Welcome to my first in my The History of… series, where I’ll be looking at the history of topics affecting or involving the disabled community.
Future posts will include sign language and wheelchairs, but the first is diabetic food, inspired by my research for Seventy Years of Books. This week is also Diabetes Awareness Week (12-18 June), so it seemed a particularly good time to explore this topic.
As I said about No-Cal ginger ale in Seventy Years of Books, the product triggered a lot of strong memories for me. I remember my great-aunt eating a variety of “diabetic” foods when I was a child, but people living with diabetes today do not rely on these products. A friend I know with diabetes has no dietary restrictions whatsoever, and if people ever comment on him consuming sugar, including alcohol (lots of people love giving unsolicited advice to people actually living with conditions that they don’t have), he points out that he has a problem with insulin, not a problem with sugar.
I’m also particularly interested in this topic as one of my symptoms is insulin resistance, caused by an endocrine disorder, which means that my cells don’t respond well to insulin and can’t easily absorb glucose from my blood so I can have dramatically fluctuating blood sugar levels. Because of this I have been on various low sugar diets in the past to try and manage it, and currently take medication to treat these symptoms.
There are of course two types of diabetes, and I have friends with both types, but as I’m focussing more on generalised recommendations made to people living with diabetes here, particularly with regard to products produced specifically to help patients manage their condition, I’m not going to go into detail about the causes and management of the two different types. This is more of a look at specialist foods and beverages marketed to people living with diabetes.
No-Cal ginger ale was first produced in 1952 and was the first zero calorie diet drink available. It was initially marketed to people living with diabetes and sweetened with sodium cyclamate. Root beer, black cherry, lemon, cola, coffee and chocolate flavours of the drink followed, with black cherry becoming the most popular. As well as marketing the product to diabetic customers, the drink took advantage of growing diet culture in the USA and began targeting the drink to the general public, focusing on housewives particularly, and was eventually worth millions. The development of “diet drinks” by major soda producers such as Coca-Cola and Pepsi-Co and an FDA ban on cyclamate sweeteners in October 1970 caused the company’s decline and eventual disappearance from the market.
But recommending sugar free drinks was by far not the first instance of specialist diet being used to treat diabetes. As far back as 3,500 BCE, Ancient Egyptian physicians identified the condition as “too great an emptying of urine” and recommended a high carbohydrate diet. In the eighteenth century it was discovered that this excess urine contained high amounts of sugar, so patients were prescribed sugar and honey to replace what was being “lost”.
In the early nineteenth century, the link between a lower carbohydrate diet and improvement of the condition was discovered and the recommendation changed to a low calorie and almost zero carbohydrate diet. While this drastic diet did have some limited benefit for managing the illness, many patients developed other illnesses as a result. The discovery of insulin in 1921 was revolutionary for the long-term management of diabetes.
Long before the production of No-Cal, the very first diabetic food was produced by Apollinaire Bouchardat, who declared “don’t let them eat cake!”* and created a 49% protein bread in 1797. And so began food products specifically marketed towards people living with diabetes.
*This is a joke. He didn’t say this. Then again, Marie Antoinette didn’t say the other thing either…
As well as his special bread, Bouchardat also recommended fast days and patients tasting their own urine to check their sugar levels - which makes the finger prick test sound pretty good.
In addition to the sodium cyclamate sweetener used in No-Cal ginger ale, saccharin was also added to low sugar foods which were then marketed towards people living with diabetes. Current advice is that all artificial sweeteners, including stevia and aspartame are suitable for people with diabetes, but people need to do their own research and make their own decisions when consuming artificial sweeteners due to the possibility of side effects.
In 1952, Horlicks marketed their malt drink as being good for some diabetic people and today a “Diabetic Plus” version of the drink is available in India which says it provides the high fibre important for diabetic patients.
Another popular product was diabetic chocolate. Diabetic chocolate was often high in bulk sweeteners including sorbitol and high in trans fats meaning they were an unhealthy choice for anyone. It’s now advisable to eat regular chocolate in moderation while remaining conscious of the effect it can have on your blood sugar levels. Dark chocolate with lower sugar content may be a better choice for people living with diabetes.
In July 2020 changes in food regulations in the UK meant that it is no longer legal sell food products with a “diabetic” or “suitable for diabetics” label. If you look up diabetic food products online today, the results will show sugar free and low sugar options instead.
There is no evidence that diabetic foods offered any benefit to people living with diabetes and, conversely, many of the products could have a laxative effect. Today it is generally recommended for diabetics to follow a high fibre, low sugar diet, though conscious consumption of sugar in moderation is manageable.
I hope you found this little journey through the history of diabetic foods interesting. The history of the discovery, treatment and management of diabetes is fascinating, and this is just a little peek into a small aspect of that. As with many conditions, development of medicine has had a revolutionary effect on life with diabetes, and my great-aunt’s packets of diabetic cookies have made their way into the history books.
Take care,
Donna
Thanks go to Choc Amor, Cedar Farm Galleries, Mawdsley and my generous friends for kindly discussing this topic with me.
Other sources used for research include:
Research into Childhood-Onset Diabetes: From Study Design to Improved Management edited by Andrea Scaramuzza, Carine de Beaufort, Ragnar Hanas
Self-care snippet
I had some bad news this last week, so made the decision not to write in the evening (for once!) and instead worked on a cross-stitch gift I’m in the middle of making and watched old episodes of Star Trek. Switching my brain off and not thinking about how to fix things I could do nothing about was really good for me and I got a really good night’s sleep as a result.
Things I’ve seen, heard, read and talked about
More people could have hidden bowel condition The story of Victoria Rennison’s fight to be diagnosed with microscopic colitis after being misdiagnosed with irritable bowel syndrome (IBS). This really hit home for me after my own issues with diagnosis and finding out my own “IBS” was actually caused by the hypermobility in my bowel.
Leeds Railway Station introduces British Sign Language service A story about British Sign Language (BSL) screens being rolled out in stations to assist deaf passengers with keeping up to date with announcements about delays, platforms etc. This is a great move towards making rail travel more accessible.
Barbie with Down's syndrome on sale after 'real women' criticism The launch of a Barbie with Down’s syndrome as the brand continues to make the range more inclusive and diverse for everyone.
Scores of local pharmacies closing across England The story about pharmacies across the UK closing at a frightening rate, despite plans for them to take over many of the services currently provided by GPs. It’s continuing to be a worrying time for obtaining healthcare consultations.