Diabetes: a growing problem in newly-rich Asia
Last Updated: 2007-03-12 9:12:44 -0400 (Reuters Health)
By Tan Ee Lyn
HONG KONG - A cheese burger one day, lasagna the next and chicken nuggets instead of a bowl of noodles.
Across the continent, a newly-affluent Asian middle class is splurging after centuries of deprivation, shaking off a diet traditionally high in vegetables and rice and low in meat and opting instead for food loaded with saturated fat.
But the new variety of foods available to affluent Asians, coupled with a less active lifestyle, has a price -- diabetes.
Health experts say Asians are especially at risk for diabetes -- caused by excess weight, fatty foods and lack of exercise -- as the Asian metabolism has over the centuries adapted to a frugal diet and a hard-working lifestyle.
"If you have a poor early life and you then rapidly move into the direction of plenty, you may be more at risk," said Clive Cockram, a professor of medicine at the Chinese University in Hong Kong.
Asians are four to six times more likely to get diabetes than Caucasians, experts say.
Health experts are concerned that diabetes, a chronic and potentially fatal disease, could reach near epidemic proportions across Asia and among affluent Asian communities living abroad. "There is more diabetes than AIDS. It will take over as the main health problem of the developing world soon," said Dr Shirine Boardman, a diabetes expert at Warwick Hospital in England.
In the Western Pacific, a region stretching from Mongolia and Japan in the north to New Zealand in the south, the number of diabetics is expected to hit 100 million in 2025 from 67 million today.
FROM FAMINE TO PLENTY
The rise in diabetes cases comes hand-in-hand with an economic boom in China and India that has brought prosperity to many poor families.
The growing affluence among many in the world's two most populated countries, experts say, could be causing the jump in diabetes cases as people in China and India have more money to spend on food and are less likely to toil in fields.
"There is a theory that famine actually protects people from diabetes," said Kirpal Marwa, a diabetes expert in Britain.
Cockram agrees.
"The human organism has evolved with a lot of protective mechanisms that are basically developed over millennia to protect us from starvation and deprivation and from being hunted down and killed," Cockram said.
"They are not there to protect us from the effects of the current environment which is the exact opposite, where we have plentiful supply of food," he added.
According to his "thrifty gene" theory, a malnourished fetus is likely to have a smaller pancreas that would be less able to cope with a plentiful and sugar-rich diet later in life.
The pancreas produces insulin, which helps to use or store sugar. But when the body doesn't make enough insulin or can't properly use insulin, sugar cannot be properly stored or used and it builds up in the bloodstream, resulting in diabetes.
The most common type of diabetes is type 2 diabetes.
There are now 246 million such cases worldwide and the figure will hit 380 million by 2025, according to the International Diabetes Federation. That figure was 194 million in 2003.
Three million deaths worldwide are attributable each year to diabetes.
Karen Lam, a professor at the University of Hong Kong's Department of Medicine, said the solution is the same regardless of the theories about Asians' susceptibility to diabetes.
"At the end of the day how you tackle it is still the same. You eat less, you may have plenty, but you don't need to eat all of it, and you do more exercise," she said.
DIABETES DEATHS
Hong Kong chef Cheung Kin-wai discovered he had diabetes when he nicked his finger at work a few years ago.
"The wound didn't heal and I had to undergo surgery at once because the bacteria had gone right into my bones. I was confirmed with diabetes," said Cheung, 51.
It's not just Cheung's age group that is at risk. Diabetes, for which there is no cure, is striking at more younger people.
In Japan, type 2 diabetes among junior high school students doubled to 13.9 per every 100,000 in that age group in 1991-1995 from 7.3 in 1976-1980.
Diabetes is best controlled and managed with drugs, exercise and a proper diet to avoid serious complications such as heart disease and strokes, high blood pressure, blindness, kidney and nerve damage, infections and gum disease.
Type 2 diabetes is also harder to manage over time and drug compliance is vital. Cheung suffered a stroke after he stopped taking his medication.
In Britain, doctors are seeing a steep rise in diabetes sufferers among Asians, especially of Indian and Pakistani origin.
According to Boardman of Warwick Hospital, one in four Asians aged over 40 in Britain will get diabetes and 40 percent of people of Pakistani origin in Britain will contract the disease.
"(Asian communities) are looking at a huge epidemic coming along as these communities become affluent and have enough to eat and are too busy working to exercise," said Boardman.
(Additional reporting by Deborah Haynes in London)
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