By Karen Kier
Pharmacist on behalf of the ONU HealthWise team
Scurvy is usually associated with pirates since sailors were susceptible to scurvy. In a January 10, 2022 article published in the Military Health System news, author Janet A. Aker reports 2 million sailors died of scurvy between the 16th and 18th centuries. Historians have documented scurvy as causing most suffering throughout history related to vitamin deficiencies.
A lack of vitamins in one’s diet can increase the risk of disease including a lack of vitamin C resulting in scurvy. Scurvy was not only common among sailors, but was a major health problem related to the great potato famine of 1845 in Ireland. Since humans are not able to make vitamin C, they must rely on their diet as an external source of vitamin C. This was confirmed in 1747 by James Lind when his controlled study evaluated diet as a cure for scurvy. He was able to identify lemons and oranges as an effective means of preventing and treating scurvy.
Vitamin C known as ascorbic acid was discovered in 1912 and chemically produced in 1933. It comes in many different formulations and doses. In 1970, Linus Pauling declared that vitamin C prevents and alleviates the common cold. His statement was based on a study of children at a ski camp in the Swiss Alps. His study was highly questioned due to many flaws in the design. A 2012 study evaluating 29 different studies indicated that vitamin C showed no benefit for colds.
Why the interest in vitamin C and scurvy?
Scurvy is an uncommon disease in the United States, but recent statistics published in the journal Pediatrics has uncovered a rise in scurvy among children. The increase started in 2017 and is believed to be related to recommendation by the American Academy of Pediatrics (AAP).
In 2017, the AAP released recommendations to limit the intake of juice by children due to the sugar content and the impact on overall health including weight, malnourishment, and tooth decay. The recommendation included no juice before the age of 1 year and 4 ounces of juice per day in ages 1-3 years. Children between ages 4 to 6 years should consume less than 4-6 ounces of juice in a day. Those over 7 and up to 18 years should limit juice intake to 8 ounces or less. The recommendation goes on to support using fresh fruit rather than fruit juices for a healthy diet. The juices provide significant calories without good nutritional benefit.
The researchers feel the reduction in juice intake has contributed to the increase in cases of scurvy because vitamin C is not being replaced with other options besides the fruit juice.
Scurvy hospitalizations increased by a factor of 8 from 2006 to 2021. The most common symptoms were joint swelling and tenderness, children refusing to bear weight on their legs, rash, bruising, bleeding, fever, and being irritable or fussy.
The recommendation to limit fruit juice is still a good idea in children, but vitamin C needs to be introduced into the diet by other food sources or supplements. Fresh fruits such as oranges, lemons, kiwi, cherries, plums, and strawberries are high in vitamin C. Other foods include tomatoes, potatoes, Brussels sprouts, broccoli, and red/yellow/green peppers. There are some specific vitamin C supplements for children including gummies and chewables as well as some good children’s multivitamins.
Talk to your pharmacist about vitamin and supplementation products!
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