Discussions of vitamin deficiencies can seem so passé in Westernised countries. Have we been lulled into thinking that all the processed food was adequately fortified, that we could take supplements and that authorities regulated food to be safe for consumption? Most of us are aware that serious problems are brewing, and that obesity is almost always a global nutritional problem, behind which is so much chronic metabolic disease accumulation. Our highly-marketed, commodity-technology driven world has been very good at eclipsing the reality, even from scientists.
Reporting significant vitamin deficiencies in clinical cases is bringing this global problem into local clinical focus, but also gives us a chance to put such disease and causes in a wider context—that of our specific human biology in our global environment and within our societies’ organisation.
Most school pupils1 know that we require the water-soluble Vitamin C for survival, and we get it from eating many types of coloured fruits. However, most of us do not realise that humans are one of few mammals that can’t synthesise Vitamin C/ascorbic acid,2 and in addition is an example of our overall metabolism being rather different from other mammals. Vitamin C and fructose interact with another metabolite, uric acid, which can rise to very high levels in humans, due to at least two mutations leading to a loss of uricase in higher order primates.3 One theory is that after humans had been consuming large qualities of plants with plenty of vitamin C in the growing season, they gorge on large qualities of sugary ripe fruit with relatively low vitamin C at the beginning of the lean period. They become comparatively insulin resistant, and like omnivorous hibernating bears, are able to gain fat stores to survive the off/wet/cold season where little food is to be had. Fat stores are metabolised, and, when lean tissue begins to be used and purines are released, uric acid levels rise markedly, maintaining blood pressure if thirst/starvation is a problem,3 and stimulating foraging.2
So what is wrong with just adding in vitamin supplements to prevent scurvy and all the other vitamin deficiencies? There have been thousands of vitamin, mineral and nutraceutical supplement epidemiological and intervention studies, and massive marketing hype keeps the supplement (and pharmaceutical) industries funded. However, overall human health will only improve with appropriate food.4 Only the few longitudinal and/or interventional studies of low input whole and heritage type food consistently show health improvement.5,6
This is where the bigger evolution picture of specialised human physiology comes in.
Evidence from human-specific evolutionary physiology indicates that, due to the high nutrient (energy and micronutrient) requirements of the enlarging brain, we co-evolved strong drives to consume energy-dense and palatable food. Some of us (mostly women) have variably large, safe, subcutaneous fat storage potential, and we rely on a wide variety and high volumes of food phytonutrients to modulate our cell protection systems for remarkably long, functional lives.
This unique set of survival physiological characteristics, that accompanied bipedalism and the use of forelimbs as dexterous hands,7 cannot be well-appreciated until many disciplines of science are reviewed.
As humans had become so nomadic, their metabolism thrived on picking and choosing the useful nutrients, but also managing the numerous plants and other toxins that came with such a diverse diet. It is these thousands of dietary secondary plant chemicals, often concentrated in herbs and spices,8 that need to be trafficked and protected as they move through our upper gut. The many types of vegetable fibre adsorb these polyphenols, flavonoids and untold types of other nutrients. Then, our healthy, diverse classes of colonic gut microbes ferment these variably soluble and digestible carbohydrates, and release the appropriate micronutrients for absorption.9 Additionally, the invertebrate chiton/chitosan polysaccharide sheets and other fibre can help excretion of excess or toxic levels of transition metals.10 Importantly, these fermentable carbohydrates, which include natural oligosaccharides (prebiotics), appear to transport and replenish digestion-resistant microbes, probably in spore form,11 all of which facilitate micronutrient absorption.
There are multiple reasons that supplemental vitamins, minerals and extracts fail to improve markers and signs of developmental and degenerative disease. There are also complex synergies within the food components:12 phytonutrients, enzymes, minerals, fibre, the microbes, and gut epithelium complex and payers patches, all of which play a part in what nutrients are absorbed and toxins excreted. Many micronutrients, including Vitamin C, function as mildly pro-oxidant signalling molecules that stimulate a coordinated, amplified anti-oxidant response pathway, in humans particularly.13 Megadoses of pro-oxidant vitamins flood the system, unbalance the interaction with other metabolites and can worsen disease.4,14
It is worth putting into context the increasingly low micronutrient to macronutrient ratio that has been occurring over the Anthropocene, when humans and their technologies have been making significant changes to large environments. Early technologies seem to have conferred nutritional benefits. Controlling fire to cook food started approximately 800,000 years ago, reducing bacterial contaminants and releasing extra nutrients.15
Gradually, some 10–12 millennia ago, after some cultures began agriculture (horticulture and animal husbandry) to produce high energy food, nutrient variety became increasingly limited. Suboptimal metabolic, immune and physical robustness became more common.15,16,17 However, periodically, agricultural systems failed due to climate disasters and pest plagues; such boom and bust cycles were typical of the altered or damaged ecologies.
Storage, transport and trade of these highly palatable energy-dense foods permitted humans to take over resource-rich, favourable niches. Possibly to escape other human competition, some peoples migrated into more difficult environments. Gradually, the exploitation of local resources and those used by other human groups increased with more sophisticated technologies, most likely initially for own-tribe social good and survival advantage.
However, there is a long history of the dominant few concentrating power in an obsessive-compulsive18 despotic19 manner. There are numerous examples of ‘advanced civilisations’ collapsing—an Easter Island effect.20 When technologies have been used for exploiting environments and for protracted wars, the remaining polluted environments mean food deprivation and susceptibility to ‘devastating plagues’ occur, such as the flu pandemic after World
More slowly developing is the toxicity and oxidative stress that damages fast turnover cells, such as cardiovascular endothelium where atherosclerosis develops.23,24 This and lack of healthy food nutrients is a plausible cause of coronary artery disease. And over many years of less overtly toxic insults and deprivation of nutrients, immune and endocrine epithelial disruption and acquired genetic damage are likely events in the cause of ever-increasing cancer rates.25,26
If humans specifically evolved to physically and mentally thrive on a wide variety of micronutrient dense/low additive food, then expecting us to adapt to degraded/foreign chemical (xenobiotic) laden foodstuffs is unrealistic. We can only expect more infant developmental disease, and earlier and more severe degenerative disease, no matter what money is spent on ‘high tech’ cancer prevention research or public health messaging to change our ‘life situation status’.
Interdependent human and environmental health requires real environmentally sustainable ‘low-input’ ecofarming of fit heritage crops and stock, and its products to be accessed in a fair and equitable manner.27,28 Enough real basic evolutionary, biological and environmental science is done to continue organic farming in some areas29 and restart mixed ecofarms.30,31,32 Conversion of the extensive high-input agribusiness areas of harmful high-energy/low nutrient crops may well rid the world of the unmetabolised toxic fat on the bodies of domestic animals and humans. This is not an unrealistic ideal, but it is the only way forward with any semblance of global health, according to a number of authors.30,31,32
In the era of ‘post truth’ administration of states, and ‘commodity technology’ being the only ‘science’ the public and industry use but don’t understand, now is the time. Real nutrition, physiology, ecology scientists and civil socialites need to take a long-term view, and mobilise, in public sector policy, on the land, in the kitchen, out on the streets and in all health clinics.