Monday, April 12, 2010

THE FAT SUCKER PROBLEM: DIABETES II

My neighbor Rose (whom I called Pansy at her request) died about a year ago and her husband was killed in a car crash last fall. Now their son has brought his small family to live here, a wife and grown son plus three beagles who kill cats! Luckily, they are securely fenced. They are also cream puffs when it comes to people.

I had thought I ought to be traditionally neighborly, which means taking over a casserole or cookies. I’m not much of a cook and buy only enough food for myself for one month at a time so I can spend the rest (if there is any) on books, but I had a bag of frozen apples from the trees in that yard that Rose had given me, so I thought it was sort of “poetic” to make the apples into a pie and take it over. (I can’t eat apples without my blood sugar going up.)

I’m really a lousy pie maker but it didn’t look too bad and I comforted myself that the beagles would keep it from being wasted. (Cats don’t eat pie.) Anyway, it was an excuse to meet the wife and son. Dismayingly, the pie had sugar in it and it appears the wife is, like me, a victim of Diabetes II, but they cheerfully reported that she ate half a candy bar her husband bought her in spite of having to give herself a shot soon after.

This little snapshot I offer in evidence. Of what? Nassim Taleb would suggest: “Evidence that we humans use thought largely for ornamental purposes."

"At the Harvard Symposium for Hard Problems in Social Science, Emily Oster presented a very simple, elementary problem: almost all people with type-2 diabetes can be cured by losing a little bit of weight. They are made aware of it, yet they usually gain weight after diagnosis. It is so obvious that we know what to do yet do not carry the action because thinking can be largely ornamental. The proof of the sterility of (a significant class of) knowledge was right there (among the obvious evidence that population has been gaining weight in spire of technological and educational progress). . . This is the great sucker problem: people who teach truly think that teaching, or, worse, preaching, cures.”

The symposium is supposed to be posted as vids later on. < http://socialscience.fas.harvard.edu/icb/icb.do?keyword=socialsciencedivision&pageid=icb.page336066>

I would suggest that brilliant -- and impatient -- as Nassim Taleb may be, he doesn’t know so much about human behavior. Here are the causes of the sucker problem in terms specific to this little example at the top.

1. Social ties established by food-related gestures. (Taking food to new neighbors.)
2. Neighbors with quite different backgrounds. (I could hardly take them a theology book! I did not think about the wife possibly having diabetes.)
3. Rural people who used to work off extra calories but who now are sedentary. (But the husband in this family is not particularly overweight. The wife is tethered to oxygen.)
4. Economic limitations. (I should have taken over a roast! Good meat can be eaten without a problem by most diabetics.)
5. The reflexive fanciness of my imagination. (I was entertaining visions of myself in an apron being a good neighbor.)
6. Some MAJOR problems with just what we’re supposed to be learning from the “expert doctors.”

Taleb is evidently not aware that diabetes II and/or metabolic syndrome is poorly understood and that it is entirely unclear whether the factors identified as “causes” might actually be “symptoms.” That is, dropping fifty pounds may be curative, but if the true causes are addressed, fifty pounds will drop off. (That’s what happened when I eliminated sugar, white flour, processed foods.)

So why doesn’t a guy so smart about other things (like Black Swans) have more clues about a near-universal health threat?

1. We’re only gripping one corner of the problem, which happens to be the same as inability to handle glucose in the body. The gizmos for monitoring blood glucose were already available, as well as blood pressure monitoring devices, cholesterol tests and tape measures for waists. Other underlying causes or symptoms are relatively inaccessible. LIke what? No home test for insulin levels, sex hormone levels, prothrombotic (blood clotting) and proinflammatory tendencies for starters. We’re looking for our lost car keys under the streetlight.

2. Cultural and economic factors. ”The root cause of most cases of metabolic syndrome can be traced back to poor eating habits and a sedentary lifestyle.” Yes, we get that, but WHY do we have poor eating habits and WHY do we have jobs and entertainments that are sedentary? Money, honey. All those people who did hard work on farms and in factories were determined that their children would go to college and “get an education” so they wouldn’t have to do physical labor. Even so simple an undertaking as walking is monetized: gotta have $100 shoes, gotta have a pedometer and maybe a stop watch. Or it’s socialized. Gotta have a walking buddy. Or a gym.

3. Our physicians and scientists are fat themselves. No creds. Any hospital is packed with fat staff. And they keep changing their ideas about what’s happening, but they refuse to admit any uncertainty. The research on nutrition and food additives is ever more complex and ever more controlled by big Pharma and big Food. Not just the evil fast food chains, but the people who put so many preservatives, bulking agents, etc. into food or the containers for food that we cannot avoid ingesting strange molecules of unknown impact, esp. long term. At the same time big Ag is developing deliberately mutated seeds that also create new molecules. That’s not mentioning ag chemicals, which are often estrogen imitators.

4. “A few cases are thought to be linked to genetic factors that are still being researched.” We have barely realized that there is such a thing as “epigenetic” molecular controls in our bodies. ONE atom in ONE molecule can alter the structure of a gene so that it is turned off or on, or does something different. I suspect that those doing the research are finding it so scary that they don’t want it publicized. Naturally, putting epigenetically active substances into our environment is not anything the corporations want to admit.

Though I was reluctant, I forced myself to watch “Children of Men,” which is an adaptation of P.D. James’ dystopic novel about what happens if human fertility ends. I was impressed. Especially since I’d just read that only one-fifth of potential fertilization ends in a healthy birth. It is an extremely delicate process, evidently managed by the epigenes. We know that glucose management problems are related to pregnancy. Getting fat may only be an early warning, something like a silent spring. The sucker problem may be "blaming the victim."

1 comment:

Art Durkee said...

And people wonder why I've gone mostly organic and gluten-free in my diet. . . .

Well, the latter I had to do, for the sake of my health: making an irritant go away. It's had a lot of good benefits, one of which was a radical decrease in the frequency of migraines.

One of the whole points of the "slow food" movement, which emphasizes buying food locally and seasonally, and also presenting good simple healthy food, is that it's better for your overall health. There are still some folks who are going to be obese no matter what you do, because they we do need to be less sedentary (in some cases, downright sessile), and diet alone won't be enough. in my own case, diet alone has been a help, but it's only part of the overall design.