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Well reversing is different but most cases can be reveresed with dietary/lifestyle changes. On the other hand prevention of type2 is N=100% with these changes.

Well reversing is different but most cases can be reveresed with dietary/lifestyle changes. On the other hand prevention of type2 is N=100% with these changes. I know people, especially in the US consider it thier right/freedom to eat what they want and live how they want, but in my mind it’s deeply disturbing especially because children don’t have any choice (it’s parental). I think as soon as a child is diagnosed with fatty liver disease...there should be some mandate on parents to “treat” their child with diet (which I know is probably equally disturbing to people, government dictated diet).

hirundo 8y ago
In the US the official nutrition advice has been both wrong and corrupt since the 1970s. Gotten wrong by sincere hard working scientists with the best intentions. Corrupted by corporate capture of regulatory bodies and funding of exculpatory studies. These same forces would choose what is mandated. That is horrifying. Not only could they give bad advice, they could compel ever larger fractions of the population to follow it. Far better to let parents decide, so when they get it wrong we can learn from it, and don't all get it wrong at once.
- will_brown 8y ago
  >Far better to let parents decide, so when they get it wrong we can learn from it, and don't all get it wrong at once. The problem is the disease is growing in epidemic proportions, no one is learning from mistakes. The government got it wrong sure, but let the doctors prescribe the diet and government won’t dictate the diet only mandate following doctor prescribed treatment/diet (and this too I know has flaws). But here is the thing, say a child does get diabeties and the doctor prescribed insulin, but the parents think they know better and refuse the treat their child. Should government be able to step in or allow the parent to withhold insulin treatment based on their freedom? Legally parents can refuse (life saving) treatment on religious grounds, and that arguement comes into play in diet, but I’ve also been involved in a case where a 13 year old was pregnant with HIV and was refusing court ordered treatments so the baby would be born without HIV, legally and morally they are complex issues.
  - village-idiot 8y ago
    Americans have by and large followed the recommendations of the government: meat and saturated fat consumption is down, and we eat way more “heart healthy” whole grains and polyunsaturated seed (excuse me, “vegetable”) oils. Lots of people followed the advice, because lots of people wanted to be healthy. The advice was just garbage. I was under the impression that parents could not decline life saving treatments for minors, and that the state had the right to step in.
    - will_brown 8y ago
      >Americans have by and large followed the recommendations of the government I agree with you the old food pyramid(s) were shit and even Obama’s revised food plates are shit advice. Still I don’t know of any statistics of people actually following it and think by and large most peoples diets in the US are even worse than what the government suggestions have been/are. As to the parental consent on treatment...Yes children die because parents decline life saving blood transfusions for their children on religious grounds. Most cases are upheld but from time to time there is intervention. In the case I referred to forced HIV treatments, the only reason that was legal for the unborn child, was because the 13 year old mother was already declared a dependent on the State. Again scary a state dependent subjected to force medical treatment for an unborn baby...but the alternative is scary too a 13 year old with hiv refusing treatment because she thought the HIV tests were “lies by the state” and having a dependent of the state give birth to another child with HIV which could have been prevented with treatment.
      - ConceptJunkie 8y ago
        And that's where the government constantly fails us. It makes enough mistakes that people start treating everything is says with skepticism, and often rightly so. But it's not a big step to doubting government recommendations for diet to doubting government recommendations for vaccinations, even though the two subjects are not equivalent at all. Things get even more complicated when the government does things like subsidize corn, which has a negative effect on the diet of Americans through the increased use of corn syrup in practically everything. People make fun of the anti-vaxxers, and they certainly are wrong, but we in this discussion are criticizing the government's diet recommendations as being misguided, it's not hard to see where people would view other government recommendations and mandates with suspicion.
- ConceptJunkie 8y ago
  It's not just that the science of nutrition is still in a state of heavy churn... I'm sure everyone remembers when high-carb, low-fat diets were supposed to be the best thing ever, and we still suffer from the effects of that with tons of "fat-free" products that are full of sugar and unsatisfying. It's also the governments fault for things like corn subsidies that assure that every processed food product is pumped full of corn syrup, because it's cheaper than air and making things sweeter is the cheapest way to get people to consume more. The food industry is also working against the health of people because so many of the things that make their products more appealing also make them worse for you. I cook a lot, so I eat less processed food than the average person probably does, and I know I need to cut down on carbs, but I eat rice with most meals. If I could eliminate some bad habits, I don't think my diet is that bad, but eating healthy is also expensive. For all the talk of childhood hunger in the U.S., obesity is more of a problem for the poor than hunger. Cheap food is often really bad for you, and busy people with more than one job can't afford the time (leave alone the money) to cook decent meals unless they are really dedicated and make an effort to educate themselves. I cook a lot because it's fun and relaxing, and usually make a bunch of food on the weekend so my family and I don't have to cook during the week. One of my problems is that I get bored easily, especially at work, and I eat when I'm bored.
vonmoltke 8y ago
> On the other hand prevention of type2 is N=100% with these changes. It is absolutely not. While the vast majority of current cases are preventable (and in most cases, reversible) through proper lifestyle changes, between 5% and 10% of people with T2DM were going to develop it regardless of what they did. Now, it's possible that some or all of those cases are not actually T2DM. In the past few decades researchers have been investigating additional forms of DM, such as Latent Autoimmune Diabetes in Adults, that may be the cause of some cases of DM that currently present as T2DM. It may be that once "true" T2DM is defined that your statement is correct, but as of right now it is not.
- will_brown 8y ago
  >between 5% and 10% of people with T2DM were going to develop it regardless of what they did. One I’ve never seen a study or heard a physician make that statement. It’s always 100% prevention. But treatment of diet to prevent 90-95% of cases isn’t bad.
dmm 8y ago
> .there should be some mandate on parents to “treat” their child with diet You're considering forcing parents to change, presumably with the threat of taking their children away. But consider this, in the past type-2 diabetes was extremely rare in children. Why is it now common? Are parents just worse? Or are terrible diets more appealing? Maybe the sources of those terrible diets would be a better place to start imposing government violence.
- bad_user 8y ago
  I don't know how life was in the Western countries while growing up in Romania. Being born in 1982, in the eighties as kids we received sweets only on holidays. I remember chinese chocolate (which was really good btw), a locally made soda and oranges and bananas. Even now when it smells like oranges, I feel like it smells like Christmas, because that's when we were getting oranges. Then in the nineties, after the revolution, we got an explosion in the junk food consumed. People importing Coca Cola from Turkey made a fortune. The result is that at this point we are in the top countries in Europe when it comes to heart disease and diabetes. It's easy to see what happened if you follow the trends: 1. sugar (sucrose, HCFS) consumption going up 2. snaking ... when we were little, we were only eating 3 meals per day at most 3. stress Also if you believe the hyperinsulinemia theory of obesity, well, there are indications that mothers that developed insulin resistance will pass that resistance to the child. Which is one explanation, besides genes, for why children born of overweight parents also have a tendency to get fat. And yes, we eat too much. Unfortunately thin people have always blamed fat people of gluttony, not thinking that the hunger and satiety signals might be broken in some people, for various reasons, including insulin resistance, or maybe because the junk we eat doesn't contain the nutrients the body needs.
- will_brown 8y ago
  Well luckily the US is not a vacuum and you can see the pattern of the explosion of type 2 and other chronic conditions in other countries, even in Okinawa which used to have the best life expectancy but now is riddled with chronic diseases and type 2. It’s not the mystery you suggest.
  - 8y ago

hirundo 8y ago

In the US the official nutrition advice has been both wrong and corrupt since the 1970s. Gotten wrong by sincere hard working scientists with the best intentions. Corrupted by corporate capture of regulatory bodies and funding of exculpatory studies. These same forces would choose what is mandated. That is horrifying. Not only could they give bad advice, they could compel ever larger fractions of the population to follow it. Far better to let parents decide, so when they get it wrong we can learn from it, and don't all get it wrong at once.

will_brown 8y ago
>Far better to let parents decide, so when they get it wrong we can learn from it, and don't all get it wrong at once. The problem is the disease is growing in epidemic proportions, no one is learning from mistakes. The government got it wrong sure, but let the doctors prescribe the diet and government won’t dictate the diet only mandate following doctor prescribed treatment/diet (and this too I know has flaws). But here is the thing, say a child does get diabeties and the doctor prescribed insulin, but the parents think they know better and refuse the treat their child. Should government be able to step in or allow the parent to withhold insulin treatment based on their freedom? Legally parents can refuse (life saving) treatment on religious grounds, and that arguement comes into play in diet, but I’ve also been involved in a case where a 13 year old was pregnant with HIV and was refusing court ordered treatments so the baby would be born without HIV, legally and morally they are complex issues.
- village-idiot 8y ago
  Americans have by and large followed the recommendations of the government: meat and saturated fat consumption is down, and we eat way more “heart healthy” whole grains and polyunsaturated seed (excuse me, “vegetable”) oils. Lots of people followed the advice, because lots of people wanted to be healthy. The advice was just garbage. I was under the impression that parents could not decline life saving treatments for minors, and that the state had the right to step in.
  - will_brown 8y ago
    >Americans have by and large followed the recommendations of the government I agree with you the old food pyramid(s) were shit and even Obama’s revised food plates are shit advice. Still I don’t know of any statistics of people actually following it and think by and large most peoples diets in the US are even worse than what the government suggestions have been/are. As to the parental consent on treatment...Yes children die because parents decline life saving blood transfusions for their children on religious grounds. Most cases are upheld but from time to time there is intervention. In the case I referred to forced HIV treatments, the only reason that was legal for the unborn child, was because the 13 year old mother was already declared a dependent on the State. Again scary a state dependent subjected to force medical treatment for an unborn baby...but the alternative is scary too a 13 year old with hiv refusing treatment because she thought the HIV tests were “lies by the state” and having a dependent of the state give birth to another child with HIV which could have been prevented with treatment.
    - ConceptJunkie 8y ago
      And that's where the government constantly fails us. It makes enough mistakes that people start treating everything is says with skepticism, and often rightly so. But it's not a big step to doubting government recommendations for diet to doubting government recommendations for vaccinations, even though the two subjects are not equivalent at all. Things get even more complicated when the government does things like subsidize corn, which has a negative effect on the diet of Americans through the increased use of corn syrup in practically everything. People make fun of the anti-vaxxers, and they certainly are wrong, but we in this discussion are criticizing the government's diet recommendations as being misguided, it's not hard to see where people would view other government recommendations and mandates with suspicion.
ConceptJunkie 8y ago
It's not just that the science of nutrition is still in a state of heavy churn... I'm sure everyone remembers when high-carb, low-fat diets were supposed to be the best thing ever, and we still suffer from the effects of that with tons of "fat-free" products that are full of sugar and unsatisfying. It's also the governments fault for things like corn subsidies that assure that every processed food product is pumped full of corn syrup, because it's cheaper than air and making things sweeter is the cheapest way to get people to consume more. The food industry is also working against the health of people because so many of the things that make their products more appealing also make them worse for you. I cook a lot, so I eat less processed food than the average person probably does, and I know I need to cut down on carbs, but I eat rice with most meals. If I could eliminate some bad habits, I don't think my diet is that bad, but eating healthy is also expensive. For all the talk of childhood hunger in the U.S., obesity is more of a problem for the poor than hunger. Cheap food is often really bad for you, and busy people with more than one job can't afford the time (leave alone the money) to cook decent meals unless they are really dedicated and make an effort to educate themselves. I cook a lot because it's fun and relaxing, and usually make a bunch of food on the weekend so my family and I don't have to cook during the week. One of my problems is that I get bored easily, especially at work, and I eat when I'm bored.

vonmoltke 8y ago

> On the other hand prevention of type2 is N=100% with these changes. It is absolutely not. While the vast majority of current cases are preventable (and in most cases, reversible) through proper lifestyle changes, between 5% and 10% of people with T2DM were going to develop it regardless of what they did. Now, it's possible that some or all of those cases are not actually T2DM. In the past few decades researchers have been investigating additional forms of DM, such as Latent Autoimmune Diabetes in Adults, that may be the cause of some cases of DM that currently present as T2DM. It may be that once "true" T2DM is defined that your statement is correct, but as of right now it is not.

will_brown 8y ago
>between 5% and 10% of people with T2DM were going to develop it regardless of what they did. One I’ve never seen a study or heard a physician make that statement. It’s always 100% prevention. But treatment of diet to prevent 90-95% of cases isn’t bad.

dmm 8y ago

> .there should be some mandate on parents to “treat” their child with diet You're considering forcing parents to change, presumably with the threat of taking their children away. But consider this, in the past type-2 diabetes was extremely rare in children. Why is it now common? Are parents just worse? Or are terrible diets more appealing? Maybe the sources of those terrible diets would be a better place to start imposing government violence.

bad_user 8y ago
I don't know how life was in the Western countries while growing up in Romania. Being born in 1982, in the eighties as kids we received sweets only on holidays. I remember chinese chocolate (which was really good btw), a locally made soda and oranges and bananas. Even now when it smells like oranges, I feel like it smells like Christmas, because that's when we were getting oranges. Then in the nineties, after the revolution, we got an explosion in the junk food consumed. People importing Coca Cola from Turkey made a fortune. The result is that at this point we are in the top countries in Europe when it comes to heart disease and diabetes. It's easy to see what happened if you follow the trends: 1. sugar (sucrose, HCFS) consumption going up 2. snaking ... when we were little, we were only eating 3 meals per day at most 3. stress Also if you believe the hyperinsulinemia theory of obesity, well, there are indications that mothers that developed insulin resistance will pass that resistance to the child. Which is one explanation, besides genes, for why children born of overweight parents also have a tendency to get fat. And yes, we eat too much. Unfortunately thin people have always blamed fat people of gluttony, not thinking that the hunger and satiety signals might be broken in some people, for various reasons, including insulin resistance, or maybe because the junk we eat doesn't contain the nutrients the body needs.
will_brown 8y ago
Well luckily the US is not a vacuum and you can see the pattern of the explosion of type 2 and other chronic conditions in other countries, even in Okinawa which used to have the best life expectancy but now is riddled with chronic diseases and type 2. It’s not the mystery you suggest.
- 8y ago