Azoreanimmigrantsloose

Do the emigrants from the Azores gain or loose in their health and longevity by migrating to North America? They loose! Why?
By Manuel Luciano da Silva, Medical Doctor
Practiced Internal Medicine for more than 40 years, in New England, USA

For several centuries people from Europe, and in this case from the Azores, wanted to migrate to North America because it was believed that it was the Land of the Eldorado! It was the land of abundance and therefore one could get rich fast, shake the tree with golden leaves, filled up the bags, and return home and live happily thereafter!…

For centuries also in Europe the feudalistic society did not allowed the common citizens attain fortune even if they had the determination and the intelligence to do it. America became the land of the opportunity! And they came from everywhere in bunches of many thousands!

Since the time of the first discoveries of North America, the Portuguese Navigators learned the way to the Cod Fish Lands or “Terras dos Bacalhaus”. Codfish since five centuries ago became the “petroleum”, the energy, that everyone in Europe aspire to obtain. And the Corte Reais navigators were the leaders on this enterprise, even loosing their lives, as it happened to Gaspar and Miguel Corte Real and their crews in their voyages of 1500-02.

In the last forty years the people from the Azores came to North America, Canada, United States and Bermuda in greater numbers. They came because the economic conditions in the nine-island archipelago were not good. They want to better their standing of living. They wanted to get better housing and abundance of food. And they did accomplish that in the majority of the cases.

They worked very hard in the factories, and obtained enough money to buy plenty of food and beverages. And they, practically ALL, gained weight, and because of this they lost in their health and longevity. Their increase in weight led to an increase of high blood pressure, increase in the percentages of diabetes, increase of strokes and even heart attacks. Official statistics in U. S.A. (February, 2002) reveal that all Americans gained in the last ten years DOUBLE weight compared with the weight gained in the 30 years prior to 1990. Phenomenal.

Also trying to imitate the America way of life, the Azorean emigrants have lived under an increased stress, because of financial constrains “to be like the Jones”, besides the tension of learning the English language and even putting up with inferiority complex.

All this mosaic of circumstances has exerted a tremendous influence on the Azorean emigrants that, strange as it may seem, they have lost in the values of their health and even in their longevity.

I do not have space to discuss in detail all these diseases, such as strokes, heart attacks, hypertension and stress affecting the Azorean Immigrants in greater numbers much more so if they had stayed in their homeland, instead of emigrating to America. Therefore I am going to discuss only the Diabetes Mellitus, or sugar diabetes, as an example, how the Azorean immigrants in America loose in health and longevity.

For many years, I saw in my office many thousand of patients, Azoreans, with sugar diabetes. Here are the question I always asked of them:

It was in the year of 70 after Christ that the physician Areteu of Capadocia, Greece, described the disease DIABETES, a Greek word which means SIPHON. Dr. Areteu, very cleverly, concluded that diabetes is the disease of FOUR Ps:

This great physician observed that even though the diabetics ate too much (polyphagia: poly = much + phagia = to eat), had much thirst (polydipsia: poly + dipsia = thirst), drank much water and therefore produced much urine (polyuria: poly = much + urine = urine) they would become weaker and emaciated, going , almost always , into coma before death. The diabetic therefore suffered from polyasthenia (poly = much + asthenia = weakness).

Diabetes was a serious and mysterious disease because of the abundance of food that entered by mouth, the bodily energies were eliminated by the urine! Everything which entered by above, (mouth), would come out through the bottom, (urine), making the body function like a SIPHON. At the present time the largest use of regular siphons is seen on the sinks where we wash the dishes and in the toilet basin.

In the United States, diabetes is in third place as the cause of mortality. In first place are the cardiovascular diseases, and in second are the cancer diseases. There are presently sixteen millions diabetics in America, but eight million do not know that they have the disease. The United States of America is the nation in the world that has the highest percentage of diabetics because it has also the highest percentage of persons who are overweight. Recently official studies have been published that the incidence of diabetes is getting even more frequent among the younger citizens, simply because the young generation are getting heavier, fatter.

Since Areteu and during 1500 years, Medicine did not add anything new to the research of diabetes. Only in 1670 did the British physician Thomas Willis discovered that the urine of diabetics was "very much sweet, loaded with sugar or honey ", because when he went to make house calls, he got into the routine of smelling the urine, and put his index finger in the chamber pot and tasted the urine!

Five years later (1675) Doctor Matthew Dobson verified that indeed there was sugar in the urine of the diabetics. In 1715 Dr. M. Chevreul confirmed that the sugar was glucose! Because of this reason it became common practice for the physicians to put their finger in the pot and taste the urine! Because of the finding of sugar in the urine the disease was called "diabetes mellitus" or sugar diabetes. Mellitus is a Latin word which means honey or very sweet.

It was in 1889 that two German scientists, Von Mering and Minkowski discovered that it is our pancreas which produces a unknown “substance” capable of controlling the sugar in our blood and therefore control the symptoms of diabetes.

Pancreas is a Greek word which means sponge-like. Anyone who wants to know what his or her pancreas looks like, needs only to place himself or herself in front of a mirror open the mouth wide and extend the tongue all out. We can call the pancreas the "tongue of our belly" because the pancreas has the same shape and the same size as our tongue. The pancreas is located at the level of the belly bottom, on horizontal position, from right to left, behind the stomach.

The pancreas is located behind the stomach at the levelof the umbilicus. It is the “tongue” of our belly

In 1869 Paul Langerhans, senior medical student, discovered that our pancreas is a gland which is composed by more than one million of very small islands. (Perhaps these islands can be compared to the taste buds on our tongue). In 1893, the French scientist Gustave Laguesse suggested that these islands - today called the Islands of Langerhans -- must produce a hormone, or a substance, which is anti-diabetic or that, controls the level of sugar in the blood.

One Island of the Langerhans of the
pancreas with the Beta and alfa cells

The islands of pancreas have cells of three types called alfa, beta e delta. Beta cells produce insulin. Alfa cells produce another hormone called glucagon which is an antagonist to insulin, which increases the blood sugar level in the blood! The delta cells produce somatostatin.

If the hormone to control the diabetes is produced by the millions of the islands in the pancreas, and the name in Latin for island is "insula", the scientists decided to baptize such a substance INSULIN, meaning that "it comes from the islands".

The greatest discovery concerning the treatment of diabetes occurred in July of 1921, when two Canadian investigators, Frederick Banting and Charles Best, from the University of Toronto, were able to extract insulin from the pancreas of one dog and inject it into another dog that they had made diabetic by removing from him his pancreas. This experiment proved that indeed insulin controlled the sugar of the diabetic dog!

In 1923 Banting and his associates received the Nobel Prize in Medicine for their discovery of extracting insulin from the pancreas. In 1922 the University of Toronto signed a contract with El Lilly Laboratory to extract insulin from the pancreas of pigs and from cows , collected at various slaughter houses, originating the production of Regular Pork and Beef Insulins.

With this manufacturing, finally the physicians had available enough Regular Pork and Beef Insulin to control the sugar in the diabetic patients. The insulin because it is made of proteins it has to be injected subcutaneously because if it is swallowed it will be destroyed by the acid of the stomach, loosing all its value or effect. It needs to be refrigerated.

The Regular Insulin by injection had an effect of only 4 to 6 hours and therefore was necessary to give several injections during the day to bad diabetics. In 1936 it appeared the insulin of slow reabsorption or Lente Insulin, allowing with this type of insulin to control the blood sugar with only one injection of Lente Insulin per day.

How does the insulin control the blood sugar in the blood? Before we answer this question we have to understand first what is a cell. The best example of a cell is a chicken egg which is composed of three parts: (1) The nucleus or yolk , (2) the cytoplasm or white, and (3) the membrane or shell.

But the shell of the chicken egg has ten thousand little holes that are necessary for the chick to breathe (to receive the oxygen from the air and to eliminate the water and carbon dioxide) during 21 days of incubation until it will be able to come out of the shell!

Well, every cell in our body is similar to the chicken egg, it has also the nucleus, the cytoplasm and the membrane or shell, with many thousand of holes. The holes of each membrane are very important because even though they are very small, microscopic, they are the ones that control all the substances, all the traffic of what enters and exits the cell membrane!

One of the vital elements that has to pass through those many thousands or millions of holes is the sugar or glucose. Glucose is the essential energy, like fuel, or gasoline to every cell of our body! But the glucose cannot enter or pass through the little holes of the each cell membrane without the help of Insulin! Insulin is the KEY which opens the little holes for the sugar to enter the cells in a normal way!

A diabetic does not have enough Insulin Keys to open the little holes of the membranes of the cells and because of this lack, the sugar circulating in the blood stream cannot enter the cells. This results in an increase of the blood sugar, which is then spilled into the urine. A diabetic without insulin is like a sailor in the middle of the ocean. He is surrounded by water (but cannot drink it). In the diabetic the cells are surrounded by sugar, but cannot use it, because they need the insulin-keys so that the sugar can enter inside of each cell and be used as energy.

What is the normal blood sugar in a person? The normal blood sugar should range from 70 to 120 milligram’s of glucose. Every diabetic should know the value of their blood sugar. Unfortunately there are diabetics that do not know or do not want to know the numbers of their blood sugar!

Besides the fasting blood sugar, there is also the test two hours post-prandial (two hours after a meal), and the glucose tolerance test. But the most important test to really evaluate if a diabetic has been under control for a period of three months is the test called Glycohemoglobin. This test measures the AVERAGE of the blood sugar in the past three months. Unfortunately many patients and even some physicians do not emphasize the value of the Glycohemoglobin.

Every diabetic is very careful with his diet before he or she goes for a blood test. This way the blood sugar is going show lower numbers when the patient goes for the test. But then the patient goes back to his or her routine, does not follow the diabetic diet, and the blood sugar goes up again. The patient and the doctor have been fooled!

The Glycohemoglobin test reveals all the SUGAR SINS, because it measures the value of the sugar, day and night, when the red blood cells are been manufactured, day and night, in the bone marrow! The test of Glycohemoglobin is also called HgA1C. The normal values should be 4-6. Anything above 6 is abnormal and reveals that the diabetic has been living sugar sin… I repeat the test of Glycohemoglobin gives the AVERAGE of the blood sugar during the day and night! It does not tell any lies!!!

If the Greek physician Areteu described the diabetes the disease of four ps, we now can increase the number of its symptoms to ten ps.

Portuguese. In New England the majority of the immigrants are from the Azores, and diabetes is a hereditary recessive disease, the chances of more diabetes are increased. Because the Azorean are practically “COUSINS” of one another, the incidence of both parents having the recessive gene of diabetes is greater. Therefore their off springs have a greater chance of developing diabetes.

Pot Belly. Any Portuguese immigrant who has a pot belly has diabetes until proven otherwise. This is an alert that the physician has to have always in mind when he examines an immigrant.

Pruritus. One of the alert symptoms of diabetes is Pruritus special on the genitalia. Women are more sensitive to this symptom, but men can start with the irritation on the head of the penis.

Potency deficiency. Many times one of the first signs of diabetes in men is decrease of his sexual potency. If he gets his diabetes under control he will regain his potency.

Perturbed vision. Another early signs of diabetes is a decrease of vision acuity. When this symptom appears a physician should be seen. As a matter of fact the greatest cause of blindness in U. S. A. is due to diabetes.

Peripheral neuropathy. Every diabetic has decrease sensibility on his extremities, especially on the feet. This is the very reason why a diabetic should NEVER cut his or her toe nails, because he or she does not feel the pain and does not see well to do a good job. The toe nails should ALWAYS be cut by a foot doctor.

The most important part of the treatment in a diabetic is the diet. And the best diet in the world is the Diet of the Portuguese Flag

I do not agree with the pyramid diet food recommended by the American Heart Association. Why? By a very simple observation: The American Heart Association recommends that dairy products should compose the base of the pyramid. I do not agree with their emphasis on cereals and dairy products. If we want the pigs, the cows and the chickens to become fat, what kind of food do we give these animals??? We feed them plenty of flour and cereals. And if we give a similar diet to humans we expect the humans to behave differently from the pigs? Come on! Let us have medical common sense!

Because it is difficult for a common patient to comprehend the concept of calories, and food exchanges, and because my clientele was predominantly composed of Portuguese immigrants, I developed the Diet of the Portuguese Flag to get my message across to them.

The Portuguese flag: the green and red are
the large areas. The white portion is very small in the cente

The Diet of the Portuguese Flag Is the best
diet in the world to control diabetes, hypertension and obesity.

The Portuguese Flag has three colors: white, red and green, but the areas of these colors have different sizes. The red and the green are the colors that occupy the larger areas on the flag. The white, much smaller, in an U shape, occupies the central part of the flag and contains the Quinas of five wounds of Christ, has a much smaller area. The different areas of these colors, red, white and green in the Portuguese Flag are going to tell us the exact proportions and the quality of the different food we must eat. Without paying attention to calories, we are going to DIVIDE ALL foods of any supermarket into three piles: reds, whites and greens.

GREENS - in this group we will include all green and fresh fruits: kale, lettuce, vegetables and fruits. The salad dressing should be vinegar or fresh lemon juice, or olive oil. From the pile of greens we can eat freely.

REDS - In this group we include all food that have blood: fish and meat, with the condition that the meat has to be lean or without fat. The meat and the fish should be boiled or broiled, in order for them to loose the fat. From this group of the reds we should eat with moderation.

It is in this group of white foods that we find the mortal sins! Those foods that are white in their natural state are the ones that cause us to get fat because they are rich in calories. Here are the TEN mortal sins:

In conclusion a diabetic who wants to control his or hers blood sugar should eat almost like a VEGETARIAN!!!

(1) Regular Insulin - extracted from the pancreas of pork and beef. Has a duration effect from 4 to 6 hours.

(2) Lente Insulin, extracted from pork and beef (with a type of oily substance for slower reabsorption). Has a duration effect from 20-30 hours.

(3) Humulin (Human Insulin) discovered about 15 years ago. It exist in the two forms: Regular and Lente

There is now a mixture of 70% Lente and 30 % Regular given in the same syringe, already mixed.

If you analyze the molecule of the Insulin we will see that it is composed by two chains of amino-acids connected by two bridges of sulfurs... as if it were the different teeth of the keys... The difference between pork and beef Insulins and the human insulin is marked by the sulfur connections are made at different levels of the amino-acid chains. But because of this minor difference, there are people, who by taking beef or pork insulin, developed resistance to these types of insulin. At the present time Human Insulin is therefore practically the only one used. It is manufactured synthetically, and eliminates the probabilities of the patient developing resistance to it or allergy to it. The "teeth" of the keys are the same...in the patient's insulin and in the insulin administrated...

Since 1955 the use of tablets - Sulfanylureas - was started to be given to diabetic patients who were usually over 40 years of age. But the mechanism of action of these tablets is different from the effects of insulin. These tablets do not produce insulin by themselves. Their action cause the alfa cells of the pancreas to produce more insulin so that there is an increase of insulin in the circulating blood and therefore control better the sugar level. But the mechanism of action of these tablets is different from the effects of insulin. These tablets do not produce insulin by themselves. Their action cause the alfa cells of the pancreas to produce more insulin so that there is an increase of insulin in the circulating blood and therefore control better the sugar level.

II- Biguanidines. Reduce insulin resistance making possible for sugar to enter the cells of liver and muscles.

III-Thiazolidinediones. Reduce insulin resistance, making possible for more sugar to enter into the cells of muscles and other organs.

IV- Alfa-glucosidase Inhibitors. Prevent sugar products from being reabsorbed at the level of the intestinal mucosa.

Here is the present scientific explanation concerning the TRIANGLE of sugar, insulin and fat deposits.

When we eat a meal with sugar, the sugar when it reaches the blood stream sends a message for the pancreas to produce more insulin to lower the blood sugar. But this insulin DOES NOT BURN the sugar. It deposits it on the warehouses of fat: liver, belly, breasts, etc.

If a persons eats a fatty meal (animal fat) it is also transformed by the liver into sugar and the same response of pancreas takes place and therefore there will be a deposit of sugar in the fat warehouses as described above.

If a person eats vegetables, fiber or with OLIVE OIL, there will NOT BE a response to the pancreas to produce more insulin, therefore the cycle of sugar --> pancreas --> insulin and --> deposit into the fat deposits DOES NOT take place. Therefore a person who avoids foods that are sweet or have animals fats, DOES NOT increase the blood sugar and DOES NOT GET FAT, does not gain weight!

This is a question most asked by the patients. And my answer was a very simple one.

For the women:
Do you remember your weight when you were a bride?
There was always a laugh! But this is the true weight for you, baby!

For men:
How much did you weigh when you went to the Armed Forces? That is your normal weight, boy!

Diabetes is a disease that can be CONTROLLED by diet, by insulin or by tablets. Its control depends on the WILL POWER of the individual.

If the individual does not control the diabetes he or she will suffered serious consequences:

Can run the risk of developing ketosis, which is caused by increase of acetone (a toxic acid product) and can lead to diabetic coma.

Uncontrolled diabetes causes artherosclerosis or rusting or hardening of the arteries, small and large, originating reduction of the lumen, and formation of blockage of the circulation, affecting the arteries of the heart, brain, kidneys and liver and feet. From the artherosclerosis heart attacks, strokes, and liver and kidney failures, easy infections, can occur much more frequently.

It causes formation of microscopic aneurysms on the retina (small little sacs) that run the risk of rupturing, originating hemorrhage, and decrease of vision and finally blindness.
In the arteries of the feet there is also decrease of circulation leading to hardening of the arteries, resulting in the decrease of the circulation on the feet and legs causing ulcers, infection, and the risk of gangrene and finally amputation of the legs.

But if the diabetic controls his or her blood sugar, ALL these terrible consequences ARE AVOIDED OR PREVENTED!