Before we discuss the vice president’s political prospects, we must first address the sacred cows in the chamber.
Contrary to recent claims from Donald Trump, JD Vance and Ted Cruz, Kamala Harris loves a good cheeseburger; she absolutely adores them. does not do wants to take away our red meat. It has singled out sugars and sodas as major culprits in our poor health. Moreover, the Biden-Harris administration has shown that it is not afraid to challenge the pharmaceutical industry’s stranglehold on insulin prices and the fees the industry charges Medicare patients for medications.
Next, let’s dispel the false narrative that Trump and his henchman Robert F. Kennedy Jr. have the ability to “make America healthy again.” As part of RFK Jr.’s recent endorsement, Trump promised to “appoint a panel of top experts, working with Bobby, to investigate the root cause of the decades-long rise in chronic health problems…” Kennedy, whose anti-vaccine work is more likely to give America a new case of measles, has recently become the darling of many metabolic health advocates for his series of half-truths about America’s obesity epidemic.
Let’s not kid ourselves. To paraphrase Harris, these are not serious people, and the consequences of putting America’s health care system in their hands would be deadly.
I happen to have type 2 diabetes, and for the past year I’ve been chronicling the ways in which one of the country’s deadliest, most expensive, and most prevalent diseases is reversible with a diet low in carbohydrates—the macronutrient that diabetics like me can’t safely process without the help of drug therapies. Nutrition in America has become quite politically polarizing, as shaky science often collides with ideology, leaving us confused about why we get fat, why we get sick, and even whether red meat causes diabetes (it does not doOur health care budget is $4 trillion per yearbut our life expectancy is only 48th in the world, and we seem to be getting heavier and sicker. Something is terribly wrong.
In this abyss lies a golden opportunity for presidential candidate Harris to present a health care agenda that would save thousands of lives, billions of dollars, and increase her appeal to voters in conservative states. She can do what no president has dared to do before: launch a national campaign to reverse America’s diabetes epidemic while improving our metabolic health. She could even declare the devastating disease a national emergency.
This initiative would be both good policy and good politics, and it is not as quixotic as it may sound at first. Type 2 diabetes is a condition in which the hormone insulin does not function properly, leading to high blood sugars and putting its sufferers at risk for heart disease, kidney disease, eye disease and other diseases. Currently, 38 million American adults have diabetes, while nearly 100 million more have prediabetes—or more than a third of American adults. At $420 billion a year, it is one of America’s most expensive diseases, accounting for more than 10 percent of the country’s $4 trillion annual health care budget. It kills more than 100,000 Americans each year, more than die from opioid overdoses.
And while it is true that people of color are more likely to have diabetes than white people, it is also true that, like the opioid crisis, diabetes is a colorblind disease that has disproportionately harmed red states in America. In fact, 14 of the 15 states with the highest rates are diabetes mortality rates voted Republican in 2020. And 14 of the 15 states with the lowest death rates voted Democratic in 2020.
What form should a Harris Initiative take? Here are my personal recommendations, based on my own experience with the disease and a year of interviews with over 100 researchers, clinicians, advocates, and patients. Frankly, it’s mind-boggling that this disease—which is killing us on a massive scale, outpacing our budget, and reversible by diet – is not yet a matter of national urgency.
1. First, she should announce her intention to appoint a diabetes czar whose job, among other things, would be to solve this puzzle — over the past quarter century, the American pharmaceutical and medical technology industries have made extraordinary strides in developing various forms of insulin and other drugs, continuous glucose monitors, and test strips. So why have seven times more Americans than were diagnosed with diabetes in 1980? Eventually, common sense solutions would emerge, such as limiting the ability of cereal makers to market their sweet treats to children.
Not only would the czar be given the power to crack down on issues like the scandalous $1 billion in sugar subsidies from American taxpayers, she would also explore healthy treatments for diabetes that focus on diet and lifestyle. (A good place to start would be the excellent book 2024 Turn Around Diabetes, written by endocrinologist Roshani Sanghani.)
2. We need to defund, disqualify, and otherwise delegitimize the American Diabetes Association (ADA). As I’ve written, the ADA has become a virtual arm of big pharma and the food industry. Yet it sets standards of care for clinicians and downplays mountains of evidence that the low-carb diet is a powerful tool for reversing the disease. It’s frankly astonishing that the world’s most powerful diabetes organization (2023 revenue: $145 million) has utterly failed to contain the disease, yet still sets the standards of care, controls research funding, and dictates the diabetes narrative in this country.
Late last year, the ADA was sued by its former nutrition director, alleging that she was fired for refusing to include the artificial sweetener Splenda, whose parent company donated $1 million to the ADA, in the ADA’s list of approved recipes. In one of the greatest tragedies in American health care, the ADA and the plaintiff, Elizabeth Hanna, settled before the facts about the ADA’s inner workings were revealed in a lawsuit. Regardless, the complaint is a scathing indictment of the organization and should be read by any clinician interested in how corporate donations have compromised the organization’s nutritional guidelines.
3. Perhaps most urgently, the federal government, including the National Institutes of Health, needs to expand its research budget to include researchers treating patients with low-carb and ketogenic diets. The past two decades have seen an explosion of courageous clinicians prescribing the low-carb diet to their patients, as well as at least two startups—Virta Health and OwnaHealth—showing promising results in treating diabetes and obesity with low-carb diets.
But because their research does not involve the search for the next blockbuster drug, researchers often do not have access to ADA, NIH, and big pharma research funding. They do not get prominent seats at pharmaceutical-funded conferences. This is a huge barrier to the low-carb diet becoming part of the medical mainstream, and in my opinion is responsible for the ongoing diabetes plague.
4. We need to give people who actually have diabetes a platform, especially those who have reversed their condition by taking control of their diet. Of all the misconceptions I’ve exposed in my diabetes reporting, the most common one is that the low-carb diet is too difficult for patients, especially low-income patients, to follow. Of course, it’s not easy to resist bread, sweets, rice, and starches, but it’s made even harder by the lack of a national consensus that these are the foods responsible for diabetes and obesity. Quitting smoking is also difficult, but when it was made a national requirement, smoking cessation dropped dramatically. In my experience, patients can change their behavior when they’re told the truth (“Stop eating carbs or your disease will get worse and you could die”). And they feel empowered.
Take the case of Jemia Keshwani, a 40-year-old woman from LaGrange, Georgia, who has had diabetes for 25 years and narrowly escaped amputation of her right foot after her doctor put her on a low-carb diet. She has lost 120 pounds (54 kg) and no longer injects insulin into her abdomen four times a day. “I didn’t understand that if you eat the right foods, you could change things,” she said. “You know how you feel helpless sometimes? Now I don’t feel that way anymore.”
Or the case of Ajala Efem, a 47-year-old woman from the Bronx, who, according to a recent article in Medscape, lost nearly 30 pounds and was off 15 medications after her healthcare provider, OwnaHealth in the Bronx, prescribed a low-carb diet.
“I went from being sick to feeling so good,” she told her endocrinologist. “My feet don’t hurt; I don’t have any pain; I eat as much as I want and I really enjoy my food.”
Last March, Harris asked an audience in Las Vegas how many people had family members living with diabetes. “There was a sea of hands going up,” she said. wrote on her Facebook page.
Harris clearly understands the diabetes plague and just needs a gentle nudge to make it a priority. So here’s a final word of loving advice. The next time she visits a state fair, she might consider eating one of those cheeseburgers she loves so much. It’s delicious, nutritious, and will make for a great photo op.
Leave out the ketchup and the bun.
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Neil Barsky, a former Wall Street Journal reporter and investment manager, is the founder of the Marshall Project