Obesity epidemic in the Asia Pacific region: an interview with Prof Drexel, European Society of Cardiology

Interview conducted by April Cashin-Garbutt, MA (Editor)Apr 15 2013

What percentage of people are obese in the Asia Pacific region?

The prevalence of obesity is about 20 % in Australia, 17 % in Japan, but only 3 – 4 % in China. Thus, Asia Pacific is a very heterogeneous region.

Why do you think the levels of obesity vary widely in the Asia Pacific region?

The speed with which western habits of nutrition and exercise are taken varies widely. This appears dominant to any other possible explanation like genetics.

How has this percentage changed over the last few decades?

The increase in Japan over two decades was about 50 %; whereas in China it was 400 %. One should be aware that e.g. 400 % of a very low preexisting level are relative numbers and only describe a steep rise but not an absolute magnitude.

How does the obesity epidemic in the Asia Pacific region compare to elsewhere in the world?

Australia is similar to Northern America and Europe, the other countries gradually lose their advantage. Overnutrition is mainly by fatty meals like burgers and by sugar-containing beverages like sodas that are consumed in larger amounts than e.g. water.

What do you think are the reasons for the rising epidemic of obesity in the Asia Pacific region?

It is the “Westernization”: overnutrition and lack of exercise.

Why do you think some countries in the Asia Pacific are becoming increasingly ‘Westernized’?

The new lifestyle is that of urbanisation, modernisation and loss of traditions of cooking, meal timing, exercise at work and so on.

Why do some societies label people of healthy weight as poor? Do you think this is a contributing factor to the obesity epidemic?

This label is typical for countries with a low gross domestic product. Obesity is viewed as an escape from poverty.

What other factors do you think are responsible for the rising obesity epidemic?

At least at the beginning of the epidemic there is a feeling, that gaining weight is good because it demonstrates economic success.

Should we be worried by the rising obesity epidemic?

Yes, because increased rates of diabetes mellitus and of coronary artery disease will inevitably ensue.

How does obesity cause diabetes and coronary artery disease?

Obesity leads to negative changes in metabolism. The body needs more insulin which is anabolic, i.e. it increases body tissues like fat. In turn blood lipids are changed with disadvantages for the arteries especially for the heart.

How do you think the rising epidemic of obesity can be prevented?

Prevention has not succeeded in other western countries. A valuable approach is multifactorial: at the society level (obesity is not a sign of wealth), in health politics, medicine and others.

Why do you think prevention of obesity has not succeeded in western countries?

Because it is very difficult to return to a healthy lifestyle with less eating and more exercise.

Are there any plans currently in place to try to reduce the obesity epidemic?

Motivation is important: almost 90 % of heart disease is preventable. The most important step will be in information of the young in schools. As soon as the lifestyle is obesity-prone it is very difficult to return to a healthy lifestyle.

How do you think the future of the obesity epidemic will develop?

The epidemic will grow with westernization and motorization. Authorities must try to retard the progression. I am not optimistic that we can stop the development totally.

Where can readers find more information?

1. Lee CMY, Martiniuk ALC, Woodward M, Feigin V, Gu DF, Jamrozik K, Lam TH, Ni Mhurchu C, Pan WH, Suh I, Ueshema H, Woo J, Huxley R. The burden of overweight and obesity in the Asia-Pacific region. Obesity Reviews. 2007;8:191-196.
2. Gupta R, Guptha S, Gupta VP, Agrawal A, Gaur K, Deedwania PC. Twenty-year trends in cardiovascular risk factors in India and influence of educational status. Eur J Prev Cardiol. 2012;19(6):1258-1271.
3. Woodward M, Huxley R, Ueshima H, Fang X, Kim HC, Lam TH. The Asia Pacific Cohort Studies Collaboration: A Decade of Achievements. Global Heart. 2012;7(4);343-351.
4. Jørgensen T, Capewell S, Prescott E, Allender S, Sans S, Zdrojewski T, De Bacquer D, de Sutter J, Franco OH, Løgstrup S, Volpe M, Malyutina S, Marques-Vidal P, Reiner Z, Tell GS, Verschuren WM, Vanuzzo D. Population-level changes to promote cardiovascular health. Eur J Prev Cardiol. 2012 May 9. [Epub ahead of print]
5. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). European Heart Journal. 2012;33:1635–1701.

http://www.escardio.org/about/press/press-releases/pr-13/Pages/epidemic-obesity-hits-asia.aspx

About Prof Drexel

Heinz Drexel, MD is currently the Professor of Medicine, Vivit-Institute, Department of Internal Medicine, Landeskrankenhaus Feldkirch.

He received his Medical degree with highest award of the Republic of Austria, University of Innsbruck.

In 2007, Prof Drexel became a Fellow of the ESC and in 2012 he became a Fellow of the AHA.

His research activities include Diabetes mellitus and pregnancy, Diabetes Dyslipidemia, Hypertension, Diagnosis of myocardial infarction, Glycation of proteins, HPLC methodology and Atherogenic lipid disorders.

Prof Drexel has been the co-investigator in around 100 clinical trials and the investigator in around 90 clinical trials.