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Good Calories, Bad Calories > Chapter Six DIABETES AND THE CARBOHYDRATE HYPOTHESIS > Flashcards

Chapter Six DIABETES AND THE CARBOHYDRATE HYPOTHESIS Flashcards

1
Q

What is the general attitude of the medical profession regarding sugar’s role in diabetes?

A

Doubtful or negative regarding statements in words, but affirmative in practice.

This indicates a discrepancy between theoretical beliefs and clinical practices.

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2
Q

According to Garfield Duncan, how should carbohydrates be consumed?

A

In starchy forms: fruits, vegetables, and cereals for slower absorption and minimal functional strain.

This suggests that the form of carbohydrate affects its impact on health.

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3
Q

What is glycosuria?

A

A condition where glucose accumulates in the bloodstream and spills over into the urine.

It is a significant symptom of diabetes, often associated with a sweet-smelling urine.

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4
Q

What did Hindu physicians suggest about diabetes two thousand years ago?

A

It was a disease of the rich caused by indulgence in sugar.

This reflects historical beliefs linking wealth and diet to health outcomes.

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5
Q

What role does the pancreas play in diabetes?

A

It is responsible for regulating blood sugar levels and insulin secretion.

Understanding this role is crucial for explaining diabetes pathology.

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6
Q

What was discovered about insulin in the 1920s?

A

Insulin is essential for the utilization of carbohydrates for energy.

This discovery changed the treatment landscape for diabetes.

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7
Q

What did Frederick Allen argue regarding excessive sugar consumption?

A

It may weaken the assimilative power of individuals susceptible to diabetes.

This highlights the relationship between diet and the body’s ability to manage glucose.

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8
Q

According to the text, how does the digestion of carbohydrates affect diabetes?

A

Slower digestion (e.g., unrefined carbohydrates) reduces strain on the pancreas.

This implies dietary choices can impact diabetes risk.

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9
Q

What was the incidence of diabetes among Bengali gentlemen compared to British officials in India?

A

10 percent of Bengali gentlemen were diabetic; only .01 percent among British officials.

This suggests a link between lifestyle, diet, and diabetes prevalence.

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10
Q

What change occurred in diabetes incidence rates during World War I?

A

Diabetes rates dropped during food shortages or rationing.

This indicates a connection between food availability, diet, and diabetes.

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11
Q

What did Elliott Joslin believe regarding sugar consumption and diabetes?

A

He refused to believe sugar consumption was responsible for the rise in diabetes.

His stance influenced diabetes treatment paradigms for decades.

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12
Q

What did Harold Himsworth contribute to diabetes research?

A

Differentiated between juvenile (Type 1) and non-insulin-dependent (Type 2) diabetes.

This distinction is crucial for understanding diabetes types and treatments.

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13
Q

What was the relationship between fat consumption and diabetes, according to Himsworth?

A

He believed that a higher fat diet caused diabetes due to patient eating habits.

This perspective contrasts with the idea that sugar is the primary culprit.

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14
Q

True or False: Joslin believed that all carbohydrates, including sugar, were equivalent in their effects on diabetes.

A

True.

This belief shaped his approach to diabetes treatment and dietary recommendations.

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15
Q

Fill in the blank: The glucose that accumulates in diabetes is also referred to as _______.

A

serum glucose.

This term is used interchangeably with blood sugar.

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16
Q

What proportion of fat consumption did Himsworth find correlated with diabetes mortality rates?

A

Higher fat consumption correlated with higher diabetes mortality rates

Himsworth noted that diabetic mortality rates were high in countries with high fat and low carbohydrate diets.

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17
Q

What was Himsworth’s view on the diet of populations that experienced a rise in diabetes after moving to urban environments?

A

Their original diets were fat-poor and carbohydrate-rich, becoming higher in fat after urbanization

Himsworth suggested that the dietary changes correlated with the rise in diabetes incidence.

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18
Q

What did Himsworth conclude about the diet of the Masai regarding diabetes?

A

He considered the evidence about the Masai diet insufficient to draw conclusions about diabetes

Himsworth acknowledged that the Masai had a high-fat diet but deemed the evidence too scanty.

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19
Q

How did Himsworth explain the absence of diabetes among the Inuit?

A

He suggested they did not actually eat high-fat diets, despite reports to the contrary

Himsworth cited journal articles to support his claim about the Inuit’s fat consumption.

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20
Q

What was the primary focus of Joslin’s textbook regarding sugar and refined carbohydrates in diabetes over editions?

A

The role of sugar and refined carbohydrates diminished significantly in later editions

In the 1971 edition, the subject had vanished entirely.

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21
Q

What paradox did Himsworth acknowledge about his fat hypothesis in diabetes?

A

Fat consumption has no negative influence on glucose metabolism, yet diabetes incidence is correlated with fat intake

Himsworth noted that other variables might also play a role.

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22
Q

Which Israeli diabetologist reported on the role of sugar in diabetes among immigrant populations?

A

Aharon Cohen

Cohen studied diabetes incidence among Yemenite Jews in Israel.

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23
Q

What significant difference did Cohen find in diabetes incidence between two groups of Yemenite Jews?

A

Only three cases of diabetes among those who immigrated in 1949 compared to a higher incidence in earlier arrivals

This indicated a potential link to sugar consumption.

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24
Q

What staple foods contributed to the high incidence of diabetes among the Maori population studied by Ian Prior?

A

Bread, flour, sugar, potatoes, and processed foods

The Maori diet included high amounts of sugar and processed foods.

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25
What was George Campbell's observation regarding the diabetes incidence among urban Zulus compared to rural Zulus?
Urban Zulus had a high incidence of diabetes, while rural Zulus had none ## Footnote Campbell noted the stark difference in diets and sugar consumption between the two groups.
26
What hypothesis did Campbell propose regarding sugar consumption and diabetes among Natal Indians?
Sugar was the obvious suspect for the high incidence of diabetes ## Footnote The per-capita sugar consumption among Natal Indians was significantly higher than in India.
27
What role did Campbell attribute to the physical activity of sugarcane cutters regarding diabetes?
Their high physical activity might mitigate the effects of excessive sugar consumption ## Footnote Campbell suggested that burning sugar as fuel could prevent diabetes.
28
Fill in the blank: Himsworth's strongest argument was based on the _______ comparison.
Japanese/American ## Footnote This comparison was used to discuss dietary influences on diabetes.
29
True or False: Himsworth believed that variations in sugar and white flour consumption could explain his findings on diabetes.
True ## Footnote Himsworth acknowledged that these factors could explain trends he observed.
30
What did Campbell find regarding the sugar consumption of urban versus rural Zulus in terms of diabetes prevalence?
Urban Zulus consumed significantly more sugar than rural Zulus, correlating with diabetes prevalence ## Footnote The difference in sugar intake was stark, with urban Zulus consuming almost ninety pounds annually.
31
What was the estimated sugar consumption among Natal Indians compared to that in India?
Nearly eighty pounds for Natal Indians versus twelve pounds for Indians in India ## Footnote This disparity highlighted the impact of sugar on diabetes incidence.
32
What did Campbell observe about the timeline for diabetes to manifest in populations after urbanization?
A peak 'incubation period' of 18 to 22 years after moving to urban areas ## Footnote This suggested that diabetes develops over time with increased sugar consumption.
33
What did Campbell find regarding the period of exposure to town life before rural Zulus developed diabetes?
The peak 'incubation period' lay between 18 and 22 years.
34
How much sugar consumption is suggested to be necessary for a diabetes epidemic according to Campbell?
Greater than seventy pounds per person each year.
35
Who is recognized as the first diabetologist to propose an incubation period for diabetes?
Campbell.
36
What was Joslin's belief about the cause of diabetes in relation to sugar consumption?
He believed that sugar consumption could cause diabetes quickly, even in a single night of acute excess.
37
What did Cleave and Campbell argue in their book 'Diabetes, Coronary Thrombosis and the Saccharine Disease'?
All common chronic diseases of Western societies are manifestations of a single primary disorder called 'refined-carbohydrate disease.'
38
What is the meaning of 'saccharine' in the context of Cleave and Campbell's work?
'Saccharine' means 'related to sugar.'
39
What was Sir Richard Doll's view on Cleave’s research?
His ideas deserved more attention than they received.
40
What was the primary obstacle to the acceptance of Cleave's work?
He was considered an outsider with no recognizable pedigree.
41
What experience influenced Cleave's understanding of chronic diseases?
His experiences in British naval hospitals and his brother's imprisonment during the war.
42
What was Cleave's theory regarding the cause of chronic diseases?
The addition of sugar, flour, and white rice to traditional diets was linked to the emergence of chronic diseases.
43
How did Cleave relate dental cavities to chronic diseases?
He considered cavities the chronic-disease equivalent of the canary in the mine.
44
What did the Law of Adaptation propose?
Species require an adequate period for adaptation to any unnatural feature in the environment.
45
What are the three ways Cleave believed refined carbohydrates do damage?
* Overconsumption due to appetite deception * Removal of protein from original products * Increased rate of digestion of carbohydrates.
46
What did Cleave and Campbell argue was overlooked in dietary studies related to disease?
The distinction between natural carbohydrates and refined carbohydrates.
47
What fundamental flaw did Cleave identify in nutrition and chronic-disease epidemiology?
The conflation of refined carbohydrates with natural carbohydrate sources.
48
What trend in American diet did Cleave identify regarding sugar consumption?
Sugar consumption increased dramatically from the mid-nineteenth century onward.
49
What did Keys fail to consider when linking low-fat diets to low heart disease rates in Japan?
He did not account for sugar consumption.
50
What was the sugar consumption in the Cretan diet according to the Seven Countries Study?
Only sixteen pounds a year of sugar, honey, pastries, and ice cream.
51
What was the major dietary difference noted in the diets of populations with low chronic disease incidence?
Minimal quantities of sugar and absence of white flour.
52
What was the misconception in cancer research regarding dietary fat and carbohydrates?
The lack of concern for health-related differences between refined and unrefined carbohydrates.
53
What are the reported benefits of the Mediterranean diet attributed to?
Fish, olive oil, and vegetables consumed, minimal quantities of sugar, and absence of white flour ## Footnote The Mediterranean diet emphasizes whole foods and healthy fats.
54
What did cancer epidemiologists compare to conclude that dietary fat caused cancer?
Carbohydrate, protein, and fat contents of diets in different countries with mortality from various cancers ## Footnote This approach failed to consider sugar consumption and refined carbohydrates.
55
What did Richard Doll and Bruce Armstrong note in their 1975 analysis of diet and cancer?
The higher the sugar intake in different nations, the higher the incidence of and mortality from various cancers ## Footnote This included cancers of the colon, rectum, breast, ovary, uterus, prostate, kidney, nervous system, and testicles.
56
What did the 1997 report by the World Cancer Research Fund and the American Institute for Cancer Research say about starch refinement?
The degree of starch refinement may be an important factor in cancer risk, particularly with high starch intake ## Footnote Epidemiological studies generally did not distinguish between refined and unrefined starches.
57
What complicates the testing of Cleave's saccharine-disease hypothesis?
It is impossible to test without a randomized controlled trial ## Footnote Factors like sugar consumption, flour type, and alcohol consumption must be considered.
58
Who was John Yudkin and what was his stance on sugar?
A prominent figure in nutrition research who advocated for a very low-carbohydrate diet, believing sugar was the worst dietary offender ## Footnote He founded the first dedicated department of nutrition in Europe.
59
What was Yudkin's criticism of Keys' dietary-fat hypothesis?
He argued that many factors correlate with heart-disease deaths, including sugar consumption ## Footnote Yudkin focused on developed nations and believed sugar was the fundamental problem.
60
What did Yudkin's experiments on animals and college students reveal?
High sugar diets raised cholesterol, triglycerides, and insulin levels ## Footnote Sticky blood cells could explain blood clots leading to heart attacks.
61
What obstacle did Yudkin face in the acceptance of his hypothesis in the 1970s?
The dominance of Keys's dietary-fat hypothesis ## Footnote The European research community was more open-minded compared to the U.S.
62
What was the outcome for Yudkin's hypothesis after his retirement?
His hypothesis effectively retired with him and was not embraced by the medical-research community ## Footnote His successor promoted Keys's fat theory of heart disease.
63
What was the title of Yudkin's book published in 1972?
Pure, White and Deadly ## Footnote This book did not lead to increased acceptance of his theories.
64
What did Sheldon Reiser say about discussing sugar's effects on health in the late 1970s?
To speak negatively about sugar was to endanger your reputation ## Footnote Yudkin was ridiculed, leading to a stigma around discussing sugar.
65
What did C. P. Donnison observe about diabetes in native populations?
Diabetes was rarely seen in local native populations, increasing with civilization influence ## Footnote This observation was based on British Colonial Office medical reports.
66
What did the 1946 edition of Joslin's textbook mention about diabetes?
It noted that certain patients developed diabetes after increasing sugar intake ## Footnote This highlights the potential link between sugar consumption and diabetes.
67
What major change occurred in diabetes management after World War II?
Improved control due to the introduction of penicillin and standard insulin syringes ## Footnote This led to better treatment outcomes for diabetic patients.
68
What was the relationship between animal fat consumption and total fat consumption in the U.S. during the period discussed?
Total fat consumption increased while animal fat consumption decreased ## Footnote This was attributed to a rise in vegetable fat consumption.
69
What plausible biological mechanism is suggested for refined carbohydrates and sugars concerning cancer?
Refined carbohydrates and sugars could cause or exacerbate cancer ## Footnote This topic is explored in Chapter 13 of the source material.

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