I want to introduce you to a brave woman at the hospital where I work. Her name is Laureen. At 34 years old, she was an active nurse -- vibrant, full of life and a volunteer EMT. But now, 10 years later, she spends three days a week tethered to a dialysis machine to rid her blood of impurities that her failed kidneys can no longer process. She has lost parts of both her legs. Her body is slowly turning on itself and each and every day revolves around managing the disease that ravages and scrapes away at her insides: diabetes.
Laureen was on "The Oprah Winfrey Show" last Thursday, courageously sharing her story. Even though it's very personal, Laureen told her story because she doesn't want others to go through what she has gone through. And there are almost 60 million potential diabetics who can watch and benefit from her experience -- though it doesn't have to be this way. One of the most painful things about her situation is that it could have been prevented. That's right -- Laureen's disease trajectory could have been slowed, stopped or even reversed through lifestyle and diet choices.
As a surgeon I have operated on thousands of people whose hearts were destroyed by diabetes - about 25 percent of all the patients I see are diabetic. Most of them could have prevented their fate.
But as the tragedy of this news sinks in, the alarm bells are ringing. Here are the statistics: there are 24 million diabetics in this country and about six million of them don't even know it yet. These are people whose blood sugar is over 125. They will most likely find out when other complications arise such as impaired kidney function, vision problems and, of course, heart disease. Even scarier is that there are 57 million pre-diabetics who are at a crucial fork in the road. Their blood sugar is between 100 and 125 and they stand at a juncture where some simple lifestyle changes and mindful diet choices will lengthen their lives and save them a world of suffering. Nearly half of Hispanic and African American children born this decade are projected to get diabetes. The CDC estimates one third of all Americans will develop diabetes and live 15 years less while losing immeasurable quality of life.
No public health problem compares in scale.
Diabetes will bankrupt our healthcare budget if left unchecked. It costs us $175 billion now to treat this killer and its complications, and that's expected to double in 25 years. Despite the best devised policy plans to manage the economics of healthcare, all solutions will fail unless we address the root causes and engage in widespread awareness and prevention. It starts with education -- you must know what this disease is, who is at risk and how to prevent it.
There are two types of diabetes. Type 1 is also called juvenile diabetes and you are born with it. It can't be reversed but it can be managed. Only 10 percent of diabetics are Type 1.
Type 2 is the culprit in 90 percent of those 24 million cases and 57 million pre diabetics in danger of slipping into full blown disease.
Type 2 takes root when fat stored in the abdomen -- belly fat called omentum -- poisons the pancreas and causes it to stop producing insulin or the insulin in your blood cannot deliver glucose into your cells. Without insulin you cannot process sugar and without glucose your cells have no power supply. Belly fat is a huge problem in America, with 60 percent of our population overweight. Any casual stroll down the street will reveal the prevalence of omentum in our society. The reason for the drastic increase is a perfect storm of poor diet and sedentary lifestyle. Our ancestors usually had little food and had to work very hard to catch or kill what food they could. As a result our bodies are designed to survive scarcity and famine. Now with food available virtually unrestricted our biology is outpaced by this abundance, and overeating creates disease. It happened incredibly fast.
Why is diabetes so destructive? Quite simply in both Type 1 and 2 your body can't metabolize sugar, leaving it to float in your bloodstream. Sugar in your blood is like shards of glass scraping the inner lining of your arteries. The scrapes heal with scar tissue and cause blockages. Smaller blood vessels in your feet close completely and cut off circulation, resulting in amputation as the tissue dies and becomes infected. The coronary arteries scar and cause heart attacks and stroke. These sugar shards damage kidneys so severely they shrivel and die and patents often wind up on dialysis.
Here's the catch: The symptoms are reversible.
Right now the average American eats 140 pounds of sugar per year, which is 40 pounds more than when Oprah and I were born 50 years ago. Sugar is hidden all kinds of places that you least expect -- condiments such as salad dressing and ketchup, peanut butter, and of course juice and soda. To be competitive and make things taste better, food companies have added more and more sugar. The intention wasn't to hurt anyone, it was just to get you to like their food. We have slipped into a cultural acceptance of "a little sugar" - a little in our coffee, a little on our cereal, and it all adds up. The consequence of all that sweetness is obesity and rampant diabetes.
But back to the good news: 90 percent of diabetes is preventable and the symptoms are reversible. Let's go through a few risk factors and action steps:
First, the warning signs are constant thirst, frequency in urination, feeling tired, frequent infections, tingling in the toes, and vision problems. If you have any of these symptoms, see your doctor.
Risk factors are a big belly which blocks insulin, a sedentary lifestyle and a family history. When we refer to a "big belly" we mean one that measures more than half your height. If you are five foot 10 inches, (70 inches) your waist should measure no more than 35 inches at your belly button. Another rule of thumb is a woman of average height should weigh less than 150 pounds for optimum health.
Can we change our biology or our genes? No. But we can nudge it in the right direction. Avoid "white" foods -- those with enriched flours, pasta, obvious sugar and rich starches like potatoes. Avoid high fructose corn syrup, which is found in everything from condiments to bread. You can just read the label to see what's in a food item. Exercise - a lot! Start by walking and set a goal of 30 minutes three times a week of vigorous walking, then move gradually into an exercise program.
Also, know your numbers. Speak with your physician about your risk factors and a screening - just about anyone can get tested for free. This is one of the most important decisions you can make for your health and your children's health. You owe it to yourself and your loved ones. It's not just a little sugar!
Follow Mehmet Oz, M.D. on Twitter: www.twitter.com/droz.com
"Type 1 is also called juvenile diabetes and you are born with it".
Are you kidding me? Why are you spreading such nonsense. You may have a genetic predisposition to developing type 1 diabetes but you are not 'born with it'. How can those of us who have children diagnosed with type 1 diabetes expect others to understand when we have doctors out there spreading such bull. Ugh.
How could sugar after ingestion retain a crystalline shape and start cutting and scraping your arterial walls? This is a novel theory and we should be skeptical of it.
Most sugar (esp. the sugar we ingest unawares) is from corn syrup anyway.
What is of interest there is that heavy corn syrup use came on the scene at the time the diabetes epidemic began.
Also, I have read that corn syrup contains mercury as a byproduct of refinement. Mercury is prob not good for the organs esp the pancreas.
We now over vaccinate our newborns and small children (alot of harmful ingredients in vaccines), and we have our main sweetener manufactured (in a dirty way) out of corn. Start the inquiry there, because the introduction of heavy vaccination and heavy corn syrup added to foods arose in the same time frame. Let's say around the first Bush admin (1988)
What is a more sensible approach to consuming sugar, 'white' foods' and other simple carbs is to add some fat to the mix, like butter, cream or oil, to slow down the foods conversion into glucose.
Slow it down and you won't get the spikes and crashes, and your pancreas won't over generate insulin and become stressed.
But I weigh 95 pounds, does that mean i can still develop type 2 diabetes and heart disease (i thought only obese people suffer from it)?
When a people in society are fulfilled, living a life of purpose and being present we do not gorge ourself to the point of full because one is not filling an emptiness that is never filled with food but it certainly helps to mask it. Food is our source of comfort and a great distraction of what you should do , could do but don't in life. It also helps us swallow our words down to our stomachs of what we could say, should say but don't.
The problem of diabetes runs a lot deeper than just food and exercise .....and we all know it -but we don't know how to treat emptiness ....we need to acknowledge their pain and help people to feel more fulfilled and purposeful. Then food because a source of nutrition rather than a source to self medicate.
All food turns to glucose and starchy carbs which are the highest glycemic
turn the fastest. And that includes baked potatos, pasta and rice. Yes, even brown rice.
Bottom line: it's the same message we've been hearing for the last century. Everything in moderation. A life without an occasional slice of pizz or a cookie is not worth living. And I seriously doubt you'll live that much longer without them as long as the rest of your diet and lifestyle is a healthy one.
The high carb/low fat diet touted by the health food industry is what's been killing us, because it's based on bad science with little or no proof that it actually works. A government panel in the late 70's came out in favor of it and by the 1980s obesity and type 2 diabetes started to increase. Now it's at epidemic proportions and spreading around the world.
In the American Journal of Clinical Nutrition: http://www.ajcn.org/cgi/content/abstract/ajcn.2009.27725v1)
Results: During 5–23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD.
Conclusions: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.
The point is, that refusing to give people an alternative that might better suit their lifestyle isn't fair. You cannot mandate exercise, and for some people it isn't even an option. And if regular exercise isn't an option, some would say lower your caloric intake. How low can you go before you make yourself sick?
Also, in case you were replacing carbs after exercising, here's an article based on a new study that says this might not be good for you: http://latimesblogs.latimes.com/booster_shots/2010/01/skimping-on-carbs-after-a-workout-may-have-health-benefits.html.
I was diagnosed with diabetes last year.... it was a bit of d'oh moment. But I've gone from 230lbs to 195lbs. Adjusted to a low-carb diet, dropped my cola habit, and exercise regularly. My blood numbers all read 'healthy-normal' now with some help from metformin and my life-style changes.
The "d'oh" is that I could have avoided the diabetes by doing all that in the first place.
You mention that half the Hispanic and African-American kids born this decade will probably get diabetes. That frames the problem better than anything. This is a disease that poor and minorities (frequently poor) get. They don't have the budgets for healthy food - their choices are usually pre-packaged and full of HFC, highly processed starches and fat. Fresh produce, whole grains and meats are more expensive, and sometimes even hard to come by in poorer neighborhoods. Add to that the problem of sedentary latchkey children who aren't allowed outside to play while their parents aren't home.
I wish you and other doctors would talk to Congress about this problem. Even if we had Universal Health Care, the diabetes problem you're discussing won't be solved, because no one wants to fund the preventative measures.
Rather than the White House and Congress letting the lobbyists for big pharm and insurance companies control the discussion of health care, why not let lobbyists for the grocery stores and food producers have a say?
Recently, I was at an hotel breakfast buffet where we observed a young AA girl fill a cereal bowl to the brim with bacon 3 times and wash it all down with a couple of giant colas. Yet the choices for fresh healthly food at this event were endless. Her mother ate the same thing, except she added sausage. It goes without saying that they were both already obese. Think they'll be needing your tax dollars real soon?
Many people don't know how to cook anymore, except for judging how long to run the microwave. Cooking equipment can cost a bit - not a ton, but when your budget is so small to begin with, a pressure cooker is essentially out of the question. People in lower income brackets live from day to day or week to week; there is not the option to buy in bulk.
cont...
I think there has been much knowledge lost between the time you and I were growing up and what is happening now. Teaching people how to make meals out of dried beans, oatmeal, ham hocks and so forth will help, but accessibility is necessary, too. These foods need to be available. An example of what I'm talking about is the problem in large urban areas - "Detroit – a city of some 830,000 people – has no major grocery store chain within its boundaries...92 percent of food stamp recipients purchase their grocers from a liquor store or a gas station or a pharmacy." (http://www.cbsnews.com/blogs/2009/09/03/couricandco/entry5286352.shtml?tag=contentMain;contentBody) Certainly, Detroit can be seen as an extreme example, to some degree, but, there are plenty of other poor urban areas with similar problems - high rent & high crime for grocery stores and money & transportation difficulties for residents.