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We are what we eat (Really)

Diabetes and obesity have become hot talking points in of late. In his National Day Rally last year, PM Lee called diabetes a “health crisis” for Singapore, citing the grim numbers: three out of 10 Singaporeans over the age of sixty are diabetic’s almost one third of our elderly who suffer from this disease.

Not only is diabetes a complex disease with many causes, it’s also not as well studied in Asian populations. Luckily, local scientists are on the job. In a one-north Festival 2016 talk , we assembled a panel of scientists to talk about diabetes, obesity and nutrition in Asia. One of them, Dr. Sumanto Haldar of the Clinical Nutrition Research Centre, returns to answer more questions about how what we eat can affect our health.

1. Is the increase in diabetes in Singapore over the last forty years solely due to diet? Are there other factors that might go into it?

The change in dietary habits in Asia is one of the most important contributors to the increased incidence in type 2 diabetes in this region. This change has partly resulted from rapid economic growth, which has led to an increase in the amounts and variety of foods we consume. This, accompanied by a genetic predisposition for increased risk, a reduction in physical activities and an increasingly stressful lifestyle, all contribute to a greater risk for the development of type 2 diabetes.

2. You mentioned in the talk that Asians put on weight differently from Caucasians–how? Where do we put on weight?

Asian populations tend to respond to foods differently as compared to Caucasian populations. The excess calories we consume are more likely to be deposited as fat around the abdominal region, and abdominal fat is a risk factor for developing diabetes. Moreover, when comparing an Asian person to a Caucasian person with the same body mass index (BMI), the Asian is more likely to have a higher percentage of body fat than the Caucasian. This characteristic body fat storage and distribution contributes to an increased type 2 diabetes risk in Asians.

3. What are the factors that affect basal metabolic rate? Is it just age and sex?

Several factors, in addition to age and gender, affect basal metabolic rate (BMR). These include a person’s body composition (e.g., having a higher percentage of fat-free mass can raise basal metabolic rate), their genetic make-up, their physical activity level (e.g., increasing general physical activity can increase BMR), as well as phase of menstruation (for those who are pre-menopausal).

4. Can you explain more about the “environmental” aspect of food choice in Asia which you mentioned during the Q&A session of the video? (Context: the question was about the importance of doing research on foods that are popular in Asia and what are the key areas of research to come, and your answer included moving away from looking at individual food items, and more about food as a whole and the “food environment”…)

Our food choice is highly dependent on our food environment and lifestyle. Where we eat, and who we eat with, has an implication on how much and what we eat. For example, family preferences, item availability in the local food supply as well as their costs will determine what foods are eaten.  Furthermore, specific foods are seldom eaten in isolation. Therefore, it is important to consider how the choice of one part of a meal can simultaneously affect the choice of other parts of the meal, or subsequent meals.