The Propaganda for Reform in Proprietary Medicines, Vol. 1 of 2

by Council on Pharmacy and Chemistry

In 1906 this laboratory, then under the direction of Dr. A. L. Winton, who is now with the Department of Agriculture, made its first examination of commercial diabetic foods. In nearly every year since it has analyzed various other brands as they appeared on the market. The demand for the reports on these foods and the many inquiries directed to us have led us to make a more extensive review of the situation, and to collect as far as possible all information as to the quality of the so-called “diabetic” foods offered to the American public. That the present state of the market is unsatisfactory is well known, and the inferiority (from the diabetic’s point of view) of many of the products at present offered is unfortunately familiar to all careful dietitians. The most dangerous feature of the present situation is that the unsuspecting patient is led to purchase foods, generally at an exorbitant price, which are not only misrepresented but which may be positively harmful to him. In this day of self-medication this condition is all the greater menace to the diabetic.

Without any attempt to suggest methods of treatment for diabetes, which is the province of the physician, I may say that it is well recognized that diabetes is primarily a disturbance of nutrition, in which the normal ability of the body to make use of carbohydrates is more or less completely impaired. All recent authorities agree in placing the chief emphasis on the role of diet in the management of this disease. Janeway, Benedict, Joslin, Futcher, Falta, Strauss, von Noorden and other writers on diabetes could be quoted at length in support of this view. The importance of a restriction of the carbohydrates in certain cases and certain aspects of diabetes is admitted by practically all competent authorities. In order to prescribe a starch-free and sugar-free dietary, which at times is necessary, and to know accurately the actual amount of these carbohydrates contained in the various available foods, the physician must rely on the cooperation of the chemist to furnish this requisite information. This is our excuse, if any be needed, for our present investigation.

There seems to be some uncertainty as to what sort of preparation is entitled to be sold as a “diabetic” food. Granting the desirability of feeding the patient all the carbohydrate he can tolerate, and recognizing the possible value of the oatmeal, potato, rice and other treatments, in which a relative abundance of carbohydrate is fed for a limited period, it would seem that a low percentage of carbohydrates should be a requisite for a “diabetic” food. Certainly no special food containing nearly as much carbohydrate as a normal food of the same class should be entitled to this appellation. Flours, breads, biscuits, chocolates, breakfast-foods, macaroni, etc., containing only a slightly lowered percentage of carbohydrates, are no more entitled to be called “diabetic” foods than the normal foods themselves. It is true that, when a patient’s carbohydrate tolerance is well established, the use of foods containing 20, 25 and even 35 per cent. of carbohydrates might be permissible, when used under the direction of a competent physician; but when a strict diet is necessary, such as is required to determine this tolerance, even these relatively low percentages are objectionable, if not dangerous.

It has been our purpose to include in this investigation, as nearly as possible, all available data on the composition of all diabetic foods sold in America. Our report, therefore, will be in part compiled, but in greater part will consist of our original analyses. It will show 539 analyses of about 400 brands, 200 of which are our own new analyses and 110 those made in this laboratory in previous years.

While the purpose of this preliminary note is to call attention to the better preparations rather than to emphasize those which are obviously objectionable and fraudulent, it may not be out of place to summarize briefly our findings in general. The full details of the investigation are now being prepared for publication and will shortly be issued as a report from the Connecticut Agricultural Experiment Station.

One hundred and eight samples of sixty-eight brands of flours and meals are included in the report. Sixty-seven of these were sold as “gluten” flours, twenty of which did not even satisfy the low government standard of 35 per cent. protein. Twelve samples contained less than 13 per cent. carbohydrates, while the remaining gluten flours ranged from 28 to 76 per cent.

The soy bean flours contained from 23 to 26 per cent. of carbohydrates, the almond meals 17 per cent., and a cotton-seed flour 21 per cent. Other “diabetic” flours, not specifically sold as “gluten” flours, contained from 67 to 80 per cent.

The purchaser of gluten flours at the present time may obtain preparations containing from 87 to 11 per cent. of protein and from 4 to 76 per cent. of carbohydrates, at a cost of from 9 cents to $1.56 per pound.

In view of the government’s low standard for gluten flour, and because of the wide variations in composition found in the brands at present on the market, proper protection of the diabetic demands that the manufacturers of these flours should be required to state on the label the guaranteed percentages of both protein and carbohydrates.

Three samples of American soft gluten breads contained from 35 to 37 per cent. of carbohydrates; two other brands contained 49 and 54 per cent., little, if any, lower than found in ordinary wheat bread.