A recent Slate article recalled a patient who baffled doctors in Springfield, Massachusetts, in 2009, until a doctor named Eric Churchill cracked the case:

The middle-aged man had shown up with bleeding gums, unexplained swelling, bruises, and fatigue. His team of internists suspected a skin infection, but every bacterial test came up negative. They were stumped until, Churchill recalls, “someone eventually thought to ask about this person's diet.”

It turned out that the man had subsisted on nothing but white bread and cheese for years, and his low vitamin C levels were consistent with scurvy—“the same scurvy made famous by pirates and British sailors from the 1700s,” according to Slate.

Indeed, those seafaring men often went without fruits and vegetables for long stretches in between ports of call. But, in large numbers, contemporary landlubbers are going without produce, too. Last summer, the CDC reported that 76 percent of Americans eat too little fruit, and 87 percent consume too few vegetables. According to the USDA, 14 percent of U.S. households were food-insecure at some point during 2014, meaning that they struggled to obtain varied, nutritious food for all members of a family.

These dietary problems are translating to a resurgence of a handful of preventable diseases. In the U.K., for instance, about 3 million people are malnourished, and malnutrition-related hospitalizations spiked by more than 50 percent between 2010 and 2015. Between 2014-2015, more than 100,000 patients were hospitalized with gout, another disease that’s associated with poor nutrition habits, the Telegraph reported. Gout—typically related to a buildup of uric acid due to over-consuming alcohol and rich foods—is a problem in the U.S., as well. A study published in the journal Arthritis & Rheumatism found that the prevalence of gout in the U.S. has steadily risen over the past two decades, affecting more than 8 million Americans in 2011.