Niacin, or nicotinic acid, is an organic compound and a vitamer of vitamin B3, which is essential for human health. It is synthesized by plants and animals from the amino acid tryptophan. Dietary sources of niacin include fortified packaged foods, meat, poultry, tuna, salmon, nuts, legumes, and seeds. Niacin supplements are used to treat pellagra, a condition caused by niacin deficiency that manifests as skin and mouth lesions, anemia, headaches, and fatigue. To prevent pellagra, many countries require the fortification of wheat flour or other food grains with niacin.
In 1937, Conrad Elvehjem extracted nicotinic acid from liver and identified it as the 'pellagra-preventing factor,' significantly reducing the prevalence of pellagra.
In 1942, to avoid confusion with nicotine, the name 'niacin' was adopted for nicotinic acid. This coincided with the beginning of flour enrichment with nicotinic acid.
In 1951, Carpenter found that niacin in corn is biologically unavailable unless treated with very alkaline lime water, explaining why Latin-American cultures using this method were not at risk for niacin deficiency.
In 1955, Altschul and colleagues described niacin's lipid-lowering properties, establishing it as the oldest known lipid-lowering drug.
In 1987, lovastatin, the first 'statin' drug, was first marketed.
In 1998, the U.S. Institute of Medicine updated the Estimated Average Requirements (EARs) and Recommended Dietary Allowances (RDAs) for niacin, also establishing Tolerable Upper Intake Levels (ULs).
In 2001, the U.S. FDA approved the combination drug niacin/lovastatin (Advicor).
In 2008, the U.S. FDA approved the combination drug niacin/simvastatin (Simcor).
Niacin prescriptions in the U.S. peaked in 2009, reaching 9.4 million prescriptions.
In 2010, a review concluded that niacin was effective as a mono-therapy for affecting lipid levels. However, its usefulness in reducing cardiovascular risk in patients already on statins was not established.
In 2014, worldwide sales of nicotinamide reached 31,000 tons, primarily driven by demand for animal feed and food fortification.
In 2015, the U.S. Institute of Medicine was renamed the National Academy of Medicine.
On 27 May 2016, the Daily Value for niacin on U.S. food and dietary supplement labeling was revised from 20 mg to 16 mg to align with the Recommended Dietary Allowance (RDA).
In 2016, the U.S. FDA withdrew approval for the combination drugs niacin/lovastatin and niacin/simvastatin, citing lack of incremental cardiovascular benefits.
A 2017 review, which included twice as many trials as previous reviews, concluded that while prescription niacin affects lipid levels, it does not reduce all-cause mortality, cardiovascular mortality, myocardial infarctions, nor fatal or non-fatal strokes.
In 2018, it was discovered that a niacin factory in Visp, Switzerland, was responsible for around one percent of the country's greenhouse gas emissions due to nitrous oxide production.
By 1 January 2020, manufacturers with annual food sales over $10 million were required to comply with the updated niacin labeling regulations.
As of 2020, 54 countries required the fortification of wheat flour with niacin or niacinamide; 14 countries also mandated the fortification of maize flour, and 6 mandated the fortification of rice.
By 2020, niacin prescriptions in the U.S. had declined significantly to 800 thousand from their peak in 2009.
By 1 January 2021, manufacturers with lower volume food sales were required to comply with the updated niacin labeling regulations.
In 2021, catalytic scrubbing technology was installed at a niacin factory in Visp, Switzerland, to eliminate most of the nitrous oxide emissions.
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