by Marion Nestle

Currently browsing posts about: Diabetes

Jan 19 2012

Weighing in on Paula Deen

The huge fuss over Paula Deen’s type 2 diabetes is understandable.   She is, after all, the queen of high-calorie Southern cooking.  And diabetes rates are especially high in the South.

Perhaps less understandable is the reaction of the American Diabetes Association.  As reported in the New York Times,

Heredity, according to the American Diabetes Association, always plays some part. “You can’t just eat your way to Type 2 diabetes,” said Geralyn Spollett, the group’s director of education.

Wrong.  You most definitely can eat your way to type 2 diabetes.

Type 2 diabetes is closely linked to overweight and obesity.  No, not everyone who is overweight develops type 2 diabetes.  But most people who have type 2 diabetes are overweight.

The first line of defense?  Lose a few pounds.  Even a relatively small reversal of calorie balance can make symptoms of type 2 diabetes disappear and reduce or eliminate the need for drugs.

Mrs. Deen does not mention weight as a factor in her disease, or losing weight as an effective treatment.

Instead, she is now a spokesperson for the drug Victoza.

According to the Times’ account, Mrs. Dean says that it is elitist to criticize her food:

You know, not everybody can afford to pay $58 for prime rib or $650 for a bottle of wine. My friends and I cook for regular families who worry about feeding their kids and paying the bills.

Really?  Does Mrs. Deen think those families can afford to pay the $500 a month drug companies charge for Victoza?

Victoza costs in other ways too.  It has to be injected and is not exactly benign.

Victoza® is not recommended as the first medication to treat diabetes. Victoza® is not insulin and has not been studied in combination with insulin…It is not known if Victoza® is safe and effective in children. Victoza® is not recommended for use in children

In animal studies, Victoza® caused thyroid tumors—including thyroid cancer—in some rats and mice.  It is not known whether Victoza® causes thyroid tumors or a type of thyroid cancer called medullary thyroid cancer (MTC) in people which may be fatal if not detected and treated early…Inflammation of the pancreas (pancreatitis) may be severe and lead to death.

The company also advises:

Victoza® is an injectable prescription medicine that may improve blood sugar (glucose) in adults with type 2 diabetes when used along with diet and exercise.

Diet and exercise?  Why not just do that in the first place?

As for the American Diabetes Association: its disinterest in promoting diet and exercise is easily explained.  It is funded by drug companies.

I gave a talk at an annual meeting of the Association a few years ago and was astounded by the number of drug companies giving things—writing pads, pens, and tape holders, but also lab coats and stethoscopes—at the trade exhibit.  Much of the scientific meeting was devoted to drug studies.  I spoke at the only session that year on dietary issues.  And Coca-Cola sponsored a session on sugars in diabetes.

Mrs. Deen’s food is best eaten in moderation.  She would do more for her own health and that of her fans if she used her television presence to promote healthier lifestyles.

Update, January 30: Brad Jacobson interviews drug reps on AlterNet (I’m quoted).

Sep 30 2011

Disappointing UN Declaration on chronic disease prevention

As I mentioned in a previous post, the United Nations General Assembly met this month to consider resolutions about doing something to address rising rates of “non-communicable” diseases (i.e., chronic as opposed to infectious diseases such as obesity-related coronary heart disease, type 2 diabetes, and cancers).

The Declaration adopted by the Assembly disappointed a consortium of 140 non-profit public health advocacy groups who issued a statement noting the conflicts of interest that occur when international agencies “partner” with companies that make products that contribute to an increase in disease risks.”

The consortium suggested actions that they hoped the U.N. would recommend, such as:

  • Realign food policies for food and agricultural subsidies with sound nutrition science
  • Mandate easy-to-understand front-of-pack nutrition labeling
  • Ban the promotion of breast-milk substitutes and high-fat, -sugar and -salt foods to children and young people
  • Prohibit advertising and brand sponsorship for alcohol beverages
  • Increase taxes on alcohol beverages
  • Expand nutritious school meal programs

The group also said that the U.N. should still work on:

  • Developing tools to navigate the trade law barriers to health policy innovation,
  •  Establishing disease-reduction targets and policy implementation schedules
  • Instituting mechanisms to keep commercially self-interested parties at arms-length and public-interest groups constructively involved

Food companies and trade associations are actively involved in lobbying the U.N. not to do any of these things.  This consortium has much work to do.


 

 

Sep 19 2011

United Nations to consider the effects of food marketing on chronic disease

In what Bloomberg News terms an “epidemic battle,” food companies are doing everything they can to prevent the United Nations from issuing a statement that says anything about how food marketing promotes obesity and related chronic diseases.

The U.N. General Assembly meets in New York on September 19 and 20 to develop a global response to the obesity-related increase in non-communicable, chronic diseases (cancer, cardiovascular disease, respiratory disease, type 2 diabetes) now experienced by both rich and poor countries throughout the world.

As the Bloomberg account explains,

Company officials join political leaders and health groups to come up with a plan to reverse the rising tide of non- communicable diseases….On the table are proposals to fight obesity, cut tobacco and alcohol use and expand access to lifesaving drugs in an effort to tackle unhealthy diets and lifestyles that drive three of every five deaths worldwide. At stake for the makers of snacks, drinks, cigarettes and drugs is a market with combined sales of more than $2 trillion worldwide last year.

Commenting on the collaboration of food companies in this effort:

“It’s kind of like letting Dracula advise on blood bank security,” said Jorge Alday, associate director of policy with World Lung Foundation, which lobbies for tobacco control.

The lobbying, to understate the matter, is intense.  On one side are food corporations with a heavy financial stake in selling products in developing countries.  Derek Yach, for example, a senior executive of PepsiCo, argues in the British Medical Journal that it’s too simplistic to recommend nutritional changes to reduce chronic disease risk.  [Of course it is, but surely cutting down on fast food, junk food, and sodas ought to be a good first step?]

On the other side are public health advocates concerned about conflicts of interest in the World Health Organization.  So is the United Nations’ special rapporteur for  the right to food, Olivier De Schutter.  Mr. De Schutter writes that the “chance to crack down on bad diets must not be missed.”

On the basis of several investigative visits to developing countries,  De Schutter calls for “the adoption of a host of initiatives, such as taxing unhealthy products and regulating harmful food marketing practices…Voluntary guidelines are not enough. World leaders must not bow to industry pressure.”

If we are serious about tackling the rise of cancer and heart disease, we need to make ambitious, binding commitments to tackle one of the root causes – the food that we eat.

The World Health Organization’s (WHO) 2004 Global Strategy on Diet, Physical Activity and Health must be translated into concrete action: it is unacceptable that when lives are at stake, we go no further than soft, promotional measures that ultimately rely on consumer choice, without addressing the supply side of the food chain.

It is crucial for world leaders to counter food industry efforts to sell unbalanced processed products and ready-to-serve meals too rich in trans fats and saturated fats, salt and sugars. Food advertising is proven to have a strong impact on children, and must be strictly regulated in order to avoid the development of bad eating habits early in life.

A comprehensive strategy on combating bad diets should also address the farm policies which make some types of food more available than others…Currently, agricultural policies encourage the production of grains, rich in carbohydrates but relatively poor in micronutrients, at the expense of the production of fruits and vegetables.

We need to question how subsidies are targeted and improve access to markets for the most nutritious foods.…The public health consequences are dramatic, and they affect disproportionately those with the lowest incomes.

In 2004, the U.N. caved in to pressures from food companies and weakened its guidelines and recommendations.  The health situation is worse now and affects people in developing as well as industrialized countries.  Let’s hope the General Assembly puts health above politics this time.

 

Jun 20 2011

More fun with cause marketing

My post last week about KFC, Pepsi, and cause marketing elicited a lively dicussion along with some further examples.

Ken Leebow of “Feed Your Head” sent this one along with a comment: “Don’t pollute the Earth, but your body: Go for it!”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cara Wilking of the Public Health Advocacy Institute (PHAI) sent this one: Give blood, eat a Whopper.  Cara, by the way, has done her own piece on why organizations that care about health should avoid partnerships with soft drink companies.

 

 

 

 

 

 

 

 

 

 

And Lisa Young sent a note about Coca-Cola’s sponsorship of continuing professional education credits for dietitians, for a course about bone health.  On that same site, if you pledge to LivePositively.com, Coke’s Sprite Zero will donate $1 to the American Cancer Society.

For those of you who insist that these kinds of partnerships raise money for Good Causes, please consider whether soft drinks are good for bone health or whether artificial sweeteners are good for cancer prevention.  The answers may not be in, but the questions are worth asking.

Cause marketing, I submit, is much more about the marketing than it is about the cause.

http://www.chicagotribune.com/sports/smack/chi-110604-smack-graphic,0,5581063.graphicCar
Jun 16 2011

The latest in cause marketing: KFC, Pepsi, and diabetes

I collect things like this—examples of food company marketing alliances with health and nutrition organizations that by all rights should be advising their members and clients not to eat much of the company’s products.  This one promotes mega-size Pepsi to raise funds for the Juvenile Diabetes Research Foundation.

 

 

 

 

 

 

 

 

 

 

This particular treasure comes from a blogger, Joe Tower, who runs a business—“Selfish Giving”—that helps companies do cause marketing.  This one crosses a line, even for him:

I’ve said this before: I don’t have a problem with nonprofits and fast-serve chains doing cause marketing. What I do have a problem with is when fast serve chains like KFC encourage consumers to buy products that directly contribute to the health conditions – in this case diabetes – they are supposedly trying to prevent by partnering with the cause in the first place….What was JDRF thinking? I’m not sure, but I’m calling them today to see if I can find out!

Here are excerpts from the response from JDRF:

We appreciate your concerns and your questions about the banner promoting a JDRF fundraising activity at KFC. Please understand that the fundraiser in question is a local initiative in Utah involving a single KFC franchise owner with a personal type 1 diabetes connection.That said, JDRF values its supporters, both individual and corporate, and their efforts to raise funds to support research aimed at improving lives and curing type 1 diabetes. JDRF carefully reviews national partnership opportunities to ensure that they are appropriate prior to joining corporate campaigns to raise funds.

Regarding this particular promotion, we understand that one of the criticisms has been the association with a sugary product, which many have associated with contributing to diabetes. It’s important to note that JDRF supports research for type 1 diabetes, an autoimmune disease that results when the immune system attacks the cells in the pancreas that produce insulin, therefore requiring a child or adult with the disease to depend on insulin treatment for the rest of their lives. It is a common misconception that type 1 diabetes is caused by obesity or eating too much junk food or sweets.

Finally, JDRF does not endorse any particular products, nor any particular diet. People with type 1 diabetes should work with their healthcare team to determine a diet that works best for them. JDRF fully supports people living with type 1 diabetes engaging in healthy eating habits and lifestyles.

–Gary Feit, National Manager, External Communications, Juvenile Diabetes Research Foundation

As I find myself saying again and again, you cannot make this stuff up.   And how does Pepsi, now promoting itself as a wellness company, feel about this?

[Thanks to David Schliefer for sending]

Update June 17: I hear rumors attributed to a Pepsi V.P. that the promotion is “no longer running.”

Jun 1 2011

What will USDA’s food plate look like?

According to William Neuman’s report in the New York Times, a USDA official, Robert C. Post, said the new food guide would be a plate and that it would serve educational purposes :

The agency would use the plate to get across several basic nutritional messages, including urging consumers to eat smaller portions, switch to low-fat or fat-free milk and drink water instead of sugary drinks.

A plate with half devoted to fruits and vegetables is not exactly a new concept.

The American Diabetes Association has been using this plate as  a food guide:

 

 

 

 

 

 

The American Institute for Cancer Research uses this one:

 

 

 

 

 

 

 

Canada’s food guide is translated into this plate:

 

 

 

 

 

 

 

And the Physicians’ Committee for Responsible Medicine has an elegantly designed 100% plant-based plate for vegetarians and vegans:

 

 

 

 

 

 

 

And here’s what CNN thinks the new USDA food icon will look like:

 

 

 

 

 

 

 

 

Can the USDA improve on the existing versions?  Does CNN have it right?

I’ll be in Washington tomorrow to find out.  You can be there virtually at www.cnpp.usda.gov.

 

Feb 13 2011

New York City’s tough anti-soda campaign

I just got off a subway car adorned with posters advertising the New York City Health Department’s “Are you pouring on the pounds?” campaign.  They are riveting.

They make a simple point, but one that is not always understood:  Soft drinks contain sugar, and lots of it.

Lots of sugar—all those packets—will make you fat.

The campaign also includes a tough video.

New York City’s Health Department is taking on the city’s high rates of heart disease and type 2 diabetes in every way it can.

Take a look.  What do you think?  Will this work?

Nov 2 2009

Meat arguments: health, climate, taxes

If only meat were just a food and not the flash point for concerns about health, climate change, and tax policy.  But it looms large in all such debates.

According to reports, meat is linked not only with a higher rate of cancer but also with type 2 diabetes.   Does this make logical sense?  It could, especially if meat eaters take in more calories and are fatter than non-meat eaters.

We’ve heard so much lately about how farm animals contribute to environmental problems and climate change, but Nicolette Hahn Niman writes in the New York Times of “the carnivore’s dilemma.”  It’s not the animals themselves that contribute to climate change, it’s the industrial methods of raising them that are the problem.  She ought to know.  She and Bill Niman run the free-range ranch in Bolinas, California highlighted in Time magazine last August.

On the other hand, Princeton professor and ethicist Peter Singer argues in the New York Daily News that meat is so bad for health and the environment that it ought to be taxed.

How to deal with all of this?  Push for more humanely and sustainably raised farm animal production, dont’ eat meat if you choose not to, and if you do eat meat, just don’t eat too much of it.

Update, November 4: I forgot to include Jonathan Safran Foer’s piece in the New York Times magazine on why he is against meat.