“if you look at just the incidence of type 2 diabetes in Asia between 1990 and 2020, that's almost 2x in Asia now. So just the number of people who have type 2 diabetes. By the way, interestingly, if you age standardized mortality rates and the incidence of deaths happening due to metabolic diseases, that's pretty much the same. So we are not in the middle of some slow change. We are actually in the middle of a fairly significant metabolic health issue in Asia.”
Childhood obesity in Asia jumped 100%+ in a decade
“Children who are obese and overweight is an even more alarming statistic. And that's been increasing dramatically. Again, according to some statistic, between 2010 and 2020, the childhood obesity rates in Asia have gone up by 100, 120%. This is actually quite a big issue.”
“GLP-1s, to your question, is a pharmaceutical way to handle it. And so what GLP-1s are are essentially drugs which mimic an internal hormone in the body. So when we eat certain substances, most food actually, our intestines secrete GLP-1s, glucagon-like peptides. And they work by having three different effects. So they give one signal which goes to the pancreas and increases insulin secretion, decreases glucagon secretion. Second, GLP-1s decrease the emptying of the stomach. And then third, they actually have an impact on the appetite centers in the brain and hypothalamus and decrease appetite.”
Obesity costs Asian governments roughly $1 trillion
“if you want to put some numbers to it in terms of the economic impact, we've quantified with the McKinsey Health Institute that in Asia alone, this comes down to about a trillion dollars in cost for governments just by obesity. If you take the metabolic syndrome at large and all the consequences that it has for people and families, we're speaking about a potential uplift of two and a half trillion dollars if that were to be properly addressed.”
“Sleep is a big part of metabolic health. If you don't sleep well, by the way, one week of deprived sleep can put you into essentially a diabetic state in terms of sugar management. Diabetes is not only, okay, now I have diabetes, I know medically that's how it works, but impaired glucose metabolism can be the result in three days of poor sleep. Your body would not process glucose the same way.”
Japanese 'hara hachi bu' rule: stop eating at 80% full
“if you take just the traditional ways of thinking, many societies inherently had prevention at the core of medical science. If you take Chinese traditional medicine, Ayurveda in India, many other mechanisms. Even very simple dictums, and I was reading the other day, there's a well-known Japanese dictum. I would say it in Japanese and I'm sure I wouldn't pronounce it right, but it's hara hachi bu, which is essentially stomach 80% full, which is a very simple idea to say, look, keep portion control as you actually think about what you're eating.”
Abu Dhabi launched 20+ cross-sector healthy living initiatives
“one example I would love to mention is relatively recent still, but what Abu Dhabi is doing. They have now institutionalized a healthy living unit whose job it is to take care of the cross-functional coordination of initiatives, and I think right now they have over 20 initiatives. They're not just in health care, they're in education, they're in infrastructure, in municipalities, sports, a holistic portfolio of initiative that are evidence-based. And hopefully, the promise is, this is going to be maybe the first place where we manage to sustainably revert the trend.”
The best habits are the ones you can actually sustain
“Number one, prevention is better than cure. Number two, it's a very, very personal and individual topic, so people should take responsibility for it. You can listen to all the advice, but I like Pancho's point of, take the time to go on the journey yourself, experience some of the stuff which works for you or not. The best habits are those you can sustain, so try to think about what works for you and what mechanism works best for you.”
