(15-06-11) Globalization of Diabetes: The role of diet, lifestyle, and genes.

Hu FB.
Source
Corresponding author: Frank B. Hu, [email protected].
Abstract
Type 2 diabetes is a global public health crisis that threatens the economies
of all nations, particularly developing countries. Fueled by rapid
urbanization, nutrition transition, and increasingly sedentary lifestyles, the
epidemic has grown in parallel with the worldwide rise in obesity. Asia's large
population and rapid economic development have made it an epicenter of the
epidemic. Asian populations tend to develop diabetes at younger ages and lower
BMI levels than Caucasians. Several factors contribute to accelerated diabetes
epidemic in Asians, including the "normal-weight metabolically obese"
phenotype; high prevalence of smoking and heavy alcohol use; high intake of
refined carbohydrates (e.g., white rice); and dramatically decreased physical
activity levels. Poor nutrition in utero and in early life combined with
overnutrition in later life may also play a role in Asia's diabetes epidemic.
Recent advances in genome-wide association studies have contributed
substantially to our understanding of diabetes pathophysiology, but currently
identified genetic loci are insufficient to explain ethnic differences in
diabetes risk. Nonetheless, interactions between Westernized diet and lifestyle
and genetic background may accelerate the growth of diabetes in the context of
rapid nutrition transition. Epidemiologic studies and randomized clinical
trials show that type 2 diabetes is largely preventable through diet and
lifestyle modifications. Translating these findings into practice, however,
requires fundamental changes in public policies, the food and built
environments, and health systems. To curb the escalating diabetes epidemic,
primary prevention through promotion of a healthy diet and lifestyle should be
a global public policy priority.

Source: Diabetes Care. 2011 Jun;34(6):1249-57.

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