When I was growing up in Scotland, celebrating Halloween was a major event in the calendar and something to look forward to at this grim time of year. Everyone got dressed up (to go “guising”) and participating households carved lanterns out of turnips (a Scottish turnip is an English swede) rather than the now ubiquitous pumpkin. The guisers were all expected to perform a song, dance, or recite a poem, with their reward for the performance being nuts or fruits but rarely sweets. The concept of trick or treat did not exist in those days. Everyone also had a go at dookin’ (bobbing) for apples or trying to eat scones covered in treacle without using hands, and the accompanying adults were invariably sober.

Back in Scotland, Halloween was generally considered a fun event, although the young participants probably caused each other short term psychological harm telling each other ghost stories or worrying about the bogeyman who just might be lurking around the next dark corner. Nowadays Halloween is big business, especially in the US. Whole streets are sealed off to traffic, houses are decorated in ghoulish paraphernalia, and it’s not just the children who get dressed up. Apparently Americans spend almost $2 billion on sweets (candy) alone for Halloween, and for the adults alcohol is ubiquitous.

In the days leading up the event, the internet is awash with medical warnings about the danger of a Halloween. The US seems especially preoccupied with concerns about the health consequences of excessive sugar consumption at Halloween. This has been linked to fluctuations in energy levels, impulsive behaviour, and making the body more acidic, to name but a few. The media are also now listing the potential health hazards associated with the celebration. As well as the hazards of nut allergy, other risk include conjunctivitis from the wearing of decorative contact lenses (these are classed as medical devices by the US Food and Drug Administration), ingesting potentially contaminated water when bobbing for apples, and the severe potential consequences of hypokalaemia caused by eating too much black liquorice on the night. For our local population of people with diabetes, the nurse educators and dieticians have been handing out advice about how to adjust insulin doses to cater for the 70 or so grams of carbohydrate in a toffee apple.

In days gone by the main concern was the idea that someone might have put razor blades inside the sweets or toffee apples. Although this may have been an urban myth, some hospitals did offer free x-rays of children’s Halloween hauls in order to find evidence of tampering. In reality, nearly all of the few known candy poisoning incidents involved parents who poisoned their own children’s. I hope that Halloween does not become overly sanitized as the risks are probably very small and down to common sense. As one respondent posted on the Huffington Post website—at Halloween you are more likely to be crushed by a pumpkin than anything else.
David Kerr wears many hats, sometimes at the same time—diabetologist, editor of Diabetes Digest, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes. You can follow him on Twiitter (@GoDiabetesMD) and Linkedin. He holds a small amount of stock in CellNovo (a new insulin pump company) and Axon Telehealth.