Asian-American Diabetes Trends Point to Diet

According to New York Times reporter Marc Santora the current diabetes epidemic is hitting the city's Asian population like a tsunami. The article warns that immigrants abandoning their traditional diets for typical American foods are at extremely high risk of developing diabetes. Santora explains:

Asians, especially those from Far Eastern nations like China, Korea and Japan, are acutely susceptible to Type 2 diabetes, the most common form of the disease and the subject of this series. They develop it at far lower weights than people of other races, studies show; at any weight, they are 60 percent more likely to get the disease than whites.

And that peril is compounded by recent immigrants' sudden collision with American culture. Many of them left places where factory and fieldwork was strenuous, televisions were rare and advertising was limited. They may speak little English and have poor access to medical care.

Many have never even heard of diabetes, much less the recent scientific studies showing that a Western diet, high in fat and sugar, puts them in danger of getting Type 2 diabetes, which has been linked to obesity and inactivity, as well as to heredity. (Type 1, which comprises only 5 percent to 10 percent of cases, is not associated with behavior, and is believed to stem almost entirely from genetic factors.)

Many recent Chinese immigrants have come from places where food was scarce, and experts say some view fat as a trophy of wealth and status. Their children try to fit into their new country by embracing its foods and its sedentary pastimes.

In Asia diabetes is so rare that many people have never heard of it, yet as the Times reports, we now know that many Asians have the genes to be highly susceptible to the disease. Of course, genes don't change much when people move to a new country, but diets certainly do.

In his book Eat to Live Dr. Fuhrman offers some insight in to why some Asians are facing severe shocks to their health when switching to the typical American diet:

The Chinese [living in China], who on the average consume more calories, are thinner than Americans.1 In China the calorie intake per kilogram of body weight is 30 percent higher than in the United States. The Chinese eat about 270 more calories per day than Americans, yet they are invariably thin. Exercise cannot fully explain this difference, as researchers discovered the same thing with Chinese office workers as well.

This may be because calories from carbohydrates are not as likely to increase body fat as the same number of calories from high-fat foods such as oils and meats, which make up such a high proportion of the American diet. The data suggests that when a very low fat diet is consumed (15 percent average dietary fat in rural China), as compared to the typical Western diet (30-45 percent of calories from fat), more calories are burned to convert carbohydrate in fat, so the body cannot store fat easily.

The modern American diet receives about 37 percent of its calories from fat, with lots of sugar and refined carbohydrates. The combination of high fat and high sugar is a metabolic disaster that causes weight gain, independent of the number of calories.

1. Campbell, T.C., and J. Chen. 1994. Diet and chronic degenerative diseases, in Western diseases: their dietary prevention and reversibility. Edited by M.J. Temple and D.P. Burkitt. Totowa, N.J.: Humana Press, pp. 67-119.

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