T HE simplest classification of nutrients in foodstuffs depends on whether the primary use of the nutrient in the body is for the provision of energy or for the building of structural tissues. If one’s concept of structural elements is in terms of bone and connective tissue with exclusion of particulate matter in the cytoplasm of cells, then the vitamins belong in neither of these two categories. For our purpose today vitamins may be considered provisionally as dietary essentials required with hormones and other products of endogenous origin in the maintenance of the complex equilibria which together make possible a steady state in the organism, a state not of rigid constancy but one quickly adjustable to normal and abnormal stresses. The diversity of the molecular structure of vitamins is striking and it is clear that their function is not dependent on any one common structural configuration or chemical property. Hormones also show such individual variations. However, hormones differ from vitamins in at least two respects. They are not dietary essentials and several have protein structures. Significantly, there is no known instance of a specific protein that is indispensable in the dietary. Whether or not other essential nutrients such as trace minerals, essential amino acids and essential fatty acids should be classed with the vitamin group is largely a matter of arbitrary definition. If desired, trace minerals can be excluded by explicitly describing vitamins as organic compounds. Similarly, essential amino acids can be put in the category of tissue building materials. The unsaturated fatty acid, arachidonic acid, is more of a problem and might easily qualify as a vitamin unless it also is found to function largely in the form of phospholipides or other derivatives used in cell walls and in brain and nerve tissue. However, no advantage is to be gained in the broadening or narrowing of definitions in order to achieve an unnatural or unrealistic pattern of conformity in the classification of nutrients, and this will not be attempted. A discussion of the physiologic role of the vitamins at this time can only be in the nature of an interim report. Despite the detailed information which has accumulated during this last half-century we are now possibly no more than at the beginning of an understanding of these bewildering constituents of food. True, rather precise statements can be made concerning the mechanism of transport of hydrogen atoms by certain riboflavin-containing protein complexes but this gain is matched by our inability to name any chemical reactions through which another vitamin, the antirachitic vitamin, has been proved to facilitate the utilization of food calcium for the formation of bone. True, the role of vitamin A in vision has been nicely delineated but there is a complete lack of recognition of the manner of its beneficent protection of epithelial cells, whether of the eye, the skin, the gastrointestinal tract or the reproductive tract. Research has linked thiamine, nicotinamide and pantothenic acid with the utilization of the carbons of pyruvic acid in the highly important citric acid cycle in animal tissues; yet, in man, beriberi results from a deficiency of thiamine, pellagra from a deficiency of nicotinamide, and no comparable deficiency disease has been associated with pantothenic acid. Although the latter statement possibly is an oversimplification of the situation one may well ask if the facts at hand, as astonishing and as useful as they are, represent only the more easily recognized aspects of the activity of certain of the vitamins. Be that as it may, the fact is that a well characterized, acute syndrome in man, beriberi, can be prevented by the daily addition of approximately 1 mg. of pure thiamine to a thiamine-deficient diet. Similarly, each of the other historically important nutritional deficiency diseases, pellagra, scurvy, xerophthalmia and rickets, can be prevented by the daily addition of appropriate amounts of pure niacinamide, ascorbic acid, vitamin A and vitamin Dz (or D3), respectively, to the corresponding deficient
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