Paula Deen: Recipes (Victoza) for a Healthy Life

by Seema Jolly on January 20, 2012

I told myself that I wasn’t going to do a post about nutrition or food because, well, that’s what I spend all day, everyday thinking about (I study nutrition) and I recognize that most people don’t think about food and nutrition to the extent that I do.  But two days ago, I saw Paula Deen’s face plastered all over the news, read these headlines, “Chef Has Diabetes, and Some Say ‘I Told You So’ ” and “Paula Deen Hawks a Dubious Diabetes Drug,” and I couldn’t resist.

Paula Deen, the Food Network celebrity chef known for her love of butter and high fat recipes, went on the “Today” show on Tuesday to tell America that she has type two diabetes . . . and that she was endorsing the diabetes medication Victoza®, which is manufactured by Novo Nordisk.

According to the Centers for Disease Control and Prevention, “Type 2 diabetes can be prevented through healthy food choices, physical activity, and weight loss. It can be controlled with these same activities, but insulin or oral medication also may be necessary.”  Paula Deen is in a position to greatly influence the general public, and at this point, her primary focus is on endorsing Victoza®.

So now, the question is this:  What IS this $500 per month drug that has gotten extensive press coverage because of Paula Deen?

Victoza® (common name is liraglutide) was first approved for use in the United States in January 2010.  It helps manage diabetes by mimicking a hormone, glucagon like peptide 1 (GLP1), to release insulin from pancreas cells in the body.  Insulin is a hormone that helps glucose (sugar) leave the blood and enter cells, which then lowers your blood sugar.  Victoza® needs to be injected into the skin but only has to be taken once per day, with or without food.

A meta-analysis of different classes of diabetic drugs was conducted in 2010, which included 7 clinical trials of Victoza®.  All the clinical trials included between 165 and 1,041 patients.  This analysis found that Victoza® did significantly lower blood sugar in patients compared to a placebo, demonstrating the drug’s effectiveness for diabetes management.  However, the longest study conducted was 26 weeks, so we still don’t know the potential effects from long-term usage.

While clinical trials have proven the effectiveness of this drug to lower blood sugar, the Victoza® website also provides this warning:

“In animal studies, Victoza® caused thyroid tumors—including thyroid cancer—in some rats and mice. It is not known whether Victoza® causes thyroid tumors or a type of thyroid cancer called medullary thyroid cancer (MTC) in people which may be fatal if not detected and treated early.”

Along with the potential risk for adverse health effects, we shouldn’t forget that this type of diabetes treatment, at $500 (retail value) per month, is only accessible to certain populations who either can afford the medication or have appropriate insurance coverage to make this medication affordable.

Paula Deen, by virtue of her status as a celebrity, has the potential to influence how diabetes is framed in this country.  Other celebrities, such as Katie Couric, who spread awareness for colorectal cancer, and Magic Johnson, through his work with HIV/AIDS awareness, have also demonstrated the power of the “celebrity effect,” but their work has generally been viewed in a positive light.

There are many approaches to dealing with diabetes in this country.  Do we focus on prevention or do we focus on treatment?  Do we focus on lifestyle changes or do we focus on medication?  And what will be the implications from Paula Deen’s “celebrity effect” and endorsement of Victoza® for the management of type two diabetes?  I guess we’ll find out in the coming months . . .

Image from: http://commons.wikimedia.org/wiki/File:Paula_Deen_Civitan.jpg

Virginia Kendall January 20, 2012 at 11:46 am

Thanks, Seema, for your timely post. Celebrities can do lots of good by raising awareness. I am very disappointed in Paula Deen. Everyone has known all along that her fat-laden recipes were quite unhealthy. She has had a perfect platform for encouraging healthy cooking and eating. Instead, she has sold out to a drug company whose product is not proven, as you point out. Personally, I like receiving nutrition information. I believe many of our ills could be reduced or eliminated by dietary adjustments. That, however, requires discipline which many people lack. Taking a pill is so much easier.

Seema Jolly January 20, 2012 at 12:50 pm

Thanks for your comments, Virginia! So many of our health problems are very complex, but I certainly agree that our diet (and the role of our environment, social, cultural factors, etc.) play a really important role.

Alex Kloehn January 20, 2012 at 1:28 pm

Hey Virginia,

I just wanted to say that I too was frustrated with the way Paula Deen appears to be handling the situation. I was reading another article/critique and it seems like she had excuses for a lot of these concerns but I wasn’t impressed. Supposedly she has always preached “moderation” in the food that she cooks on her show. Being an avid food network viewer, I rarely if ever remember her making a statement about it. She also claims: “I’m a chef, not your doctor” as an excuse for why people shouldn’t necessarily be following her lead. The fact of the matter is that the food network does a decent job in varying their shows with healthful and not so healthful shows. As much as I wish all of the cooks/chefs would focus more on healthy eating, there is always going to be the profit driven market, especially for comfort food. It comes down to the fact that unfortunately, people have to be in charge of their own health first and foremost and they has to happen along side plenty of marketing and opportunity to be unhealthy.

michele brown January 23, 2012 at 12:48 pm

As a very well controlled type 1 diabetic of 39 years, I would like to share some insight and thoughts…

First of all, no one wishes for diabetes. But those of us who are diagnosed with it, have to make choices. And sometimes those choices require lots of discipline, courage, and perseverence.

Which is why I call diabetes a gift. It has truly challenged me and taught me so much about myself and life.

I must admit, I eat pretty healthy (not perfectly), run marathons, chase my kids, and really monitor my diabetes closely. I test my bloodsugar ten plus times a day and wear the insulin pump. Even with all that being said, I still have bad or challenging days. It is part of life. Part of diabetes.

I cannot speak for paula, but I can say that it took a lot of courage coming forth with her diagnosis. Yes, she hid it, but her brand/her company was so opposite of what diabetics are suppose to do. A brand she built from the ground up.

And now she will hopefully modify her brand and make it more diabetic friendly. In addition, she can speak on behalf of victoza. A good thing folks. Create awareness about diabetes. Get people to take their meds. Celebraties work. I, also, have done some work for novolog, another novo nordisk brand. I am not a celebrity. Rather a person living a great life with diabetes. I was proud to do the work and loved inspiring people. You can seem my videos on the novolog website. I did it from the heart. To encourage and inspire others. And I trust paula will do the same.

So give paula a break. Let her find peace with her diabetes and her brand. Instead, we should focus on creating awareness about diabetes and making sure all 26 million diabetics out there are getting the care and meds they need.

And paula…would love to cook with you anytime…

Michele brown
Totallydiabetic.wordpress.com
Twitter: totallydiabetic
Totallydiabetic@gmail.com

Virginia Kendall January 27, 2012 at 3:10 pm

OK, Michele. You are right. I have been too hard on Paula Deen. I have several friends who have either Tyoe I or Type II diabetes. And I realize Paula built her business through long hours, hard work, determination, and the force of her personality. I will give her a break and hope that she will now give us all some wonderful, tasty healthy dishes. Thanks.

Liz Borkowski January 20, 2012 at 12:02 pm

“Victoza® needs to be injected into the skin but only has to be taken once per day, with or without food.”

This sounds like an important aspect of the drug. When medication for chronic conditions needs to be taken daily, the frequency and route of administration matters. The more complicated it is to take a drug — if it needs to be taken multiple times per day, with food, or with very specific intervals between doses, etc. — the less likely it is that the patient will adhere to the instructions. Injecting a drug is more complicated (and potentially a little scary, at least at first) than swallowing a pill, but having to take it only once per day without regard to food might outweigh that for some users.

As you point out, it’s important to consider the downsides of the drug (cost and side effects) as well as the potential benefits, and for many patients this drug won’t be the best one. For some, though, the dosing might make an important difference.

Seema Jolly January 20, 2012 at 12:53 pm

These are great points, Liz. It’s not just about access to a medication, but patient compliance (and possible barriers to compliance) also plays role in the management of diabetes. I think the key is that there really isn’t one quick fix for everyone.

Paula Johnson January 20, 2012 at 12:21 pm

I really liked this piece! And the way you summarized the science was easy to read and quickly understand.

Seema Jolly January 20, 2012 at 12:55 pm

Thanks, Paula!

Eric Greenwood January 20, 2012 at 12:26 pm

Nice job covering a hot news item! I love what Magic did for the awareness of HIV/AIDS & I really hope that Paula Deen sees the light and uses her influence to help teach ‘preventative’ (healthy!) eating habits.

I wish you had given a more personal opinion on this – I have to assume that, as a nutrition student, you would prefer if Paula was a spokesperson for healthy eating (not a quick-fix drug).

As a culture, we’re too content to solve our problems with quick, easy solutions. We need people with credentials (like you) and people with high exposure (celebrities) working together to push the right solutions.

Seema Jolly January 20, 2012 at 1:00 pm

Eric, I guess in some ways, I did a “good” job because I was really trying NOT to interject my opinion (which can never be done completely, of course). I think I’m still figuring out when/how to insert my own viewpoints on a topic. You are right, I definitely am an advocate for encouraging environments that promote healthy habits, though!

Gaythia Weis January 20, 2012 at 12:30 pm

I think that this article does a great job, compared to others I have read, of playing off of the current headlines regarding Paula Deen while still holding the door open for Paula Deen to correct course in the future. This is also the most complete report I’ve seen on the drug she has chosen to use and sponsor and its pros and cons.

For a blogger, it is also important to not only provide concise information in a reasonable space, it is also good to provide a “hook” to make people want to come back to this site again. I think that this post accomplishes that.

One quibble: I think that many members of the public would not know what a “meta analysis” is.

One concern: I think that “high sugar” needs to be emphasized here.

Seema Jolly January 20, 2012 at 1:03 pm

Thanks, Gaythia! There were a lot of directions I could have taken this post, and I’m glad you found it a little different than everything else that’s already out there. You’re right, I should have defined meta-analysis, and good point about the high sugar factor, definitely an important part.

MB Lewis January 20, 2012 at 12:39 pm

Great lead paragraph, Seema! Taking us to the dark side… Seriously, this story has truly been plastered everywhere (esp in regards to the crass timing of her announcement to coincide with her pharma deal), and you add gravity to the discussion. That said, I’m still pondering your choice to spend most of your blog real estate assessing a single drug, rather than further exploring the loaded points you raise near the end: “Do we focus on prevention or do we focus on treatment? Do we focus on lifestyle changes or do we focus on medication?” Maybe it’s just me, but that’s the post I expected to read and probably was more eager to read, from a public health perspective. They are more than rhetorical questions!

In the early days of blogging at the University of Michigan, we were instructed to go light on the mention of specific name-brand products. Perhaps times have changed enough that it isn’t as much of an issue anymore. But I am left wondering, if this drug any better or worse than the others? And do you have another lively and “prescriptive” post in you about prevention and lifestyle changes?

Best,
MB

Seema Jolly January 20, 2012 at 1:26 pm

Mary Beth, you bring up a good point about taking a step back and remembering that I’m looking at things from a different lens than most of our readers. From my “nutrition” lens, I spend a lot of time thinking about prevention of chronic disease, especially in regards to the built environment, diet/lifestyle changes, policy, etc., and almost take it as a given, but I have to remember that not everyone does. So for me, I WAS curious about this drug since there is a potential for it to become very widely used (as far as I know, though, it’s the only drug in this class that has been shown to cause tumors in animals). I think part of my hesitancy with directly addressing the issues of prevention/treatment, lifestyle factors, etc., is knowing when/how to voice my opinion about this and when to “report the facts.” I’m sure in the coming weeks, I’ll find that balance! As for drawing attention to the actual drug, I am new to the blogging world, so I don’t know the “rules.” Guess I’ll find out soon!

Thanks for your comments!

Maryse January 20, 2012 at 10:28 pm

Hi Seema! Yes, even I’ve managed to find out about Paula Deen and her diabetes but I missed the part about the product endorsement. (I don’t tend to seek this info. out; I’ve had enough health care info. for my lifetime.)

Good timely topic and I like the way you dug into some of the information about it. I am curious about the meta-analysis. This V drug was compared to a placebo in the seven studies? I’m a little unclear, does this mean that the V drug was not compared to standard treatment for type2 diabetes? Be it exercise and diet and/or possibly some insulin. I need things spelled out sometimes.

Also, I’m curious about whether or not Deen is being compensated for her endorsement since you compare her efforts to Johnson’s and Couric’s who presumably are not being compensated. It may be just that I’m tired but it was not crystal clear for me. If she is being compensated, doesn’t that erode her credibility a little bit as compared to Johnson and Couric and, consequently, affect her power to frame the diabetes discussion in the US? Cheers, Maryse

Seema Jolly January 22, 2012 at 10:54 am

Maryse, in some of the studies, comparisons were made between Victoza and metformin (a non-insulin diabetic medication) to placebo (metformin alone). So, none of the studies did comparisons between Victoza and other diabetes management (insulin, diet/exercise). I hope that makes sense.

From my understanding, Paula Deen is being compensated for her endorsement of Victoza, which, as you mention does impact her credibility. However, I would also argue that the “average consumer” of the media won’t necessarily know that Deen is being compensated (she has been a little evasive answering that question), still putting her in a position to have a large influence on the public. Thanks for your comments!

Andrea King January 21, 2012 at 10:56 am

Great job Seema! I like how the viewpoint that you took was a bit different than what has been talked about in the news media…should Paula Dean be endorsing this drug rather than should Paula Dean have told the public and stopped making such high fat/sugar foods.

Seema Jolly January 22, 2012 at 10:14 am

Andrea, I’m glad you found this take on the situation with Paula Deen a little different than what has already been written in the media. I really wanted this post to be less about Paula Deen and her personal health issues, and more about the impact that she can have on the public.

Kathryn Curtis January 21, 2012 at 11:08 am

Hi Seema! Great post about Type II diabetes, the role of the media in the public’s framing of health issues, and the importance of taking a closer look! Keep up the solid writing!

Best,
Kat

Seema Jolly January 22, 2012 at 10:05 am

Thanks for reading, Kat!

Michelle Mathas January 21, 2012 at 8:08 pm

HI Seema, A great article on a topic which sadly is extremely relevant to a lot of people whether they like it or not. As variously mentioned above, I think it would have been good to include just a bit more content about drugs vs healthy eating, and why the food on that show is particularly distasteful. Where you have an article that largely focusses identifying a problem, where possible it is always a good idea to point at a better alternative to prevent just looking like a critic (not suggesting that you do that). I love your use of links for further information. This is one of the most important and powerful ways that blogging differs from magazines. Its a great way to give your audience more information without crowding your article, and providing depth for those who want to explore a subject further. It also shows that you have done your research and your opinion is backed up by others.

Seema Jolly January 22, 2012 at 10:05 am

Michelle, thanks for your comments and feedback. I’ll keep these in mind for my future posts!

Aniketa Shinde January 23, 2012 at 11:58 am

Great post! I was very intrigued by this news story when it came out and also the backlash against Deen. I think it brings up the issue of how much responsibility these celebrities have to the public. Is she merely an entertainer? Should there be any disclaimers on cooking shows about their recipes and how poeple should eat these rich dishes in moderation? The same could be said about fast food chains and their responsibility to public health. We’re now seeing chains display their nutrition information and offer healthier alternatives.
I wonder if she’s doing other things (lifestyle changes like exercise, stress etc) to control the diabetes in addition to the drug.

PF Anderson January 23, 2012 at 12:16 pm

Bravo, Seema! A beautifully written and well-balanced overview of the core issues in this messy situation. The most well-balanced and even-handed piece I’ve seen so far, and superior to the official news media coverage I’ve seen to date. Not only is the content excellent, the presentation is framed beautifully, beginning with a personal point of view and extending that into the broader concerns. And you found a great Creative Commons image and cited it, all very good. I would recommend a slightly different citation? The link you provide goes to the image, but not to the page that includes the actual provenance and intellection property permissions. That would have been this page:
http://commons.wikimedia.org/wiki/File:Paula_Deen_Civitan.jpg
The image is CC3, requiring attribution to be included. http://creativecommons.org/licenses/by-sa/3.0/deed.en
The image is by WorkerBee http://commons.wikimedia.org/wiki/Special:Contributions/WorkerBee and was provided as part of their work for Civitan http://www.civitan.com/.
Thank you again, for this excellent post!

Angela January 23, 2012 at 2:45 pm

Interesting blog post – thank you! I am surprised that the product appears to be on the market already, despite health concerns, but then Botox is, too! Couldn’t hep but think about Richard Jones’ article on nano-cosmetics ( http://www.softmachines.org/wordpress/?p=135 ): ‘Will the association of these cosmetics with scare stories about the dangers of nanotechnology be bad for their sales? Somehow I doubt it. Given the popularity of botox, it seems that a combination of outrageous expense and the suggestion of danger is exactly what sells an anti-ageing treatment.’
Seems to be a similar story with this new diabetes medicine…?

Anna January 24, 2012 at 1:06 pm

Seema, great, clear, concise definitions of the disease and what the drug does!

If there’s an unknown risk for thyroid cancer do doctors who prescribe this drug also schedule regular thyroid blood tests or MRIs or sonograms of the thyroid?

Anuj Mahajan January 24, 2012 at 4:06 pm

Good job on the article! It was very well laid out and I liked the transition from the initial story into the definitions and subsequent details about Victoza. The way you started the blog gave me the impression that there would be personal insight embedded within the article. I think that it would have been nice to hear your thoughts on the matter as well in addition to the facts.

On another point that a few others have mentioned, I dont think Paula should alter her shows/receipes. I think that nutritional responsibility lies with the consumer. There are plenty of alternative shows that someone else can watch. For her sake though, I hope she doesn’t eat what she makes on those shows anymore.

Surabhi Mahajan January 25, 2012 at 9:54 am

Hi Seema,
The blog was very informative (surprisingly). I thought it would be more opinion based, but I liked the educational components you put in (for the non saavy layman that don’t know much about diabetes, healthy eating, nutrition, etc). I do agree with most, that her double messages are very contradictory to each other. But I also wanted to point out that she is not just a chef but also a BUSINESSWOMAN! There is definitely a big business perspective that I think initally we might not allow ourselves to see.

If she begins to introduce healthier cooking then what will happen to her show, her followers, and what does she bring to the table that every other healthy chef isn’t already promoting? “Paula’s Home Cooking” markets an audience that wants to learn southern comfort type of foods, which is known to be unhealthy and rich in butter, fat, sugar. Another point to ponder is that if she starts promoting healthy cooking that would mean less people that are diabetic, and in turn the drug company for Victoza (R) would make less money off of people’s poor judgments in relation to health and nutrition. Since she is a representative for the type of food that leads to diabetes, and she is a representative for Victoza, I see one factor directly negatively impacting the other. I think at the end of the day, this all comes down to her hidden agenda of how much money comes into her personal pocket from promoting the things that she does. So I say keep on cooking Paula Deen the consumer can choose to follow you or not.

Luciana January 27, 2012 at 9:57 am

Good post! Although you deal with nutrition, language was clear and the use of the celebrity effect caught readers attention to the real scientific results and debate (prevention x treatment).

Seema Jolly January 27, 2012 at 12:15 pm

Thanks for reading!

Ankur Jolly January 28, 2012 at 3:56 pm

Great post Seema. I like how informative it is and the relative ease for me to read through the material. The best part of the post for me was that it was concise, yet still provided the information necessary to give the reader something to think about. It also fostered some good dialogue.
On to my soapbox. I think it is very irresponsible for drug companies to solicit celebrities for endorsements. These people are not Michael Jordan, peddling shoes and Gatorade. My fear is that people in our society value celebrity opinions more than their health care providers. Ultimately this puts more pressure on the health care industry to use these products due to the marketing push, years later we find out that such and such drug has adverse affects on people, someone is upset because they now have a tumor or other illness, they in turn want to find someone else to blame, rather than take responsibility for their own actions. All because Paula Deen likes to cook with butter.

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