I grew up in Vietnam, where freshly cooked meals were a daily staple. Getting them was effortless—just a few steps from home.
Coming to the U.S., however, turned this into a major challenge, especially while raising my own kids. Ultra-processed food is everywhere, and preparing fresh meals takes significant time, even though I’ve become quite efficient (a typical meal takes 30–60 minutes).
While this doesn’t fully solve our food challenges for kids, it’s a step in the right direction for the future.
For zoning, there's plenty of places that don't allow commercial operations near residential zones- hence the push for more mixed-use zoning. Unfortunately, urban environments still have very high rents, so to stay cheap enough you'd have to get permission to operate a good truck or sidewalk stand.
For regulations, there's no way to run (or rent) a commercial kitchen and sell low cost freshly made food and make enough money, especially if you aren't operating out of a food truck. There's several other licenses involved depending on the nature of the business.
The US is a rich country (compared to Vietnam), so I'd have thought they'd have the resources to automate much of the process of making healthy meals, and thus cheaply. Yet here we are.
That is such a huge question! I feel like the answers are many and varied.
For one obvious one, US health codes are much stricter, and your average Vietnamese food cart or street vendor would probably be flat-out illegal anywhere in the US, because they probably don't have the equipment to handle safe food holding temperatures. Not to say that the vendors aren't skilled and capable of serving safe food; just that the US health codes don't take that as a given and require you to prove it. It's why the hot dog stand is about the only iconic American food stall these days. Consider also the fairly prolific business of selling home-cooked food on Facebook Marketplace. Totally illegal, but it fills an underserved niche.
A second factor might be the cost of doing business. Ingredients are much more expensive, and so is labor, and that makes cheap food harder to produce cost effectively. The labor is probably the most expensive part of any prepared meal in the US, so you see "fast food" shift towards ultra processed foods that are quick to produce and serve.
Likewise, US real estate is just less conducive to this behavior. In cities, sure, you might see foot traffic that can support a food stall or small restaurant. But even a small location in a busy city area can be very expensive to rent, and the US has less by way of semi-permanent market areas that vendors can leverage to have easy access to customers. There's a Thai Buddhist temple in Dallas that runs a weekend market with food vendors after their Sunday services, and it's always busy. There's almost certainly demand, but reasonable locations are hard to come by.
Lastly, I just want to point out that fresh does not necessarily mean healthy! Consider salt, for example. If your freshly cooked dish is over seasoned, then you might not be getting something as healthy as you wanted, even though you might recognize all the ingredients and their sources. Be careful to avoid biases in labeling certain foods healthy and some foods not based on perception and not actual contents.
While US food codes focus on safety, they don't necessarily equate to healthy food either. Many processed items that meet regulations are loaded with unhealthy additives. Freshly made food, even if it contains a lot of salt, at least provides more control over ingredients and is often more digestible. The challenge is educating people on how to cook fresh food in a balanced and nutritious way. We need to look beyond just 'safe' and focus on whole, minimally processed foods.
Dentists in the U.S. are often driven by profit rather than patient care, much like many other healthcare providers. Over the past 20 years, I’ve seen more than ten dentists, and only one genuinely seemed to care about my dental health, doing everything necessary to save a tooth. She may have cared because we’re distantly related.
Here are a few examples from my experiences:
1. I went in for a routine cleaning, but they recommended $2,500 worth of unnecessary procedures. When I declined and asked for just the cleaning, the dentist spent less than five minutes on it.
2. Dentists seem overly eager to drill and fill, often doing poor-quality work that requires repeated visits. I still have six fillings from when I was young, and they've lasted for over 30 years.
3. For a minor broken corner on a tooth, one dentist recommended a $2,500 procedure (above my insurance coverage) and insisted on treating all my teeth for better care. I declined, but still received a $250 bill for the consultation. My previous dentist fixed it for $120 in cash.
4. My wife’s teeth had no visible signs of major cavities, yet one dentist filled six teeth. Fortunately, the fillings were minor and are still holding up after 10 years.
5. I have several friends with similar stories. For example, dentists often recommend extensive procedures like root canals on baby teeth, costing between $2,500 and $7,000. In one case, a root-canaled tooth fell out the very next day.
6. Orthodontists often put braces on young children, as early as age 6-8, even though in many other countries (like Korea), the average age is around 18. I’ve read stories of people who regret early braces, particularly when the wrong teeth were extracted.
6. Orthodontists often put braces on young children, as early as age 6-8, even though in many other countries (like Korea), the average age is around 18. I’ve read stories of people who regret early braces, particularly when the wrong teeth were extracted.
This happened to me and caused me all sorts of jaw problems later in adulthood.
> Dentists in the U.S. are often driven by profit rather than patient care
Isn't this arguably the case for any healthcare treatment in the US? It's all profit motivated and you are essentially gouged at every step of the way.
My 3 years old iPhone mini 13 is still very fast, reliable, and I love every part of the phone. It's such an amazing phone that functions well. The only thing got worsened is the battery, now at 87% even though I always charge it to 80-85%, now I have to charge it to 100% to use through the day. I still have extra power (like 30%) for a whole day. Replacing the battery isn't a problem. If Apple does support it like other models, it should last another 4-5 years more. I have no plan to upgrade to anything as I don't see anything comparable on the horizon.
I find food in the US contains too much toxin that harms the body. They have a lot of synthetic chemicals and preservatives. Many of which have very bad long term damages to the body. Even with these labels, sometimes it doesn't really tell the whole story about the ingredients. Most of the food that sits on the shelf for weeks shouldn't be consumed.
> Most of the food that sits on the shelf for weeks shouldn't be consumed.
Salt? Flour? Oil? Oats? Rice? Garlic? Black pepper? Most ground spices? Nuts? Beans? Honey? Vinegar? Quinoa? All of these can reasonably sit on a shelf for weeks. I guess none of these are safe to be consumed, all just "toxins".
Or months plus. Flour probably gives better results for yeast breads in the weeks timeline but the average household isn’t buying a new bag of flour every couple weeks.
Pretty much all oils are processed foods. Vinegar is a preservative and is a processed food. Most salts are processed and are common preservatives. Flour is a processed food.
The reasons why Twinkies are so shelf stable are largely the same reasons why flour or rice or olive oil is shelf stable.
Better be careful of those chemicals like sodium chloride and dihydrogen monoxide.
> Salt? Flour? Oil? Oats? Rice? Garlic? Black pepper? Most ground spices? Nuts? Beans? Honey? Vinegar? Quinoa? All of these can reasonably sit on a shelf for weeks.
They're probably full of things that are bad for you too.
Your salt is full of microplastics (https://www.nationalgeographic.com/environment/article/micro...). Your oats are full of chlormequat. Your spices are full of heavy metals (arsenic, cadmium, and lead), and the same is true for vinegar, nuts, beans, and rice.
Most honey sold in stores isn't real honey but comes from China and can be filled with chloramphenicol and other illegal animal antibiotics. Almost all of the extra virgin olive oil sold in US stores is fake and can also be contaminated with phthalates. Around half the garlic sold in the US comes from china and according to some this is Communist Sewage-Garlic, and a threat to national security (https://www.bbc.co.uk/news/business-67662779) which can also be covered in chemicals (the common claim is methyl bromide is used although I haven't seen anything to back that up)
I think there has not or not much. However, we seem to consume the meat differently like processing it heavily, cooking it at very high temperature. These actually produces lots of carcinogens that add up over time. Sugary food can cause lots of body inflammation which can fasten the process.
i don't know if i agree that it possibly will be too late—but i sincerely doubt i'll be around long enough to find out one way or the other. i think that's another inherent part of the problem.
Everyone has only 1 life, imprisonment of a life is one of the ultimate forms of torturing. This basically is killing his most meaningful years away.
I can only agree this form of imprisonment for murderers, rapists, ones who physically and mentally hurt people with permanent losses.
Ones can argue that he mentally & physically hurt others, but we need evidence. We should have a better system to force these individuals to pay back or make up the losses. Of course, he will never be able to pay back all the losses, but at least that's a better punishment and I'm almost certain every prisoner will agree to do. They will absolutely trade all of their finances for x years in exchange for freedom.
I think what's going on right now isn't deterring people from committing frauds like SBF either.
I think imprisonment doesn't make it's one of the fairest penalty. A set of humans made that up to imprison/strip away freedom/rights of other humans. No human at birth signs these laws, it is all made up by the people with power.
I agree that creating a system to force him payback is challenging, there's no easy way to create a system like that. Maybe something as simple as 50% tax to start with for the rest of his life as long as he belongs to this society.
Personally, I think we should offer prisoners corporal punishment alternatives. Flogging every six months for ten years, plus fines, plus community service, plus you can't handle investors money or be in the c-suite or start a company, and you pay double taxes seems fair to me.
This type of imprisonment is just as much to scare other people as it is to punish him. Repaying the people he stole from is also required here, but that has no meaning as a deterrent.
It's clearly wrong, and it will be a nightmare down the road, period. So you know the path to take even if it's meant to break the relationship or the company. There goes your negotiation skill 101.
Prevention of diabetes or even of pre-diabetes is well worth the experiment. At least for folks in the US, where metabolic syndrome is hanging over the head of a huuuuuge percentage of the population.
Hiding information from people because they might misinterpret it is not a successful medical strategy, the better strategy is to educate, see if the information will be welcome, then provide the information in the context of what it means.
I wasn't technically pre-diabetic, but did have a few higher-than-expected resting glucose blood tests, and the CGM showed me that I'm actually really close to pre-diabetes.
That was the kick I needed to clean up my diet (specifically eat less), exercise 5-7 days of the week, and I'm feeling better than ever.
Anecdata, of course, but there is no single intervention that has been discovered to improve people's weight and metabolic problems in the US (except perhaps the new GLP-1 inhibitors). Adding a CGM, at least for people interested in it, can be very effective, and we should use all the tools we have to improve the population's health.
I think your approach is that giving more data to individuals so that they can be informed and make better decision about life choices. However, if we look at reality, the data is already there, without experimenting we can already get a ton of data. Then the question is have people made better decisions about their life choices. I think the answer is No.
And thus I doubt very much that with this device or devices like this, the diabetic population will be reduced. In fact, I believe it to be the opposite.
I don't know why modern days we get so many problems wrong.
A -> B, then B -> A => incorrect
In a fire, we see firefighters, that doesn't mean firefighters cause fire.
In diabetic patients, we see high glucose level. That doesn't mean eating high GI food causes someone to have diabetes.
If we look at the Blue Zone, many people eat mostly carb. So carb/high GI food definitely doesn't cause diabetes.
Devices like this will make other people fearful of high glucose and think they're getting diabetes. People without the disease shouldn't focus on monitoring the glucose level, focus on eating healthy instead. And of course eating healthy is another complex topic.
> If we look at the Blue Zone, many people eat mostly carb. So carb/high GI food definitely doesn't cause diabetes.
While obesity is known to be the greatest risk factor for T2DM, you can induce insulin resistance in weight-stable individuals just by shifting the macro composition of their diet towards saturated fat:
Sugar, amusingly, doesn't seem to have the same effect.
Given that the typical recreational CGM wearer (in my experience) is a low-carb/keto type (who ruined their insulin sensitivity), you should probably take the comments in this thread touting CGM use with a grain of salt.
> In a fire, we see firefighters, that doesn't mean firefighters cause fire. In diabetic patients, we see high glucose level. That doesn't mean eating high GI food causes someone to have diabetes.
This is correct but probably not in the way you think. It is not the glucose in and of itself that is the problem but the level of the hormone insulin circulating around your system that is at the root of Type II diabetes. Glucose and insulin are highly related. Insulin is released by the pancreas to help control the level glucose in our blood.
Virtually no insulin is required when metabolising fats, a small amount is required for protein and a larger amount of insulin is required when dealing with glucose dense carbohydrate based foods. The faster a carbohydrate is metabolised the greater the dose of insulin required to quell the resulting glucose rush in the blood.
What does the insulin do? As a hormone it has many functions. The presence of insulin in the blood signals to all cells to burn sugar (glucose) rather than fats (ketones) for their energy. It prompts the cells in the skeletal muscles to store up glucose in the form of glycogen for later use and it signals the liver to store excess glucose that is not immediately needed. Once the liver and muscles are full then the liver then converts any excess to triglycerides.
Where do the triglycerides go? They get stored as subcutaneous fat all over but largely in the belly (in men) and bum/upper legs (in women). What happens when subcutaneous stores are full? Then the triglycerides are shoved anywhere and everywhere. Fat is pushed into muscle cells as well as the cells in individual organs. The fat molecules present in cells in organs are particularly pernicious (visceral fat) but any cells that contain these triglycerides seems to disrupt the insulin signalling within the cell. This results in insulin resistance i.e., the ineffectiveness of insulin to signal to the cell to take up excess glucose.
When sufficient threshold of insulin resistance is reached, you will get higher blood sugar readings and a higher A1C at which point your doc will say you have prediabetes or full on type II diabetes.
Insulin is the master key variable that unlocks the type II diabetes puzzle. High blood sugar levels are just a symptom. The problem with modern day Type II diabetic care is they consider the high blood sugar as the root problem. So this is treated with meds such as metformin and eventually MORE insulin. Understanding type II diabetes as a disease of too much insulin sheds the disease in a very different light.
Anyway, you are correct, the high glucose level per se is not the cause, but high levels of insulin constantly circulating around your system is the big problem. Of course an effective way of doing that is to continuously eat foods dense in glucose and fructose that are metabolised very quickly e.g., cookies, ice-cream, orange juice etc.
> If we look at the Blue Zone, many people eat mostly carb. So carb/high GI food definitely doesn't cause diabetes
Blue Zone areas such as Okinawa, you do find people eating carb rich foods but they are also high in fibre e.g., root vegetables, sweet potatoes etc. look at books by Robert Lustig to learn more about the importance of fibre in relation to metabolism and diabetes risk.
Thank you for the detail :). And yes, I do believe lacking of fibre is one of the key important factors causing many kinds of diseases, and the modern diet is totally missing lots of fibre.
You're welcome. I must add that I am not a doctor so take the above with the appropriate level of skepticism on your behalf. I am only summarising what I have learned from books and have omitted A LOT of detail.
Recommended further reading
- Pure, White and Deadly (John Yudkin)
- Fat Chance (Robert Lustig)
- Outlive (Peter Attia) contains an excellent and concise synopsis of the mechanisms behind metabolic disease
Glycemic index is only sort of useful for people who actually have diabetes, where blood sugar dysregulation makes insulin regulation equally as precarious. For anyone who doesn't have diabetes, GI doesn't really mean anything other than that their insulin may or may not spike in a short period of time related to a food. Glucose spiking, hence insulin spiking, is not something you want, but this also doesn't mean that something with a lower GI score is better for you and doesn't cause you to release as much insulin. Whether it's table sugar or whole grain pasta, they'll become glucose that the body will use or store in one way or another. Fasting glucose will still remain higher.
> Devices like this will make other people fearful of high glucose and think they're getting diabetes.
Elevated glucose is exactly what causes type 2 diabetes. Take away the glucose supply, and you don't have elevated insulin. Fear of glucose that is too high too often is entirely justified and is not something that should be going on if people can avoid it. Sugar molecules are damaging to cells and are related to other things like cardiovascular calcification.
> If we look at the Blue Zone, many people eat mostly carb.
So-called "Blue Zones" are not science. They are anecdotal, cherry-picked, uncontrolled, and can't be tested. Also, some of those zones, such as Okinawa, are mythical. Okinawans historically have eaten a lot of pork, and still eat a ton of pork. They also used to not keep much in the term of birth records, so there was really no way to know how old any of those people were back when they were studied.
> So carb/high GI food definitely doesn't cause diabetes.
Propose a model of type 2 diabetes that doesn't involve dysregulation of blood glucose and come back to us.
> Elevated glucose is exactly what causes type 2 diabetes. Take away the glucose supply, and you don't have elevated insulin. Fear of glucose that is too high too often is entirely justified and is not something that should be going on if people can avoid it. Sugar molecules are damaging to cells and are related to other things like cardiovascular calcification.
Reread that article. It has literally nothing to do with cause and effect. The study finds an association between intramyocellular lipids and insulin resistance, and has absolutely nothing to say about whether diabetes is caused solely by glucose dysregulation or something else.
Your comments aren't the responses to my comments. Let's take an example, my comment is neither proposing a model for T2D nor saying CGM is part of any model.
You said Okinawa people eat a ton of pork, please compare with something.
You said they don't have birth record accuracy which is not totally true. In many asian culture, they use Zodiac and similar methods to keep track of age, the exact date may be off, but the year cannot be off because if it's off, that's 12 year difference. I cannot be a dragon and claim myself to be 84 when I am only 72 because all of my friends around know how old I am around.
When 1 or 2 persons say it, it may be mythical. But when most of population say it, there must be some truth. And it's also up to you how you believe it.
Coming to the U.S., however, turned this into a major challenge, especially while raising my own kids. Ultra-processed food is everywhere, and preparing fresh meals takes significant time, even though I’ve become quite efficient (a typical meal takes 30–60 minutes).
While this doesn’t fully solve our food challenges for kids, it’s a step in the right direction for the future.