Pellagra Health Dictionary

Nicotinic acid is a member of the vitamin B complex. It is essential for human nutrition, the normal daily requirement for an adult being about 15–20 mg. A de?ciency of nicotinic acid is one of the factors in the etiology of PELLAGRA, and either nicotine acid or NICOTINAMIDE is used in the treatment of this condition. Nicotinic acid also reduces the concentration of blood lipids (see HYPERLIPIDAEMIA).... nicotinic acid

(Hominy) See also Flour, Vegetable oils, Wheat cereals.

Nutritional Profile Energy value (calories per serving): Moderate Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low Major vitamin contribution: Vitamin A (in yellow corn), B vitamins, vitamin C Major mineral contribution: Potassium

About the Nutrients in This Food Like other grains, corn is a high-carbohydrate, high-fiber food. Eighty-one percent of the solid material in the corn kernel consists of sugars, starch, and dietary fiber, including insoluble cellulose and noncarbohydrate lignin in the seed covering and soluble pectins and gums in the kernel.* Corn has small amounts of vitamin A, the B vitamin folate, and vitamin C. Corn is a moderately good source of plant proteins, but zein (its major protein) is deficient in the essential amino acids lysine, cystine, and tryptophan. Corn is low in fat and its oils are composed primarily of unsaturated fatty acids. Yellow corn, which gets its color from the xanthophyll pigments lutein and zeaxanthin plus the vitamin A-active pigments carotene and cryptoxanthin, contains a little vitamin A; white corn has very little. One fresh ear of yellow corn, 5.5– 6.5 inches long, has three grams dietar y fiber, one gram fat (0.1 g saturated fat, 0.3 g monounsaturated fat, 0.4 mg polyunsaturated fat), 137 IU vitamin A (6 percent of the R DA for a woman, 5 percent of the R DA for a man), 34 mcg folate (9 percent of the R DA), and 5 mg vitamin C (7 percent of the R DA for a woman, 6 percent of the R DA for a man). * The most plent iful sugar in sweet corn is glucose; hydrolysis (chemical splitt ing) of corn starch is t he principal indust rial source of glucose. Since glucose is less sweet t han sucrose, sucrose and fructose are added to commercial corn syrup to make it sweeter.

The Most Nutritious Way to Serve This Food With beans (which are rich in lysine) or milk (which is rich in lysine and tryptophan), to complement the proteins in corn. With meat or a food rich in vitamin C, to make the iron in corn more useful.

Diets That May Restrict or Exclude This Food Low-fiber diet

Buying This Food Look for: Cobs that feel cool or are stored in a refrigerated bin. Keeping corn cool helps retain its vitamin C and slows the natural conversion of the corn’s sugars to starch. Choose fresh corn with medium-sized kernels that yield slightly when you press them with your fingertip. Very small kernels are immature; very large ones are older and will taste starchy rather than sweet. Both yellow and white kernels may be equally tasty, but the husk of the corn should always be moist and green. A dry yellowish husk means that the corn is old enough for the chlorophyll pigments in the husk to have faded, letting the carotenes underneath show through.

Storing This Food Refrigerate fresh corn. At room temperature, fresh-picked sweet corn will convert nearly half its sugar to starch within 24 hours and lose half its vitamin C in four days. In the refrigera- tor, it may keep all its vitamin C for up to a week and may retain its sweet taste for as long as ten days.

Preparing This Food Strip off the husks and silk, and brush with a vegetable brush to get rid of clinging silky threads. R inse the corn briefly under running water, and plunge into boiling water for four to six minutes, depending on the size of the corn.

What Happens When You Cook This Food Heat denatures (breaks apart) the long-chain protein molecules in the liquid inside the corn kernel, allowing them to form a network of protein molecules that will squeeze out moisture and turn rubbery if you cook the corn too long. Heat also allows the starch granules inside the kernel to absorb water so that they swell and eventually rupture, releasing the nutrients inside. When you cook corn, the trick is to cook it just long enough to rupture its starch granules while keeping its protein molecules from turning tough and chewy. Cooking fresh corn for several minutes in boiling water may destroy at least half of its vitamin C. At Cornell University, food scientists found that cooking fresh corn in the microwave oven (two ears/without water if very fresh/4 minutes/600 –700 watts) preserves most of the vitamin C.

How Other Kinds of Processing Affect This Food Canning and freezing. Canned corn and frozen corn both have less vitamin C than fresh- cooked corn. The vitamin is lost when the corn is heated during canning or blanched before freezing to destroy the natural enzymes that would otherwise continue to ripen it. Blanch- ing in a microwave oven rather than in boiling water can preserve the vitamin C in frozen corn (see above). Milling. Milling removes the hull and germ from the corn kernel, leaving what is called hominy. Hominy, which is sometimes soaked in wood ash (lye) to increase its calcium con- tent, can be dried and used as a cereal (grits) or ground into corn flour. Coarsely ground corn flour is called cornmeal. Processed corn cereals. All processed, ready-to-eat corn cereals are much higher in sodium and sugar than fresh corn. Added calcium carbonate. Pellagra is a niacin-deficiency disease that occurs most com- monly among people for whom corn is the staple food in a diet lacking protein foods with the essential amino acid tryptophan, which can be converted to niacin in the human body. Pellagra is not an inevitable result of a diet high in corn, however, since the niacin in corn can be made more useful by soaking the corn in a solution of calcium carbonate (lime) and water. In Mexico, for example, the corn used to make tortillas is boiled in a dilute solution of calcium carbonate (from shells or limestone) and water, then washed, drained, and ground. The alkaline bath appears to release the bound niacin in corn so that it can be absorbed by the body.

Medical Uses and/or Benefits As a wheat substitute in baking. People who are allergic to wheat or cannot tolerate the glu- ten in wheat flour or wheat cereals can often use corn flour or hominy instead. Bath powder. Corn starch, a fine powder refined from the endosperm (inner part) of the corn kernel, can be used as an inexpensive, unperfumed body or face powder. Because it absorbs oils, it is also used as an ingredient in dry shampoos.

Adverse Effects Associated with This Food Allergic reaction. According to the Merck Manual, corn is one of the 12 foods most likely to trigger the classic food allergy symptoms: hives, swelling of the lips and eyes, and upset stomach. The others are berries (blackberries, blueberries, raspberries, strawberries), choco- late, eggs, fish, legumes (green peas, lima beans, peanuts, soybeans), milk, nuts, peaches, pork, shellfish, and wheat (see wheat cer ea ls).... corn

Diseases of the SKIN for which sunlight is partially or wholly responsible. In su?cient dosage, short-wave ultraviolet light (UVB – see ULTRAVIOLET RAYS (UVR)) always causes ERYTHEMA. Higher doses progressively cause OEDEMA and blistering; this is acute sunburn. Graduated exposure to UVB causes pigmentation (tanning). Prolonged chronic exposure to sunlight eventually accelerates ageing of the exposed skin with LENTIGO formation and loss of COLLAGEN and elastic tissue. After decades of such exposure, epidermal DYSPLASIA and CANCER may supervene.

Drugs given orally or topically may induce phototoxic reactions of various types. Thus, TETRACYCLINES exaggerate sunburn reactions. and the diuretic FRUSEMIDE may cause blistering reactions. Psoralens induce erythema and pigmentation. AMIODARONE also induces pigmentation. (See also PHOTOCHEMOTHERAPY.)

Phytophotodermatitis is a streaky, blistering photodermatosis typically seen on the limbs of children playing in grassy meadows in summer. The phototoxic reaction is caused by psoralens in weeds.

Berlocque dermatitis is a pattern of streaky pigmentation usually seen on women’s necks, caused by a reaction to psoralens in perfumes.

Certain rare metabolic diseases may lead to photosensitisation. They include the PORPHYRIAS and PELLAGRA. Other skin diseases such as lupus erythematosus (see under LUPUS) and ROSACEA may be aggravated by light exposure. Sometimes, in the absence of any of these factors, some people spontaneously develop a sensitivity to light causing various patterns of DERMATITIS or URTICARIA. The most common pattern is ‘polymorphic light eruption’ which typically appears within a day or two of arrival at a sunny holiday destination and persists until departure. Continuously exposed areas, such as the hands and face, may be ‘hardened’ and unaffected.

Treatment Appropriate clothing and headgear, sunscreen creams and lotions are the main preventative measures.... photodermatoses

Conditions of the tongue At rest, the TONGUE touches all the lower teeth and is slightly arched from side to side. It has a smooth surface with a groove in the middle and an even but de?nite edge. It is under voluntary control and the tip can be moved in all directions.

Ankyloglossia or tongue-tie is a rare disorder in which the frenum or band connecting the lower surface of the tongue to the ?oor of the mouth is so short or tight that the tongue cannot be protruded. Surgery can remedy the defect. It is easy to overdiagnose and is not a common cause of di?culty in feeding at birth or speech defects in infancy.

Gross enlargement of the tongue can make speech indistinct or make swallowing and even breathing di?cult. This is known as macroglossia and may be such that the tongue is constantly protruded from the mouth. The cause may be CONGENITAL, as in severe cases of DOWN’S (DOWN) SYNDROME, or it may occur as a result of ACROMEGALY or be due to abnormal deposits as in AMYLOIDOSIS.

A marked tremor of the tongue when protruded may be seen in various neurological diseases, but may be caused by alcoholism.

After a STROKE involving the motor nerve centre, the control of one side of the tongue musculature will be lost. This will result in the protruded tongue pointing to the side of the body which is paralysed. The sense of taste on one side of the tongue may also be lost in some diseases of the brain and facial nerve.

The presence of fur on the tongue may be obvious and distressing. This is due to thickening of the super?cial layers of the tongue which may appear like hairs which trap food debris and become discoloured. Furring is common during fever and as a result of mouth-breathing and smoking.

In some conditions the tongue may appear dry, red and raw (GLOSSITIS). An in?amed beefy tongue is characteristic of pellagra, a disease caused by de?ciency of NICOTINIC ACID in the diet. A magenta-coloured tongue may be seen when there is a lack of RIBOFLAVIN.

Ulcers of the tongue are similar to those elsewhere in the mouth. The most common are aphthous ulcers which are small, red and painful and last for about ten days. They are associated with stress, mild trauma (such as from jagged teeth), and occasionally with folic acid and vitamin B12 de?ciency. Ulcers of the tongue are sometimes found in patients with chronic bowel disease.... tongue, disorders of

A group of spots or an area of red, inflamed skin. A rash is usually temporary and is only rarely a sign of a serious underlying problem. It may be accompanied by itching or fever.

Rashes are classified according to whether they are localized (affecting a small area of skin) or generalized (covering the entire body), and the type of spots. A bullous rash has large blisters, a vesicular rash has small blisters, and a pustular one has pus-filled blisters. A macular rash consists of spots level with the surrounding skin and discernible from it by a difference in colour or texture. Nodular and papular rashes are composed of small, raised bumps.

Rashes are the main sign of many infectious diseases (such as chickenpox), and are a feature of many skin disorders, such as eczema and psoriasis. They may also indicate an underlying medical problem, such as the rashes of scurvy or pellagra, which are caused by vitamin deficiency. The rashes of urticaria or contact dermatitis may be caused by an allergic reaction. Drug reactions, particularly to antibiotic drugs, are a common cause of rashes.

A diagnosis is based on the appearance and distribution of the rash, the presence of any accompanying symptoms, and the possibility of allergy (for example, to drugs). Any underlying cause is treated if possible. An itching rash may be relieved by a lotion, such as calamine, or an antihistamine drug.... rash

a rare hereditary defect in the absorption of the amino acid tryptophan, leading to learning disability, thickening and roughening of the skin on exposure to light, and lack of muscular coordination. The condition is similar to *pellagra. Treatment with nicotinamide is usually effective. [Hartnup, the family in whom it was first reported]... hartnup disease

A group of watersoluble vitamins comprising thiamine (vitamin B1), riboflavin (vitamin B2), niacin, pantothenic acid, pyridoxine (vitamin B6), biotin (vitamin H), and folic acid. Vitamin B12 is discussed above.

Thiamine plays a role in the activities of various enzymes involved in the utilization of carbohydrates and thus in the functioning of nerves, muscles, and the heart. Sources include whole-grain cereals, wholemeal breads, brown rice, pasta, liver, kidney, pork, fish, beans, nuts, and eggs.

Those susceptible to deficiency include elderly people on a poor diet, and people who have hyperthyroidism, malabsorption, or severe alcohol dependence. Deficiency may also occur as a result of severe illness, surgery, or injury.

Mild deficiency may cause tiredness, irritability, and loss of appetite. Severe deficiency may cause abdominal pain, constipation, depression, memory impairment, and beriberi; in alcoholics, it may cause Wernicke–Korsakoff syndrome. Excessive intake is not known to cause harmful effects.

Riboflavin is necessary for the activities of various enzymes involved in the breakdown and utilization of carbohydrates, fats, and proteins; the production of energy in cells; the utilization of other B vitamins; and hormone production by the adrenal glands. Liver, whole grains, milk, eggs, and brewer’s yeast are good sources. People who are susceptible to riboflavin deficiency include those taking phenothiazine antipsychotic drugs, tricyclic antidepressant drugs, or oestrogen-containing oral contraceptives, and those with malabsorption or severe alcohol dependence. Riboflavin deficiency may also occur as a result of serious illness, surgery, or injury.

Prolonged deficiency may cause soreness of the tongue and the corners of the mouth, and eye disorders such as amblyopia and photophobia.

Excessive intake of riboflavin is not known to have any harmful effects.

Niacin plays an essential role in the activities of various enzymes involved in the metabolism of carbohydrates and fats, the functioning of the nervous and digestive systems, the manufacture of sex hormones, and the maintenance of healthy skin. The main dietary sources are liver, lean meat, fish, nuts, and dried beans. Niacin can be made in the body from tryptophan (an amino acid). Most cases of deficiency are due to malabsorption disorders or to severe alcohol dependence. Prolonged niacin deficiency causes pellagra. Excessive intake is not known to cause harmful effects.

Pantothenic acid is essential for the activities of various enzymes involved in the metabolism of carbohydrates and fats, the manufacture of corticosteroids and sex hormones, the utilization of other vitamins, the functioning of the nervous system and adrenal glands, and growth and development. It is present in almost all vegetables, cereals, and animal foods. Deficiency of pantothenic acid usually occurs as a result of malabsorption or alcoholism, but may also occur after severe illness, surgery, or injury. The effects include fatigue, headache, nausea, abdominal pain, numbness and tingling, muscle cramps, and susceptibility to respiratory infections. In severe cases, a peptic ulcer may develop. Excessive intake has no known harmful effects.Pyridoxine aids the activities of various enzymes and hormones involved in the utilization of carbohydrates, fats, and proteins, in the manufacture of red blood cells and antibodies, in the functioning of the digestive and nervous systems, and in the maintenance of healthy skin. Dietary sources are liver, chicken, pork, fish, whole grains, wheatgerm, bananas, potatoes, and dried beans. Pyridoxine is also manufactured by intestinal bacteria. People who are susceptible to pyridoxine deficiency include elderly people who have a poor diet, those with malabsorption or severe alcohol dependence, or those who are taking certain drugs (including penicillamine and isoniazid). Deficiency may cause weakness, irritability, depression, skin disorders, inflammation of the mouth and tongue, anaemia, and, in infants, seizures. In very large amounts, pyridoxine may cause neuritis.

Biotin is essential for the activities of various enzymes involved in the breakdown of fatty acids and carbohydrates and for the excretion of the waste products of protein breakdown. It is present in many foods, especially liver, peanuts, dried beans, egg yolk, mushrooms, bananas, grapefruit, and watermelon. Biotin is also manufactured by bacteria in the intestines. Deficiency may occur during prolonged treatment with antibiotics or sulphonamide drugs. Symptoms are weakness, tiredness, poor appetite, hair loss, depression, inflammation of the tongue, and eczema. Excessive intake has no known harmful effects.

Folic acid is vital for various enzymes involved in the manufacture of nucleic acids and consequently for growth and reproduction, the production of red blood cells, and the functioning of the nervous system. Sources include green vegetables, mushrooms, liver, nuts, dried beans, peas, egg yolk, and wholemeal bread. Mild deficiency is common, but can usually be corrected by increasing dietary intake. More severe deficiency may occur during pregnancy or breastfeeding, in premature or low-birthweight infants, in people undergoing dialysis, in people with certain blood disorders, psoriasis, malabsorption, or alcohol dependence, and in people taking certain drugs. The main effects include anaemia, sores around the mouth, and, in children, poor growth. Folic acid supplements taken just before conception, and for the first 12 weeks of pregnancy, have been shown to reduce the risk of a neural tube defect.... vitamin b complex