Health Statistics

Diabetes Deaths Rise as Sugar Sales Grow

City Health Department Reports Fatalities Up 50% for Men and 150% for Women in 30 Years.

Increased consumption of sugar is given as a probable explanation of the increased death rate from diabetes during the last thirty years, in a bulletin issued by the New York City Health Department yesterday. According to the bulletin, the diabetes death rate has increased 50 per cent for men during that period, and 150 per cent for women.

"Hand in hand with this has been a corresponding increase in the per capita consumption of sugar," the bulletin continues, "so that it appears probable that we, especially the ladies, are overtaking our bodies with too much sugar."

The average number of deaths per year for the five-year period ended with 1902 is given as 395. Averages for successive five-year periods from then to the present are given as follows: 

1902-1907, 588;

1907-1912, 748;

1912-1917, 1,049;

1917-1922, 1,122;

1922-1927, 1,359;

The suggestion that women particularly are eating more sweets gained added interest by its contrast to conclusions drawn in London following the drop of the cocoa market. Recent dispatches gave the explanation that cigarettes have leargely displaced candy in the diet of young women, thus diminishing the demand for cocoa. But in this country, it would seem from the Health Department's view, sugar has not been similarly affected.

by J. B. Orr and J. L. Gilks

 - IV.-SUMMARY OF RESULTS. Preliminary observations and a review of existing information suggested that disease is more prevalent amongst native races than is generally supposed, and indicated that the incidence of certain diseases might be correlated with diet. A survey of two tribes, the Masai and Akikuyu, showed that the diet of the former consisted to a large extent of milk, meat and raw blood, and that of the latter mainly of cereals, roots and fruits, the bulk of the diet being cereals. The outstanding points of difference in chemical composition of the two diets were that the Masai have a relatively very high intake of protein, fat and calcium, while the Kikuyu have a high intake of carbohydrate and a low one of calcium. Differences were found in the dietary customs between men and women in both tribes, the diets of the females approaching in each case to the mean between the diets of the males. Physical measurements showed that the full-grown Masai male is on an average, 5 inches taller and 23 lb. heavier than the full- grown male Kikuyu, and his muscular strength, as determined by the dynamometer, is 50 per cent. greater. Marked differences were found in the incidence of disease in the two tribes, bony deformities, dental caries and anaemia, pulmonary conditions and tropical ulcer being much more prevalent amongst the Akikuyu. On the other hand, intestinal stasis and rheumatoid arthritis were more common amongst the Masai. Analyses showed that routine Hospital and Prison diets are markedly deficient in calcium, the average daily intake being only about 0.3 gm. Ca, as compared with the assessed requirement of about 1 gm. Examination of the blood of Kikuyu and other natives on a similar dietary showed that the concentration of calcium was lower than the European standard, the average of 90 cases, prisoners and farm labourers (not pathological) being 9.4 mg. per 100 c.c. serum, as compared with 10-0 to 10.5 mg. in Europeans at home, and 11.4 mg. in 13 Europeans in Kenya. The range of variation in blood calcium was wide, from 7.3 mg. to 11.2 mg., the highest figure being below the mean for Europeans in Kenya. -

It would be an interesting study to correlate diet and stature in different countries, to ascertain whether any correlation exists between the quality of the diet and mean adult stature. There are differences in the incidence of disease in the two tribes, and one of the tribes, the Akikuyu, show abnormalities in the composition of the blood. The diet of this tribe is very rich in carbohydrate, relatively rich in phosphorus, but deficient in calcium. Experimental data have been brought forward to lend support to the suggestion that deficiencies in the diet, abnormal composition of the blood and reduced susceptibility to certain diseases which have been noted in this tribe, may be correlated. The possibility that diet may influence the susceptibility to certain infectious diseases raises one of the most important problems in nutritional research. With regard to the bearing of the results of the investigation on conditions in Kenya, we are probably justified in concluding that the diet commonly in use amongst the Akikuyu and other tribes of similar customs is badly balanced, being too rich in carbohydrate and deficient in calcium. It is probably deficient also in other substances required as constructive material for growth, and in certain of the vitamins. On the other hand, the Masai, with a diet at the opposite extreme, possibly have too little vegetable food rich in carbohydrate and cellulose. Improvement might be brought about by increasing the use of green vegetables by both tribes, and of milk by the Akikuyu. The problem is therefore one which concerns not only medical and public health, but also agricultural authorities. A general improvement of agriculture and animal husbandry amongst the Akikuyu will almost certainly be accompanied by an improvement in the health and working capacity of the natives themselves. This problem is not confined to Kenya. It appears to exist in many different areas in our tropical dependencies. It may be judged from the introductory statements in the early part of this report that the loss of health and efficiency attributable to deficient diet is, therefore, of considerable economic importance.

One of the first RCMP officers to make repeated visits to the trading posts and Inuit camps on Victoria Island was Corporal G. M. Wall. In February 1932, Wall left Coppermine with two guides and traveled to Rymer Point, Read Island, Prince Albert Sound, Minto Inlet, and Walker Bay. In his report, written upon his return to Coppermine, Wall made a number of interesting observations regarding the conditions of the Inuit groups he encountered. On islands off the north shore of Minto Inlet, Wall met a large group of Inuit and reported:

This was the largest encampment visited in the country patrolled through, comprising 21 families. Some of the houses were joined together and others had passages leading off a main one to their own igloo. One native here had put up a 10 x 12 foot tent and built a snowhouse over it (RCMP Patrol Report 1932:4).

Wall's observations indicate that the large snowhouse settlements that had always been a feature of traditional Copper Inuit life that were still in use even after traders had entered the region and encouraged people to take up trapping rather than seal hunting. Wall encountered the same group the following year, this time finding fourteen families camped on the ice in the middle of Minto Inlet (RCMP Patrol Report 1933:2).

Wall offers an interesting comparison between the Prince Albert Sound people and the Copper Inuit living around Read Island and Rymer Point:

The natives on the southwest coast of Victoria Land had all done well trapping and in all the camps there was ample evidence of this. They were all well supplied with tea, sugar, biscuits, jam, etc. These natives are also getting away from the use of the seal oil lamps and although they had them they would use the primus lamps they had bought this winter, this may only be for a year as long as they can buy coal oil from the traders. The continual use of primus stoves does not tend towards cleanliness, and the houses are very dirty as was the clothing which had been purchased from the traders. The calico artigues and the men's trousers have been covered in grease and are dirty…. There was a remarkable difference in the Prince Albert Sound natives. These peoples did not have the white man's food and clothing, depending on the country for food. The houses were all clean and tidy and they were all well clothed with deer skins, only using a very little white men's clothing. All the sleds, harpoons and equipment was all of the best and in good repair, also all the dogs were in fine condition. The people themselves were all a fine healthy looking bunch and there was only one case of sickness; this was a very old woman. These natives only go into Read Island once a [year] to trade, usually at the end of April and stay on the south coast of Victoria Land three or four weeks visiting the other relatives and then return again (RCMP Patrol Report 1933:7).

Wall's comments are echoed in later reports. By and large, those Copper Inuit who were in less direct contact with white traders seemed to be healthier and better clothed than those living closer to trading posts. Wall believed that the people of Minto Inlet ranked somewhere in between the people of Prince Albert Sound and the Inuit of southwest Victoria Island, possibly due to the influence of both the westerners and the two trading posts at Walker Bay.

"The influence of the missionaries is very noticeable and at all the camps visited the natives would show me their hymn books. The Minto Inlet natives held a service while I was there which consisted of singing six hymns. They observe Sunday very closely and will not do a thing, spending most of the day singing hymns even if the camp is out of meat" (RCMP Patrol Report 1933:7).

Another observation made by Wall during his 1932 patrol is fascinating. In assessing game conditions for the regions visited, Wall notes that caribou are very scarce, and that the people subsist primarily on seal, fish, and small game. To the north of Prince Albert Sound, he notes, "the natives hunt in the summertime and get a few caribou, but live chiefly on fish." Wall continues:

The Minto Inlet natives spend the summer around the post at Walker Bay and last summer they killed about 60 caribou roughly 20 miles north of the post.

Dr. Greist's reply to my letter was to the effect that the man I asked about had not died in hospital, that there had been no post mortem, and that the cause of death was unknown. Thus it was not until 1957, some twenty-two years later, that I discovered I had failed to get the information I needed, because I had asked a loaded question and the doctor had answered me literally. I had asked whether a certain specified man had died of cancer and the answer I got was that, in this specified case, the cause of death was unknown. Meantime it was known to Dr. Greist that another Eskimo had died of cancer. From the records of his hospital it is apparent that a cancer patient died there of the disease on July 27, 1933.

Because this was the first known malignancy death in northern Alaska, occurring forty-nine years after Leavitt began his search on the north coast, I shall set down all the details of which I feel sure.

When I took up again those inquiries which led to the writing of this book, an early step was to attempt to revive my correspondence with Dr. Greist, who had resigned his medical missionary position in 1936 and retired to his Indiana home at 318 North Bluff Street, Monticello. The reply came from Mrs. Greist, for her husband had died two years before.

In a letter dated February 19, 1957, Mrs. Greist explains that she remembers nothing of a disagreement between her husband and Mr. Brower on the cause of anybody's death, and suggests that if there was such a dispute it would be outside her sphere unless the man died in hospital or unless for some reason there was s post mortem, at which, in her capacity as head nurse, she would have assisted or at least have been told about it. Then Mrs. Greist continues:

“... I do remember nursing a case of cancer of the liver of an old man who came to Barrow from far to the eastward. After a week or two he died and Dr. Greist and I held a post mortem. We were then satisfied it was cancer ...”

This was all Mrs. Greist was able to say from memory, except that northern Alaska's first identified cancer illness and death came during some year early in the 1930's. But when she learned that her testimony was intended for publication, along with other testimonies, she instituted a search and finally discovered precise dates for this case. She wrote me on August 30, 1958:

“After three days and late nights reading through three years of my diary that I kept in the North, I found what you wish to know about the cancer case. On July 27, 1933, at 7:45 A.M. Jobe passed. I have recorded the fact that Lee, Helen and I helped Dr. Greist with the autopsy. [We found] an immense cancer of the liver; we guessed the weight at 25 or 30 pounds ... Helen is dead; Lee should remember [the cancer victim's] full [Eskimo] name... Lee is head of the native store at Barrow now.”

Mrs. Greist followed up this second letter by lending me a handwritten diary dating from January 1, 1933, to December 31 of that year. Into this she has freshly written, opposite the entry for July 5: “The day Jobe came in.” The entry says: “Jobe came in with obstruction of the bowels; very bad shape.”

The diary for July 17 says: “Old Jobe much worse; going to die ... Up on duty till 4:00 A.M., did not sleep till 4:30.”

In a further recent entry Mrs. Greist indicates on the margin for July 27 that here is the crucial passage of her informal, private diary. Insofar as applicable the passage reads:

“Helen came and called me at 3:00 A.M. as she thought Jobe was passing ... but he did not die until 7:45 A.M. Both girls were very sleepy so we let them sleep ... Worked all day; cleaned some in the operating room and clinic. Helped Dr. with the autopsy on Jobe (Helen, Lee and I). An immense cancer of the liver ... it must have weighed 25 to 30 pounds. Helen and I washed and dressed Jobe for burial."

Apart from assuring me that this was the first case known to herself, or to Dr. Greist, of death from cancer by an Eskimo native from the north coast of Alaska, Mrs. Greist had little pertinent information on the case of Jobe. He was an elderly man. Whether he had worked on shipboard (thus living a good deal European style) she cannot say.

Abstract : The observations were made in Angmagssalik in 1936-1937. The natural Eskimo diet was found to provide oh the average 299 g. protein, 169 g. fat and 22 g. carbohydrate, equivalent to 2800 Cal., with 0.5 g. Ca and 2 g. P per man value. Per head the energy value of the diet was 1900 Cal. per day, and the vitamin C [ascorbic acid] intake averaged 36 mg., of which one-half was derived from marine algae. The daily vitamin A intake was judged to be about 50, 000 I: U. per head.
Influenza and pneumonia occurred, especially in the summer and autumn, after visits of ships; Colds occurred frequently but ear and sinus complications were rare. Tuberculosis seemed to have a comparatively mild course. Acne was not seen, but carbuncles and impetigo were frequent, especially in the winter. Obesity, albuminuria, goitre and chronic constipation were not seen. Arteriosclerosis was relatively common and occurred at an early age. Convulsions in children under one year were frequent. Rickets was not seen in Eskimos living on a primitive diet. Bleeding of the navel in the newborn and from the nose and lungs in adults was frequent. The visual acuity in dim light was higher in the Eskimos than in North European seamen. Basal metabolism was on the average 13 per cent. higher in the Eskimos than that prediered bythe DU Bois standard. R.Q. values lower than 0.7 were not observed in starvation experiments, hut lower values were found on diets rich in fat. Ketone bodies were not commonly found in the urine, in spite of the low carbohydrate intake, and appeared in small amounts only in starvation and on diets rich in fat. The N.P.N. and the CO2-binding capacity of the plasma were 29 mg. per 100 ml. and 60 volumes per cent., respectively. The fasting blood sugar averaged 88 mg. per 100 ml.-R. Nicolaysen (Norway).