LIVING WHITE KILLS YOU AFRIKAN

Observations by missionary doctors 100 years ago offer clues to fighting cancer and other diseases

By Mark Ellis

Nobel prize winning physician and theologian Albert Schweitzer worked at the missionary hospital he founded for more than 40 years before he saw his first case of appendicitis among the African natives. Cancer was completely unknown when he first reached the interior lowlands of West Africa in 1913.

“On my arrival in Gabon, I was astonished to encounter no cases of cancer,” Schweitzer noted. “I can not, of course, say positively that there was no cancer at all, but, like other frontier doctors, I can only say that if any cases existed they must have been quite rare.”

It is not as if Schweitzer saw few patients. In the first nine months after he set up his practice, he ministered to 2,000 patients. Over the next four decades, he saw an average of 30 to 40 patients each day and performed three operations a week. By the 1930s, he began to see the first cancer cases emerge, and formed his own conclusions.

“My observations inclined me to attribute this to the fact that the natives were living more and more after the manner of the whites,” he said.

Gary Taubes, a brilliant researcher, chronicles these historical reports from missionaries and other doctors on the frontiers of medicine in his book, “Good Calories, Bad Calories: fats, carbs, and the controversial science of diet and health.” (Anchor Books) Taubes convincingly demonstrates that diseases common to Western civilization emerged in native populations after they adopted a Western diet.

“The absence of cancer in these populations was profound,” Taubes observes. “There’s no reason to think these missionary doctors were not smart enough to know what they were seeing,” he says. “You could get recognized in a British medical journal at that time if you discovered cancer in a black African.”

On the other side of the world from Dr. Schweitzer, Dr. Samuel Hutton began treating patients – primarily Eskimos — at a missionary hospital on the northern coast of Labrador in 1902. Among Eskimos isolated from European settlements, he could not find any cancer, asthma, appendicitis or other “European” diseases. Hutton discovered the Eskimo was a meat eater and the vegetable portion of his diet was practically non-existent.

Even today, in the more isolated Eskimo villages of Alaska, natives still consume about 80-90 percent of their diet from fish, seal, caribou, walrus, eggs, beaver, and other small mammals. Less than five percent of their diet comes from fruit and vegetables, according to naturalist Karen Dodd, a resident of Chugiak, Alaska.

“What both Schweitzer and Hutton had witnessed during their missionary years was a ‘nutrition transition,’ Taubes notes. “The more civilized and more westernized the population, the higher the cancer rates.”

“Through the 1960s breast cancer was virtually nonexistent in the Inuit,” he adds. The Inuit are the indigenous people who inhabit the Arctic region, which includes Alaskan Eskimos. (The Inuit of the Canadian arctic consider Eskimo a pejorative term.)

Taubes also relates the observations of Hugh Trowell, who spent 30 years as a missionary doctor in Kenya and Uganda, beginning in 1929. When Trowell first arrived in Kenya, he noticed the Kenyans were as thin as “ancient Egyptians,” yet when he dined with them they always ate their fill and had leftovers they gave to their domestic animals.

By the 1950s, fat Africans were a more common sight, and in 1956, Trowell diagnosed his first case of coronary heart disease in a native East African, but this was someone who consumed a Western diet for 20 years.

Trowell left East Africa and returned in 1970 to find an amazing spectacle: the towns were full of obese Africans and there was a large diabetic clinic in every city.

After examining 150 years of records and medical research, Taubes believes it is essential to remove sugar, white flour products, and other refined carbohydrates to maintain a healthful diet and avoid diseases such as cancer, heart disease, Alzheimer’s, diabetes, gout, appendicitis, and a host of other chronic diseases.

“There is a relationship between insulin and cancer,” he notes. “What you want to do is keep insulin levels as low as possible.” Taubes rejects the vegan approach to diet and health; his recommended diet very closely resembles the Atkins diet.

“The one nutrient that doesn’t stimulate insulin secretion is fat,” he says. “The best way to keep insulin low is to switch to a diet that is mostly fat, an animal products diet – that’s the Atkins diet.” The Atkins diet is a low carbohydrate diet created by Dr. Robert Atkins, based on his bestselling book launched in 1972.

A leading researcher at one of the Harvard cancer research centers recently told Taubes he had switched to an Atkins diet as a preventative diet for cancer. Another leading figure at the Memorial Sloan Kettering Cancer Center who has done research on insulin, blood sugar, and cancer also switched to the low-carb diet “because he doesn’t want to get cancer.”

The researcher told Taubes he had to keep his somewhat controversial dietary choices quiet at Sloan Kettering because it might be perceived as food faddism. “It’s not hard to get people to agree that sugar and refined carbohydrates are harmful,” Taubes says. “But getting people to accept that saturated fat is good for them sounds like quackery.”

Recently, studies have demonstrated that low levels of insulin inhaled in a nasal spray reversed or halted the progress of Alzheimer’s disease in a study group. Some have even suggested that Alzheimer’s may be a form of diabetes in the brain.

“When you have high levels of insulin in the blood, such as when you have diabetes or eat a high carbohydrate diet, you get low levels in the brain,” Taubes notes. He says the link between sugar and Alzheimer’s is probably there, but the mechanism is not completely understood.

Still, mining the historical records of missionary doctors and others on the frontiers of medicine more than a century ago may help untangle the mysteries of our deepest health concerns today.

Cancer: A Disease of Civilization? – Part I

Sunday, 21 July 2002

Is cancer a disease of civilization? Is it related to other diseases that seem to increase with industrialization? If so, what are the implications for readers living in the 21st century? Back in the 19th century, many of the diseases that now plague us were rare. Diabetes was twenty-seventh on the list of causes of death in the statistics of the Metropolitan Life Insurance Company in 1900. By 1950 it had become the third leading cause of death. The famous surgeon Alton Ochsner, MD, once related that, when he was in medical school in the early 20th century, one of his professors took his class to see the autopsy of a patient who had died of lung cancer. The disease was so rare at that time that his professor feared they might never see another such instance! Obesity was the subject of circus displays, not an everyday occurrence. In fact, until the mid-1800s, cancer was relatively rare and was not considered statistically important. This was particularly true outside of the major cities. Then, in the mid-19th century, cancer began its stratospheric rise. Around the same time, well-trained medical personnel began to travel and even to live among indigenous peoples (the so-called "natives"). The news they brought back was startling. These diverse populations, many of whom lived a hand-to-mouth existence, were generally much healthier than their Western counterparts. True, they had a high infant mortality rate and easily succumbed to epidemics that originated in the West such as measles, smallpox and tuberculosis. But they had far less asthma, allergies, indigestion, and heart disease. The same disparity in health was seen between rural and urban populations in Europe. The French or English farmer was much less likely to develop cancer than the cosmopolite of Paris or London. And despite the stereotypical image of Eskimos and South Sea islanders as roly-poly, obesity was extremely rare among such people. Most startling of all, cancer seemed nonexistent. In 1843, a French surgeon, Stanislas Tanchou, MD, formulated this observation into "Tanchou's Doctrine": the incidence of cancer increases in direct proportion to the "civilization" of a nation and its people. This doctrine was embraced by John Le Conte, MD (1818-1891), first president of the University of California, and his enthusiasm led medical missionaries, ship surgeons, anthropologists and others to undertake an avid search for cancer among the Alaskan Eskimo (Inuit), northern Athapaskans of Canada and the native peoples of Labrador. The result was always the same: For 75 years, not a single case of cancer was documented among the tens of thousands of such people studied by competent medical examiners. The Harvard-trained anthropologist, Vilhjalmur Stefannson, for instance, lived for 11 years among the Eskimo and never saw a case. In later life, he wrote a book on the topic, Cancer: A Disease of Civilization? Unfortunately, whatever protection these native populations had against cancer was lost when they began to adopt Western ways in the 1920s. By the early 1930s, cases of cancer were being documented in Alaska and Canada. On July 27, 1933, an Eskimo named Jobe died of liver cancer at the Farthest North Hospital in Alaska. Similarly, in 1935, Michael Nochasak, an Eskimo, died of colon cancer in Labrador. After that, the rates of cancer among these native peoples underwent a steady rise, until they began to rival that of the white population. Evidence from Africa and Asia Similar stories are told about the indigenous peoples of Africa and Asia. Albert Schweitzer, MD, the famous Nobel laureate, testified as follows: "On my arrival in Gabon, in 1913, I was astonished to encounter no case of cancer...I cannot, of course, say positively that there was no cancer at all, but, like other frontier doctors, I can only say that if any cases existed they must have been quite rare. The absence of cancer seemed to me due to the difference in nutrition of the natives as compared with the Europeans... "In the course of the years, we have seen cases of cancer in growing numbers in our region. My observations incline me to attribute this to the fact that the natives were living more and more after the manner of the whites...I have naturally been interested in any research tracing the occurrence of cancer to some defect in our mode of nutrition." The Hunza people, who live in a remote valley of the Himalayas, in the territory of Kashmir, provide further evidence of the rarity of cancer among indigenous populations. The Hunza were the subject of study from the 1910s onward by a number of diligent observers, including Sir Robert McCarrison, Major General in the Indian Health Service (1878-1960). McCarrison's seven years of careful scrutiny led him to conclude that there was little if any cancer among this population. It might be objected that cancer is an "occult" disease, difficult to diagnose, and that for this reason it may have eluded early observers. I do not believe this to be the case. At least one-quarter of all cancers are external in nature. Basal and squamous cell carcinomas, tumors of the head and neck region, breast cancer and those of the external genitals, to name but a few, are all readily apparent and do not take great diagnostic skills to detect. Breast cancers in particular were well known and described even by ancient physicians. Other cancers also form noticeable lumps or break to the surface. Besides, we are not talking about medieval medicine. By the late nineteenth and early twentieth centuries cancer pathology had taken great strides. Such works as James Ewing's Neoplastic Diseases, which was first published in 1920, demonstrate the sophistication of cancer science at that time. Frontier doctors were, by and large, competent, serious and well-trained. I don't think there is any doubt that if cancer had been widespread, they would have found it. I can only conclude that cancer is indeed a disease of industrial society.

Cancer: A Disease of Civilization? - Part II
Sunday, 28 July 2002
Even today, we find huge disparities in the incidence of cancer worldwide, with increased rates seemingly tied to the adoption of a refined diet and other harmful habits. Hungary, for instance, has a cancer death rate of 272.2 per 100,000 (men) and 138.4 per 100,000 (women). Contrast this with Mexico, where the death rate among men is 85.0 and among women 78.9 per 100,000. "Civilization" is not only a chauvinistic term but is such an all-encompassing concept that it is difficult to pinpoint exactly what aspects of it have contributed to the dramatic rise of cancer in the last century. Certainly tobacco has been a major culprit. Hungary has the highest rate of lung cancer in the world. I have visited that country four times and always came away shocked at the amount of smoking. On one trip I visited a number of famous medical facilities and never did my hosts fail to offer me cigarettes. When I met with one of the country's highest ranking scientists, he nonchalantly chain-smoked throughout the entire meeting. After the fall of Communism, downtown Budapest became plastered with ads for American cigarettes. Philip Morris, makers of Marlboro, sponsored televised rock concerts and young women in Marlboro suits dispensed free samples of Marlboro cigarettes. Concertgoers who agreed to smoke the cigarettes received a complimentary pair of "designer Marlboro sunglasses." There is no doubt that smoking has played a role in the rising rates of cancer. However, an overwhelming body of evidence points to drastic changes in diet as the primary explanation for the increase in cancer. Indigenous people of regions across the globe seem protected so long as they eat the diet that their ancestors ate for millennia. But once they adopt Western dietary habits, cancer appears and then begins its inexorable climb towards the same astronomical heights as are seen in the societies they emulate. Some scholars who studied vegetarian cultures have concluded that it was the high fruit and vegetable content that kept these native peoples from getting cancer. Conversely, some researchers who focused on northern populations in which meat was prominent have advocated a meat-based diet for cancer protection. Others have ascribed the healthfulness, longevity and lack of cancer in indigenous populations to the intake of specific nutrients (such as the "laetrile" found in such abundance in apricot kernels, a staple of the Hunza diet). But no single, simplistic answer will fit these tremendously varied cultures. In my opinion, what these diverse populations ate is much less important than what they did not eat (at least until recently): "white" foods, specifically white sugar, white flour, and salt. The addition of these foods to their diet was disastrous to their health, as it has been to ours. White sugar and white flour are especially harmful, because these "high glycemic" foods are quickly absorbed into the bloodstream, where they wreak havoc with the regulation of insulin and blood sugar levels. This is a major factor in increasing rates of type 2 diabetes and obesity. Unfortunately, white sugar, white flour, and refined sweeteners are ubiquitous in the Western diet. They are found in sodas and other sweet drinks, breads and snack foods, beer and ice cream, you name it. But even "natural" forms of carbohydrates may not be as innocent as once thought. Whole wheat flour, potatoes, and other seemingly healthy foods also have a high glycemic index and may not be safe to consume in anything except small quantities. Atkins Vindicated Robert Atkins, MD, has been preaching against a high-carbohydrate diet for 30 years, much to the chagrin of the medical establishment. A recent cover story in the New York Times Magazine (7/7/02) vindicated the low-carbohydrate, high-protein and high-fat diet advocated by Atkins, citing a growing body of research which suggests that a diet of carbohydrate-rich foods is no guarantee of good health, let alone weight loss. In fact, as the American public has increased its consumption of carbohydrates and decreased its consumption of fatty meat, obesity rates have skyrocketed. In 1998, more than 50 percent of adults in the US were overweight. Obesity and type II diabetes among American children have also increased. At the same time, levels of physical activity have declined, further contributing to soaring rates of obesity and obesity-related illnesses in the US. The list of diseases linked to obesity is a lengthy one. According to the American Cancer Society, obesity contributes to hypertension, lipid disorders, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems. And as body mass index goes up, rates of cancer also increase, by as much as 80 percent in women. The Key to Cancer Prevention It seems clear to me that cancer was not a major medical problem in recorded history until the last 150 years. And even today, populations that eat an indigenous diet rarely, if ever, get cancer. (Unfortunately, such populations are exceedingly scarce in this century.) However, in reviewing the evidence from these cultures as well as our own, the key issue for cancer prevention does not seem to be whether the diet is vegetarian or meat-eating, or whether it contains high quantities of fat and protein. The single most drastic change in the Western diet, which has occurred simultaneously with rising rates of cancer among those who consume it, has been the cheap availability of white flour, white sugar, and refined sweeteners such as corn syrup, as well as their inclusion in just about every food in the marketplace. The key to cancer prevention may turn out to be avoidance of the same foods that make your blood sugar run wild and that cause a plethora of other illnesses. --Ralph W. Moss, Ph.D.