The hypothesis advanced by Hertzel Gerstein and Laura Waltman,1explaining why the age-adjusted prevalence of diabetes ranges from about 5% among people of European ancestry to 40% or higher in newly westernized Aboriginal populations, represents virtually the same hypothesis that I first proposed in 1998,2 corroborated in 19993and further developed in 2004.4
The substantial difference between their hypothesis and mine is that they regard Europeans' adaptation to a diabetogenic environment as a relatively recent phenomenon, beginning 300 to 400 years ago, whereas I believe that it occurred several millennia earlier, when incipient agriculture, apiculture, sheep farming, and rudimentary technologies enabled Europeans' ancestors to produce “genetically unknown foods,”2,3 such as those containing sugars in concentrations exceeding 250 g/L, which is the physiologic limit imposed by evolution.4
If a diabetes epidemic similar to the tragic one now afflicting the Pima Indians3 had ravaged Europe centuries ago, this scourge would have certainly been reported by historians, who did not fail to write about the numerous plagues that decimated the European population during the Middle Ages. However, no diabetes epidemic in Europe was reported by either medieval or subsequent historians. There is also no mention of a diabetes epidemic in Latin literature, despite the fact that half of the 468-odd recipes in a Roman cookery book call for honey as an ingredient.2 The Europeans' passable adaptation to diabetogenic foods, therefore, is likely to reflect a selection that mostly occurred before their remote ancestors could leave written records.