96 : c h a p t e r s e v e n
consensus about how much of them the body needed. By 1938 Ameri-cans were spending $100 million a year on them, and producing them had become a very big, and very profi table, business indeed.⁴
Food producers countered by trott ing out McCollum and other nutri-tional scientists to tell Americans to get their vitamins from “protective foods” like milk and canned spinach, not pills. The American Medical Association, fearing that people would turn to vitamin pills, rather than doctors, to cure what ailed them, rallied to their side. So did pharmacists, who feared that vitamins would be sold in every corner store. They all pressed the government to have vitamin supplements sold only by pre-scription. But the Food and Drug Administration resisted, declaring that as long as vitamins were not prescribed for illnesses or accompanied by any health claims, they were a kind of food and could therefore be sold virtually anywhere. Soon department stores such as Macy’s and super-markets such as Kroger were selling their own brands of vitamins.⁵
The outbreak of war in Europe in September 1939 seemed to sharply raise the stakes in this confl ict over nutrition. By the late summer of 1940, the Nazis dominated most of the Europe and were preparing to in-vade Great Britain. For the United States, the possibility of being drawn into the war now loomed large. A massive rearmament program was mounted and a military draft begun. Questions now arose as to whether the Depression-batt ered workforce would be vigorous enough to meet the demands of industrial or military service. Government nutrition ex-perts solemnly warned that three-quarters of the nation suff ered from
“hidden hunger,” meaning vitamin defi ciencies that were camoufl aged by full stomachs and healthy appearances.⁶
Since “hidden” signifi ed having no apparent symptoms, the nutri-tionists could avoid showing how the defi ciencies were linked to seri-ous diseases or death. Instead, they warned of such things as the dangers inherent in sending soldiers defi cient in vitamin A, which was thought to protect against night blindness, on patrol at night.⁷ The results of the physical examinations given to men in the fi rst draft call-up in Octo-ber 1940 stoked these worries. Almost 50 percent of them were rejected, mainly for physical disabilities that were said to be related to vitamin defi ciencies. Only those who read far below the headlines learned that the largest number were rejected for tooth decay, which, as we have seen, was thought to be related to a defi ciency of vitamin D.⁸
The draft board news seemed to confi rm suspicions of the dire ef-fects of modern food processing. Medical and public health offi cials now warned that the nation was suff ering from a “vitamin famine” because so
97 : “Hidden Hunger” Stalks the Land
many foods were deprived of their vitamin content before they reached Americans’ homes.⁹ Hygeia, the American Medical Association maga-zine for laypeople, warned that “the trend away from the use of fresh or
‘whole’ foods and the substitution of preserved and refi ned food” was threatening the health of Americans.¹⁰ The New York Times said, “The discovery that tables may groan with food and that we nevertheless face a kind of starvation has driven home the fact that we have applied science and technology none too wisely in the preparation of food.”¹¹
In May 1941 President Franklin Roosevelt, concerned about worsen-ing reports of draft ee rejections, called fi ve hundred of the nation’s lead-ing food and nutrition experts to a conference in Washlead-ington to “create a framework for a national nutritional policy.” During World War I, the government’s food conservation program had helped propagate the ba-sics of the New Nutrition. The next generation of nutritional scientists now sought a program that would educate the public about the Newer Nutrition, with its emphasis on vitamins. In his keynote address, Vice President Henry Wallace said people should be taught to consume more
“protective foods,” which would provide the nutrients to “furnish the nervous energy to drive us though to victory.” Dr. Russell Wilder, chair-man of the National Research Council’s Committ ee on Food and Nutri-tion, warned that 75 percent of Americans were suff ering from “hidden hunger, a hunger more dangerous than hollow hunger, because the suf-ferer, lacking in essential food elements, although his stomach might be full, was existing on the borderline between health and disease.” Other speakers echoed these warnings that Americans must add additional vi-tamins to their diets to combat “hidden hunger.”¹²
The problem was that estimates of how much of these nutrients were necessary were still all over the map. A committ ee of nutritionists was asked to prepare a list of “standards” for eight important nutrients—that is, the minimum amounts necessary to prevent illnesses. Instead, they produced what they called “recommended daily allowances” (RDAs).
These were the average of various scientists’ estimates, but with a 30 per-cent “margin of safety” added on. This seemed to satisfy those whose estimates were high while mollifying the low-ballers with the argument that an oversupply of vitamins could surely do no harm.¹³ But the eva-sive term “allowances” was soon ignored, and the RDAs were almost im-mediately taken as the minima necessary for good health.¹⁴ The Surgeon General presented them as a new “yardstick” to the public—“a nutri-tional gold standard for the American people.”¹⁵
By then, a major villain in fostering “hidden hunger” had hove into
98 : c h a p t e r s e v e n
sight: the one that McCollum had performed his fl ip-fl op over in 1923.
Once again, modern milling was accused of removing essential vitamins from fl our. Leading this charge was Russell Wilder, head of the NRC’s food and nutrition committ ee, who deft ly used the new RDAs to rally the nation behind his pet project. This was to ensure that the nation had the
“nervous energy” necessary to win the war by stoking the national diet with vitamin B1 (thiamine), the “morale vitamin.”
A handsome white-haired doctor with the avuncular looks associated with medical wisdom, Wilder had already convinced many of the na-tion’s leaders by the time of the 1941 National Nutrition conference that America’s very survival was being threatened by a lack of thiamine. How did he accomplish this? It all began when he and some of his colleagues at the Mayo Clinic in Rochester, Minnesota, became convinced that the nutritional quality of the American diet had deteriorated markedly over the past sixty years. The main cause, they thought, was that the new steel roller-milling process introduced in the 1880s removed most of the vi-tamins in the B complex, including 90 percent of the thiamine, from the white bread that constituted about 30 percent of most Americans’ caloric intake.¹⁶
To demonstrate the baneful consequences of this, they put four young female patients at the nearby state mental hospital on a diet that was very low in thiamine. Aft er fi ve weeks, the researchers observed a num-ber of symptoms, led by “anorexia, fatigue, loss of weight . . . constipation, and inconstant tenderness of the muscles of the calves.”¹⁷ This was fol-lowed by a study of six more female inmates who worked on the Mayo Clinic cleaning staff . Aft er six weeks on the same diet, they suff ered from
“debility . . . fatigue and lassitude.” Among the symptoms recorded were
“depressed mental states, generalized weakness, dizziness, backache . . . anorexia, nausea, loss of weight,” and vomiting. They also suff ered from
“psychotic trends” and mental problems that the researchers said closely resembled those of neurasthenia, the one-size-fi ts-all diagnosis of “ner-vous exhaustion” popular in Victorian times. When, in the midst of the experiment, thiamine was restored to the diets of two of the women, they experienced “a feeling of unusual well-being associated with unusual stamina and enterprise.” All the women recovered well when they went back on their normal diets.¹⁸
The implications for the nation’s defense eff ort seemed obvious: thia-mine was essential for the psychological health of the nation. The publi-cation of the study in October 1940 prompted an editorial in the Journal of the American Medical Association warning that, in case of invasion, the
99 : “Hidden Hunger” Stalks the Land
“moodiness, sluggishness, indiff erence, fear, and mental and physical fa-tigue” induced by lack of thiamine would mean the diff erence between resistance and defeat. Various government offi cials joined in, saying that the nation had to be educated about the importance of this “potent mo-rale builder.” Thiamine quickly became “the momo-rale vitamin.” No one said that this was based on a study of the mental states of ten patients in what was then called an insane asylum.¹⁹
Wilder’s solution to the problem was to restore back into white fl our the thiamine that roller milling removed.²⁰ This went down very well indeed with vitamin manufacturers. New techniques for measuring vitamin content were now allowing them to sell vitamins concentrates to manufacturers of a number of processed foods, including chewing gum.²¹ By late 1940 General Mills—makers of Wheaties, the “Breakfast of Champions”—was already on the thiamine wagon. It advertised that it added thiamine to the product because “in the necessary process of trans-forming whole wheat into a delicious breakfast cereal, the vitamins and sometimes the minerals are too oft en impaired or destroyed.” A shield on its box proclaimed that it was “Accepted by the American Medical Assn. Council on Foods,” which verifi ed that its “Nutr-a-sured” process restored the “vital vitamin B1” and other nutrients to the wheat.²²
The fl our millers, on the other hand, balked at paying the high prices that vitamin manufacturers were demanding. McCollum tried to help them out by advising Americans to eat other foods to make up for what was lacking in white bread. He also proposed fortifying bread not with vitamin concentrates, but with inexpensive skim milk powder and brew-ers’ yeast. The American Meat Institute had a diff erent suggestion, adver-tising that one pork chop provided an individual’s entire daily require-ment of thiamine.²³ Perhaps the most bizarre alternative was that put forward by an Andrew Viscardi. He patented a process for giving smok-ers the “therapeutic benefi t” of vitamin B1 by impregnating tobacco with it.²⁴
However, nothing but adding thiamine to fl our would satisfy Wilder.
Aft er he gained federal government backing for this, the millers were forced to respond. In February 1941 most of them agreed to begin pro-ducing “enriched” fl our for bread. (They rejected calling the fl our “re-inforced,” because it implied, said one report, “that there was something wrong with the old fashioned bread and it needed jacking up.”) The new fl our included not only thiamine, but also iron, ribofl avin, and pellagra-fi ghting nicotinic acid (later called niacin).²⁵
The step was hailed as “designed to rescue some 45,000,000
Ameri-100 : c h a p t e r s e v e n
cans from hungerless vitamin famine.” The millers pointed out that this was being done “the American way,” voluntarily.²⁶ But the millers did not volunteer enough, and three-quarters of the nation’s fl our—much of which was not used for bread—still remained un-enriched. The media now called for making enrichment mandatory, emphasizing the impor-tance of boosting intake of the “morale vitamin.” The Washington Post wrote of “how vital are certain vitamins in maintaining . . . the morale of the nation.” The Surgeon General said that the national defense de-manded the use of thiamine to “build up the morale, pep and infection resistance of the Nation.”²⁷
Again Wilder took the lead. He said that the Nazis were deliberately depriving the conquered peoples of European of thiamine to reduce them “to a state of mental weakness and depression and despair which will make them easier to hold in subjection.” This soon morphed into the charge that they were systematically destroying the thiamine content of all the food in the occupied nations. In April 1941 he told the College of Physicians that over the past sixty years (that is, since the new roller mills), there had been a “constantly increasing defi ciency” in nutrients in the American diet, leaving two-thirds of the nation suff ering from
“serious malnutrition.” Tests on young women at the Mayo Clinic had shown that a defi ciency of thiamine in the American diet “may have led to a certain degree of irremediable deterioration in the national will.”²⁸
He also used the experiment to warn that thiamine defi ciency was imperiling American industry. In June he told a scientists’ meeting that depriving the cleaning women of thiamine had led to “drastic person-ality degeneration and working ineffi ciency.”²⁹ In an interview for the New York Times Magazine, he described them as
a number of women volunteers [who] began as sociable, contented work-ers on what looked like an acceptable palatable diet. In a few weeks they were quarrelsome, depressed, and easily fatigued. They even went on strikes.
Forty-eight hours aft er thiamin was added to their defi cient diet they were their old selves again.³⁰
When a number of strikes broke out in defense industries, he warned that lack of thiamine in workers’ diets was a major component in indus-trial unrest.³¹
Wilder’s campaign was a resounding success. By June 1942 the millers had fallen in line, and almost all of the nation’s bread was being made with enriched fl our. A year later the millers complied with a
govern-101 : “Hidden Hunger” Stalks the Land
ment order to increase the amounts of other vitamins added to fl our as well.³²