Thursday, October 14, 2010

What has oxidation to do with disease?

We have discussed the use of oxygen and how it is used to create energy by the process of oxidation. Now I am going to tell you how oxidation reflects health and disease. Many people are aware of the classical nutritional deficiency diseases known as beriberi (thiamine, B1), pellagra (niacin, B3) and scurvy (vitamin C). Each one represents one or more aspects of inefficient oxidation.
The best example for illustration is beriberi. This disease has existed for thousands of years and it was not until the early years of the 20th century that it was found to be due to deficiency of vitamin B1. Thiamine is an essential factor in the oxidation of glucose, a major fuel for the brain and nervous system. All simple sugars that include lactose (milk sugar), sucrose, fructose (fruit sugar) and even starch are broken down in body metabolism to glucose.
The commonest cause of beriberi for centuries has been the consumption of white rice and why it was so common in Eastern cultures. It has recently been reported in Japan in a group of adolescents consuming sodas and simple carbohydrate food substances. White rice is the grain from which the cusp has been removed by milling. Outbreaks of the disease occurred throughout history and were related to increased affluence when the peasants were able to afford the luxury of having their rice crop milled. They did this because it looked better when served to their friends and demonstrated their newfound affluence. Thiamine occurs naturally in the cusp around the grain and the miller would throw the rice polishings to the pigs that were therefore better fed than the humans. The grain, with the cusp removed, is just starch and the disease is therefore represented as a load of glucose with an insufficiency of thiamine to oxidize it in the synthesis of cellular energy. Epidemics also occurred in the summer months when workers in the factories would take their lunch outside. When the sun shone on them, some would develop their first symptoms of the disease so it was natural to believe for a long time that the disease was caused by an infection. An adult human body consists of between 70 and 100 trillion cells, all of which require thiamine, the equivalent of a spark plug in a car engine.
The tissues that have the highest metabolic rate, correlating with their consumption of oxygen, are the heart, the brain and the nervous system, so beriberi has its primary effect on those organs. If the affected cells are starved of either oxygen or the major catalyst that enables glucose to be oxidized, their energy is curtailed and their function becomes abnormal or ceases. In the next blog I will tell you more about how this process affects our health in the modern world.
It has long been thought that these classical nutritional deficiency diseases have been conquered in developed countries because of vitamin enrichment. Unfortunately, that is simply not true. They do exist but not in their classic presentation and I have seen them all, often unrecognized even in a major hospital setting. Most modern physicians do not even consider the possibility of a nutritional deficiency as a cause of disease and rarely do they recognize the way that they appear. The diagnosis is nearly always missed.

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