Wednesday, 18 December 2019

Food and Diabetes, or, People are Weird

A relative of mine had a recent health scare, and it turns out he has diabetes. Now that he knows about it and is treating it, he’s doing much better, thankfully.

One of the things that struck me when people asked what had happened or how he was doing was how quick people were to insert their own assumptions about food and health. One of his coworkers swung by my workplace to drop off a get-well card, and made comments about how he would have to start a whole new way of eating. Um, maybe? I don’t actually live with him so I’m not aware of what his diet was like before, and also I just don’t know what to say to that.

Like, yes, diabetes is influenced by both diet and genetics. Someone with a genetic predisposition who eats one way is more likely to get it, and sooner, than someone with that same genetic predisposition who eats differently. But that’s a far cry from saying that every diabetic person on the planet “did it to themselves” or from knowing that a newly diagnosed diabetic needs to make drastic dietary changes, without even knowing how they were eating to begin with.

Of course, it goes back to that just world fallacy that undergirds so much prejudice. If a health problem is the patient’s fault, then other people don’t have to worry that it will happen to them. Even if it does happen to you, there’s a weird comfort in taking the blame on yourself, because if you caused it, then there’s a chance you can fix it. On the other hand, if the cause is that your number came up in the genetic lottery, and your prize was a shiny new chronic illness, that feels a lot scarier, and a lot less hopeful.

I realized how strongly it was affecting me when I found myself feeling scared of eating anything carb-heavy. The diabetic relative is an in-law, not a blood relative, so their having diabetes has no bearing on how likely I am to end up with it, but it reminded me of the history of diabetes in my own family tree.

But that fear is counterproductive. Agonizing over every bite of food I put in my mouth might reduce my carb intake, therefore reducing my blood sugar a bit.  Or, it might ramp it up, because that fight or flight response prompts your body to make stored energy–fat and glucose–available for use. That’s super useful if you’re being chased by a tiger, but less useful for fears you can’t physically run away from, like worries about food and chronic illness. Between the lack of an actual tiger to run away from, a little black yippy dog of anxiety who was already prone to excess worry about being attacked by tigers, and a metabolism that’s already a little dodgy in terms of handling sugar, the overall effect of the stress might be worse for my blood sugar than the “evil” carby food that stress was trying to protect me from.

So, I remind myself that the only time I should be this worried about a single instance of eating or preparing food is when I’m doing home canning.  (Clean everything and follow the USDA directions, because botulism will kill you dead.) A donut, by contrast, will not kill me dead. A donut every day might increase my chance of ending up with diabetes, or mean that I get it sooner than I otherwise would. But even at that, it would depend on everything else I was eating that day.  Did I eat the donut at the end of a meal with protein and fat in it?  Did I eat the donut and then go for a half-hour bike ride?

I’m trying to exercise more, in ways that are fun and sustainable. I’m trying to avoid stand-alone carby snacks. This isn’t really a hardship, because I’d rather have fruit and cheese than a handful of potato chips. And I’m trying to manage my own anxiety by not letting other people’s worries about food and mortality into my brain.

via Kelly Thinks Too Much