India, China top Asia-Pacific region with highest metabolic diseases burden

A recent review of data from the Global Burden of Disease, Injuries and Risk Factors Study (GBD), 1990-2023, found that India and China have among the highest absolute burdens of metabolic diseases in the Asia-Pacific. It also includes forecasts for the Asia-Pacific region through 2030 based on these trends.

Recently published in peer-reviewed journal Metabolism, Huang Zhang et al.’s paper presents an analysis of GBD with special reference to the Asia Pacific region. Scientists from multiple research institutes around the world analyzed estimates of disability-adjusted life years (DALYs) and mortality rates for five common metabolic diseases and risk factors in the region: Type 2 diabetes, high systolic blood pressure, high body mass index (BMI), high LDL cholesterol, and steatotic liver disease (MASLD) associated with metabolic dysfunction). Metabolic diseases occur when the normal process of breaking down, storing or using energy from food is disrupted by a number of factors.

‘Burden of metabolic diseases, 1990-2023, with projections to 2030 for the Asia-Pacific region’ Metabolism

India’s burden

On all parameters considered, India and China top the list. India has one of the highest absolute burdens of metabolic disease in the Asia-Pacific, says Anoop Misra, a co-author of the study and director of the Fortis Center for Diabetes, Obesity and Cholesterol in New Delhi. “In 2023, there were around 21 million DALYs and 5.8 lakh deaths due to type 2 diabetes in India. High systolic BP caused around 3.8 crore DALYs and around 15.7 lakh deaths. We should also be aware that high BMI is increasing steadily (at a rate of 2.7-2.9% per annum), as are LDL cholesterol and MASLD,” he explains. The burden is so heavy that these two countries are not only at the top of the sub-region, but also at the top worldwide.

In terms of DALYs, in 2023 India has replaced China in the list of top 5 countries in the region (from its top position in 1990). According to all four other parameters, India continues to rank second after China, but the gap between the countries is gradually narrowing. This is especially true for High BMI, LDL cholesterol and MASLD.

An emergency prevention call was made

Dr. “It is clear that most metabolic risks will continue to increase until 2030,” says Misra. “Therefore, it is time to initiate urgent integrated prevention strategies.” In his view, the government should promote healthier eating by regulating overly processed foods, clearly implementing nutrition labeling on the front of packaging, and reducing excess sugar, salt and unhealthy fats in commonly consumed foods. While this is done in some regions, a more uniform practice needs to be implemented throughout the country.

He also adds that cities and communities need to be redesigned to encourage daily activity through safe walking areas, bike paths, and school- and workplace-based exercise programs. “Obviously that’s the hardest part, and I don’t think that’s going to happen in most cities in the near future,” he says.

Additionally, large-scale screening for obesity, diabetes, hypertension and fatty liver disease should be integrated into primary health care so that high-risk individuals can be identified and treated early. This has been done independently by the Union Health Ministry and some States but needs to be consolidated and strengthened.