South Burlington, Vermont – A deadly nutrient-related disease, pellagra, once plagued the American South in the early 20th century. The illness, caused by a deficiency in niacin and/or tryptophan, led to devastating symptoms known as the four “D’s”: diarrhea, dermatitis, dementia, and death. During the Great Depression, pellagra claimed the lives of nearly 7,000 Southerners annually, affecting around 3 million Americans between 1906 and 1940.
To combat the epidemic, fortification of wheat and other cereals with niacin, also known as Vitamin B3, became both voluntarily and eventually mandatory. As a result, pellagra nearly disappeared from the United States by the middle of the 20th century. However, recent studies suggest that the excessive intake of niacin from fortified processed foods could be contributing to an increased risk of cardiovascular disease, potentially leading to heart attacks, strokes, and death.
Stanley Hazen, a leading researcher at Cleveland Clinic’s Lerner Research Institute, conducted a study linking high blood levels of a breakdown product of niacin to a higher risk of major adverse cardiovascular events (MACE). This risk appears to be independent of traditional risk factors such as high cholesterol. Hazen’s findings present a new perspective on how niacin intake may impact cardiovascular health, offering new possibilities for treatment and prevention.
Hazen and his team initially identified niacin as a potential factor contributing to cardiovascular disease by analyzing the blood plasma of over 1,100 patients with cardiovascular conditions. Through metabolomic analysis, the researchers discovered a particular unknown metabolite significantly associated with a higher risk of MACE. This metabolite, identified as the final breakdown products of niacin, was found to be linked to elevated cardiovascular risks within the cohort.
The study’s findings shed light on a previously unrecognized pathway that could play a significant role in the development of cardiovascular disease. By pinpointing the impact of niacin breakdown products on heart health, researchers are paving the way for new approaches to addressing and preventing cardiovascular events. The insights gained from this study may lead to innovative strategies for treating and mitigating the risks associated with cardiovascular disease.
Overall, the research suggests that while the fortification of foods with niacin was a crucial step in eradicating pellagra, it is essential to reevaluate the potential health implications of excessive niacin intake from processed foods. As the understanding of the relationship between niacin and cardiovascular disease continues to evolve, researchers like Stanley Hazen are working towards uncovering new strategies for safeguarding heart health and preventing adverse cardiovascular events.