Food Less Fortified: Vitamins in a Time of Grid-Down Existence – Part II, by PA Jes

Today, we’ll conclude the article reviewing the vitamin situation in a SHTF scenario and how to provide our body with necessary vitamins without bottled vitamins or vitamin-enriched foods. Vitamins D, vitamin C, vitamin A, and vitamin E are reviewed in Part 1, so go back and read it if you missed it yesterday.

Vitamin K

Vitamin K is necessary for the body to produce blood clots. Blood clots are the body’s method to control bleeding. Without enough vitamin K, people could easily bleed to death. Worldwide, vitamin K deficiency is a major cause of death in newborns, a result of uncontrollable bleeding. In adults, vitamin K deficiency is uncommon because it is both present in green leafy vegetables and in our own guts, as our microbes actually synthesize a type of vitamin K.

In a SHTF scenario, the biggest risk for vitamin K deficiency is in babies who are exclusively breast fed, as human milk lacks adequate vitamin K. In developed countries, newborns are given vitamin K soon after birth. Infant formula also contains vitamin K. There are no clear guidelines for giving babies vitamin K via dietary means, in the absence of infant vitamin K supplements. In theory, a combination of human milk with an occasional bottle of infant formula (if available) would certainly help maintain healthy vitamin K levels (as well as vitamin D). A review of published literature revealed a report of babies being given some cow’s milk within the first few days of life for its vitamin K content; however, there are known risks with cow’s milk, such as the inability for babies to digest it and the resultant stress on the GI tract, liver, and kidneys. Parents and health care providers would need to weigh the risks versus benefits on a case by case basis. Preppers who plan to procreate, or who will barter with people with babies, may consider storing infant formula. The powdered variety takes less space and may have a longer shelf life than the liquid.

Thiamin (vitamin B1)

Thiamin may be the most important nutrient to consider in a long-term SHTF scenario. Thiamin is widely available in many foods and aids our metabolism process. It is found in almost every living thing. It can be found in:

• Whole-grain foods,
• Meat/fish/poultry/eggs,
• Milk (animal and human),
• Vegetables (green, leafy vegetables; beets; and potatoes),
• Legumes (lentils, soybeans, nuts, and seeds), and
• Orange and tomato juices.

Thiamin deficiency, called beriberi, is commonly due to a diet of highly-refined carbohydrates (such as white rice, white flour, white sugar) in developing countries, especially in Asia. In the U.S., it is sometimes seen in severe alcoholism. Symptoms include neuropathy in the feet and hands, leg swelling, heart failure, acute dementia, and sudden death. Early thiamin deficiency (low levels in the body without frank symptoms of beriberi) is sometimes seen in people who consume excessive amounts of carbonated drinks and refined sugars without a varied diet. Historically, it was also seen in epidemic proportions in populations with rations of refined flour, such as sailors and prisoners. Even today, beriberi is seen in refugee camps with populations dependent on international food aid. Infantile beriberi is the most significant deadly form of malnutrition for babies who are breastfed. It is directly related to the thiamin content of the mother, and is prevented by adequate thiamine intake by the mom. Beriberi has very high death rates, but if it is recognized, it can be treated by eating thiamine-rich foods.

In TEOTWAWKI, having a varied diet that is not fully reliant upon refined rice or refined wheat will prevent beriberi. Preppers who have stored primarily white rice and white flour may find themselves at risk. If the SHTF leads to refugee camps in the U.S., beriberi can become epidemic to those survivors.

Some cooking techniques to prevent thiamin losses during food preparation include:

• Use the minimum amount of water for the preparation of vegetables.
• Cook for the minimum amount of time possible; a high temperature for a short time is preferable. Cover the pot with a lid to shorten cooking time.
• Wash vegetables before cutting them.
• If possible, rice should not be washed before cooking. If necessary, only rinse once with a little cold water.
• Do not cook rice with excess water that needs to be discarded.
• Use parboiled rice, where available.

Niacin (Vitamin B3)

Niacin is vital in cell metabolism. Because tryptophan can be metabolized to niacin, foods rich in tryptophan (dairy products) can compensate for inadequate dietary niacin. Breads, cereals, and pastas have been enriched with niacin in the U.S. for many years. Natural food sources include red meat, fish, poultry, and peanuts. It is recommended that adults ingest 14-16 mg of niacin per day.

Dietary niacin deficiency leads to a condition called pellagra. Currently, pellagra occurs in countries, such as India, where maize (Indian corn) is a primary staple in the diet (although the niacin in maize becomes absorbable, if it is first treated with an alkali). In the 1800s, pellagra was common among poor Americans, whose diets consisted mostly of corn, molasses, and salt pork, which are poor sources of niacin. Symptoms of pellagra include “the three Ds”– dermatitis (rash-especially in sun-exposed skin); diarrhea; and dementia (as well as other widespread neurologic problems). If diagnosed, the condition can be treated by adding niacin to the diet. It should be noted that high doses of niacin supplements can be toxic. In a SHTF scenario, a varied diet that includes red meats, poultry, or dairy should provide adequate niacin.

Vitamin B6

Vitamin B6 is involved with hundreds of types on enzyme activities, especially protein metabolism. It is found in a wide variety of foods, such as beef liver and other organ meats, beef, poultry, starchy vegetables, and some non-citrus fruits. Given the wide variety of dietary sources, it is unlikely the B6 deficiency would be problematic when SHTF in the absence of an underlying medical cause of deficiency, such as malabsorption syndromes.

Vitamin B12

Vitamin B12 is a nutrient that is found in animal products but not plant products. It is necessary for healthy red blood cells and nerve tissue. Deficiency can cause a type of anemia, rendering the person very weak and fatigued, or nerve tissue damage, such as numbness, movement problems, and dementia, which can be irreversible, if the deficiency is not corrected. B12 deficiency is a component of pernicious anemia (a medical condition where the gut cannot absorb B12), and post-surgical malabsorption. These medical conditions are beyond the scope of this article.

Healthy intake for kids is 0.4 to 1.8 mcg, depending on the age of the child. Adults should take 2.4 mcg daily. Pregnant or breastfeeding mothers, however, need 2.8 mcg so that an adequate amount is passed to the baby. Vitamin deficiency in babies can cause permanent nerve damage and death. Common natural sources of vitamin B12 include:

• Beef liver and clams (best sources of vitamin B12)
• Fish, meat, poultry, eggs, and milk

Some breakfast cereals are fortified with vitamin B12, which is one way that many vegetarians are able to consume adequate B12 amounts. However, strict vegetarians and vegans are otherwise unable to obtain B12, unless they take supplements. When SHTF and the bottles of vitamins run out, listen to your body: use your canine teeth (eat meat).

Folate

Folate or folic acid (a form of folate found in supplements and enriched cereals and grains) is a water soluble B-vitamin that is important for DNA synthesis. It has been proven that deficiency just before and during early pregnancy can cause brain and spinal cord birth defects in the baby. As a result, the U.S. began a cereal and grain fortification program in 1998, which was a success in reducing folate deficiencies in the U.S. Adults should take 400 mcg per day.

Folate comes naturally from a variety of foods, such as vegetables (especially dark green leafy vegetables), fruits, nuts, beans, peas, dairy products, poultry and meat, eggs, seafood, and grains (see Table 3). Prolonged cooking destroys folate.

Table 3.Folate Content in Selected Foods (Recommendation is 400 mcg daily for adults)

Folate deficiency in expectant mothers can lead to spinal cord defects. It can also cause anemia, skin changes, and mouth ulcers. The groups most at risk for deficiency are young women and alcoholics. In a SHTF scenario, folate deficiencies could re-emerge as the fortified grains and cereals become scarce. A varied diet, however, may be all that is needed to maintain adequate folate levels. In the meantime, “eat your Wheaties.”

Iodine

Iodine deficiency is the single biggest cause of mental retardation in the world. Iodine deficiency is not currently a problem in North America, although it once was (and it could be again). Recent reports suggest that in the U.S., many young women have levels that are considered borderline iodine-deficient. For maintenance of normal thyroid function, the recommended daily intake of iodine for adult women is 150–300 µg; for men, it is somewhat less at 150 µg. Pregnant and lactating women must maintain healthy iodine levels, as iodine is passed into breast milk.

The body uses iodine to make thyroid hormones, which are critical for metabolism and many normal functions. In fetuses and infants, deficiency causes mental retardation, growth stunting, and delayed sexual maturation. In adults, deficiency can lead to thyroid goiters—swollen thyroids—that may lead to hypothyroidism. It can also contribute to cystic breasts in women, and possibly breast cancer.

Iodine is a mineral, typically found in the soil and water of coastal areas. Seaweed is one of the best food sources of iodine. Iodine deficiency is most problematic in extreme inland regions without access to seafood (mountainous or desert regions). In the U.S., the proclaimed “goiter belt” includes the great lakes region, Appalachia, and Northwestern states, which are particularly notorious for having poor iodine levels in the soil.

The iodine levels in plants is determined by the iodine content of the soil. The iodine content in meat is thereby determined by the iodine content in the animal feed, and the content in the feed is determined by the content in the soil in which it grows. Iodine deficiency in the U.S. was mostly corrected in the early 1900s with iodized salt (table salt). Many American’s eat processed foods that contain excessive amounts of salt, and it should be noted that this salt is typically NOT iodized.

Dairy and grain products are the major contributors of iodine to the American diet. Iodine is present in cow’s milk, primarily because of iodine in the sanitation agents used in dairies, and iodine in the feed. In a world without those sanitation practices, cow milk will cease to be a good source of iodine. Fruits and vegetables contain iodine, but the amount varies depending on the iodine content of the soil and fertilizer. Furthermore, not all table salt is iodized, and not all multivitamins contain iodine (or list kelp); therefore, labels should be read to determine content.

So what happens when the trucks stop rolling? Once the supplies run out, one could theorize that we will slowly return to the state of iodine regionalization that was present pre-1920s, with the resurgence of the goiter belt in the U.S. Iodized salt, when stored properly, can last indefinitely. One solution for goiter belt inhabitants is to store plenty of iodized salt and simply sprinkle a dash of iodized table salt on dinner. Of note, a few health conditions have specific warnings about excessive salt intake, most notably is congestive heart failure.

Summary

Malnutrition is clearly a risk for even the most carefully prepared individuals, largely due to regionalization of available foods. Appropriate preparations can be taken simply with awareness of the risks inherent to one’s location. To conclude this somewhat complicated topic, below is a list of the “Top Ten Food for Thought when SHTF” (with a dash of tongue in cheek):

10. Don’t get burned; get a tan for vitamin D.

9. People living in cold-winter regions or who decide to become pirates, will need a source of fruit and vegetables year ’round (particularly to prevent scurvy).

8. Popeye had it right: eat spinach, which contains folate, vitamin C, and other good treats.

7. In the absence of vitamin supplements, people will need to use both their canine teeth and their molars. (Eat both meat and plants, ensuring vitamin B12 and other goodies in the diet.)

6. Less is more. Don’t overdo fat-soluble vitamin supplements, as they may be toxic when overdosed.

5. As your mother told you, eat your carrots for maintaining quality eyesight (and vitamin A).

4. A diet of white flour and white rice is not as good as it tastes. Beriberi is not fun… and don’t be a refugee.

3. Goiter belt residents can go pound salt—check your salt stores, and make sure you have plenty of the iodized variety.

2. Breastfeeding is the best food for babies, hands down, but an occasional bottle of formula for junior is a good idea for reproducing preppers.

1. TEOTWAWKI is not a place for gender equality: If propagation of future generations is a priority, give the young women, particularly pregnant and breastfeeding women, a larger portion of the vitamin stock.

Sources:

• Wagner CL, Hulsey TC, Fanning D, Ebeling M, Hollis BW. “High-dose vitamin D3 supplementation in a cohort of breastfeeding mothers and their infants: a 6-month follow-up pilot study” Breastfeed Med. 2006 Summer;1(2):59-70.
• U.S. Department of Agriculture, Agricultural Research Service.2011. USDA National Nutrient Database for Standard Reference, Release 24. Nutrient Data Laboratory Home Page, http://www.ars.usda.gov/ba/bhnrc/ndlexternal link icon. Accessed June 13, 2014. National Institutes of Health, Office of Dietary Supplements.http://ods.od.nih.gov/factsheets/. Accessed June 20-July 26, 2014. CDC Online Newsroom.http://www.cdc.gov/media/releases/2012/p0402_vitamins_nutrients.html. Accessed July 16, 2014
• Winkler, Sarah.  “Are carrots really good for your eyesight?”  19 August 2009.  HowStuffWorks.com. <http://health.howstuffworks.com/human-body/systems/eye/carrots-eyesight.htm>  17 July 2014.
• Leung, A, Braverman, and Pearce, E. “History of U.S. Iodine Fortification and Supplementation”Nutrients.Nov 2012; 4(11): 1740–1746.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509517/. Accessed July 23, 2014.
• The Merck Manual for Health Care Professionals. “Vitamin K.” http://www.merckmanuals.com/professional/nutritional_disorders/. Accessed July 26, 2014.
• Victora, C and Van Haecke, P. “Vitamin K prophylaxis in less developed countries: policy issues and relevance to breastfeeding promotion.” Am J Public Health. 1998 February; 88(2): 203–209.
• Prinzo, Z. “Thiamine deficiencyand its prevention and control in major emergencies.” World Health Organization, 1999. http://www.who.int/nutrition/publications/en/thiamine_in_emergencies_eng.pdf. Accessed July 25, 2014.