Lucy Wills

LOVE it or hate it, Marmite is a globally recognised brand. Not so well known is the role the thick, gooey yeast extract spread has had on global public health.

A new book by Professor Victor Hoff­brand, who worked for decades at Hampstead’s Royal Free Hospital, explains that Marmite was a key factor in a trail­blazing researcher’s work on anaemia and the condition’s disastrous effects on pregnant women.

Prof Hoffbrand came across the remarkable Lucy Wills when he took up a post at the hospital in September 1974.

“A pile of battered old books had been deposited into my smart new clean office and I was about to throw them out,” he recalls. “Among them were a set of worn, dark green, hard bound notebooks.”

He was astonished to find inside the careful handwritten notes of a medical trailblazer, Lucy Wills. They were a record of her work to treat anaemia – a condition that makes sufferers susceptible to infections and birth defects – using the yeast extract Marmite.

The notebooks started in 1931, the year Dr Wills wrote that she had found a factor in yeast that helped cure anaemia among poor pregnant women she had been treating in Bombay. “This observation turned out to be one of the major discoveries in medical science during the 20th century,” Prof Hoffbrand says.

Wills’ research – which discovered one of the 13 vitamins – focused on which element within the spread protected against anaemia in pregnant women. Anaemia – a lack of red blood cells – could cause serious problems for the unborn child.

The work lead to her identifying a compound called folate, which now has the household name of folic acid. It has helped prevent the birth of babies with conditions such as spina bifida.

As well as telling a detailed medical story, Prof Hoffbrand reveals the process of discovery, and includes a number of scandals around folate, including the ethics of medical testing, the use of placebos and how informed patients were about the clinical trials they were taking part in and the cost of supplements. All this is set against a background of the obstacles a woman encountered as she tried to pursue her academic specialism.

Professor Victor Hoff­brand

Wills was born in 1888 in the West Midlands. Her family ran a successful tool business, making scythes and sickles. This well-off background meant when it came to her education, money would not be a factor stymying her learning, as it was for many intelligent women.

Wills joined Cheltenham Ladies College aged 15 in 1903. She showed an aptitude for science and flourished, walking the Oxford and London exams with top marks and earning a place at Newham College Cambridge, where she studied science and botany. Like her brothers, she showed a strong interest in the natural sciences, geology, fossils, animals and plants. She was a member of the Geological Society.

Graduating from Cam­bridge in 1910, she was only given a certificate to say she had passed exams, instead of a full Cam­bridge degree. She would not receive it until 1948.

“In contrast to the men who made scientific discoveries in the first half of the 20th century, Lucy Wills was never honoured in England, the country were she was born and educated and where her career was based, or in any other country,” says Prof Hoffbrand. “There are no laboratories, lecture theatres, buildings, institutions, awards, prizes or scholarships named after her and by which she might be remembered.”

In the immediate pre-war years, Wills travelled east to Ceylon. By 1915 she had started at the Royal Free Hospital School of Medicine for Women. Five years later, she had received a degree from the University of London.

“Always more interested in medical practice, she decided on research and teaching in the department of pregnant pathology at the Free,” says Prof Hoffbrand. The hospital had links with India that dated back to Victorian times and in 1928 Wills she accepted an offer to look at the high number of cases of anaemia in women in Bombay. She spent five years there.

“She proved to be tireless,” adds Prof Hoffbrand. “She first studied the prevalence of the big red cell anaemia of pregnancy among different ethnic and social groups, and observed that the highest incidence was among poor Muslim women existing on the most deficient diets which lacked protein, fruit and vegetables.”

Her work ruled out a bacteria, and found that while “pernicious” anaemia could be treated by an iron rich diet, the same solution was ineffective for pregnant women. Using rats to test her theories, she tried numerous diets – and then discovered the anaemia responded to yeast. A similar trial with monkeys had the same results.

“For clinical trials in pregnant woman in Bom­bay, Wills chose Marmite as a cheap source of yeast,” Prof Hoffbrand says. As it proclaims on its jar, the spread is rich in B vitamins – and contains the magic ingredient, folate, that helps the body absorb it.

Will’s work has changed the lives of an unthinkably large number of people, and as Prof Hoffbrand’s deeply researched and splendidly told story reveals, she deserves to have her name elevated to the highest echelons of medical researchers whose intelligence and diligence has shaped the world we live in today.

• The Folate Story: A Vitamin Under the Micro­scope. By Victor Hoff­brand. Troubadour, £20