January 9, 2006
Diabetes and Its Awful Toll Quietly Emerge as a Crisis
By N. R. KLEINFIELD
Begin on the sixth floor, third room from the end, swathed in fluorescence: a 60-year-old woman was having two toes sawed off. One floor up, corner room: a middle-aged man sprawled, recuperating from a kidney transplant. Next door: nerve damage. Eighth floor, first room to the left: stroke. Two doors down: more toes being removed. Next room: a flawed heart.

As always, the beds at Montefiore Medical Center in the Bronx were filled with a universe of afflictions. In truth, these assorted burdens were all the work of a single illness: diabetes. Room after room, floor after floor, diabetes. On any given day, hospital officials say, nearly half the patients are there for some trouble precipitated by the disease.

An estimated 800,000 adult New Yorkers - more than one in every eight - now have diabetes, and city health officials describe the problem as a bona fide epidemic. Diabetes is the only major disease in the city that is growing, both in the number of new cases and the number of people it kills. And it is growing quickly, even as other scourges like heart disease and cancers are stable or in decline.

Already, diabetes has swept through families, entire neighborhoods in the Bronx and broad slices of Brooklyn, where it is such a fact of life that people describe it casually, almost comfortably, as "getting the sugar" or having "the sweet blood."

But as alarmed as health officials are about the present, they worry more about what is to come.

Within a generation or so, doctors fear, a huge wave of new cases could overwhelm the public health system and engulf growing numbers of the young, creating a city where hospitals are swamped by the disease's handiwork, schools scramble for resources as they accommodate diabetic children, and the work force abounds with the blind and the halt.

The prospect is frightening, but it has gone largely unnoticed outside public health circles. As epidemics go, diabetes has been a quiet one, provoking little of the fear or the prevention efforts inspired by AIDS or lung cancer.

In its most common form, diabetes, which allows excess sugar to build up in the blood and exact ferocious damage throughout the body, retains an outdated reputation as a relatively benign sickness of the old. Those who get it do not usually suffer any symptoms for years, and many have a hard time believing that they are truly ill.

Yet a close look at its surge in New York offers a disturbing glimpse of where the city, and the rest of the world, may be headed if diabetes remains unchecked.

The percentage of diabetics in the city is nearly a third higher than in the nation. New cases have been cropping up close to twice as fast as cases nationally. And of adults believed to have the illness, health officials estimate, nearly one-third do not know it.

One in three children born in the United States five years ago are expected to become diabetic in their lifetimes, according to a projection by the Centers for Disease Control and Prevention. The forecast is even bleaker for Latinos: one in every two.

New York, perhaps more than any other big city, harbors all the ingredients for a continued epidemic. It has large numbers of the poor and obese, who are at higher risk. It has a growing population of Latinos, who get the disease in disproportionate numbers, and of Asians, who can develop it at much lower weights than people of other races.

It is a city of immigrants, where newcomers eating American diets for the first time are especially vulnerable. It is also yielding to the same forces that have driven diabetes nationally: an aging population, a food supply spiked with sugars and fats, and a culture that promotes overeating and discourages exercise.

Diabetes has no cure. It is progressive and often fatal, and while the patient lives, the welter of medical complications it sets off can attack every major organ. As many war veterans lost lower limbs last year to the disease as American soldiers did to combat injuries in the entire Vietnam War. Diabetes is the principal reason adults go blind.

So-called Type 2 diabetes, the predominant form and the focus of this series, is creeping into children, something almost unheard of two decades ago. The American Diabetes Association says the disease could actually lower the average life expectancy of Americans for the first time in more than a century.

Even those who do not get diabetes will eventually feel it, experts say - in time spent caring for relatives, in higher taxes and insurance premiums, and in public spending diverted to this single illness.

"Either we fall apart or we stop this," said Dr. Thomas R. Frieden, commissioner of the New York City Department of Health and Mental Hygiene.

Yet he and other public health officials acknowledge that their ability to slow the disease is limited. Type 2 can often be postponed and possibly prevented by eating less and exercising more. But getting millions of people to change their behavior, he said, will require some kind of national crusade.

The disease can be controlled through careful monitoring, lifestyle changes and medication that is constantly improving, and plenty of people live with diabetes for years without serious symptoms. But managing it takes enormous effort. Even among Americans who know they have the disease, about two-thirds are not doing enough to treat it.

Nearly 21 million Americans are believed to be diabetic, according to the Centers for Disease Control, and 41 million more are prediabetic; their blood sugar is high, and could reach the diabetic level if they do not alter their living habits.

In this sedentary nation, New York is often seen as an island of thin people who walk everywhere. But as the ranks of American diabetics have swelled by a distressing 80 percent in the last decade, New York has seen an explosion of cases: 140 percent more, according to the city's health department. The proportion of diabetics in its adult population is higher than that of Los Angeles or Chicago, and more than double that of Boston.

There was a pronounced increase in diagnosed cases nationwide in 1997, part of which was undoubtedly due to changes in the definition of diabetes and in the way data was collected, though there has continued to be a marked rise ever since.

Yet for years, public health authorities around the country have all but ignored chronic illnesses like diabetes, focusing instead on communicable diseases, which kill far fewer people. New York, with its ambitious and highly praised public health system, has just three people and a $950,000 budget to outwit diabetes, a disease soon expected to afflict more than a million people in the city.

Tuberculosis, which infected about 1,000 New Yorkers last year, gets $27 million and a staff of almost 400.

Diabetes is "the Rodney Dangerfield of diseases," said Dr. James L. Rosenzweig, the director of disease management at the Joslin Diabetes Center in Boston. As fresh cases and their medical complications pile up, the health care system tinkers with new models of dispensing care and then forsakes them, unable to wring out profits. Insurers shun diabetics as too expensive. In Albany, bills aimed at the problem go nowhere.

"I will go out on a limb," said Dr. Frieden, the health commissioner, "and say, 20 years from now people will look back and say: 'What were they thinking? They're in the middle of an epidemic and kids are watching 20,000 hours of commercials for junk food.' "

Of course, revolutionary new treatments or a cure could change everything. Otherwise, the price will be steep. Nationwide, the disease's cost just for 2002 - from medical bills to disability payments and lost workdays - was conservatively put by the American Diabetes Association at $132 billion. All cancers, taken together, cost the country an estimated $171 billion a year.

"How bad is the diabetes epidemic?" asked Frank Vinicor, associate director for public health practice at the Centers for Disease Control. "There are several ways of telling. One might be how many different occurrences in a 24-hour period of time, between when you wake up in the morning and when you go to sleep. So, 4,100 people diagnosed with diabetes, 230 amputations in people with diabetes, 120 people who enter end-stage kidney disease programs and 55 people who go blind.

"That's going to happen every day, on the weekends and on the Fourth of July," he said. "That's diabetes."

One Day in the Trenches

The rounds began on the seventh floor with Iris Robles. She was 26, young for this, supine in bed. She wore a pink "Chicks Rule" T-shirt; an IV line protruded from her arm. For more than a year, she had had a recurrent skin infection. The pain overwhelmed her. Then came extreme thirst and the loss of 50 pounds in six weeks. In the emergency room, she found out she had diabetes.

She was out of work, wanted to be an R & B singer, had no insurance. It was her fourth day in Montefiore Medical Center. Her grandmother, aunt and two cousins have diabetes.

"I'm scared," she said. "I'm still adjusting to it."

Next came Richard Dul, watching news chatter on a compact TV. Now 64, he has had diabetes since he was 22. A month before, he had a blockage in his heart and needed open-heart surgery. He was home a few days, but an infection arose and he was back. Postoperative infections are more common with diabetes. This was his 21st straight day in the hospital.

Here, then, was the price of diabetes, not just the dollars and cents but the high cost in quality of life.

Simply put, diabetes is a condition in which the body has trouble turning food into energy. All bodies break down digested food into a sugar called glucose, their main source of fuel. In a healthy person, the hormone insulin helps glucose enter the cells. But in a diabetic, the pancreas fails to produce enough insulin, or the body does not properly use it. Cells starve while glucose builds up in the blood.

There are two predominant types of diabetes. In Type 1, the immune system destroys the cells in the pancreas that make insulin. In Type 2, which accounts for an estimated 90 percent to 95 percent of all cases, the body's cells are not sufficiently receptive to insulin, or the pancreas makes too little of it, or both.

Type 1 used to be called "juvenile diabetes" and Type 2 "adult-onset diabetes." By 1997, so many children had developed Type 2 that the Diabetes Association changed the names.

What is especially disturbing about the rise of Type 2 is that it can be delayed and perhaps prevented with changes in diet and exercise. For although both types are believed to stem in part from genetic factors, Type 2 is also spurred by obesity and inactivity. This is particularly true in those prone to the illness. Plenty of fat, slothful people do not get diabetes. And some thin, vigorous people do.

The health care system is good at dispensing pills and opening up bodies, and with diabetes it had better be, because it has proved ineffectual at stopping the disease. People typically have it for 7 to 10 years before it is even diagnosed, and by that time it will often have begun to set off grievous consequences. Thus, most treatment is simply triage, doctors coping with the poisonous complications of patients who return again and again.

Diabetics are two to four times more likely than others to develop heart disease or have a stroke, and three times more likely to die of complications from flu or pneumonia, according to the Centers for Disease Control. Most diabetics suffer nervous-system damage and poor circulation, which can lead to amputations of toes, feet and entire legs; even a tiny cut on the foot can lead to gangrene because it will not be seen or felt.

Women with diabetes are at higher risk for complications in pregnancy, including miscarriages and birth defects. Men run a higher risk of impotence. Young adults have twice the chance of getting gum disease and losing teeth.

And people with Type 2 are often hounded by parallel problems - high blood pressure and high cholesterol, among others - brought on not by the diabetes, but by the behavior that led to it, or by genetics.

Dr. Monica Sweeney, medical director of the Bedford-Stuyvesant Family Health Center, offered an analogy: "It's like bad kids. If you have one bad kid, not so bad. Two bad kids, it's worse. Put five bad kids together and it's unmanageable. Diabetes is like five bad kids together. You want to scream."

The Caro Research Institute, a consulting firm that evaluates the burden of diseases, estimates that a diabetic without complications will incur medical costs of $1,600 a year - unpleasant, but not especially punishing. But the price tag ratchets up quickly as related ailments set in: an average $30,400 for a heart attack or amputation, $40,200 for a stroke, $37,000 for end-stage kidney disease.

One of the most horrific consequences is losing a leg. According to the federal Agency for Healthcare Research and Quality, some 70 percent of lower-limb amputations in 2003 were performed on diabetics. Sometimes, the subtraction is cumulative. One toe goes. Two more. The ankle. Everything to the knee. The other leg. Studies suggest that as many as 70 percent of amputees die within five years.

Yet medical experts believe that most diabetes-related amputations are preventable with scrupulous care, and that is why the offices of conscientious doctors post signs like this: "All patients with diabetes: Don't forget to bare your feet each visit."

To witness the pitiless course that diabetes can take, simply continue on the hospital tour. This one day will do. Dr. Rita Louard, an endocrinologist, and Anne Levine, a nurse diabetes educator, were making their way through the rooms at Montefiore.

Here was Julius Rivers, 58, on the sixth floor. Three years with diabetes. He had been at home in bed when he saw a light like a starburst and told his wife to take him to the emergency room. His blood sugar was 1,400, beyond the pale. (A fasting level of 126 milligrams per deciliter is the demarcation point of diabetes.)

This was his third trip to the hospital in seven months. At the moment, he had a blood clot in his left leg. He had a heart attack a few years ago. He was on dialysis. "Tuesday, Thursday and Saturday," he said.

On the sixth floor was Mauri Stein, 58, a guidance counselor, a diabetic for 20 years. She had been at a party recently and "zoned out." Her words slurred. Foam appeared on her mouth. She had had a mild stroke.

Now she tried to control her emotions, tried not to cry. She had had repeated laser surgery on her eyes, and was effectively blind in one. She had recovered from the stroke, but doctors had also found a tumor on her heart and said it would need surgery.

"My feet burn," she said. "My toes burn all the time. My days of wearing my pumps are over. I've gotten more cortisone shots in my feet than I'm sure are legal."

She mentioned her brother, who lived in California. Diabetes had ransacked his body - an amputation, kidney dialysis, heart disease, blindness in one eye. He now resided in an assisted-living center. He was 53.

Ms. Stein's husband walked in and sat on the bed. Six months ago, he found out the same truth: he had diabetes.

This was one day in one hospital.

Inside the Incubator

Little about diabetes is straightforward, and to comprehend why New York is such an incubator for the disease, it is necessary to grasp that diabetes is as much a sociological and anthropological story as a medical one. While it assaults all classes, ages and ethnic groups, it is inextricably bound up with race and money.

Diabetes bears an inverse relationship to income, for poverty usually means less access to fresh food, exercise and health care. New York's poverty rate, 20.3 percent, is much higher than the nation's, 12.7 percent.

African-Americans and Latinos, particularly Mexican-Americans and Puerto Ricans, incur diabetes at close to twice the rate of whites. More than half of all New Yorkers are black or Hispanic, and the Hispanic population is growing rapidly, as it is around the nation.

Some Asian-Americans and Pacific Islanders also appear more prone, and they can develop the disease at much lower weights. Asians constitute one-tenth of New York's population, more than twice their proportion nationwide.

The nature of these groups' susceptibility remains under study, but researchers generally blame an interplay of genetic and socioeconomic forces. Many researchers believe that higher proportions of these groups have a "thrifty gene" that enabled ancestors who farmed and hunted to stockpile fat during times of plenty so they would not starve during periods of want. In modern America, with food beckoning on every corner, the gene works perversely, causing them to accumulate unhealthy quantities of fat.

But the velocity of new cases among all races has accelerated significantly from just a few decades ago. Genetics cannot explain this surge, because the human gene pool does not change that fast. Instead, the culprit is thought to be behavior: faulty diet and inactivity. Dr. Vinicor, of the Centers for Disease Control, likes to use this expression: "Genetics may load the cannon, but human behavior pulls the trigger."

Of the country's spike in diabetes cases over the last two decades, C.D.C. studies suggest that about 60 percent stem from demographic changes: a population increasingly comprising older people and ethnic groups with a higher risk.

The studies ascribe the other 40 percent to lifestyle changes: the fundamental shift that has people eating jumbo meals and shunning exercise as if it were illegal. At every turn, technology has made physical activity unnecessary or unappealing. Gym class has largely been deleted from schools. Fewer than a third of junior high schools require physical education at all, the C.D.C. says.

On the whole, New York's corpulence is below the national average, with 20 percent of adults qualifying as obese, compared with 30 percent for the country, the C.D.C. says. But the figure is much higher in poor areas like the South Bronx and East Harlem.

When the health department studied diabetes in the city's 34 major neighborhoods, the distribution echoed demographic patterns: Diabetes left only a light imprint on more affluent, white areas like the Upper West Side and Brooklyn Heights. The prevalence was about average in working-class Ridgewood, Queens, and almost nil on the Upper East Side.

But that apparent immunity is weakening. Of those 34 neighborhoods, 22 already have diabetes rates above the national average, and the numbers are rising all over as the city continually remakes itself.

"New York is switching from a mom-and-pop type of environment to a chain-store type of environment, a proliferation of fast food, even in high-rent neighborhoods they haven't had access to before, like the East Village and Lower Manhattan," said Peter Muennig, an assistant professor of health policy and management at Columbia.

If changes in daily living can bring on diabetes, they can also delay it, though it is uncertain for how long.

A federal program studied people around the country at high risk of getting diabetes, and concluded that 58 percent of new cases could be postponed by shifts in behavior - most notably, shedding pounds.

But Dr. Frieden, New York's health commissioner, says meaningful prevention cannot be achieved at the city level. "I can urge people until I'm blue in the face to walk and take the stairs and eat less, and it won't make much difference," he said.

His emphasis is on trying to better treat those who already have diabetes, an ambitious goal in its own right. Most primary care doctors treat too many patients to provide the attention that diabetics need, or to check for the disease, he said. Specialists are scarce. And compliance among patients is notoriously poor.

Even the most basic step in controlling the disease - watching one's blood sugar - is too much for many diabetics. Doctors recommend that two to four times a year, patients take a so-called A1c test, which gauges the average sugar level over the prior 90 days and is more revealing than daily at-home measurements.

But in 2002 , the health department found that 89 percent of diabetics did not know their A1c levels. Of those who did, presumably the most conscientious, four out of five had readings over the level the American Diabetes Association says separates well-controlled from poorly controlled diabetes.

The patients in the survey were not much better at knowing their blood pressure and cholesterol, which are also crucial for diabetics to control.

"Diabetes is an interesting beast," said Dr. Diana K. Berger, who heads the diabetes division at the health department. "It's probably one of the easier conditions to diagnose but one of the hardest to manage."

Shortages and Shipwrecks

There is an underappreciated truth about disease: it will harm you even if you never get it. Disease reverberates outward, and if the illness gets big enough, it brushes everyone. Diabetes is big enough.

Predicting the path of a disease is always speculative, but without bold intervention diabetes threatens to hamper some of society's most basic functions.

For instance, no one with diabetes can join the military, though service members whose disease is diagnosed after enlisting can sometimes stay. No insulin-dependent diabetic can become a commercial pilot.

Shereen Arent, director of legal advocacy for the American Diabetes Association, says she already fields 150 calls a month from diabetics who complain that they are being discriminated against in the workplace, double the number just a couple of years ago. She mentioned a typical case, a man rejected for a job at a baked-bean factory in Texas as a safety risk. "If this continues," she said, "we're in big trouble."

Dr. Daniel Lorber is an endocrinologist in Queens who thinks a lot about the disease's present and future. "The work force 50 years from now is going to look fat, one-legged, blind, a diminution of able-bodied workers at every level," he said, presuming that current trends persist.

As more women contract diabetes in their reproductive years, Dr. Lorber said, more babies will be born with birth defects. Those needy babies will be raised by parents increasingly crippled by their diabetes.

"At a time when we are trying to shift health care out of hospitals, with diabetics you don't have a choice," he said. "Nursing homes are going to be crammed to the gills with amputees in rehab. Kidney dialysis centers will multiply like rabbits. We will have a tremendous amount of people not blind but with low vision. And we have lousy facilities in this country for low-vision problems. These people will not be able to function in society without significant aid."

Cost pressures have been slashing the number of hospital beds, and some exasperated doctors are known to denigrate advanced diabetics as "shipwrecks," because they have so many health problems and virtually live in the hospital.

Not only will the future mean too few beds and unsupportable drains on Medicaid and Medicare, Mr. Muennig said, but if an emergency strikes - a terrorist attack, an earthquake - the city health system's ability to respond may be compromised because all the beds will be full of diabetics.

Most schools do not have full-time nurses. Some public schools, Ms. Arent said, try to turn away children with diabetes, even though that is illegal. Others ban them from field trips and sports teams. And this is now, when diabetes is still relatively rare among children.

If trends continue, people will live through years blighted by disability, then die too young. Diabetes is thought to shave 5 to 10 years off a life.

"Life expectancy usually decreases because there's a plague or there's a massive economic trauma," Mr. Muennig said. "In this case, we will see a decline in life expectancy due to a chronic condition."

In 2003, diabetes vaulted past stroke and AIDS from the sixth-leading cause of death in New York to the fourth. It was fifth, slightly behind stroke, in 2004. But the health department says it believes the actual toll is much worse because doctors who fill out death certificates may ascribe the death to a complication rather than to the diabetes at its root. Lorna Thorpe, deputy health commissioner, combed through medical charts and concluded that diabetes should be third, trailing cardiovascular disease and cancer.

Laurie Raps is a claims representative for Social Security on Staten Island, 31 years on the job. From her perspective, interviewing people embarking on full-time disability, she has seen the disease's long tentacles. When she started, she saw people in their 50's and 60's, hobbled by the usual problems of age: arthritis, herniated discs, heart conditions. Now, every week, she gets diabetic after diabetic, people as young as 30.

In fact, a 2004 study by UnumProvident, a major provider of disability insurance, found that the number of workers filing claims for Type 2 diabetes doubled between 2001 and 2003.

"It's a double whammy," Ms. Raps said. "You don't have these people working and paying into the system, and then you have these people collecting from the system."

Ten years ago, Ms. Raps developed diabetes. Her husband has it. Both her parents have it, their lives being washed away.

"When I look at the people who sit before me with disability claims, I have to check the birth date in their records," she said. "They look 10 or 20 years older. Diabetes does that. It wears you down and wears you down. We're looking at a future of people 10 or 20 years older in sickness than they are. What kind of future is that?"

'A 15-Year-Old Is Immortal'

"I'm Linda and I've had diabetes for 13 years."

"I'm Dominique and I've had diabetes for seven years."

"I'm Joseph and I've had diabetes for two months."

The brisk introductions went on, the ritual start to the monthly meeting of a support group called Sugar Babes Place. All the members had diabetes. All were children.

Sugar Babes is the idea of Dr. Yolaine St. Louis, chief of pediatric endocrinology at Bronx-Lebanon Hospital Center. When she started practicing medicine 16 years ago, the only children she saw with diabetes had Type 1.

Now, of Sugar Babes' 90 official members, roughly 40 percent have Type 2. One is 8. Another is 7.

It scares Dr. St. Louis. It scares many doctors who see the same thing, because they know it does not have to be. Type 2 was supposed to be an old person's disease. Diabetes still increases with age in an almost linear fashion - today, one in five New Yorkers age 65 and older have it - but the starting point used to be mostly in their 50's.

Dr. Alan Shapiro, a pediatrician with the Children's Health Fund and Montefiore Medical Center who has spent 13 years ministering to children in the South Bronx, said there was an easy way to illustrate the change. When he began, there was a "failure-to-thrive" clinic, meant to address the undernourished, because so many children were dangerously thin and small.

"Now I don't think we hardly ever see a failure-to-thrive case," he said.

In the clinic's place is an obesity program. Dr. Shapiro never saw children with Type 2 diabetes in his early years in medicine. Now, the program has about 10 cases.

One concern he and fellow doctors have is the surge in children who take antipsychotic drugs for anxiety and conditions like autism. Some newer drugs can promote weight gain and thus elevate the risk of diabetes. Dr. Shapiro has an autistic patient who he feels needs the new medication. But since taking it, the young man has markedly put on weight and, at 18, developed diabetes.

This extension of the disease to the young is where health care professionals feel society and public policy have most glaringly failed. Diabetes, they say, should never have gotten there.

There has been little research into the long-term impact of Type 2 diabetes on children. But doctors have a rough idea. The harsh consequences that can accompany diabetes tend to arrive 10 to 15 years after onset.

If people contract diabetes when they are 15, 10 or even 5, they may well start developing complications, not on the cusp of retirement but in the prime of their lives.

There is a big difference between losing a limb at 21 and at 70. There is a big difference between going on dialysis at 30 and at 65.

"I heard a horror story a few weeks ago," Dr. Lorber said, "of a girl who was born deaf, got diabetes at 11 or 12 and went blind from diabetes at 30."

The C.D.C. has projected that a child found to have Type 2 diabetes at age 10 will see his life shortened by 19 years.

"Imagine if kids were showing up at emergency rooms in cardiac arrest," said Dr. David L. Katz, director of the Prevention Research Center at the Yale University School of Medicine. "Frankly, I think that's the next big thing. It's that dramatic. If diabetes doesn't respect age, why should coronary disease? Lord knows, I hope this never happens. But this is what keeps me up at night."

Yet children can be the most reluctant to accept the truths of their condition.

"A lot of them are in denial," Dr. St. Louis said. "They have blood sugars of 300, 400, and they tell me right to my face they don't have diabetes. 'You're wrong,' they say. 'I don't feel anything.' I tell them what can happen down the road, and they shrug. A 15-year-old doesn't care what's going to happen at 35 or 45. A 15-year-old is immortal."

The doctor was telling the Sugar Babes that everyone should have two compact blood-sugar meters, one for home and one for school. Then she warned them, "If your sugar is bad and you don't do anything, you're going to be dropping down all over the Bronx."

Interest was tepid. Some children couldn't keep their eyes off the waiting dinner arranged at a buffet table by the wall. No rapt attention from Joseph, 12, who had begged not to come, until his mother put her foot down. He moaned that he had schoolwork.

"Look at that," said Dorothy Morris-Swaby, a diabetes nurse educator who worked with Dr. St. Louis, nodding at a girl who was talking on her phone. "We're educating about diabetes, and she's on her cellphone. Typical teenager."

As time ran out, hula hoops were brought out. Dr. St. Louis was trying to identify activities other than video games and TV that the children might try. Last meeting, they held a jump-rope contest.

"They have 10,000 excuses why they can't do something," the doctor said. "So you have to give them ideas and then hope."

The meeting wound up. The hoops were stashed away. Some of the children stepped toward the buffet table and began to eat.


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Diabetes has no cure.


Thats nonsense. the cure is called prevention. Stop eating sugar and corn syrup!

Diabetes has no cure.


Thats nonsense. the cure is called prevention. Stop eating sugar and corn syrup!

OnTheWay, Nonsense??? I can tell you're not a medical professional... Sugar don't cause Diabetes... Processed foods, which the body turns into glucose, causes diabetes... Once you've got that kind of condition, you can no longer eat sugars, because the mechanisms which deal with sugar - insulin - has been rendered inoperable... So what you just said only contributes to the problem... IGNORANCE of the problem, contributes to the problem...

For example, unbleached and unprocessed Brown RICE is a grain, not a starch, as I've heard folks who don't know what they're talking about say... RICE combined with VEGETABLES, and LEGUMES(BEANS)is an absolutely perfect meal... ADD Fried Chicken, with that processed White Flower, and some processed White Rice, you got a recipe for DIABETES... Add them donuts and bagels and pastries, with their processed flowers, you got a recipe for DIABETES...

Once again, it is NOT the sugar you are eating that causes DIABETES, it is the processed foods we eat... Consult a doctor, and they'll tell you same...at least a REAL doctor that knows their business, will tell your same... Stop listening to gramma, talkin' 'bout she got SUGAR... I assure you, wise as she may be, she didn't get the full understanding of how she got it...


Peace!
Isaiah

doctors are ok as far as they know. I dont bet my life on anything they say. ill bet my life on one 'healer' who knows more about health than all the modern doctors put together.

'hear ye him'

HOW TO EAT TO LIVE
Sugar Diabetes
By Messenger Elijah Muhammad
Reprinted from the April 14,1967 edition of Muhammad Speaks

http://www.muhammadspeaks.com/Diabetes.html


SUGAR -DIABETES - It is true that sugar diabetes is taking a toll of lives among us. As the

doctors say, there are many victims of sugar diabetes who do not even know it. That is really

true, because no pain comes upon you to notify you that it is there. You have to detect its

presence by other means, which the doctor will explain to you. BUT. regardless of the presence

of sugar in our blood, if it has not gone too far ( into the bones ), there is a cure for it - if the

right steps are taken ( fasting and not eating sugar and starches ) What you find in this column,

How to Eat to Live, on the teaching of food will rid your blood of sugar because we get all of

our energy and our health through eating and drinking. Therefore, to correct any ailment in our

bodies, we must attack the food and drink causing it. We can pick up poison germs in the

atmosphere and that, too, can be removed from our bodies most of the time - by eating the

proper foods at thde proper time. The victims of sugar diabetes to stop eating sugar, starches

and all of that grease that you are frying and eating and you will get well .You will get the suger

out of your blood by purging it out. Even if it has gone to the bone ( as it works its way to the

bone very fast, ) you will be able to get along far better by not adding more suger to that which

is already there. And, there is a chance, in the long run of a few years, that the sugar could be

purged from the bones. Nothing is incurable, if the disease can be checked before it gets into its

last stage ( or gone too far ) You cannot cure a man or woman who is dying with a disease at

once, But, if you can get to the victim before the disease has gone too far, just by correcting

their eating and drinking habits and other poison habits - such as using tobacco and other drugs

the disease cand be cured or minimized to such an extent that they hardly know they have it.

THERE ARE so many people who do not think they can exist unless they are eating two or

three meals a day - and meals with some foods that we should not eat . Learn to eat one meal a

day ; it will lengthen your lives. And eat the right food that has been prescribed in this column.

You do not have to eat all the fine dishes of food to have good health. These fancy dishes are

the ones that destroy health. Just eat pure food. Bread, pure milk and a few of the good

vegetables and beans are sufficient ( and not the dainty meats that we love so. ) There are even

some fish what are edible that we should not eat. We should not eat too large a fish. God, in the

Person of Master Fard Muhammad, advised me against the eating of a fish that weighs 50

pounds. EVEN FISH weighing 10, 12,15, and 20 pounds are too large. I would advise you

not to eat fish that weigh over 10 pounds.

Most of the "complications" diabetics suffer don't come from diabetes itself but from all the medications they are forced to take.

Once they start taking over a dozen pills a day, death is not far away.


The nerve damage isn't cause by glucose.....it's caused by the medications that regulate blood pressure and cholestorol.

Much of the vision loss is also caused by those medications, but MOST of the vision loss is caused by the DIET POP that diabetics consume.
The aspartame most diet pop contain in them is a known neuro-toxin.

Most of the "complications" diabetics suffer don't come from diabetes itself but from all the medications they are forced to take.

Once they start taking over a dozen pills a day, death is not far away.





Agreed.

the corn syrup and sugar in sodas, cookies gum etc is just as badd as any diet sweet.
I dare anyone to stop drinking sodas and cookies and ice cream etc for 6 months and see the benefit for yourself. youllnever catch another cold. your diabetes will be on its way out.

Agreed.

the corn syrup and sugar in sodas, cookies gum etc is just as badd as any diet sweet.
I dare anyone to stop drinking sodas and cookies and ice cream etc for 6 months and see the benefit for yourself. youllnever catch another cold. your diabetes will be on its way out.


ONTHEWAY, Let's be clear, brother... You talked about the eating of sugars being the CAUSE of Diabetes... It is a totally confirmed NO on that account, and I don't care what the Messenger said about... The Messenger was not a medical professional... He suffered from his own ills, which he could not cure, brother... I know, because I was THERE, man... So, please don't whip out How To Eat To live on me... I understand it as a book on Preventing disease, not CURING it... Again, let's you and I be clear about this...

As for your faith in healers - after all of the damage has been done - no, I don't believe in that... I don't believe in any man or woman placing their sweaty palms on me, and curing me of my ills... I don't believe in annointed oils, and talismans, and black cat bones, and all of the nonsense many of our people believe in as per cures for chronic and terminal illness, and I believe the promotion of such ideas is flat out scurrilous and dangerous... We talk so much of how I don't trust the White Man's hospitals, but you trust his cars, and his planes, and the food he sell ya in his supermarkets... Yes, you trust the very garbage that makes us sick in the first place... As my beautiful sister Triniti would say, TELL ME WHY???(smile!)


Peace and Blessings!
Isaiah

ONTHEWAY, Let's be clear, brother... You talked about the eating of sugars being the CAUSE of Diabetes... It is a totally confirmed NO on that account, and I don't care what the Messenger said about... The Messenger was not a medical professional... He suffered from his own ills, which he could not cure, brother... I know, because I was THERE, man... So, please don't whip out How To Eat To live on me... I understand it as a book on Preventing disease, not CURING it... Again, let's you and I be clear about this...

the only real cure of any disese is prevention.
the mesenger confessed that the reason he got ill was because he stoped fasting every 2 days when he was in jail (because of the evil acts of the prison guards who messed with their food)



As for your faith in healers - after all of the damage has been done - no, I don't believe in that... I don't believe in any man or woman placing their sweaty palms on me, and curing me of my ills... I don't believe in annointed oils, and talismans, and black cat bones, and all of the nonsense many of our people believe in as per cures for chronic and terminal illness, and I believe the promotion of such ideas is flat out scurrilous and dangerous


i dont have faith in that type of healing. isaid the messenger is a 'healer' because of his thorou knowledge of prevention.


We talk so much of how I don't trust the White Man's hospitals, but you trust his cars, and his planes, and the food he sell ya in his supermarkets... Yes, you trust the very garbage that makes us sick in the first place... As my beautiful sister Triniti would say, TELL ME WHY???(smile!)[/FONT][/SIZE]


Peace and Blessings!
Isaiah

i dont 'trust' this things. i just use them. if a car dont work well i fix it or get another one. theyr just mechanical things. theeres no comparison between them and my body..

As a person who has been recently diagnosed with type two diabetes (Syndriome X) there are two out of 5 major risk factors I can control...diet and exercise to reduce weight and elevated glucose levels.

However, there are three others I have no conrol over...
1. genetic, heredetary factors.
2. Race.
3. Over age 45.

Point, if you are a Black male over the age of 45 with a family history of diabetes and/or high blood pressure you are in a high risk category.


brother omowale,
instead of dwelling on the intellectual stuff of what modern doctors say you can or cannt control, why dont you do this,

take no sugar, corn syrup, sweeteners, or white bread for 6 months then check your diagnosis again. i challenge you with all due respect...

the only real cure of any disese is prevention.
the mesenger confessed that the reason he got ill was because he stoped fasting every 2 days when he was in jail (because of the evil acts of the prison guards who messed with their food)




i dont have faith in that type of healing. isaid the messenger is a 'healer' because of his thorou knowledge of prevention.



i dont 'trust' this things. i just use them. if a car dont work well i fix it or get another one. theyr just mechanical things. theeres no comparison between them and my body..

Brother, is that why Minister Farrakhan developed Prostate Cancer, or brother Khalid died at like 50 of a massive heart attack - because of the preventative powers of The Messenger's teachings???

Brother, I am a former muslim, and I have great respect, still to this day, for the Honorable Elijah Muhammad... But I don't take everything he said as THE WORD on medical and health affairs... Again, he was not a medical professional, though he had great ideas... The conclusions he drew about Diabetes weren't even standard at the time - except to Black people, and others, who completely misinterpreted what it meant to have developed the disease of Diabetes... Processed Sugar(there's that word again)will kill you, and contribute to the onset of diabetes, but it will not of itself CAUSE diabetes... Hence, you have elders who don't even eat a lot of sugars, yet develop diabetes... You have people who drink cokes and pepsis all day and night, and do NOT develop diabetes, as well...

Here's another one for ya... It has lately been established that fats are not only not what causes one to be fat, but they are necessary for good health!!! How you like that one???(smile!) Of course, we're not talking about fats in the frying pan, or on those ox tails some folks love to eat... Those'll make ya fat in an unhealty way, and so will those breads and pastries and pizzas made of processed flour, and so on...

I, too, am not a medical professional, and do not claim to be, but diabetes is a disease that has negatively impacted on my family, and lots of "African families about the world... We need to get clear tha there are aspects of our diet, as we've developed them in this hemisphere, that are conducive to disease... This does not mean throwing out the baby with the bathwater... We eat a lot of great foods, like legumes, grain, and green vegetables.. But when we combined those foods with bisquits and butter and hamhocks and smoked this and that...recipe for disease...

Additionally, we no longer prepare our own meals... We let Chiny mon and McDonalds do it for us...recipe for disease, man... The way I see it, we 0nly have to make some very minor adjustments to our diets, and we can improve our health immediately... Stop going to Chiny Mon and McDonalds, and preparing good balanced, home-cooked meals minus that processed bread and chesse and macaroni, stove-top style, and see what happens... We don't need miracles and faith healers, we just need to eliminate the processed things we're eating(flour on that fried chicken, for example), and we will see immediate drops in the diabetes problem... Every single morning, I see our children buying the classic ghetto breakfast, fried eggs with cheese and bacon on a bun - or what some feel is healthy, the turkey sausage replacing the bacon...recipe for an epidemic... Eat some oatmeal or farina instead, and watch our children's health improve...


Peace!
isaiah

brother omowale,
instead of dwelling on the intellectual stuff of what modern doctors say you can or cannt control, why dont you do this,

take no sugar, corn syrup, sweeteners, or white bread for 6 months then check your diagnosis again. i challenge you with all due respect...

Brother, yes, those things will, indeed, improve one's health, but they are AFTER THE FACT solutions... They are NOT CURATIVE of the disease... There is no known CURE for the disease, and for you to purport that there is one is ridiculous.. BTW, brother O is not dwelling on the negative to point those things out, he is pointing out some information which would put folks on the ALERT about the disease... Brother, if you are not a medical professional, why are you posturing as if you are one???(smile!) Come on, now, we got enough savants in our communities, who know how to solve all of our problems, and aint solved problem the first...


Peace!
Isaiah

Brother, is that why Minister Farrakhan developed Prostate Cancer, or brother Khalid died at like 50 of a massive heart attack - because of the preventative powers of The Messenger's teachings???



...they did all that because they didnt follow his preventetive powers.

brother, you know that diseses are living things, right? bacteria, virus etc.

how do they survive?...just like you and me... i.e they need food.

you cure ALL of them by starving them of the food they need. thats called fasting. also by starving them of paraticular foods for each one, like sugar in the case of diabets.
that simple.

brother omowale,
instead of dwelling on the intellectual stuff of what modern doctors say you can or cannt control, why dont you do this,

take no sugar, corn syrup, sweeteners, or white bread for 6 months then check your diagnosis again. i challenge you with all due respect...

Rather than accept your words as a "challenge" I have already made changes in my diet and exercise routine that include what you suggest. As a Type A blood group I also much do without dairy and WHEAT bread because wheat contains a particular sugar which is difficult to digest. Taking "no sugar" basically means eating no carbohydrates and this may not work as I do need some source of carbs as "energy" to assist in burning fat. However, I keep no sugar or salt in my house, the only snack food present right now are fruit, vegetables and a few pretzels, which I bought because my daughter is visiting..

Over the past two years I have lowered my cholesterol from 196 to 176 and my triglycerides from 190 to 174, which is still high (normal 150). In three weeks of changing exercise pattern my glucose changed from 219 to 154 but the normal range is 70-105...I have gone the last two years without being diagnosed and have lowered these readings during the same period of time. My weakness is pizza and other pasta, and soda, which I am trying to ween myself from. I am quite familiar with "How to Eat to Live" and early adopted it instead of "Living to Eat."

Diabetes is, however, a disease that has afflicted almost every elderly member of my family on my father's side. An aunt died last summer who was in her ninety's while at the same time I just lost a cousin in his early forties who contracted pnuemonia due to diabetes-related symptoms..

Brother Isaiah,

I think you just mentioned one lifestyle change that I have recently implemented which is having a positive effect. I am preparing my own meals more and only use olive oil, and NEVER fry any more meat.

Brother O, you've gotten instant positive results from that change as well???


Peace!
Isaiah

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KD

Brother Isaiah, I have a little project for you - courtesy of myself, and my young people.

My mother has diabetes, so I am DETERMINED not to get it. On another note, I have come to understand that the reason why people "STOP" eating unhealthy, but then go back to eating unhealthy, is because they have no replacement foods. It's like keeping a pet from drinking dirty water, but then not giving them anything alternative to drink. Eventually, they will get thirsty, and try to run back to the dirty water.

My project is this-

See if you can compose a list of healthy food that will not just keep you from diabetes, but guarantee a healthier personality - because I learned (from Malcolm X) that you are what you eat, and what you eat affects your mind, heart, and body. In other words, depending on what you eat, will determine how you act, how long you live, etc.

If that is doable, please post the list ASAP. I have no problem with eating the way I do (which is better than junk); I just feel that I am unaware of what is VERY healthy, essential, and conducive to living a healthy lifestyle.

That is my project for you.

I would also like to mention that at my college, I am trying to cut back on meat, even though I recently ate little roast beef, and some turkey. I have not drunken any soda in such a long time, I forgot and forget that it still exists! Maybe some juice, then again, I don't want too much sugar, especially after reading through this thread. On top if that, it upsets me when I go to eat veggies, and they pour butter on them! I forgot how unhealthy biscuits were (w/ or w/o butter. oil, and grease); I don't eat fried chicken or french fries anymore, I officially stopped eating pork after reading this thread: http://destee.com/forums/showthread.php?t=2134 special thanks to Aqil, I stopped eating hotdogs, and I stopped eating Ramen Noodles (which turns into glucose). I stopped using hot sauce as a condiment, stopped eating excessive bags of chips (grease), stopped eating all those candy bars; I made many changes. I just do not know if my replacements are very effective. I am trying to learn to live and eat right WITHOUT being charged $1200 by doctors. By the way, I need to 'scoop' on the rice, in terms of whether to eat white or brown,

Anyhow, I need that list.


Brother Cedric, remember these things...

Drink lots of water, because water not only cleanses your body of impurities, it also washes out FATS in your system...


Stay away from the processed foods... Processed Foods are MAN-MADE, like Cheese, or bleached flower and rice, and ENRICHED pasta/spaghetti... If you see ENRICHED on anything, leave it alone... It's been tampered with by man's manufacturing processes... The processed foods are those which cause major problems for most people, and include those cakes and pies, pastries and bagels... Your system literally turns them into GLUE.... That mucuous buildup is akin to Glue... Ask yourself, what does GLUE DO???? What is its function??? Do you need it performing those functions in your body???

Now, of course, sugar destroys like acid... When we die, about the only thing that remains are our bones and teeth... They're damned near indestructible, right??? That is until they come into contact with WHITE PROCESSED SUGAR, which causes cavities and decay... SUGAR estroys our teeth, which under normal circumstances are indestructible! What is it doing inside of our bodies???

Eat plenty of VEGETABLES, BEANS(LEGUMES), BROWN RICE, and fruits and nuts of all kinds... These are natural, LIFE-SUSTAINING foods, brother Cedric, and feeding the body THESE foods pretty much guarantees you good physical health under normal conditions... The body is a wonderful machine, but like any other machine, it takes a beating when it is not properly OILED, brother... Oil in this instance is a metaphor for FOOD...

Cedric, I am not a nutritionist, but I've tried to develop a basic working understanding of how eating fruits and veggies benefits me... For example, brother, fruits and vegetables are naturally compatible with our digestive enzymes and acids... Thus, it does not have to work as hard to extract what it needs, and expelll the wasted physical product... When it expells the wasted physical product, it does it with an ease which preserves you bowels and bladder, and if you are a man, your prostate glands... That's basic stuff...

Oh, and you are correct brother... A good rule of thumb is that the DARKEST of fruit, like Blue Berries, and DARKEST of GREEN vegetables are the healthiest foods on Earth... Those collard greens are Awesome! We just don't cook 'em right... Those lima and kidney beans are AWESOME, but Black folks just wont cook 'em right...and then we eat 'em in combo with white rice... Throw the white stuff out... It is processed and deadly in the long run...

And Ced, if you are eating in those take out restaurants, stop that right away... Know what the hell is going into your body, Ced... You can't do that at the Chiny Mon...(smile!) Those are MY rules of reference, and I don't know if these things will work for everyone, but I do know that the elimination of Red Meats, animal flesh, and processed foods, will go along way to improving anyone's health...


Peace!
Isaiah

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KD

I went out to the store yesterday, and I bought peanuts, grapes, bananas, [baby] carrots, and a box of Triscuits. However, I am not sure if I should have bought the Triscuits, or the carrots; the carrots contained 8 gallons of sugar, and I am not sure of how healthy Wheat is.

Another thing, how about milk, cereal, corn, and strawberries?

Not to mention, I always drunk water, but then I heard that you have to drink it in room temperature for it to be healthy. Is this true?

CD

Alright, brother Cedric, the fruit are great, and you can drink COLD water, particularly in SUMMER, as it instantly lowers your body temp... It is said that it is a shock to the system, but our system endures far greater shocks than cold water, man... Use your "bible"(your intuition)to decipher any information given you on this subject, brother Cedric... Some stuff is just so nit-picky it's ridiculous... Until evidence proves cold water is bad, I don't believe that...

Cereal??? That depends on what kinda cereal it is... Organic oats, farina, even grits, are quite wonderful for you... Remember, natural stuff is right up the charts on the human food chain... They're first on that chain, as a matter of fact, so eat lots of fruit, my brother... Eat lots of veggies and soups, and stay away from the processed things that are not LIFE SUSTAINING... Some say that if it's in your cupboard, and not your garden, it aint life sustaining... Cereals are not in our gardens... They are in your cupboard most of the time, but they are life sustaining food...

Of course, stay away from animal's milk, too... It's for animals, not human beings(smile!) Red Meat is a proven carcinogenic and high-blood pressure inducing... If you got to eat animal flesh, eat chicken roasted, broiled, boiled, baked... Same thing for turkey and fish...

You know, Cedric, it's funny, but I actually think that it's good to throw some garbage into our bodies, like those hostess twinkies, as long as we do it in great moderation... GREAT MODERATION, like once every quarter, 4 times a year, dig???(smile!) Quench your desire for these things by having them once and a long while... What I personally do is, I buy small portions, and never bring large cakes and pastries into my house... If it aint up in there, you caint eat it... I eat nuts and raisins mixed with BAKER's Granola for my snacks... Try some of that Ced, it's delicious, but addicting...

Peace!
Isaiah

I went out to the store yesterday, and I bought peanuts, grapes, bananas, [baby] carrots, and a box of Triscuits. However, I am not sure if I should have bought the Triscuits, or the carrots; the carrots contained 8 gallons of sugar



CD

brother, there's nothing wrong with the natural sugar in carrots and fruits. Only the processed sugar (both the brown and white stuff, plus the processed corn syrup and artificial sweeteners) are poison for the body because they remove all the nutrients in it.



otw

Cedric

Not to mention, I always drunk water, but then I heard that you have to drink it in room temperature for it to be healthy. Is this true?
Funny you should bring that up.

This little chinese health practicioner I've been going to since my accident told me the EXACT same thing.

He said everything I drink should be at room temperature.


Problem is everything at room temperature is almost intolerable for me to swallow down and I feel like spitting it out like "luke warm water " in that parable Jesus allegedly gave.


He also told me not to drink milk or eat certain foods because my body easily stores calcium.

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KD

Cedric


Funny you should bring that up.

This little chinese health practicioner I've been going to since my accident told me the EXACT same thing.

He said everything I drink should be at room temperature.


Problem is everything at room temperature is almost intolerable for me to swallow down and I feel like spitting it out like "luke warm water " in that parable Jesus allegedly gave.


He also told me not to drink milk or eat certain foods because my body easily stores calcium.

What's up, brother Dual!

Actually, drinking water at most any temp it is going to be healthy for us, as long as the water is drinkable(not too hot, or filled with poisons), so the practioner is giving out standard advice... No one has proven to me that drinking ice cold water produces enough of a shock to the body that it is detrimental to the health...

Brother O, and OnTheWay are correct as well... Natural sugars are easily absorbed and processed as energy by an operable pancreas... If you don't yet have diabetes, you should not be concerned about sugars - particularly the natural variety... Again, little brother, it is not the sugars that will give you diabetes anyway, so why would you be so concerned???

The garbage, the processed flours, White Rice, cheeses, sausages with all those polyunsaturated fats, man... Check those, eat right, drink right, exercise, and do some meditation and reading, and thinking good health, life-sustataining thoughts, and you'll be straight... You are too young to get all hung up on not getting diabetes Cedric... Live your life, man... Worry too much about diabetes, and you wind up with cancer(smile!) I'm serious, brother... How we THINK is just as essential to good health as how we eat, black man... The mind and body are ONE... Remember that....


Peace!
Isaiah

I noticed a few things to comment on...I understand the concern with fish so maybe it would be best to find a local Carniceria or Fish Market and buy it fresh...Fish is probably the best "meat" to consume because it contains high levels of protein and assists in lowering the blood pressure....but again, that depends on your blood type...for example, snapper is preferable to catfish which is a scavenger and can contain neuro-toxins..Fish oil can be taken as a supplement to aid in lowering cholesterol...Fish is better than chicken because it contains more water, and is easily digestible...do like the Muslims and cultivate a taste for whiting..almonds are preferable to cashews (even though I like cashews more)...and should be unsalted...Premium crackers...made of white refined flour even though I occasionally eat them with home cooked gumbo...brother Isaiah spoke of how certain foods/breads/pasta turn into glue so think about glucose as being GLUE and pasta as "PASTE"..Lol! The less glue and paste you consume the freer you blood flows without clogged arteries...canned fruit...sugar and sodium...if you must...rinse thoroughly with SPRING water...I have started just buying fresh fruit and some fruit such as apple sauce and pineapple in the plastic containers..small portions already prepared...donuts, honey buns, etc....along with cinammon rolls...my death food...LOL!...im laughing but crying at the same time:cuss: because I am now monitoring my glucose level daily and must leave the sweet rolls and rolls alone along with my favorite two foods...fried chicken and pizza...suggestion....any canned or packaged foods...check the sodium sugar and TRANS FAT levels..and if you must, again, eat with moderation..


Brother O, that was beautifully put... Glue and Paste! That's what the processed foods represent...

Ced, I cannot say it better than brother O has here... Remember, that when we talk about "PROCESSED FOODS", youngblood, we are talking about CANNED GOODS, as well... Frozen Vegetables are more preferrable to canned goods, which have sodiums and other preservatives as you mentioned...

Think abou those canned fruit... Does the nectar of a fresh, live fruit, look like that goo spilling outta that can??? Is it sweet off-da-hook, or what??? It's had sugar added to it, that's why??? Of course its' dangerous, particularly to someone who's already diabetic...

You know, Ced, I eat a lot of soups these days, brother, and they're so delicious... I get my corn, carrrots, green beans, broccoli, spinach, peppers of all colors, tomatoes, okra, and potatoes, and seasonings, and I get mad creative... It is tantamount to doing a gumbo, but without all of the meats, and its still wonderful... You don't feel crazy full... When you go to the bathroom, the procedure is so quick and painless, you aint got time to read nothing but the scott's label, and you outta there...

This pays off later in your life, the body's ability to easily process and dispose of wastes... Your vital organs aren't all burned out with the constant revving up the motor, engine, carbueretor, and the gear box...(smile!) Think about it, brother, our bodies are machines... Take care of the machine by feeding it what it needs, and it will take care of you... Also, excercise it, mr QB/Point Guard...(smile!)
PEACE!
iSAIAH

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KD

If yall knew how many close people I lost in my family to the COMPLICATIONS of diabetes, you'd shake your head.
The health-care when it comes to this disease is a joke.

Sometimes I think if they had just stayed the hell away from these doctors and thier destructive medications, they's still be alive today.


Lifting weights is the most theraputic exercise for those with diabetes because it's "anaerobic" and burns up excess glucose in the system.





Isaiah

Actually, drinking water at most any temp it is going to be healthy for us, as long as the water is drinkable(not too hot, or filled with poisons), so the practioner is giving out standard advice... No one has proven to me that drinking ice cold water produces enough of a shock to the body that it is detrimental to the health...
I never had any bad experienced drinking cold water.

But when I used to lift weights this cavie told me that the best feeling in life is to relax in the hot-tub and immediately take a cold shower afterwards.
He was serious about it because that's what he and his friends did after each workout. So I tried the same thing one morning.

Said like Richard Pryor: As soon as that cold water hit my *****...

....my lungs were locked for a good minute or two.

I was so paralyzed I couldn't even turn the water off; I fell back OUT of the shower and eventually warmed up to the point I could move and crawl the fvck away.

((shakes head))

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KD

Let me be clear about something. I recently have been diagnosed as a type 2 diabetic AND I am taking atenalol for HBP. So I have my issues..Yesterday I had a shrimp po'boy AND a corned beef sandwich..amazingly I did not faint or catch a stroke..but my glucosee reading has gone from 154 to 193 to 186 in the past week...so I am not the best source of information...I know what I am supposed to do but at times the flesh is weak so I empathize with your "binging"..all that you mentioned prior to the roast beef is PASTE then you added the beef on top of that...problem:how long will it take for the meat to digest and go through your colon while making its way through the paste....folks say that the sugar you consume is not the problem but I beg to differ..it is the sugar contained in the pasta/bread/cake,etc which turns into sugar and can increase INSULIN RESISTENCE...which can lead to diabetes...and speaking of coughing and sneezing...those same cakes and processed snack foods...such as chocolate candy products...just look at the ingredients...most are made of egg, milk, etc...that is to say, dairy...try eliminating cheese completely for a few weeks and see if you notice any weight loss, reduction in mucus and/or allergic symptoms..as far as the apple sauce...i eat the Mott's natural with no sugar added...i also bought a blender and a juicer to make my own natural "smoothies"...and have developed a liking to cranberry juice...which aids in metabolic functions and flushing the colon..

No wonder why they give Cranberry Juice for Communion in churches.

Actually, the mucus is clearing out, and I stopped eating cheese a while ago. I have not eaten cake in a few, I drink AT LEAST 1 gallon of water a day, and that is because I usually get in the habit of drinking it excessively, and I live in the bathroom! LOL! Also, you mentioned to stop eating that what Isaiah calls "garbage" and see what happenbs - already, I got my voice back, and I slept exceptionally well, and it has only been a day or two! But then I try to keep my mind off of trying to EAT something ALL the time. However, I learned from a spiritual perspective that one of the reasons people end up with eating disorders, is because they eat when they are not hungry, and they do not eat when they are hungry. In other words, there is a failure of communication when the stomach is hungry, and is not fed, let alone not fed the right ingredients. I cut down on the Candy bars, because they contribute to (help me here) hypoglycemia. However, according to Dictionary.com, they say hypoglycemia is "An abnormally low level of glucose in the blood." I thought GLUE did not belong in the blood? Or are we talking about another form on GLUE-COAST?

CD

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KD

My Brother,
What a Powerful Statement!
May GOD Bless You and Your Posterity as well!

Hotep!
Omowale.

Brother O, thank you too, for being so forthcoming and passing along your wisdom on this subject... I gotta admit that your piece on glucides and glucose had me smiling to know a brother can break it down so well(smile!) Thanks for that, man...

Brother Ced, live your llife, have fun, and remember SOME of what has been said here, because I can tell you from personal experience, just listening to some of the info passed along by my moms, who had diabetes herself, has been most beneficial to me... I laugh when I think about her, because she used to try and get slick with me, and my siblings... She'd bake a few cakes, and tell us she'd baked 'em for us... Meanwhile, she's pinchin' and pinchin' and pinchin', and we can't wake her up, ya dig???(smile!) After awhile, I'd wait a day or so, and take the cake to work, and feed it to my friends, and throw the rest down the chute, yo...(smile!) I wasn't going to let what she told me go in vain... I'd go mad months - even years - without messin' with no cake, then I'd binge on some donuts, or something, and come to my senses, and stop for months... All of that resistance is based on what moms told me about trying eat better...


Peace!
Isaiah

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My baby sis was diagnosed as a diabetic at the age nine.
We didn't know what was wrong with her at first.
She lost alot of weight and became catatonic.
The doc told my mother she had a virus and prescribed an 80 dollar cough medicine.
My parents couldn't afford the medicine.
The following day my step father said let's take her a childrens hosptial.
Low and behold she a glucose level in the 500's.
If they had given her the cough medicine my sister would have died.
I think she was born with it.
As a toddler my mother gave her juice alot.
Her teeth rotted in the front.
Thank God they fell out and good teeth grew back.
She is now 16 and takes two insulin shots a day.
She's always tired or sick.
Her kidneys are bad.
She tries to follow her diet but it's hard being a teen socialbly for her.
I wish I could take it away from her and give it to me.
We have a history of diabetes in our family.
My mothers father had it.
My mothers sister has it also.
It's nothing to play with.!

Why would she have died from taking the cough medicine?

It was full of sugar! Diabetics cannot take regular cough meds. It has to be sugar free.She already had a sugar in the 500's. She would have been in a coma or not here at all.:crying:

It was full of sugar! Diabetics cannot take regular cough meds. It has to be sugar free.She already had a sugar in the 500's. She would have been in a coma or not here at all.:crying:

Okay. I got'cha.:glasses:

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KD

I forgot to do two quick things:

1. I forgot to give Brother Isaiah his grade for his project, which was a big A+!:congrats:

2. I forgot to give Dual credit for involving the medicine. I just finished officially reading that front page article given by Isaiah, and what we are talking about is nothing compared to what is contained in that article. Not only will there be a health crisis, but there will also be a financial crisis. I'd say that everyone who makes 'processed foods' should be shut down! But then again, I can see why NYC would have such a massive amount of residents with Diabetes. Then they say that poverty = (paraphrasing) a lack of healthy resources. All of these problems, yet what are we (the people) doing? Still watching TV, still growing in temptation over the Giant Bacon Double Cheeseburger for $3.99 at Burger King, still craving on that Chinese 'processed' food, even though they have frequent cases of SARS; you know what I mean. It needs to come to a stop.

Also before I go on, I would just like a few more suggestions (back to student mode):

How about the following:
Peppermints
Strawberries
Wheat Thins
Lemons
Pistachios
Tortillia Shells?

What kind of soup?

CD

:tweety:Cedric, glad you read the article, which is only one of a 6 or 7 part expose on the subject...and thanks for the high grade you gave me, my teacher(smile!)

As for the foods you mentioned, listen, eaten moderation none of tha stuff will harm you... Diabetes and other diseases are caused by folks going overboard, and eating these processed foods and sweets to excess...

As far as soups are concerned, prepare them to your taste, good brother... Get creative, but always remember what you like to eat best... Myself, I dig veggies of all kinds... When I am preparing a soup, however, I gots to have my peppers, green, red, orange, hot and mild, and some tomatoes... I dig those veggies both for flavor and coloring... Other indispensable vegetables are OKRA, the African vegetable our ancestors brought here, and broccoli and spinach, which are high in beta kerotin... Beta Kerotin wards off cancer, and is a anti-oxidant, which wards off old age, yo - so they say...(smile!) The broccoli is also high in Beta kerotin, and so are carrots... The OKRA makes hittin' the latrine easy on your bowels, Cedric... It coats your intestines with a wonderful natural lubricant, that aids your digestion and disposal of waste product... Fact of the matter is, all of those vegetables and legumes aid in that process... It's the animal flesh and processed food that messes it up...

Finally, Cedric, I'm happy to know that you are as concerned about your health NOW, as you are... Years ago I worked a municipal hospital, and came in contact with lots of folk who told me that if they'd known that how they were living was going to lead to so much suffering, they'd have ceased living those deleterious lifestyles... Good, healthy living begins now, brother, and will carry you into your old age...


Peace!
Isaiah

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Brother, I'm not sure of sunflower seeds but sunflower oil...cool...The seeds are fine so long as they don't cause digestive problems, as some nuts do. Cucumbers,tomato, okra, are good for type O. type a's don't do well with tomato.
Now this is my problem, since recently being diagnosed with type 2 diabetes. especially since I love pizza, lasagna and mexican food, and use salsa quite extensively. "Corn lectins affect the production of insulin, often leading to diabetes and obesity. All type O's should avoid corn--especially if you have a weight problem or a family history of diabetes."

"Tomatoes are a special case. Heavily laced with a powerful lectins, called panhemaglutinans (meaning they agglutinate all blood types), tomatoes are trouble for Type A and Type B digestive tracts. However, Type O's can eat tomatoes. They become neutral in your system."

If you are a Type O highly beneficial are Collard Greens, Romaine Lettuce, Okra, Red Onions, Broccoli, Garlic, Yellow Onions, Red Peppers, Sweet Potatoes, Spinach and Turnips...However, type Os should avoid Cabbage, corn, mushrooms, mustard greens, olives red and white potatoes and sprouts..My guide also says to avoid strawberries and some melons because of high mold content..oranges, tangerines and strawberries have high acidic content. As do coconut and plantans, while bananas are "neutral". Type A's can eat strawberries but are advised to avoid bananas, and the same with melons...this is another problem for me because I love cantaloupe and honeydew, and of course, watermelon (which is ok because it is neutral)....let me explain, not only am I diabetic...I am Tye A+(positive) which means my digestive system is highly ALKALINE and a major part of my problem is eating foods that are ACIDIC and my body does not metabolize and digest these foods well due to insulin resistence..this leads to weight gain and increased glucose in the blood...I now have to almost completely alter my diet...I tend to eat mostly sandwiches for lunch...after teaching for 20 years this was typically all I had time to eat in a 30 minute lunch period, much of which I spent doing playground supervision...half a sandwich, some fruit, which usually was cantaloupe or watermelon, and maybe a small salad...and now I must avoid sandwiches with the following condiments...ketchup, mayonnnaise, pickels, pickle relish and worchestershire sauce...****...worcherstershire sauce....that's gonna make those turkey burgers much less appetizing...and yes...pickels and vinegar should be avoided because of their low,levels of stomach acid..

Big O, powerfully intriguing info, man... You love them melons, Too, eh?!(smile!) I dig 'em myself - with a passion! I also love MANGO MANGO MANGUE!

But I'm an O+ blood type, and you tellin' me I can't have no cabbage! I aint yo friend no mo, bro...(smile!) I must admit that sister Jewell Pookrum, a wonderful Detroit physician and nutritionist, once told me to stop eating white potatoes, as they were not consistent with our genetic make up as African people...

Like you, she suggested yams/sweet potatoes, but I cannot see putting yams in my soup(smile!) I just don't see yams like that(smile!) And I must admit to digging white poatoes in a lot of forms, including french fries and potato chips - LOL! I eat the stuff in moderation, though, because it's most clear that White foods are as bad for you as White folks are for Black folks...

But thanks for the great information, and continue to take good care of yourself... My mother actually was diagnosed with Diabetes before I was born, and she lived at least a good 40 years after that diagnosis by following her diet - albeit not strictly(smile!) Just be disciplined, and eat them po boys in moderation(smile!) You'll be straight...

Peace!
Isaiah

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KD

http://dherbs.com/blog/2005/12/20/diabetes/

This is an interesting read...I have gotten alot of good information from this brother about both my fibroids and my prediabetic status....I have been working with my body for about a year and a half....I have reduced my weight and exercise more but my numbers have not come down so I am regrouping and looking at it from a more body system wholistic approach...trying to create more overall balance in my body by becoming more alkaline (reducing my carbs was creating a very acidic environment that "fed" a host of other issues)....I will be detoxing and going back to regular colonics (haven't had one in 6 years!) and a more plant based diet...also listening to my body more has helped tremendously....when I eat something and "feel" horrible I don't force it on myself because it is the "right" thing for those seeking to avert diabetes to eat....just my .02

http://dherbs.com/blog/2005/12/20/diabetes/

This is an interesting read...I have gotten alot of good information from this brother about both my fibroids and my prediabetic status....I have been working with my body for about a year and a half....I have reduced my weight and exercise more but my numbers have not come down so I am regrouping and looking at it from a more body system wholistic approach...trying to create more overall balance in my body by becoming more alkaline (reducing my carbs was creating a very acidic environment that "fed" a host of other issues)....I will be detoxing and going back to regular colonics (haven't had one in 6 years!) and a more plant based diet...also listening to my body more has helped tremendously....when I eat something and "feel" horrible I don't force it on myself because it is the "right" thing for those seeking to avert diabetes to eat....just my .02

Thanks for the link. I think this is why the Akins Diet never has owrked for me on a prolonged basis as you state, "(reducing my carbs was creating a very acidic environment that "fed" a host of other issues)"..Nothing wrong with "complex carbs" so long as one exercises and uses them as "fuel". I am slowly cleaning out my cabinets and refrigerator of "bad habit" food (i.e. unhealthy snacks, dairy) and replacing with more fruit and veggies...it's a process...

It is a process....I believe one of the reasons I was born into my family (which is full of diabetic members) is to break the chain of misinformation about food and lifestyle and overall health....My auntie on my mom's side is one of the diabetics in the family who has joined me on moving towards a different view of this condition and how we react to it...So while she is on insulin and I am not, together we are constantly searching, refining, trying what works and doesn't, and reporting all of this to our extended family...one of which (my 79 year old insulin dependent dad) thinks its a waste of time because "everyone in our family is bound to get this and succumb"....his thinking sometimes makes me feel :insane: ......but I meditate/pray/ask for guidance and continue knowing that .....It is a process

It is a process....I believe one of the reasons I was born into my family (which is full of diabetic members) is to break the chain of misinformation about food and lifestyle and overall health....My auntie on my mom's side is one of the diabetics in the family who has joined me on moving towards a different view of this condition and how we react to it...So while she is on insulin and I am not, together we are constantly searching, refining, trying what works and doesn't, and reporting all of this to our extended family...one of which (my 79 year old insulin dependent dad) thinks its a waste of time because "everyone in our family is bound to get this and succumb"....his thinking sometimes makes me feel :insane: ......but I meditate/pray/ask for guidance and continue knowing that .....It is a process


Good job:great: I was wondering if you were self-testing. I just started last week, twice a day, and now three times (at least). Saturday I had some ice cream and chocolate cookies and shot up to 333 mg/dl...No sweets since and went back down yesterday to 122 mg/dl...ate a home cooked turkey burger and went up to 222 mg/dl...then was exercising during the Laker/Heat game and went down to 166....woke up this morning and was at 177 mg/dl, the lowest MORNING reading since I have been testing...the normal range is 70-105 mg/dl and at times it seems as impossible to reach but I know that if I continue to reduce the intake of sugar and starch, while increasing:cardio: that I may not drastically lower the glucose into a normal range but I HAVE begun lowering my triclycerides, which also means lowering the "bad cholesterol" reducing the risk of stroke or heart disease, and maybe one day I will be able to function without taking prescribed blood pressure medication...:run:

You know what the irony is? I was never a huge "sweets" eater....my snack of choice is/was popcorn...i know i know its not exciting or sexy like cookies or icecream (of which i never ate either due to the lactose thing)...but i was still surprised when I went in for a routine exam and he said I was borderline...but truth be told i had let my health take a back seat since my son was born 5 years ago...but now i am BACK....plus I want to introduce health correctly initially for him so he doesn't have a lot of unlearning/relearning to do as an adult...I recently began running..I was surprised how much I liked it.....I had always been a yoga/pilates type of gal....but I am enjoying the running...next I want to try and add :weights: to the mix...I'm 36...got to keep it firm and healthy;)

You know what the irony is? I was never a huge "sweets" eater....my snack of choice is/was popcorn...i know i know its not exciting or sexy like cookies or icecream (of which i never ate either due to the lactose thing)...but i was still surprised when I went in for a routine exam and he said I was borderline...but truth be told i had let my health take a back seat since my son was born 5 years ago...but now i am BACK....plus I want to introduce health correctly initially for him so he doesn't have a lot of unlearning/relearning to do as an adult...I recently began running..I was surprised how much I liked it.....I had always been a yoga/pilates type of gal....but I am enjoying the running...next I want to try and add :weights: to the mix...I'm 36...got to keep it firm and healthy;)
Sounds good...I just bought three DVD's yesterday...one yoga...one Tai Chi and another, Tae Bo...only now I need to get off this PC and start working out...going to the "driving range" to knock around some golf balls then hit the treadmill...best of luck to you...I think regular weight lifting IS of healthy benefit...Peace!

Omowale..

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Chocolate is believed to be healthy in one sense because it is rich in zinc and potassium. Again, the key word is moderation because it also is high in saturated fat, and combined with other foods, may lead to a high caloric intake, which means more exercise is needed to burn off the saturated fat..

Tuna can be high in pesticides, so organic tuna is best...Tuna is considered "neutral" which means that it will not lead to weight gain or assist in weight loss...it is an excellent source of selenium and vitamin B12...any foods rich in B12 are great for the bloodstream..

Yes, brother, I was reading some info on Omega-3 and Omega-6 Oily Fish, such as Mackerel, Sardines, and Salmon, and how they are reputed to be great for the brain, or brain food...

You know, what is interesting - and sometimes contradictory - to me, are the vegetarian disclaimers about in-take of fish... Is this a spiritual thing on the part of vegetarians, or is it really and truly a negative to eat the flesh of fish... I have to admit that these days, that is the only "flesh" I consume outside of the flesh of beans and other vegetables... I feel pretty good... I have lost some weight, and body has energy to BURN for anyone my age(47)... This thread has elicited some fantastic information from you, brother O... Keep on bringin' it...

Peace!
Isaiah

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KD

--------------------------------------------------------------------------------

January 10, 2006
Bad Blood
Living at an Epicenter of Diabetes, Defiance and Despair
By N. R. KLEINFIELD


Santos Alicea tottered haltingly over to the art shop in East Harlem, his legs screaming. The regulars knew what he was going through. They always did - the diabetes was speaking. He confirmed this with numerical rigor: 228, his nasty blood-sugar reading this morning. Nods all around. They had ugly numbers, too.

James De La Vega owned the art shop on Lexington Avenue, near 104th Street, and regarded the sidewalk out front as his living room. There, with his friends and family, he shared a lot over the years: Latino art and culture, the slow cadences of East Harlem life, runs of hard luck. And diabetes.

Indeed, in East Harlem, it is possible to take any simple nexus of people - the line at an A.T.M., a portion of a postal route, the members of a church choir - and trace an invisible web of diabetes that stretches through the group and out into the neighborhood, touching nearly every life with its menace.

Mr. De La Vega, a 33-year-old self-styled "sidewalk philosopher" whose murals and sidewalk chalk drawings are familiar neighborhood ornaments, has a mother with diabetes. His stepfather's case was confirmed in March. And a number of Mr. De La Vega's friends who occupied his chairs or sat in the bordering garden, well, they had it. Mr. De La Vega said he would probably get it, too.

In East Harlem, in fact, it seems peculiar if you don't have it.

Months spent in the easy company of the shop's dozen or so regulars reveal something more than just the insidiousness of Type 2 diabetes, the disease's most common form. Those months, and conversations, disclose with relentless consistency the human behavior that makes dealing with Type 2 often feel so futile - the force of habit, the failure of will, the shrugging defeatism, the urge to salve a hard life by surrendering to small comforts: a piece of cake, a couple of beers, a day off from sticking oneself with needles.

That behavior is all the more evident in East Harlem, a gritty neighborhood where problems back up on people like fallen dominoes.

For as bad as diabetes is in New York, it is staggeringly worse in East Harlem. Precise numbers are hard to ascertain, but the prevalence of the disease, factoring in an estimate for undiagnosed cases, has fluctuated in recent city health department surveys between 16 percent and 20 percent, as many as one in five adults.

People in East Harlem die of diabetes at twice the rate of people in the city as a whole. Diabetes-related amputations are higher than in any other part of New York. For hospitalizations linked to diabetes, East Harlem is the third-worst neighborhood. It has the largest percentage of obese people, whose weight makes them more susceptible to Type 2.

The fact that East Harlem is roughly 90 percent Hispanic and black, groups believed to have a genetic predisposition to the disease, explains part of the problem. There are also other factors: bad food habits, little exercise, rampant poverty and, according to health officials, poor access to medical care.

In East Harlem, then, you're in the teeth of an epidemic, a place where, as health officials warn of a worsening crisis, you can see the ruins the disease has already wrought.

Most of the afflicted people in East Harlem have Type 2 diabetes, the focus of this series, which has been linked to obesity and inactivity, as well as to heredity. (Type 1, which comprises only 5 percent to 10 percent of diabetes cases, is not associated with behavior, and is believed to stem almost entirely from genetic factors.)

East Harlem is not just any neighborhood. It is the fabled home of Rao's, the always-booked Italian restaurant, and El Museo del Barrio, which celebrates Latin culture. Early on, it was the repository of Russian Jewish, Irish and Italian immigrants, congealing into the city's hub of Italian life; after World War II, a Puerto Rican influx converted it into Spanish Harlem.

Recently, there has been an uptick in Mexican, Dominican and Asian arrivals, and stirrings of gentrification. But the core population that has been its ballast for a half-century is being eroded by forces as powerful as real estate values and immigration waves: a deviously complicated disease, poverty and simple human frailty.

'Then I Started Cheating'

The sun was piercing, and the light banged off the side of the art shop. The air was stippled with fragrances of fried meat. Crammed inside the claustrophobic interior were assorted paintings, decorated mugs, greeting cards and other oddments. Elsie Matos, Mr. De La Vega's mother, sat out front, her dark hair in a ponytail. The two of them still lived together. She was 56 and worked in the office at a local public school.

She discovered her diabetes coincidentally, as many do, nine years ago. A boil on her left thigh refused to heal. A blood test told her what she didn't want to know. Her fasting blood-sugar reading was nearly triple the 126 milligrams per deciliter that defines the illness.

She was no stranger to the complexities of diabetes. A few years ago, an East Harlem coalition fighting the disease enlisted her son to sketch some pithy warnings. He did this for brochures; and he scattered chalk drawings across the sidewalks of East Harlem, depicting his barefoot mother in a sun dress and hoop earrings, beseeching people: "Eat well and exercise!" "Test your blood for sugar!" "Check and protect your feet!"

It turns out that the woman in his sketches was a version of Ms. Matos that had ceased to exist. She was no longer that thin. And like most people burdened with the disease, whether they lived in East Harlem or Chelsea or Jamaica, Queens, she toggled back and forth between obeying its dictates and ignoring them.

When she got the diagnosis, the doctor told her to shed 100 pounds. With a crash diet she did just that, slimming down to 150. She stayed thinner for a year.

"Then I started cheating," she said. "Sandwiches. Frankfurters. I didn't care. I didn't think it would matter."

She was put on pills. Those who have diabetes usually suffer from related conditions, especially high blood pressure and high cholesterol, and often swallow 8 to 10 pills a day. Ms. Matos had high cholesterol and asthma.

She was warned that she had to control her lust for calorie-rich food, that taking pills was not enough. Doctors like to say that patients can eat their way through the pills. And a cruel truth of diabetes care is that many oral medications prompt weight gain. Oral diabetes drugs also tend to lose effectiveness. They sometimes work for a few years, then have to be teamed with other drugs. Anyone who has diabetes long enough is likely to find herself on insulin.

Ms. Matos frowned at her stomach. She said she was 165 or 170 pounds, still too much. "The doctor said if I didn't diet, I'd have to take the insulin," she said. "I don't want the needle."

Despite that dreaded prospect, she had difficulty satisfying the disease's persistent needs. Among widespread chronic conditions, diabetes is arguably the most arduous to control.

Diabetics not only need to take an array of drugs, but must also ***** themselves one to four times a day to check their blood sugar, keeping a log of the results, and then adjust their eating habits according to the readings. Blood-sugar meters are much improved from years ago, when they had to be plugged in and warmed up for an hour. But some diabetics skip the readings, filling in fake numbers to show their doctors.

For many Type 2 diabetics, doctors say, a half-hour of daily exercise and the loss of as little as 10 to 15 pounds can make a big difference in their health. Still, that can be a formidable challenge.

Understandably, people talk about wanting to take a vacation from diabetes, but it grants no time off.

Ms. Matos often found herself succumbing to a lifestyle guaranteed to make her sicker. Until it has been in the system for a long time, diabetes doesn't hurt. In East Harlem, what doesn't hurt is often ignored.

She pointed out that many people in her world were stressed out and depressed. There are other serious health issues, like asthma and H.I.V., the signposts of many poor neighborhoods. Their cobbled-together lives drain residents of their resolve. And so they cede diabetes the upper hand and eat what tastes good to them to counteract the gravity of unhappiness.

So if diabetes didn't cause her pain, as it didn't most of the time, then Ms. Matos dismissed it as a problem for another day.

"Listen, if I want to eat a piece of cake, I'm going to eat it," she said. "No doctor can tell me what to eat. I'm going to eat it, because I'm hungry. We got too much to worry about. We got to worry about tomorrow. We got to worry about the rent. We got to worry about our jobs. I'm not going to worry about a piece of cake."

Ms. Matos gave a feeble glance at a shopper mulling the mugs and T-shirts. She carried her glucose meter around, but didn't like to use it regularly, especially when she was with friends, a vanity of hers. "It's embarrassing to check your blood in front of people," she said. It irked her, this machine laying a claim on her.

Diabetes, then, had worn her out. She was quite direct about that. "I hate it," she said. "I hate diabetes. I'm tired of checking my blood three times a day." She tidied up some merchandise.

"You get used to it, but you know what?" she said. "You don't get used to it."

Society of the Sick

First Raul Rivera parked his bike, then he slid into a chair. A shadow fell over his face. The street was characteristically cacophonous. The door to the art shop was agape.

Diabetes hadn't visited him yet, but his stomach was expanding, and that gave him pause. He knew what diabetes did. It made you somebody else.

He was 50 and lived with his mother. She was 66, and after more than a dozen years with diabetes had been hit by its full-court press. Kidney dialysis three times a week. Open-heart surgery. Dependent on a wheelchair. Legally blind. It was Mr. Rivera who had to inject her with insulin twice a day. "She's black and blue from all the needles," he said. Lately, she had been in the hospital more than out.

Mr. Rivera, after a back injury, quit his job as a parking attendant 15 years ago. He had no income or insurance. He had not been to a doctor in several years. Last time he saw one, he was told he had high cholesterol and given medication. He didn't take it. He didn't like pills. "That's me," he said.

Juan Concepcion, 57, Mr. De La Vega's stepfather, materialized. He had been a truck mechanic, until he became disabled by rheumatoid arthritis. In March, he spent 12 days in the hospital after nearly passing out, and his diabetes became bleakly clear. Ten years ago, his father died of diabetes. "He kept taking sugar," Mr. Concepcion said. "He kept drinking beer. He was a stubborn guy. They cut one leg at the ankle. Then they took the other above the knee."

He stared unblinkingly into the distance. "I felt I was too strong for it," he said.

He drew on a cigarette, ashes fluttering in the air. He knew he should quit. Smoking is especially bad for diabetics. "I check my blood every morning and every night," he said. "I'm supposed to do it four times, but sometimes my fingers hurt and I don't do it as often." He was trying to lose weight. "I loved my coffee with three sugars. My Pepsi, Coke, beer." He was given a book about diabetes by a doctor. "But I didn't go deep into the book, because it makes me lose my mind," he said. "I'm going to do it slowly. But I know, this is a killing machine."

He shook his head. "Everywhere you go here, someone tells me they have diabetes. I'll go into a store and ask for coffee, no sugar. They say, 'Oh, you have diabetes?' "

He was having trouble figuring out how to fit the disease's maxims into his life. "I'm trying to give up beer," he said. "I would drink at 7 at night until 3 in the morning, watched boxing and baseball, drinking beer. I drank 15 or 20 beers in a night."

He had been avoiding his drinking buddies. "I have friends who have diabetes and they continue drinking," he said. His doctor told him to avoid stress. "How do you do that, not put worries in your head?" he asked. "I have to go on living. I've always been a fast guy."

Across East Harlem, there is a great range in response to the disease: some diabetics embrace the daily regimens that now frame their lives, many others constantly struggle to. Doctors say the will to fight the disease is often eroded by its psychological toll.

Sitting with these men and women whose lives were pervaded by diabetes, one couldn't escape feeling that they shared a dark cosmic joke - that diabetes was too much to master at the individual level in a world that had become so hospitable to it.

Mr. Concepcion said: "Everything about this neighborhood, the pollution in the air, it all makes you sick. Don't get me wrong, we love this place, we love Spanish Harlem. But it does stuff to us. Now it's giving us all diabetes."

Mr. De La Vega nodded. "We love eating trash," he said. "We grew up eating McDonald's, and I still find myself eating candy and chocolate cake."

People got huffy about their doctors. "Mine tells me, 'Lose weight, exercise more,' " Ms. Matos said. "Let him live my life and see."

Mr. Rivera said: "You know what I think? I think there's a cure. We're the poor, so they don't want to give it to us."

Mr. Concepcion rubbed his forehead. "Since I got the diabetes, maybe twice a week I sit down and pray," he said. "Because if I don't take care, I'm going to go down the drain. I put myself in God's hands."

Mr. Rivera bathed Mr. De La Vega with an odd look: "Did Mike have diabetes? The guy who passed away?"

Mr. De La Vega said, "Yeah, he had it."

"He was, like, 300 pounds."

"He would brag about eating a pint of ice cream every night."

"He used to eat six pork chops in one sitting. Then he would drown them down with a quart of Budweiser. What was he when he died?"

"Fifty-four."

"You know Bigwig? He's 42. He just found out he has diabetes. Like, two weeks ago."

New Rhythms, Old Patterns

Bigwig pulled up a chair beneath a thicket of light. The streets were puddled from morning rain. His real name was Luis Hernandez. His job was route supervisor for a produce company. He was a veteran member of the art-shop crowd, and now a new admission to its diabetic subset.

His vision had been getting a little blurred - he'd look at a paper and it was like 3-D vision; one morning he woke up and one eye wouldn't focus - and a physical found the source. "When they told me, it was like somebody punched me in the gut," he said.

His diabetic mother died in 2004, at 59. She had done little to address her condition. She continued to smoke and eat generously.

He was confused. He said his doctor put him on pills and suggested avoiding juice or sweets, but didn't tell him much more.

He weighed 252 when he got the news. He had cut it to 245. He knew it should be lower. But he found it excruciatingly hard to adopt a new rhythm of life, particularly since it was less appealing than the one he had.

Bigwig had to go. Maria Calderon stopped by to visit Elsie Matos. Give her a moment. Ms. Matos was waiting on a young woman torn between two T-shirts.

Yes, Ms. Calderon had it, too. Seven years since the diagnosis. She was 69. She was 210 pounds, and had been told to lose weight. "I didn't think it was important," she said.

Then, more than a year ago, a solution presented itself, and it was the worst kind. Her grandson was killed in a holdup over a car.

Devastated, she lost her will and her appetite. She shed 60 pounds. Now she was gaining again, six pounds in a month.

"How can you worry about your health when you don't know where you're going to live next week?" she said.

She watched Ms. Matos help the customer. "We are the poor people," she said. "We only get the crumbs. I used to advocate a lot. I got tired. I don't do it anymore. I'm not tired in my heart. I'm tired in my body."

She said to Ms. Matos: "I have a friend, she's diabetic and everything else. She takes 52 pills a day. She has everything in the book. When she calls, she wants to talk for 99 hours. I say: 'My sister's calling. I've got to get off.' "

Ms. Matos said: "What, 52 pills? She's nuts."

Frank Gonzalez had something to say. He was 77, compact, peppy. He used to work as a security guard at a hospital, had clocked 16 years with diabetes.

When things were not going well, as they weren't now, you could see the fanned-up embers in his eyes. Hear his speedy voice: "Diabetes is the worst disease I've ever seen. You can't trust it. Two weeks ago, I got all messed up. You know why? I've got two machines. One gave me a reading of 150. The other machine gave me 130. I said this can't be. So I changed the batteries on both machines. You've got to keep an eye on your machines."

He went on. "Diabetes is something you have to look at from all sorts of angles. It takes a long time to find out the real truth. And you know what? You never find out the real truth."

He went home, a couple of blocks away, to take a blood-sugar reading. He opened a hallway closet, wedged full of supplies - test strips and lancets and pill bottles and batteries. Most, but not all for diabetes. He showed a bottle: Viagra. Opened it and smiled: half-full.

He inserted a strip into his machine. He swabbed his ring finger with alcohol, then pricked it with a lancet. The machine counted down 45 seconds. The reading: 152. High. He stared balefully at the number.

"It could be I've been sitting too much," he said. "I should be out and walking. I don't know, I was going to do the cleaning."

A Geography Lesson

A few things to notice. On Third Avenue, around the corner from the art shop, a banner outside McDonald's proclaimed, "$1 Menu." Down the way, plastered on Burger King, "New Enormous Omelet Sandwich. It's Huge." At KFC, a sign boasted, "Feed Your Family for Under $4 each."

The art-shop gatherers sometimes talked about 96th Street, the tangible southern divide of a neighborhood and of a disease. Go north of 96th Street and you enter a constricted world laden with poverty. Go south and you find promise and riches, thin not fat, the difference between East Harlem and the Upper East Side, the difference between illness and health.

Go north and the chances of bumping into a diabetic are maybe 20 times greater than if you go south. For the Upper East Side, according to the health department, has the lowest prevalence in the city, about 1 percent.

In East Harlem, people sometimes have to choose between getting their diabetes medication and eating. They sometimes share their pills, cut them in half and take half-dosages. They improvise. Everywhere blare the signals that the best meal is the biggest meal.

Nutritious food exists, but it isn't easy to find. Dr. Carol R. Horowitz, an assistant professor at Mount Sinai School of Medicine, heads an East Harlem coalition trying to improve diabetes care. She oversaw a study several years ago that tracked the availability of diet soda, low-fat or fat-free milk, high-fiber bread, fresh fruit and fresh vegetables in food stores in East Harlem and the Upper East Side.

Stores on the Upper East Side were more than three times more likely than those in East Harlem to stock all five items. It did not seem to matter that East Harlem has more than twice as many food stores per capita as its wealthier neighbor to the south.

Diet on the Down Low

All the same, it was worth asking: Why not stop with the doughnuts and fried calories and eat salads, drink diet soda?

James De La Vega laughed. "We've got cultural differences," he said. "Here, for a guy to eat a salad, he's a wimp. He'll eat a big portion of rice and beans and chicken. The women can't be chumps, either. A woman can eat a salad but has to eat it on the low. She has to do it quiet. They make fun of you: What are you, a rabbit?"

What's wrong with an orange?

Mr. De La Vega said: "Oranges are messy. You dirty your teeth."

Uncontrolled diabetes is a forced death march. Literature handed out in the community underscores this.

Knowledge alone, though, is never enough to change behavior, particularly in an overwhelmed neighborhood. Chocolate cake may be a risk, but it tastes so good on a bleak day. What stops that?

Mr. De La Vega said: "People ultimately feel powerless about a lot of things. People think about bigger things. They think about survival. Kids grow up fighting in the streets, so you want to raise big, strong kids. So you give them three pork chops, a nice tall glass of soda to make them strong. You realize, some of these people go to prison, and they have to be strong. They eat and they eat. Nobody teaches them about diabetes."

"I have two nieces," Ms. Matos said. "They're 24. I call them the sumo wrestlers. They eat everything."

Mr. De La Vega said: "A lot of people eat on the streets. I eat breakfast on the street and lunch on the street, and sometimes dinner. I have hot dogs. I had two today."

His mother said, "If you drink a diet soda and a man is watching, he'll say, 'Why you drinking that?' "

Mr. De La Vega said: "Nobody here goes out and gets an apple. They get cake. People here associate diet as unhealthy. If you're dieting, then you're sick. You look at the people on the streets, they're heavy. That's the way we grow up here."

Mr. De La Vega was silent, listening to the boom box. He said: "Around here, if you make it to 40, you think, hey, I'm lucky, I made it to 40. You have to understand, the philosophy out here is we're going to die from something."

Young and Unconcerned

At times the art-shop regulars pondered what diabetes meant for the neighborhood's young. They surveyed the pudgy children sauntering past and shook their heads.

And so, a not uncharacteristic East Harlem story. A couple of blocks away, on East 102nd Street, lived Xiomariz Downs. She was 15, sweet and polite. She weighed 287 pounds. She lived with her mother, Olga Pagan, her grandmother, her brother, her sister and two cousins in an apartment not intended for that many people. Someday, she said, she wants to be a missionary or a beautician.

On a Thursday, after school, she was in sweatpants at the Bally gym near her home, her second day in an attempted fitness regimen. Her grandmother had enrolled her.

At the start of last year, when she was still 14, she was found to have Type 2 diabetes. It happened this way: She had gotten horribly depressed. Her mother had lupus, and had had two strokes. School had been going badly; Xiomariz was failing math, English, science and history. She made a feeble attempt to cut her wrists. She spent a week in a hospital and the diabetes revealed itself.

Doctors had been hectoring her for years, saying that if she didn't lose weight she was going to end up with diabetes. But she didn't feel sick. She wasn't worried about what might happen at 40. She was a teenager, with teenage hauteur, living in the now.

Again she was told to diet. Her mother said Xiomariz was "on the see-food diet - every food she sees, she eats." Her mother felt frustrated: "I want her to go live with her father and have him knock some sense into her - literally." He, too, had diabetes.

Xiomariz didn't mind her weight. "I feel my weight makes me look like me," she said. "So I don't have to look like those skinny people."

Not long after starting, in fact, she quit the gym - too much time and too much money.

She didn't comprehend the terror of the disease. "I know you can't pass it like kissing someone or something," she said.

Some mornings, rushing, she neglected to take her pills. She had stopped checking her sugar. She said she had lost the meter.

Was she worried about her diabetes?

She moved her head from side to side. "Sometimes I forget I have it," she said. "It's not that big a deal."

What other disease would she compare diabetes to? She thought a moment, and found the answer. She said, "A cold."

Veterans, and War Stories

Santos Alicea had not been by the art shop in days. He was usually around so often that he seemed part of the décor. Now, here he was again, scraping somnolently along behind his walker. He had just gotten out of the hospital. Doctors had removed his right eye. The usual reason around here: diabetes. He got the disease 20 years ago, at 47. He used to work in a laundry and as a security guard, until he had a heart attack.

He plopped down onto the brick ledge beside the art shop. "I'm killing time," he said. He gave a craggy grin.

He settled his walker before him. "The circulation is no good in my legs," he said. He rubbed them.

He unabashedly admitted that good management of his diabetes often seemed like a drama of grand futility. "I got 200 this morning," he said, reciting his latest reading. "Not good. Maybe I ate the wrong thing. I had rice and beans last night. It was good."

He was talking to Jose Castro, 52, a squat man with a grizzled face, worlds of feeling in his eyes. "I got it, too," he said. "Yeah, I got the diabetes."

The diagnosis came six years ago. Was he monitoring his sugar?

"I check once a day or every two days."

How was it?

He laughed. "Been a little high," he said. "I started eating Frosted Flakes. What can I say? I like them. You can't always be eating things without sugar. Sometimes, you have to take a chance."

He used to deliver flowers, but stopped a few years ago after having a liver transplant. Besides insulin, he took 10 pills a day.

He took a drag on a cigarette. He said he was working on quitting. His method, he said, was to sleep a lot. "Sometimes, I sleep all day," he said.

He bore a visible scrape on his left arm. His circulation was bad and he sometimes saw double. "I'll be watching TV and I'll see two images," he said. "I have to wink to see the show."

He had fainting spells, falls. Thus his bruised left arm. He showed another mark on his right arm and one above his eye.

"The other day, I took my blood count and it was 40," he added. "My son took me to the hospital. They said I may have forgotten to take my insulin. I don't know. I don't remember."

He used to keep a log of his readings, but quit. Why?

"I don't know," he said. "So many things you have to do. It gets boring."

A mariachi band arrived in the garden and began to play. Mr. Alicea and the others tapped their feet.

As New York got ready for its evening routines, Mr. Alicea tired, his eyelids sailing down, and he returned to his two-room apartment across the street. His furniture was plain. Bare bulbs protruded from the ceiling. Mr. Alicea shared the place with his older brother, Pedro.

He, too, had diabetes. His vision was poor, his circulation was not good, he had asthma, he had a weak heart. A while ago, he had fallen and broken his arm and hit his head, and had not been himself since. "He's like a baby," Mr. Alicea said. "He's supposed to use insulin, but he doesn't like the needle."

He didn't like to ***** his finger to check his sugar level, so he had no idea what it was. Pedro didn't go out much. No scale was needed to judge that he was obese. He watched TV, one more soap.

A home attendant helped care for them. She had dinner on the stove, cream of tomato soup. The dining table was shoved against the wall. Resting on it was a box of corn flakes and a container with doughnuts.

The phone rang. Santos spoke briefly. "My daughter," he said when he hung up. He said she lived in the Bronx, and worked as a waitress near Yankee Stadium. "Yes, my daughter," he repeated. "She has diabetes."

Racing Against the Blade

There is no way to talk about diabetes without talking about money, because they are interwoven. The story with Fernando Salicrup was the foot and the money.

Go see him, Mr. De La Vega had said. He'll tell you something about diabetes.

He was an artist, too, 58. He did computer-assisted art, printed out his efforts on a big Epson printer in the back of his apartment.

He got the diagnosis 20 years ago. His mother and grandmother died of diabetes complications. "They told me about diet and exercise," he said. "But you're a young man, and you don't listen. I didn't take it very seriously."

He had no insurance, either, and so he took his medication when he could afford it, tested himself when he could afford it.

He got a drink. He walked slowly, with a cane. He told the story. Nearly two years ago, overseas for an art exhibit, he twisted the big toe on his right foot on the cobblestone streets. It became infected. When he finally got to see a doctor, the toe had to be removed, along with two others. The infection spread, and he lost the final two.

"All the things you take for granted, you have to give up," he said. "Dancing. You have to plan things out, take things slow. It's not just that they operate on your toes. Your veins aren't working properly. You don't have feel."

He was worried about his vision. An artist without eyes, that was tough to imagine. He mentioned a sad case, a jazz drummer he knew. He had diabetes and had to have a hand amputated. His hand, his livelihood.

When he had the amputations, Mr. Salicrup was in the hospital a month and a half, amassing medical bills he put at more than $300,000. It was an amount in some ways laughable to him, because he expected never to pay it off in this lifetime, but at the same time he knew it was a serious matter. He gave something each month, and it constricted his life, hanging over him like a sentence. He had since acquired insurance, for which he paid stiff premiums.

"You make choices," he said. "Instead of buying sneakers, you stay with what you're wearing. I've got to stay ahead of the blade."

He massaged his leg. Diabetics, often with subdued feeling in their legs, don't realize they have cuts until irreversible infections set in. Doctors caution that they should check their feet daily, using a mirror if they can't see past their stomachs. That they never go around barefoot. That even abrasive socks can lead to an infection. That a simple toenail-clipping mishap can escalate into an amputation.

Five toes gone, Mr. Salicrup didn't want to lose more. He did his best, he said, to tame his illness. He never cut the toenails on his left foot. He paid a podiatrist. He still had a hard time wrapping his mind around that: Here he was, a grown man, paying somebody else to clip his nails.

One Fewer Shop, One More Ghost

The city seemed caught in overcooked air. The art-shop regulars were out, the usual byplay. A gaunt man was selling Gillette razors out of a backpack: $7. Interested, Santos Alicea dug out some bills and took one.

Mr. Alicea mentioned that another diabetic had died the other day. A massive heart attack, and the man became one more diabetes ghost to haunt the neighborhood.

Elsie Matos was displeased with her blood sugar. It was mercilessly high.

Raul Rivera, wearing a smudged T-shirt, began watering the garden's plants, swishing the spray back and forth. How was his mother? Bad, he said. Very bad.

Bigwig said that he had shed some weight, was getting used to one-and-a-half spoonfuls of sugar on his corn flakes instead of four. But also, he had stopped taking his diabetes pills, not wanting to get too used to them, not knowing if that was right or wrong.

James De La Vega's art shop closed at the end of August. Word arrived that the space would become a hot-dog place. Mr. De La Vega moved down to the East Village.

The regulars frowned on the displacement. "Just what the diabetics need," Ms. Matos said. "Hot dogs."



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January 12, 2006
Bad Blood
East Meets West, Adding Pounds and Peril
By MARC SANTORA



May Chen is slender and healthy, a lively little girl whose parents left their rural Chinese village just a decade ago in search of a better life. But at age 9, still in pigtails, she is already coming face to face with the forces that many say are making America fat and diabetic.

When May watches cartoons in her family's apartment in Flushing, Queens, the commercials tell her that junk food is good food - the latest message from an industry that spends $10 billion a year marketing to children.

When she strolls down Main Street, she walks a growing gantlet of fast-food restaurants, many of them built with the help of government loans.

At her public school, the city sells sugary Snapple in vending machines to raise money. But it does not pay for a full physical education program, so May's fourth-grade class has gym just once a week, in violation of state law.

And when she and her friends gather for snacks, she basks in their approval as she produces the high-calorie American-style treats, from chips to sweets, that are rapidly replacing traditional foods in the local markets.

Children all over the world are walking the same sort of obstacle course as obesity and Type 2 diabetes increasingly strike the young.

But to spend time with May Chen and the other children of immigrants in Flushing - at home in front of the TV, in the places where they eat and buy food, in their schools - is to appreciate the everyday threat confronting a particularly vulnerable group: the Asian-Americans who make up half the community's population.

It is also to understand what alarms health authorities about the future of New York, a city of immigrants where Asians are the fastest-growing racial group.

Asians, especially those from Far Eastern nations like China, Korea and Japan, are acutely susceptible to Type 2 diabetes, the most common form of the disease and the subject of this series. They develop it at far lower weights than people of other races, studies show; at any weight, they are 60 percent more likely to get the disease than whites.

And that peril is compounded by recent immigrants' sudden collision with American culture. Many of them left places where factory and field work was strenuous, televisions were rare and advertising was limited. They may speak little English and have poor access to medical care.

Many have never even heard of diabetes, much less the recent scientific studies showing that a Western diet, high in fat and sugar, puts them in danger of getting Type 2 diabetes, which has been linked to obesity and inactivity, as well as to heredity. (Type 1, which comprises only 5 percent to 10 percent of cases, is not associated with behavior, and is believed to stem almost entirely from genetic factors.)

Many recent Chinese immigrants have come from places where food was scarce, and experts say some view fat as a trophy of wealth and status. Their children try to fit into their new country by embracing its foods and its sedentary pastimes.

"When they give you the visa to the United States in Shanghai, Fujian or Beijing, they should stamp a clear warning: danger to your health," said Marcelo M. Suarez-Orozco, co-director of immigration studies at New York University.

So far, that danger has not been fully realized. Flushing has only half as many diabetics as the New York neighborhoods where the disease has made its deepest inroads. City epidemiologists say they have limited data on its spread among Asians.

But they do know that 14 percent of Asian children in New York are obese, more than twice the rate among their parents. And they say there is mounting evidence - including soaring diabetes rates in major cities in China, and in other countries with Chinese immigrants - that New York will soon experience a similar explosion as more Asians arrive and have their first encounters with Western ways.

The clash of cultures is vividly apparent in Flushing, one of the city's new Chinatowns. On streets like Roosevelt Avenue, older immigrants still throng traditional Asian markets, with their signs in Chinese, and dine at noodle shops where windows fog with steam. Their children, however, are increasingly lured by fast food. Along a 100-yard strip of storefronts are a McDonald's, a Burger King, a Taco Bell, a Pizza Hut, and a Joe's Best Burger.

Even in China, the number of obese people has tripled since 1992 to 90 million, as Western food has become popular and prosperity has made it possible to eat more. The World Health Organization has warned that Asia faces a "tsunami" of diabetes in the coming decade, and health officials have assailed the Chinese government for its tepid response to the crisis.

But in this country, where children are bombarded with much more food advertising, many health experts say the response has not been much stronger.

In Washington, money for school gym programs is measured in the millions, while billions are spent on subsidies for those who produce food sweeteners.

In Albany, where the restaurant and food industries are generous campaign donors, bills to raise awareness of nutrition and diabetes have been dismissed or derided.

In New York's City Hall, a former councilwoman who has been outspoken on childhood obesity, Eva S. Moskowitz, sees similar apathy. "We have a massive problem on our hands," she said. "There is an utter lack of urgency to do anything about it."

And in Flushing, where the Small Business Administration has lent $4.6 million in the last decade to spur fast-food franchises, the community health center has trouble finding money for diabetes education.

Here, for anyone who cares to look, are the people left to fend for themselves: a new generation that will soon fill New York's schools and workplaces, making the daily choices that could mean the difference between a healthy city and a colony of the sick.

A Melting Pot, Boiling Fiercely

Incredible, Li Li kept repeating, simply incredible.

For 14 years, ever since he moved to Flushing from Canton, China, he has hewed to the same diet that his ancestors ate for hundreds, if not thousands, of years. "Chicken, frog, duck, all very fresh - that is what we like," said Mr. Li, a 40-year-old business consultant, as he steered a cart through the Hong Kong Market on Main Street.

But at only 3 years old, his twin daughters have already blazed their own path away from history. "They both like the American food," he said. "I cannot stop that."

He found the switch profoundly unsettling - not because he saw health consequences, but because it had happened so fast.

"Only recently, they tried Coke and they loved that," he said, as one twin tried to grab a package of candy. "They won't drink tea anymore. Can you believe it? They will not drink tea."

It was a classic scene from the well-known story of American immigration: the children of newcomers eagerly assuming the ways of their new world, and rejecting the old.

But a rite of passage that used to take most immigrant families a generation or two - fully adopting the American diet - has accelerated for Asians, said James L. Watson, a Harvard anthropologist who has studied their response to fast food. Many have moved in just a few years from villages to China's increasingly Westernized cities and then to the United States, he said, quickly abandoning traditional foods.

"Everything is happening at warp speed," Dr. Watson said. "The melting pot may have been simmering in the past, but now it is raging."

And the American diet they are taking up is far different from what it was for earlier generations of immigrants: a mind-boggling array of processed products, with added sugars and fats that can turn these unfamiliar foods into seductive pleasures.

Even the store Mr. Li was shopping in is a startling departure from the small produce and poultry shops that still crowd Flushing. The Hong Kong Market, which opened in 1996, is a meeting spot for old and new: a huge supermarket that stocks Chinese versions of processed American foods.

One shopper, Jian Kang Qiu, 43, an artist who moved from a coastal village in the province of Guangdong six years ago, said his family's eating had changed radically.

"At home we would shop in the open market," he said. "There was not so much packaged food. We would eat maybe two meals a day. Rice with something on the side, fish or vegetables." Now, faced with the unlimited choices here, they eat a far broader diet, with many treats.

Mr. Qiu's mother has Type 2 diabetes, and recently his younger sister learned that she does, too. It has made him a little more conscious of what he consumes. But he has given up trying to control what his 16-year-old daughter, Vicky, eats.

"She would prefer American food," he said. "Her friends are going for pizza, she wants to go for pizza. It is normal. She wants to do what her friends are doing."

The need to fit in is no less important for the fourth graders at Public School 120, where May Chen, the pigtailed 9-year-old, was the center of attention one afternoon as snack time rolled around.

May's parents co-own a sushi restaurant, but she had come to school with a bag of all-American snacks: a shiny blue can of Lay's Stax potato chips and a package of neon-orange Cheetos Puffs. She passed out chips to her friends, and in no time hands were stretched out all over the classroom.

No one gave a second glance to the steamed dumplings that a classmate, Annie Wu, had brought from home.

"There is a kind of shame issue," said Professor Suarez-Orozco of N.Y.U., who has spent the last five years studying the lives of 400 immigrant families, with a focus on Asians. "The kids feel if they bring food from home, some ethnic dish, they are seen as not as cool and not with it."

School is one place where good eating habits can be taught. Yet at P.S. 120, fats, sugars and calories figure heavily in cafeteria fare: burgers, pizza and chicken nuggets.

In the last two years, the Bloomberg administration has made some changes: hiring an executive chef to make food in all schools more nutritious; installing salad bars at many schools, including P.S. 120; and cutting the fat and calories in some of the most popular items. At lunch, every student gets a banana or an apple - a requirement that schools must meet to receive federal reimbursements.

But schools, critics say, are reluctant to change their menus too drastically and risk a drop in sales that would reduce those reimbursements. And at the end of each school day, the trash baskets at P.S. 120 are filled with the compulsory fruit.

'If It Is Delicious, I Love It'

A sweet tooth is standard equipment on any child. But the sweetness that satisfies it is no longer limited to cookies and candy.

When 18-year-old Jin Yang dashed into a Key Food supermarket one rainy afternoon to buy food for her friends at Flushing High School, she wasn't looking at nutrition labels. If she had, she might have noticed that nearly every purchase she considered - the low-fat yogurt, the basil vinaigrette and even the chicken noodle soup she ended up buying - shared the same major ingredient: high-fructose corn syrup, a sweetener first derived from corn in the 1960's.

Underwritten by roughly $40 billion in federal subsidies paid to corn growers in the past 10 years alone, it is now so cheap that it has all but replaced cane sugar as the sweetener of choice in processed foods.

The syrup has been singled out by many health experts as one of the chief culprits in the rise of obesity. Its inexpensiveness, they say, has helped soda producers create the larger portions that have led to overconsumption. It is so versatile, they say, that it now shows up in many foods that would not have been sweetened at all in the past.

There is wide disagreement among scientists over some studies indicating that high-fructose corn syrup can hinder the body's ability to process sugar, and can promote faster fat growth than sweeteners derived from cane sugar.

What no one disputes, however, is that since the advent of the syrup, consumption of all sweeteners has soared; the average American's intake has increased about 35 percent, according to the Federal Department of Agriculture. And a 2004 study in The American Journal of Clinical Nutrition showed that the rise of Type 2 diabetes since 1980 had closely paralleled the increased use of sweeteners, particularly corn syrup.

Food industry officials say there is nothing wrong with the syrup as long as people eat it in moderation.

But Jin, who came here just a year ago from rural northeastern China, said she had never even heard of the sweetener - or diabetes, for that matter. Thin and healthy, she subjects each food purchase to only one test. "If it is delicious," she said, "I love it."

Moderation may also be a foreign concept to many new immigrants from China because of deep-seated attitudes they have brought with them.

In many Chinese families, it is difficult to get parents and grandparents who were raised during the deadly famines and deprivations of the 1950's to stop overfeeding their children. "Increased girth is an indicator of wealth," said Dr. Thomas Tsang, medical director of the Charles B. Wang Community Health Center in Flushing.

But any extra weight is dangerous for Asians, research shows, because of their susceptibility to Type 2 diabetes. For example, a 5-foot-9 Japanese man who weighs 156 pounds - and who may never develop the sort of belly that is a warning sign for the disease - is twice as likely as a white man that size to become diabetic.

Because of that, Dr. Tsang said he believed that the number of Asian diabetics is underestimated; he has recently diagnosed at least a dozen new cases among his longtime patients. "It's astounding," he said. "And it puts a lot of pressure on us to educate them."

The Wang Center has hired three diabetes nurse educators and a nutritionist in the last two years. But the effort to prevent, diagnose and treat the disease is hobbled, Dr. Tsang said, by cultural barriers. Asian immigrants who are in the country illegally tend to avoid doctors, and some Chinese people will not test their blood sugar.

"My own mother has diabetes," the doctor said, "and she will not draw her own blood. She believes blood is the life essence and should not be lost."

Selling Frosted Flakes and Fitness

At age 3, Henry Chen is learning his first words in English. "Mother" was first, followed by "father." What came next, however, surprised his aunt, Cindy Chen.

"McDonald's," she said. "It was one of his first words."

Neither fast food nor television was part of the Chens' life in Fuzhou, a Chinese city where they struggled to find work before moving to Flushing four years ago.

Now Henry and his family show up at least once a week at McDonald's. At home, he perches on the sofa to watch Nickelodeon. By his aunt's estimate, he spends as much as 30 hours a week in front of the TV - more than double the average for a child in China, according to data collected for The New York Times by AGB Nielsen Media Research. Like a human SpongeBob, he soaks up ads for Pop-Tarts and Lucky Charms.

There is nothing new about the marketing of food to children, with all of its cartoon characters and free toys. According to a study released in May by the Grocery Manufacturers Association, the average child watches 4,900 food commercials a year.

What is new, though, is the message that child - and his parents - are hearing.

Ronald McDonald now snowboards, and his once-portly frame looks to have shed at least 30 pounds. The box for Henry's Happy Meals reads, "A game of tag keeps me happy and fit." In one commercial, a woman does a victory jig when she finds out her Lay's potato chips are low-fat. A Frosted Flakes ad shows children running around a soccer field with Tony the Tiger.

"Without a doubt, the food industry, while not moving away from convenience, has begun to push health as the main driver of food packaging and promotion," said Don Montuori, publisher of Packaged Facts, which does consumer research for food companies.

The companies say they are doing their part to combat obesity by offering lower-calorie, lower-fat choices, and encouraging children to exercise. McDonald's sponsors track events for young runners, and Coca-Cola has created the Tiger Woods Foundation to promote children's sports.

But what would seem to be welcome news has simply created a different problem, according to many nutritionists and public health officials. Despite a salad here or a lower-fat oil there, they say, the food industry has done little to change the basic unhealthfulness of its best-selling products. And by making the link to fitness, they say, the companies are telling children that all of those foods are good for them.

New immigrants from China are keenly receptive to such claims because the Chinese have used foods to cure illnesses and promote general health for thousands of years, said Dr. Watson, the Harvard anthropologist. One cure for a cough, for instance, involves duck gizzards, apricot kernels and watercress. A variety of foods are thought to improve brain function.

Many Chinese people have replaced those traditional foods with processed foods, Dr. Watson said, and have little idea what is in them. Still, the faith in food persists: for instance, he said, there is a widespread perception in China that eating at McDonald's can somehow make you smarter. In New York, Professor Suarez-Orozco said, immigrant parents often reinforce that connection by rewarding academic achievement with a McDonald's meal.

And many Chinese companies have adopted the same kind of health pitches as their American counterparts. At the Hong Kong Market, a juice box called Vita Chrysanthemum Tea promotes itself as a health drink for children, though nutritionally it is little different from Snapple.

Ye Zhou, a sixth grader whose parents arrived from China shortly before she was born, said she tried to eat right, and knew that some foods were unhealthful. On this day she had come to the McDonald's on Main Street to try the new Premium Crispy Chicken Breast Sandwich, drawn by the ads that touted the "energy" packed in the meal, which includes French fries and a soda.

How, she was asked, did it compare nutritionally with the stir-fried chicken and rice her mother made at home?

"They taste different," she said. "But one is not healthier than the other."

Actually, the fast-food meal has at least one-third more calories, carbohydrates and grams of fat than a typical homemade one.

Even before the latest blitz of health messages, children were confused, the Henry J. Kaiser Family Foundation said in a 2004 report on childhood obesity. In a 1997 study it cited, fourth and fifth graders were asked which of two foods - say, corn flakes or frosted flakes - was more healthful; the children who watched the most TV were the most likely to pick the less nutritious one.

For more than two decades, Dr. Daniel S. Acuff helped hone food ads aimed at children as a marketing consultant to companies like Coca-Cola and Nestle. But about two years ago, he said, he stopped consulting on products he did not consider nutritious after recognizing the threat posed by obesity. He called the industry's new sales strategies disingenuous. "To position themselves as leaders in providing healthy food for children is nonsense," he said.

He and others - including the American Academy of Pediatrics and the American Psychological Association - have called for tighter restrictions on advertising to children, similar to limits in Australia, Canada and England. They are also concerned about the increasing use of the Internet and video games to sell food.

But repeated attempts to enact such strictures in the United States have failed for three decades, and at a meeting last July in Washington, the Federal Trade Commission told food and advertising executives that it favored letting the industry police itself.

A few companies have done just that - most notably Kraft Foods, which decided last January to curb its advertising of certain products, like Oreos and Kool-Aid, to children under 12. The move raised eyebrows both in the food industry and in public health circles because of its implicit suggestion that there are bad foods. The industry has long maintained that there are no bad foods, only bad habits - like overeating.

Tim Wong is only 10, but he had no problem polishing off a large dinner platter from the adult menu one afternoon at the KFC on Main Street in Flushing. He had asked his mother to take him and his 6-year-old sister, Tiffany, so they could try "the new stuff" on the menu. "I see the new items on television and I want them," he said.

When he was asked what his favorite foods were, his mother laughed.

"Look at him," she said in a matter-of-fact way, as Tim is obviously overweight. "He likes his junk."

Time for Gym! O.K., Time's Up!

"Two fingers in the air!" the teacher aides shouted at the more than 100 children squirming in the auditorium seats.

Two fingers held high is the way students at May Chen's school signal that they are sitting quietly enough to be let out for recess. It was 10:30 a.m., less than two hours after they had been served a breakfast that included chocolate milk, a doughnut and a juice box - at least 400 calories and 47 grams of sugar waiting to be burned off.

Finally the doors opened, and the students scampered out to the playground, a parking lot ringed by a chain-link fence. Several boys ran around like mad. In a makeshift game of keep-away, May and some other girls tossed around a bag of cheese snacks.

They had to play fast. Twelve girls were lined up to jump rope, but only three had a chance before a bell summoned them back inside for lunch.

May's recess had lasted eight minutes.

It was, as always, the only recess for the day, and fortunately the weather was mild. On cold or rainy days, the children stay inside and watch movies.

Recess and physical education are treated like luxuries in the New York City schools. Though half the grade schoolers are overweight and roughly one in four are obese, the city did little until last year to promote one of the best antidotes: exercise.

May, like most schoolchildren in the city, does not get even the minimum amount of physical education mandated by state law, two hours a week. She has a single gym class each week, for 50 minutes.

She is among the lucky ones. More than half the city's 700 elementary schools have no usable outdoor play space, according to a 2003 survey by the City Department of Education. May's school has only one gym teacher for its 1,000 students, but roughly one in seven elementary schools in the city have no teacher dedicated to physical education.

And although P.S. 120 has a functioning gym, many elementary schools do not, according to reports by the City Council and the State Assembly. Even those that have gyms often use them for classes or meetings. There has been no standardized testing of student fitness in more than a generation.

The sad state of the school gym class is a legacy of the city's fiscal crisis in the 1970's, when the budget for physical education was slashed to protect other academic programs. But New York's plight is not much worse than the rest of the country's.

Even as the health authorities pronounced obesity a national epidemic, daily participation in gym classes dropped to 28 percent in 2003 from 42 percent in 1991, according to the Centers for Disease Control and Prevention. And the Bush administration recently proposed cutting Physical Education Program grants to schools by more than one-quarter, to $55 million, though Congress rejected the proposal.

Schools are so desperate to finance exercise programs that many have turned to food companies for help. McDonald's is offering curriculums and undisclosed sums to 31,000 schools across the country to improve physical education through an effort called Passport to Play; every piece of program literature that children see will carry the company's golden-arches logo.

Two years ago, even as New York's health department was assigning a team to improve the treatment of diabetics, the city signed a deal with Snapple that made its fruit drinks the only beverages, besides water, sold in school vending machines. A 12-ounce can of Snapple contains 170 calories and 40 grams of sugar, as much as most colas. The calories in three cans - the amount many students drink every day - would take at least three hours to walk off.

The 29 fourth graders in May Chen's class have gym directly after lunch, and their stomachs were full this day with chicken nuggets. They did not change into gym clothes. The teacher, Bruce Adler, started them off with calisthenics, moving quickly to situps and three leisurely laps around the basketball court. There were groans, and several children were winded, but few broke a sweat.

Mr. Adler, 55, said the school could really use a second teacher, recalling how different things were when he was growing up in Yonkers. Students there had at least three gym classes a week, he said.

New York school officials say they are adding more physical education teachers each year. And two years ago, the Bloomberg administration created the Office of Fitness and Physical Education. Its director, Lori Rose Benson, has begun a program called Physical Best, which will track students' fitness, charting progress for each school. She said she hoped to start the program by the end of this school year in every grade school with a physical education teacher, including May's.

She conceded it was merely a first step. "It is very difficult to reverse a culture that existed for 20 to 30 years," she said.

Tilting at Golden Arches

At least two unthinkable things happened in Albany in the past year.

One made headlines: The Legislature passed a budget on time. The other went unnoticed: The Assembly actually debated a bill that tried to address, in some small way, the leap in obesity and Type 2 diabetes.

It was a rare moment of attention for a cause that has drawn little more than lip service from government officials, and it was short-lived. The debate, and the bill, died in mocking laughter.

The story of that bill, known as A5664, is a lesson in the ways of Albany - and the apathy that diabetes experts say is blocking any effective response to the epidemic.

The lesson was an abrupt one for Assemblyman Jimmy Meng of Flushing, who had already embarked on a sharp learning curve. When he was elected the previous fall - the first Asian-American voted into state office in New York - diabetes was nowhere near the top of his list of health issues.

But as he became more aware of the disease's threat to children and young adults in his community, Mr. Meng said, he became frustrated with the ignorance and inaction he discovered.

In April, he organized and led the first march in Queens to raise money and awareness in the battle against diabetes. And he agreed to support legislation by a fellow Assembly Democrat, Felix Ortiz of Brooklyn.

The bill would require all restaurants to prominently post the amounts of calories, fat and salt in each menu item. It was hardly a radical notion. Many fast-food chains had already begun listing calorie counts in restaurants and on Web sites, and months later McDonald's would decide to print nutritional data right on its wrappers.

But Mr. Ortiz felt those moves were only a start. Who knew how many calories were in a slice of the neighborhood pizza or a Starbucks caramel macchiato?

His passion for the issue - this was just one of six bills he introduced in the 2004-5 session to fight obesity and diabetes - was fed by his own loss. His mother died of the disease when she was only 58.

"Everything was caused because she did not take care of her weight," he said.

In Albany, the path from legislation to law is thorny, and Mr. Ortiz brought along his own set of hurdles. He was hardly an insider within the Democratic conference, which is controlled by Speaker Sheldon Silver, and some of his bills were considered odd. One would have made it a crime for a person not to come to the aid of another in trouble.

The restaurant labeling bill looked like another loser. It had no support from the Democratic leadership. Although it was backed by the American Diabetes Association, which has spent $9,000 lobbying New York lawmakers in the past few years, it was opposed by the food industry, which contributed more than $4 million to legislative and gubernatorial campaigns between 1999 and 2005, according to state records.

And diabetes had hardly caught fire as a pressing health issue. The Pataki administration is investing $9 million this year to encourage physical activity among children, but the state has not moved to limit the sale of unhealthful snacks in schools, as a half-dozen other states have. Only $1.9 million of the $100 billion state budget goes directly to diabetes prevention and control, roughly the same amount spent to fight anorexia and bulimia.

Two months after the Health Committee approved Mr. Ortiz's bill, it had still not come up for a full Assembly vote. But on June 22, as the legislative session wound down, the bill found its moment.

Many members were in a hurry to leave town. As evening approached, Mr. Ortiz spotted Mr. Silver, chased him down a corridor and cornered him outside the speaker's office, in a space where legislators often horse-trade in whispers. Mr. Ortiz, however, was shouting: "I get the same excuse every year!"

He wanted his bill debated and voted on by the full Assembly - an unusual request in Albany, where measures rarely make it to the floor of either house unless they are assured passage. Mr. Ortiz's five other bills to fight obesity had languished in committees.

If a bill this mild could not succeed in New York, Mr. Ortiz argued, what hope was there for more sweeping measures?

Mr. Silver relented. And when the bill came up for a vote, near midnight, Mr. Ortiz had the floor. "This is about the future of our children," he said.

When he stopped, the sarcasm began.

James D. Conte, a Long Island Republican, said his family owned a burger restaurant. What would happen, he asked, in the case of all-you-can-eat buffets?

Mr. Ortiz said the law would apply only to standard menu items.

"What about the weekly specials?" Mr. Conte asked.

Laughter rose in the chamber. Daniel J. O'Donnell, a fellow Democrat from Manhattan, kept it going. "I watch people who work at McDonald's, and they don't measure how much salt they put on fries," he said. "Do you expect there to be a shaker lesson?"

Mr. Ortiz said he guessed that employees were adequately educated.

An hour went by. A few colleagues defended the measure. Others argued that enforcing it would be a nightmare, and that the costs would hurt small restaurants.

As the time for debate waned, Joel M. Miller, a Republican from Poughkeepsie, rose to state his position. "I did not develop this physique by eating healthy," Mr. Miller, a stout man, said to guffaws. A colleague completed the joke by bringing him a generous plate of cookies.

"The bottom line is, it is not going to matter," Mr. Miller said. "We are fooling and deluding ourselves."

Mr. Ortiz made one last plea. "When we look at the rate of diabetes in our state," he said, "and when we look at this bill, we should remind ourselves that the decision we make here tonight will make an impact on our kids."

The result was clear as soon as the voting began. The yes votes showed up on an electric signboard in green, the no votes in red. Within minutes, the board was glowing red.

Before the tally could be completed, Mr. Ortiz stood and delivered the final word: "I would like to say, with a lot of passion, I withdraw this bill."
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My maternal grandmother had Type-2 diabetes and it caused her to lose an eye. I remember playing with her fake glass eye when I was a small child, not realizing that it was odd that she could take her eye out and put it back in. She was obese.

I've never been overweight--5'6" and 138lbs and never weighed more than 150. I can lose weight easily, I guess. When I gain a few pounds, I just cut back on my food intake for a few days and the weight drops off. I don't know whether my grandmother's eye subconsciously has anything to do with it, but I can easily control my eating. There is NOTHING that tastes that good to me!!

I know that I can be slim and still have diabetes since it runs in my family, so I get my blood sugar checked on a regular basis.

PM ME FOR INPUT

KD

Quickly-

Is Yellow Rice healthy or unhealthy?

CD

Depends.

My perspective and approach to this topic has changed from my earlier posts.

Let me explain it this way. It comes down to how many carbs per meal that your diet allows without exceeding a glucose level over 160 2 hours after eating.

And if you exceed the prescribed intake exercise and then test your level to make sure that after exercise you test within a range of 90-130, ideally...

Since attending a nutrition class, and recently joining a fitness center, increased exercise, particularly cardiovascular activity, and limiting my meals to 45 grams per meal has greatly improved my health, reducing my blood sugar level in addition to increasing the amount of fat I am burning while the body is at rest, leading to an increase in muscle mass and weight reduction...


1/3 cup of rice, brown or white, is suggested per meal....i don't know if yellow rice is any different, but think it's about the same portion recommended...

PM ME FOR INPUT

KD

I have recently added bilberry and an herbal supplement mix (gymnema leaf, tumeric, cinnamon, funnugreek, bitter melon, jambul seed, ginger) that I take after I eat...I have also added a digestive enzyme and this combination (along with exercise and constantly refining my diet) has put my numbers back into a reasonable range....I am not getting comfortable tho...I will continue to research and refine my lifestyle to support health...