Health and Fitness
Diabetic epidemic in Asian American population
Diabetes is a rapidly growing health concern among Asian Americans affecting
10% of total population. Asian Americans are more likely to develop diabetes than
Causians despite relatively lower body weight.(1) Also, Asian Americans are known
to be at higher risk for metabolic syndrome which can be a predisposing condition
to diabetes and other chronic illnesses. Interestingly, the rate of Asian American
diabetic patients is notably higher than the rate of Asian diabetic population
living in Asia.
What are the roles of visceral fat as a culprit of diabetes?
Abdominal fat can be categorized into subcutaneous fat( fat outside abdominal
muscle) and visceral fat( intraabdominal fat). It should be recognized that
there are ethnic differences in abdominal visceral fat volume. Studies showed
that Asians have more abdominal visceral fat than Caucasians.(2-3)
While subcutaneous fat has very little effect on our health, visceral fat secrets
a variety of proteins, called adipocytokines, that can directly contribute to
develop diabetes, high cholesterol, high blood pressure, and other metabolic
syndrome.(4-5) It has been well known that metabolic syndrome is closely linked
to cardiovascular disease.
Why Asian Americans are more vulnerable to diabetes?
The cause of diabetes is genetic and environmental influences. 90-95% of Asian
American diabetic population has type 2 diabetes and it is more closely linked
to environmental factors.
For instances, Asians have had a long history of eating white rice as a main
diet. Since majority of people in old Asia lived on farm industry, they would
need more calories and white rice is the highest calorie source than any other
food. Rice has twice higher glycemic index than pasta. .(6) In highly industrialized
society, such as in Unites States where most people do not metabolize enough
calories while they work, most of Asian Americans still consume white rice as
a main diet. Excessive calories would accumulate in the body(especially in the
visceral fat) and the visceral fat will produce harmful proteins that cause
diabetes.
What should we do to prevent further diabetic epidemic in Asian American
community?
First of all, there needs to be more public awareness among Asian American society
in regards to diet modification. Study showed that unpurified grain, such as
brown rice, whole grain bread, is helpful to prevent diabetes and reduce visceral
fat. Without changing current diet(mainly white rice), you will need more frequent
exercise if you work in the office and spends quite amount of your time in the
car.
Dr. Lee is a board certified in Internal Medicine and had an additional training
in Pulmonary disease. Currently, he runs one of the busiest practices in Los
Angeles and his practice serves patients of varying ethnic background, including
Koreans, Filipino, Chinese, Latinos, Caucasians and Blacks. He is currently
an active staff in Good Samaritan Hospital in Los Angeles and has served various
community organizations. He has published weekly health columns in Koreatimes
since 2005 and spoke in various Korean media to comment on health issues in
the community.
References
1. Shai I; Jiang R; Manson JE; Stampfer MJ; Willett WC; Colditz GA; Hu FB.
Ethnicity, obesity, and the risk of type 2 diabetes in women’s 20 year
follow-up study. Diabetes Care. 2006 Jul:29(7):1585-90
2. Park YW, Allison DB, Heymsfield SB, GallagherD. Larger amounts of visceral
adipose tissue in Asian Americans. Obes Res. 2001;9:381-387.
3. Fain JN, Madan AK, Hiler ML, Cheema P, Bahouth SW. Comparison of the release
of adipokines by adipose tissue, adipose tissue matrix, and adipocytes from
visceral and subcutaneous abdominal adipose tissues of obese humans. Endocrinology.
2004;145:2273-2282.
4. Shimomura I, Funahashi T, Takahashi M, et al. Enhanced expression of PAI-1
in visceral fat:possible contributor to vascular disease in obesity. Nat Med.
1996;2:800-803.
5. Fried Sk, Bunkin DA, Green Berg AS. Omental and subcutaneous adipose tissues
of obese subjects release interleukin-6:depot difference and regulation by glucocorticoid.
J Clin Endocrinol Metab. 1998;83:847-850.
6. see http://www.glycemicindex.com/
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