Japan Hit by Diabetes

[Real4]

From a major Japanese Newspaper, Asahi:

Diabetes cases up by 2.5 million

An estimated 18 percent of the nation's adult population had diabetes or were borderline cases in 2006, according to the health ministry.

It was estimated that 18.7 million people aged 20 or older had or were at risk of coming down with diabetes, the ministry said. The figure was up 2.5 million from 2002.

Lack of exercise and unhealthy eating habits were blamed for the jump, the ministry said.

The estimates were based on hemoglobin A1c (HbA1c) which measures average blood glucose levels.

The survey found that an estimated 8.2 million people had levels of at least 6.1 percent, which could indicate diabetes.

Levels of about 10.5 million people stood at 5.6 percent to less than 6.1 percent.(IHT/Asahi: May 2,2008)

[adiantum]

" The survey found that an estimated 8.2 million people had levels of at least 6.1 percent, which could indicate diabetes."



why would A1C of 6.1% indicate diabetes? Seems rather harsh to me

[fgummett]

The Canadian Diabetes Association 2003 Clinical Practice Guidelines... (http://www.diabetes.ca/cpg2003/) (to be updated this year), state:

A fasting plasma glucose (FPG) level of 7.0 mmol/L correlates most closely with a 2-hour plasma glucose (2hPG) value of >11.1mmol/L in a 75-g oral glucose tolerance test (OGTT) and best predicts the development of microvascular disease (1). This permits the diagnosis of diabetes to be made on the basis of the commonly available FPG test. Although the frequency distributions of glycosylated hemoglobin (A1C) levels in some studies have characteristics similar to those obtained from FPG and 2hPG tests, the lack of standardization of the A1C test precludes its use in the diagnosis of diabetes.

And I agree, an A1c of 6.1% is pretty good

[Evermont]

6.1% may be good but clearly, the trend is bad and it's going to get worse. I think it's noteworthy.

[Gordonm]

Gee, they have adapted the western way of eating. TOO MUCH.

To many McDs have gone in over there.

[REDLAN]

did a very quick google search and found this

http://care.diabetesjournals.org/cgi/content/abstract/18/10/1337

entitled The effect of aging on HbA1c in a working male Japanese population. They found that HbA1c increased with age - the largest increase was in the 40-49 year group with a BMI below 26, and in the 30-39 group with a BMI>26. Hba1c was not related to physical activity, but was related to family history.

the authors concluded...

The age-dependent increase in HbA1c may be a consequence of the aging process itself.

The following quote

t is the fastest ageing society in the world and one in five Japanese people is over 65. By 2015, that proportion will have grown to a quarter – 33.8 million people – and it is projected to rise to 40 per cent by 2055.

from the independent

http://www.independent.co.uk/news/world/asia/land-of-the-rising-geriatrics-403315.html

What was that the fastest ageing society in the world? Just might go some way to explaining that rising Hba1c. ;)

A significant proportion of the rise is very likely to be due to an ageing population. In the US from my own rough estimate from census figures, approximately half the rise in type 2 is explained by ageing in the US population.

[fgummett]

That is interesting... even with McD and Co. over there, I find it hard to picture many Japanese switching to a Western diet on a regular basis... I didn't think they had the same issue of obesity that is so widespread (hah!) in the Western World. Although I do understand that folks from Asia who move to the West are seen as a high risk group, presumably when they adapt to our healthy Western ways :)

[MJB]

The lab my doc uses lists A1c < 6.0 as non-diabetic.

I'm sure this varies but could explain the reason for 6.1 being considered diabetic in this case.

Edited to add it does say at least 6.1 and it could indicate diabetes.

[Janlaton]

I have read many articles about the decline in eating tradional foods in Japan. Not nearly as much fish as used to be in the diet. This is true in most of the more progressive oriental countries. THe more western the more diabetic...so that means it's an American disease. Don't think so but we could learn more about eating and exercise.

[volleyball]

Money brings more of a good thing and people pay for it twice. While its been awhile since I spent a lot of time in the Pacific, I could not eat their american food. Why? It made me nauseas. The package may have the same name on it but it is not the same food. Think cereal. You go buy a box of Kashi, they go buy a box Kashi, only theirs is really the no name brand of cereal sold at the dollar store. Not saying Kashi actually does this.
Their almost overnight change to our foods has caused them some real problems. It would be like us going to the bahamas and drinking cistern water like the locals do. Many of us would get sick because our bodies are not equipped to deal with it.
I just wanted to point out that their american diet is not our american diet.

[volleyball]

I just ran across this article which mentions diabetes as well as different body types

[matingara]

Gee, they have adapted the western way of eating. TOO MUCH.

To many McDs have gone in over there.

are we perhaps too quick to blame what you are referring to generically as the "Western" diet.

I have heard diabetes is greatly on the rise in Japan, China and India.

perhaps it is their level of carbohydrate consumption (i.e. rice and wheat) that is causing the problem?

also, i agree that MacD is high in fat - but it is even higher in Carbs. everyone blames the fat meat and the fact that chips are fried in fat for MacDs poor nutrition. BUT, perhaps it is the carbs that are equally (if not more) to blame.

i think these arguments need to be considered.

:)

-- Joel.

[volleyball]

Another thing to think about is body type. Asians and Indians tend to put on fat around their organs while maintaining thin limbs, The apple vs pear body. The song "baby got back" just doesn't come to mind with the typical population. Also muscle mass is much less and we all know how much muscle helps in using free energy.
A typical value meal will exceeds most daily requirements for calories for small people. Like us getting super sized meals all the time. Remember that movie, Supersize Me?
They are also eating fake meat made from carbs and coupling that with sticky rice which has the most starch and they don't wash it off.

[REDLAN]

Thought you might find this interesting

The change of dietary habits and the resultant changes in health of Japanese children (http://cat.inist.fr/?aModele=afficheN&cpsidt=1927322)

The article discusses the changes in dietary intake for 6 year old japanese girls from 1954 to 1994.

Carbohydrate intake has decreased from 73% to 53%
Fat intake has risen from 14% to 32%

calorie intake rose to a high of 1884 Kcal in 1971 and has decreased to 1627 Kcal by 1994.

The article recommends that japanese children should INCREASE their carbohydrate intake.

[Evermont]

Thought you might find this interesting...

You were right. Thanks!

[volleyball]

That may have been fact but it is still misleading. A post war Japan was not a stable environment
Another thing is that the traditional asian diet is very regional. A person 50 miles away could have a very different diet. Image the lack of seafood in the midwest 60 years ago.