PEOPLE WHO INSTILLED FIBRE HYPOTHESIS IN BURKITTS MIND- PART 2 G. D. CAMPBELL MD, FRCP, FRS (SOUTH AFRICA)

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Dr George Duncan Campbell was born in Durban in 1925. He qualified in medicine in Edinburgh, UK. He did war service in the South African Artillery, a year in Philadelphia, USA.  He worked as Senior Research Fellow in Therapeutics in Edinburgh for a year in 1956–1957.He returned to Natal in South Africa and worked there for the rest of his life. He was known to everyone as ‘GD’, Campbell.

Campbell was a physician to the diabetic clinic in the king Edward VIII hospital, Durban, Natal. He encountered diabetes in both the Indian and Zulu populations of Natal. He set up the first diabetic clinic in Durban in 1958 and attracted 650 patients in the first 18 months. He successfully treated patients by combining dietary management with insulin and oral hypoglycaemic agents. Campbell spent a lot of time with the local Indian and Zulu populations to find appropriate management for people who were very poor and lived on high-carbohydrate diets. He wrote extensively about diabetes and its treatment in Africa.

Campbell research and observations was not restricted only to diabetes. He was one of the first people who warned that thalidomide might not be safe for human use. He was also a reputable marine biologist and wrote a series of papers about shark attacks. He spoke fluent Zulu and Xhosa and was a Fellow of the Royal Society of South Africa.

The 1966 edition of Cleave’s book ‘The Saccharine disease’ included Dr George D. Campbell as co-author. Cleave was in England and Campbell in South Africa. How did Cleave and Campbell work together for this book being at different countries?

By the end of 1961, Campbell had published eight letters or papers in the British Medical Journal and the Lancet about diabetes in Natal Indians and the Zulu. Campbell’s name might have come to Cleave’s attention through his writings on diabetes.

Cleave and Campbell
Pictures taken from  John H. Cummings and Amanda Engineer. Denis Burkitt and the origins of the dietary fibre hypothesis. Nutrition Research Reviews (2018), 31, 1–15

On 1 December 1962, Cleave wrote to Campbell asking if he would co-operate with him in writing about diabetes for his book. Cleave also sent him his most recent book that he had written on peptic ulcer. Campbell was happy to collaborate with Cleave and they both worked together for the various editions of ‘The Saccharine Disease’ in 1966, 1969 and 1971. However in 1974 edition, Cleave had dropped all co-authors but acknowledged Campbell in the preface for his ‘…excellent racial studies in diabetes and coronary thrombosis’.

Campbell’s interest in diabetes was further stimulated by Cleave. In 1969, he worked on the blood glucose response to carbohydrate digestion and the concept of the glycaemic index that preceded the work of others. Campbell recruited healthy volunteers and fed them 50 g of carbohydrate from white or wholemeal bread, apples, maize starch, sucrose and glucose. He ranked the various carbohydrates according to the AUC of blood glucose versus time noting that sucrose was not the top of the list. He presented a paper about this at the Congress of the International Diabetes Federation in Amsterdam, 1971. These studies, of what was later known as glycaemic index of a food, was preceded by a number of years the better known work of Phyllis Crapo in the USA and David Jenkins in Canada.

Campbell believed ‘passionately that diabetes was somehow related to sugar’ (Jim Mann, University of Otago, personal communication, 2015), but almost certainly fibre was not on the thinking of either Campbell or Cleave in 1966. But Campbell mentioned the importance of fibre in his later paper on the history of the ‘saccharine disease’ concept. By 1969, Cleave had modified his ideas somewhat about fibre and it is clearly seen in the 1969 edition. The emphasis still remains on refined foods and overconsumption but removal of fibre as a consequence‘…of the refining of carbohydrates’, is now stated as reason.

Cleave ideas are now modified that fibre having an important role in these diseases. This change in concept might be possibly by Burkitt, whom he met in late 1967. Or does someone else play a role in bringing this change in concept to Cleave.

References:
John H. Cummings and Amanda Engineer. Denis Burkitt and the origins of the dietary fibre hypothesis. Nutrition Research Reviews (2018), 31, 1–15

Wait for the next post to know who influenced Cleave in giving importance to fibre…….

                                                                                    Written by Dr.Priyavadhana

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