Title: Diabetes Is a Major Public-Health Crisis in China
Headings: Diabetes Is a Major Public-Health Crisis in China
Diabetes Is a Major Public-Health Crisis in China
Content: "The roughly 10-fold increase in prevalence of type 2 diabetes over the past 3 decades among Chinese adults suggests that the epidemic is driven primarily by unhealthy diet and lifestyle, along with industrialization, urbanization, and increased aging populations," said coauthor Xu Lin, MD, PhD, professor and assistant director at the Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences. Increases in the standard of living and a shift away from a more traditional Chinese lifestyle have resulted in a "mismatch" between biology and environment, Dr. Lin and colleagues write. Rapid urbanization — about half of the Chinese population now lives in cities and towns compared with 20% in the late 1970s — combined with reduced physical activity and changes in diet have helped fuel the epidemic. And both the Western diet, characterized by food abundance, increased consumption of fat, foods from animal sources, and sugar-sweetened beverages, and the traditional Chinese diet, heavily laden with rice and salt, may tip the balance toward the development of diabetes. Other contributing factors include psychosocial stress, very high rates of smoking (China has over 300 million smokers), exposure to endocrine disruptors like bisphenol A from environmental pollution, and social stratification. In addition, both maternal malnutrition and gestational diabetes (which has also increased in China) could predispose offspring to diabetes. Genetic heritability of type 2 diabetes likely also plays a large role, but studies have yet to pinpoint specific genetic factors that can explain some of the ethnic differences seen between the epidemic in China and Western countries. "Overall, China still has a long way to control the epidemic trend of obesity and type 2 diabetes," Dr. Lin emphasized. " Government, public and private enterprises, nutritional and medical researchers, and doctors need to work together, not only to have a better understanding about the key factors contributing to this epidemic, but also to provide better foods, nutrition recommendations and policies, effective public education, intervention strategies, and a friendly environment for healthy living." Treatment Strategies: