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Richard W. Vilter, M.D.
JAMA. 1961;175(11):1000-1001. doi:10.1001/jama.1961.03040110064015.
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AS the standard of living has improved in the United States, and as education in good dietary practices has reached housewives in the remotest sections of the nation, overt nutritional deficiency diseases have almost disappeared. Only in the food faddist, the chronic alcoholic addict, and the patient with illness resulting in hypermetabolism, vomiting, diarrhea, anorexia, or intestinal malabsorption are physicians likely to find the signs and symptoms of severe nutritional deficiency diseases. Very occasionally, a congenital or acquired metabolic block may increase the requirements for a particular nutrient to such an extent that illness occurs. Also occasionally a drug, usually an antibiotic, will so alter the intestinal microflora that manifestations of vitamin lack appear. These are very special circumstances and have no bearing on the health of the great majority of U. S. citizens. Except in a small percentage of persons in the lowest income group where funds are insufficient


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