Diabetes Around the World: Japan
Jaylyn Porras and Mariana Turner
Japan is one of the nations most affected by the worldwide diabetes epidemic. The greatest threat for Japan isn’t type 1 diabetes, but rather type 2 diabetes (T2D), which has had a major impact on children and adults. Based on statistics, 13.5% of Japan’s population has either T2D or impaired glucose tolerance. In Japan, T2D has created a significant economic burden, with 6% of the healthcare budget allocated to diabetes. By 2015:
- 7.2 million people were diagnosed with diabetes
- The average cost per patient was ¥400,000 ($3,770.74) a year, mostly covered by health insurance
- About 7.6% of adults between the ages of 20 and 79 were diabetic, with more than 3 million suspected undiagnosed cases.
Why Are Japan’s Numbers Increasing?
With Age Comes Wisdom … and T2D?
One reason noted for the increase in diabetes in Japan is the growth of the Japanese population over 60 years old, the age when T2D becomes more prevalent. Notably, it’s not just Japan with this increase in diabetics. Asia is on track to become the epicenter for diabetes due changes in diet habits and less active lifestyles. In Japan, an acclaimed author named Monique Truong stated, “As a diabetic, I actually found it much easier than I thought it would be to eat delicious, healthy, low-carb meals during my months in Tokyo. The biggest obstacle, of course, is that the Japanese diet is centered on rice and noodles. She also mentioned that “the irony is that the Asian diets with their rice and noodles have not been a problem for earlier generations, clearly due to food shortages and also to a life that involves physical labor and exertion, but once diabetes is triggered, then rice and noodles exacerbate the disease.” Luckily, Japanese T2D patients are better at adhering to diet and exercise recommendations than their peers in Western countries.
White Rice and T2D
What’s Rice Got to Do With It?
Refined carbohydrates are thought to bes a deteriorated to glucose metabolism. However, it remains unclear if those with elevated white rice intake – a major Japanese food staple – experience increased risk of developing type 2 diabetes. To solve this mystery, the Japan Public Health Center surveyed 25,666 men and 33,622 women aged 45-75 years old with no prior history of diabetes. They ascertained each individual’s food intake via a validated 147-item food- frequency questionnaire. Odds ratios of self-reported, physician-diagnosed type 2 diabetes over 5 years were estimated by using logistic regressions. What they found:
- A total 1103 new self-reported cases of T2D
- A significant association between rice intake and an increased risk of T2D in women
- While unclear if men shared the same rice intake association to T2D, there was a small positive association with men who were not engaged in strenuous activities.
The Takeaway? There is a positive association between health and fitness and type 2 diabetes for not only the Japanese, but every population. Luckily the Japanese are major advocates for health and promote better adherence to health and exercise recommendations than Western countries. This said, it is up to the people to follow recommendations, and adopt healthier lifestyles in order to decrease their risk of developing diabetes.
- Akiko Nanri, Tetsuya Mizoue, Mitsuhiko Noda, Yoshihiko Takahashi, Masayuki Kato, Manami Inoue, Shoichiro Tsugane, for the Japan Public Health Center–based Prospective Study Group, Rice intake and type 2 diabetes in Japanese men and women: the Japan Public Health Center–based Prospective Study, The American Journal of Clinical Nutrition, Volume 92, Issue 6, December 2010, Pages 1468–1477, https://doi.org/10.3945/ajcn.2010.29512
- Kingston, Jeff. “Diabetes Emerges as Japan’s Hidden Scourge.” The Japan Times, 7 May 2016, www.japantimes.co.jp/opinion/2016/05/07/commentary/diabetes-emerges-japans-hidden-scourge/
- Neville SE;Boye KS;Montgomery WS;Iwamoto K;Okamura M;Hayes RP; “Diabetes in Japan: a Review of Disease Burden and Approaches to Treatment.” Diabetes/Metabolism Research and Reviews, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/19795421/