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America’s losing battle against diabetes

55 points by prostoalex 5y ago

02020202 5y ago
it's such an easy solution to fix the insulin resitance that i don't know why this is still a thing. stop eating processed foods. ban sugar and vegetable oils from your house. eat a ton of meat, eggs, butter, ghee, lard, bacon..and you'll be fit in no time. omg.
NonContro 5y ago
Easiest solution to diabetes: Sugar tax. Easiest solution to climate change: Carbon tax. If we havn't used these solutions, someone high up in the food chain is placing a greater emphasis on profits from the status quo instead of the wellbeing of the population.
- 00deadbeef 5y ago
  Is this the solution, though? Even if you could prevent new diabetes cases there are still countless millions of diabetics who wouldn’t be helped by a sugar tax.
- Smithalicious 5y ago
  Any tax on food hits poor people much more than wealthier people. You are taking food out of people's mouths.
  - Retric 5y ago
    Taxes can be redirected to the poor or even used to subsidize other food choices. The point is people and companies would make different choices if empty calories where relatively more expensive. The same is true of carbon taxes, they don’t extract money from the economy they move it around within the same economy.
    - Smithalicious 5y ago
      Sure, though in my experience that rarely really happen. Here's another angle: it creates a kind of social stratification where only the wealthier can afford to eat certain popular foods. I grew up poor, it's very humiliating to not be able to eat the same things as your peers.
  - adrianN 5y ago
    Sugar is not an essential food.
- nostromo 5y ago
  Good luck explaining to people that Apple Juice has a sugar tax applied to it now even though the only ingredient listed is “apples.” And, yes, it’s just as bad for you as soda. Don’t forget that we'll be needing a flour tax too…
- post_break 5y ago
  Stop taxing everything. Tax is not the solution for everything. The people buying soda are generally the poor or middle class. All this does it take more money from those who need it the most. What we need to do is regulate how much sugar you can put into foods. But we can't do that. We have to prop up the corn industry with subsidies. Sugar and HFCS is in literally everything. By adding a sugar tax you're basically saying everything you eat must get more expensive, that'll teach you to eat.
  - sokoloff 5y ago
    I think it’s probably worth examining how well taxing tobacco worked (and where/when it didn’t work).
  - fighterpilot 5y ago
    Tax sugar and give it back as a UBI. That alleviates the regressive tax concern. But I suspect that that's not the real reason you're against it. If your real concern is the expansion of the state, then implement a sugar tax and reduce other taxes. Whatever your concern, a sugar and carbon tax are great ideas (due to incentive alignment) and can be made to work.
    - ItsMonkk 5y ago
      Exactly. The tax externalities and dividend system is such an underappreciated idea. Sugar, carbon, and land are things that we move quickly to implement and bring it to more and more externalities.
      - fighterpilot 5y ago
        What do you mean by "dividend" in this context?
        ItsMonkk 5y ago
        UBI. The verbiage comes from the climate plan[0] using the same mechanism. [0]: https://en.wikipedia.org/wiki/Carbon_fee_and_dividend https://en.wikipedia.org/wiki/Carbon_fee_and_dividend
- mattrighetti 5y ago
  *Easiest also non working solution
- ajsnigrutin 5y ago
  So, a giant corporation outsources their production to china, pays zero carbon tax, and still pollutes the same planet, but Johnny average cannot heat his house and drive his car, because he cannot afford it anymore?
  - option 5y ago
    then tax import goods from China on entry to US until US authorities are satisfied with the amounts of carbon taxes paid in China (to China).
    - MrFlibbles 5y ago
      I believe we had a recent President who tried to raise import taxes (for whatever reason) on imports from China and the opposition went totally berserk. If it didn't work then or for whatever those reasons were, why would it work now?
      - option 5y ago
        why do you think it didn’t work? It certainly hurt China economically and they aren’t exactly the friend of US.
  - nend 5y ago
    Taxing sugar means people can no longer heat their house or pay for gas? Sounds like a bit of a reach. How much exactly is Johnny Average spending on sugar every month?
    - ajsnigrutin 5y ago
      taxing carbon does that.
      - fighterpilot 5y ago
        No, you can cut other taxes or give a UBI to offset it.
- deleted 5y ago
  [deleted]
- MattGaiser 5y ago
  A lot of the people who buy those things also object.
- fortran77 5y ago
  80% of people with Type 2 diabetes who are overweight would be asymptomatic if they lost weight. Perhaps we should tax obesity and not burden those who know how to eat responsibly?
  - Red_Leaves_Flyy 5y ago
    Perhaps we should treat unhealthy foods like we treat other unhealthy things like cigarettes and alcohol. Tax them at 90%, must be 21 or older, ban advertising, and require scary warning labels on the retailers that sell them, the containers, and the menus. The real problem is two fold. tons of people are negligently ignorant about what they eat and how it affects them. Lots of people’s livelihoods depend upon most people having terrible diets. Like seafood? You’re probably eating multiple times the safe limit of heavy metals. Like live events with popup food services? Would you like it as much if the only affordable foods were vegetable and fiber rich options without the large servings of carbs and sugars? Want cirrhosis with your alcohol? Want diabetes warnings on your ice cream and coffees? To solve the diabetes epidemic we must get structure the parts of society that rely on people actively eating themselves too expensive and early deaths.
- jimbob45 5y ago
  The right solution is to educate people about what their A1C means and to incentivize them to check it. Most people don't know what theirs is - I would bet that less than five people in this very thread have checked their A1C in the last six months. Remember that diet isn't always sufficient to lower A1C and you may need drugs or other lifestyle changes. Mandate A1C checks bi-yearly for insurance providers or have them pass along the penalty.
  - jaywalk 5y ago
    It sounds like you don't really understand what A1C tests are meant for either. There's a reason it's not part of a standard physical while blood sugar is.
    - mnw21cam 5y ago
      And that reason would be? HbA1C is effectively a measure of the average amount of sugar that has been in your blood over the last couple of months. A spot sugar level is the amount of sugar in your blood right now, and can vary a huge amount, depending on when you last ate, what you ate, and what exercise you have just done. It's less useful. You can do a fasting blood glucose, and a glucose challenge, but these tests are much more inconvenient for the patient. Outside the US, most testing has switched to HbA1C for these reasons.
- oxymoran 5y ago
  It’s not just sugar though, it’s junk, processed, and fast food in general. It’s astonishing how bad our current nutritional advice is.
- slownews45 5y ago
  No question - but there is so much special interest tied into things like climate change that there is no will to actually solve it. We've got now the hydrogen thing (aka fossil fuel with a ton of steps before you actually run an electric motor). We're going to have billions in special interest for this in the dems new bill. http://dx.doi.org/10.1002/ese3.956 http://dx.doi.org/10.1002/ese3.956 We've got the ethanol thing https://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=341491 https://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntr... I could go on endlessly.
- collaborative 5y ago
  Everyone talks about sugar. But the real problem is food culture (or the lack of). American, and now many European diets now consist of either fast food, oven-ready food or fried food. I recently went shopping and had a look at the "healthy" aisle. I could only find supposedly healthy food consisting of extremely savory dishes -carbonara, paella, etc. This is no way to eat healthy In many western countries, no one is willing to eat a plate of barely seasoned boiled potatoes, or of barely seasoned pulses, etc Everything is meaty, savory, rich. Edit: I see I caused a reaction. I will explain. We are training our taste, and our children's tastes, to expect an explosion of flavor in every bite. This is not healthy. It promotes ordering take-out food, buying ready-meals, etc. Food doesn't need to be complex. We have fallen to "recipe book" diets. For example, I am mediterranean. When I read mediterranean recipe books, I see the same meals we eat, but turbo-charged with flavor. You can see the same thing in Chinese take-outs, where you will rarely see the owner eat the loaded meals he sells. He'll sautee some bean sprouts and mix them with boiled rice Our stomachs aren't nuclear reactors, but in the western world, they are trained to be Recipe book meals are ok to eat twice a week. The rest of the week should include steamed veggies with olive oil and salt, boiled apple puree, lentil soup, chick peas with carrots, mash with cabbage and til, leek and potato cream, etc
  - Arrath 5y ago
    Honest question, why the push for 'barely seasoned'? What are the dietary implications of a dash of pepper, paprika, garlic powder, turmeric, garam masala etc. if the salt and sugar is kept in check?
    - Jtsummers 5y ago
      I think it's because people don't know how to cook. Seriously, adding those spices in has essentially no caloric effect on the meal (especially because many spices are strong enough you don't need to add a lot to have a massive effect on the flavor). The result, though, is that you can cook "the same thing" every day, but vary the spices and never get bored with chicken and vegetables or whatever it is you settle on.
  - 00deadbeef 5y ago
- mdbug 5y ago
  Sugar does not cause diabetes.
  - 00deadbeef 5y ago
    Too much sugar causes high insulin. Prolonged high insulin causes insulin resistance. Insulin resistance causes diabetes.
    - mdbug 5y ago
      This is a common misconception. Insulin resistance and type 2 diabetes is mostly caused by obesity. Sugar has a relatively high caloric density and can be addictive, leading to obesity. However, you can eat large amounts of sugar if you do a lot of sport, for example, and then burn off the calories again. Then you don't get diabetes from it either.
      - inetknght 5y ago
        > mdbug: Sugar does not cause diabetes. > mdbug: Insulin resistance and type 2 diabetes is mostly caused by obesity. Your statements are misleading. Sugar can be addictive. Sugar can also cause obesity. Sugar can also cause insulin resistance. Sugar can also cause diabetes. These concepts are not mutually exclusive. 2007: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235907/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235907/ The reviewed evidence supports the theory that, in some circumstances, intermittent access to sugar can lead to behavior and neurochemical changes that resemble the effects of a substance of abuse. 2010: https://pubmed.ncbi.nlm.nih.gov/20138901/ https://pubmed.ncbi.nlm.nih.gov/20138901/ It is thought that SSBs contribute to weight gain in part by incomplete compensation for energy at subsequent meals following intake of liquid calories. They may also increase risk of T2DM and CVD as a contributor to a high dietary glycemic load leading to inflammation, insulin resistance and impaired beta-cell function. 2012: https://pubmed.ncbi.nlm.nih.gov/22289979/ https://pubmed.ncbi.nlm.nih.gov/22289979/ Temporal patterns over the past three to four decades have shown a close parallel between the rise in added sugar intake and the global obesity and type 2 diabetes (T2D) epidemics. 2013: https://pubmed.ncbi.nlm.nih.gov/23657152/ https://pubmed.ncbi.nlm.nih.gov/23657152/ The incidence of T2D increased dramatically over the last decades mainly due to Western lifestyle factors such as lack of exercise and high calorie diets. In fact, high-sugar diets are thought to promote weight gain and insulin resistance predisposing to T2D 2015: https://pubmed.ncbi.nlm.nih.gov/26376619/ https://pubmed.ncbi.nlm.nih.gov/26376619/ There are plausible mechanisms and research evidence that supports the suggestion that consumption of excess sugar promotes the development of cardiovascular disease (CVD) and type 2 diabetes (T2DM) both directly and indirectly. I'll just stop looking there.
- someonevouchme 5y ago
  The best solution is that people choose to eat less sugar. It's better because it doesn't require treating adults like children, or humans like pets or cattle. Diet choices are not a problem of policy.
  - inetknght 5y ago
    > The best solution is that people choose to eat less sugar People choose to eat high-sugar foods because they're cheap. A tax will help make them less-cheap.
- hansor 5y ago
  >Easiest solution to diabetes: Sugar tax. Wrong. You should BAN High-fructose corn syrup. https://en.wikipedia.org/wiki/High-fructose_corn_syrup https://en.wikipedia.org/wiki/High-fructose_corn_syrup It is way more harmful than natural sugar. It is not banned yet because: - It is made from corn, and corn is heavily substituted by US government. - It is super cheap (high volume of corn available) - It is not only slightly sweet but also prevents spoilage (that's why they add it to US "bread" !) - It is good anti-oxidizer - It is good and cheap liaison
  - hannob 5y ago
    This HFCS story is a bit of a strange thing. At some point it was marketed as a more "natural" alternative to plain sugar. Then it became the villain and people said you should use normal sugar. The truth is: HFCS is not much different from normal sugar. They're both calorie dense and not very healthy.
    - Guest42 5y ago
      Anecdote, but hfcs requires approximately 3 times the insulin, if anyone has a different experience, please tell
  - BeetleB 5y ago
    It's funny you link to the Wikipedia page, and then make a comment like: > It is way more harmful than natural sugar. When the Wikipedia page doesn't agree with your assertion.
- 01100011 5y ago
  Easiest reaction maybe. I'd need to see some evidence to be convinced it is a solution. It seems to me more like a feel good measure that just further burdens people who are making poor choices already. Sure, there's some sort of libertarianish, survival of the fittest argument to be made for that, but if you're actually interested in positive results I think you're going to need something more nuanced. My personal opinion, based on nothing more than my experiences, and probably not worth much: How did we reduce smoking, another addictive, pleasurable activity with negative health consequences? We taxed it, sure, but we also had aggressive public health campaigns, provided medical assistance, and developed harm-reducing substitutes. Most importantly, we changed the culture, marketing and image of smoking. We didn't simply tax cigarettes and get smoking rates to appreciably fall. Food is even more difficult. Everyone needs to eat. No one needs to smoke. People with unhealthy attitudes towards food can't just give up eating. We have a culture that celebrates overconsumption. We have holidays seemingly dedicated to it. Advertising and the media are constantly promoting unhealthy eating.. Unhealthy eating is an easily accessible pleasure to many in the lower economic classes thanks to subsidies combined with the inherently low cost of production. With such a low starting price, you'd have to have crushing taxes to cause a meaningful shift in habits. Such taxes would be unfair to the people who can safely consume those products. Does it help if we tax, say, sweetened, carbonated beverages while excluding fruit juices or sugary fruits? Honey has even more fructose than "high fructose" corn syrup. Should we tax that too?
- lhorie 5y ago
  I'm not opposed to the idea, but there are some counterpoints that suggest it may not be as effective as you think. Look at gasoline tax. California has the highest tax in the country, yet it's also the largest consumer. I think other commenters have it right when they say there's a culture problem. In Niagara Falls, for example, it's a fairly common occurrence for Americans going into the Canadian side to get into arguments with Starbucks employees because they think they're being scammed/ripped off, when the reality is simply that canadian sizes are smaller than the american ones. Japanese snack sizes look minuscule in comparison with american ones. Take out food in many places is pretty much restricted to just burgers and pizza, (compare to Japan selling oden at 7-eleven). "Healthy" food like salads is often drizzled with oily, high sodium dressings, the list goes on.
  - brundolf 5y ago
    But the culture problem is a result of the corporate problem. Expectations are set by what people are used to being offered - heck, your stomach physically grows when you're regularly eating larger portions - it should be no surprise that those norms carry over when people leave their environment for short periods. I don't think it's fair to call it a moral failing of consumers. We've been set up to fail.
    - lhorie 5y ago
      I mean, it's partly its fault, sure. To see what happens if you completely let corporations dictate your diet, look no further than Super Size Me. But also, that's kinda abdicating responsibility a bit, don't you think? My in-laws live in North America, but cook traditional homemade chinese food (and they were teachers by trade in China, so the "low income peeps don't have time" argument doesn't exactly fly either). It costs them something to the tune of $150 a month in groceries to feed 6 lavishly when we go visit (probably even less otherwise because they're even thriftier when cooking for themselves). The fact that the vast majority of americans don't know how to cook rice in a regular pot, or pickle their own radishes is largely due to its culinary culture (or rather, a lack of it). In Japan, there's the concept of Yamato Nadeshiko, a desirable set of traits in a romantic partner which involves among other things being excellent at home cooking. I'm not aware of this kind of intertwining between cooking and other aspects of life in the US. IME, cooking is mostly just seen as an annoying chore, or associated with snobbishness. Another example: there's animes/mangas portraying cooking in home economics class in school (like cutting veggies and making rice). The closest I've seen in the US so far is third graders making homemade ice cream (which is basically just dumping cream in a bag of ice). Point being, I think there's more than just corporate narratives when it comes to culture.
- bArray 5y ago
  > Easiest solution to diabetes: Sugar tax. > > Easiest solution to climate change: Carbon tax. It sounds all good and well, until you realize it's essentially just a tax on the least wealthy people. Cheap food is typically high in sugar, so all you're doing is removing cheap food. I offer the alternative of subsidizing healthy food, use the carrot and not the stick. Subsidizing healthy food also has the added bonus of supporting local farmers and manufacturing of food. > If we havn't used these solutions, someone high up in the food chain is placing a greater emphasis on profits from the status quo instead of the wellbeing of the population. I think the fundamental assumption here is a lack of agency of the individual. The answer isn't to 'tax the plebs until they do what we want' - we need to understand exactly why people are making the decisions they do. I have some theories of my own about this, but it's an actively ongoing investigation. I spoke to a friend in Biology just the other day, and they had a completely different perspective from their field about why people are becoming more obese.
  - prostoalex 5y ago
    > It sounds all good and well, until you realize it's essentially just a tax on the least wealthy people. You could in theory offset that by changing the mix of products qualified for SNAP program. 20% of food stamp money is spent on sugary stuff https://fns-prod.azureedge.net/sites/default/files/ops/SNAPFoodsTypicallyPurchased-Summary.pdf https://fns-prod.azureedge.net/sites/default/files/ops/SNAPF...
    - bArray 5y ago
      > 20% of food stamp money is spent on sugary stuff I think the idea of a government dictating what you get to eat is still insane. How long till some politician gets paid off to pass some specific food? Such power should always be setup under the assumption that a bad actor will eventually corrupt it. And then of course you get the blind thinking "the government put it on the healthy list, so it must be healthy"... The better solution (in my opinion) is to educate people - to the point where they choose to make the right choices. Diet and exercise is just as important as Math and English when teaching kids to be productive members of the work force. This will massively pay off in the long run, as such habits usually get passed down for generations.
- kyriakos 5y ago
  Did it really stop smoking?
- bwship 5y ago
  Don't you tax my big gulp!
- tomjen3 5y ago
  How will you enforce a climate tax on China?
carom 5y ago
Seriously just make sugar illegal. It is cheap calories with no nutritional value. It is killing over half the population. I can not believe that 75% of Americans are overweight or obese. Top causes of death are weight related. I dont have much to say besides that it blows my mind. Sugar is poison.
throwitaway1235 5y ago
Do you guys think the mid-late 20th century phenomena of fat = bad, sugar = no comment, has anything to do with this battle?
- TylerE 5y ago
  Yes, t had a lot to do with it. The war against salt, also.
  - throwitaway1235 5y ago
    As a millennial, I remember my Mom buying those Snack well cookies for herself, thinking they were more healthy than traditional cookies. I assume they compensated for less fat with added sugar.
- mdbug 5y ago
  Interestingly, the whole thing now seems to have turned into the opposite. sugar = bad, fat = good. But that is not true. Sugar is actually only problematic because it's a bit addictive and it's easy to eat a lot of it. The real problem is taking in too many calories (in whatever form) and/or burning too few.
  - timbit42 5y ago
    Carbs cause a sugar rush and after the pancreas deals with it, you get hungry again a couple of hours later. This is why people snack between meals, increasing their caloric intake. If you avoid carbs and focus on proteins and healthy fats, you can go 4, 6 or even 8 hours without getting hungry, effectively reducing your caloric intake.
jcun4128 5y ago
I am fortunate I don't have diabetes but man, I wonder the fear when a shot you need to live is so expensive.
criticaltinker 5y ago
I strongly believe that fasting is one of the best ways to combat obesity, diabetes, cancer, high blood pressure, and more. The scientific literature is certainly accumulating tremendous evidence supporting this hypothesis [1]. Here is one of my favorite videos on the subject [2], a talk by Dr Pradip Jamnadas who is one of the top cardiologists in Florida. There is no industry that profits on you being healthier through fasting. Consequently it doesn't get the attention or consideration that it should given the supporting evidence. However it has an advantage over every other solution suggested here - everyone can start reaping the benefits immediately. No legislation, no taxation, etc. Eating healthy and natural foods is still a critical part of the solution. Perhaps most importantly, we need to properly educate the youth and show them the benefits and consequences of their choices when it comes to diet and exercise. [1] Fasting: Molecular Mechanisms and Clinical Applications https://www.sciencedirect.com/science/article/pii/S1550413113005032 https://www.sciencedirect.com/science/article/pii/S155041311... [2] Fasting For Survival Lecture by Dr Pradip Jamnadas https://www.youtube.com/watch?v=RuOvn4UqznU https://www.youtube.com/watch?v=RuOvn4UqznU
- dorchadas 5y ago
  For me it was a combination of fasting and cutting out as much added sugar as possible (I still do natural sugars in fruits, etc). I'm down 20 pounds since June, and it's mostly been all fat. My exercise level did go up a bit (from ~5 miles a day to 6+) simply because I'm a teacher and didn't have school all day, but in general I'm just all around healthier from really focusing on fasting (was doing it before, but more stringently now) and cutting out sugar. It's been great.
- hpoe 5y ago
  I took up IF a while back, and I wish my adherance was better but I have noticed once you get into the groove fasting days are fantastic, I do feel "lighter" and I have also realized that most of what I thought was "hunger" is "boredom" and most of my cravings are quite easily handled. Really we should start teaching people the value of IF.
- neurobashing 5y ago
  I have never been more miserable than when I was doing fasting. It was truly one of the most horrible times of my life. I tried for months. My sleep as disrupted, I felt awful, and I had no energy. But more to the point, _nothing happened at all_ in terms of weight loss. Just thinking about it makes me angry! I have no idea what the hell is going on with my metabolism and why I am the pure opposite case. I'm genuinely curious. Right now, I lift heavy 3x a week and do moderate cardio 3x a week (run, bike, swim, etc). I feel great! And I get to eat like an insane teenager. My blood chemistry is perfect and my resting heart rate is in the high 40s. It's more than a little frustrating at times that I have to do all that _work_ when I personally know people who dropped a bunch of weight with almost no effort via fasting. I feel great, though, and at this point I'm used to the program.
tomohawk 5y ago
You have to go way out of your way to get food that is not loaded with sugar. Just normal food, let alone something that is meant to be a desert. Peoples taste becomes so attuned to it that they don't even realize that almost everything they eat is a desert. It takes attention and effort to get off of that soft addiction. The first several months things will taste bland. But, once you reset your taste buds, you will have a hard time believing you used to eat all that sugar. And you will experience all of those other flavors that the sugar was drowning out. And the addiction is real. A friend who is a nurse has seen people sneaking in sugary foods to people who are in the facility due to diabetes, and in danger of losing limbs or going blind. They won't stop.
- dorchadas 5y ago
  > You have to go way out of your way to get food that is not loaded with sugar. Just normal food, let alone something that is meant to be a desert. Seriously. It's such a pain to shop. I've, thankfully, managed to find one brand of 100% whole wheat bread that has <1g added sugar. All the rest were crazy levels for bread imo. And protein bars, despite being labeled as 'healthy', usually contain tons of added sugar, sadly. Or, just as bad, they have sugar alcohols to make them sweeter. It'd be nice to just find one that only has sugar from what's in it, without all the added stuff. Closest I've gotten to zero is one with 2g sugar and 2g sugar alcohols. As for the addiction, you're 100% right. I used to drink way too much sweet tea a day. I went without for only a week and the first one I drank after that was just not flavorful. It was quite disgusting. I've since added it back in from time to time, but mostly I just drink unsweet anymore.
  - Ancalagon 5y ago
    Is this the Dave's Power Bread? That's what I've switched to but I just recently realized they still add stevia as a sweetener. Wondering if there is an even plainer version of bread with that level of sugar (< 1g)
    - dorchadas 5y ago
      It's Nature's Own 100% Whole Wheat. I get it from Kroger. Total sugars are <1g, all of which seems to be added. The only sweetener I see on the ingredients list is brown sugar, but the FDA defines that as an added sugar so it's taken into account.
jbverschoor 5y ago
So now everybody needs 2 vaccines against diabetes?
deleted 5y ago
[deleted]
nostromo 5y ago
Alternate title: After a many years of improvement, there was one bad year for diabetics during a pandemic.
- officialchicken 5y ago
  Which imaginary years were those? The years where a proliferation of marginal drug improvements (due to expiring patents) were replaced by a cure? Where access to diagnostic equipment and preventative care wasn't severely limited by for-profit healthcare companies? I'd like to know more!!!
  - nostromo 5y ago
    It’s in the article.
    - officialchicken 5y ago
      Author has a great imagination and no need for insulin.
yawaworht1978 5y ago
The health care model in the US doesn't really help much on the matter, but this isn't a battle against diabetes, diabetes is just the result of an overweight population with bad dietary habits. There is the inherited kind, and then there is the "earned" kind. One is genetically unavoidable, the other is mostly preventable. It is not even the food, or fats, or carbs, or sugars, it's too many calories over extended time frames and all the fizzy drinks with sugar and lattes with more calories than a pizza are what transfers people to diabetes city. The body has ok ish prevention systems when it comes to food via ghrelin feedback loop and stomach size, but the body cannot cope with too much fast absorbed fluid calories. The rise of zero calorie drinks is a decent first step, some people say these can make you fat as well, but that is entirely physically impossible, they contain zero energy and they do not cause blood sugar level volatility , else diabetics drinking them could drop dead within minutes. Many people have very poor education on food matters and are falling to all kinds of marketing tricks, like bio(doesn't make it healthy) , no fat(replaced by sugar), natural ingredients or juice(how much and still, fluid fruit sugar is not good for you if you drink a bottle). Sure, a basketball professional can have a Gatorade after a training when he is depleted of glycogen, but the Avery joe whos daily exercise is grabbing the beer and tv remote and constantly being saturated with carbs? Will not end well. I didn't look up historical data but the self caused diabetes will certainly be more wide spread in nations with more obesity problems than nations with slimmer people. And diabetes and blood sugar levels are just the start, there are many more undesired side effects. Source, ex gf has masters in nutrition.
- MisterBastahrd 5y ago
  There's an inherited kind, an earned kind, and a "whoops, diabetes!" kind. My sister spent the first 36 years of her life without diabetes or symptoms of diabetes. 5'3", 130 pounds. Then she had her second child, and whatever happened during that time eradicated her ability to deal with sugar. She had been perfectly healthy aside from an ovarian cyst which was removed before she was pregnant with the second child. So now she's a type 1 diabetic, complete with a blood glucose monitor and an insulin pump.
  - nradov 5y ago
nradov 5y ago
Virta Health has peer reviewed studies showing that type 2 diabetes can be reversed in many patients through dietary changes, specifically nutritional ketosis. Many of their patients are no longer insulin dependent. https://www.virtahealth.com/research https://www.virtahealth.com/research
oxymoran 5y ago
“… poor and living alone – rarely left her apartment, ordering fast-food delivery instead of risking the grocery store” This poor lady was given such bad advice. Groceries can be delivered too, diabetes+fast food is a recipe for disaster.
- dehrmann 5y ago
  The other part was she overestimated the risk of covid and should have invested in an N95 respirator and brave the grocery store and seen her doctor. That said, I'm curious how reporters find these stories. A poor diabetic who lived alone and died from diabetes complications during covid because it stopped her from eating well and getting regular blood tests is a very specific story.
lawrenceyan 5y ago
Consider checking out CGMs (continuous glucose monitors) for what I think is a pretty comprehensive solution. They can even be useful for people who don't have diabetes, but are just interested in maintaining healthy blood glucose levels during the day.
- 00deadbeef 5y ago
  When these are available in non-invasive form in a smartwatch, it could be a gamechanger.
dghughes 5y ago
Sugar doesn't cause diabetes anymore than water causes thirst. A person with undiagnosed pre-diabetes, or is diabetic craves sugar.
00deadbeef 5y ago
I reversed Type 2 diabetes with a ketogenic diet. I had been referred to my local hospital's diabetes department and was prescribed Metformin. On my second appointment I was given "the talk" and told I would definitely end up on insulin - everyone does - and will probably have all kinds of nasty complications. Then we looked at my most recent HbA1c result. "The metformin is working well for now", he said. "Your a1c is back to normal". "No, I haven't been taking it. I've done that through diet alone." I was discharged from their care on the spot and haven't been back.
ravenstine 5y ago
Let's stop pretending we care about diabetes. All the time an article like this gets trotted out and life goes on the minute the world has stopped reading it. If we cared, we'd address the culture that is making us miserable. We can try to address diabetes, obesity, depression, and suicide by passing bills and popping pills, but it doesn't actually address anything. People are miserable whether they know it consciously or not. Many Americans believe they are happy and yet are spiritually devoid. They know deep down that the reward they're getting for their effort is break-even most of the time. The more aware can see this reflected as stagnant wages. American society is that of decreasing trust and we've never been more divided. What do people do when they feel alienated? They seek out escape. What kind of escape can most people afford? Comforting, cheap, and addictive food and vicarious living through mainstream mass entertainment. Yeah, no shit they're getting fat and sick.
- officialchicken 5y ago
  I agree, and luckily, we can all profit from this disease - https://diabeticinvestor.com/ https://diabeticinvestor.com/ Note: I got tired of others profiting from my pain so I try to share this link with everyone to show just how f&$^@#d up healthcare is in the USA. I'm not the creator, but they are also diabetic.
- minikites 5y ago
  >Many Americans believe they are happy and yet are spiritually devoid. They know deep down that the reward they're getting for their effort is break-even most of the time. The more aware can see this reflected as stagnant wages. Exactly. There's also the chorus of people who sing lies about how things are better than ever and we should be so lucky to live in the USA. It all rings hollow against the lived experience of so many people. Capitalism profits from people being tired and afraid, which is why capital fights against any improvement to the lives of individuals (universal healthcare, higher wages, education, etc).
- criticaltinker 5y ago
  > If we cared, we'd address the culture that is making us miserable. Many people do care, the real question is how do we change this culture? Where do we even begin? Obviously we must teach the youth about the relationships between diet, exercise, and mental health - which science has unveiled over the past decades. How do you help people fill their spiritual void? Historically religion has served that function. Now science is the new religion, and the world is slowly being reduced to mechanistic and predictable processes which displace the wonder and awe humanity once held. > Yeah, no shit they're getting fat and sick. Just about everyone can see the problems, yet no one seems to have solutions.
tailius 5y ago
You should see Southern endocrinological clinics are massive patient and provider factories and typically have "diabetes" before "endocrinology" in the title.
Jtsummers 5y ago
Not strictly to the article, but rather the discussion here. There are a number of people saying the "solution" is to tax sugars or various other things. I think people would benefit from reading (or re-reading) Donella Meadows "Leverage Points" [0] essay. I'll reproduce the list here, like a top-10 list the most effective is at the bottom (but it's also the hardest to accomplish): 12. Constants, parameters, numbers (such as subsidies, taxes, standards). 11. The sizes of buffers and other stabilizing stocks, relative to their flows. 10. The structure of material stocks and flows (such as transport networks, population age structures). 9. The lengths of delays, relative to the rate of system change. 8. The strength of negative feedback loops, relative to the impacts they are trying to correct against. 7. The gain around driving positive feedback loops. 6. The structure of information flows (who does and does not have access to information). 5. The rules of the system (such as incentives, punishments, constraints). 4. The power to add, change, evolve, or self-organize system structure. 3. The goals of the system. 2. The mindset or paradigm out of which the system — its goals, structure, rules, delays, parameters — arises. 1. The power to transcend paradigms. Why I think this is relevant: Taxation is #12. It is not at all the most effective way, and is highly unlikely to provide us with a solution. #11 & #10 are related to another idea here, outright banning sugars or HFCS. It can work, but there are other issues (like portion size at restaurants) beyond just sugars. This isn't to say these can't be used, but they're unlikely to be effective. They also miss a major part of the diabetes epidemic which is the relatively sedentary nature of people in the US, and that requires more of a culture change. Sugars are the low hanging fruit, it'll help some, but it's far from a solution. #6 has been applied for over a decade now in the US as restaurants have increasingly placed caloric values on their menus. And caloric values have been listed on food packaging for decades. But just having the information is not itself that useful unless people understand what to do with it or have the discipline to track and make use of it (or at least say, "Maybe I don't need that 2000 calorie hamburger and the 500 calorie fries and the 300 calorie drink."). [0] https://donellameadows.org/archives/leverage-points-places-to-intervene-in-a-system/ https://donellameadows.org/archives/leverage-points-places-t...
underseacables 5y ago
What would the effect be if the FDA, for example, sharply limited the amount of sugar and sweeteners in food and beverages?
deleted 5y ago
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endisneigh 5y ago
America should subsidize healthy foods in food deserts. Then to pay themselves back they should implement "bad food" taxes that increase until the healthy food places, such as grocery stores, as the majority. Repeat this process within grocery stores for produce and processed foods.

55 points by prostoalex 5y ago

02020202 5y ago

it's such an easy solution to fix the insulin resitance that i don't know why this is still a thing. stop eating processed foods. ban sugar and vegetable oils from your house. eat a ton of meat, eggs, butter, ghee, lard, bacon..and you'll be fit in no time. omg.

NonContro 5y ago

Easiest solution to diabetes: Sugar tax. Easiest solution to climate change: Carbon tax. If we havn't used these solutions, someone high up in the food chain is placing a greater emphasis on profits from the status quo instead of the wellbeing of the population.

00deadbeef 5y ago
Is this the solution, though? Even if you could prevent new diabetes cases there are still countless millions of diabetics who wouldn’t be helped by a sugar tax.
Smithalicious 5y ago
Any tax on food hits poor people much more than wealthier people. You are taking food out of people's mouths.
- Retric 5y ago
  Taxes can be redirected to the poor or even used to subsidize other food choices. The point is people and companies would make different choices if empty calories where relatively more expensive. The same is true of carbon taxes, they don’t extract money from the economy they move it around within the same economy.
  - Smithalicious 5y ago
    Sure, though in my experience that rarely really happen. Here's another angle: it creates a kind of social stratification where only the wealthier can afford to eat certain popular foods. I grew up poor, it's very humiliating to not be able to eat the same things as your peers.
- adrianN 5y ago
  Sugar is not an essential food.
nostromo 5y ago
Good luck explaining to people that Apple Juice has a sugar tax applied to it now even though the only ingredient listed is “apples.” And, yes, it’s just as bad for you as soda. Don’t forget that we'll be needing a flour tax too…
post_break 5y ago
Stop taxing everything. Tax is not the solution for everything. The people buying soda are generally the poor or middle class. All this does it take more money from those who need it the most. What we need to do is regulate how much sugar you can put into foods. But we can't do that. We have to prop up the corn industry with subsidies. Sugar and HFCS is in literally everything. By adding a sugar tax you're basically saying everything you eat must get more expensive, that'll teach you to eat.
- sokoloff 5y ago
  I think it’s probably worth examining how well taxing tobacco worked (and where/when it didn’t work).
- fighterpilot 5y ago
  Tax sugar and give it back as a UBI. That alleviates the regressive tax concern. But I suspect that that's not the real reason you're against it. If your real concern is the expansion of the state, then implement a sugar tax and reduce other taxes. Whatever your concern, a sugar and carbon tax are great ideas (due to incentive alignment) and can be made to work.
  - ItsMonkk 5y ago
    Exactly. The tax externalities and dividend system is such an underappreciated idea. Sugar, carbon, and land are things that we move quickly to implement and bring it to more and more externalities.
    - fighterpilot 5y ago
      What do you mean by "dividend" in this context?
      - ItsMonkk 5y ago
        UBI. The verbiage comes from the climate plan[0] using the same mechanism. [0]: https://en.wikipedia.org/wiki/Carbon_fee_and_dividend https://en.wikipedia.org/wiki/Carbon_fee_and_dividend
mattrighetti 5y ago
*Easiest also non working solution
ajsnigrutin 5y ago
So, a giant corporation outsources their production to china, pays zero carbon tax, and still pollutes the same planet, but Johnny average cannot heat his house and drive his car, because he cannot afford it anymore?
- option 5y ago
  then tax import goods from China on entry to US until US authorities are satisfied with the amounts of carbon taxes paid in China (to China).
  - MrFlibbles 5y ago
    I believe we had a recent President who tried to raise import taxes (for whatever reason) on imports from China and the opposition went totally berserk. If it didn't work then or for whatever those reasons were, why would it work now?
    - option 5y ago
      why do you think it didn’t work? It certainly hurt China economically and they aren’t exactly the friend of US.
- nend 5y ago
  Taxing sugar means people can no longer heat their house or pay for gas? Sounds like a bit of a reach. How much exactly is Johnny Average spending on sugar every month?
  - ajsnigrutin 5y ago
    taxing carbon does that.
    - fighterpilot 5y ago
      No, you can cut other taxes or give a UBI to offset it.
deleted 5y ago
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MattGaiser 5y ago
A lot of the people who buy those things also object.
fortran77 5y ago
80% of people with Type 2 diabetes who are overweight would be asymptomatic if they lost weight. Perhaps we should tax obesity and not burden those who know how to eat responsibly?
- Red_Leaves_Flyy 5y ago
  Perhaps we should treat unhealthy foods like we treat other unhealthy things like cigarettes and alcohol. Tax them at 90%, must be 21 or older, ban advertising, and require scary warning labels on the retailers that sell them, the containers, and the menus. The real problem is two fold. tons of people are negligently ignorant about what they eat and how it affects them. Lots of people’s livelihoods depend upon most people having terrible diets. Like seafood? You’re probably eating multiple times the safe limit of heavy metals. Like live events with popup food services? Would you like it as much if the only affordable foods were vegetable and fiber rich options without the large servings of carbs and sugars? Want cirrhosis with your alcohol? Want diabetes warnings on your ice cream and coffees? To solve the diabetes epidemic we must get structure the parts of society that rely on people actively eating themselves too expensive and early deaths.
jimbob45 5y ago
The right solution is to educate people about what their A1C means and to incentivize them to check it. Most people don't know what theirs is - I would bet that less than five people in this very thread have checked their A1C in the last six months. Remember that diet isn't always sufficient to lower A1C and you may need drugs or other lifestyle changes. Mandate A1C checks bi-yearly for insurance providers or have them pass along the penalty.
- jaywalk 5y ago
  It sounds like you don't really understand what A1C tests are meant for either. There's a reason it's not part of a standard physical while blood sugar is.
  - mnw21cam 5y ago
    And that reason would be? HbA1C is effectively a measure of the average amount of sugar that has been in your blood over the last couple of months. A spot sugar level is the amount of sugar in your blood right now, and can vary a huge amount, depending on when you last ate, what you ate, and what exercise you have just done. It's less useful. You can do a fasting blood glucose, and a glucose challenge, but these tests are much more inconvenient for the patient. Outside the US, most testing has switched to HbA1C for these reasons.
oxymoran 5y ago
It’s not just sugar though, it’s junk, processed, and fast food in general. It’s astonishing how bad our current nutritional advice is.
slownews45 5y ago
No question - but there is so much special interest tied into things like climate change that there is no will to actually solve it. We've got now the hydrogen thing (aka fossil fuel with a ton of steps before you actually run an electric motor). We're going to have billions in special interest for this in the dems new bill. http://dx.doi.org/10.1002/ese3.956 http://dx.doi.org/10.1002/ese3.956 We've got the ethanol thing https://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=341491 https://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntr... I could go on endlessly.
collaborative 5y ago
Everyone talks about sugar. But the real problem is food culture (or the lack of). American, and now many European diets now consist of either fast food, oven-ready food or fried food. I recently went shopping and had a look at the "healthy" aisle. I could only find supposedly healthy food consisting of extremely savory dishes -carbonara, paella, etc. This is no way to eat healthy In many western countries, no one is willing to eat a plate of barely seasoned boiled potatoes, or of barely seasoned pulses, etc Everything is meaty, savory, rich. Edit: I see I caused a reaction. I will explain. We are training our taste, and our children's tastes, to expect an explosion of flavor in every bite. This is not healthy. It promotes ordering take-out food, buying ready-meals, etc. Food doesn't need to be complex. We have fallen to "recipe book" diets. For example, I am mediterranean. When I read mediterranean recipe books, I see the same meals we eat, but turbo-charged with flavor. You can see the same thing in Chinese take-outs, where you will rarely see the owner eat the loaded meals he sells. He'll sautee some bean sprouts and mix them with boiled rice Our stomachs aren't nuclear reactors, but in the western world, they are trained to be Recipe book meals are ok to eat twice a week. The rest of the week should include steamed veggies with olive oil and salt, boiled apple puree, lentil soup, chick peas with carrots, mash with cabbage and til, leek and potato cream, etc
- Arrath 5y ago
  Honest question, why the push for 'barely seasoned'? What are the dietary implications of a dash of pepper, paprika, garlic powder, turmeric, garam masala etc. if the salt and sugar is kept in check?
  - Jtsummers 5y ago
    I think it's because people don't know how to cook. Seriously, adding those spices in has essentially no caloric effect on the meal (especially because many spices are strong enough you don't need to add a lot to have a massive effect on the flavor). The result, though, is that you can cook "the same thing" every day, but vary the spices and never get bored with chicken and vegetables or whatever it is you settle on.
- 00deadbeef 5y ago
mdbug 5y ago
Sugar does not cause diabetes.
- 00deadbeef 5y ago
  Too much sugar causes high insulin. Prolonged high insulin causes insulin resistance. Insulin resistance causes diabetes.
  - mdbug 5y ago
    This is a common misconception. Insulin resistance and type 2 diabetes is mostly caused by obesity. Sugar has a relatively high caloric density and can be addictive, leading to obesity. However, you can eat large amounts of sugar if you do a lot of sport, for example, and then burn off the calories again. Then you don't get diabetes from it either.
    - inetknght 5y ago
      > mdbug: Sugar does not cause diabetes. > mdbug: Insulin resistance and type 2 diabetes is mostly caused by obesity. Your statements are misleading. Sugar can be addictive. Sugar can also cause obesity. Sugar can also cause insulin resistance. Sugar can also cause diabetes. These concepts are not mutually exclusive. 2007: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235907/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235907/ The reviewed evidence supports the theory that, in some circumstances, intermittent access to sugar can lead to behavior and neurochemical changes that resemble the effects of a substance of abuse. 2010: https://pubmed.ncbi.nlm.nih.gov/20138901/ https://pubmed.ncbi.nlm.nih.gov/20138901/ It is thought that SSBs contribute to weight gain in part by incomplete compensation for energy at subsequent meals following intake of liquid calories. They may also increase risk of T2DM and CVD as a contributor to a high dietary glycemic load leading to inflammation, insulin resistance and impaired beta-cell function. 2012: https://pubmed.ncbi.nlm.nih.gov/22289979/ https://pubmed.ncbi.nlm.nih.gov/22289979/ Temporal patterns over the past three to four decades have shown a close parallel between the rise in added sugar intake and the global obesity and type 2 diabetes (T2D) epidemics. 2013: https://pubmed.ncbi.nlm.nih.gov/23657152/ https://pubmed.ncbi.nlm.nih.gov/23657152/ The incidence of T2D increased dramatically over the last decades mainly due to Western lifestyle factors such as lack of exercise and high calorie diets. In fact, high-sugar diets are thought to promote weight gain and insulin resistance predisposing to T2D 2015: https://pubmed.ncbi.nlm.nih.gov/26376619/ https://pubmed.ncbi.nlm.nih.gov/26376619/ There are plausible mechanisms and research evidence that supports the suggestion that consumption of excess sugar promotes the development of cardiovascular disease (CVD) and type 2 diabetes (T2DM) both directly and indirectly. I'll just stop looking there.
someonevouchme 5y ago
The best solution is that people choose to eat less sugar. It's better because it doesn't require treating adults like children, or humans like pets or cattle. Diet choices are not a problem of policy.
- inetknght 5y ago
  > The best solution is that people choose to eat less sugar People choose to eat high-sugar foods because they're cheap. A tax will help make them less-cheap.
hansor 5y ago
>Easiest solution to diabetes: Sugar tax. Wrong. You should BAN High-fructose corn syrup. https://en.wikipedia.org/wiki/High-fructose_corn_syrup https://en.wikipedia.org/wiki/High-fructose_corn_syrup It is way more harmful than natural sugar. It is not banned yet because: - It is made from corn, and corn is heavily substituted by US government. - It is super cheap (high volume of corn available) - It is not only slightly sweet but also prevents spoilage (that's why they add it to US "bread" !) - It is good anti-oxidizer - It is good and cheap liaison
- hannob 5y ago
  This HFCS story is a bit of a strange thing. At some point it was marketed as a more "natural" alternative to plain sugar. Then it became the villain and people said you should use normal sugar. The truth is: HFCS is not much different from normal sugar. They're both calorie dense and not very healthy.
  - Guest42 5y ago
    Anecdote, but hfcs requires approximately 3 times the insulin, if anyone has a different experience, please tell
- BeetleB 5y ago
  It's funny you link to the Wikipedia page, and then make a comment like: > It is way more harmful than natural sugar. When the Wikipedia page doesn't agree with your assertion.
01100011 5y ago
Easiest reaction maybe. I'd need to see some evidence to be convinced it is a solution. It seems to me more like a feel good measure that just further burdens people who are making poor choices already. Sure, there's some sort of libertarianish, survival of the fittest argument to be made for that, but if you're actually interested in positive results I think you're going to need something more nuanced. My personal opinion, based on nothing more than my experiences, and probably not worth much: How did we reduce smoking, another addictive, pleasurable activity with negative health consequences? We taxed it, sure, but we also had aggressive public health campaigns, provided medical assistance, and developed harm-reducing substitutes. Most importantly, we changed the culture, marketing and image of smoking. We didn't simply tax cigarettes and get smoking rates to appreciably fall. Food is even more difficult. Everyone needs to eat. No one needs to smoke. People with unhealthy attitudes towards food can't just give up eating. We have a culture that celebrates overconsumption. We have holidays seemingly dedicated to it. Advertising and the media are constantly promoting unhealthy eating.. Unhealthy eating is an easily accessible pleasure to many in the lower economic classes thanks to subsidies combined with the inherently low cost of production. With such a low starting price, you'd have to have crushing taxes to cause a meaningful shift in habits. Such taxes would be unfair to the people who can safely consume those products. Does it help if we tax, say, sweetened, carbonated beverages while excluding fruit juices or sugary fruits? Honey has even more fructose than "high fructose" corn syrup. Should we tax that too?
lhorie 5y ago
I'm not opposed to the idea, but there are some counterpoints that suggest it may not be as effective as you think. Look at gasoline tax. California has the highest tax in the country, yet it's also the largest consumer. I think other commenters have it right when they say there's a culture problem. In Niagara Falls, for example, it's a fairly common occurrence for Americans going into the Canadian side to get into arguments with Starbucks employees because they think they're being scammed/ripped off, when the reality is simply that canadian sizes are smaller than the american ones. Japanese snack sizes look minuscule in comparison with american ones. Take out food in many places is pretty much restricted to just burgers and pizza, (compare to Japan selling oden at 7-eleven). "Healthy" food like salads is often drizzled with oily, high sodium dressings, the list goes on.
- brundolf 5y ago
  But the culture problem is a result of the corporate problem. Expectations are set by what people are used to being offered - heck, your stomach physically grows when you're regularly eating larger portions - it should be no surprise that those norms carry over when people leave their environment for short periods. I don't think it's fair to call it a moral failing of consumers. We've been set up to fail.
  - lhorie 5y ago
    I mean, it's partly its fault, sure. To see what happens if you completely let corporations dictate your diet, look no further than Super Size Me. But also, that's kinda abdicating responsibility a bit, don't you think? My in-laws live in North America, but cook traditional homemade chinese food (and they were teachers by trade in China, so the "low income peeps don't have time" argument doesn't exactly fly either). It costs them something to the tune of $150 a month in groceries to feed 6 lavishly when we go visit (probably even less otherwise because they're even thriftier when cooking for themselves). The fact that the vast majority of americans don't know how to cook rice in a regular pot, or pickle their own radishes is largely due to its culinary culture (or rather, a lack of it). In Japan, there's the concept of Yamato Nadeshiko, a desirable set of traits in a romantic partner which involves among other things being excellent at home cooking. I'm not aware of this kind of intertwining between cooking and other aspects of life in the US. IME, cooking is mostly just seen as an annoying chore, or associated with snobbishness. Another example: there's animes/mangas portraying cooking in home economics class in school (like cutting veggies and making rice). The closest I've seen in the US so far is third graders making homemade ice cream (which is basically just dumping cream in a bag of ice). Point being, I think there's more than just corporate narratives when it comes to culture.
bArray 5y ago
> Easiest solution to diabetes: Sugar tax. > > Easiest solution to climate change: Carbon tax. It sounds all good and well, until you realize it's essentially just a tax on the least wealthy people. Cheap food is typically high in sugar, so all you're doing is removing cheap food. I offer the alternative of subsidizing healthy food, use the carrot and not the stick. Subsidizing healthy food also has the added bonus of supporting local farmers and manufacturing of food. > If we havn't used these solutions, someone high up in the food chain is placing a greater emphasis on profits from the status quo instead of the wellbeing of the population. I think the fundamental assumption here is a lack of agency of the individual. The answer isn't to 'tax the plebs until they do what we want' - we need to understand exactly why people are making the decisions they do. I have some theories of my own about this, but it's an actively ongoing investigation. I spoke to a friend in Biology just the other day, and they had a completely different perspective from their field about why people are becoming more obese.
- prostoalex 5y ago
  > It sounds all good and well, until you realize it's essentially just a tax on the least wealthy people. You could in theory offset that by changing the mix of products qualified for SNAP program. 20% of food stamp money is spent on sugary stuff https://fns-prod.azureedge.net/sites/default/files/ops/SNAPFoodsTypicallyPurchased-Summary.pdf https://fns-prod.azureedge.net/sites/default/files/ops/SNAPF...
  - bArray 5y ago
    > 20% of food stamp money is spent on sugary stuff I think the idea of a government dictating what you get to eat is still insane. How long till some politician gets paid off to pass some specific food? Such power should always be setup under the assumption that a bad actor will eventually corrupt it. And then of course you get the blind thinking "the government put it on the healthy list, so it must be healthy"... The better solution (in my opinion) is to educate people - to the point where they choose to make the right choices. Diet and exercise is just as important as Math and English when teaching kids to be productive members of the work force. This will massively pay off in the long run, as such habits usually get passed down for generations.
kyriakos 5y ago
Did it really stop smoking?
bwship 5y ago
Don't you tax my big gulp!
tomjen3 5y ago
How will you enforce a climate tax on China?

carom 5y ago

Seriously just make sugar illegal. It is cheap calories with no nutritional value. It is killing over half the population. I can not believe that 75% of Americans are overweight or obese. Top causes of death are weight related. I dont have much to say besides that it blows my mind. Sugar is poison.

throwitaway1235 5y ago

Do you guys think the mid-late 20th century phenomena of fat = bad, sugar = no comment, has anything to do with this battle?

TylerE 5y ago
Yes, t had a lot to do with it. The war against salt, also.
- throwitaway1235 5y ago
  As a millennial, I remember my Mom buying those Snack well cookies for herself, thinking they were more healthy than traditional cookies. I assume they compensated for less fat with added sugar.
mdbug 5y ago
Interestingly, the whole thing now seems to have turned into the opposite. sugar = bad, fat = good. But that is not true. Sugar is actually only problematic because it's a bit addictive and it's easy to eat a lot of it. The real problem is taking in too many calories (in whatever form) and/or burning too few.
- timbit42 5y ago
  Carbs cause a sugar rush and after the pancreas deals with it, you get hungry again a couple of hours later. This is why people snack between meals, increasing their caloric intake. If you avoid carbs and focus on proteins and healthy fats, you can go 4, 6 or even 8 hours without getting hungry, effectively reducing your caloric intake.

jcun4128 5y ago

I am fortunate I don't have diabetes but man, I wonder the fear when a shot you need to live is so expensive.

criticaltinker 5y ago

I strongly believe that fasting is one of the best ways to combat obesity, diabetes, cancer, high blood pressure, and more. The scientific literature is certainly accumulating tremendous evidence supporting this hypothesis [1]. Here is one of my favorite videos on the subject [2], a talk by Dr Pradip Jamnadas who is one of the top cardiologists in Florida. There is no industry that profits on you being healthier through fasting. Consequently it doesn't get the attention or consideration that it should given the supporting evidence. However it has an advantage over every other solution suggested here - everyone can start reaping the benefits immediately. No legislation, no taxation, etc. Eating healthy and natural foods is still a critical part of the solution. Perhaps most importantly, we need to properly educate the youth and show them the benefits and consequences of their choices when it comes to diet and exercise. [1] Fasting: Molecular Mechanisms and Clinical Applications https://www.sciencedirect.com/science/article/pii/S1550413113005032 https://www.sciencedirect.com/science/article/pii/S155041311... [2] Fasting For Survival Lecture by Dr Pradip Jamnadas https://www.youtube.com/watch?v=RuOvn4UqznU https://www.youtube.com/watch?v=RuOvn4UqznU

dorchadas 5y ago
For me it was a combination of fasting and cutting out as much added sugar as possible (I still do natural sugars in fruits, etc). I'm down 20 pounds since June, and it's mostly been all fat. My exercise level did go up a bit (from ~5 miles a day to 6+) simply because I'm a teacher and didn't have school all day, but in general I'm just all around healthier from really focusing on fasting (was doing it before, but more stringently now) and cutting out sugar. It's been great.
hpoe 5y ago
I took up IF a while back, and I wish my adherance was better but I have noticed once you get into the groove fasting days are fantastic, I do feel "lighter" and I have also realized that most of what I thought was "hunger" is "boredom" and most of my cravings are quite easily handled. Really we should start teaching people the value of IF.
neurobashing 5y ago
I have never been more miserable than when I was doing fasting. It was truly one of the most horrible times of my life. I tried for months. My sleep as disrupted, I felt awful, and I had no energy. But more to the point, _nothing happened at all_ in terms of weight loss. Just thinking about it makes me angry! I have no idea what the hell is going on with my metabolism and why I am the pure opposite case. I'm genuinely curious. Right now, I lift heavy 3x a week and do moderate cardio 3x a week (run, bike, swim, etc). I feel great! And I get to eat like an insane teenager. My blood chemistry is perfect and my resting heart rate is in the high 40s. It's more than a little frustrating at times that I have to do all that _work_ when I personally know people who dropped a bunch of weight with almost no effort via fasting. I feel great, though, and at this point I'm used to the program.

tomohawk 5y ago

You have to go way out of your way to get food that is not loaded with sugar. Just normal food, let alone something that is meant to be a desert. Peoples taste becomes so attuned to it that they don't even realize that almost everything they eat is a desert. It takes attention and effort to get off of that soft addiction. The first several months things will taste bland. But, once you reset your taste buds, you will have a hard time believing you used to eat all that sugar. And you will experience all of those other flavors that the sugar was drowning out. And the addiction is real. A friend who is a nurse has seen people sneaking in sugary foods to people who are in the facility due to diabetes, and in danger of losing limbs or going blind. They won't stop.

dorchadas 5y ago
> You have to go way out of your way to get food that is not loaded with sugar. Just normal food, let alone something that is meant to be a desert. Seriously. It's such a pain to shop. I've, thankfully, managed to find one brand of 100% whole wheat bread that has <1g added sugar. All the rest were crazy levels for bread imo. And protein bars, despite being labeled as 'healthy', usually contain tons of added sugar, sadly. Or, just as bad, they have sugar alcohols to make them sweeter. It'd be nice to just find one that only has sugar from what's in it, without all the added stuff. Closest I've gotten to zero is one with 2g sugar and 2g sugar alcohols. As for the addiction, you're 100% right. I used to drink way too much sweet tea a day. I went without for only a week and the first one I drank after that was just not flavorful. It was quite disgusting. I've since added it back in from time to time, but mostly I just drink unsweet anymore.
- Ancalagon 5y ago
  Is this the Dave's Power Bread? That's what I've switched to but I just recently realized they still add stevia as a sweetener. Wondering if there is an even plainer version of bread with that level of sugar (< 1g)
  - dorchadas 5y ago
    It's Nature's Own 100% Whole Wheat. I get it from Kroger. Total sugars are <1g, all of which seems to be added. The only sweetener I see on the ingredients list is brown sugar, but the FDA defines that as an added sugar so it's taken into account.

jbverschoor 5y ago

So now everybody needs 2 vaccines against diabetes?

deleted 5y ago

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nostromo 5y ago

Alternate title: After a many years of improvement, there was one bad year for diabetics during a pandemic.

officialchicken 5y ago
Which imaginary years were those? The years where a proliferation of marginal drug improvements (due to expiring patents) were replaced by a cure? Where access to diagnostic equipment and preventative care wasn't severely limited by for-profit healthcare companies? I'd like to know more!!!
- nostromo 5y ago
  It’s in the article.
  - officialchicken 5y ago
    Author has a great imagination and no need for insulin.

yawaworht1978 5y ago

The health care model in the US doesn't really help much on the matter, but this isn't a battle against diabetes, diabetes is just the result of an overweight population with bad dietary habits. There is the inherited kind, and then there is the "earned" kind. One is genetically unavoidable, the other is mostly preventable. It is not even the food, or fats, or carbs, or sugars, it's too many calories over extended time frames and all the fizzy drinks with sugar and lattes with more calories than a pizza are what transfers people to diabetes city. The body has ok ish prevention systems when it comes to food via ghrelin feedback loop and stomach size, but the body cannot cope with too much fast absorbed fluid calories. The rise of zero calorie drinks is a decent first step, some people say these can make you fat as well, but that is entirely physically impossible, they contain zero energy and they do not cause blood sugar level volatility , else diabetics drinking them could drop dead within minutes. Many people have very poor education on food matters and are falling to all kinds of marketing tricks, like bio(doesn't make it healthy) , no fat(replaced by sugar), natural ingredients or juice(how much and still, fluid fruit sugar is not good for you if you drink a bottle). Sure, a basketball professional can have a Gatorade after a training when he is depleted of glycogen, but the Avery joe whos daily exercise is grabbing the beer and tv remote and constantly being saturated with carbs? Will not end well. I didn't look up historical data but the self caused diabetes will certainly be more wide spread in nations with more obesity problems than nations with slimmer people. And diabetes and blood sugar levels are just the start, there are many more undesired side effects. Source, ex gf has masters in nutrition.

MisterBastahrd 5y ago
There's an inherited kind, an earned kind, and a "whoops, diabetes!" kind. My sister spent the first 36 years of her life without diabetes or symptoms of diabetes. 5'3", 130 pounds. Then she had her second child, and whatever happened during that time eradicated her ability to deal with sugar. She had been perfectly healthy aside from an ovarian cyst which was removed before she was pregnant with the second child. So now she's a type 1 diabetic, complete with a blood glucose monitor and an insulin pump.
- nradov 5y ago

nradov 5y ago

Virta Health has peer reviewed studies showing that type 2 diabetes can be reversed in many patients through dietary changes, specifically nutritional ketosis. Many of their patients are no longer insulin dependent. https://www.virtahealth.com/research https://www.virtahealth.com/research

oxymoran 5y ago

“… poor and living alone – rarely left her apartment, ordering fast-food delivery instead of risking the grocery store” This poor lady was given such bad advice. Groceries can be delivered too, diabetes+fast food is a recipe for disaster.

dehrmann 5y ago
The other part was she overestimated the risk of covid and should have invested in an N95 respirator and brave the grocery store and seen her doctor. That said, I'm curious how reporters find these stories. A poor diabetic who lived alone and died from diabetes complications during covid because it stopped her from eating well and getting regular blood tests is a very specific story.

lawrenceyan 5y ago

Consider checking out CGMs (continuous glucose monitors) for what I think is a pretty comprehensive solution. They can even be useful for people who don't have diabetes, but are just interested in maintaining healthy blood glucose levels during the day.

00deadbeef 5y ago
When these are available in non-invasive form in a smartwatch, it could be a gamechanger.

dghughes 5y ago

Sugar doesn't cause diabetes anymore than water causes thirst. A person with undiagnosed pre-diabetes, or is diabetic craves sugar.

00deadbeef 5y ago

I reversed Type 2 diabetes with a ketogenic diet. I had been referred to my local hospital's diabetes department and was prescribed Metformin. On my second appointment I was given "the talk" and told I would definitely end up on insulin - everyone does - and will probably have all kinds of nasty complications. Then we looked at my most recent HbA1c result. "The metformin is working well for now", he said. "Your a1c is back to normal". "No, I haven't been taking it. I've done that through diet alone." I was discharged from their care on the spot and haven't been back.

ravenstine 5y ago

Let's stop pretending we care about diabetes. All the time an article like this gets trotted out and life goes on the minute the world has stopped reading it. If we cared, we'd address the culture that is making us miserable. We can try to address diabetes, obesity, depression, and suicide by passing bills and popping pills, but it doesn't actually address anything. People are miserable whether they know it consciously or not. Many Americans believe they are happy and yet are spiritually devoid. They know deep down that the reward they're getting for their effort is break-even most of the time. The more aware can see this reflected as stagnant wages. American society is that of decreasing trust and we've never been more divided. What do people do when they feel alienated? They seek out escape. What kind of escape can most people afford? Comforting, cheap, and addictive food and vicarious living through mainstream mass entertainment. Yeah, no shit they're getting fat and sick.

officialchicken 5y ago
I agree, and luckily, we can all profit from this disease - https://diabeticinvestor.com/ https://diabeticinvestor.com/ Note: I got tired of others profiting from my pain so I try to share this link with everyone to show just how f&$^@#d up healthcare is in the USA. I'm not the creator, but they are also diabetic.
minikites 5y ago
>Many Americans believe they are happy and yet are spiritually devoid. They know deep down that the reward they're getting for their effort is break-even most of the time. The more aware can see this reflected as stagnant wages. Exactly. There's also the chorus of people who sing lies about how things are better than ever and we should be so lucky to live in the USA. It all rings hollow against the lived experience of so many people. Capitalism profits from people being tired and afraid, which is why capital fights against any improvement to the lives of individuals (universal healthcare, higher wages, education, etc).
criticaltinker 5y ago
> If we cared, we'd address the culture that is making us miserable. Many people do care, the real question is how do we change this culture? Where do we even begin? Obviously we must teach the youth about the relationships between diet, exercise, and mental health - which science has unveiled over the past decades. How do you help people fill their spiritual void? Historically religion has served that function. Now science is the new religion, and the world is slowly being reduced to mechanistic and predictable processes which displace the wonder and awe humanity once held. > Yeah, no shit they're getting fat and sick. Just about everyone can see the problems, yet no one seems to have solutions.

tailius 5y ago

You should see Southern endocrinological clinics are massive patient and provider factories and typically have "diabetes" before "endocrinology" in the title.

Jtsummers 5y ago

Not strictly to the article, but rather the discussion here. There are a number of people saying the "solution" is to tax sugars or various other things. I think people would benefit from reading (or re-reading) Donella Meadows "Leverage Points" [0] essay. I'll reproduce the list here, like a top-10 list the most effective is at the bottom (but it's also the hardest to accomplish): 12. Constants, parameters, numbers (such as subsidies, taxes, standards). 11. The sizes of buffers and other stabilizing stocks, relative to their flows. 10. The structure of material stocks and flows (such as transport networks, population age structures). 9. The lengths of delays, relative to the rate of system change. 8. The strength of negative feedback loops, relative to the impacts they are trying to correct against. 7. The gain around driving positive feedback loops. 6. The structure of information flows (who does and does not have access to information). 5. The rules of the system (such as incentives, punishments, constraints). 4. The power to add, change, evolve, or self-organize system structure. 3. The goals of the system. 2. The mindset or paradigm out of which the system — its goals, structure, rules, delays, parameters — arises. 1. The power to transcend paradigms. Why I think this is relevant: Taxation is #12. It is not at all the most effective way, and is highly unlikely to provide us with a solution. #11 & #10 are related to another idea here, outright banning sugars or HFCS. It can work, but there are other issues (like portion size at restaurants) beyond just sugars. This isn't to say these can't be used, but they're unlikely to be effective. They also miss a major part of the diabetes epidemic which is the relatively sedentary nature of people in the US, and that requires more of a culture change. Sugars are the low hanging fruit, it'll help some, but it's far from a solution. #6 has been applied for over a decade now in the US as restaurants have increasingly placed caloric values on their menus. And caloric values have been listed on food packaging for decades. But just having the information is not itself that useful unless people understand what to do with it or have the discipline to track and make use of it (or at least say, "Maybe I don't need that 2000 calorie hamburger and the 500 calorie fries and the 300 calorie drink."). [0] https://donellameadows.org/archives/leverage-points-places-to-intervene-in-a-system/ https://donellameadows.org/archives/leverage-points-places-t...

underseacables 5y ago

What would the effect be if the FDA, for example, sharply limited the amount of sugar and sweeteners in food and beverages?

deleted 5y ago

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endisneigh 5y ago

America should subsidize healthy foods in food deserts. Then to pay themselves back they should implement "bad food" taxes that increase until the healthy food places, such as grocery stores, as the majority. Repeat this process within grocery stores for produce and processed foods.