Weighing in on Paula Deen

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The Food Network star has been living with diabetes for three years we now know, but the most stunning part about this story might be the American Diabetes Association's reaction.

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The huge fuss over Paula Deen's type 2 diabetes is understandable. She is, after all, the queen of high-calorie Southern cooking. And diabetes rates are especially high in the South.

Perhaps less understandable is the reaction of the American Diabetes Association. As reported the New York Times:

Heredity, according to the American Diabetes Association, always plays some part. "You can't just eat your way to Type 2 diabetes," said Geralyn Spollett, the group's director of education.

Wrong. You most definitely can eat your way to type 2 diabetes.

Type 2 diabetes is closely linked to overweight and obesity. No, not everyone who is overweight develops type 2 diabetes. But most people who have type 2 diabetes are overweight.

The first line of defense? Lose a few pounds. Even a relatively small reversal of calorie balance can make symptoms of type 2 diabetes disappear and reduce or eliminate the need for drugs.

Deen does not mention weight as a factor in her disease, or losing weight as an effective treatment. Instead, she is now a spokesperson for the drug Victoza.

According to the Times' account, Dean says that it is elitist to criticize her food:

You know, not everybody can afford to pay $58 for prime rib or $650 for a bottle of wine. My friends and I cook for regular families who worry about feeding their kids and paying the bills.

Really? Does Deen think those families can afford to pay the $500 a month drug companies charge for Victoza? Victoza costs in other ways too. It has to be injected and is not exactly benign:

Victoza is not recommended as the first medication to treat diabetes. Victoza is not insulin and has not been studied in combination with insulin.... It is not known if Victoza is safe and effective in children. Victoza is not recommended for use in children.

In animal studies, Victoza caused thyroid tumors -- including thyroid cancer -- in some rats and mice. It is not known whether Victoza causes thyroid tumors or a type of thyroid cancer called medullary thyroid cancer (MTC) in people which may be fatal if not detected and treated early.... Inflammation of the pancreas (pancreatitis) may be severe and lead to death.

The company also advises:

Victoza is an injectable prescription medicine that may improve blood sugar (glucose) in adults with type 2 diabetes when used along with diet and exercise.

Diet and exercise? Why not just do that in the first place?

As for the American Diabetes Association: its disinterest in promoting diet and exercise is easily explained. It is funded by drug companies.

I gave a talk at an annual meeting of the Association a few years ago and was astounded by the number of drug companies giving things -- writing pads, pens, and tape holders, but also lab coats and stethoscopes -- at the trade exhibit. Much of the scientific meeting was devoted to drug studies. I spoke at the only session that year on dietary issues. And Coca-Cola sponsored a session on sugars in diabetes.

Deen's food is best eaten in moderation. She would do more for her own health and that of her fans if she used her television presence to promote healthier lifestyles.

Image: NBC, Peter Kramer/AP.

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This post also appears on Food Politics, an Atlantic partner site.

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Marion Nestle is a professor in the Department of Nutrition, Food Studies, and Public Health at New York University. She is the author of Food Politics, Safe Food, What to Eat, and Pet Food Politics. More

Nestle also holds appointments as Professor of Sociology at NYU and Visiting Professor of Nutritional Sciences at Cornell. She is the author of three prize-winning books: Food Politics: How the Food Industry Influences Nutrition and Health (revised edition, 2007), Safe Food: The Politics of Food Safety (2003), and What to Eat (2006). Her most recent book is Feed Your Pet Right: The Authoritative Guide to Feeding Your Dog and Cat. She writes the Food Matters column for The San Francisco Chronicle and blogs almost daily at Food Politics.

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