The news wasn’t exactly a stunner, but now it’s a fact. Paula Deen has Type 2 diabetes.
I’m actually a fan of the gregarious Deen, whose engaging personality has made her show, “Paula’s Best Dishes,” a hit on the Food Network. But as a medicine writer, I’ve always been a bit wary about the southern fare she flogs — fried, fatty and loaded with butter. The dishes certainly look good, but as for their nutritional virtues? Well, that’s an entirely different story.
Deen, 64, has been roundly criticized for promoting the kind of high-fat, high-sugar food that is known to lead to overweight and obesity, which is in turn known to contribute to the risk of developing diabetes. Upon announcing her own diagnosis on the Today show Tuesday morning, however, Deen defended her style of cooking, saying, “On my show I share with you all these yummy, fattening recipes, but I tell people, ‘in moderation.’ I’ve always eaten in moderation.”
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That’s fair enough. As Deen said, “Like I told Oprah, ‘Honey, I’m your cook, not your doctor.’ You have to be responsible for yourself.” So I wondered how nutritionists would view the announcement by the doyenne of down-home cuisine that she’s had diabetes for three years now, a diagnosis that may have arisen at least in part from eating her own cooking.
Can Deen’s revelation finally help convince Americans that overindulging in fatty, sugary foods — like her famous Lady’s Brunch Burger, a bacon-and-fried-egg hamburger sandwiched between two doughnuts — can be damaging to their health? “I could definitely use this as a lesson that eating large amounts can lead to obesity, and that is a risk for developing Type 2 diabetes,” Constance Brown-Riggs, spokesperson for the Academy of Nutrition and Dietetics, says of Deen’s diagnosis.
“Those who like to demonstrate the link between high calorie foods and diabetes could use her case as an example,” agrees Dr. Michael Dansinger of the division of endocrinology, diabetes and metabolism at Tufts Medical Center.
But while diet is certainly a big part of diabetes risk, experts say it’s not the only factor. “It’s an oversimplification to say that her cooking brought about her diabetes,” says Brown-Riggs. “Certainly eating high-fat and sugary foods leads to high caloric intake, which leads to obesity. But it’s the obesity that increases the risk of developing Type 2 diabetes.”
And obesity alone doesn’t necessarily lead to the disease. Other risk factors, including genetic vulnerabilities, and an unhealthy, sedentary lifestyle, also raise the risk of diabetes. “All of those stack the deck,” says Brown-Riggs. “And if you have the perfect storm of everything coming together, you may go on to develop diabetes.”
As Dansinger notes: “We don’t know all the medical facts about her case. I don’t want to say there is a one-to-one correlation between her diet and her diabetes. It’s too simplistic to say that she clearly ate a lot of high-calorie foods, has had chronic obesity which caused her diabetes, and that her diagnosis would never have occurred if the hadn’t made the kind of food she made. The fact is, we don’t know.”
Nevertheless, Dansinger and others agree that overeating and eating foods that are high in calories are the risk factors that doctors focus on most for patients with Type 2 diabetes, in which the body’s insulin is no longer able to properly break down sugar (in the form of carbohydrates) from the diet. So, the question is, why, despite having been diagnosed with diabetes three years ago did Deen keep her disease from her viewers and continue to whip up rich foods on her show that were loaded in fat, sugar and calories?
Deen said that she decided not to make her diagnosis public until she could “bring something to the table when I came forward. I’ve always been one to think that I bring hope.”
For her, that hope apparently comes in the form of Victoza, a diabetes medication made by Novo Nordisk. Deen is now the spokeswoman for the drug. Deen and her sons, Jamie and Bobby, have also partnered with the drugmaker to promote the new Diabetes in a New Light program, which provides food tips and stress-management techniques as well as medical interventions for controlling diabetes.
“I was determined to share my positive approach and not let diabetes stand in the way of enjoying my life,” Deen said in a statement about the launch of Diabetes in a New Light.
There is something slightly unsavory about the fact that Deen has continued to advocate the type of unhealthy, fattening foods that contribute to obesity and, therefore, to Type 2 diabetes, only to step forward now as the pitchperson for a drug that is designed to treat that disease, which she herself has had in secret for years. As Anthony Bourdain, an outspoken critic of Deen’s cooking style, told Eater.com:
When your signature dish is hamburger in between a doughnut, and you’ve been cheerfully selling this stuff knowing all along that you’ve got Type 2 Diabetes… It’s in bad taste if nothing else. How long has she known? I suspect a very long time.
At the very least, as a cooking-show personality, why wouldn’t Deen simply focus on helping people with diabetes adjust their diets and eat healthier, rather than making money off a pill to control the condition? “As a celebrity cook or chef, I believe she could use her position to demonstrate the importance of dietary change in order to drive home the importance good nutrition,” says Dansinger. “I hope she doesn’t overlook the opportunity to try to improve her diabetes through dietary change and good role modeling.”
But giving Deen the benefit of the doubt, doctors also say that many patients have such high blood-sugar levels that they may need medication to control their glucose first, before dietary changes and exercise can help. It’s not clear why Deen herself needs the drug, but doctors say it’s possible that the medication is necessary to help her avoid more severe complications such as kidney failure and eye diseases, which can occur if diabetes goes untreated.
Despite her defense of artery-clogging southern cooking, however, we don’t know that Deen even eats the same high-fat foods she sells to her viewers. “You know, people see me on TV two or three times a day and they see me cooking all these wonderfully Southern, fattening dishes. That’s only 30 days out of 365,” she said. “And it’s for entertainment.”
“We have to remember that these are celebrities,” says Brown-Riggs. “It’s a show. It’s entertainment. It’s over the top. It doesn’t necessarily mean that this is the way she actually eats, that this is her reality.”
In fact, Deen says she is now walking on a treadmill every day and has cut back on her sweet tea habit, and will soon be offering lighter versions of her traditional recipes for her fans. Her son Bobby, who has appeared on her show to cook healthier dishes centered around fish and seafood, has also launched a new show called “Not My Mama’s Meals” on the Cooking Channel that will promote lower-fat versions of his mother’s meals.
But any pointers from Deen or her family might get a bit harder for her fans to swallow. Perhaps University of Pennsylvania bioethicist Art Caplan put it best in his recent column for MSNBC: “[G]iven her lack of ethics about what foods she has promoted in the past and a lack of honesty about a disease known to be closely tied to those very foods, I certainly would be extremely wary about following her advice about either what to cook or what medicines to take in the future.”