India and China Lead Asia’s Metabolic Disease Crisis

Context

Asia is on the brink of a growing metabolic disease epidemic, India and China being at the top of the list, with the cause being the fast urbanization, change in food habits, and genetic factors. The recent Global Burden of Disease (GBD) reports indicate their disproportionate contributions to diabetes (type 2), hypertension, obesity, high cholesterol and liver diseases such as MASLD.

Metabolic Diseases Defined

Metabolic diseases include the disorders that affect the body energy processing, such as type 2 diabetes (T2DM), high systolic blood pressure (SBP), high body mass index (BMI), high LDL cholesterol, and steatotic liver disease caused by metabolic dysfunction (MASLD). Such conditions co-exist as metabolic syndrome, which increases the risks of heart disease, stroke, and death. They led to a 1.7 to 3.7-fold increase in the disability-adjusted life years (DALYs) in the period between 1990 and 2023 in Asia-Pacific.

Burden in India and China

According to GBD 2023 data, India has T2DM DALYs (more than 21 million) and death rate (almost 580,000) at the forefront of Asia-Pacific in 2023. The other four risks, SBP (greatest absolute burden), high BMI, high LDL, and MASLD, are topped by China, and India, in this case, is the second, in terms of population size and lifestyle changes. Indonesia is the most ranked in the third position, and Pacific Islands are the hardest hit in the relative burdens.

Historical Trends (1990-2023)

The number of DALYs of these diseases soared in Asia-Pacific with absolute burdens being concentrated in large countries such as India and China. The mortality rate in T2DM in India is higher than that of the rest of the world in relation to age, as well as the prevalence of T2DM is higher in the urban areas of China, as compared to the neighbors such as Pakistan at around 15-46%. This was spurred by aging populations and the shift towards obesity whereby drivers who used to smoke were replaced by those who are hyperglycemic and high BMI.

Projections to 2030

The increases in burdens are going to be experienced by all other than MASLD, but SBP is leading. The trends of BMI and LDL in India indicate that there is a clustered risk of cardiometabolic, and that the trends will increase DALY without interventions. Asia is vulnerable as globally, India, China and the US will contribute a third of burdens of diabetes by 2050.

Regional Comparisons

South and Central Asia are behind in care quality (lowest QCI scores), as compared to East Asia. Increased relative burden is experienced in Pacific Islands despite the low populations. The age-standardized rates of diabetes in India are insignificant compared to those of China (31.1 vs. 8.98 deaths per 100,000), but they are still higher than those in the US.

Key Risk Factors

The urbanization encourages sedentary and processed food consumption of sedentary obesity, which is another South Asian characteristic known as central obesity. Indian beliefs predispose them to diabetes at lower levels of BMI. According to SHAP analyses, aging demographics increase the effects of SBP and hyperglycemia. These are compounded by environmental changes, such as pollution and stress when population density is high.

Policy Initiatives

The National Programme of Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke in India is aimed at screening and China has succeeded in T1DM but T2DM is on the increase. In Shanghai, SCO Metabolic Diseases Centre supports research / tie-up between India and China. Professionals call on UN-oriented measures in 2030 objectives.

Prevention Strategies

Focus on healthier diets, physical exercise, and weight loss. India requires upgrades of infrastructure to do the screening, China, the continuation of the interventions. Combined efforts, including the treatment of obesity, hypertension, and dyslipidemia, would reduce increases. The community education and equal access to care is essential.

Implications for Public Health

This has put pressure on healthcare systems and the economy costs lost productivity are skyrocketing. It highlights the policy requirements in NCDs as a part of Sustainable Development Goals to the civil services aspirants. The metabolic epidemic in Asia can be controlled with quick and concerted efforts to protect millions of people.

Source: The Hindu 

UPSC Prelims Practice Question 

Q. Consider the following statements regarding metabolic diseases in the Asia-Pacific region:

1. India has the highest burden of disability-adjusted life years (DALYs) due to type 2 diabetes, while China leads in systolic blood pressure, high BMI, high LDL cholesterol, and MASLD.
2. From 1990 to 2023, DALYs for these conditions increased 1.7- to 3.7-fold, with absolute burdens concentrated in India, China, and Indonesia.
3. Projections indicate that burdens will decline for all metabolic risks except MASLD by 2030.

Which of the statements given above is/are correct?

A) 1 and 2 only
B) 2 and 3 only
C) 1 and 3 only
D) 1, 2, and 3

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