TORONTO — Canadian doctors are being told to consider scurvy when assessing patients at risk of poor nutrition and food insecurity.
A case study in the Canadian Medical Association Journal warns the syndrome most associated with 18th-century seafaring persists in modern times.
It describes a 65-year-old woman who turned up last year at a Toronto hospital emergency department with a raft of mobility and health problems that curbed her ability to shop for groceries and cook balanced meals.
With little social and family help she largely subsisted on canned soup, tuna fish, white bread and processed cheese.
Senior author Sally Engelhart, a doctor in general internal medicine at Toronto’s Mount Sinai Hospital, says it’s hard not to consider rising food costs as a likely factor in this case.
"It is a diagnosis that people associate with sailors in the 18th century, and not something that is relevant in 2024 in Canada and Toronto," she said.
“But what I've learned is that it's not such an esoteric diagnosis, and individuals who suffer from food insecurity or who have an extremely restrictive diet for a variety of reasons, are at risk for nutritional deficiencies, including scurvy.”
The study says reports from the United Kingdom suggest the prevalence of vitamin C deficiency may be as high as 25 per cent in some low-income groups.
Scurvy, referred to in the study as hypovitaminosis C, is caused by a deficiency in vitamin C, which plays an essential role in numerous metabolic processes.
While a daily vitamin can help, Engelhart said fresh fruits and vegetables are the best source.
She said scurvy would take "several weeks to months" of poor diet to emerge, but notes "there are people who can go several months without getting fruits, vegetables or other sources of vitamin C in the diet.”
“When you think about the cost of groceries, if the best source of vitamin C is fruits and vegetables, with a rising cost of fresh produce, I think that it is relevant,” Engelhart said.
"I think improving the income of low-income households, bolstering access to community resources to help vulnerable populations ensure consistent and reliable access to healthy foods are all important," she added.
This report by The Canadian Press was first published Oct. 7, 2024.
Cassandra Szklarski, The Canadian Press