Healthcare

A weighty issue

More obesity means more diabetes

Few would deny that China is enjoying a new heavyweight status in terms of its international influence.

But as far as the tag goes, it is far less welcome one when used to refer to its people.

Unfortunately, however, China is getting fatter as measured by the percentage of the population classified as overweight or obese. An equally unwelcome side effect is a rapid increase in its reported rates of diabetes. The China Daily said this week that diabetic patients now account for 3.1% of the population – up from 0.6% in 1978.

In fact the Ministry of Health thinks that the country now has at least 40 million diabetics, with 1.5 million more cases being reported each year. Only India now suffers more from the disease in absolute terms.

Some of that increase is down to more people being correctly identified as diabetes sufferers.

But the disease is also far more likely to develop among the overweight or the obese. So changing diets (in which high-fat, high-calorie foods replace more traditional fare) are a major culprit. Lifestyles and workplaces are also becoming more sedentary. Having close to 350 million smoking habits doesn’t help the nation’s health prospects much either.

Some experts also blame the cultural context. A recent history of famine and malnutrition has been said to explain obesity’s attraction to some older Chinese – as weight is associated with health and prosperity.

A more recent phenomenon – the one-child policy – gets some of the blame for tubby youngsters. Parents are spoiling the “little emperor” generation of single children – sometimes literally.

Of course, China still trails Western countries by some distance in the obesity stakes. Reuters reported at the beginning of July that 26% of Americans are obese (or scoring 30 or more in their Body Mass Index, which is calculated by dividing weight in kilograms by height in metres squared).

Compare this to China (where 2.8% of males and 5% of females fall into a similar category, according to data from the Journal of American Medicine) and the situation looks a lot less severe.

Still, the proportion of Chinese who are overweight is growing quickly. The more GDP the more BMI, it seems.

The BMI score may also be telling only part of the story, as Asians are also much more prone to “central” obesity in which fat gathers around the abdomen.

Health professionals contend that China’s abdominal obesity problem may have more to do with the speed at which the country has undergone economic change. Local metabolism (and body shape) has not had the time to catch up. Low birth weights may also be a factor.

But the overall effect is that many Chinese lack the capacity to store excess fat in other areas of the body.

Sufferers of abdominal obesity are also more prone to developing Type 2 diabetes – anything from two to five times more likely. So this tends to mean that diabetes sufferers in China are often younger and less overweight than their international counterparts. Unfortunately for them, if they do contract diabetes they are also more likely to develop other illnesses later in life, especially kidney and heart disease.

This is already having a major economic impact; the World Health Organisation estimates that China will lose $558 billion in income due to diabetes and heart disease between 2006 and 2015.


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