Keeble McFarlane

According to the Psalms, human beings are destined to last about three-quarters of a century - the proverbial three-score years and ten. For a long time, in most parts of the world, that was a distant figure, as the life of the ordinary person was, to use the words of the celebrated English philosopher, Thomas Hobbes, "solitary, poor, nasty, brutish and short". People had to contend with the forces of nature; the possibility of attack by hungry beasts or other people; infection by virulent bacteria, fungi and viruses; as well as the general effects of wear and tear by the daily grind of hunting and gathering food, and later, the coaxing of such food from the ground and from other animals.

Knowledge of how the body functions came slowly and at a high price - people died from often simple conditions which could have been easily prevented or cured. Gradually, the human race learned how to prevent infection by such simple techniques as boiling water before drinking it; preserving food to keep it wholesome; and later, by more sophisticated methods such as imbibing chemical concoctions to counter the effects of infection, inflammation or physical damage. And just recently, we taught ourselves to perform the most intricate repairs of all kinds of conditions - even to taking organs out of dead people and grafting them to the living.

These developments occurred in parallel with the phenomenal growth in wealth. As our societies accumulated wealth - measured by whatever method - we found ourselves occupying ever more comfortable dwellings, clothing ourselves in greater variety than ever before, and consuming food not just to survive, but for unadorned pleasure. As the old saying goes, "I don't eat to live, I live to eat." This brings to mind a story my late colleague, Peter Walker, once related about his folks in England in the years between the World Wars. The poorer relatives had better teeth than the more well-off ones. The reason? The poorer ones couldn't afford the candy, chocolates and other sweetmeats which contributed to dental decay.

Today, as we are able to arrest the growth of the most diabolic forms of cancer, improve vision by using lasers to trim out-of-round corneas, or install new livers and kidneys, we find ourselves suffering what amounts to an epidemic of self-inflicted diseases. We have heart attacks, psychological complaints and conditions caused by chemical pollution. But these pale in comparison with one, in particular, which has burgeoned into a full-scale epidemic in (not surprisingly) the wealthiest parts of the earth, instead of the poorest. While AIDS ravages Africa, diabetes is sweeping North America. And make no mistake about it, diabetes is a disease of affluence.

When we were children, things like bottled soft drinks (aerated water, we used to call them) were a rare treat, which we got only at a party. Similarly with confections made from concentrated sugar, although those were much more commonplace. But we were also very active, running around outside in play and work, at home and at school.

Nowadays, drinks, baked items, candy and dairy items laden with sugar and fats are commonplace. In North America, particularly the US, portions served in restaurants and fast-food outlets have become larger and larger, as have the sizes of bottled drinks. Obesity and overweight conditions have become national in scope, and, consequently, there's been an explosion of instances of what the medical profession calls late-onset, or Type II diabetes.

Type I is the classic form of diabetes, affecting only a small proportion of the population.

Children are born with that form, which is generally auto-immune, that is, the body attacks the cells in the pancreas that produce the vital hormone, insulin. Insulin breaks down complex carbohydrates into a simple sugar, glucose. It is the body's gasoline, providing the energy for the cells to work, for the muscles to expand and contract, for the brain to perform its myriad calculations, and maintain the temperature. In the case of Type II, the pancreas either becomes compromised and can't produce enough insulin, or, more commonly, produces enough, but the body loses the capacity to use it properly.

Because diabetes doesn't cause pain or obvious discomfort, people can have it for quite a while before finding out. And during that time it wreaks its quiet havoc among many of the body's systems. It damages nerves, leading to a loss of sensation in the extremities, such as the feet; it also impairs the function of those tiny blood vessels that feed organs like the eyes, and causes eventual blindness; it can lead to heart attacks, strokes, and kidney failure. Because of the reduced sensation and curtailed blood supply, people often develop sores and gangrene, and have to have limbs amputated. Among men, the damage to the nerves and blood vessels can lead to what we used to call impotence, but is now known as erectile dysfunction.

The main reason for this explosion is that North Americans - and, increasingly, Jamaicans - are becoming seriously overweight. In North America, about half the population is classifed as overweight or obese; in Jamaica, things are somewhat better. A recent study by the University of the West Indies and the Ministry of Health found that 30 per cent of men, and 60 per cent of women, were either overweight or obese. Eight per cent were diabetic. And here's where the picture for the future emerges - 40 per cent were either inactive or engaged in very little physical activity, and about half ate more fat than they should. These are warning signs which people ignore at their peril.

An uncle of mine used to admonish us youngsters as we stuffed ourselves: "You are digging your grave with your teeth!"

keeble.mack@sympatico.ca

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