IECEMBER, 1933
757
SUGAR CONSUMPTION AND DIABETES b the Editor SIR: In the present developmental stage of the preparaion of lemlose it may appear interesting to enlarge lpon the possibility of using great quantities of it so as B U ~to claim that it its hould to any large extentreplace sucrose is fantastic, o say the least. Each sugar has individual advantages in specific ases, and new uses are bound to be found for each, rs tirne advances. ~t is quite necessary to avoid urnping at conclusions from fragmentary information, lowever, regarding the replaceability of one sugar by mother. case in point is the claim that levulose A ;hould replace sucrose in human diet because diabetes las inneased in prevalence lately and there has also Ieen an increase in consumption of sucrose. Luxurious iving appears to be accompanied by a rise in the iiabetes rate, and a luxurious diet is notably higher in xotein and fat than in carbohydrate. To draw conclusions from statistics a t large is most langerous, for such information is extremely incomdete. For instance, out of 178 American cities report1ng diabetic deaths in the past year, McKeesport, Pa., shows 1.8 per 100,000 inhabitants, while Williamsport, Pa., shows 56.5 deaths per 100,000inhabitants. Is it to be concluded that people in Williamsport eat thirty as the times as much supr Or even harder working inhabitants of McKeesport? In 1913 Germany consumed only half as much sugar, per =put, as the U. S., yet had just as many deaths from diabetes. N w i f we want to find the relation between diabetes, or any other disorder, and sucrose or any other foodstuff we must obtain more individual statistics than two years ago, groups afford' Thus, an individual study of the diabetic patients in the University of California Hospital, reported by Frederick L. Hoffman, LL.D., in the Spectator for July 6, 1933, showed that of 209 males only 10.5% reported themselves as eating much sugar and of the 245 females only 6.5%; and this in spite of the fact that diabetes is much more prevalent among females than males. Again, how erratic it is to suggest reversing the world's experience of the past thousand years in eating cane sugar because of some fancied difference in the assimilability of sucrose and of levulose, when the facts, as reported by Josh are that the respiratory quotient, normally 0.77, is raised 0.12 by dextrose, 0.14 by lactose, 0.18 by lemlose, and 0.21 by sucrose undsimilar experimental conditions. In those evidences of approximately similar metabolism one can find little argument for lauding one sugar or criticizing another. If one is in earnest about this matter, let him give attention to his diet as a whole, so arranging it as to embrace about 60% of carbohydrates, 30% fats, and 10% proteins. An abundance of carbohydrate is necessary to serve as food for body heat and muscular )EAR
energy, as well as to insure the proper oxidation of fats and to prevent the formation of &oxybutyric acid and the development of the dreaded acidosis. In Our Present knowledge of the subject* diabetes cannot be said to be produced by sucrose, and it certainly cannot be said that if sucrose does tend toward its incidence, levdose does not. I t is a matter to be considered in each individual case on its own merits. If one finds, on examination, he is predisposed to diabetes he should certainly follow his diet as scientifically as possible, being careful to work out his individually needed ratio of carbohydrates to fats, for this will vary with each individual. But for the population a t large to throw overboard a leading article of diet, used through the centuries, just through fear of its connection with a disorder that increases with obesity is little short of ridiculous. Some people might as well change their religious affiliations because diabetes is found to be more prevalent in one sect than in others or some might as well refuse to be female because that sex is more susceptible than the Other. W. D. HORNE,Consulting Chemist CnsEK, PA
* * * * * * T~ the ~ d i ~ ~ ~ D~~~ sIR: After reading Dr. Horne,s criticism and re-reading on l e d o s e * which he found the section of our most disturbing (the diabetes section) we hd few, if any, points which seem to require defense. statements, while good, appear to be directed at his om conclusions and not ours. We cannot agree with Dr. Home's opinion that our story is fantastic, Some years ago the suggestion that corn sugar should become an important sweetening agent was similarly received, yet in 1933 the production of this commodity has reached tremendous proportions~ We are not physicians and do not feel qualified to debate the diabetic question. As laymen, however, we have enjoyed reading most of the several hundred articles in the medical journals concerning the use of levulose by diabetics. Anyone who has read these study papers will appreciate our statement that of the metabolism of tlw three major sugars becomes a challenge to the medical profession." We mentioned the subject in our paper to call attention to the disagreement and to arouse comment, which we hoped constructive scient&c study. We therefore appreciate Dr. Home,s statement of his personal opinions and invite others to comment. Permit us to repeat our belief that levulose is destined to take its place along with cane, beet, and corn sugar in the nation,s food supply. JAMES H. MCGLUMPW IOWA STATE COLLEGE JACK W.EICHXNGER, JR. -AMES,IOWA J. CEEM.Eonc.. 10, 453-63 (Aug.. 1933).
