An outline of the history of pellagra in Italy

During the 16th and 17th centuries maize, a New World cereal defi cient in niacin (vitamin B3 or PP), replaced cereals of higher economic and nutritional value in the staple diet of the poor in Southern Europe. As a consequence of quasi-monophagic maize porridge-based diets pellagra, a lethal new disease due to severe niacin defi ciency, spread dramatically among the Southern European peasantry. For over 200 years, between the 18th and the 20th centuries, pellagra was endemic in those parts of Italy whose agrarian economy depended on maize as a staple crop. The disease, first discovered in Spain, took its name from the Lombard dialect and was intensively studied in Italy during the latter part of the 18th and the 19th century. This led to a quick recognition of its association with maize as a staple and with poverty, stimulating heated debates and the emergence of a social conscience among Italian scientists. During the first half of the 20th century international research efforts clarified the biochemical and physiopathologic bases of deficiency diseases. In 1937 this lead to the discovery by Elvehjem and collaborators in the USA of niacin, the pellagra-preventing factor. Between 1937 and 1940 fi eld studies on pellagrins conducted in endemic areas of Northern Italy by the Institute of Biology of the National Research Council gave a key contribution to the demonstration of the curative eff ect of niacin. In Italy pellagra is now a disease of the past but it teaches an enduring lesson on the impact that social structure, cultural adaptation and environmental/economic change have on human health.