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Barnes and... A Conversation with Dan Hurley

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Steve Barnes speaks with Dan Hurley about his book "Diabetes Rising".  Hurley, who is a diabetic,  talks about how diabetes has increased within our society and has become a world pandemic.

TRANSCRIPT

HELLO AGAIN, EVERYONE. THANKS VERY MUCH FOR JOINING US. IT IS TEMPTING TO THINK OF DIABETES IN ARKANSAS AS A TICKING TIME BOMB, BUT IN FACT, THE BOMB'S ALREADY GONE OFF, AND IT CONTINUES TO EXPLODE AT ENORMOUS COST TO THE PUBLIC AND THE PRIVATE SECTOR. THERE IS, OF COURSE, ALSO THE PERSONAL COSTS, BLINDNESS, DISEASE, KIDNEY FAILURE, AMPUTATION, DEATH. THE STATE HEALTH DEPARTMENT CALLS IT AN EPIDEMIC. IN LESS THAN TWO DECADES, THE NUMBER OF DIAGNOSED CASES OR CLASSIFIED CASES OF DIABETES IN ARKANSAS ROSE BY ALMOST 44%. IT'S ESTIMATED THAT 372,000 ADULT ARKANSANS HAVE DIABETES AND PERHAPS AS MANY AS HALF OF THOSE ARE NOT RECEIVING ANY TREATMENT WHATSOEVER. ARKANSAS, IN FACT, HAS BEEN ABOVE THE NATIONAL AVERAGE IN DIAGNOSED DIABETES CASES IN EACH OF THE PAST 15 YEARS. IT IS DIABETES THAT BRINGS DAN HURLEY TO ARKANSAS, AND DAN HURLEY, MEDICAL JOURNALIST, THANKS SO MUCH FOR COMING AND TO DISCUSS YOUR WORD, "DIABETES RISING", HOW A COMPARATIVELY RARE DISEASE BECAME A NATIONAL PANDEMIC. YOU ARE FOCUSING ON DIABETES 1 AND 2.

YES.

STEVE BARNES: IF DIABETES IS NOT PECULIAR TO ARKANSAS, NOT RESTRICTED TO ARKANSAS, IF IT IS ESPECIALLY ACUTE IN ARKANSAS, IT IS HARDLY RESTRICT TODAY ARKANSAS. WE ARE TALKING ABOUT A REGIONAL AND EVEN NATIONAL --

BY PANDEMIC, I AM TALKING ABOUT THE WHOLE WORLD. STRANGE TO IMAGINE THAT INDIA AND CHINA, WHERE WHEN I WAS A KID IN THE '60s, THEY WOULD SAY FINISH YOUR PEAS THERE. THEY'RE STARVING IN INDIA. NOW THOSE TWO COUNTRIES HAVE MORE PEOPLE WITH DIABETES THAN ANYWHERE IN THE WORLD. IT'S RISING IN AFRICA, EVERYWHERE AROUND THE WORLD.

STEVE BARNES: THIS IS NOT SOME ABRUPT, SUDDEN MANIFESTATION OF A GENETIC FLAW THAT IS ONLY MAKING ITSELF KNOWN IN THE 21ST CENTURY?

DAN HURLEY: OF COURSE NOT. IT'S THE WAY WE LIVE TODAY. BUT WHAT HAS HAPPENED -- YOU KNOW, IT REALLY WAS RARE -- A HUNDRED YEARS AGO WAS ABOUT THE TIME THAT DIABETES REALLY STARTED INCREASING WITH THE RISE OF MODERN CULTURE.

STEVE BARNES: YEAH, I STARTED TO SAY, IF I MAY INTERRUPT, I'M OVER 30. WHEN I WAS IN HIGH SCHOOL, I COULD SCARCELY -- I MAY HAVE HAD ONE CLASSMATE, AND I KNEW PERHAPS OF ONE PARENT IN MY CIRCLE WHO HAD DIABETES. AND NOW IT IS -- IT'S A CONSTANT IN OUR CULTURE.

DAN HURLEY: YOU CAN'T WALK THROUGH A TOWN ANYWHERE WITHOUT SEEING WHAT'S CAUSING THIS. IF YOU JUST LOOK AT THE AVAILABILITY OF FOOD, THE NUMBER OF RESTAURANTS. WHEN I WAS A KID, GOING TO A RESTAURANT WAS OH, THIS BIG THING. I REMEMBER WHEN THE FIRST McDONALD'S CAME TO TOWN, AND THAT WAS WOW, THIS COOL PLACE.

STEVE BARNES: WE'VE ARRIVED.

DAN HURLEY: WE HAVE ARRIVED SPOP IT'S KIND OF LIKE --

DAN HURLEY: SO IT'S KIND OF LIKE HUMANITY'S WISH FOREVER TO BE ON THE LAND OF MILK AND HONEY HAS COME TRUE, AND DIABETES IS THE CATCH.

STEVE BARNES: WHAT ABOUT THE DIABETES THAT IS NOT NUTRITIONALLY -- IF THAT'S THE PROPER WORD -- INDUCED, IN OTHER WORDS, MUCH OF TYPE 1 IS --

DAN HURLEY: AND ACTUALLY, TYPE 2 DIABETES, ALTHOUGH PEOPLE THINK OF IT AS JUST ABOUT FOOD, IT DOES RUN IN FAMILIES REALLY STRONGLY, SO THERE'S A VERY STRONG GENETIC RISK. IF YOUR PARENT, IF YOUR UNCLE, IF YOUR SIBLINGS HAVE TYPE 2 DIABETES, YOU'RE MUCH MORE LIKELY TO GET IT THAN SOMEONE WHO DOESN'T. SO IT ABSOLUTELY HAS MUCH TO DO WITH THE FAMILY YOU HAPPEN TO BE BORN INTO. BUT TYPE 1 DIABETES IS -- I ACTUALLY HAVE TYPE 1 DIABETES. THIS IS WHAT IS CALLED JUVENILE DIABETES. AND WHAT IS REALLY STRANGE IS THAT THAT IS ALSO INCREASING AND HAS BEEN INCREASING JUST AS FAST AS TYPE 2 DIABETES, AND THAT'S NOT BECAUSE PEOPLE ARE OVEREATING.

STEVE BARNES: WHY? ARE THERE CLUES? ARE THERE ESTABLISHED REASONS?

DAN HURLEY: TYPE 1 LOOKS LIKE SOME OF THE SAME KINDS OF CHANGES THAT ARE GOING ON IN OUR MODERN SOCIETY ARE AFFECTING IT, SO FOR INSTANCE, THE LACK OF TIME THAT PEOPLE SPEND OUTSIDE IS GETTING THEM LESS EXPOSURE TO SUNSHINE, WHICH VITAMIN D IS THE SUNSHINE VITAMIN, SO LOWER LEVELS OF VITAMIN D HAVE BEEN ASSOCIATED WITH AN INCREASED RISK OF TYPE 1 DIABETES.  EXPOSURE TO INFANT FORMULA, COW'S MILK, EVEN SO I MILK IN THE FIRST SIX MONTHS OF LIFE HAS BEEN ASSOCIATED WITH AN INCREASED RISK OF TYPE 1 DIABETES. SCIENTISTS ARE TRYING TO RUN THESE DOWN TO FIGURE OUT IS THIS REALLY TRUE OR NOT. THERE'S MAJOR CLINICAL TRIALS GOING AROUND THE WORLD SO NOBODY IS SAYING TAKE THAT BABY FORMULA AWAY FROM YOUR BABY YET, BUT THERE IS -- OBVIOUSLY, WHEN TYPE 1 DIABETES IS NOW FIVE TIMES MORE COMMON THAN IT WAS 50 YEARS AGO, SOMETHING'S HAPPENED TO INCREASE IT. THE GENETICS HAVEN'T CHANGED.

STEVE BARNES: RIGHT. SO THE LIKELY INDICATORS WOULD APPEAR TO BE DEMOGRAPHIC SHIFTS, AS IN POPULATION TRANSFERS, IMMIGRATION, AND THE CULTURAL CHANGES THAT ARE REFLECTED AT THE NUTRITIONAL LEVEL -- ENVIRONMENTAL LEVEL, I GUESS.

DAN HURLEY: YEAH. DIABETES HAS BEEN ONE OF THE MOST CONFOUNDING, PUZZLING DISEASES TO PHYSICIANS FOR, ACTUALLY, THOUSANDS OF YEARS. DOCTORS IN INDIA THOUSANDS OF YEARS AGO WERE TRYING TO FIGURE OUT WHAT THE HECK CAUSED IT. IT WAS ALWAYS VERY MYSTERIOUS. IN THE MIDDLE AGES, THEY CALLED IT -- BECAUSE PEOPLE WOULD URINATE A LOT, THEY CALLED IT -- MAY I SAY -- THE PISSING EVIL. AND THIS WAS ONE OF THE HALLMARK SYMPTOMS OF IT. SO THEY'VE KNOWN FOR A LONG TIME THAT IT HAD TO DO WITH WEIGHT, BUT IT'S ONLY IN RECENT YEARS THAT THAT MORE HAS BEEN FIGURED OUT ABOUT IT.

STEVE BARNES: WELL, IS IT STILL THE CASE, AS IT IS WITH SO MANY DISEASES, MALADIES, THAT WE STILL -- DESPITE THE SURGE IN RESEARCH -- THAT WE STILL KNOW LESS ABOUT IT THAN -- WE DON'T KNOW WHAT WE DON'T KNOW.

DAN HURLEY: YEAH, ONE OF THE REALLY INTERESTING THINGS ABOUT TYPE 2 ALREADY GOING BACK TO TYPE 2, THE KIND THAT NINE OUT OF TEN PEOPLE WITH DIABETES HAVE, IS THAT, YOU KNOW, THIS SURGERY, BARE YAT RICK SURGE -- WE ARE YAT RICK -- BARIATRIC SURGERY TO CHANGE YOUR STOMACH SO YOU ARE GOING TO LOSE WEIGHT, IT'S NOW BEING CALLED DIABETIC SURGERY BECAUSE FASTER THAN YOU LOSE WEIGHT -- IN FACT, ALMOST WITHIN DAYS OF GOING THROUGH THIS SURGERY -- YOUR NEED FOR DIABETES MEDICATION DISAPPEARS. EVEN BEFORE YOU'VE LOST ANY WEIGHT. SO THERE'S CLEARLY A HORMONAL THING, HORMONES RELEASED BY YOUR STOMACH IN RESPONSE TO EATING THAT HAVE TO DO WITH TYPE 2 DIABETES. IT'S A REALLY COMPLICATED THING, AND YOU WOULD EXPECT IT TO BE COMPLICATED BECAUSE YOUR BODY HAS NO BIGGER JOB THAN SORT OF KEEPING YOU ALIVE IN RESPONSE TO EATING. AND THE BODY WANTS TO HOLD ON TO ALL THE SUGAR THAT YOU EAT, SO IT'S GOT LOTS OF WAYS TO HANG ON TO THAT STUFF, AND THE PROBLEM IS WHEN YOU'RE TRYING TO GET RID OF DIABETES, IT'S LIKE SQUEEZING A BALLOON. IT'S VERY HARD FOR THE ORDINARY PERSON JUST TRYING TO EAT LESS TO MAKE IT GO AWAY.

STEVE BARNES: IS SUGAR THE BIG VILLAIN?

IT'S REALLY NOT SUGAR SO MUCH. A LOT OF PEOPLE WILL TALK ABOUT SUGAR, AND CERTAINLY IF YOU EAT SOMETHING EXTREMELY SWEET, YOUR SUGAR CAN SPIKE UP. BUT IT'S ALL ABOUT AMOUNT. SO IF YOU EAT TWO BANANAS AND YOU HAVE DIABETES, IT'S REALLY ABOUT HOW MUCH SUGAR IS IN THAT FOOD AND HOW MUCH OF IT DO YOU EAT.  SO IF YOU HAVE A FEW SPOONFULS OF ICE CREAM OR YOU HAVE ONE TASTE OF THAT PIE, THAT'S NOT A BIG DEAL; WHEREAS, IF YOU EAT THREE PIECES OF BREAD WITH DINNER AND EVERY TIME I HAVE AN ITALIAN DINNER WITH A BUNCH OF FRENCH BREAD, YOU KNOW, YOU END UP GETTING HIGH BLOOD SUGAR BECAUSE IT'S VERY HARD TO SAY NO TO THAT. AND YOU KNOW. WE'VE ALL BEEN THERE.

STEVE BARNES: WELL, YES, WE HAVE. BUT IT'S NO COINCIDENCE, ONE WOULD SUSPECT, THAT AT LEAST THE SURGE -- I TAKE IT TO BE A SURGE -- IN OBESITY LEVELS IN THIS COUNTRY, WHICH IS CERTAINLY EPIDEMIC, IF NOT PANDEMIC. IT'S NOT GLOBAL. THERE'S A STRIKING CORRELATION.

DAN HURLEY: THERE CERTAINLY IS. THERE'S NO QUESTION THAT THE BOTTOM LINE, THE THING THAT'S DRIVING THE INCREASE IN DIABETES IS THE INCREASE IN WEIGHT, AND THE THING THAT'S DRIVING THAT IS THE CHEAPER FOOD, LESS REASON TO GO OUTSIDE. I MEAN, LISTEN, 20 YEARS AGO THERE WERE NO -- PEOPLE WEREN'T PLAYING TOO MANY VIDEO GAMES. THERE WAS NO INTERNET TO SIT AROUND AND PLAY. IT'S CRAZY TO THINK THAT JUST 20 YEARS AGO THERE WAS -- THERE REALLY WAS NO INTERNET FOR THE AVERAGE PERSON. SO ALL THESE KIDS WHO ARE PLAYING WITH THEIR CELL PHONE, GOING ON THE INTERNET, THEN PLAYING THEIR VIDEO GAMES, NONE OF THAT EXISTED JUST 20 YEARS AGO. THERE WAS TV, BUT HOW MUCH TV WOULD A KID SIT AND WATCH? SO PEOPLE ARE SPENDING LESS TIME OUTSIDE. THEY ARE SPENDING MORE TIME INSIDE. WE GO TO RESTAURANTS ALL THE TIME, WHERE PEOPLE TEND TO EAT MORE. AND FOOD IS SO MUCH LESS EXPENSIVE THAN IT USED TO BE THAT YOU CAN BUY A BAG OF CHIPS FOR THE SAME TODAY THAT YOU COULD HAVE BOUGHT IT FOR 25 YEARS AGO. IT'S STILL ABOUT 75 CENTS. IT WAS 75 CENTS 20 YEARS AGO

STEVE BARNES: WELL, PHYSICIANS WITH WHOM I'VE DISCUSSED THE MATTER OF OBESITY CALL IT SCREEN TIME.

DAN HURLEY: YEAH.

STEVE BARNES: TELEVISIONS, COMPUTERS, NOW THERE'S MOBILE THINGS. AND THEY ALSO RECORD SEEING A LOT OF VITAMIN D DEFICIENCY IN KIDS. SCREEN RESOLUTION ISN'T TERRIFIC OUTSIDE. INSIDE WORKS PRETTY WELL. I THINK THAT'S QUITE OMINOUS. THEY ALSO NOTE THAT IN MANY FAST -- I DON'T WANT TO SINGLE ONE OUT -- BUT IN MANY FAST-FOOD ESTABLISHMENTS, THEY CONTINUE TO INCREASE THE SIZE OF THE SERVING.

DAN HURLEY: BECAUSE IT'S SO INEXPENSIVE FOR THE RESTAURANT TO DO THAT. THE FOOD COST TO THE RESTAURANT IS SO LOW THAT THEY MIGHT AS WELL JUST GIVE YOU MORE TO GET YOU TO STAY LONGER AND GET YOU TO BUY MORE. SO IT'S A GREAT STRATEGY FOR THEM. YOU KNOW, MUCH OF WHAT WE ARE TALKING ABOUT -- I THINK MANY OF YOUR VIEWERS HAVE HEARD THAT OBVIOUSLY, BE CAREFUL. AND THE IMPORTANT MESSAGE THAT I'VE LEARNED FROM RESEARCHING THE TOPIC AND TALKING TO A LOT OF PEOPLE IS THAT JUST PREACHING TO PEOPLE TO STOP EATING SO MUCH AND TO GET OUTSIDE MORE AIN'T WORKING BECAUSE PEOPLE HAVE BEEN DOING THAT. WE ALL KNOW THAT. I KNOW THAT. YOU KNOW THAT. EVERYBODY WATCHING THIS KNOWS THAT THEY SHOULD EAT LESS AND GET OUT MORE, AND THAT'S OLD SCHOOL. THE PROBLEM IS IT'S HARD TO DO. SO THE NEW STRATEGY THAT'S EMERGING NOW IS TO MAKE THIS A PUBLIC HEALTH ISSUE, THAT IT'S PART OF A COMMUNITY'S EFFORT TO WORK TOGETHER TO SOLVE THESE AS A SOCIETY. AND JUST LIKE IN THE BIG HEALTHCARE BILL THIS YEAR, ONE OF THE LITTLE NOTICED FEATURES OF IT WAS THAT THEY ARE GOING TO REQUIRE THAT THE CALORIES OF EVERYTHING THAT YOU EAT AT A CHAIN RESTAURANT IS GOING TO BE PRINTED ON THE MENU THE SAME SIZE, AND PEOPLE ARE GOING TO JUST GET THAT INFORMATION RIGHT WHEN THEY'RE MAKING THAT CHOICE. AND THAT CAN BE A REALLY POWERFUL THING.  SO THERE'S A LOT AT WORK FROM THE NATIONAL LEVEL AND PUBLIC HEALTH PEOPLE AND EVEN POLITICIANS TO TRY TO TAKE THIS ON AS A CHALLENGE TO HEALTH. JUST LIKE 150 YEARS AGO, WE HAD COMMUNICABLE DISEASES, MEEZLESS, MUMPS, ALL THE THINGS THAT WERE GOING ON WHEN PEOPLE DIDN'T KNOW WHAT TO DO WITH THE SEWER SYSTEM. AND THEY STARTED SAYING HEY, LET'S GET THE SEWER WATER OUT OF YOUR DRINKING WATER, AND LET'S START SETTING UP SANE PUBLIC HEALTH POLICIES. AND IT MADE A HUGE CHANGE 100, 150 YEARS AGO. THIS IS THE NEXT CHALLENGE FOR PUBLIC HEALTH.

STEVE BARNES: THERE IS, THOUGH, POLITICAL AND I THINK, DARE I SAY, CULTURAL RESISTANCE TO WHAT IS SOMETIMES REFERRED TO AS THE COMING OF THE NANNY STATE.

DAN HURLEY: THE NANNY STATE. AGAIN, THIS IS NOT ABOUT PREACHING TO PEOPLE. I THINK WHEN PEOPLE FIRST HEAR THIS IDEA, THEY'RE IMAGINING THAT SOME LADY WITH HORN-RIMMED GLASSES IS GOING TO BE SITTING THERE WAGGING HER FINGER AT YOU AND TELLING YOU WHAT TO DO AND WHAT NOT TO DO. AND THAT'S REALLY NOT WHAT IT'S ABOUT. IT'S REALLY USING, YOU KNOW -- WE'RE ALREADY -- WE'VE ALREADY CREATED THIS SOCIETY; RIGHT? WE'VE CREATED A SOCIETY IN WHICH CHIPS ARE CHEAPER THAN FRUIT AND VEGETABLES TO BUY SOME DELICIOUS FRUITS AND VEGETABLES. IT'S ACTUALLY -- WHAT IS IT? $3, $4 TO GET A NICE -- A POUND OF ASPARAGUS? FOR $3 OR $4, YOU COULD HAVE A MEAL AT McDONALD'S. SO THESE KINDS -- AND THERE'S A GREAT TAX INCENTIVE TO A LOT OF THESE MAKERS OF CORN AND WHEAT GET TAX BENEFITS, AND WHERE THE FRUIT AND VEGETABLE PEOPLE ARE NOT GETTING SO MUCH. SO IT'S REALLY ABOUT REPRIORITIZING AND SAYING WAIT A MINUTE. IF WE ARE IN A CULTURE WHERE IT'S NOW PREDICTED ONE IN THREE KIDS WHO WAS BORN TEN YEARS AGO IN THEIR LIFETIME IS GOING TO DEVELOP DIABETES, ONE-THIRD OF KIDS ARE GOING TO DEVELOP DIABETES, THIS IS CRAZY. THIS IS REVERSING OUR LIFE SPAN. THERE ARE STATES WHERE THE LIFE SPAN IS NOW TURNING BACK BECAUSE OF DIABETES. IT'S THE MOST BORING DISEASE IN THE WORLD, AND IT'S NOT LIKE CANCER THAT PEOPLE GET SO EXCITED ABOUT, WHICH SEEMS LIKE A BATTLE, A WAR AGAINST CANCER. BUT IT IS SLOWLY ROBBING US OF OUR LIVES, AND IT'S TIME -- YOU KNOW, REALLY, AS A COMMUNITY -- FOR PEOPLE TO GET TOGETHER AND SAY HEY, HOW CAN WE DEAL WITH THIS, INSTEAD OF JUST PREACHING TO PEOPLE LIKE IT'S THEIR FAULT.

STEVE BARNES: OBESITY WOULD SEEM, FOR OBVIOUS REASONS, NOT TO HAVE MUCH CAMERA APPEAL. DURING THE ROOSEVELT ERA, WHEN WE FIRST STARTED TO ATTACK POLIO, WE HAD THE MARCH OF DIMES, THESE HEART-RENDERING PICTURES OF THESE CHILDREN HOBBLING ALONG. HOW DO WE MAKE -- I HATE TO SAY IT -- PUT IT THIS WAY. HOW DO WE MAKE OBESITY AND DIABETES SEXY? HOW CAN WE REV UP AND MAKE THIS TRULY A PUBLIC HEALTH ISSUE, ENGAGE THE PUBLIC?

I TELL YOU, I'VE REALLY BEEN TOUCHED BY MEETING SO MANY PEOPLE WITH -- I HAVE TYPE 1 DIABETES, WHICH IS A REAL PAIN, BUT I THINK SOMETHING WHICH EVERY PERSON WITH DIABETES KNOWS IS THE GUILT AND BEING TOLD IF ONLY YOU WOULD TAKE CARE OF YOURSELF BETTER. EVERYBODY SAYS THAT. AND I THINK ANYONE WATCHING THIS HAS FELT EITHER THEY KNOW SOMEONE WITH THE DISEASE, AND THEY THINK THEY KNOW WHAT THAT PERSON SHOULD DO, AND THEY THINK IT'S SO EASY. WHY WON'T THAT PERSON DO IT? AND YOU KNOW WHAT? IN A COUNTRY OF -- WHAT IS IT? -- 300 MILLION PEOPLE WITH ONE-THIRD HEADING TOWARD DIABETES, IF IT WAS SO EASY TO CHANGE, PEOPLE WOULD DO IT. SO THERE'S A PROBLEM IN OUR -- IT'S OUR ENVIRONMENT. IT'S OUR FOOD AND LEISURE ENVIRONMENT. IT'S OUR WORK ENVIRONMENT. AND IT'S THE ENVIRONMENT THAT HAS TO CHANGE. IT'S THE ENVIRONMENT THAT HAS BROUGHT US WHERE WE ARE. PEOPLE DIDN'T WAKE UP BEGINNING LAST YEAR AND SAY HEY, I FEEL LIKE GETTING TOO FAT. THEY DIDN'T DO THAT. PEOPLE STRUGGLE WITH IT. NOBODY WANTS TO BE UNHEALTHY.

YOU TALKED ABOUT THE ECONOMICS OF THE OBESITY PROBLEM AND, BY EXTENSION, THE DIABETES PROBLEM, NOTING THAT IT IS FAR, FAR CHEAPER TO EAT POORLY THAN TO EAT SMART AND TO EAT A HEALTHY DIET. HOW DO WE GO ABOUT -- HOW COULD YOU ALTER THE ECONOMICS OF THE SITUATION? OR IS THAT EVEN POSSIBLE?

WELL, IT IS. A LOT OF THESE -- THERE'S A LOT OF STRATEGIES THAT PUBLIC HEALTH PEOPLE ARE BORROWING FROM CIGARETTES, SEAT BELTS, YOU KNOW, THERE'S A STORY ON THE FRONT PAGE OF USA CALIFORNIA TODAY JUST TODAY, WHEN WE'RE -- USA TODAY JUST TODAY WHEN WE'RE SPEAKING NOW ABOUT TRAFFIC DEATHS ARE AT AN ALL-TIME LOW. YOU KNOW, BACK IN THE '60s, BEFORE THEY STARTED MACHING CARS SAFER, THEY USED TO DO THE SAME THING. THE AUTO MANUFACTURERS WOULD BLAME THE DRIVERS. HEY, WHY ARE YOU DRIVING SO UNSAFELY? AND THEN FINALLY IT DAWNED ON PEOPLE, THROUGH A LOT OF POLITICAL PRESSURE, THAT YOU HAD TO MAKE CARS SAFER. SO FOR INSTANCE, SOFT DRINKS. SHOULD SWEETENED SODAS -- SHOULD EVEN ORANGE JUICE, WHICH IS JUST AS SWEET -- SHOULD THAT BE IN A KID'S SCHOOL? DO THEY REALLY NEED THAT? OR DO THEY -- SHOULDN'T THEY JUST HAVE WATER? WHAT ABOUT ALL THOSE COMMERCIALS THAT ARE ON TV? YOU CAN'T PUT A CIGARETTE COMMERCIAL ON TV ANYMORE. WHY ARE THERE STILL COMMERCIALS ADVERTISING ALL THESE FOODS, ESPECIALLY THESE FOODS ON KIDS' SHOWS, WHERE YOU KNOW, LISTEN, I WAS THERE. I USED TO WATCH THOSE SHOWS, AND YOU KNOW, YOU'D TURN AROUND TO YOUR MOM, I WANT, YOU KNOW, SUGAR SMACKS OR WHAT USED TO BE CALLED SUGAR POPS AND ARE NOW CALLED CORN POPS. SO THERE ARE A LOT OF TOOLS. THERE'S ADVERTISING, THERE'S TAXES, MANY STATES ARE CONSIDERING PUTTING A TAX ON SWEETENED DRINKS. THERE IS THE RESTAURANT MENU LABELS, WHERE YOU CAN PUT THE CALORIE COUNTS ON THERE, WHICH IS GOING TO WAKE PEOPLE UP AND, AT THE EXACT SAME TIME, WILL GET THE RESTAURANT MAKERS TO MAYBE LOWER THE CALORIES OF SOME OF THESE PRODUCTS. THERE IS -- JUST EVERY BUILDING, EVERY OFFICE BUILDING IN THIS COUNTRY -- HAVE YOU EVER LOOKED AT THOSE STAIRWAYS? AND WE ALL LOOK AT THE STAIRS, THE DOOR TO THE STAIRS, AND WE GO IF I OPEN THAT DOOR, IS AN ALARM GOING TO GO OFF? AND THEN YOU THINK YOU ARE GOING TO WALK IN THAT DOOR, YOU ARE GOING TO WALK UP ONE LEVEL, AND YOU ARE NOT GOING TO BE ABLE TO GET IN THE NEXT LEVEL. SO STAIRS HAVE BECOME THIS, GEE, IT'S JUST AN EMERGENCY THING. IT'S JUST SOMETHING THERE FOR AN EMERGENCY. WHAT ABOUT MAKING STAIRS INVITING? WHAT ABOUT MAKING THEM NICELY LIT? WHAT ABOUT HAVING CLEAR SIGNS? HEY, TAKE THE STAIRS. ALL THESE LITTLE THINGS. IT'S LITTLE THINGS THAT HAVE GOTTEN US INTO THIS PROBLEM. AND IT'S GOING TO BE THESE LITTLE MEASURES WORKING TOGETHER TO CHANGE OUR ENVIRONMENT AND MAKE IT SEEM LIKE BEING ACTIVITY AND EATING HEALTHFULLY IS THE NORMAL THING TO DO AGAIN.

STEVE BARNES: BACK TO FAST FOOD FOR A MOMENT, IF I MAY.

DAN HURLEY: SURE.

STEVE BARNES: SOME OF IT -- YOU MENTIONED ONE IN PARTICULAR, AND I THINK EVEN THAT PARTICULAR ONE -- AMONG OTHERS -- HAS INDICATED THAT -- OR PROFESSES TO BE MAKING MENU CHANGES AT A MINIMUM OFFERING LESS CALOREIC OR LOWER-FAT OPTIONS. THE PERFORMANCE OF THE FAST-FOOD INDUSTRY IN RESPONSE TO THIS OBESITY AND DIABETES PROBLEM, ARE YOU IMPRESSED BY IT?

DAN HURLEY: WELL, YOU KNOW, BURGER KING SELLS A VEGGIE BURGER, WHICH I GET. I LOVE THAT. McDONALD'S AND SOME OF THE OTHER PLACES NOW HAVE THE LITTLE APPLE SLICES THAT YOU CAN GET. THOSE ARE GREAT. I GET THEM. YOU KNOW, THERE'S NO REASON IS TO MAKE FAST FOOD -- TO DEMONIZE THEM. OBVIOUSLY, PEOPLE WANT THEM. BUT YOU KNOW, THERE ARE TOWNS AND PLACES -- I WENT TO THIS COUNTY WITH THE HIGHEST LEVEL OF DIABETES IN THE COUNTRY. THIS IS LOGAN COUNTY, WEST VIRGINIA. AND THERE WERE 36 FAST-FOOD RESTAURANTS THAT I COULD COUNTY IN THIS SMALL, RURAL COUNTY. AND IT WAS ALMOST IMPOSSIBLE TO FIND ANY KIND OF NORMAL SIT-DOWN FAMILY RESTAURANT. AND I ALMOST HAD A FEELING OF IT BEING LIKE AN INVADING ARMY OF CORPORATE INTEREST WHO WERE SORT OF JUST SHOWING UP. AND OF COURSE PEOPLE LIKE THE FOOD. IT'S EASY TO LIKE IT. IT'S GREAT. THE PROBLEM IS NOT THAT IT DOESN'T TASTE GOOD. IT TASTES GREAT. NO, IT'S GREAT. IT'S GREAT-TASTING FOOD. PEOPLE LIKE IT. I THINK WHAT WE NEED TO DO, AS A SOCIETY, IS SAY IS THIS SAFE FOR US? IS THIS GOOD FOR US? IS THIS WHAT WE WANT FOR OUR CHILDREN AND OURSELVES?

STEVE BARNES: BIG POLITICAL DISPUTE IN ARKANSAS, AMONG OTHER STATES, OVER THE MATTER OF BODY MASS INDEX MEASURING IN THE PUBLIC SCHOOLS. IS IT WORTH IT? IS IT WORTHWHILE? IS IT VALUABLE?

DAN HURLEY: WELL, I MEAN, I DON'T KNOW IF THEY NEED TO MEASURE IT, BUT I DO KNOW THAT KIDS NEED MORE TIME PLAYING. AND THEY NEED MORE TIME GOOFING OFF. THEY NEED MORE TIME DOING PHYSICALLY STRENUOUS ACTIVITIES. THERE ARE HIGH SCHOOLS WHERE -- IN THIS COUNTRY WHERE PHYS ED HAS BEEN RELEGATED TO SOMETHING YOU MIGHT DO FOR AN HOUR ONCE A WEEK. THERE ARE KIDS WHO GO THROUGH A WHOLE SCHOOL DAY -- ELEMENTARY SCHOOL KIDS WHO GO THROUGH A WHOLE SCHOOL DAY WITHOUT REALLY DOING ANYTHING PHYSICAL. THIS ISN'T RIGHT. THIS IS NOT -- THIS IS NOT NATURAL TO CHILDREN. THIS IS NOT WHAT CHILDREN NEED. AND YOU KNOW, IT WAS CALLED PHYSICAL EDUCATION. IT REALLY IS A KIND OF EDUCATION. KIDS NEED TO BE EXPOSED TO RUNNING AND DOING THINGS AND GETTING OUT AND GETTING AWAY FROM THE DARN SCREENS THAT THEY'RE PLAYING WITH. ATTENDANCE AT NATIONAL PARKS IS DOWN TO A REAL LOW OVER THE PAST 10 AND 20 YEARS. PEOPLE ARE JUST GETTING OUT LESS. AND THE PERFECT PLACE TO START THAT KIND OF ACTIVITY IS IN SCHOOLS. SO IF THEY WANT TO MEASURE THEM, YOU KNOW, WHATEVER, BUT I THINK THEY NEED TO SET ASIDE TIME FOR GETTING THEM MOVING.

STEVE BARNES: OUR GUEST HAS BEEN DAN HURLEY, AND THE BOOK IS "DIABETES RISING". DAN HURLEY, THANK YOU VERY MUCH FOR FOR YOUR TIME.

DAN HURLEY: THANKS FOR HAVING ME.

STEVE BARNES: AND THANK YOU FOR YOURS.

STEVE BARNES: AND THANK YOU FOR YOURS. WE'LL SEE YOU NEXT TIME.

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