Scale Of The Problem
People are terrified about the current COVID-19 pandemic. At the time of this writing there have been roughly 5 million cases and 160K deaths. This represents 1.5% of Americans. Not insignificant but if you want to be terrified about an epidemic consider the following statistics.
Before 1900 diabetes was rare (I’ll be referring to type two diabetes here, type one will be discussed later). Between 1824 and 1898, 172 cases of diabetes were recorded at the Massachusetts General Hospital. Now, according to the CDC roughly 13% of Americans have diabetes representing 34 million people. How did this happen in just a few short generations?
Metabolic syndrome is a precursor to full blown diabetes. It’s not a well known condition but, just like diabetes, it represents a powerful driver of coronary heart disease. It is defined as the cluster of glucose intolerance, insulin resistance, hypertension, elevated triglycerides and increased waist circumference. It is estimated that 1/3 of Americans have metabolic syndrome. Increasing from a prevalence of 1/4 in 1988.
Based on this data one half of all Americans are metabolically unhealthy. This is an epidemic and it is terrifying.
Overweight and obesity.
According to the CDC about 40% of adults in America are obese defined as a BMI greater than 30. Body Mass Index (BMI) takes both height and weight into account as a crude index of obesity. Overweight is defined as BMI between 25 and 30. Around 72% of Americans are either overweight or obese. Compare this to the statistics from 1960. At that time 32% of the population were overweight and 14% were obese. Below is a graph of the trend since 1960.
There must be an environmental cause for the explosion of metabolic syndrome, diabetes, overweight and obesity. A case can be made for a variety of factors but I believe it is due to the introduction of large amounts of sugar and refined carbohydrates into our diet. In addition there may be a causal role related to the explosion in consumption of refined “seed” oils (soy, corn, canola, etc…)
[More on this in an upcoming post]
Why isn’t anyone worried about the explosion of diabetes, metabolic syndrome and obesity?
The CDC lists diabetes as the 7th leading cause of death in the US but the general public don’t view diabetes as a killer disease. It does its damage too slowly.
With COVID-19 people may develop symptoms on a Monday and are dead within two weeks.
“No one” dies from diabetes and obesity. You just don’t see these conditions listed as the cause of death. People die from complications of these conditions. It takes a long time to develop these life threatening complications such as heart attack, stroke, kidney failure, cancer, gangrene, to name a few.
Diabetes and obesity are dietary diseases.
Just as there’s controversy about the best approach to combating COVID-19 there’s also tremendous controversy about what constitutes a healthy diet. A diet that would avoid or reverse metabolic illness and overweight. We’re getting conflicting information from the experts on a daily basis. Not a day passes without another report in the literature of a new food villain or food miracle. This result is uncertainty and apathy about dietary choices.
In upcoming posts I plan to discuss why thoughts on the topic of diet and chronic illness. Every day in my office I see a parade of people with multiple interrelated chronic medical problems. Diabetes, overweight, obesity, hypertension, coronary heart disease, cancer, stroke, chronic kidney disease, atrial fibrillation, sleep apnea, among others. After considerable le research I believe most of these are at least in part driven by dietary factors. I feel duty bound to make sound, scientific, practical and actionable recommendations to help alleviate these problems.
