Estimating the Impact of Medication on Diabetics’ Diet and Lifestyle Choices
Introduction
Often repeated diet and health recommendations from the public health community are to
increase consumption of fruits and dark green leafy vegetables, reduce intake of added sugars,
trans-fats, saturated fats, cholesterol, salt, and alcohol while maintaining bodyweight by aligning
caloric intake with one’s level of physical activity. The impetus for such advice is that scientific
evidence suggests obesity leads to an increased risk of premature death, type II diabetes, heart
disease, stroke, hypertension, gallbladder disease, osteoarthritis, and many other maladies (U.S.
Department of Health and Human Services, 2001). Regardless, recent statistics on obesity and
dietary intake show that the majority of Americans are far from complying with this advice: the
majority of Americans are overweight; approximately one third are obese; and the average diet is
too high in calories, added sugars and saturated fat. To meet the 2005 Dietary Guidelines, the
typical American would need to more than double their current intake of vegetables and whole-
grain foods while halving their intake of solid fats and added sugars (Hedley, et al., 2004; United
States Department of Health and Human Services and United States Department of Agriculture,
2005).
This increasing prevalence of obesity and diet-related illnesses begs the question why so many
people are putting themselves at risk of such serious illnesses. There must be something that
compensates for accepting such risks—a tradeoff that makes the risks worth accepting. Clearly,
many Americans still eat too much food and choose those that are too high in fat, salt refined
grains and added sugar. Given these strong preferences, the task the public health community