I actually agree with you.
> I'd rather have diabetes than be dead, certainly, but wouldn't it better to not risk diabetes just to stay alive?
Again I agree, but I also think there's a huge cultural component to food/eating that is often missed in these discussions.
This is a mischaracterisation. If you have any choice in what you eat, you risk diabetes just to stay alive.
There is so much food that far fewer people are dying of malnutrition than in the past. As part of there being lots of food available, it's also possible to eat yourself into heart disease and type 2 diabetes. Great availability requires some responsibility.
Since I reached the "can afford to shop at whole foods if I wanted to" stage of my life, the combination of lifestyle, genetics, and diet means I'm pretty far from diabetes at the moment.
But when I was a lot worse off, I bought the food I could afford, which tended to be the low-cost, high-calorie stuff that leads to health problems. Maybe (and I'm just spitballing here) we should find a way to lower the cost of higher-quality food. The decision for huge swaths of the world should not be "afford enough food to not starve, but the food is of such low quality that it leads to long-term health problems" vs "starve while eating food that, if eaten in sufficient quantity, would not lead to long-term health problems". Optimizing for dollars per calorie means you end up picking high carb options.
Telling people in Somalia or wherever "have you just tried keto?" is a pretty problematic stance.
I think this is letting the good be the enemy of the perfect (a rare construction, to be sure). Yes, we've solved a very bad 1st order problem. That frees us up to work on 2nd order problems that we've never had to deal with before. This is a thalidomide-style problem in that the side-effects of the "cure" are a disease in their own right.
I'd rather have diabetes than be dead, certainly, but wouldn't it better to not risk diabetes just to stay alive?
I'm substantially in agreement with you though. The less land we use on food production, the better. The less labor we can expend growing and harvesting that food, the better.
All of that said, the parameter space of agriculture has a complicated shape, so optimizing for any one parameter will be at the expense of other parameters.