the city politic

New York’s Overlooked Epidemic

The diabetes crisis deserves far more attention than the mayor’s branzino.

A patient receiving dialysis treatment at a clinic in New York. Photo: Seth Wenig/AP/Shutterstock
A patient receiving dialysis treatment at a clinic in New York. Photo: Seth Wenig/AP/Shutterstock

It’s too bad Mayor Eric Adams fibbed and flubbed the rollout of one of his most important initiatives, the battle against the overlapping epidemics of obesity, diabetes, and hypertension that are killing New Yorkers by the thousands every year. By not being honest about the fact he occasionally cheats on his plant-based vegan diet by eating fish, the mayor muddled the main message: that a rising tide of preventable sickness and death was devastating communities of color, even before the COVID pandemic made things much worse.

Faced with reports from restaurant workers who’d seen Adams order and eat fish, the City Hall press office at first denied it, before Adams acknowledged being “perfectly imperfect” on the subject. New York’s political press corps, predictably, focused on the simple story on the surface — look, the mayor lied! — but failed to report on the deeper crisis that has swamped Black and Latino communities.

As long as a decade ago, city officials declared diabetes an epidemic, noting that the disease killed 5,695 people in 2011 — about 16 deaths every single day, or one every 90 minutes. The grim numbers have continued to soar since then: An estimated 975,000 New Yorkers have type 2 diabetes, and 19 percent of them don’t even know it, according to New York City Health Department, which also emphasizes the disease “can cause blindness, end-stage renal disease — which may require dialysis — and lower-extremity amputations in adults.”

Black and Latino neighborhoods throughout the five boroughs are peppered with storefront dialysis clinics, where victims of the epidemic are waging a losing battle against kidney failure. Bronx-based community health activist Chris Norwood noted in a 2018 report that over an eight-year period, New York City saw a 55 percent increase in foot amputations among diabetes patients.

A dialysis center in Brooklyn. Photo: Braulio Jatar/SOPA Images/Shutterstock

The crazy thing is that this epidemic is preventable. Type 2 diabetes is a “lifestyle” disease, meaning it can be halted or even reversed in a surprisingly short amount of time by changing one’s diet and exercise habits. In his book called How Not to Die — often cited by Adams — Dr. Michael Greger points out that people he treated, who’d suffered from diabetes for decades, restored normal blood-sugar levels and were able to drop the insulin altogether after only a couple of weeks on a plant-based diet.

Adams discovered this firsthand in March 2016, when he began going blind due to high levels of blood sugar that damaged the blood vessels behind his eyes. Years of working midnight shifts for the NYPD and scarfing down junk food had taken their toll.

“Like all Americans who struggle with chronic pain, I soldiered through. I convinced myself that feeling unwell was just a natural by-product of aging,” Adams writes in his book Healthy at Last. “It was only a matter of time before I succumbed to the ‘Black package,’ as my family likes to call it: diabetes, high cholesterol, and high blood pressure. When I received my diabetes diagnosis, my mom was taking at least four pills per day: one pill to lower her blood sugar, another for her cholesterol, and two more for blood pressure. And at age 56, it was my turn.”

But fatalism gave way to fact-finding. Adams visited the renowned Cleveland Clinic and on the advice of Dr. Caldwell Esselstyn, shifted to a plant-based, whole-foods diet, cutting out meat, dairy, and processed meals in favor of fresh fruit, vegetables, beans, nuts, unsweetened tea, and other foods that are free of added sugar, salt, and fats. Within weeks, he’d lost 35 pounds and saw his blood-sugar levels drop to healthy levels, leaving no trace that he’d ever had diabetes.

The horrors of sickness, blindness, kidney failure, amputation, and death can be prevented with a simple change in diet and a bit of exercise. That, and not the mayor’s occasional nibbling on fish, is the story that needs to be told.

As Brooklyn borough president, Adams funded a pilot program at Bellevue Hospital to help diabetes patients attack the disease through lifestyle changes. As mayor, he is expanding the program to other public hospitals. That’s a great start, but the scale of the epidemic demands a broad public campaign that isn’t limited to a hospital setting.

I, for one, would like to hear more about the diet and eating habits of Eric Adams. Not because we need more “gotcha” moments to illustrate that politicians often exaggerate (we don’t), but because, like COVID, fighting the diabetes epidemic requires sustained, thoughtful communication with the public.

There’s no quick or easy way to inform and convince every New Yorker, especially the nearly 1 million diabetics among us, that they can reduce or even reverse the disease by methodically replacing bad meals with healthy ones.

One myth — which Adams, unfortunately, has given some oxygen to — is the idea that following a vegan diet is some towering, near-impossible task. That’s silly. Systematically choosing plant-based, unprocessed whole foods whenever possible is a good idea, and progress, not perfection, should be the goal.

“No question, a whole-food, plant-based diet is the best way to go. But you don’t have to do it this very minute,” Adams writes in his book. “In fact, I never encourage people to go cold turkey (or tofurkey as plant-based folks like to say) unless they really want to, of course. … Changing your diet is a learning process, the goal being not just to eat better but to become smarter about your life’s choices.”

Amen to that.

I would love to see City Hall promote a string of success stories — New Yorkers explaining how they dropped weight, reversed diabetes or heart disease, and discovered the joys of eating better, feeling healthy, and tossing their insulin needles in the trash forever. It might not be as much fun as finding a waiter who caught the mayor munching on branzino, but it’s a story that at least a million New Yorkers need to hear.

And who knows? Perhaps, at some point, reporters, editors, and producers around the city might wake up and realize that thousands of New Yorkers dying unnecessarily every year is a story worth following up on.

New York’s Overlooked Diabetes Epidemic Is the Real Scandal