In 20 or 30 years, everybody on that island will either be a dialysis patient

[greg10]

How Western Diets Are Making The World Sick

"No country in the world has the resources to continue to treat diabetics the way that they're being treated now, if the prevalence rates increase at the rates that they're increasing for much longer," he says. "I worked in Saipan, which is in the Marianas Island in the Pacific, and there, the dialysis population was increasing at about 18 percent a year, all as a consequence of diabetes and acculturation — exactly the same process as what's going on with the Inuit.

"When you look at the curves, it's clear how unsustainable it is. In 20 or 30 years, everybody on that island will either be a dialysis patient or a dialysis nurse unless something fundamental is done about the rise in diabetes. That's no less true in Canada and in Samoa and Hawaii, and even in Omaha and Toronto. We all have exactly the same problem when we plot out those curves."

http://www.npr.org/2011/03/24/132745785/how-western-diets-are-making-the-world-sick

In an essay published last November in Canada's Maisonneuve journal, physician Kevin Patterson described his experiences working as an internist-intensivist at the Canadian Combat Surgical Hospital in Kandahar, Afghanistan.

One detail he noticed: The Afghan soldiers, police and civilians he treated in Kandahar had radically different bodies from those of the Canadians he took care of back home.

"Typical Afghan civilians and soldiers would have been 140 pounds or so as adults. And when we operated on them, what we were aware of was the absence of any fat or any adipose tissue underneath the skin," Patterson says. "Of course, when we operated on Canadians or Americans or Europeans, what was normal was to have most of the organs encased in fat. It had a visceral potency to it when you could see it directly there."
Anchor Press

In a conversation on Fresh Air, Patterson tells Terry Gross that the effects of urbanization are making people everywhere in the world both fatter and sicker.

"Type 2 diabetes historically didn't exist, only 70 or 80 years ago," says Patterson. "And what's driven it, of course, is this rise in obesity, especially the accumulation of abdominal fat. That fat induces changes in our receptors that cells have for insulin. Basically, it makes them numb to the effect of insulin."

For a long time, the human body can compensate — the pancreas secretes even larger amounts of insulin, which regulates blood sugar levels. But over time, the pancreas begins to fail to secrete enough insulin, and that is when diabetes develops.

He explains that the increase in abdominal fat has driven the epidemic of diabetes over the last 40 years in the developed world — and that he's now seeing similar patterns in undeveloped regions that have adapted Western eating patterns.

Patterson explains that in his Canadian practice, where he takes care of indigenous populations near the Arctic Circle, there is a marked increase in the number of diabetic patients he sees.

"The traditional Inuit culture of relentless motion and a traditional diet consisting mainly of caribou, Arctic char, whale and seal has been abandoned over this period of time for Kentucky Fried Chicken and processed food and living a life very similar to ours," he says. "[They're] spending a lot of time in front of a glowing screen."

Part of the problem, says Patterson, is that it's so much cheaper for processed food to be flown into the Arctic Circle than fresh food.

"There's no roads or rail access to any of those communities," he says. "So a 4 liter jug of milk can cost you $10 or $11. But there's a very clear parallel between that and the inner city. In poorer neighborhoods in North American cities, fresh food is either not available or extremely expensive compared to — on a calorie-by-calorie basis — compared to fast food available on every street corner."

And the diabetes epidemic correlates to a strain on health care systems around the globe, says Patterson.

"No country in the world has the resources to continue to treat diabetics the way that they're being treated now, if the prevalence rates increase at the rates that they're increasing for much longer," he says. "I worked in Saipan, which is in the Marianas Island in the Pacific, and there, the dialysis population was increasing at about 18 percent a year, all as a consequence of diabetes and acculturation — exactly the same process as what's going on with the Inuit.

"When you look at the curves, it's clear how unsustainable it is. In 20 or 30 years, everybody on that island will either be a dialysis patient or a dialysis nurse unless something fundamental is done about the rise in diabetes. That's no less true in Canada and in Samoa and Hawaii, and even in Omaha and Toronto. We all have exactly the same problem when we plot out those curves."

Patterson fictionalized his experiences working with the Inuit in Canada in his novel, Consumption, about an Inuit woman who spends her teen years in a sanitarium. His other books include Outside the Wire: The War in Afghanistan in the Words of its Participants and the short story collection Country of Cold, which won the Rogers Writers' Trust Fiction Prize in 2003.
Excerpt: 'Consumption'

by Kevin Patterson

[MooseMom]

I read this article a couple of days ago, and it has been on my mind ever since.  I think it is really frightening.  The ESRD population is growing so very quickly.  I had this dream the other night that we lived in a world split between those with functioning kidneys and those without...the dialysis-free vs the dialysis dependent.  It was apocalyptic, and when I woke up, I thought it would make one of those spooky movies that make you think, "Ya know, that could happen..."

[greg10]

How Western Diets Are Making The World Sick

"unless something fundamental is done about the rise in diabetes"

http://www.npr.org/2011/03/24/132745785/how-western-diets-are-making-the-world-sick..

Yes, put a steep tax on sugar, corn syrup and other unhealthy foods as it is done with tobacco and alcohol.... but that could never pass in a democracy.

[cariad]

What a load of tripe!

There are a few simple reasons for the so-called rise in diabetes - people living longer, earlier diagnosis, and the ever-popular chortle, chortle let's change the diagnostic criteria and revel in the panic!

If eating loads of sugar caused diabetes, my brother (the PhD, not the psycho), who lived off of chocolate for 10 or so years, would have every flavor of diabetes on offer. The theory of diabetes that I subscribe to: it is a genetic disease with obesity as a symptom, not a causative factor. When you manage your diabetes through diet, you cut out a lot of carbs and lose weight. Losing weight has not cured your diabetes, this is a side effect of eating appropriately. Not all diabetics lose weight, not all have weight to lose. I might go on the renal diet and lose weight, and it may improve my labs, but that does not mean that losing weight was the key to controlling renal failure.

Oh, to be back in an anthro course. We would tear this one to shreds. The people he is talking about went through an evolutionary bottleneck. But I suppose it's more fun to blame native people's illnesses on their behaviour, not their genetics.

I see nothing wrong with sugar - it is not an unhealthy food! I can even abide corn syrup, it is the high-fructose crap, processed with poisons, that I will not purchase. However, it has such a terrible rap that it is quite common to see even kids foods emblazoned with "no high-fructose corn syrup!" How do we define unhealthy? Unhealthy for whom?

Afghans held up as role models, by a doctor no less. Isn't their life expectancy among the lowest on planet earth? Have I heard everything from the supposed experts yet, because I am getting a headache from all the forehead smacking....

[lmunchkin]

DITTO, Cariad, to everything you said.  But I know that all of us could get Diabetes whether genetic or not.  Processed foods is a big part of our problem, but I personally eat anything I want. I really think its the portions or the excess of foods I eat that can be a behavioral problem.  I feel like if I tone my portions(No seconds either) I can maintain my b/s & b/p fairly well.
Really I think it is my personal responsibility to maintain healthy eating habits so as to prevent this tragic disease. Diabete is a silent killer along with B/P.  I just have to be responsible with what I put in my body!  Unfortunately, my husband got this ESRD due to high B/S & B/P.
But in his sickness, he has changed alot of loved ones lives, because they see what he is going through and they could see themselves going that route had changes in behavior not been done. Especially ME cause I was headed down the same road!!! SAD  :(that in his sickness, he has brought awareness to ones closet to him.

[greg10]

There may be hope.  Saipanese, meet the Yup'ik Eskimos, who don't seem to be building too many dialysis clinics.

http://www.sciencedaily.com/releases/2011/03/110324153712.htm

According to results from the study, which was published in the March 23 issue of the European Journal of Clinical Nutrition, 70 percent of the Yup'ik Eskimo population is considered to be overweight or obese, but due to their increased intake of omega-3 fats they are at a lower risk than most other Americans for diabetes and cardiovascular disease, including heart attacks.

ScienceDaily (Mar. 25, 2011) — A study of Yup'ik Eskimos in Alaska, who on average consume 20 times more omega-3 fats from fish than people in the lower 48 states, suggests that a high intake of these fats helps prevent obesity-related chronic diseases such as diabetes and heart disease.

The study, led by researchers at Fred Hutchinson Cancer Research Center and conducted in collaboration with the Center for Alaska Native Health Research at the University of Alaska-Fairbanks, was published online March 23 in the European Journal of Clinical Nutrition.

"Because Yup'ik Eskimos have a traditional diet that includes large amounts of fatty fish and have a prevalence of overweight or obesity that is similar to that of the general U.S. population, this offered a unique opportunity to study whether omega-3 fats change the association between obesity and chronic disease risk," said lead author Zeina Makhoul, Ph.D., a postdoctoral researcher in the Cancer Prevention Program of the Public Health Sciences Division at the Hutchinson Center.

The fats the researchers were interested in measuring were those found in salmon, sardines and other fatty fish: docosahexaenoic acid, or DHA, and eicosapentaenoic acid, or EPA.

Researchers analyzed data from a community-based study of 330 people living in the Yukon Kuskokwim Delta region of southwest Alaska, 70 percent of whom were overweight or obese. As expected, the researchers found that in participants with low blood levels of DHA and EPA, obesity strongly increased both blood triglycerides (a blood lipid abnormality) and C-reactive protein, or CRP (a measure of overall body inflammation). Elevated levels of triglycerides and CRP increase the risk of heart disease and, possibly, diabetes.

"These results mimic those found in populations living in the Lower 48 who have similarly low blood levels of EPA and DHA," said senior author Alan Kristal, Dr. P.H., a member of the Hutchinson Center's Public Health Sciences Division. "However, the new finding was that obesity did not increase these risk factors among study participants with high blood levels of omega-3 fats," he said.

"Interestingly, we found that obese persons with high blood levels of omega-3 fats had triglyceride and CRP concentrations that did not differ from those of normal-weight persons," Makhoul said. "It appeared that high intakes of omega-3-rich seafood protected Yup'ik Eskios from some of the harmful effects of obesity."

While Yup'ik Eskimos have overweight/obesity levels similar to those in the U.S. overall, their prevalence of type 2 diabetes is significantly lower -- 3.3 percent versus 7.7 percent.

"While genetic, lifestyle and dietary factors may account for this difference," Makhoul said, "it is reasonable to ask, based on our findings, whether the lower prevalence of diabetes in this population might be attributed, at least in part, to their high consumption of omega-3-rich fish."

For the study, the participants provided blood samples and health information via in-person interviews and questionnaires. Diet was assessed by asking participants what they ate in the past 24 hours and asking them to keep a food log for three consecutive days. Height, weight, percent body fat, blood pressure and physical activity were also measured.

The median age of the participants was 45 and slightly more than half were female. The women were more likely than the men to be heavy, and body mass index (height-to-weight ratio) for all increased with age.

"Residents of Yup'ik villages joined this research because they were interested in their communities' health and were particularly concerned about the health effects of moving away from their traditional ways and adopting lifestyle patterns similar to those of residents in the lower 48 states," Makhoul said.

Based on these findings, should overweight and obese people concerned about their chronic disease risk start popping fish oil supplements or eat more fatty fish?

"There are good reasons to increase intake of fatty fish, such as the well-established association of fish intake with reduced heart disease risk," Makhoul said. "But we have learned from many other studies that nutritional supplementation at very high doses is more often harmful than helpful."

Before making a public health recommendation, the researchers said that a randomized clinical trial is needed to test whether increasing omega-3 fat intake significantly reduces the effects of obesity on inflammation and blood triglycerides.

"If the results of such a trial were positive, it would strongly suggest that omega-3 fats could help prevent obesity-related diseases such as heart disease and diabetes," she said.

The National Center for Research Resources, and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health funded the study, which also involved investigators from the University of California-Davis.