Michael - You may be right, the number of Dupuytren's cases may be going down (after all in the Reykjavik study, when they divided the 1297 men into two groups, those who were above average weight and those who were below, there were fewer cases of Dupuytren's among the fat group than among the thin group). However, it is not necessarily so. Suppose, for example, that two men are pushing a car: one is at the front pushing it backwards and the other is at the back pushing it forwards. Which way will the car go? It depends on which man is stronger, and also on other factors, such as whether the road is sloping. Just so we have two factors here: an increasingly unhealthy diet, which might be seen as pushing the Dupuytren's rate up, and an increasing number of fat cells, which, if fat cells are protective to a certain extent, might be seen as pushing the Dupuytren's rate down; there might also be other factors such as genetics involved. It is difficult to predict which factor will be dominant. So although it would be interesting to gather figures for the rate of Dupuytren's, it would not necessarily solve this argument. Nor of course would it be of any practical use. Even if fat cells do protect against Dupuytren's, no one is suggesting that you take hormones to give yourself feminine curves or eat huge amounts to become like a Sumo wrestler! But the fact that fatter people are less prone to Dupuytren's is interesting nonetheless. My explanation is that fat cells mop up excess glucose, which seems to fit all the other facts rather well. What's yours?

Jim - Yes, true, it would indeed not be a very good bet to undergo an arduous regime and deny yourself many pleasures in the hope of a minor and possibly quite illusory benefit in the distant future, such as the hope of perhaps being able to postpone Dupuytren's surgery by a few months. But what I am saying (and what I believe Kevin is saying) is not like that at all. Supposing that, having reached the age of 40 or 50 or whatever it is, you are beginning to develop signs of ill health: you are getting a pot belly, your joints are getting stiff or arthritic, you are coughing a lot, you have high blood pressure or glaucoma of the eye, or you develop Dupuytren's nodules. None of these things happen out of the blue: they are all the result of years of poor diet and ill treatment of the body. They are warning signs that we need to stop doing whatever we are doing and do something different. If you were coughing a lot, it would make obvious sense to look at smoking. In the case of Dupuytren's, since it obviously has something to do with blood sugar (in view of the fact that diabetics are five to ten times more likely to get it than non-diabetics), it would make sense to look first at the things that are making your blood sugar roller-coaster.

But, you will say, if I were to give up alcohol/smoking/coffee/cola etc. (or whatever it is that you think is causing the problem) life would become very flat and boring - there just wouldn't be any pleasure in it any more. Well, yes, that is true for the first two or three weeks - life does seem rather flat and boring - but after that it is no longer true. Two months ago, stirred by Kevin's article, I gave up alcohol, bread, and tea and began exercising and sleeping more. At first I missed those things; my mind was woolly and I couldn't concentrate as well on my work; the evenings seemed dull. But after a while I stopped missing them. I have plenty of beer and wine in my fridge and tea of all sorts in my cupboard; I serve these things up to guests but don't feel the slightest temptation to try them myself any more. My concentration is now as good as it ever was. In a restaurant I used to pounce on the bread, but now I no more feel like eating it than eating the flowers. In return I have lost a stone in weight (without ever feeling hungry) and feel a whole lot fitter and healthier and really enjoy my food. Isn't it worth doing that (even if it has no effect on Dupuytren's) just for its own sake?

But on the contrary, I say, it does seem to be having an effect on Dupuytren's, even after this short time. A month ago when I stirred a pot with a wooden spoon I had to hold the spoon from the side since it felt like I was stabbing my palm; now I can do it normally. Try it yourself and see! Stop procrastinating and plunge in! And if after a couple of months, after giving up the unhealthy sugary things and finding the diet (more towards protein or more towards carbohydrate or something in between) which suits you best, you don't notice a big difference for the better, report back to this website and say so!

Andrew Goodson
agdg@supanet.com

I suspect that Dupuytren's, like Peyronie's, goes through an 'inflammatory' stage which is associated with discomfort. Peyronie's is typically painful after onset, but the pain goes away in a few months, and the nodules (or "plaques" as they're referred to in the context of Peyronie's) may actually seem smaller. The bend, however, does not change. So I'm very skeptical of positive results consisting of just a reduction in discomfort. I want to see evidence of reversal of the fibrosis, in the form of reduced contracture (or bend in the case of Peyronie's). Are you ready to claim that yet?

I'm healthy and reasonably fit in my mid-50s; I exercise adequately and sleep well - normally I feel great. I do eat a lot of whole-grain carbohydrates and I enjoy coffee. My reference to blood sugar just meant that when I get hungry, I feel run-down and out-of-it - maybe more than the average person.

With regard to the data from Iceland, how do we rule out the converse interpretation: that whatever causes Dupuytren's tends to make you thinner? As always, a cause-and-effect relationship is much harder to prove that a simple statistical association.

Now, don't get me wrong here. I'm interested in these speculations and hope they lead to something.

Let's try it from another angle. It has been known for years that asthma and hayfever are hardly ever found in diabetics, but only in hypoglycemics. (In rare instances where diabetics have asthma, it seems that they are the type who swing between diabetes and hypoglycemia.) Knowing this, if you had a child with asthma, would you not try, at least as an experiment, giving your child a diet designed to stabilise their blood sugar? If you are a hayfever sufferer and the pollen count is high, is it not better to breakfast on, say, an apple or an egg without bread rather than on orange juice, toast, marmalade, and coffee, all of which which will fill the blood with sugar followed shortly afterwards by reactive hypoglycemia and a fit of sneezing? And yet what advice is given to asthma sufferers? Only to vacuum the house and to take this or that medication. I am only stating what is common sense. And yet people don't have any common sense, or insist on thinking that asthma is a disease of the lungs and hayfever a disease of the nose, not a symptom of a disorder of the whole body. Meanwhile the incidence of asthma continues to go up and up, not only in smoggy cities but also in remote country areas like the Scottish highlands, in direct proportion as the sales of sugary cereals, colas, and sweeties increase in the local shops.

What I am suggesting is that in some, if not all, cases Dupuytren's appears to be a sign of a disorder in the blood sugar. Is it not worthwhile, at least as an experiment, to try correcting that disorder, if it exists? Whether this will reverse or even slow down Dupuytren's will take some weeks to establish; but in the meantime you may notice lots of other improvements. Kevin, who appears to have found the diet which is right for him - though it might not necessarily be right for the rest of us - declares that, after an initial period of adjustment, it was like "running on nitro". That seems a worthwhile goal even if the Dupuytren's is unaffected. (But as I say, I don't think it will be unaffected.)

Of course (to turn to the other points) I don't believe that whatever causes Dupuytren's also makes people thin, any more than I believe that whatever causes Dupuytren's also makes people men. Otherwise it would not affect fat people, or if fat people got it they would become thinner. It just happens that this disease affects thin people and men more than fat people and women. But once they become diabetic, it seems that it affects everybody, fat or thin, male or female, in equal numbers. If you have a better explanation for that than mine, let's hear it.(Incidentally, Kevin, note that the fat/thin correlation was found not only in the Icelandic study but also in the Swedish one.)

Up to now it appears that no statistics have been published to show whether Dupuytren's is getting more or less common. But let us suppose that in 20 years' time the Icelandic study was to be repeated, and that in the meantime the Icelandic population had taken to an American diet and their average weight had gone up. Then no doubt the researchers would find, after interviewing another 1300 men, that there would still be more cases of Dupuytren's among the 650 thinner-than-average ones than among the 650 fatter-than-average. But I would not like to make any predictions about whether the actual number of cases would have gone up or down.

Actually it is by no means a foregone conclusion that the Icelanders' average weight will go up. I'm visiting Paris at the moment (and having difficulty writing this as several of the keys are not in their usual places on the keyboard) and can testify that the title of that recently published book "French women don't get fat" is perfectly correct. (Check it out for yourself, if ever any of you come to Paris for NA with Dr Badois.) French men - at least as far as Parisians are concerned - don't seem to get fat either: you'd be hard put to find any man in the city with a waist size above 34"; in fact most of them are so skinny you wonder how their trousers stay on at all! Why this is I don't know. Maybe because everyone walks everywhere; maybe because all their food is cooked from fresh ingredients; or maybe because their food is of better quality. After all, you can have two tomatoes of which one is nutritious and tasty while the other, though lasting a long time, has no taste at all; or two pieces of meat which look identical, but one comes from an animal that has fed all its life on grass, while the other comes from a cow which has been artificially fattened on corn, antibiotics, cardboard, and ground up pieces of other animals. Which would you rather eat? To my earlier slogan "If you want to avoid surgery, don't eat food that's sugary" I add the following one: "If you put rubbish into your body, you will end up with a rubbish body"!

But to turn to another point, what is it that causes Dupuytren's to suddenly become active after a period of quiescence? Sean, you must be reading this. What did you do differently, if anything, that might have caused your Dupuytren's to flare up three years ago, as you say it did?

The link between hypoglycemia and asthma/hayfever and the inverse relationship between diabetes and asthma is documented in books such as "Body, Mind, and Sugar" by E.M. Abrahamson, MD, and A.W. Pezet (1951) and "Low Blood Sugar and You" by Carlton Fredericks, PhD, and Herman Goodman, MD (1969). On the web, the link is mentioned more often by alternative sites than mainstream ones; however, here is one example from a mainstream informational website maintained by the pediatrician Alan Greene, MD FAAP (http://www.drgreene.com/21_317.html):

"Asthma, Diabetes Related? - Children with type 1 diabetes are less likely to get asthma, eczema, or hayfever. And the reverse is true, that those with asthma, eczema, or hayfever are less likely to get type 1 diabetes. However, countries where diabetes is common also tend to be the countries where asthma is common, according to a report in the February 24, 2001 issue of The Lancet. One possible explanation for this is the imbalance between two types of immune cells, T-helper 1 cells and T-helper 2 cells. In children with diabetes, the balance tends to favor T-helper 1 cells; in those with asthma, T-helper 2 cells. It's difficult for one child to have both. But some countries have conditions that may increase imbalance or inflammation in general. According to the Lancet report, the more affluent the country, the more common the imbalance."

(The article mentions only type 1 diabetes, since the website is concerned with children, who rarely get type 2 (adult onset) diabetes.) There can be no doubt that the "conditions" that cause either diabetes or asthma in wealthy countries have something to do with diet, and very possibly with the huge quantities of sugar which are nowadays consumed in those countries.

You might also like to check out the articles "Diseases Linked to Obesity and Insulin Resistance" by Fred Pescatore, MD (at http://www.diabetesincontrol.com/Pescatore/i151.pdf) and "Hypoglycemia & Neurosis", by a psychiatrist called Jonathan Christie (at http://www.survivediabetes.com/hypt2.htm), both of which emphasise the link between hypoglycemia and asthma, and the role of sugar in causing hypoglycemia.

Returning to my earlier observation, that Frenchmen don't get fat, two days ago I spent 20 minutes in the playground of a French secondary school during morning break. The children had just finished two hours of lessons and had two more hours to go before lunch. Some English children who were visiting used this moment to eat lollipops and sweets, as one would expect; but among the French children (all of whom were skinny) I saw something astonishing: not a single one was eating anything at all. I was told that soft drinks vending machines have recently been banned from all French schools, and one can see that the cinemas (of which there are well over a hundred in Paris) do not sell popcorn. These facts may have much to do with the French people's apparent leanness. As for the lunch itself, we (the visitors) were served up a delicious three-course meal which began with salmon and caviar (though the pudding was rather sweet), so we have no complaints.

agdg@supanet.com

I've been following this forum off and on for the past few months but hadn't read this thread before. I've had DC for over 10 years and am scheduled for NA from Dr. Eaton in about two weeks. I try to keep current on lit and had seen info about higher rates in No. Europeans but had never before seen a reference to those of Scottish heritage. I'm female, DC occured before 50, half Scots, hypothyroid, formerly overweight (So. Beach diet only diet that ever worked for me and thus concluded am insulin resistant), took gluc/chondroitin in 2003 and DC seemed to worsen, sleep deprived 1995- 2002. In other words, a lot of the factors some are theorizing contribute to DC. I have 3 brothers, all overweight, all over 50, one diabetic and none has DC and there has been no previous DC in my family-- interesting, eh?