Mohan Viswanathan, Ruchi Vaidya, Gayathri Rajagopal, Bai Mookambika Ramya, Sudha Vasudevan, Anjana Ranjit Mohan, Pradeepa Rajendra
Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialties Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, Chennai, India.
WHO South East Asia J Public Health. 2016 Apr;5(1):5-16. doi: 10.4103/2224-3151.206554.
The nutrition transition occurring in the World Health Organization South-East Asia Region, as a result of rapid urbanization and economic development, has perhaps made this region one of the epicentres of the diabetes epidemic. This review attempts to evaluate the role of diet and physical inactivity in the South-East Asia Region in promoting this epidemic and points to strategies to slow it down by lifestyle modification. The emerging new food-production technologies and supermarkets have made energy-dense foods more easily available. This includes refined carbohydrate foods like those with added sugars, and refined grains and unhealthy fats. In addition, increased availability of modern technology and motorized transport has led to decreased physical activity. South Asian diets tend to be based on high-carbohydrate foods, with a predominance of refined grains. All of these accentuate the risk of diabetes in people of this region, who already have a unique "south Asian phenotype". However, there is increasing evidence that altering diet by replacing refined cereals like white rice with whole grains (e.g. brown rice) and increasing physical activity can help to prevent diabetes in high-risk individuals. An urgent, concerted effort is now needed to improve diet quality and encourage physical activity, by introducing changes in policies related to food and built environments, and improving health systems to tackle noncommunicable diseases like diabetes.
由于快速城市化和经济发展，世界卫生组织东南亚区域正在经历营养转型，这或许使该区域成为糖尿病流行的中心之一。本综述试图评估东南亚区域饮食和身体活动不足在推动这一流行病方面所起的作用，并指出通过改变生活方式来减缓这一趋势的策略。新兴的新食品生产技术和超市使能量密集型食品更容易获得。这包括添加糖的精制碳水化合物食品、精制谷物和不健康脂肪。此外，现代技术和机动交通工具的增加导致身体活动减少。南亚饮食往往以高碳水化合物食品为主，精制谷物占主导。所有这些都加剧了该区域人群患糖尿病的风险，而这些人群本身就具有独特的“南亚表型”。然而，越来越多的证据表明，通过用全谷物（如糙米）替代精制谷物（如白米）来改变饮食以及增加身体活动，有助于预防高危人群患糖尿病。现在迫切需要共同努力，通过改变与食品和建筑环境相关的政策，并改善卫生系统以应对糖尿病等非传染性疾病，来提高饮食质量并鼓励身体活动。
