Driving around any big city in Asia often seems like a big advertisement campaign to spread diabetes when I see huge billboards displaying glossy images of fatty, fried, carbohydrate-rich food. This stands in stark contrast to the World Health Organization’s global advocacy Beat Diabetes launched for World Health Day 2016. The campaign calls for immediate action at all levels to change the course of the worldwide epidemic of diabetes, recognized as the world’s fastest growing chronic condition and a leading cause of death globally.
Most people with diabetes live in Asia and the Pacific, where the incidence of the disease can reach up to 30% of the population in some Pacific island nations. This creates a huge burden for health systems and families, who must bear the cost of chronic treatment and premature death. So what should we do to address the problem and eradicate diabetes once and for all in the region? The majority (58%) of respondents in our April blog poll believe leading a healthy lifestyle is the way to go.
One big misconception is that diabetes only affects older people. Actually, in Asia people tend to develop diabetes at a younger age, and suffer longer with more complications like kidney failure compared to non-Asians. That is why dialysis clinics are becoming a lucrative business here. The picture becomes even more dramatic when you consider that 50% of people with diabetes are not yet diagnosed, thus aggravating the risk of complications. It is also shocking that South Asia has the highest incidence of diabetes in children, which can affect school performance, productivity and fertility if the disease is not treated and managed early on.
Looking at these facts, a person with common sense will ask why Asian governments don’t step up and quickly address the issue. Well, the problem is that broad personal behavioral and social change is needed to tackle diabetes. That of course is easier said than done, and here are 5 things we need to achieve that change:
- Lifestyle. If we extrapolate the results of our survey to the whole population in the region, we would assume that over half of all Asians understand the importance of a healthy lifestyle. However, even in a developed country like the US most people admit they don’t eat and live healthy, so even if a majority of the population is aware of the solution, they don’t know how—or are not willing—to translate this knowledge into action.
- Education. Action for behavioral and social change has to be facilitated by government; it should start with early childhood education, and continue throughout school. Education does not stop at the classroom chalkboard. Unfortunately, this is even the case in the canteens of international private schools, where the kids in theory can afford to eat healthy but about 80% of the food offerings are not healthy and include sugary drinks. We need strict policies to prevent diabetes at school and in the workplace.
- Communication and advocacy. The media and civil society have begun to promote healthy lifestyles in Asian countries, but only targeting those who can afford healthier food choices, and very little information trickles down to low-income groups. The majority of the population gets their information from television advertisements and programs where unhealthy food is widely displayed. This should be banned like cigarette advertising.
- Bold policies. Let’s face it – unhealthy food is cheap. We can see this in any supermarket in a developing country, which usually carry a big selection of low-quality processed food. I would demand supermarkets clearly label unhealthy food, provide alternative options, and tighten regulations against the import of processed food with low nutritional value.
- Conducive environment. Urban planning may not seem related to diabetes prevention, but ensuring our future cities have open spaces, encourage people to walk or bike to work and stay physically active can do a lot to fight the disease. In the workplace, companies should facilitate playing sports during breaks, and require their canteens to serve healthy food options. The Cities Changing Diabetes initiative from Novo Nordisk brings together urban decision-makers, planners and health experts to create cities designed to prevent diabetes.
To sum it up, diabetes can’t be solved by health systems alone; it’s a global problem that is driven by our lifestyle choices. To beat diabetes, governments across Asia need to introduce bold policies to ban unhealthy processed food, promote fresh nutritious food, and encourage physical exercise from an early age. The world does not need a bigger selection of cereals, sweets, chocolate milk, soft drinks, fried chicken and consumption-oriented urban centers – people need an environment in which they can stay healthy and happy.