Sugar, Diabetes and Public Health?
International Sugar consumption increased at incredible rates until 1980, from then its increase slowed. The richer developed countries had neared their saturation rates whilst growth would continue in poorer countries which had not neared their saturation levels. Annual growth of the international sugar market slowed to around 2.2% per annum during the 1990’s but began to rise again in the 2000’s. The Asian growth rate was 4.9% p.a., Middle East 4.6% p.a. and Africa 4.1% p.a. In 1980 international sugar consumption stood at 90 million tonnes, today the 4 billion people of Asia consume 165 million, that is 23 kg per capita on average. There is considerable disparity across Asia: Bangladeshis consume around 8 kg p.a. per person whilst Israelis consume around 66 kg p.a. per person.
There is a connection between the prevalence of sugar consumption and diabetes rates. The exact nature of that connection will continue to be debated, researched and disputed. Diabetes is the breakdown of the body’s sugar management capacities, specifically the mechanism of insulin production. Diabetes is most widespread in the developed world, especially the United States of America – 9.2% – and Europe – 8.4% –
The five countries will the largest numbers of people with diabetes are India, China, the United States, Russia and Germany. The five countries with the highest prevalence rates are Nauru, United Arab Emirates, Saudi Arabia, Bahrain and Kuwait. The number of people with diabetes is expected to increase alarmingly in the coming decades, rising to 380 million people in 2025. Developed countries have higher prevalence rates than developing countries, but the latter will be hit the hardest by the diabetes epidemic. Increased urbanization, westernization and economic development in developing countries have already contributed to a substantial rise in diabetes. — University of Ohio
Bangladesh with a population of 156.6 million people has 5 million cases of diabetes around 3.2% in 2013, whilst Israel with a population of 8 million people has 317,360 cases of diabetes around 4% in 2013 in Singapore 11% of the population have diabetes.
What we see in the popular media are claims that this food causes this and that food causes that disease. Epidemiology the branch of medicine that studies the distribution of disease in populations has its limits, we cannot say that this causes that in the cases of diseases such as diabetes, the factors that cause diseases such as diabetes are alot more complex than such simple correlations. What we do know without a doubt is that factors as diet, specifically the increase in sugar consumption and high protein diets and lifestyle correlations are present across the countries with diabetes. It seems that wheresoever our western lifestyles spread accompanying the spread are the same patterns of disease.
The problem of industrial medicine is that research follows funding, which follows product/patent outcomes severely limiting the approaches to public health. If we are to deal with the public health epidemics which are presently emergent we will have to break away from this approach, which has placed a legal and intellectual stranglehold on traditional and alternative approaches in order to restrict the competition’s access to the marketplace. We must ask a number of questions and one of them is how much will we allow corporate interest to dominate public health? And how ruthlessly committed are we to a results based approach to public health? If we are we will have to encourage a variety of approaches to proliferate, we will have to judge them by results and the relative demands (financial and otherwise) upon the population and public coffers.