Pushpa Narayan | TNN | Apr 29, 2015, 08.21 PM IST
In what could hold important lessons for bringing down diabetes prevalence in India, a study published recently shows that Indians in America have been able to delay or prevent the disease largely through healthy lifestyle modifications.
Not too long ago, research studies showed that many Indians who moved to the US became obese and developed type-2 diabetes at a very young age. Their genetic predisposition to the disease and the adoption of American lifestyle - high fat diet and sedentary life -- was a dangerous combination.
The study published in the April issue of medical journal Diabetes Care compared the health status of Indians living in India with those living in the US. Researchers compared data relating to 2,305 people in Chennai who were a part of a Centre for Cardiometabolic Risk Reduction in South-Asia study (CAARS) with 757 Asian Indians who were part of a Mediators of Atherosclerosis in South Asian Living in America (MASALA) study. The results showed that the prevalence of diabetes was up to 38% in India when compared to 24% in the US in the 40-84 years age group although pre-diabetes was higher in the US (33%) when compared to India (24%).
There are no data to pinpoint the reasons for the difference, but the first author of the research Unjali P Gujral of Emory University in Atlanta says that Indians in America - or at least the study participants - may be highly aware of diabetes prevention as well as have better access to healthcare and insurance than those in India. "That is big enough to bring in behavior changes that made the difference," she said.
The situation was quite the opposite a few decades back. As Indian immigration to the US surged during the IT boom in the 1990s, diseases like diabetes showed an uptick in the Indian population.
Salaries soared and many Indians could afford cars, had more choices in food and their lifestyle become more comfortable - all potential contributors to lifestyle-related diseases. Many Asians including the Chinese and the Japanese faced similar problems.
"We saw a lot of that within our family. At one point all of us were so obese that we began not just to worry about our looks but also about our health status," says Madhavi M, a software professional who grew up in California.
Now, as a result of awareness programmes by the government, she like many Indians, has begun to lead healthier lifestyles. Her family eats healthy food that includes two servings of vegetables and fruits every day. They use brown basmati rice or millets like quinoa instead of white rice.
"My health insurance company is even paying for gadgets like pedometers that track the exercises we do," she said.
Much like their affluent white American colleagues, desis in America are frequenting gyms, yoga and swimming classes, and zumba sessions.
"If Indians in America can do it, so can Indians in India. They belong to the same genetic pool and are exposed to similar environmental triggers. It is the awareness to exercise regularly and eat healthy that is delaying diabetes among Indians in America," says Dr V Mohan of the Madras Diabetes Research Foundation.
In contrast, Indians in India are increasingly leading diabetes-promoting lifestyles. Since the 1970s there has been a nearly 10-fold increase in the prevalence of diabetes in Chennai alone. Indians are increasingly taking to a high-fat, low-protein fast food diet and there is a huge increase in the number of people who smoke and drink. In addition, studies have found that less than 10% of Indians do any kind of physical activity.