Dribs
and drabs of research from a few countries around the world have raised concern
that diabetes is growing as a cause of death and disability.
But the first
coordinated global look at the disease, published in The Lancet this week, has fully sounded the
alarm.
Pooling data from 751 studies involving 4.4 million adults,
researchers estimated that the number of adults with diabetes in 200 countries
has nearly quadrupled, from 108 million in 1980 to 422 million in 2014. And the
disease is growing faster in low- and middle-income countries than in
high-income countries. The lowest prevalence of diabetes — about 5 percent of
the population — was in northwestern Europe. At the other end of the spectrum,
approximately 1 in 4 adults has diabetes in the Pacific islands of Polynesia
and Micronesia. American Samoa holds the dubious distinction of the highest
rate of diabetes in the world: 30 percent of the adult population.
NPR talked with Dr. Majid Ezzati of
the School of Public Health at the Imperial College of London, who designed the
study and oversaw the research. The interview has been edited for clarity.
We
hear a lot about the exportation of the worst of the Western diet — fast food,
soda — to developing nations. Is that what's causing the increase in diabetes
around the world?
I think that's an old
idea, and overstated. After all, there are features of the diet in the
developed world that are good. The role of technology and affluence has been to
provide whole grains, fresh fruits and vegetables all year round. It would be
great if we could export that. The increase in diabetes is a food story, but
not necessarily fast food.
So
as regions of the world climb out of poverty, people eat more of whatever
they'd been traditionally eating.
Yes, and
obesity goes up. I emphasize that it doesn't have to be a lot of fast food and
commercial food. Eating more of the same foods increases BMI [body
mass index]. Calories are calories and carbs are carbs. If they're eating the
white rice that they traditionally ate, but eating more of it, that could be
increasing BMI.
What
else might be causing the increase?
The short answer is that
we don't completely know. But one idea is that people who were malnourished,
either as fetuses or as young children, and are now eating more and gaining
weight, are more susceptible to diabetes. The evidence is accumulating that
poor childhood conditions can affect how we produce or use insulin.
Reference:
npr.org
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