Pellagra is a long-standing and sometimes misdiagnosed condition that results from a dietary deficit of niacin (vitamin B3). Its name, "pelle agra " is derived from the Italian and refers to "sour skin," as one of its defining signs is rough, scaly skin. The illness was initially identified as "mal de la rosa," or "the disease of the three Ds"—dermatitis, diarrhea, and dementia—in Spain in the eighteenth century. Nevertheless, the whole understanding of the connection between nutrition and pellagra did not emerge until the early 1900s. Because corn lacks readily available niacin unless treated with lime or other alkalis, pellagra was more common in communities whose diets consisted primarily of corn. In the early 1900s, pellagra epidemic proportions occurred in the southern United States, when corn was a staple meal for many.Early in the 20th century, American Public Health Service physician Dr. Joseph Goldberger made significant contributions to the field of pellagra study. Rather with the infectious theory that was prevalent at the time, he proposed a link between the disease and food. Goldberger experimented on convicts to test his theory, showing that pellagra could be healed or created with a simple diet change. Niacin, which is present in foods including meat, chicken, fish, and nuts, was later proven to be the missing component in avoiding pellagra as a result of Goldberger's research. As a result, niacin-enhanced foods like enriched flour were developed, significantly lowering the prevalence of pellagra in the West. These days, pellagra is uncommon in wealthy nations because of enhanced food fortification initiatives and diets. Still, it endures in regions of the world where starvation and poverty are common. Pelagra is still a major health risk in these areas, underscoring the continued need of having access to a varied and nourishing diet. If pellagra is not treated, its symptoms may become incapacitating. These include rashes on the skin, digestive disorders including diarrhea, and brain conditions like dementia and disorientation. Niacin supplements or dietary modifications are simple treatments for pellagra, provided it is detected early. In the battle against this once-devastating disease, awareness and access to a healthy diet are essential because severe instances can cause irreversible harm.
