It’s National Diabetes Month, 2012. In the effort to solve diabetes and childhood obesity, why do we look at research based on data collected in 2005 and even farther back in time? Because to a certain extent, that’s how it is in any kind of study. It has to be set up, the plans have to be approved by some kind of authority, and the funding has to be in place. The work has to be done, and the results written up. It all takes time, so we’re never quite on top of things.
On the other hand, especially in the areas of both diabetes and childhood obesity, time is an important part of the equation. The farther back we look for their origins, the more surprises are in store. Promising discoveries have been made about life in utero. It appears that the general health of a mother, even before a baby is conceived, is of primary importance. There is much to be learned from longitudinal studies that follow their subjects for years and even decades. It takes patience.
Unfortunately, in the academic and political realms, there are a lot of situations where results have to be produced now. Sometimes, because of scarce funding or for other reasons, scientists resort to meta-studies, combing back over the results of field work done long ago, comparing and collating the reports to find patterns that may have eluded their awareness before.
Definitely, there is a place for meta-studies, but we need the other kind, too, in real-time, if possible. Most important of all, there is a need for wisdom in making a determination about what kind of research is more meaningful for any given question.
We compared diabetes to the plague that swept through much of the world several centuries ago. The beaky mask shown on this page was meant to protect the wearer from the bad air and from catching the plague. Who knows if it worked? It is known, however, that most diabetes is preventable, because 90% of it or more is Type 2 diabetes, the preventable kind.
Both diabetes and childhood obesity are worldwide epidemics. China, for instance, could sink under the weight of its newly acquired flab. On the bright side, their health care system has figured out how to treat diabetes patients for a fraction of the cost that is typical in, say, the United States. But why is so much of the world economy devoted to treating diabetes in the first place? Why is the world having a preventable plague?
Time is crucial in another way. Researchers could know every possible fact about a group of subjects and how they react up until the end of the study. But maybe something is going on that won’t show up for 20 years. In the public health field, one of the difficulties of policy-making is the danger of jumping the gun and acting too soon on a premise that later turns out to have been inconsequential. When rules are made and enforced for the public good, there are always unintended consequences and societal side effects.
Is it possible, for instance, that normal juvenile rebellion is a factor? Are there kids who get fat because the grownups say fat is bad? Is obesity a badge of individuality, like an eyebrow piercing? Is there pride, as in the deaf community that rejoices in creating its own language and culture? What are obesity’s cultural components?
The Centers for Disease Control and Prevention found that diabetes has really ramped up in the Southern states, more so than in the other regions. Is there a Southern pro-obesity attitude, based on a perception that healthy weight is just another damn fool Yankee notion? It might be a wacky idea, but life and society are so complicated, even the wacky ideas are worth looking at, because sometimes it pays off.
Your responses and feedback are welcome!
Source: “Big rise in Americans with diabetes, especially in South,” Reuters, 11/15/12
Image by goatling.