McCarrison Society

Health Through Nutrition, A Birthright

Diabetes: A Western Dietary Related Disease.

Diabetes whilst identified, was rare in those on pre-industrialised diets. (See Donnison table page 11 and 13,14,15 Other sources on western disease on non western-groups ) It appears to be a disease of ‘urbanisation so civilisation’ also called ‘Western Diseases”. Donnison also notes the figures shown, even though low, are likely higher than seen in the general indigenous population, presumably due to access by some to western foods.Whilst there is often focus on carbohydrates and particularly simple sugars in relation to diabetes 2, it arguably has multi-factoral origins, including in addition to carbohydrate related causes, imbalances in lipid and antioxidant pathways, and dysfunction in the energy pathways, which will be outlined part by part below in due course.

Rising diabetes levels

“8.5% of adults worldwide has diabetes” – BBC news” 6th April 2016

Trowell – In 1933 many Doctors in Kenya had never before seen diabetes in an African

From Western Disease; their emergence and prevention. Burkitt and Trowell Ch1, page 22. Edward Arnold
Diabetes ch1 Western Disease jpg

Cleave and diabetes

Cleave’s book The Saccharine Disease, chapter 7 “On the Causation of Diabetes” is available on line free
(Link) and  starts Times New Roman,Georgia,Times; On the Causation of Diabetes

Preliminary Considerations

SOME twenty years ago, that is, in 1955, if the incidence of diabetes was being related to the consumption of any particular class of foodstuff, it was being related to the consumption of fats. This was largely due to a paper by H. Himsworth (1949), [1] who showed that during the 1939-45 war, when the diabetes mortality fell steeply in all the countries that experienced food-rationing, the only class of foodstuff to show a coincident fall in consumption was the fats; the carbohydrates and proteins showed an actual rise. After demonstrating this relationship, Himsworth continued: ‘There is a mass of evidence with similar import. The progressive rise in diabetic mortality in Western countries during the last fifty years coincides with a gradual change towards higher fat and lower carbohydrate diets; the protein and caloric values have altered little… But that is not to say that fat is the deleterious factor; it may simply serve as an indicator of other and more important contingent variables.” (Link)

Thought provoking indeed. (I have almost fortutioulsy found a copy of Himsworth’s paper by after much searching in libraries including the British Library, which paper I will post in due course. Himsworth position was more nuanced, at least in later years than Cleaves then summary suggests – more information available today would suggests there were merits in both arguments in that both particular fats and refined carbohydrates, with other declines in dietary quality arguably factor in development of diabetes.) Arguably fats and particularly Omega 6 linoleic acid and its oxidised products in excess, and in the context of a ‘western’ diet, are co-factors in Diabetes 2, as are refined foods rather than just carbohydrate intake.

This is Himsworth’s graph as reproduced in Ch.7 of “The Saccharine Disease”, which is taken direct from his book so better quality than in the Small Farms Library version.

It helps separate out the effect of carbohydrates from refined carbohydrates including sugar. The thought provoking graph below of diabetes incidence over a longer time frame representing Himsworth data and adding two more years was produced by Cleave.

As well as sugar intake falling, net refined flour intake also fell; the amount of bran in flour was increased; given the hazards of shipping grain in WWII it was considered unacceptably wasteful not to use as much of the imported grain as pragmatically possible to feed people.

Sugar consumption superimposed on diabetes mortality figures

Cleave notes in “The Saccharine Disease” ch.7 cleave_ch7 diabetes was lower in peoples living on traditional diets with low sugar intake “<em>a very high incidence of the disease in a large number of the descendants of past immigrants from India (the ‘Natal Indians’ numbering some 400,000 persons) and, on the other hand, a very low incidence of the disease in native Africans, of the Zulu tribe, still living in the tribal manner on unrefined carbohydrates (largely maize). These incidences of diabetes were matched with studies in sugar consumption, which in the Natal Indians is very high, but which in the tribal Zulus has always been very low, though in recent years there has been a spectacular rise (for example, from 6 lb. per head per year in 1953 to 60 lb. in 1964)” . . .</em> In northern India “diabetes<em> is rarely seen there amongst the country-dwellers living on these unrefined foods, the admission rate for diabetes at the latter hospital, for example, during 1957-71 averaging only 1 case per 1000 admissions.” . . . </em>but is higher in Southern India where sugar intake was higher, and it is reported elsewhere that they have a higher vegetable oil in take

In relation to vegetable oils, further and interestingly “Dr. Campbell’s studies also showed that the fat consumption in the Natal Indians mainly consisted, not of animal fats, but of vegetable oils, largely unsaturated, and yet the incidence of coronary disease in these people is almost as striking as the incidence of diabetes.”

Cleave states “diabetes itself — which, starting around the middle of the nineteenth century (In Britain), progressed to such an extent that the disease, from being twenty-seventh in the list of causes of death in the statistics of the Metropolitan Life Insurance Company in 1900, became the third commonest cause by 1950.”(Link)

Highly refined very fine ground flour consumption started in the 1870s with the invention of the steel roller mill, and vegetable oil consumption rose with the extraction of cotton seed oil to produce polyunsaturated oil based margarines and related products. Those born around 1870 would have been reaching their 60s and 70s in 1930-40, the ages in which cardiovascular conditions at that time were manifesting

Refined sugar v sugar cane consumption

Cleave also notes “of the utmost importance, is that the Zulu and Pondo cane-cutters in Natal, who have always been allowed to chew as much sugar-cane as they please, have been shown to be singularly free from diabetes — indeed in over 2000 of these cane-cutters tested by Dr. Campbell [7] and his colleagues, all that has been found is a trace of sugar in the urine in 3 of them, which supports the contention that the consumption of unrefined carbohydrates is as harmless as that of refined carbohydrates is dangerous, assuming the former are eaten by the indigenous inhabitants.” (Link)

Cleave reports s similar lack of diabetes among cane sugar workers applying for work in Panama in 1924 was noted by F G Banting co-discoverer of insulin.

Ability of a high fibre diet in some to ameliorate diabetes and reduce insulin need

Diabetes Mellitus. – James Anderson
This short abstract from a chapter in “Western Diseases – Their emergence and prevention” by Trowell and Burkitt on Diabetes titled “Diabetes mellitus” (Link) by James Anderson looking at the impact of high fibre diets and their ability on some to significantly reduce or even remove need for insulin is particularly thought provoking as is much of the book’s contents.

Diabetes James Anderson graph 1 Diabetes James Anderson graph 2

Download (PDF, 626KB)

Sadly the dietary details are not specified; a high fibre diet may have meant more than the addition of bran. Clearly the sort of pre western  diets eaten by those in Africa and elsewhere in the early 1900s and where diabetes  was virtually never seen by then doctors, were rounded and high in fibre, and not comparable to the addition of singly sources of highly process fibre to highly processed nutrient depleted diets.

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