Food Vision Asia: Can Asia win the war on diabetes and obesity?
The focal point of discussions at this year’s Food Vision Asia, a three-day leadership forum for Asia’s food and nutrition industry, centered around how the region is tackling the growing diabetes epidemic it is facing.
Singapore’s Minister of State for Health, Mr Chee Hong Tat, set the tone by sharing official statistics that show how Singapore is in the midst of waging a “war on diabetes” to help its 400,000 residents who currently suffer from the condition – a figure that is set to rise to more than a million if nothing is done. The issue is not limited to Singapore; in 2015, the International Diabetes Federation stated that 78.3 million people in South East Asia had diabetes and predicted that by 2040 this number will have reached 140.2 million.
The importance of early detection and collaboration – combined with the need for a better understanding of diabetes from an Asian perspective – were the key points highlighted at the event:
1. Research from an Asian perspective is vital
Research stemming from Asia will prove crucial in understanding more about how to manage the disease. For example, Professor Christiani Jeyakumar Henry, Director at the Clinical Nutrition Research Centre, Singapore, shared that Asians have a unique phenotype that makes them particularly susceptible to obesity and type II diabetes. The population in Asia is characterized by what he calls the ‘TOFI (thin outside, fat inside)’ phenomenon, where people who are seemingly of reasonable weight are frequently found to be diabetic. Coupled with traditionally carbohydrate-rich diets, this makes individuals in the region particularly at risk.
2. Early detection for prediabetes
Raising awareness of the importance of early detection is crucial for the prediabetic population; that is, those who have blood glucose levels that are higher than average but not high enough for a type 2 diabetes diagnosis. However, prediabetic individuals are often unaware of their condition due to the lack of clear symptoms. Because prediabetics have an increased risk of developing type 2 diabetes and other serious health issues including cardiovascular disease, it is key to identify prediabetes while it is still in the early stages as it is easier to treat and reverse.
3. Collaboration is key
Multi-stakeholder working is required to tackle the diabetes epidemic, and this includes educating consumers and even healthcare providers to ensure a holistic approach. It is estimated that more than 60% of type 2 diabetes can be prevented or delayed by addressing lifestyle factors, such as lack of exercise or poor diet.
Active partnership between governments, academia and food manufacturers will be key to success, particularly as regulatory bodies start to engage with the concept of nutrient-energy density. This refers to the ratio of nutrients relative to the energy in foods. Information that can help individuals to identify products that have a low energy to nutrient ratio will support them in compiling diets that address nutritional shortfalls, without increasing the risk of obesity.
One positive example brought up was Singapore’s Healthier Choice Symbol (HCS), which was created through close collaboration between the government and the food industry. It is intended to guide purchases in a way that incorporates healthier options into the diet. Products with the symbol are generally lower in fat, saturated fat, sodium and sugar, and higher in dietary fiber, calcium and whole grains. To make labeling more comprehensive, the Health Promotion Board is also introducing enhanced versions of the HCS, each of which focuses on a specific nutritional aspect of the product. For a more in-depth look at the nutrient-energy density concept and how it is being applied in the rest of the world, read our whitepaper.
Alongside the insights discussed at Food Vision Asia, continued engagement in emerging scientific research into key nutrients and diabetes is also of critical importance. For example, the Singapore Clinical Nutrition Research Centre is researching how functional ingredients can help fight diabetes in Asia. A recent study published in Food Chemistry explored the diabetic properties of commonly used spices such as cumin, ginger and turmeric in the prevention and management of diabetes. Meanwhile, a new paper published in the European Review for Medical and Pharmacological Sciences has suggested that high dose vitamin D and omega-3 fatty acids may play a role in preventing the progression of type 1 diabetes.
There is also a strong correlation between diabetes and an increased risk of cardiovascular disease (CVD). This means that a diet with a balanced nutrient-energy density is critical on two levels; to control the condition, and to reduce the risk of later developing CVD. For more information on the role of nutrients in supporting cardiovascular health, read DSM’s whitepaper here.
This presents opportunities for food manufacturers to develop products and services that enable consumers to choose appealing and affordable diets, for instance by making popular foods healthier through nutrient fortification. Several examples were shared during the forum, including the launch of fortified rice and noodles that can aid in weight and diabetes management.
Furthermore, functional ingredients are emerging that can help support the management of diabetes, such as oat beta-glucan, which improves glucose control in both healthy and diabetic individuals. The EU commission has already authorized a cause and effect relationship between the consumption of beta-glucans from oats and a reduction of post-prandial glycemic responses.
Ultimately, fortified foods and dietary supplements should be considered as part of a wider, more holistic nutritional strategy. Individuals should seek advice on eating a balanced diet, exercise more and avoid smoking for the best results.
1. International Diabetes Federation, IDF Diabetes Atlas -7th Edn, 2015, http://www.diabetesatlas.org
2. Tan, V. M. H. et al., "Glycaemic And Insulin Responses, Glycaemic Index And Insulinaemic Index Values Of Rice Between Three Asian Ethnic Groups". British Journal of Nutrition 113.08, 2015, p. 1228-1236. https://doi.org/10.1017/S0007114515000586
3. Huang, Y et al., "Association Between Prediabetes And Risk Of Cardiovascular Disease And All Cause Mortality: Systematic Review And Meta-Analysis". BMJ, 2016, p. i5953. https://doi.org/10.1136/bmj.i5953
4. Diabetes Prevention Program Research Group, ‘Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin’, N Engl J Med, vol. 346, no 6, 2002, p. 393-403. http://www.nejm.org/doi/pdf/10.1056/NEJMoa012512
5. Bi, Xinyan, Joseph Lim, and Christiani Jeyakumar Henry. "Spices In The Management Of Diabetes Mellitus". Food Chemistry, vol. 217, 2017, p. 281-293. https://doi.org/10.1016/j.foodchem.2016.08.111
6. Cadario F. et al., ‘Can Type 1 diabetes progression be halted? Possible role of high dose vitamin D and omega 3 fatty acids’, Eur Rev Med Pharmacol Sci., vol. 21, no 7, 2017, p. 1604-1609, http://www.europeanreview.org/article/12416.