Historical perspective
Pellagra and the asylums — the history that built this campaign
What happened
In the early 1900s, pellagra filled American mental asylums. Its "three Ds" — dermatitis, diarrhoea, dementia — meant thousands of people were institutionalized as insane for what was, in truth, a niacin-deficiency disease of a corn-based poverty diet. Estimates put the US toll at roughly 3 million cases and 100,000 deaths between 1906 and 1940 — labelled as estimates, because they are.
What it looked like
Wards of "insanity" that rose and fell with diet and season.
What the labs found
Dr. Joseph Goldberger's dietary trial in a mental asylum showed it directly: of 72 patients with pellagra, all were cured after the introduction of the new diet — and about half relapsed when returned to the old one. In 1937, Elvehjem identified niacin as the missing factor.
What changed
Flour fortification in the early 1940s was followed by the near-eradication of pellagra in the US. An entire category of "madness" turned out to be a missing vitamin — the historical proof of concept for everything this campaign says.
The test that told the story
Dietary and niacin assessment — the original "lab before label."
Sources: Multiple independent historical accounts of Goldberger's trial, Elvehjem 1937, and 1940s fortification.