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Frederick Madison Allen (16 March 1879 – 14 April 1957) was a physician who is best remembered for his carbohydrate-restricted low-calorie diet for sufferers of
diabetes mellitus Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...
. He was known for pioneering the "starvation diet".


Life

Born in
Iowa Iowa () is a state in the Midwestern region of the United States, bordered by the Mississippi River to the east and the Missouri River and Big Sioux River to the west. It is bordered by six states: Wisconsin to the northeast, Illinois to th ...
, Allen studied medicine in
California California is a state in the Western United States, located along the Pacific Coast. With nearly 39.2million residents across a total area of approximately , it is the most populous U.S. state and the 3rd largest by area. It is also the m ...
and obtained a fellowship at
Harvard University Harvard University is a private Ivy League research university in Cambridge, Massachusetts. Founded in 1636 as Harvard College and named for its first benefactor, the Puritan clergyman John Harvard, it is the oldest institution of high ...
to work on sugar consumption. He soon became obsessed with diabetes. In 1913, he privately printed a 1179-page book on diabetes that described hundreds of animal experiments and featured a 1200-item bibliography. He was appointed to a junior position at the Rockefeller Institute in 1914.


Diabetes treatment

Allen believed that previous diabetic treatments had been ineffective because they attempted to substitute fats for carbohydrates. This eventually led to
acidosis Acidosis is a process causing increased acidity in the blood and other body tissues (i.e., an increase in hydrogen ion concentration). If not further qualified, it usually refers to acidity of the blood plasma. The term ''acidemia'' describes ...
, followed by coma and death. Only a starvation diet that limited the total caloric consumption would be effective. Allen found that a liquids-only diet could eliminate
glycosuria Glycosuria is the excretion of glucose into the urine. Ordinarily, urine contains no glucose because the kidneys are able to reabsorb all of the filtered glucose from the tubular fluid back into the bloodstream. Glycosuria is nearly always caused ...
and
acidosis Acidosis is a process causing increased acidity in the blood and other body tissues (i.e., an increase in hydrogen ion concentration). If not further qualified, it usually refers to acidity of the blood plasma. The term ''acidemia'' describes ...
. The diabetic could then begin to eat gradually increasing diets, until sugar again began to show up in the urine. This test would allow him to determine how many calories a patient could safely consume. Allen opened the Physiatric Institute in Morristown, New Jersey, the world's first clinic for sufferers of diabetes mellitus, on April 26, 1921. Patients were held to diets as low as 400 calories per day, with carbohydrates virtually eliminated from the diet. Although successful in eliminating
glycosuria Glycosuria is the excretion of glucose into the urine. Ordinarily, urine contains no glucose because the kidneys are able to reabsorb all of the filtered glucose from the tubular fluid back into the bloodstream. Glycosuria is nearly always caused ...
, Allen's extreme diets were difficult to follow. Patients who dropped out of treatment and returned to their former diets would die shortly afterwards. Patients who followed the diets faithfully would become undernourished and die of starvation, although they would live longer. Allen was given early access to insulin after its discovery at the
University of Toronto The University of Toronto (UToronto or U of T) is a public university, public research university in Toronto, Ontario, Canada, located on the grounds that surround Queen's Park (Toronto), Queen's Park. It was founded by royal charter in 1827 ...
, but the quantities available were limited due to production difficulties. One of his patients, Elizabeth Hughes, the daughter of U.S. Secretary of State
Charles Evans Hughes Charles Evans Hughes Sr. (April 11, 1862 – August 27, 1948) was an American statesman, politician and jurist who served as the 11th Chief Justice of the United States from 1930 to 1941. A member of the Republican Party, he previously was the ...
, went directly to Toronto to be treated with insulin by
Frederick Banting Sir Frederick Grant Banting (November 14, 1891 – February 21, 1941) was a Canadian medical scientist, physician, painter, and Nobel laureate noted as the co-discoverer of insulin and its therapeutic potential. In 1923, Banting and Joh ...
. Hughes weighed just when she left. Three months later, Allen visited Hughes in Toronto and saw a healthy 15 year-old of normal weight: "Dr. Allen said with his mouth wide open – Oh! – and thats all he did."


After insulin

The discovery of insulin ended Allen's preeminence in diabetes treatment. Diabetes specialists were no longer in great demand, as insulin made it possible for any general practitioner to treat diabetes. He refocused his efforts on hypertension, using low-salt diets to control blood pressure. In 1927, he marketed an oral hypoglycemic pill with Squibb that was made from mulberry and blueberry leaves, but the pill failed and left him deep in debt. By 1929, Allen had moved the Physiatric Institute to
Rye, New York Rye is a coastal suburb of New York City in Westchester County, New York, United States. It is separate from the Town of Rye, which has more land area than the city. The City of Rye, formerly the Village of Rye, was part of the Town until it r ...
and was opening a new treatment center for metabolic disorders in Midtown Manhattan. In 1936, the Physiatric Institute was shut down. Allen spent the rest of his life moving between hospitals, doing research into refrigeration in surgery and cancer. He died in 1964 at the age of 84."Frederick Allen, Physician, was 84; Authority on Diabetes Dead —Won Banting Medal"
''The New York Times''. Retrieved 10 October 2022.


Legacy

Allen was not the first person to recommend treatment of diabetes by diet; as Ramachandran and Viswanathan (1998) point out, dietary treatment of diabetes mellitus was used in ancient Egypt as long ago as 3,500 B.C., and was being used in India about 2,500 years ago. These authors note that in the eighteenth century, John Rollo had observed that
glycosuria Glycosuria is the excretion of glucose into the urine. Ordinarily, urine contains no glucose because the kidneys are able to reabsorb all of the filtered glucose from the tubular fluid back into the bloodstream. Glycosuria is nearly always caused ...
in diabetics could be reduced if sufferers of diabetes mellitus reduced the quantity of their food consumed. However, Allen became famous in his own day for his recommendations, and Allen and his co-workers published their work on the
diabetic diet A diabetic diet is a diet that is used by people with diabetes mellitus or high blood sugar to minimize symptoms and dangerous complications of long-term elevations in blood sugar ( i.e.: cardiovascular disease, kidney disease, obesity). Among ...
in 1919, in a work entitled "Total Dietary Regulation in the Treatment of Diabetes". Today, however, diabetologists would take quite different views on this subject to those promoted by Allen. Indeed, Joslin, in 1922, suggested different diet recommendations to those of Allen, suggesting a reduction of
fat In nutrition, biology, and chemistry, fat usually means any ester of fatty acids, or a mixture of such compounds, most commonly those that occur in living beings or in food. The term often refers specifically to triglycerides (triple est ...
rather than
carbohydrate In organic chemistry, a carbohydrate () is a biomolecule consisting of carbon (C), hydrogen (H) and oxygen (O) atoms, usually with a hydrogen–oxygen atom ratio of 2:1 (as in water) and thus with the empirical formula (where ''m'' may or m ...
, with the overall goal of reduction in calorie intake (Hockaday, 1981). Allen has been named as one of the two leading diabetologists, along with Elliott P. Joslin, in the period 1910 to 1920.


Selected publications


''Studies Concerning Glycosuria and Diabetes''
(1913)
''Total Dietary Regulation in the Treatment of Diabetes''
(1919)


See also

*
Diabetic diet A diabetic diet is a diet that is used by people with diabetes mellitus or high blood sugar to minimize symptoms and dangerous complications of long-term elevations in blood sugar ( i.e.: cardiovascular disease, kidney disease, obesity). Among ...


References


Sources

*Hockaday, T.D.R. (1981). Should the diabetic diet be based on carbohydrate of fat restriction? In M. Turner & B. Thomas (eds.). Nutrition and Diabetes. London : Libbey, 1981. pp23–32. *Ramachandran, A. & Viswanathan, M. (1998). Dietary management of diabetes mellitus in India and South Asia. In K.G.M.M. Alberti, R.A. DeFronzo & P. Zimmet (eds.). International textbook of diabetes mellitus. pp773–777. Chichester : Wiley, 1997. *Williams, G. & Pickup, J. (2004). The handbook of diabetes (third edition). Oxford : Blackwell Science, 2004. {{DEFAULTSORT:Allen, Frederick Madison 1879 births 1964 deaths 20th-century American physicians American diabetologists Fasting researchers Harvard University faculty Low-carbohydrate diet advocates People from Iowa