Beriberi and other Food-deficiency Diseases in Newfoundland and Labrador

Abstract

1. Beriberi occurring on a white-flour staple is similar to that occurring on a rice staple.2. Under the difficult climatic conditions of North Newfoundland and Labrador, families are obliged to buy food stores in November or December to last until the following May or June. When poverty prevents a sufficient variety of foodstuffs, and calories are the foremost consideration, white flour with few extras forms the main dietary, and beriberi tends to occur in April, May or June. It occurs in families who have grown few vegetables and shot little game.3. The disease attacks more men than women, and very rarely children between the ages of infancy and puberty. The age and sex incidences of beriberi are difficult of explanation and differ in different countries.4. Infantile beriberi probably occurs in Newfoundland and Labrador, but is largely unrecognised.5. The main cause of beriberi is vitamin B1 deficiency, but the diets of patients suffering from beriberi are deficient in other respects.6. It is suggested that the infrequency of wet beriberi in Newfoundland may be due to the fact that wheat flour has a higher protein content than polished rice.7. Since poverty and deficiency disease are rigidly associated, prevention is an economic rather than a medical problem.8. Severe scurvy and rickets are not often met.9. Functional hemeralopia or night-blindness occurs mainly during the summer among men. It occurs on a diet deficient in vitamin A, and is rapidly curable by vitamin A containing foods, a fact well known to the Newfound landers. The disease may occur in men taking a deficient diet for less than one month. Other evidences of vitamin A deficiency are lacking.10. Tuberculosis, severe dental caries, functional stomach complaints and constipation are common. Gastric and duodenal ulcer, diabetes and obesity are rare.

The Work of Wallace Aykroyd: International Nutritionist and Author

“…The disease was also rare among children under 16 y of age. Aykroyd showed that the sex and age patterns for the disease were similar to those recorded in both Japan and in an area of India and did not seem to be explained by a difference in diet between men and women (4).…”

“…However, of most interest now is the paper that resulted from Aykroyd's return to Newfoundland to gain a better understanding of why beriberi had also been a continuing problem there (4). Beriberi has always been thought of as a disease typically of poor Asian laborers living on white rice and not much else, and it was in the Far East that workers such as Kanehiro Takaki in Japan and Christiaan Eijkman and Gerrit Grijns in Indonesia first showed it to be caused by a deficiency in the diet.…”

“…They might also buy some potatoes and beans or peas, but these would not last through the winter, and it was at the end of winter that most cases of beriberi were seen at the hospital in North Newfoundland. In addition, in late summer, families would typically pick a large barrel-full [;91 kg (200 lb)] of wild cranberries and cloudberries that would last through the winter, and this was probably responsible for keeping them free from scurvy (4).…”

Night Blindness Due to Vitamin A Deficiency: A Consideration of Its Importance in Traffic Problems

“…This fact was well demonstrated by Aykroyd,5 who found that it was the custom among some persons in Labrador, where severe vitamin A deficiency was common, to wear a bandage over one eye, while the other eye was left uncovered, in order to see to carry on the day's activities. After dark they would remove the bandage.…”

The Incidence of Xerophthalmia and Night-Blindness in the United States—A Gauge of Vitamin A Deficiency

“…A similar comment has been made in a recent account of xerosis in Tientsin where the diet of the infants consisted of rice water or condensed milk, and that of the adults of bread, rice or vegetable water and salted cabbage or turnips.4 Probably the condensed milk was given greatly diluted. Aykroyd,5 who has published an interesting account of the development of xerophthalmia among the fishermen in Labrador, states that their diet consisted mainly of white bread, molasses, fresh cod fish, salt meat, beans, peas, some potatoes, but no milk, butter, eggs or green vegetables.…”