Carvings July 1, 2021

In the news

            A distressing report appeared a few days ago at the Medscape site: “ ‘Staggering’ doubling of type 2 diabetes in kids during the pandemic ”.

            Type 2 diabetes has become an epidemic throughout the world, especially First World countries. In the U.S. it now affects more than 12 percent of adults and an astonishing 60 percent in persons over the age of 65.

            In my 35 years of pediatric practice I managed several patients with type 1 diabetes but none with type 2 – the co-called “adult onset” version. Nearly half of new childhood diabetics are now type 2, and the number is even higher in metropolitan clinics.

            The recent news is extremely troubling. During 2020 the number of children hospitalized for type 2 diabetes doubled compared to 2019. Those with the severest form, ketoacidosis, a life-threatening condition, was nearly 6-fold higher!

            The majority of these children were African-American: 7 out of 8 in one study and 16 of 17 in another. The apparent reasons are numerous and I’ll address these in a future post.

            This is a global problem and it is especially serious in Asia. By coincidence I was reviewing a paper published in 2004, a harbinger of the current disaster: The global spread of type 2 diabetes mellitus in children and adolescents, in the Journal of Pediatrics.

            Can we do something about this? Perhaps, but it will be a long process. It begins with teaching our children and grandchildren about the importance of avoiding obesity and the need to be physically active. For example, in one study, 80 percent of kids with diabetes were obese.

            Our country – and the world – cannot afford to have half its people affected by a devastating life-long disease.

Lifestyle

            Major controversies in the organic/conventional food battle: nutrition and the environment.

            It’s not easy to find wholly impartial observations in this area and the question of whether or not organic foods provide better quality nutrition is an example.

            A study published in the journal Environmental Health in 2017 noted that there was only a marginal increase in nutritional quality but persons who prefer organic produce tend to have healthier lifestyles as well, making a direct comparison of health effects difficult. In 2012 the Nutrition Action Healthletter observed that in about 60 percent of the studies, organic food is higher in some nutrients, in 30 to 35 percent there is no difference and in 5 to 10 percent of studies conventionally-grown foods have higher amounts of nutrients. That is not a ringing endorsement.

            Given that nutrient content varies by climate, soil type, plant variety, degree of ripeness, length of storage and other factors you can see why after decades of study there is no clear consensus. Theoretically since organically-grown plants have to provide their own, i.e., not helped by chemicals, defense mechanisms in the form of polyphenols and other phytonutrients, that should be a plus. It is, but not by much.

            In regard to the environment it’s obvious that runoff carrying nitrogen, antibiotics and other damaging chemicals into our waterways is a major problem to which organic farming contributes almost nothing. However, it takes many more people to control weeds and insects without the help of chemicals, and more people means more human waste, energy requirements, gasoline for transportation, etc. Organic foods also cost more, sometimes a great deal more.

            Buying from local farmers is not a solution unless you know that they use certified organic methods and they don’t simply stock their stands with produce trucked in from distant farms whose practices may or not be organic.

            In my opinion, organic foods are better for you and the environment and often taste better. Their health benefits, however, are less significant than those that we can obtain by eating more fruits and vegetables, eliminating sugar-containing foods, limiting calories in general and being more physically active.

1 thought on “

  1. I’ve been aware of the increasing incidence of type 2 DM in kids for several years. I have a Navy colleague you might have known, Steve Lewis, an Internist and Endocrinologist, Researcher, who has kept me informed about this. He tells me the condition has become “epidemic” in East Asia. He says that dietary changes, i.e. bringing the Western Diet to East Asia is seen as the major contributor. Apparently there is a lot of knowledge developing about the genetics of this.

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