A spoonful of sugar : dietary advice and diabetes in Britain and the United States, 1945-2015

Rights statement
Awarding institution
  • University of Strathclyde
Date of award
  • 2022
Thesis identifier
  • T16210
Person Identifier (Local)
  • 201591299
Qualification Level
Qualification Name
Department, School or Faculty
  • In 1924, Haven Emerson, professor of preventative medicine and former health commissioner for the city of New York, along with his colleague Louise Larrimore, published the results of the first major epidemiological study of diabetes. The study found a wide range of factors associated with diabetes, including; race, affluence, lack of physical activity and changes in dietary habits, in particular a growing abundance of all foods. Overall, the findings suggested that diabetes was influenced considerably by social, economic and environmental factors. Despite these findings, governments, the medical profession and academics have predominantly focused on drug development and have tended to favour pharmaceutical responses to the disease, despite the fact that only 10% of diabetes (Type 1) is treatable with insulin. In contrast to this medical focus, this thesis adopts a social and cultural analysis of chronic disease in the twentieth century which considers the idea of Type 2 diabetes as a ‘disease of civilisation’, linked to societal changes, such as: the development of agriculture, industrialisation, dietary changes linked to advances in the food industry and the growth of the pharmaceutical industry and its consequent power to determine how disease is defined and treated. Using oral history testimonies this thesis outlines the changes in dietary recommendations received by diabetic patients against the backdrop of these changes occurring throughout the course of the twentieth century. Through this lens, this thesis places the current epidemic of Type 2 diabetes in historical perspective, illuminating the ways in which medical advice and treatments are shaped by social, cultural and political contexts.
Advisor / supervisor
  • Smith, Matthew, 1973-
  • McIvor, Arthur
Resource Type
  • This thesis was previously held under moratorium from 26th April 2022 until 26th April 2024.