Vitamin Culture Part I: The Intriguing History of Vitamins

Vitamin Culture Part I: The Intriguing History of Vitamins

February 2, 2024

Joy Stepinski, MSN, RN-BC

How many times have you heard that taking a daily vitamin is very important for your health? Vitamins are considered a dietary supplement, often marketed with the assumption that ordinary diets are gravely deficient. According to the U.S. Food and Drug Administration [1], a dietary supplement is defined as a product that includes a dietary ingredient taken to enhance one’s diet. Examples include vitamins, minerals, herbs, botanicals, probiotics, and other ingredients. Learning about vitamin’s historical perspective is an invaluable tool when considering health decisions.

Initially, scientists discovered that certain components of food were effective in treating beriberi and scurvy, rare diseases of the early 20th century. In 1913, Casimir Funk suggested that “vital amines” or “vitamine” were organic substances crucial to sustaining life. He is now known as the “godfather of the vitamin movement” [2]. Funk invented the name from the Latin word for life, “vita,” with the ending of “amine” because he thought that these compounds were related to amino acids (the building blocks of protein). Vitamins are now known to have a different purpose - participation in metabolic processes, like energy production.

When looking from a historical perspective, the growth in vitamin popularity is rather quite complex and extensive. Not in public awareness even 100 years ago, Vitamin C was the first vitamin synthesized for mass production in 1933 [3] by a Swiss pharmaceutical company called Hoffman-La Roche (now known as Roche). By the mid-1940s, the remaining vitamins currently known were discovered. These thirteen micronutrients facilitate chemical reactions in the body. Examples include Vitamin C (ascorbic acid), Vitamin B1 (thiamin), and Vitamin A (retinol). The term micronutrient is key because the body needs vitamins only in small quantities. Many vitamins are essential, meaning that the body cannot produce them on its own and must acquire them through food (or in the case of Vitamin D, considered a hormone, the sun). Vitamins were used to treat diseases of deficiency, like pellagra, pernicious anemia, and rickets.

Under Franklin Delano Roosevelt, the National Nutrition Conference for Defense was held in 1941 [4]. During the conference, discussion ensued that Americans were ill-prepared during wartime as a result of impending food shortages [5] and malnourished draftees [6]. Consequently, food policy became part of national security. By 1943, the USDA sponsored “The Basic Seven” food groups. This is now known as “My Plate.”

The vitamin industry excelled with the help of food product marketing. Companies like Fleischmann’s Yeast advertised that yeast was full of B vitamins [4] and by the mid-1920s, the company’s net income increased by 75%. By 1943, the US government required that flour be enriched with vitamins that were lost due to the refinement of grains. Vitamins were common in everyday households by the 1960s. By the 1970s, supplement sales expanded dramatically.

The FDA grew concerned about risks. While overdosing on vitamins found in foods would be difficult, there was a possibility with the synthetic version. Yet, even with public policy, the FDA has had little influence over vitamin regulation. Important pieces of legislation were the Food, Drug, and Cosmetic Act of 1938, the Proxmire Amendment of 1976, and the Dietary Supplement Health and Education Act (DSHEA) of 1994. The 1938 act deemed that vitamins were considered food, as long as they were not prescribed for illness or marketed for disease prevention. In 1976, the Proxmire Amendment prohibited the FDA from establishing supplement standards. Furthermore, the FDA could not classify supplements as drugs, or regulate ingredients.

The consequence of DSHEA included defining the term “dietary ingredients” by extending this category beyond vitamins and minerals to botanicals, herbs, enzymes, and others. All dietary ingredients in years prior were grandfathered in, without any new requirements for new ingredients. Under this act, safety and efficacy data for supplements is not required. Therefore, dietary supplements can be sold without evidence that they are nontoxic and beneficial. Once the products are on the market, the FDA must demonstrate that the product is unsafe (not the other way around like medication).

Why is delving into the history of vitamins so crucial for health-related decisions? Consider the following.

1. Dietary supplements can be sold to the public without FDA approval or evaluation [5]. Products are simply assumed to be safe. Although the FDA has established recommended manufacturing practices, minimal regulations or oversight exist.

2. Supplements are not subjected to the tight regulations of drugs [4]. The FDA warns on its website that “natural” products are not equated with safe [7].

3. Before DHSEA, 4,000 dietary supplements existed. As of 2017, 90,000 were available. These supplements have not undergone rigorous testing like the same standards used for drugs [8]. Therefore, how does the public know if these supplements truly support health?

4. The FDA inspected 656 dietary supplement manufacturing companies in 2017 and cited violations directly relating to the product in half of these facilities [8]. The possibility of contaminated or mislabeled supplements sold to the public exists.

5. According to one study [9], the majority of physicians are not aware of the lack of regulation or even how to report supplement adverse reactions. The FDA does have a voluntary reporting system [8], which is the way this organization can detect supplement problems.

6. Healthcare providers may not always ask patients about supplements to consider drug interactions or side effects [3]. Likewise, patients may not share dietary supplements with their healthcare provider.

7. Taking supplements is not without the risk of harm. For example, drugs.com (a standard drug reference guide) reports that side effects of Vitamin C (ascorbic acid) include joint pain, weakness, fatigue, weight loss, stomach pain, and others [10].

8. In Food Politics, Marion Nestle states, “Because many different nutrients are involved in every aspect of human physiology, high doses of just one nutrient can create imbalances that adversely affect the absorption or metabolism of other nutrients” [5, p. 278]. How does the public acquire information about these imbalances?

9. Let’s return to the historical perspective that led to the discovery of vitamins in the first place. When was the last known vitamin deficient-causing disease prevalent in recent history? Scurvy, rickets, and pellagra are not common public health concerns.

Do vitamins and supplements have their place? Yes, depending on the situation. For example, Vitamin B12 is necessary for those who do not consume animal products. Normally this vitamin is found in bacteria that cover food. Because of the washing and cooking of plant food, many vegans and vegetarians are not exposed to a sufficient quantity [11]. As a result, neurological problems can ensue. However, decisions to take vitamins and supplements should be prudent ones by weighing the risks and benefits, and awareness of long-term health outcomes.

In closing, some questions to consider when deciding to take a vitamin are:

1.      Does the vitamin or supplement avoid eating nutritious plant food, which is rich in vitamins?

2.      Have I reviewed the side effects and potential drug interactions with my healthcare professional?

3.      What kind of benefits does this particular vitamin/supplement have? Do studies support a long-term beneficial health outcome?

References

1.      U.S. Food and Drug Administration. (2022). Questions and answers on dietary supplements. https://www.fda.gov/food/information-consumers-using-dietary-supplements/questions-and-answers-dietary-supplements

2.      Spedding, S. (2013). Vitamins are more funky than Casimir thought. Australasian Medical Journal, 6(2), 104 – 106. https://doi.org/10.4066/AMJ.2013.1588

3.      Roche. (2024). Moments that made us. https://www.celebratelife.roche.com/explore/moments/

4.      Price, C. (2016). Vitamania: How vitamins revolutionized the way we think about food. Penguin Books.

5.      Mozaffarian, D., Rosenberg, I., & Uauy, R. (2018). History of modern nutrition science—implications for current research, dietary guidelines, and food policy. BMJ, 361.

6.      National Park Service. (2023). Nutrition on the home front in World War II. https://www.nps.gov/articles/000/nutrition-on-the-home-front-in-world-war-ii.htm

7.      FDA. (2022). Mixing medications and dietary supplements can endanger your health. https://www.fda.gov/consumers/consumer-updates/mixing-medications-and-dietary-supplements-can-endanger-your-health

8.      Caldwallader, A. B. (2022). Which features of dietary supplement industry, product trends, and regulation deserve physicians’ attention? AMA Journal of Ethics, 24(25), E410 – 418. https://doi.org/10.1001/amajethics.2022.410

9.      Ashar, B. H., Rice, T. N., & Sisson, S. D. (2007). Physicians' understanding of the regulation of dietary supplements. Archives of Internal Medicine, 167(9), 966-969.

10.   Drugs.com. (2024). Ascorbic acid. https://www.drugs.com/mtm/ascorbic-acid.html

11.   Joshi, S. (2020). Why every vegan and vegetarian needs Vitamin B12. Forks Over Knives. https://www.forksoverknives.com/wellness/every-vegan-vegetarian-needs-vitamin-b12/