Slowing the diabetes epidemic in the World Health Organization South-East Asia Region: the role of diet and physical activity

ABSTRACT

The nutrition transition occurring in the World Health Organization South-EastAsia Region, as a result of rapid urbanization and economic development, hasperhaps made this region one of the epicentres of the diabetes epidemic. Thisreview attempts to evaluate the role of diet and physical inactivity in the South-EastAsia Region in promoting this epidemic and points to strategies to slow it downby lifestyle modification. The emerging new food-production technologies andsupermarkets have made energy-dense foods more easily available. This includesrefined carbohydrate foods like those with added sugars, and refined grainsand unhealthy fats. In addition, increased availability of modern technology andmotorized transport has led to decreased physical activity. South Asian diets tendto be based on high-carbohydrate foods, with a predominance of refined grains.All of these accentuate the risk of diabetes in people of this region, who alreadyhave a unique “south Asian phenotype”. However, there is increasing evidencethat altering diet by replacing refined cereals like white rice with whole grains (e.g.brown rice) and increasing physical activity can help to prevent diabetes in highrisk individuals. An urgent, concerted effort is now needed to improve diet qualityand encourage physical activity, by introducing changes in policies related to foodand built environments, and improving health systems to tackle noncommunicablediseases like diabetes.