Nutrition science is often the center of jokes about the seemingly never-ending flow of contradicting research.
Eggs are good for you. No, now they’re bad for you. No, just the whites are good. Nope, wait…now they’re good again.
How are we supposed to know which is true? How do we know how anything in medicine is true?
Enter, the clinical trial.
Clinical trials are the gold standard of medical science and the cornerstone of systematic experimentation used to discover medical truths. They’re not perfect, but they’re standard practice in today’s medical community.
And they all started with micronutrients. Vitamins, to be precise. And like many scientific research endeavors, this one started with the military.
Scurvy was the scourge of the British Royal Navy. Sailors would often spend months out at sea. Over time, many would grow weak and lose their teeth. And 2 million sailors between the years 1500-1800 would never return home. In fact, more British sailors died in the 1800s from scurvy than from all enemy action!
In 1593, Admiral Richard Hawkins recommended citrus for sailors, and in 1614 the British East India Company published The Surgeon’s Mate recommending citrus. The anecdotal evidence was there.
But the technique didn’t catch on.
That is, not until James Lind. James Lind was a Scottish-born surgeon who performed what many believe to be the first clinical trial in medicine in 1747. By systematically controlling and comparing different diets on disease-ridden sailors, he determined that those on diets including oranges and lemons fared better.
Unfortunately, his understanding of what really was going on was a bit off the mark. He believed scurvy was the decaying of the body which could be cured by adding acids to the diet.
The real underlying mechanism? Vitamin C!
Although James Lind didn’t know it, a vitamin C deficiency led to the first clinical trial.
The story brings us back to the beginning. How do you know what to trust?
James Lind’s story is a good example. Although he conducted a clinical trial, he got the mechanism wrong. Big deal, right?
Well, not exactly.
Not knowing that vitamin C was the solution, the British substituted limes into the mix because they were cheap. They also boiled them in copper vessels, reducing their already lower vitamin C content. Scurvy re-surfaced and the British began to question citrus as the solution.
It wasn’t until 1927 that Albert Szent-Györgyi discovered the biochemical cause and cure for scurvy, and later won the 1937 Nobel Prize in Medicine for discovering vitamin C.
Today, vitamin C conjures up the common cold, due in no small part by a study by the great Linus Pauling in 1970. However, a 2013 meta-analysis suggests vitamin C does not reduce the incidence of the common cold in the general population, nor does it help treat a cold already in progress. However, the analysis suggests it may reduce the duration of colds and incidence in periods of intense physical stress (think, marathoners!). OSU provides a nice summary of vitamin C studies for those that are interested in getting up to speed.
Modern medicine continues its rigorous approach to uncovering the truth. Although the quest is seemingly never-ending, progress continues to improve over time. In the meantime, check the literature and the latest consensus on nutrition to see what the field has to say about a subject. Or ask us here at Intake to do the investigative work for you!
So next time you hear something about a clinical trial, remember its modest seafaring beginnings, and thank a micronutrient deficiency for the start of modern medical research!
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