At Least Half of Americans Diabetic or Pre-Diabetic by 2020 | Hacker News Reader

At Least Half of Americans Diabetic or Pre-Diabetic by 2020

singularityhub.com

12 pointskkleiner25 comments

Here is the actual study (3 links deep): http://www.unitedhealthgroup.com/hrm/UNH_WorkingPaper5.pdf . Take a look at page 8, the one that contains this prediction. It was made by taking the rates of diabetes and pre-diabetes in 2007 and in 2010 (37.0% and 39.9% respectively), and drawing a line through them to get 51.9. That includes a 26.3% (2007) and 28.4% (2010) rate of "pre-diabetes", which really just means a HbA1c test that was higher than average.

But between 2007 and 2010, the diagnostic test for pre-diabetes, the HbA1c, got much cheaper and became part of routine screenings where it wasn't before, so the slight uptick observed may actually be an artifact of increased testing, and it is definitely not part of a trend that can be linearly extrapolated ten years out.

It's true that obesity is a growing problem, and it is likely also true that nearly all cases of type II diabetes can be prevented with dietary changes. But, the article repeats the 'reduce saturated fat' meme, which lately has been called into question.

Gary Taubes http://higher-thought.net/complete-notes-to-good-calories-ba...

Robert Lustig http://www.youtube.com/watch?v=dBnniua6-oM

Cynthia Kenyon http://donmatesz.blogspot.com/2009/12/how-insulin-controls-a...

Nutrition and Vision Research at Tufts (Allen Taylor) http://hnrc.tufts.edu/1192109687036/HNRCA-Page-hnrca2ws_1192...

Kurt Harris http://www.paleonu.com/get-started

Mike Eades http://www.proteinpower.com/drmike/

Uffe Ravnskov, "fat and cholesterol are good for you" http://www.ravnskov.nu/cholesterol.htm

LivinLaVidaLowCarb http://www.thelivinlowcarbshow.com/shownotes/

Weston A Price http://www.westonaprice.org/dentistry/289-invisible-toothbru...

William Davis http://heartscanblog.blogspot.com/

etc.

Also, Marion Nestle: http://www.foodpolitics.com/

This article has a bad smell. One commenter said it best -- the author is confusing 'risk factor' with 'cause'.

Which is less bad, but still bad and doesn't change the fact that obesiety is a major problem that is growing rapidly.

Curiously, problems aren't solved with weak methods of inquiry. They're also not solved by pointing at them, jumping up and down, saying, "THIS IS A PROBLEM! SOMEBODY FIX IT!"

There's this thing our parents said to us, "Whenever you point a finger, there's three pointing back at you."

I guess they had a point, after all. Yes, there are FAT people. Yes, there are MORE fat people than there used to be. There are also more alcoholics, drug addicts, poorly educated children and incidents of road rage. These problems have more in common than not. And one thing they have in common is that people write articles about them using words like, "Scared yet?"

Useless tripe.

(eta: no pun intended)

What fraction of "pre-diabetics" develop diabetes?

Note that people who live a long time actually consume more health care than folks who don't. Yes, even if the oldsters are "healthy" because they get more expensive and they keep consuming.

Black men in the US are pretty close to ideal from the public perspective. Their biggest contribution is that they die right around retirement, so they never see a dime of what they paid for govt retirement programs. However, not only do they pay the taxes that the rest of us pay (SSI and medicare), they also pay a disproportionate share of "lifestyle" taxes.

Yes, dying from lung cancer at 65 is cheaper from the public health perspective than living to 95.

Is this limited tomthe US or is this a global phenomenon?

I would guess that all developed countries suffer from these issues to some degree, but the homeland of fast food and food franchises is probably world champion.

Nevertheless, you can't really blame McDonalds--People choose what they do and eat. Choose poorly, die young. But how can you argue for actual cooking with fresh ingredients in a society that does not value these activities? How can you make people see that fresh food actually tastes better and literally makes you a more happy person? How can you show people that light workout can do more to enhance your life than any drug or TV show ever will?

What I don't get is why mcdonalds, with all their clout, doesn't make value meals that are good for your health at the same time. People are lazy, so if you allow them to be lazy and eat healthy food at the same time, there must be a goldmine of potential revenue there. McDonalds could create a market for healthy fast food and dominate it for decades to come, but they just sit there like couch potatoes.

Typical innovator's dilemma I suppose.

Fat, salt and sugar make stuff taste 'good' because these were rare resources when humanity was young. This is the simple recipy of McDonalds and it is true for all food, including healthy stuff. If McDonalds were to use less fat and sugar they would have to use more delicate and more expensive ingredients to keep it yummie.

Sadly, many people care more for simple and cheap (i.e. fat and sugar) than delicate and healthy (i.e. unprocessed food). Even though every doctor, cook and common sense would advise otherwise.

McDonald's has tried to do this, over and over again. People make the choice for the bad food over the healthy food, even when McDonald's offers both.

This article also links to the following article on "Blue Zones", which is also very interesting:

http://singularityhub.com/2009/07/20/blue-zones-places-in-th...

Do you know how difficult and motivate oneself to an exercise routine, much less change diet to a healthy and more expensive one?

Yes, it's the individual's fault that he didn't do much about it. However, we must also recognize the obstacles that made it difficult for individuals to do something about it.

I drive to school. I don't ride bikes or walk to school. The road aren't bike friendly. The suburban landscape in which I live in, doesn't have sidewalks to anywhere. There are sidewalks, and there's the uncomfortable feeling of walking too close to traffics.

Whose fault is to promote and subsidize the car industry at the expense of human health and everything else?

Someday, I will move to a town where I can walk and ride bikes to my heart's content. Until then, I am focusing on becoming a viable programming freelancer.

Meanwhile, million of Americans don't have the same option. They got a house mortgage to pay, family to take care of..

I don't want to sound rude, but I think that you are just pushing exercise for some day in the future that may never arrive.

I don't bike to school either, I use public transportation, however I regularly exercise. Believe me, there is time. It takes only 20 minutes every two days to stay fit and healthy. I am sure you can find the time to do it. Just reduce the amount of time you read HN or Reddit or sth.

If you need motivation to start, you can begin by following a program like http://www.100pushups.info/ to get started. Break free of being lazy.

Motivation is far easier said than done. If it was so easy, than everybody would be doing it.

The market for wacky exercise machine, trainer, gyms, etc, are huge. Yet, we're seeing lot more fat people.

Maybe people aren't doing the whole motivation right. Lazy? Well, some of them are. A lot of people waste their time and procrastinate. A lot of people waste their money. A lot of people find it difficult to self-educate themselves.

Clearly, we're living in a world where human beings are not optimizing toward their best.

I am still trying to figure this out.

You're right. Human beings are not searching for a local/global maximum, we try to follow the easiest route there is.

So, if you really can't motivate yourself, try to find the easiest path there is to get you exercising.

One easy way is to make it obligatory (the same way elementary school is obligatory - and for most kids boring). Open your calendar, pick 2 days of the week and add 1/2 hour of exercising there. If you fail to do it, find some 'punishment', like doing over-hours. Play both the role of the student and the teacher. Maybe it will work.

Most importantly, start easy. Don't exaggerate or you will never make it a habit.

The market for wacky exercise programs/devices claiming you can lose weight with only 3 minutes per day without being hungry is huge.

Strangely, the interest in Fit Flops + everyday activities doesn't seem to translate into running shoes + daily running after the Fit Flop inevitably fails.

Motivation is the problem here.

FWIW: I have lived without a car for about three years. There are precious few sidewalks where I live. I considered getting a bike but decided that would be far worse than walking. At one point, I purchased a skateboard but failed to learn to use it. I leave for work on foot every morning and we do our shopping regularly on foot. Humans developed the ability to walk long before sidewalks were invented. They aren't really necessary, though, certainly, some terrain is more pedestrian-friendly than others.

If you are "unmotivated" and think it's hard, then it's possible you are already more unhealthy than you think: Lack of energy and mental focus for accomplishing goals is an early indicator of not really being well. And if you think eating healthier is too expensive, you should look into what it costs for medical care for a really serious chronic condition like diabetes. Google "diabetic ulcer". People get their feet amputated after these ulcers have eaten away flesh all the way to the bone. I guess having one or both feet amputated is a good reason to not walk anywhere. I would rather keep my feet though.

Giving up my car turned out to be wildly anti-climactic. The transition was really not that big a deal -- though I already lived close to work and shopping, so not everyone can just do it. But the first time I walked with my sons to the local grocery store, on the way back, my oldest said "That's IT?" He really thought it would be a lot longer walk than it was. My sons both prefer walking to being in a car. They get out more now than when we owned a car.

Peace.

It took me 20 miles to drive to school. I can't imagine walking there.

BTW, I love to walk.

As I said: Not everyone can just do it. But you did not initially state "it's 20 miles to school". Your objections were things like lack of sidewalks, which I have found to be quite insignificant. Walking long stretches on pavement is actually quite hard on the feet and joints. My sons and I have endless criticisms of the "pedestrian highway" our city created. We have scathing things to say about most of their "improvements", which essentially turned a perfectly serviceable walking route into a bike path. Sigh.

What Mz said. I'm doing this living-without-a-car experiment as well, and it's one of the best things I've ever done. Like Mz, I just walk, and take public transportation, and don't use a bike.

It's great walking around, getting more exercise, talking to neighbors, noticing the weather and the landscape and people's gardens.

Oddly, after my last full-time gig ended, and I was "doing nothing," it seemed at first that I needed a car. To do nothing! The fuller realization of how much money, fuel, and environmental damage is caused by (often unnecessary activity in) the standard car-owning American lifestyle deepened my commitment to mindful choices in all aspects of how I live.

"The suburban landscape in which I choose live in,"

"Meanwhile, million of Americans chose to eliminate that option. They got a house mortgage to pay, family to take care of.."

Fixed that for you.

The only people who have no choice in this matter are the children forced to live in the suburbs, trapped by distance in their parents house, being taught terrible lifestyle habits from a young age.

Being physically active is a state of mind, and you can see opportunity where ever you live to do that. You don't have to take time out for planned exercise or pay big bucks for a personal trainer to be active.

For example:

- Automatically take the stairs instead of the elevator when going up, even to climb 5 floors. Or perhaps, if you have to go 20 floors up, climb 5 floors by stairs, and then take the elevator. Use the elevator only for going down, to save your knees (gotta protect those knees).

- Walk to the store when possible. If you have to visit two stores that are a ten minute walk apart, leave the car at the first store, walk to the second one, and walk back.

- Take detours, on foot, on purpose. Take walks around nice neighborhoods if you happen to find yourself in one (perhaps visiting a relative?) and have fifteen minutes to spare.

- Buy only the big items in bulk and go shopping for fresh produce every two days on the way home from work with a carry bag. Carry your groceries on your arm inside the store instead of pushing them around in a cart. Fresh fruit and vegetables are expensive, but if that's all you buy on a daily basis (buying everything else the cheap way), it's affordable for most people in most places.

- If you don't have the time or skills to cook fresh food, get smaller, cheaper ready-made meals and offset them with large fresh fruit desserts (anyone can peel an orange), and regular fruit and vegetable snacks. Anyone can find healthy foods they like eating, and most people can find ones that fit in their budget.

- Involve friends and relatives. Find active things to do instead of just meeting up at bars or homes. I heard earlier today of two friends, a stand-up comedian and a lawyer, who take lakeside jogs on sunday afternoon to discuss politics with each other.

Anyway, maybe none of those things apply to your personal situation, and I respect that. But I do think that opportunity finds the opportunistic. I'm sure that everyone, literally everyone, can find ways to be more active and healthier than they already are. Even if it's something small and ridiculous (like carrying groceries instead of pushing them), it's still better than nothing.

Two highly-recommended resources for those struggling with diabetes:

http://www.rawfor30days.com/ http://www.drfuhrman.com/

Take 1000 mg Metformin twice a day. Walk 30 minutes every day. You'll be fine.

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