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David Katz, M.D.

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Diet, Diabetes and Paula Deen: The Case for Loving Food That Loves Us Back

Posted: 01/20/2012 8:40 am

I needn't belabor the news that Paula Deen, a celebrity chef on TV (that was news to me; nobody tells me anything...) "came out" with her Type 2 diabetes. Paula Deen's cooking has apparently long been a study in Southern-style indulgence, with an emphasis on the deep fryer and plenty of butter. From what I have gleaned, Ms. Deen has never met a nutrition fact she didn't like to ignore.

But I'm not inclined to wag a finger at Ms. Deen. Nor do I want to wade into the debate about her advocacy for a particular diabetes drug to treat a condition she need not have developed in the first place.

I want simply to talk about the opportunity to love food that loves us back, and the fundamental importance of making that the prevailing norm.

First, food matters. We have incontrovertible evidence, reaffirmed many times over the past several decades, that the major determinants of premature mortality and chronic morbidity in modern society are tobacco use, dietary pattern and physical activity. Or, as I like to put it -- feet, forks and fingers.

We have clear evidence that even moderate improvements of diet and activity can prevent Type 2 diabetes in nearly 60 percent of high-risk adults, and evidence that more fundamental improvements to lifestyle could prevent almost all of it -- and certainly more than 90 percent. We know that children now get Type 2 diabetes, while a generation ago it was called "adult onset" diabetes, because the condition in children was essentially unheard of.

We know that diet can be and often is the difference between good health, and ill health. This is not controversial.

The trouble is, we have propagated the view that we have to choose between food we love, and health we love. And since food provides immediate gratification, while good health is a long-term return on a long-term investment, the immediate gratification of food tends to prevail. We eat, drink and make merry -- and defer worrying about the cost. But the cost eventually comes due -- all too often in the form of a serious chronic disease that need not have occurred.

As chronic diseases develop at ever younger age, while we live to ever older -- the percentage of our lives encumbered by that "cost" is rising. And, consequently, so is the cost itself. We pay dearly.

In essence, then, we are mortgaging our health to pay for the pleasure of our palate. This may be hard to justify under any circumstances. But there would, at least, be a case to be made if the only way to enjoy food were to give up health. If the only food that tasted good were bad for us, we would have a tough decision to make. And some might say -- to hell with health! They might come to regret it, but we could all understand the choice.

But there is no such choice to be made. There are variations on the theme of optimal eating available to us all. Among them is the Mediterranean diet, which is itself a dietary theme and parent to a number of variations. Important about them all is this: Many of us would go to Mediterranean countries and gladly spend our good money on the excellent food! Not because the food is good for us -- but because it's just plain good!

But it is also good for us. It offers us the opportunity to love food that loves us back. To get pleasure in the pursuit of health, and health in the pursuit of pleasure. The Mediterranean diet offers this -- and so do many other cuisines around the globe. Whatever your palate, there is room for you where culinary pleasure and health converge.

Given this possibility, why practice the brand of denial that seems to prevail? Those of us who advocate for healthful eating need not be culinary cretins. My wife, raised in southern France, is a fabulous cook. Catherine and I, and our kids -- love good food. We just love food that loves us back.

And chefs need not fry butter to show they care about cuisine. In an age of epidemic obesity and diabetes, chefs can shoulder the responsibility of making food that is both good, and good for us.

An analogy springs to mind. Cars can have incredible horsepower. They can also have great fuel efficiency. There was a time when great horsepower at the expense of lousy fuel efficiency was fine. But we now know the costs of that profligacy -- monetary costs, and more importantly, environmental costs. We are now inclined to demand both fuel economy and performance, or strike a balance between the two. But the world no longer condones a "to hell with fuel efficiency" attitude, because the stakes are too high.

I suppose you might watch a car race for fun (I don't get that, actually, but different strokes...), but in doing so, you generally aren't planning on getting that kind of car, or driving that way. Car racing is not intended as an audience-participation experience. If cooking shows were a similar diversion, it might not matter much what the chefs are cooking. But if, as seems probable, the intent is "go ahead and try this at home!" -- then what's cookin' truly does matter.

The stakes are every bit as high in our kitchens, as in our garages. Our health, the health of those we love -- is on the line. So maybe it's time for us all to draw a line in the sand and not cross. Chefs who can't make food both good and good for us don't really have enough expertise to warrant our attention. They don't have the full culinary skill set modern living requires. We should tune them out.

Pretending that food doesn't matter to health is at best denial, at worst a serious delusion. We should not mortgage health to pay for culinary delight, any more than we should give up culinary pleasure to purchase health. We can love food that loves us back.

Bring on the chefs talented enough and responsible enough to help us bake that particular cake, and eat it, too!

-fin

For more by David Katz, M.D., click here.

For more on diet and nutrition, click here.

Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org

 

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I needn't belabor the news that Paula Deen, a celebrity chef on TV (that was news to me; nobody tells me anything...) "came out" with her Type 2 diabetes. Paula Deen's cooking has apparently long bee...
I needn't belabor the news that Paula Deen, a celebrity chef on TV (that was news to me; nobody tells me anything...) "came out" with her Type 2 diabetes. Paula Deen's cooking has apparently long bee...
 
 
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03:20 AM on 01/25/2012
I think everyone is coming down on Paula as if she'd committed murder. Her cooking is typical of the South and although it is not the healthiest way of eating, it's traditional Southern Cuisine. Give this lady a break.... how can this publicist expect Paula's two sons to continue working with her if she bailed the minute things got tough. Paula not coming out with the news of her being diabetic was her personal choice about something that is frankly no one's business. Paula represents more than Fried Turkeys and Butter... she is a woman who went above and beyond to make a life for herself and her two boys and I'm guessing that it wasn't easy... not then, not now. She's never forced anyone to eat her food or agree with her lifestyle... but apparently some of did or she wouldn't have branched out like she has. I'll still continue to watch her.
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Chas53
10:34 PM on 01/24/2012
Honeybear I encourage you to take the time to view this lecture by John McDougall MD, one of the world's experts on Diabetes, so that you may understand the role of animal products and fat in the development of Diabetes.
http://www.youtube.com/watch?v=iosoXlr3ZVI
07:15 PM on 01/23/2012
Thank you, Dr. Katz. "Love food that loves us back" is the best analogy.

The fats that Paula Deen was cooking and obviously consuming (MEAT, DAIRY, EGGS) can cause Type 2 Diabetes.

GOOD FATS are avocado, nuts, seeds, olives, soy, peanut butter, olive oil.

Paula Deen's diet and lifestyle were NOT loving her back. The tragic part is that she refuses to admit that.

But then, Deen is making her millions off FACTORY-FARMED animals with her promotion of one of the biggest, SMITHFIELD. Now she will make more millions with PHARMACEUTICALS that in studies have shown, can cause thyroid cancer and pancreatitis.(See Huffington Post article on Mother Jones).
03:03 PM on 01/23/2012
I would like to point out that fats in food do not cause diabetes. In addition, being fat does not cause diabetes. Research indicates that initially diabetes comes on quietly and undiagnosed; it is diabetes that drives up an individuals appetite and then their weight. I can understand Deen's behavior. I know that when I was first diagnosed it took a long time to emotionally come to terms with the changes I was going to have to make. This included my identity as an avid baker and cook who garnered a lot of praise from these skills. Deen has the added problems of many people financially dependent on her success and a highly public image. To work this out in public may have been heroic but she is human. I hope she can go forward and redefine herself and become healthy as well as help others.
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Chas53
04:01 PM on 01/23/2012
Hopefully once and for all we are going to get over this idea about fat not causing DM. The data overwhelmingly links the fat laden Western Diet to the development of DM. It is very rare to find DM in folks who eat a low fat starch based diet. i.e Asians. Neal Barnard has done seminal work showing that this diet reverses DM. Its the fat.
http://www.happyhealthylonglife.com/happy_healthy_long_life/2012/01/reversing-diabetes.html
05:22 PM on 01/24/2012
Then how do you explain the traditional Inuit, who got 75-80% of their calories from fat, and among whom diabetes was essentially non-existent until the introduction into their population of modern processed foods consisting largely of refined carbohydrates?

Dr. Barnard is right to discourage the use of white flour and sugar, but his idea that dietary fat CAUSES diabetes is unproven. Type II diabetics to tend have high levels of insulin circulating in their system (at least until the pancreas begins to burn out), and this insulin promotes fat storage, so there is a correlation between BEING fat and being diabetic, but this is not the same thing as saying that dietary fat is CAUSATIVE of diabetes. One of the first things you learn in Science 101 is the principle that "correlation is not causation".

We see all kinds of variation in the diets of traditional populations where diabetes was a rare disease - from high fat, to high protein, to high carbohydrate. So singling out some one macronutrient from natural whole foods as the cause of diabetes is not justified by the evidence. The diets of the Inuit and the Kitavans of Papua New Guinea, whose diet was something like 60% carbohydrate, were as different as it's possible to be, yet neither population was beset with diabetes. What did they have in common? Lack of access to refined sugar and processed grains.
05:46 PM on 01/24/2012
Incidentally, your esteemed Dr. Barnard is president of PCRM, the so-called "Physician's Committee for Responsible Medicine", which is in fact an animal-rights group thinly disguised as a public health advocacy organization, so of course they're going to espouse a diet that includes no animal products. In the link you provided, the author cites Barnard as saying that even an occasional bit of salmon is off limits, when if you ask anyone in the field of nutrition who has no agenda BUT nutrition, cold-water oily fish is one of the healthiest foods you can eat (apart from the issue of heavy-metal contaminants, of course, but that's a different matter altogether). You cite Asians as an example of people who eat a "low fat starch based diet", but if the fat from fish is an offending substance, as Barnard would have you believe, then I must point out that Asians do eat rather a lot of fish, as I would assume you must be aware.

Incidentally, the Japanese, yet another traditional population among whom diabetes was rare, have been seeing skyrocketing rates of the disease over the last several decades, and the only dietary factor I can ascribe that to is the introduction of processed foods primarily consisting of sugar and super-refined grains. Again correlation is not causation, and I'm not saying that this proves anything, but it certainly warrants further investigation, and does not support the notion that dietary fat is what causes diabetes.
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Michael Stanclift, N.D.
12:05 PM on 01/23/2012
It is wonderful to hear other like-minded doctors sing this overlooked concept that food can be good and good-for-us! Beautifully written Dr. Katz. People inspired by this article might even find that there ARE short term benefits to eating food that loves us back... increases in energy, motivation and self esteem often follow healthy eating habits sooner than we expect!
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Fromageball
09:24 AM on 01/23/2012
There is widespread belief that the only way that something can taste good is if it is terrible for you. I had to overcome years of eating junk/empty carbs/sugar to change my tastes so I know how it is for a lot of other people. Now I'm accused of being a health nut because I basically follow a Mediterranean type diet, but I actually enjoy my food so it's not hard for me to stick to healthy eating.

I grew up in the south and sure there is plenty of fried chicken, mac & cheese, pulled pork, etc but there are also a lot of veggies, fish, beans, etc in southern cuisine. The perception of southern cooking is pretty much the same as Italian in this country. The symbol of Italian here is a huge plate of pasta with garlic bread - Olive Garden essentially. Not representative of how people in Italy eat.

Anyway, there is nothing inherently wrong with the stuff that Paula Deen makes. I think her bacon-wrapped mac & cheese sounds pretty good, but I would have a small piece of that and then a big salad or something.
05:39 PM on 01/24/2012
Paula Deen's food tastes great! My family is from the south and her style of cooking is common.
My family eats food prepared similarly to Paula Deen's cooking, and none of us have health issues associated with those foods. The secret to eating rich food is monitoring your food intake. Eat a variety of food and never over eat. I'm 68 and my Father is 93, and both in great health.
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Whimsy Anderson
Naturopathic Doctor
09:15 PM on 01/21/2012
If people are looking for a whole foods vegan support group--we have started one of fb. this group is moderated by two Naturopathic doctors. While this is a closed group if you send us a request I will sign you in. https://www.facebook.com/groups/143624349071213/
06:44 PM on 01/21/2012
It's not about the butter that she puts in her food! Her problem is that she eats high carb and has a great deal of sugar in her recipes. Guaranteed if she went low carb, she would have a better control of her diabetes. It's worked for so many type two diabetics. Fat hasn't been the problem ever. We have gotten fatter and fatter eating processed foods, low-fat foods and then that terrible thing called fast food. We don't get fat from eating a nice steak in the right portion, or putting butter in our cooking. I have seen low-carb diets cause people to completely reduce the need for medications and get blood sugars down to normal levels. I'm also have an enlightened diabetes educator, who doesn't subscribe to the American Diabetes Associations recommendations. Have a great day!
10:03 AM on 01/21/2012
She's not the sort to really care about her intake and thus her problem with diabetes. That's just how the ball rolls I guess. There is still hope tho. I'm an walking example of how changing your diet and exercise routines to something healthier helps your diabetes.

I've personally lost 180lbs since Dec 2009. My blood pressure was 160/110, now its 120/80. My cholesterol was 256 mg/dL, now its 176mg/dL. I'm no longer Pre-Diabetic and I'm in the best shape of my life. It wasn't easy but I can say that everyone can do it if they have the right program.

If you're interested in my story please head over to Zdiets.net

Cheers.

Ryan E. Parker
JWoode
yes.. my micro bio is meaningless
12:58 AM on 01/21/2012
Donuts are healthier than her cooking.
07:30 PM on 01/20/2012
I love ya, Paula, But you don't need 5lbs of butter in everything you cook.Regardless if it has or doesn't have anything to do with diabetes, Noone needs that much butter.
07:25 PM on 01/20/2012
I'm glad there are several intelligent writers adding some balance to Ms. Deen's "coming out". I'm disturbed by readers who comment that no one is forced to watch/listen/cook Paula Deen, but the reality is, advertising works, and TV is hypnotic, and she was being irresponsible, in denial, or both. She's not alone. Also, I don't understand vegans trying to combat one extreme with another. I don't have to eat meat every day or none at all. Anyone familiar with gluten intolerance knows that a vegan diet is simply not an option for such people, especially children, and depriving them of animal protein would probably lead to malnourishment. People can't live on supplements. I eat animal protein, including fish
09:22 AM on 01/21/2012
You seriously think that you can't be vegan and avoid gluten at the same time? I've done it myself, so I know it's definitely possible. While I'm no longer vegan, I certainly support (and admire) those who are.
07:02 PM on 01/20/2012
What's with the covert attack on butter? Butter, especially a quality organic butter is one of the finest foods you can eat. High quality saturated fats are the foods our bodies need to keep them running energetically and smoothly.
09:19 AM on 01/21/2012
I agree! I include organic pasture raised butter in my diet every day.

And I don't have diabetes.
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ThurmanLady
more fun - and logical - to be right
06:19 PM on 01/20/2012
I keep saying that we need to stop blaming the butter for something that is actually sugar's fault. It's obvious that low fat has made us fatter as a nation. We need to take another look at sugar.
04:40 PM on 01/20/2012
Thanks for the great article Dr. Katz. As a Registered Dietitian, living in Greece, yes there are healthy and tasty choices out there. This is not the time to blame a certain lifestyle for the appearance of chronic disease, we don’t know all the details of Deen’s diagnosis, but to show that there are healthy alternatives out there, such as the Mediterranean diet which may able to prevent the need for drugs in newly diagnosed individuals. The bland, boring, low fat diet we’ve all been taught to think is the only solution, is not. I write more in my blog OliveTomato.com. Elena Paravantes, RD