Carb-Loaded: A Culture Dying to Eat: One in three Americans is pre-diabetic. A huge percentage of them do not know that they are sick. Adult onset diabetes is no longer an illness for the obese and elderly. Millions of Americans who regularly exercise and eat a diet recommended by the USDA are classified as "skinny-fat". The connection between the standard American diet and numerous metabolic disorders is now an unspoken fact in most medical circles