April 1st, 2015 ~ Vol. 85 No. 13
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Looking Back - John Kinnear
Too Much of the Same Thing Can Be Deadly
Crowsnest Pass Herald Front Page
Archive Photo
Pellagra sufferer with skin lesions
Russell Montelbetti‘s recipe was submitted by his daughter Cathy Painter back in 2004 for the Coleman Centennial Cookbook. It is one of the most basic formulas for an ethnic dish you will ever come across. It is simply: 1 cup cornmeal to 4 cups cold water, salt to taste. Cook for 45 to 50 minutes stirring frequently. Or one may use his updated version which involves using a microwave for about 36 minutes. This preparation gives, in the end, a firm product that can be eaten like porridge or can then be baked, fried or grilled.
The product is known as polenta, a traditional Italian preparation that dates back to the early part of the 16th century when corn was first introduced to Europe from the North American First Nation’s culture. Within forty years of its introduction it became the favourite crop of many farmers in northern Italy who planted a fast-growing variety of corn they called cinquantino after their wheat, barley and buck-wheat harvests were taken in July. This gave them two crops a year from the same fields so farmers sold the grains and ate the corn. By the nineteenth century it was being called the “miracle crop” as it prepared the ground for wheat and provided the poor with cheap food.
Corn became a staple food but in central and northern Italy it turned out to have a rather disturbing side effect. In parts of Italy where the poor had nothing but polenta to eat something went terribly wrong for a long time. There was over a century of suffering before the problem was solved and apparently even longer before Italians would accept the solution.
It seems that a diet made up exclusively of maize can lead to the development of B3 avitaminosis or what is more commonly known as “pellagra.” Pellagra is a vitamin deficiency disease caused by a lack of niacin (B3) and leads to some rather nasty symptoms sometimes described as “the four Ds”: diarrhea, dermatitis, dementia and death. Sounds bizarre but by the eighteenth century it began to affect hundreds of thousands in Spain, France and Italy.
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It had no name until 1735 when a Spanish doctor, Don Gaspar Casal, called it “mal de la rosa” and stated that the disease caused dermatitis of exposed skin like the hands, feet and neck. It was often mistaken for leprosy. As the symptoms progressed the afflicted became fearful, depressed, dizzy and eventually insane.
It became endemic in northern Italy where Francesco Frapoli of Milan named it: pelle agra where pelle = skin and agra = sour. According to Lynne Bowen in her book “Whoever Gives Us Bread: “By 1810, two thirds of the inmates in a large insane asylum in Milan were suffering from the malady. As the disease became endemic, authorities could not build enough asylums to hold all the pellagra patients and many had to remain home.”
The exclusive dependence on cornmeal polenta brought with it an appalling nutritional deficiency and symptoms which "begin with head and back pains, numbness of the extremities, and stomach aches. The sight becomes foggy, hearing declines, and then palsy begins, starting in the trunk and spreading to the extremities and tongue. It's generally a progressive disease, but can become acute, almost like typhus, and kill quickly. However, it usually takes several months, with flare-ups that exhaust the victim and can kill them in a variety of ways that mimic other diseases. It frequently induces madness, which is also intermittent, and takes many forms, in particular depression and despondency..."
It wasn’t until early in the twentieth century that French and Spanish scientists finally made the link between a deficiency in niacin and pellagra. It was noted that American First Nations people prepared and ate their corn as a form of hominy or ash bread and that the process they used released that important B3 vitamin (niacin) for the body. European cultures did not know about the liberating effect of lime or ash on corn nor did they realize their way of preparing it did not release the niacin. Those who had a varied diet were okay, it was only those who could only afford to eat polenta that suffered this “sickness of the poor.”
Scientific evidence was ignored for a long time by the Italian government who instead decided to launch a sanitation campaign that would keep corn from being spoiled by what they called “pellagra-causing-microbes.” Some claimed it was hereditary and that there was nothing to be done. As the emigration of Italians to North America peaked in the early twentieth century “rumours that pellagra was infectious gave racists yet another reason to despise Italians.”
In the early 1900s pellagra became epidemic in the southern United States and Dr. Joseph Goldberger was assigned by the Surgeon General to study it. He looked at outbreaks of pellagra in orphanages and mental hospitals and noted that they seemed to be the most susceptible and theorized that it was due to diet. Lack of meat, milk, eggs and legumes etc. The stats are somewhat astonishing on this outbreak as between 1906 and 1940 more than 3 million Americans were affected and there were over 100,000 deaths. The epidemic resolved itself right after the introduction of dietary niacin fortification in 1938 in bread. Today it is routinely added to cereals, bread and pasta which are labelled as “enriched” or “fortified.”
Author’s Note: So given that the Herald published this week on a day that Italians conduct what they call “il pesce d”Aprile” and given that I have been known to get really creative every few years on this particular day one has to ask one’s self this. Is my leg being pulled or not?
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April 1st ~ Vol. 85 No. 13
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