"Asian Diabetes Tsunami" and Ethnic burdens of obesity and diabetes: "Equality" where we don't want it!

The obesity epidemic is becoming worldwide, offerring equal access to diseases that were once the province of the wealthy.  This is not a dig against people who happen to be obese, I struggle with weight as well.  It's also not a claim that everyone who is obese is unhealthy.  However, obesity is the entry point to many diseases that worsen quality of live and shorten duration of life for millions of people:  diabetes, heart disease, arthritis, depression, and other conditions.


Obesity, and with it, diabetes, is growing in the developing world as well as the developed world.  The numbers are increasing as more and more people become sedentary, drive more, walk less, eat excesses of processed obesigenic foods, and work too many hours in sedentary jobs, to exercise off the excess calories, processed carbohydrates, and fats.


This article from New Zealand, quoting New England Journal of Medicine:  "The global diabetes hub is in China, where one in 10 individuals is suffering from the disease, as per the most recent report found in the New England Journal of Medicine."



Here is the NEJM article.  (Please forgive my stream of consciousness style of linking).  "In the past 20 years, the rates of obesity have tripled in developing countries that have been adopting a Western lifestyle involving decreased physical activity and overconsumption of cheap, energy-dense food. Such lifestyle changes are also affecting children in these countries; the prevalence of overweight among them ranges from 10 to 25%, and the prevalence of obesity ranges from 2 to 10%. The Middle East, Pacific Islands, Southeast Asia, and China face the greatest threat. The relationship between obesity and poverty is complex: being poor in one of the world's poorest countries (i.e., in countries with a per capita gross national product [GNP] of less than $800 per year) is associated with underweight and malnutrition, whereas being poor in a middle-income country (with a per capita GNP of about $3,000 per year) is associated with an increased risk of obesity."




The growing prevalence of type 2 diabetes, cardiovascular disease, and some cancers is tied to excess weight. The burden of these diseases is particularly high in the middle-income countries of Eastern Europe, Latin America, and Asia, where obesity is the fifth-most-common cause of the disease burden — ranking just below underweight. The high risk of both diabetes and cardiovascular disease associated with obesity in Asians may be due to a predisposition to abdominal obesity, which can lead to the metabolic syndrome and impaired glucose tolerance.



Of course, this is not just a "foreign" (ie, non-US or non-Western) issue.  For minorities in the US,

  • All minorities, except Alaska Natives, have a prevalence of type 2 diabetes that is two to six times greater than that of the white population.
  • Improving the lipid profile of African Americans with diabetes could help to lower their risk of diabetes-related cardiovascular disease.
  • Health care interventions that take into consideration cultural and population-specific characteristics can reduce the prevalence and severity of diabetes and its resulting complications.

(AHRQ.gov)  - a US government website regarding health care priorities and oversight.


There are many disparities in health and medical care regarding ethnicity and race, in the US and other developed countries and around the world.  I find it interesting that development and equality might leapfrog from the malnutrition and underseight aspects, to aspects of overconsumption, skipping a middle ground of healthy living.


What will happen?  I suspect it's a good time to buy stock in Diabetes-related companies, such as those that make insulin products and pills for diabetes.  (Just a wild guess, don't come to me if your favorite pharamceutical company goes under in 5 years.)



As an aside (really aside but still related to this topic in the sense of "yes, b ut what can I do about this for ME), a while back I started a discussion group on healthy living, and will try to give that some more focus now.  Race and ethnicity-related issues are among the most important topics for me, but interest is as not high on Nexus at this time.  I'll continue to post here, but it will also be fun to look at a topic that all nontheists need to consider thoughtfully, how best to live their one-lives to the fullest and healthiest.



Enjoy Today and Tomorrow


Eubie Blake was chosen as the profile pic for that group, as someone who appeared to live life to its fullest, lived long, made life more fun for others, and is famous for saying " "If I'd known I was going to live this long, I would have taken better care of myself."




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Replies to This Discussion

A lot of hispanic and Native American population where I live. And it seems that seeing a child who isn't significantly overweight is the exception to the rule.
Jo Jerome, thank you so much for commenting. It tells me that someone is interested in reading this stuff!

There's an interesting story regarding Pima populations and their tendency toward overweight and diabetes. Briefly, it was hypothesized that " for thousands of years populations who relied on farming, hunting and fishing for food, such as the Pima Indians, experienced alternating periods of feast and famine. Neel said that to adapt to these extreme changes in caloric needs, these people developed a thrifty gene that allowed them to store fat during times of plenty so that they would not starve during times of famine." With a change to westernized/Americanized diet and lifestyle, the tendency to store calories as fat is now working against these populations. (I wonder if this is also a situation among Samoans, more than 75% of urban Samoans are obese according to WHO definition of obesity).

The linked article goes on to say "Recently, Ravussin visited a Pima community living as their ancestors did in a remote area of the Sierra Madre mountains of Mexico. These Mexican Pimas are genetically the same as the Pima Indians of Arizona. Out of 35 Mexican Pimas studied, only three had diabetes and the population as a whole was not overweight, according to Ravussin."

I don't know if there is modern evidence for this thrifty gene hypothesis among the Pima or if it has been debunked. A google search brings up some genetic research, such as here, implicating "a gene called FABP2 that may contribute to insulin resistance." another very arcane research report here implicates at least one gene related to diabetes among Pima. "The result offers suggestive evidence for the presence of a gene affecting obesity in this region."

Even with a gene identified in this population, or a group of genes, the best way to work with the tehdency toward obesity still falls back to change of lifestyle and diet. Not an easy solution, but there won't be a pill to fix this situation.
I too have heard the Thrifty Gene hypothesis, mostly from Natives themselves. But like you, haven't seen if there have been hard studies to back it up or not. It does make sense though.

Have also been told by many natives that wheat - which most people throughout the world have some degree of intolerance for - Native Americans tend to have even less tolerance for. That it is much more likely to be converted to fat. This too, from a purely anecdotal view, sounds plausible as the Americas practiced a lot less wheat cultivation up until 500 years ago than many other areas of the world.
Interesting thoughts.

In general, wheat intolerance is an immune reaction caused by antibodies to gluten, the wheat protein. This reaction causes breakdown of the absorptive tissues in the small intestine, resulting in malabsorption - nutrients pass through without absorption. There is often chronic diarrhea, which is often the 1st step to diagnosis. This causes malnutrition and underweight status. It's called celiac sprue. If I remember correctly, this is most common for people with Celtic or Jewish heritage. I don't know about the wheat grain resulting in an overweight issue, except that when bran is removed, it has a higher relative amount of carbohydrate and is more fattening to all of us.

Also, I was under the impression that wheat was a purely European plant - the grain was Maize / corn. Similar to SE Asia the grain was rice until globalization. Was there wheat in the Americas, at all, before Europeans brought it here?

A side note - even though we say there is no genetic basis for RACE, there are genetic differences among ethnic groups. This demonstrates one of those differences.
A side note - even though we say there is no genetic basis for RACE, there are genetic differences among ethnic groups. This demonstrates one of those differences.

Yes, a HUGE distinction.

If one wants to split hairs, there is a genetic mutation/adaptation that accounts for skin color; either your DNA is coded to produce more melanin or less. But it's no more a genetic difference than blonde versus brunette, or blue eyes versus brown eyes.

Anthropology class the other day we discussed Kennewick Man. 9,000 year old skeleton found in Washington State that has curiously caucasoid features rather than Native American.

And there again lies the shitstorm that results from the layman's interpretation of "Caucasoid features" as "White." Just because caucasoid features today tend to go along with light skin doesn't necessarily mean that's true 9,000 years ago. Even if he was light of skin and European of descent should not mean anything to the issue of who 'discovered' America or who the country 'belongs' to. If there were Europeans in America 9,000 years ago, by the time Columbus got here they appear to have either died out or more likely got absorbed into the more dominant Asian/Mongol genetic pool.

Once again, underscoring the silliness of trying to separate everyone by 'race.' It's skin deep. Literally.
I took a health psych class and what was presented was that Europeans have developed a higher metabolic rate due to evolutionary progress. That certain high caloric foods had been introduced into their populations well before the other ethnic groups and therefore have developed this trait earlier.

What is also noteworthy is that food companies specifically target consumers hardwired desire for fatty, salty, sugary foods. Like what you brought up about the alternating feast and famine times, whenever people taste sugary, fatty, salty foods, they eat it in abundance because of our biological predisposition. The companies isolate those flavors and develop synthetic products that our bodies have yet to metabolize at a sufficient rate to keep weight down.

Have you seen the movie Food Inc? I highly recommend it. Companies put sugar into products you wouldn't think would have sugar in them or worse, use high fructose corn syrup(HFCS). In a Princeton study, it was shown that all sugars aren't equal. "The first study showed that male rats given water sweetened with high-fructose corn syrup in addition to a standard diet of rat chow gained much more weight than male rats that received water sweetened with table sugar, or sucrose, in conjunction with the standard diet." I think its despicable that these companies also target children's desire for colorful, toy products. Making these foods either resemble toys or selling them with toys.

I'm very interested in this, not just as a Native American but for people who are unaware of this and believe they're buying healthy food for their families and themselves. I try to talk about it as much as I can because people should be informed.
I wonder about that higher metabolic. Was it measured? There is certainly no lack of obesity among European Americans, although Europe so far appears less generously proportioned than USA white people.

That being said, there is that Thrifty Gene hypothesis mentioned above, as well as studies related to glucose tolerance for Pima and some study of Samoans. Probably not much, I would have to do more research on the topic.

I have seen Food Inc but it's been a while. I think there have been discussions on hormonal responses to high fructose corn syrup, I don't know if any of it is conclusive.

What I do know is that packing in high concentrations of calories well beyond what is consumed for activity, results in increasing body fat levels. An excess of 100 calories per day results in weight gain of about 10 pounds per year. 100 calories isn't much, when you read labels. 1 ice cream bar is 150 cal. Over 5 years, that's 50 pounds extra, over 10 years, 100 pounds extra. 8 oz of coca cola classic is 98 cal. A large serving of French fries is 539 cal, so all you need is that once weekly, plus 8oz of coke for 4 days per week, and you have that 10# weight gain per year.

Another rough measure is 3500 calories = 1 pound. So, to lose 1 pound in 1 week, you need to decrease intake by 500 calories per day for 1 week, or burn off 500 calories per day with increased exercise.

What this all adds up to is the factory produced western diet is a great way to increase body weight for everyone. Some faster than others.



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