A paragraph of a chapter by Trowell taken from ‘Western Disease; their emergence and prevention’, Burkitt and Trowell Ch1, page 26.
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Western Disease: Their Emergence and Prevention. Chapter 13 ‘Uganda West Nile district‘
Edward Williams and Peter Williams
Edward Williams and Peter Williams from 1941 and 1948 respectively worked at 108 bed Kuluva Hospital on the northern Uganda border. They treated 150,000 patients over 38 years. In patient and outpatients notes were kept together so providing continuous long term records.
The hospital was quite well equipped portable x-ray, ECG, specialist opthalmological instruments etc, and had an operating theatre.
“Traditional Regional Diet”
The regional diet is set out in paragraph of chapter 13. Significant changes include salt, sim-sim and cotton seed oil of East African manufacture also had come onto the market, as had sugar. In the better off refined sugar intake when available and affordable rivaled that of the west at 100g a day. For salt historically (1902 report) they used burnt reeds and water plants, rich in potassium, but low in sodium. Vegetable oil consumption was also seen in Southern India, and in Indian African populations, who generally exhibited higher incidence of Western Disease, and are a potential factor.
The setting out of disease incidence in this chapter (Western Disease Ch. 13 by E and P Edwards see above) is particularly concise and has been selected as mirroring in very general terms the reports of the increasing incidence of ‘Western Disease’ in populations including western refined foods into their diets. As earlier on the grounds this book is out of print and the information is of considerable public interest given the rising global individual and public health burdens of cardiovascular with related conditions, and diabetes, it is felt there is justification for positing this small section intact as representation of the wider content of the book; the words have much more power in their original form than if paraphrased.
It is clear that the information was based on the observations of highly experienced very professional dedicated doctors, and cannot be dismissed as the flights of fancy of the inexperienced working in an unsophisticated third world environments, which may be the initial reaction of some to the suggestion that western diseases likely have their roots in dietary changes, and were almost never seen in populations on traditional diets free of refined western products. Clearly infectious and other disease, hunger, and general living conditions meant that this was no Shangri-la but notwithstanding western diseases were rare
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Western Disease: Their Emergence and Prevention. Chapter 14 ‘Zimbabwe‘
Zimbabwe Africans’ diet and lifestyle
“The country of Rhodesia became Zimbabwe in 1980, but in this chapter the shorter terms Zimbabwe Africans ( or just Africans) and Rhodesian Europeans (or just Europeans) will be used to distinguish the two main ethnic groups before independence came to Zimbabwe. Zimbabwe Africans total at present six and a half million; two million live in the townships, four and a half million in rural areas, and one and a half million live on European farms. Comparatively few of those living in the townships are true urban dwellers, for most of them retire to their rural homes after middle-age; also during their sojourn in the urban areas there is continual movement from town to country and back again. Rhodesian Europeans number at present about half a million. Zimbabwe Africans have accepted many of the material features of Western culture, such as its dress and economic system. Western foods have come into vogue, although in both rural and urban areas traditional foods still predominate: white bread, refined sugar, jam and tea are all popular nowadays and are taken between the two main meals of lunch and dinner. These main meals consist of large portions of stiff porridge, usually made from maize
meal, and eaten with a vegetable relish and some meat or fowl occasionally. Breakfast, a modern innovation, eaten even by rural inhabitants, consists largely of tea with milk and sugar and one or two slices of white bread and jam. Salt has been in common use by Africans for a long period of time. It was commonly said that African men and women employed by Europeans, usually as cooks, were liable to indulge in rich dishes, thereby predisposing themselves to certain diseases, such as appendicitis and peptic ulcer. However, after investigating this matter closely, I am unable to prove this
association, although the figures definitely showed that urban Africans were more prone to develop both these diseases than rural Africans (Gelfand,1971).
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