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Created: January 14, 2006
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Index of Topics on Site Backup of Bad Blood: East Meets West, Adding Pounds and Peril
By Marc Santora
SOURCE: New York Times
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January 12, 2006
Bad Blood: East Meets West, Adding Pounds and Peril
By MARC SANTORA

May Chen is slender and healthy, a lively little girl whose parents left their rural Chinese village just a decade ago in search of a better life. But at age 9, still in pigtails, she is already coming face to face with the forces that many say are making America fat and diabetic.

When May watches cartoons in her family's apartment in Flushing, Queens, the commercials tell her that junk food is good food - the latest message from an industry that spends $10 billion a year marketing to children.

When she strolls down Main Street, she walks a growing gantlet of fast-food restaurants, many of them built with the help of government loans.

At her public school, the city sells sugary Snapple in vending machines to raise money. But it does not pay for a full physical education program, so May's fourth-grade class has gym just once a week, in violation of state law.

And when she and her friends gather for snacks, she basks in their approval as she produces the high-calorie American-style treats, from chips to sweets, that are rapidly replacing traditional foods in the local markets.

Children all over the world are walking the same sort of obstacle course as obesity and Type 2 diabetes increasingly strike the young.

But to spend time with May Chen and the other children of immigrants in Flushing - at home in front of the TV, in the places where they eat and buy food, in their schools - is to appreciate the everyday threat confronting a particularly vulnerable group: the Asian-Americans who make up half the community's population.

It is also to understand what alarms health authorities about the future of New York, a city of immigrants where Asians are the fastest-growing racial group.

Asians, especially those from Far Eastern nations like China, Korea and Japan, are acutely susceptible to Type 2 diabetes, the most common form of the disease and the subject of this series. They develop it at far lower weights than people of other races, studies show; at any weight, they are 60 percent more likely to get the disease than whites. And that peril is compounded by recent immigrants' sudden collision with American culture. Many of them left places where factory and field work was strenuous, televisions were rare and advertising was limited. They may speak little English and have poor access to medical care. Many have never even heard of diabetes, much less the recent scientific studies showing that a Western diet, high in fat and sugar, puts them in danger of getting Type 2 diabetes, which has been linked to obesity and inactivity, as well as to heredity. (Type 1, which comprises only 5 percent to 10 percent of cases, is not associated with behavior, and is believed to stem almost entirely from genetic factors.) Many recent Chinese immigrants have come from places where food was scarce, and experts say some view fat as a trophy of wealth and status. Their children try to fit into their new country by embracing its foods and its sedentary pastimes. "When they give you the visa to the United States in Shanghai, Fujian or Beijing, they should stamp a clear warning: danger to your health," said Marcelo M. Suarez-Orozco, co-director of immigration studies at New York University. So far, that danger has not been fully realized. Flushing has only half as many diabetics as the New York neighborhoods where the disease has made its deepest inroads. City epidemiologists say they have limited data on its spread among Asians. But they do know that 14 percent of Asian children in New York are obese, more than twice the rate among their parents. And they say there is mounting evidence - including soaring diabetes rates in major cities in China, and in other countries with Chinese immigrants - that New York will soon experience a similar explosion as more Asians arrive and have their first encounters with Western ways. The clash of cultures is vividly apparent in Flushing, one of the city's new Chinatowns. On streets like Roosevelt Avenue, older immigrants still throng traditional Asian markets, with their signs in Chinese, and dine at noodle shops where windows fog with steam. Their children, however, are increasingly lured by fast food. Along a 100-yard strip of storefronts are a McDonald's, a Burger King, a Taco Bell, a Pizza Hut, and a Joe's Best Burger. Even in China, the number of obese people has tripled since 1992 to 90 million, as Western food has become popular and prosperity has made it possible to eat more. The World Health Organization has warned that Asia faces a "tsunami" of diabetes in the coming decade, and health officials have assailed the Chinese government for its tepid response to the crisis. But in this country, where children are bombarded with much more food advertising, many health experts say the response has not been much stronger. In Washington, money for school gym programs is measured in the millions, while billions are spent on subsidies for those who produce food sweeteners. In Albany, where the restaurant and food industries are generous campaign donors, bills to raise awareness of nutrition and diabetes have been dismissed or derided. In New York's City Hall, a former councilwoman who has been outspoken on childhood obesity, Eva S. Moskowitz, sees similar apathy. "We have a massive problem on our hands," she said. "There is an utter lack of urgency to do anything about it." And in Flushing, where the Small Business Administration has lent $4.6 million in the last decade to spur fast-food franchises, the community health center has trouble finding money for diabetes education. Here, for anyone who cares to look, are the people left to fend for themselves: a new generation that will soon fill New York's schools and workplaces, making the daily choices that could mean the difference between a healthy city and a colony of the sick. A Melting Pot, Boiling Fiercely Incredible, Li Li kept repeating, simply incredible. For 14 years, ever since he moved to Flushing from Canton, China, he has hewed to the same diet that his ancestors ate for hundreds, if not thousands, of years. "Chicken, frog, duck, all very fresh - that is what we like," said Mr. Li, a 40-year-old business consultant, as he steered a cart through the Hong Kong Market on Main Street. But at only 3 years old, his twin daughters have already blazed their own path away from history. "They both like the American food," he said. "I cannot stop that." He found the switch profoundly unsettling - not because he saw health consequences, but because it had happened so fast. "Only recently, they tried Coke and they loved that," he said, as one twin tried to grab a package of candy. "They won't drink tea anymore. Can you believe it? They will not drink tea." It was a classic scene from the well-known story of American immigration: the children of newcomers eagerly assuming the ways of their new world, and rejecting the old. But a rite of passage that used to take most immigrant families a generation or two - fully adopting the American diet - has accelerated for Asians, said James L. Watson, a Harvard anthropologist who has studied their response to fast food. Many have moved in just a few years from villages to China's increasingly Westernized cities and then to the United States, he said, quickly abandoning traditional foods. "Everything is happening at warp speed," Dr. Watson said. "The melting pot may have been simmering in the past, but now it is raging." And the American diet they are taking up is far different from what it was for earlier generations of immigrants: a mind-boggling array of processed products, with added sugars and fats that can turn these unfamiliar foods into seductive pleasures. Even the store Mr. Li was shopping in is a startling departure from the small produce and poultry shops that still crowd Flushing. The Hong Kong Market, which opened in 1996, is a meeting spot for old and new: a huge supermarket that stocks Chinese versions of processed American foods. One shopper, Jian Kang Qiu, 43, an artist who moved from a coastal village in the province of Guangdong six years ago, said his family's eating had changed radically. "At home we would shop in the open market," he said. "There was not so much packaged food. We would eat maybe two meals a day. Rice with something on the side, fish or vegetables." Now, faced with the unlimited choices here, they eat a far broader diet, with many treats. Mr. Qiu's mother has Type 2 diabetes, and recently his younger sister learned that she does, too. It has made him a little more conscious of what he consumes. But he has given up trying to control what his 16-year-old daughter, Vicky, eats. "She would prefer American food," he said. "Her friends are going for pizza, she wants to go for pizza. It is normal. She wants to do what her friends are doing." The need to fit in is no less important for the fourth graders at Public School 120, where May Chen, the pigtailed 9-year-old, was the center of attention one afternoon as snack time rolled around. May's parents co-own a sushi restaurant, but she had come to school with a bag of all-American snacks: a shiny blue can of Lay's Stax potato chips and a package of neon-orange Cheetos Puffs. She passed out chips to her friends, and in no time hands were stretched out all over the classroom. No one gave a second glance to the steamed dumplings that a classmate, Annie Wu, had brought from home. "There is a kind of shame issue," said Professor Suarez-Orozco of N.Y.U., who has spent the last five years studying the lives of 400 immigrant families, with a focus on Asians. "The kids feel if they bring food from home, some ethnic dish, they are seen as not as cool and not with it." School is one place where good eating habits can be taught. Yet at P.S. 120, fats, sugars and calories figure heavily in cafeteria fare: burgers, pizza and chicken nuggets. In the last two years, the Bloomberg administration has made some changes: hiring an executive chef to make food in all schools more nutritious; installing salad bars at many schools, including P.S. 120; and cutting the fat and calories in some of the most popular items. At lunch, every student gets a banana or an apple - a requirement that schools must meet to receive federal reimbursements. But schools, critics say, are reluctant to change their menus too drastically and risk a drop in sales that would reduce those reimbursements. And at the end of each school day, the trash baskets at P.S. 120 are filled with the compulsory fruit. 'If It Is Delicious, I Love It' A sweet tooth is standard equipment on any child. But the sweetness that satisfies it is no longer limited to cookies and candy. When 18-year-old Jin Yang dashed into a Key Food supermarket one rainy afternoon to buy food for her friends at Flushing High School, she wasn't looking at nutrition labels. If she had, she might have noticed that nearly every purchase she considered - the low-fat yogurt, the basil vinaigrette and even the chicken noodle soup she ended up buying - shared the same major ingredient: high-fructose corn syrup, a sweetener first derived from corn in the 1960's. Underwritten by roughly $40 billion in federal subsidies paid to corn growers in the past 10 years alone, it is now so cheap that it has all but replaced cane sugar as the sweetener of choice in processed foods. The syrup has been singled out by many health experts as one of the chief culprits in the rise of obesity. Its inexpensiveness, they say, has helped soda producers create the larger portions that have led to overconsumption. It is so versatile, they say, that it now shows up in many foods that would not have been sweetened at all in the past. There is wide disagreement among scientists over some studies indicating that high-fructose corn syrup can hinder the body's ability to process sugar, and can promote faster fat growth than sweeteners derived from cane sugar. What no one disputes, however, is that since the advent of the syrup, consumption of all sweeteners has soared; the average American's intake has increased about 35 percent, according to the Federal Department of Agriculture. And a 2004 study in The American Journal of Clinical Nutrition showed that the rise of Type 2 diabetes since 1980 had closely paralleled the increased use of sweeteners, particularly corn syrup. Food industry officials say there is nothing wrong with the syrup as long as people eat it in moderation. But Jin, who came here just a year ago from rural northeastern China, said she had never even heard of the sweetener - or diabetes, for that matter. Thin and healthy, she subjects each food purchase to only one test. "If it is delicious," she said, "I love it." Moderation may also be a foreign concept to many new immigrants from China because of deep-seated attitudes they have brought with them. In many Chinese families, it is difficult to get parents and grandparents who were raised during the deadly famines and deprivations of the 1950's to stop overfeeding their children. "Increased girth is an indicator of wealth," said Dr. Thomas Tsang, medical director of the Charles B. Wang Community Health Center in Flushing. But any extra weight is dangerous for Asians, research shows, because of their susceptibility to Type 2 diabetes. For example, a 5-foot-9 Japanese man who weighs 156 pounds - and who may never develop the sort of belly that is a warning sign for the disease - is twice as likely as a white man that size to become diabetic. Because of that, Dr. Tsang said he believed that the number of Asian diabetics is underestimated; he has recently diagnosed at least a dozen new cases among his longtime patients. "It's astounding," he said. "And it puts a lot of pressure on us to educate them." The Wang Center has hired three diabetes nurse educators and a nutritionist in the last two years. But the effort to prevent, diagnose and treat the disease is hobbled, Dr. Tsang said, by cultural barriers. Asian immigrants who are in the country illegally tend to avoid doctors, and some Chinese people will not test their blood sugar. "My own mother has diabetes," the doctor said, "and she will not draw her own blood. She believes blood is the life essence and should not be lost." Selling Frosted Flakes and Fitness At age 3, Henry Chen is learning his first words in English. "Mother" was first, followed by "father." What came next, however, surprised his aunt, Cindy Chen. "McDonald's," she said. "It was one of his first words." Neither fast food nor television was part of the Chens' life in Fuzhou, a Chinese city where they struggled to find work before moving to Flushing four years ago. Now Henry and his family show up at least once a week at McDonald's. At home, he perches on the sofa to watch Nickelodeon. By his aunt's estimate, he spends as much as 30 hours a week in front of the TV - more than double the average for a child in China, according to data collected for The New York Times by AGB Nielsen Media Research. Like a human SpongeBob, he soaks up ads for Pop-Tarts and Lucky Charms. There is nothing new about the marketing of food to children, with all of its cartoon characters and free toys. According to a study released in May by the Grocery Manufacturers Association, the average child watches 4,900 food commercials a year. What is new, though, is the message that child - and his parents - are hearing. Ronald McDonald now snowboards, and his once-portly frame looks to have shed at least 30 pounds. The box for Henry's Happy Meals reads, "A game of tag keeps me happy and fit." In one commercial, a woman does a victory jig when she finds out her Lay's potato chips are low-fat. A Frosted Flakes ad shows children running around a soccer field with Tony the Tiger. "Without a doubt, the food industry, while not moving away from convenience, has begun to push health as the main driver of food packaging and promotion," said Don Montuori, publisher of Packaged Facts, which does consumer research for food companies. The companies say they are doing their part to combat obesity by offering lower-calorie, lower-fat choices, and encouraging children to exercise. McDonald's sponsors track events for young runners, and Coca-Cola has created the Tiger Woods Foundation to promote children's sports. But what would seem to be welcome news has simply created a different problem, according to many nutritionists and public health officials. Despite a salad here or a lower-fat oil there, they say, the food industry has done little to change the basic unhealthfulness of its best-selling products. And by making the link to fitness, they say, the companies are telling children that all of those foods are good for them. New immigrants from China are keenly receptive to such claims because the Chinese have used foods to cure illnesses and promote general health for thousands of years, said Dr. Watson, the Harvard anthropologist. One cure for a cough, for instance, involves duck gizzards, apricot kernels and watercress. A variety of foods are thought to improve brain function. Many Chinese people have replaced those traditional foods with processed foods, Dr. Watson said, and have little idea what is in them. Still, the faith in food persists: for instance, he said, there is a widespread perception in China that eating at McDonald's can somehow make you smarter. In New York, Professor Suarez-Orozco said, immigrant parents often reinforce that connection by rewarding academic achievement with a McDonald's meal. And many Chinese companies have adopted the same kind of health pitches as their American counterparts. At the Hong Kong Market, a juice box called Vita Chrysanthemum Tea promotes itself as a health drink for children, though nutritionally it is little different from Snapple. Ye Zhou, a sixth grader whose parents arrived from China shortly before she was born, said she tried to eat right, and knew that some foods were unhealthful. On this day she had come to the McDonald's on Main Street to try the new Premium Crispy Chicken Breast Sandwich, drawn by the ads that touted the "energy" packed in the meal, which includes French fries and a soda. How, she was asked, did it compare nutritionally with the stir-fried chicken and rice her mother made at home? "They taste different," she said. "But one is not healthier than the other." Actually, the fast-food meal has at least one-third more calories, carbohydrates and grams of fat than a typical homemade one. Even before the latest blitz of health messages, children were confused, the Henry J. Kaiser Family Foundation said in a 2004 report on childhood obesity. In a 1997 study it cited, fourth and fifth graders were asked which of two foods - say, corn flakes or frosted flakes - was more healthful; the children who watched the most TV were the most likely to pick the less nutritious one. For more than two decades, Dr. Daniel S. Acuff helped hone food ads aimed at children as a marketing consultant to companies like Coca-Cola and Nestle. But about two years ago, he said, he stopped consulting on products he did not consider nutritious after recognizing the threat posed by obesity. He called the industry's new sales strategies disingenuous. "To position themselves as leaders in providing healthy food for children is nonsense," he said. He and others - including the American Academy of Pediatrics and the American Psychological Association - have called for tighter restrictions on advertising to children, similar to limits in Australia, Canada and England. They are also concerned about the increasing use of the Internet and video games to sell food. But repeated attempts to enact such strictures in the United States have failed for three decades, and at a meeting last July in Washington, the Federal Trade Commission told food and advertising executives that it favored letting the industry police itself. A few companies have done just that - most notably Kraft Foods, which decided last January to curb its advertising of certain products, like Oreos and Kool-Aid, to children under 12. The move raised eyebrows both in the food industry and in public health circles because of its implicit suggestion that there are bad foods. The industry has long maintained that there are no bad foods, only bad habits - like overeating. Tim Wong is only 10, but he had no problem polishing off a large dinner platter from the adult menu one afternoon at the KFC on Main Street in Flushing. He had asked his mother to take him and his 6-year-old sister, Tiffany, so they could try "the new stuff" on the menu. "I see the new items on television and I want them," he said. When he was asked what his favorite foods were, his mother laughed. "Look at him," she said in a matter-of-fact way, as Tim is obviously overweight. "He likes his junk." Time for Gym! O.K., Time's Up! "Two fingers in the air!" the teacher aides shouted at the more than 100 children squirming in the auditorium seats. Two fingers held high is the way students at May Chen's school signal that they are sitting quietly enough to be let out for recess. It was 10:30 a.m., less than two hours after they had been served a breakfast that included chocolate milk, a doughnut and a juice box - at least 400 calories and 47 grams of sugar waiting to be burned off. Finally the doors opened, and the students scampered out to the playground, a parking lot ringed by a chain-link fence. Several boys ran around like mad. In a makeshift game of keep-away, May and some other girls tossed around a bag of cheese snacks. They had to play fast. Twelve girls were lined up to jump rope, but only three had a chance before a bell summoned them back inside for lunch. May's recess had lasted eight minutes. It was, as always, the only recess for the day, and fortunately the weather was mild. On cold or rainy days, the children stay inside and watch movies. Recess and physical education are treated like luxuries in the New York City schools. Though half the grade schoolers are overweight and roughly one in four are obese, the city did little until last year to promote one of the best antidotes: exercise. May, like most schoolchildren in the city, does not get even the minimum amount of physical education mandated by state law, two hours a week. She has a single gym class each week, for 50 minutes. She is among the lucky ones. More than half the city's 700 elementary schools have no usable outdoor play space, according to a 2003 survey by the City Department of Education. May's school has only one gym teacher for its 1,000 students, but roughly one in seven elementary schools in the city have no teacher dedicated to physical education. And although P.S. 120 has a functioning gym, many elementary schools do not, according to reports by the City Council and the State Assembly. Even those that have gyms often use them for classes or meetings. There has been no standardized testing of student fitness in more than a generation. The sad state of the school gym class is a legacy of the city's fiscal crisis in the 1970's, when the budget for physical education was slashed to protect other academic programs. But New York's plight is not much worse than the rest of the country's. Even as the health authorities pronounced obesity a national epidemic, daily participation in gym classes dropped to 28 percent in 2003 from 42 percent in 1991, according to the Centers for Disease Control and Prevention. And the Bush administration recently proposed cutting Physical Education Program grants to schools by more than one-quarter, to $55 million, though Congress rejected the proposal. Schools are so desperate to finance exercise programs that many have turned to food companies for help. McDonald's is offering curriculums and undisclosed sums to 31,000 schools across the country to improve physical education through an effort called Passport to Play; every piece of program literature that children see will carry the company's golden-arches logo. Two years ago, even as New York's health department was assigning a team to improve the treatment of diabetics, the city signed a deal with Snapple that made its fruit drinks the only beverages, besides water, sold in school vending machines. A 12-ounce can of Snapple contains 170 calories and 40 grams of sugar, as much as most colas. The calories in three cans - the amount many students drink every day - would take at least three hours to walk off. The 29 fourth graders in May Chen's class have gym directly after lunch, and their stomachs were full this day with chicken nuggets. They did not change into gym clothes. The teacher, Bruce Adler, started them off with calisthenics, moving quickly to situps and three leisurely laps around the basketball court. There were groans, and several children were winded, but few broke a sweat. Mr. Adler, 55, said the school could really use a second teacher, recalling how different things were when he was growing up in Yonkers. Students there had at least three gym classes a week, he said. New York school officials say they are adding more physical education teachers each year. And two years ago, the Bloomberg administration created the Office of Fitness and Physical Education. Its director, Lori Rose Benson, has begun a program called Physical Best, which will track students' fitness, charting progress for each school. She said she hoped to start the program by the end of this school year in every grade school with a physical education teacher, including May's. She conceded it was merely a first step. "It is very difficult to reverse a culture that existed for 20 to 30 years," she said. Tilting at Golden Arches At least two unthinkable things happened in Albany in the past year. One made headlines: The Legislature passed a budget on time. The other went unnoticed: The Assembly actually debated a bill that tried to address, in some small way, the leap in obesity and Type 2 diabetes. It was a rare moment of attention for a cause that has drawn little more than lip service from government officials, and it was short-lived. The debate, and the bill, died in mocking laughter. The story of that bill, known as A5664, is a lesson in the ways of Albany - and the apathy that diabetes experts say is blocking any effective response to the epidemic. The lesson was an abrupt one for Assemblyman Jimmy Meng of Flushing, who had already embarked on a sharp learning curve. When he was elected the previous fall - the first Asian-American voted into state office in New York - diabetes was nowhere near the top of his list of health issues. But as he became more aware of the disease's threat to children and young adults in his community, Mr. Meng said, he became frustrated with the ignorance and inaction he discovered. In April, he organized and led the first march in Queens to raise money and awareness in the battle against diabetes. And he agreed to support legislation by a fellow Assembly Democrat, Felix Ortiz of Brooklyn. The bill would require all restaurants to prominently post the amounts of calories, fat and salt in each menu item. It was hardly a radical notion. Many fast-food chains had already begun listing calorie counts in restaurants and on Web sites, and months later McDonald's would decide to print nutritional data right on its wrappers. But Mr. Ortiz felt those moves were only a start. Who knew how many calories were in a slice of the neighborhood pizza or a Starbucks caramel macchiato? His passion for the issue - this was just one of six bills he introduced in the 2004-5 session to fight obesity and diabetes - was fed by his own loss. His mother died of the disease when she was only 58. "Everything was caused because she did not take care of her weight," he said. In Albany, the path from legislation to law is thorny, and Mr. Ortiz brought along his own set of hurdles. He was hardly an insider within the Democratic conference, which is controlled by Speaker Sheldon Silver, and some of his bills were considered odd. One would have made it a crime for a person not to come to the aid of another in trouble. The restaurant labeling bill looked like another loser. It had no support from the Democratic leadership. Although it was backed by the American Diabetes Association, which has spent $9,000 lobbying New York lawmakers in the past few years, it was opposed by the food industry, which contributed more than $4 million to legislative and gubernatorial campaigns between 1999 and 2005, according to state records. And diabetes had hardly caught fire as a pressing health issue. The Pataki administration is investing $9 million this year to encourage physical activity among children, but the state has not moved to limit the sale of unhealthful snacks in schools, as a half-dozen other states have. Only $1.9 million of the $100 billion state budget goes directly to diabetes prevention and control, roughly the same amount spent to fight anorexia and bulimia. Two months after the Health Committee approved Mr. Ortiz's bill, it had still not come up for a full Assembly vote. But on June 22, as the legislative session wound down, the bill found its moment. Many members were in a hurry to leave town. As evening approached, Mr. Ortiz spotted Mr. Silver, chased him down a corridor and cornered him outside the speaker's office, in a space where legislators often horse-trade in whispers. Mr. Ortiz, however, was shouting: "I get the same excuse every year!" He wanted his bill debated and voted on by the full Assembly - an unusual request in Albany, where measures rarely make it to the floor of either house unless they are assured passage. Mr. Ortiz's five other bills to fight obesity had languished in committees. If a bill this mild could not succeed in New York, Mr. Ortiz argued, what hope was there for more sweeping measures? Mr. Silver relented. And when the bill came up for a vote, near midnight, Mr. Ortiz had the floor. "This is about the future of our children," he said. When he stopped, the sarcasm began. James D. Conte, a Long Island Republican, said his family owned a burger restaurant. What would happen, he asked, in the case of all-you-can-eat buffets? Mr. Ortiz said the law would apply only to standard menu items. "What about the weekly specials?" Mr. Conte asked. Laughter rose in the chamber. Daniel J. O'Donnell, a fellow Democrat from Manhattan, kept it going. "I watch people who work at McDonald's, and they don't measure how much salt they put on fries," he said. "Do you expect there to be a shaker lesson?" Mr. Ortiz said he guessed that employees were adequately educated. An hour went by. A few colleagues defended the measure. Others argued that enforcing it would be a nightmare, and that the costs would hurt small restaurants. As the time for debate waned, Joel M. Miller, a Republican from Poughkeepsie, rose to state his position. "I did not develop this physique by eating healthy," Mr. Miller, a stout man, said to guffaws. A colleague completed the joke by bringing him a generous plate of cookies. "The bottom line is, it is not going to matter," Mr. Miller said. "We are fooling and deluding ourselves." Mr. Ortiz made one last plea. "When we look at the rate of diabetes in our state," he said, "and when we look at this bill, we should remind ourselves that the decision we make here tonight will make an impact on our kids." The result was clear as soon as the voting began. The yes votes showed up on an electric signboard in green, the no votes in red. Within minutes, the board was glowing red. Before the tally could be completed, Mr. Ortiz stood and delivered the final word: "I would like to say, with a lot of passion, I withdraw this bill." * Copyright 2006The New York Times Company



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