So, if you run low on Vitamin C you’re body will literally fall apart.

AscorbicAcid_NIH
Ascorbic Acid: look at this little guy necessary for life. Super excited and maybe a fun robot arm on the left

But we can’t make ascorbic acid in our bodies. It’s not hard we just can’t. That gene was lost a long time ago and it did not hinder our ability to survive soooo we’re still here and the gene just ain’t. Why did we survive though? If we don’t get ascorbic acid our bodies start to literally fall apart (I repeated that because it’s important). Well it’s not because we’re super smart or strong or great at finding food but because ascorbic acid is literally everywhere. See that leaf? Eat it. It probably has all the vitamin C you need for today. Well, you might need to eat a few more of the leaves.

(Actually, don’t eat that leaf unless you 100% know what it is please. It could be poisonous. I mean it still will have a good amount of vitamin C, but you might die and who knows what kind of weird leaves people bring on planes)

Wait…you still don’t look so good. Are you in an airline wasteland with zero plants and not even a complimentary fresh snack on a cross country flight? Okay I got you. See that furry animal. Yeah, that cute, furry one. NO! not the Guinea Pig with the orange! He’s got his stuff together. That other furry one…Kill it. Now eat it. You can even cook it a little if you want. Unless you’re a monster and killed that sweet little guinea pig or a fellow primate you’re probably now teeming with the almighty protective power of Vitamin C.

All mammals, with the exception of primates, guinea pigs, and humans, still retain the gene that allows them to produce their own ascorbic acid (must be nice). The fact that this necessary chemical is found in basically all the living things that we eat and are surrounded by is a major factor in why it wasn’t discovered until 1930. And is probably why humans kept getting confused on what caused scurvy.

Oh, yeah I forgot to mention. Did you not take my advice before? eating wild leaves weirded you out and that little fur-ball was too adorable to slaughter, right? Well, if you keep this up for too long (a month or so) you’ll get scurvy and then soon die…within a few days to weeks.

Please don’t die

That’s what happens when you don’t take my advice. You get scurvy. Ascorbic Acid comes from the word scorbutic which means ‘relating to scurvy’. You get a disease that plagued sailors for centuries. When you have scurvy, the collagen in your body isn’t properly formed and it starts to break down so you start to get lesions on your skin and your gums start growing over the teeth, and your hair may fall out. Remember when I mentioned that collagen is about 30% of your body’s protein, so when it starts to degrade your body literally starts falling apart. It’s not very fun, but luckily just get a few lemons down and you’ll be back to your normal old swashbuckling self in no time.

c_fig11_02_hydroxylation of proline in collagen proteins
Vitamin C’s main job in the human body. In very simplified terms Proline and Hydroxyproline are key parts to Collagen. The Hydroxyproline can form bonds with other  molecules allowing collagen fibers to bound each other (keeping your body from literally falling part). In the body Iron ,Fe(II) is used to donate an electron, but to keep reusing the iron it needs to be reduced back from Iron 3+ to Iron 2+ and Vitamin C does that by donating its own electron. THANKS VC!

Really all you have to do is just eat a fruit or a vegetable

Or really any fresh food. Scurvy has been with us probably since humans stopped being able to produce Vitamin C, but all in all we didn’t have to worry about it too much in normal, everyday land-lubbing life because the solution was that you just had to eat some sort of fresh food. And if you had any worthwhile friends around when you started feeling bad, that accidental cure wasn’t too far away. As civilizations started taking records, evidence of scurvy does pop up.

On the Ebers Papyrus dated around 1550 BCE there was a mention of scurvy-like symptoms and the remedy was eating raw onions (100g of raw onions contains about 9% of your daily Vitamin C needs).

In 400 BCE, Hippocrates describes scurvy-like symptoms.

But how did scurvy, a vitamin C deficiency, become such a killer and obstacle to nautical aspirations if vitamin C is readily available in so many of our foods? Well, it seems that it is not a sturdy molecule. Ascorbic Acid breaks down easily when exposed to heat, oxygen or light. So many common preservation methods destroy it completely. When do humans rely completely on preserved foods? When they do extremely silly things like:

Besiege cities – just don’t do it

Go on long sailing expeditions – fun, but take time to get some fresh food now and again

Go on long sailing expeditions then try to reach either the north or south pole – unwise

Participate in prolonged military campaigns – again just don’t

Become a miner – Overall, okay, but do some self-care. You could have salad with those biscuits and jerky

Participate in preserved food and pasteurized milk fads – This one got a lot of upper class Western European children in the 19th century

War time usually necessitates large groups of humans to rely heavily on preserved foods thereby increasing the likelihood of scurvy. Long sailing expeditions also necessitate a reliance on preserved foods as well. Miners relied heavily on preserved food also since they wanted to focus on gold diggin’ and were usually unfamiliar with the little mountain flora that presented itself in the shortened alpine growing season. A few of the smarter miners did rely on small leafy plants (like Miner’s Lettuce Claytonia perfoliata) and conifer tips (Picea sp. , Pseudotsuga sp., etc.) that alleviated their symptoms.

Lessons learned:

If you’re an imperialist, scurvy is a real killjoy.

If any other mammalian species managed to feel the need to go on long sailing voyages, they’d be a lot better at it, well, except for guinea pig pirates. Expeditions that were not hell-bent on missions or capitalistic endeavors usually avoided scurvy, by carrying enough live animals as fresh food, taking time to fish for fresh food, and stop when possible to gather edible plants. GuineaPigPirate

Humans in the past (well, some humans) have been pretty good at creating remedies to scurvy when necessary. You saw the onions prescribed by the Egyptians.

Another example is when Jacques Cartier’s expedition ended up trapped by river ice in North America. A notable Iroquois, Domagaya, showed them how to make a tea from a certain tree bark (probably white cedar, Thuja occidentalis) that would cure their scurvy and saved Cartier’s expedition. And thank goodness, if not for the kindness of Domagaya and that tree humans would have been denied this:

 

Vasco de Gama’s crew on their way to India noticed an improvement after they bought and ate some oranges (Citrus x sinensis) from Africa and demanded them at every sign of scurvy thereafter. De Gama obviously didn’t believe his dumb sailor employees and thought it was just the “good air” of southeast Africa. Around 100 of his 160 men most likely died of scurvy.

Scurvy continued to plague 18th century humans of the richest nations in Europe were losing thousands of sailors each year to the scurvy killer. They were usually losing more men to scurvy than to other nation’s canons.

Then some science happened.

James Lind was a surgeon of the British Royal Navy and in 1747 aboard the HMS Salisbury he saw an opportunity. There was an outbreak of scurvy among 12 crew members and Lind did a little experiment. He gave them all the same exact base diet of sea rations and then gave pairs of them different folk remedies for scurvy: vinegar, seawater, citrus fruit, etc. At the end he found that the patients supplied with oranges and lemons recovered within six days! Even though this was an excellent controlled trial, he didn’t even believe his own results and reverted to the old superstition that “bad air” was the main culprit for scurvy – so close.

Luckily, other officials of the Royal Navy eventually understood the results of his work and pushed for a daily ration of citrus fruit – lemons (Citrus limon) which became the rule in 1799. This dramatically dropped the British Navy’s rate of scurvy.

“In 1780, the admissions of scurvy cases to the Naval Hospital at Haslar were 1,457; in the years from 1806 to 1810, they were two.”

We did it, right?! No more scurvy?

This most definitely assisted in the British’s imperial aspirations as well as giving their sailors the eternal nickname, ‘limeys’. (If you’ve ever spoken Spanish in a grocery you may have had the conundrum of really wanting to find lemons and not limes and not being able to express this clearly). English like Spanish for much of its citrus fruit history used lemon and lime interchangeably and you have to agree limey sounds cooler than lemony but definitely less seductive. I’d say overall con.

Humans continued to struggle with scurvy because they weren’t sure what the cause was for a long time after. Some thought it was still bad air, others believed bacterial growth in spoiled food, others thought only tangy, acidic fruit could help, and some others still believed in the “bad air” idea. To their credit it must have been frustratingly difficult since it was the absence of something and not the presence of something that was the cause. Compounding that was the fact that the cure, Vitamin C, was in so many food options and usually the only reason their food lacked it was because they preserved it against harmful, disease-causing bacteria. Those that were clever enough got around this by realizing no matter what scurvy was caused by, you could cure it with fresh food especially fruits and vegetables.

If you’re interested in the historical context surrounding the battle against scurvy and why it was so difficult for Western science to tackle you should definitely read Idle Words blogpost titled “Scott and Scurvy” found here.

So I should eat more oranges just to be safe?

Ehhh…sure. I mean they have a lot of Vitamin C – around 160% of your daily value in 1 cup. (The recommended daily value is 60 mg). But you know what else has lots of Vitamin C? Kale, Brussel Sprouts, Broccoli, Bell Peppers, Snow Peas, Kiwis (the fruit, you monster), Tomatoes, Cauliflower, and of course Lemons.

IMG_5769
These bad boys have 112% of your recommended daily allowance of Vitamin C

But just so you know Ascorbic Acid doesn’t taste like orange or lemon or even limes. It doesn’t taste like any citrus fruit really. That’s why even though 1 cup of Broccoli has around 135% of your daily recommended value it tastes substantially subpar to an orange. Ascorbic Acid is just a little bit bitter tasting and the taste you and pretty much everyone else associates with it is more due to high levels of Citric Acid. Which is delicious! They put it in Gatorade! and in a lot of other delicious, sugary drinks, but it does not prevent scurvy. It is important for other things in the body, mostly mineral uptake. All the Vitamin C supplements that taste like orange, lemon, or other tangy fruits do so because they taste good and remember one of the prevailing ideas for a long time was that the overall acidity and tanginess of citrus fruit (which is due to their Citric Acid content) was what cured scurvy.

This #fakenews would ruin some more nautical aspirations down the line. To save some money and their brand the British Royal Navy started using limes from their acquired lands in the Caribbean instead of purchasing lemons from Mediterranean countries. Limes which made the limey moniker stick even harder have less ascorbic acid than lemons and they were often distributed as lime juice that had run through copper piping which destroyed most of the ascorbic acid in the juice – whoopsies.

Macleans-March-19-1955-page-049_channel365
Unbeknownst to this ad, Vitamin C doesn’t make you stronger and preserving it in cans probably destroys all the Vitamin C.

Some other scurvy mishaps included Commodore George Anson’s voyage with eight ships and 1,854 sailors in the south seas and lost most of them to scurvy. He returned with 188 sailors aboard 1 ship in contrast to James Cooke’s 2nd voyage to the southern reaches of the planet where he lost four crew and none to scurvy. He did this by giving his crew plenty of fresh fruits and vegetables (well, probably just a little) and sometimes making a spruce beer from a recipe his botanist friend, Joseph Banks, gave him. He was awarded the Copley Award from the Royal Society for not losing any sailors to scurvy.

As for your flight. Having enough vitamin C is very important for preventing scurvy, but may not be doing what you think it is when it comes to preventing sickness. Linus Pauling (the famous physicist) fell in love with Vitamin C during his retirement and did a bunch of home experiments with his friends to show all the benefits of Vitamin C. He and his other super smart friends believed it was great at preventing the common cold and also at extending one’s life especially if you took an absurd amount of it intravenously. In contrast though the National Institute of Health studies say Vitamin C doesn’t decrease your chances of catching the common cold. It does in fact help though around ~50% greater common cold prevention rates if you are someone that completes strenuous exercise daily.  Also the tolerable upper limit is about 2,000 mg per day so if you do 2 Emergen-C’s that’s about it and you end up peeing most of it out anyway. NIH studies also show that it does not reduce colds after you get them. But Vitamin C might be beneficial in other ways. Research is showing that Vitamin C introduced intravenously can destroy cancerous cells! It does this by creating a build-up of Hydrogen Peroxide (H2O2) in the cells which healthy cells can neutralize but tumor cells can’t.

Print
How Vitamin C injections can discriminately destroy tumor cells

So maybe in the end it wouldn’t even have mattered if you had taken those two packs of Emergen-C. Just like Scott, Wilson, and Shakleton’s expedition to the Antarctic, so many other things can go wrong that scurvy is just a small part to the horrible travel experience you’re having. While Scott was unwavering about being adequately prepared it was difficult for him to realize that since the true cause of scurvy still hadn’t been discovered he should plan for all the possible causes. Instead he planned only for the tainted meat theory and not only got scurvy every time they went to the interior (away from Vitamin C packed marine mammals and penguins to eat) but also threw away all of their preserved meat in fear. His expedition fell to the same scurvy hardships as other polar journeys like the Nares’ British Arctic Expedition and the Jackson-Harmsworth Expedition to Franz-Josef Land.

If you would like to experience this knowledge in cartoon form, described and illustrated by much more talented folks (Lucy Bellwood & Eriq Nelson) than I would go here.

Actually, just go there. There’s a nautical capybara in a naval officer’s uniform.

An Understanding & Real Talk

It wasn’t until a few years after Scott’s expedition that Norwegian researchers, Holst and Frølich, accidentally found that a deficiency in a vitamin causes scurvy when they decided to switch from pigeons to using guinea pigs (Cavia porcellus) for their medical experiments. The guinea pigs developed symptoms very much like scurvy in humans when they were fed a poor diet with few fresh vegetables and fruits. The were trying to research another deficiency disease, beriberi, as well as solve the scurvy that was all too common in the Norwegian Fishing Fleet at the time.

fruit ship
New design for scurvy-proof sailing vessels

Although their experiments showed that a deficiency caused scurvy, still other prominent scientists attributed it to other causes like constipation. Thanks, Elmer McCollom. Elmer with Marguerite Davis helped discover Vitamins A, B, and D, but for some reason was super doubtful that a Vitamin deficiency was the cause of something like scurvy. This might be due to the fact that Time magazine called him “Dr. Vitamin”.

It wasn’t until 1928, that Albert Szent-Györgyi, isolated what we today know as Ascorbic Acid. Albert was unexcited by it since it was a small, simple, edible, and I guess he believed that real chemists like himself should be studying more exciting things. (He tried to name it ‘ignose’ and ‘Godnose’ at first because it didn’t know its biological purpose. His humorless boss replied with a hard ‘no’.) Despite his displeasure in his work, in 1932 he showed that it cured scurvy, called it Ascorbic Acid (for its anti-scurvy properties, and he would eventually travel Europe to explain to folks the benefits of this new isolated compound. Most were uninterested and he would eventually be awarded a Nobel Prize for his work in metabolism as well as Ascorbic Acid isolation, but overall a lackluster ending to something that had influenced so much of Western European History and killed so many people.

Real talk

A word on supplements. The NIH suggests getting all nutrients from daily diet and using supplements when medically necessary or if your diet lacks certain vitamins. Many supplements are produced in Asia and many time are derived from petroleum products. So if you are buying them, check to see if their produced locally, are from natural sources, and if you could get those nutrients from just shifting your diet just a little bit.

A world without scurvy? No, we’re not there yet. While we’re surrounded by edible species of plants and animals scurvy still persists and again it’s mostly due to human mistakes. Scurvy becomes a real health concern in refugee camps where much of the little food available to them is preserved and lacking in Vitamin C.

Even in the U.S. scurvy occurs and throws medical interns a diagnosis challenge once in a while. In the 2000’s an increase in cases was reported by a doctor in Springfield, MA. After finding that one patient with mysterious symptoms actually had scurvy they curiously started to test patients’ Vitamin C levels that came in with unusual symptoms. Turns out 29 people in 5 years had low enough levels for scurvy and they started to become even more curious about this possible resurgence of sailors’ bane. The western MA doctors found that the Center for Disease Control and Prevention performed a widespread study in 2004 and showed that 6 – 8% of the American population had Vitamin C levels low enough to cause scurvy. The studied showed that rates were higher in low income communities and the articles that I read about hint at connections to increase in food deserts within the nation to perhaps be one of the drivers of this very preventable deficiency disease.

(Food Deserts are defined by the United States Dept. of Agriculture “as parts of the country vapid of fresh fruit, vegetables, and other healthful whole foods, usually found in impoverished areas. This is largely due to a lack of grocery stores, farmers’ markets, and healthy food providers.”) Under former First Lady Michelle Obama’s Let’s Move! Initiative you can search an interactive map maintained by the USDA to view areas in the U.S. that are experiencing ‘ food desertification’. Look at it here and clink on the “Enter the Map’ button.

food-deserts_map_USDA
USDA map of ‘Food Deserts’ in the U.S.

Springfield, MA talked about above is located in western Massachusetts which is listed as a food desert. So, we could be seeing more of a resurgence of scurvy in the future if food deserts continue growing in impoverished areas and if the folks there (including the guinea pigs) lack means or funds to reach whole food providers. A long time ago humans lost the ability to produce our own Vitamin C but it was a blip in our genetic history since we had a good track record of finding plenty of fresh food no matter where in the world we ended up. The dark cloud of scurvy seems only to pop-up when humans socially create conditions for it to thrive. Long Expeditions, sieges, mining, refugee camps, and food deserts. The cure for scurvy is easy to get but the solution may be a lot more difficult.

 


 

Good Sources of Vitamin C Knowledge

Schleicher, R.L., Carroll, M.D., Ford, E.S., Lacher, D.A., “Serum vitamin C and the prevalence of vitamin C deficiency in the United States: 2003-2004 National Health and Nutrition Examination Survey (NHANES).” Am J Clin Nutr. 2009. 90(5) pg. 1252-63. doi: 10.3945/ajcn.2008.27016.

Steller’s Island: Adventures of a Pioneer Naturalist in Alaska by Dean Littlepage

The Worst Journey in the World by Apsley Cherry-Garrard

The Drunken Botanist by Amy Stewart

“Scott and Scurvy”. Idle Words http://idlewords.com/2010/03/scott_and_scurvy.htm

“A brief history of vitamin C and its deficiency, scurvy.” by Harri Hemilä http://www.mv.helsinki.fi/home/hemila/history/#mozTocId342297

“Scurvy is a Serious Health Public Health Problem”. Slate. Nov. 20, 2015. Karen D. Brown http://www.slate.com/articles/health_and_science/medical_examiner/2015/11/scurvy_is_common_and_should_be_diagnosed_and_treated.html

“USDA defines food deserts” Nutrition Digest. Vol. 38, No. 2 http://americannutritionassociation.org/newsletter/usda-defines-food-deserts

“11.5 ECM”. A comprehensive approach to LifeScience. The University of Tokyo. 2011 http://csls-text3.c.u-tokyo.ac.jp/active/11_05.html

“Vitamin C History – timeline”. March 18, 2011. The Science Learning Hub.  https://www.sciencelearn.org.nz/resources/1690-vitamin-c-history-timeline

University of Exeter. “Vitamin C Is Essential For Plant Growth.” ScienceDaily. ScienceDaily, 27 September 2007. <www.sciencedaily.com/releases/2007/09/070923205844.htm>.

“Vitamin C Health Fact Sheet for Health Professionals” Feb. 11, 2016. National Institutes of Health: Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

“Twelve Quick Facts about Citric Acid, Ascorbic Acid, and Vitamin C” Jul. 20, 2009. Fooducate.com. https://www.fooducate.com/app#!page=post&id=57A32609-6464-775E-459F-A09A4CA49629

M. Waheed Roomi, Ph.D., Neha Shanker, Ph.D., Aleksandra Niedzwiecki, Ph.D. and Matthias Rath, M.D. Dr. Rath Research Institute, CA, USA. “Vitamin C in Health: Scientific focus on its anti-cancer efficacy” Journal of Cellular Medicine and Natural Health. 2015. http://www.jcmnh.org/vitamin-c-in-health-scientific-focus-on-its-anti-cancer-efficacy/#1450268899597-ca69d0b4-060d

Photo Credits

Featured: North Dakota State University

1.) Sigma – Aldrich

2.) A comprehensive approach to LifeScience

3.) The depths of pinterest

4.) Erick Dowell

5.) Florida Citrus Commission

6.) Roomi, et al. 2015

7.) Depths of pinterest

8.) U. S. Dept. of Agriculture

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