The Fat Pack Wonders if It's Time to Slim Down

[Miami Danny]

On another site I read, a thread regarding this article had a post by Jim Leff in it, founding member of Chowhound.  One of Jim's points in his post was about how he only needs a taste of something if he's planning on spending an afternoon eating his way through fish tacos in San Diego.  Just a taste.  He doesn't need to eat the whole thing to do a comparative study.  I love that.

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Jim is correct. For fish tacos.

[melkor]

On another site I read, a thread regarding this article had a post by Jim Leff in it, founding member of Chowhound.  One of Jim's points in his post was about how he only needs a taste of something if he's planning on spending an afternoon eating his way through fish tacos in San Diego.  Just a taste.  He doesn't need to eat the whole thing to do a comparative study.  I love that.

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Jim is correct. For fish tacos.

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That doesn't seem wasteful to anyone else? How hard is it to drag a few friends along so the food you order doesn't go to waste?

[K8memphis]

On another site I read, a thread regarding this article had a post by Jim Leff in it, founding member of Chowhound.  One of Jim's points in his post was about how he only needs a taste of something if he's planning on spending an afternoon eating his way through fish tacos in San Diego.  Just a taste.  He doesn't need to eat the whole thing to do a comparative study.  I love that.

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Jim is correct. For fish tacos.

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That doesn't seem wasteful to anyone else? How hard is it to drag a few friends along so the food you order doesn't go to waste?

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Where does it say he wastes the food? There's carry outs too.

[Darcie B]

I just read the article, and it gives the definition of the Fat Pack as:

The journalists, bloggers, chefs and others who make up the Fat Pack combine an epicure’s appreciation for skillful cooking with a glutton’s bottomless-pit approach.

The innuendo in the remainder of the article seems to be that everyone on eGullet or anyone who is a food enthusiast and/or has a food blog is a glutton, obsessed and unhealthy. I am obsessed about food, to be sure. I don't come to eGullet for health advice and don't see a need for forums dedicated to health or wellness. There are plenty of health sites out there. It's great that threads occasionally arise about healthy eating, but I'd hate to see this site and other great foodie places turn into Cooking Light.

I have no doubt that obesity is a nationwide issue. But I don't come here looking for a resolution to that problem, and I resent the assumption that because I live to eat, not the other way around, that I'm a glutton or unhealthy.

Maybe I'm just overly sensitive.

[helenjp]

I guess I don't find a concern with bodies out of place, since everything we eat (or even smell) affects us. Nutrition is part of food - why wouldn't we want to talk about overeating/undereating, allergies, nutrition etc?

That's why food is so interesting, to me - the intersection of function and delight is fascinating enough to keep a person busy for a lifetime. I love plants and airplanes for the same reason, but I digress...

[Endy']

I just read the article, and it gives the definition of the Fat Pack as:

The journalists, bloggers, chefs and others who make up the Fat Pack combine an epicure’s appreciation for skillful cooking with a glutton’s bottomless-pit approach.

The innuendo in the remainder of the article seems to be that everyone on eGullet or anyone who is a food enthusiast and/or has a food blog is a glutton, obsessed and unhealthy. I am obsessed about food, to be sure. I don't come to eGullet for health advice and don't see a need for forums dedicated to health or wellness. There are plenty of health sites out there. It's great that threads occasionally arise about healthy eating, but I'd hate to see this site and other great foodie places turn into Cooking Light.

I have no doubt that obesity is a nationwide issue. But I don't come here looking for a resolution to that problem, and I resent the assumption that because I live to eat, not the other way around, that I'm a glutton or unhealthy.

Maybe I'm just overly sensitive.

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maybe I read it backwards, but to me the quote says "set of people who are epicures AND gluttons = Fat Pack". If you're obsessed with food but not a glutton, then I don't think any conclusions are being drawn about you.

[melkor]

maybe I read it backwards, but to me the quote says "set of people who are epicures AND gluttons = Fat Pack".  If you're obsessed with food but not a glutton, then I don't think any conclusions are being drawn about you.

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I read that the same way as you did.

[Fat Guy]

To a certain extent, that's a good thing. However, separately, the diagnostic threshold for type 2 diabetes has been lowered over time, such that people are being diagnosed with diabetes today who -- even if tested and evaluated -- would not have been diagnosed as such in the past. Those people -- the ones in the 140 to 126 mg/dL category -- are not being well served by diagnoses of type 2 diabetes, metabolic syndrome, etc., and especially not by the attendant drug regimens.

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But they are being well served if early detection and treatment can help ward off more severe disease and complications. The truth, though, is that those people are rarely started out on drug regimens. They are usually treated with dietary modifications.

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John, I think you -- and anybody else interested in this subject -- would find this piece in American Family Physician ("New Diabetes Guidelines: A Closer Look at the Evidence," by Woolf and Rothemich) to be a good summary of the opposite position, if you haven't read it already. Woolf and Rothemich note that

Lowering the diagnostic threshold shifts the definition of diabetes into the central bulge of the bell curve where the glucose level of most Americans falls.

and that therefore

Under the new guidelines, at least 1 million Americans (and possibly more) with fasting plasma glucose levels of 126 to 140 mg per dL (7.0 to 7.8 mmol per L), who previously would have been told that they had normal (or impaired) glucose tolerance, will now be informed that they harbor a disease.

They make several arguments as to why this is a bad idea. First, they point to studies that conflict with the studies underlying the new diagnostic threshold. Second, they note that

even if risk is increased, the new policy argues that having a risk factor (a mildly elevated fasting plasma glucose level) is tantamount to having a disease. There is wide overlap between healthy persons and persons with diabetes in the fasting plasma glucose range of 126 to 140 mg per dL (7.0 to 7.8 mmol per L). . . . . Labeling persons with a fasting plasma glucose level of 126 to 140 mg per dL (7.0 to 7.8 mmol per L) as having diabetes, when most will not develop meaningful disease, is akin to labeling persons with elevated cholesterol levels as having heart disease.

Third, they point to the scant evidence that correcting mild elevations in glucose levels improves health. Furthermore, they argue:

The benefits of an earlier diagnosis must also be weighed against potential harms. . . . . Although the first-line treatment for patients with mild fasting blood glucose elevations should be diet and exercise, some physicians may be tempted to prescribe glucose-lowering drugs if levels remain elevated, exposing patients to potential side effects (e.g., hypoglycemia). Given current uncertainties about the health benefits of detecting or correcting a fasting plasma glucose level of 126 to 140 mg per dL (7.0 to 7.8 mmol per L), these patients may be subjected to harm for no appreciable gain.

More recently, there were some real blockbuster study results reported earlier this year that undercut the conventional medical wisdom about type 2 diabetes. As the New York Times summarized:

For decades, researchers believed that if people with diabetes lowered their blood sugar to normal levels, they would no longer be at high risk of dying from heart disease. But a major federal study of more than 10,000 middle-aged and older people with Type 2 diabetes has found that lowering blood sugar actually increased their risk of death, researchers reported Wednesday.

Those reports followed on the heels of the Avandia controversy. For those who missed it, the short version is:

An independent analysis of thousands of older people with diabetes found that those treated with the widely used drug Avandia had significantly elevated risks of heart attack and death.

I posted earlier about the "epidemic of diagnoses," and I hope folks took a look at that article. In any event, it's not as cut and dry as "early detection is good." There's a lot more to it than that.

[Fat Guy]

So far, it seems that the medical professionals posting in this topic agree that diabetes is a big problem, and it is being under-diagnosed - see docsconz and hummingbirdkiss' posts above. 

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Surely this line of reasoning is flawed for at least two major reasons. First, the medical professionals posting here may not be diabetes experts. Second, we don't have enough medical professionals posting here to indicate any sort of consensus position -- not that I disagree about the existence of a consensus position that I believe to be wrong. More significantly, though, consensus is just not relevant to science. Science is about truth independent of what anyone or everyone believes, expert or no. While it's interesting to note where a consensus has arisen in a professional community, history has taught us time and again that we'd be foolish to assume majority positions are always right.

[Fat Guy]

One of the things I love about the internet is that it provides a platform for someone with no background on a topic to argue at length about it with people who have made that topic their life's work. 

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It's not my position that the diabetes epidemic is actually an epidemic of diagnosis. I didn't invent it. I read it. It's the position of diabetes researchers -- you know, people who have made it their life's work -- as reported in their published work.

As for people with no background -- people who haven't done the reading, haven't done any critical thinking, and are not the slightest bit skeptical of conventional wisdom -- making authoritative statements with no basis, I agree that's pretty funny.

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You're picking a small detail in the larger discussion and focusing on it as if it were relevant.

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If your position is that diabetes is not relevant to this discussion, that's kind of funny too. I'll be the first to say that diabetes is not the whole discussion. But irrelevant? No, it's highly relevant. It's relevant because what I've found in researching this topic extensively -- from a journalistic perspective, of course, as I'm not a medical professional (I suck at math and can't stand the sight of blood) -- over a period of a nearly a decade is that when we start unpacking the specific beliefs about obesity and health that underly the conventional wisdom there's some pretty surprising (to most people) information there. Diabetes is one example. I imagine that almost everybody reading this topic thought the notion of a diabetes epidemic was axiomatic. Now at least I hope everybody reading this topic sees that there is a body of evidence and thinking that says it's a hoax. I don't expect everybody to agree with that position, but I hope at least some folks now know the position exists and has support in credible, mainstream publications.

[melkor]

You're picking a small detail in the larger discussion and focusing on it as if it were relevant. 

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If your position is that diabetes is not relevant to this discussion, that's kind of funny too. I'll be the first to say that diabetes is not the whole discussion. But irrelevant? No, it's highly relevant. It's relevant because what I've found in researching this topic extensively -- from a journalistic perspective, of course, as I'm not a medical professional (I suck at math and can't stand the sight of blood) -- over a period of a nearly a decade is that when we start unpacking the specific beliefs about obesity and health that underly the conventional wisdom there's some pretty surprising (to most people) information there. Diabetes is one example. I imagine that almost everybody reading this topic thought the notion of a diabetes epidemic was axiomatic. Now at least I hope everybody reading this topic sees that there is a body of evidence and thinking that says it's a hoax. I don't expect everybody to agree with that position, but I hope at least some folks now know the position exists and has support in credible, mainstream publications.

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My position isn't that diabetes is irrelevant, I apparently foolishly thought that everyone would be able to grasp that after reading what I've already posted in this topic.

The Times article wasn't specifically about diabetes, it was about health problems brought on by obesity. Batali, Cutlets, Steingarten, and the rest of the people interviewed aside from Jason aren't diabetic. The argument you seem to be making is that being morbidly obese isn't a health problem. Is that accurate? If that's the position you're taking, that's fine - just don't hide it behind what you believe about diabetes.

Edited March 22, 2008 by melkor (log)

[Fat Guy]

My position isn't that diabetes is irrelevant, I apparently foolishly thought that everyone would be able to grasp that after reading what I've already posted in this topic.

My reading of your posts is that you only think diabetes is irrelevant if you're wrong about it.

The Times article wasn't specifically about diabetes

It was, in part, about diabetes. So I'm not sure what the word "specifically" means in that sentence. Perhaps it means the article isn't only about diabetes. That's certainly true.

it was about health problems brought on by obesity

Health problems like diabetes?

Batali, Cutlets, Steingarten, and the rest of the people interviewed aside from Jason aren't diabetic.

Did the article say that? I have no idea whether that's a true statement or not. In any event, let's come back to the other people in the article in a moment.

The argument you seem to be making is that being morbidly obese isn't a health problem.

As far as I can tell based on the weights and heights noted in the article, only one of the people interviewed was morbidly obese. "Morbidly obese" is a defined term that at present means a BMI of 40+.

In terms of whether morbid obesity is a health problem, it certainly can be. But the BMI measure is flawed as has already been explained on this topic and in a million other places, and it's entirely possible to be fit with a BMI of 40+, as 3% of NFL players are.

So no, being defined as "morbidly obese" by a flawed definition does not establish a health problem. Now if somebody's weight is interfering with basic physiological functions (breathing, walking) then, sure, that's a health problem. That can occur in different people at different weights.

Now let me ask you a question, Melkor. Do you have any evidence that the incidence of morbid obesity, or just obesity, is higher among online foodies than it is among the general population? And would you agree that, if it isn't higher, everything you're saying is beside the point?

[Tess]

Exactly. I read about all my fellow eGulleteers eating the lovely super-rich foods that they do, so that I don't have to! Except when I really want to, and in portions that don't blow my routine out of the water.

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Exactly!

[melkor]

As far as I can tell based on the weights and heights noted in the article, only one of the people interviewed was morbidly obese. "Morbidly obese" is a defined term that at present means a BMI of 40+.

Drew Nieporent used to be 325 pounds - unless he's six-four, he had a BMI over 40 when his doctor was recommending gastric bypass. I'd bet Batali is a similar weight.

In terms of whether morbid obesity is a health problem, it certainly can be. But the BMI measure is flawed as has already been explained on this topic and in a million other places, and it's entirely possible to be fit with a BMI of 40+, as 3% of NFL players are.

So no, being defined as "morbidly obese" by a flawed definition does not establish a health problem. Now if somebody's weight is interfering with basic physiological functions (breathing, walking) then, sure, that's a health problem. That can occur in different people at different weights.

At the dozen or so eGullet events I've been to and the several dozen I've seen photos of on the site I can't recall ever seeing anyone who looked like they played in the NFL.

Now let me ask you a question, Melkor. Do you have any evidence that the incidence of morbid obesity, or just obesity, is higher among online foodies than it is among the general population? And would you agree that, if it isn't higher, everything you're saying is beside the point?

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At every eGullet event I've been to, the bulk of the significantly overweight people in the building have been at our tables. I'd expect the same to be true in NYC, but perhaps not in a place like Cleveland. In a city like SF, I'd say the foodie community is heavier than the general population. Hop over to chowhound and take a look at the pics of their events.

[Fat Guy]

Those anecdotes -- which by the way do not square with my observations at all, and I've been to more online foodie events than most -- are not even close to being evidence in any meaningful sense of the word.

I would love to see a population study of 1,000 online foodies versus 1,000 members of the general population, randomly selected and controlled for age, gender, race and all the other factors good studies control for. I really wonder what it would show. But since no such study has been done, I think it's kind of silly to assume we know that the results would demonstrate an unusual health problem. Certainly, the data could just as easily show that online foodies are as a group exceptionally healthy.

[melkor]

Those anecdotes -- which by the way do not square with my observations at all, and I've been to more online foodie events than most -- are not even close to being evidence in any meaningful sense of the word.

I would love to see a population study of 1,000 online foodies versus 1,000 members of the general population, randomly selected and controlled for age, gender, race and all the other factors good studies control for. I really wonder what it would show. But since no such study has been done, I think it's kind of silly to assume we know that the results would demonstrate an unusual health problem. Certainly, the data could just as easily show that online foodies are as a group exceptionally healthy.

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So to summarize - You don't think being overweight is a health risk, nor do you believe that food focused communities like this one support being significantly overweight.

[Fat Guy]

I believe that for the overwhelming majority of people being overweight, without more, is not a health risk. And I think the suggestion that food-focused communities support being significantly overweight is not only risible but also nonsensical to anybody who has bothered to read the decisive refutations already posted on this topic.

[melkor]

I believe that for the overwhelming majority of people being overweight, without more, is not a health risk. And I think the suggestion that food-focused communities support being significantly overweight is not only risible but also nonsensical to anybody who has bothered to read the decisive refutations already posted on this topic.

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So, the Times article in your opinion is junk, and Jason, aside from his diabetes, was in fine shape?

[Fresser]

I just read the article, and it gives the definition of the Fat Pack as:

The journalists, bloggers, chefs and others who make up the Fat Pack combine an epicure’s appreciation for skillful cooking with a glutton’s bottomless-pit approach.

The innuendo in the remainder of the article seems to be that everyone on eGullet or anyone who is a food enthusiast and/or has a food blog is a glutton, obsessed and unhealthy... I have no doubt that obesity is a nationwide issue. But I don't come here looking for a resolution to that problem, and I resent the assumption that because I live to eat, not the other way around, that I'm a glutton or unhealthy.

Maybe I'm just overly sensitive.

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You're not too sensitive, Darcie--you're just perceptive.

It's hilarious how horn-blowing media outlets like the NYT like to polarize eGullet members: on one side we have the Carrot-Nibbling Extremists and on the other are the Fat-Infused, Caloric Hedonists.

Fat Guy's screen name notwithstanding, to imply that eGullet glorfies gluttony is pernicous and wrong. I've written at length about how diabetes has changed my diet (and my taste buds), and Chris Amirault has cited the many "healthy eating" threads. I've even written two myself: Hypoglycemia and Food details my travails with low-blood sugars and how I remedy the condition with the proper food. Avoiding the Bonk ties in cycling and nutrition, as I bicycle to control blood-sugars and stay healthy. But to eat in moderation and then burn off the calories just doesn't titillate the way stories about orgiastic eating do.

We now return you to our regularly scheduled diatribe.

[Fat Guy]

So, the Times article in your opinion is junk

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My comments speak for themselves, but I thought it was a weak article. Kim Severson is the best food reporter at the New York Times, but this was a poor effort on her part.

[OnigiriFB]

Oy Vey. This thread is going in circles. I don't think a forum discussing food needs to be concerned with other people's health. If you want to pat yourselves on the back about healthy eating or show info on it then start a thread. There is nothing stating you can't. If you don't want to participate in a thread that you consider unhealthy then don't. Simple as that. The people here are not my keeper, they are not my doctor, they don't pay my medical bills, and in the end have no say in what I choose to eat or don't eat. In the years I've been here I have come to appreciate all the knowledge that is available here. I've tried many recipes that are around whether they are healthy or not healthy. If I choose to eat pork belly everyday while trying to determine how to get it perfect that is my choice and is no ones concern but my own.

To FG, Chris, and other who run this forum: Thank you. Keep up the hard work!

[Corinna Dunne]

This NYT piece is just spin on a topical issue: diet and diabetes.

The only difference here is a new ‘how to’ get obese angle. To be honest, it all sounds like pre-promotion for a book, although maybe that’s just me being cynical, tainted by my old PR hat from years ago.

So here’s the new angle on an old told story:

The history: Man loves food. Gets together with people who love food and starts a website.

Food website attracts likeminded people, co-founder finds himself happily ensconced in a:

…community where no food was too fatty and no field trip too extreme. Ferreting out the best place for an empanada or the perfect way to braise pork belly meant tasting countless versions, often in the same day. Being the first in the group to find it was golden.

A bit short on detail, but this journo won’t be the first to let it get in the way of a good story. So, the wonderful life of gluttony seems like heaven to our foodie… but it all goes horribly wrong and there’s a price to pay:

Now, like some of his fellow travelers, he is learning what happens when the Fat Pack’s philosophy of excess meets the body’s limits of endurance.

The implication that everyone is blindly eating their head off is quite simply nonsensical.

And just in case we’d missed the point:

The journalists, bloggers, chefs and others who make up the Fat Pack combine an epicure’s appreciation for skillful cooking with a glutton’s bottomless-pit approach. Cramming more than three meals into a day, once the last resort of a food critic on deadline, has become a way of life. If the meals center on meat, so much the better.

Mr. Perlow, who has embarked on an aggressive diet and fitness overhaul, believes that his online colleagues will soon realize that the time has come for healthier eating.

This makes great copy, but is a totally unsupported statement. And Fat Guy makes that point suscintly here:

I would love to see a population study of 1,000 online foodies versus 1,000 members of the general population, randomly selected and controlled for age, gender, race and all the other factors good studies control for. I really wonder what it would show. But since no such study has been done, I think it's kind of silly to assume we know that the results would demonstrate an unusual health problem. Certainly, the data could just as easily show that online foodies are as a group exceptionally healthy.

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But hey, there’s the ‘new’ angle. “Time for healthier eating” is hardly (yawn) revolutionary, but if you work in some internet spin, you have a story and maybe a book (after all sick lit is the new chick lit, and with an ageing population, more relevant by the day). And of course there’s the blame game. Now we’ve got a new culprit. The internet; that delicious ‘it isn’t your fault angle’ (crowd pleasers = more readers).

My opinion? Obesity, as we all know is on the increase and there is a clear link between it and diabetes. Obviously there are cases outside of this group also. To say that internet discussion groups contribute to this is a totally unsupported statement and the finger pointing about responsibility and culpability is just designed to reinforce the spin. The key culprit (as pointed out by many above) appears to be processed food and the increased use of the car.

When I first visited the US in the early 80s, I couldn’t believe the huge servings of sodas and was fascinated by the whole fast food phenomenon. I did also notice that there were quite a number of obese people, a thing that was rare at the time in Ireland which was in deep recession. But Ireland’s recent prosperity and higher discretionary spend has meant that it is ‘catching up’ and time poor parents are looking for time saving options. So obesity is seriously and worryingly on the increase here too. However, the obesity problem is largely at the lower end of the social scale, with middle class parents being more aware of the need to avoid highly processed foods and ensuring that they and their families get exercise. So far there have been no reports of food discussion groups being a contributing factor, but plenty of comment about children sitting on their fat backsides watching television and playing computer games when they should be outside kicking a ball. Yes, some of the genetic evidence has been cited, but with previous generations of hard working, carless skinnies, it doesn’t hold much anecdotal water.

So Henny Penny… Yeah, obesity and diabetes is on the rise (nothing new there). The internet is to blame…. Yeah, right… spin me another yarn.

[JasonTrue]

I remember when my overweight (but shrinking) manager was commenting about the accuracy of BMI... He also mentioned that it's not accurate for all people. I think he just wanted it not to apply to him (or me). Both of us were relatively fit with BMIs around 25-26 at the time, but we visibly had more body fat around our midsection than was healthy for our relatively sedentary lifestyles. And we kept up the exercise routines and found that we continued to lose fat, reduce resting heart rate, and improve most of the other metrics that indicate fitness.

Of course, in the big bell curve, BMI is a fairly appropriate metric for all but the fittest (most muscular) and the anorexic or undernourished (least muscular). But there are other tools to further distinguish obesity from musculature, namely, things like waist-to-hip ratio or full-on body fat percentage measurements, and I suspect very few people who complain about the accuracy of BMI are actually outside of its diagnostically valuable ranges. The waist-to-hip ratio and, for men, the presence of a waistline larger than about 36-38 inches, is a pretty good indicator of excess fat, regardless of muscle mass.

And most of those "healthy" football players, body builders and so on still have relatively small waistlines. Those that don't often do have health problems:

Many coaches and players believe supersize guards and tackles can dominate the line of scrimmage. But the researchers found no link between body mass indexes and teams' rankings. The real, and disturbing, correlations may relate to health. A 2003 study found higher blood pressures and more breathing disorders during sleep in professional football players with high body mass indexes.

Diabetes is just one of the many concerns of excess weight. Sleep apnea and insomnia, blood pressure and heart disease, elevated cholesterol, increased rate of injury to joints (in spite of my running injury at a relatively skinny weight, knee injuries turn out to be more common among overweight people), kidney problems, certain categories of cancer, along with more mundane things like hemorrhoids, clearly occur at higher rates, and some small health problems become bigger ones with excess body fat.

I'm sure they exist, but I have yet to find anyone in the obese category who didn't at least have some health problems associated with excess body fat. Dismissing the associations between excessive consumption, excessive body fat, and excessive health problems is not particularly helpful.

Edited March 22, 2008 by JasonTrue (log)

[ghostrider]

John, I think you -- and anybody else interested in this subject -- would find this piece in American Family Physician ("New Diabetes Guidelines: A Closer Look at the Evidence," by Woolf and Rothemich) to be a good summary of the opposite position, if you haven't read it already. Woolf and Rothemich note that

Lowering the diagnostic threshold shifts the definition of diabetes into the central bulge of the bell curve where the glucose level of most Americans falls.

and that therefore

Under the new guidelines, at least 1 million Americans (and possibly more) with fasting plasma glucose levels of 126 to 140 mg per dL (7.0 to 7.8 mmol per L), who previously would have been told that they had normal (or impaired) glucose tolerance, will now be informed that they harbor a disease.

They make several arguments as to why this is a bad idea. First, they point to studies that conflict with the studies underlying the new diagnostic threshold. Second, they note that

even if risk is increased, the new policy argues that having a risk factor (a mildly elevated fasting plasma glucose level) is tantamount to having a disease. There is wide overlap between healthy persons and persons with diabetes in the fasting plasma glucose range of 126 to 140 mg per dL (7.0 to 7.8 mmol per L). . . . . Labeling persons with a fasting plasma glucose level of 126 to 140 mg per dL (7.0 to 7.8 mmol per L) as having diabetes, when most will not develop meaningful disease, is akin to labeling persons with elevated cholesterol levels as having heart disease.

Third, they point to the scant evidence that correcting mild elevations in glucose levels improves health. Furthermore, they argue:

The benefits of an earlier diagnosis must also be weighed against potential harms. . . . . Although the first-line treatment for patients with mild fasting blood glucose elevations should be diet and exercise, some physicians may be tempted to prescribe glucose-lowering drugs if levels remain elevated, exposing patients to potential side effects (e.g., hypoglycemia). Given current uncertainties about the health benefits of detecting or correcting a fasting plasma glucose level of 126 to 140 mg per dL (7.0 to 7.8 mmol per L), these patients may be subjected to harm for no appreciable gain.

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Not to try to extend a tangent with another personal anecdote, but there may be some value in this story of why I changed one facet of my diet:

Last year my doc told me I was getting to be borderline diabetic because my glucose level was around 120. I guess he was going by the new guidelines. I'll admit that hearing "diabetic" applied to me for the first time scared the bejeebers out of me & led to some immediate dietary changes that took my glucose levels in the other direction.

The important thing here was that the doc was able to show me steadly increasing glucose levels over 3 years of blood tests & explain that it was the trend, more than the actual level, that was worrisome even though I hadn't yet gotten beyond "mild elevation."

I'll suggest that arbitrary threshold levels, wherever they're set, may be a less useful tool than patterns, & a good doctor-patient relationship will focus on the latter & perhaps avert a crisis diagnosis. That of course requires regular visits to the doc.

Sadly, I still haven't lost weight, but that's a separate issue. Good blood work results after a year of more controlled eating are their own reward.

[gini]

On another site I read, a thread regarding this article had a post by Jim Leff in it, founding member of Chowhound.  One of Jim's points in his post was about how he only needs a taste of something if he's planning on spending an afternoon eating his way through fish tacos in San Diego.  Just a taste.  He doesn't need to eat the whole thing to do a comparative study.  I love that.

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Jim is correct. For fish tacos.

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That doesn't seem wasteful to anyone else? How hard is it to drag a few friends along so the food you order doesn't go to waste?

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I would suggest that you go read the thread for yourself before jumping to conclusions, melkor.