Why is type 2 more common in Mediterranean countries?

Beats me ... I'd heard it was more common among Asian and Carribean communities yet I belong to neither, I'm of Polish/Irish origins but born in England.

When I look back to my childhood I'm almost sure my mother was an undiagnosed diabetic - I remember her losing lots of weight very quickly and drinking gallons of tea all the time. I don't think she ever had any blood tests done, the doctor just gave her these huge round pills called 'Wate On' - they were about the size of a 2p piece! She liked her cakes, sweets and biscuits and her health wasn't good in general.

Dad was a concentration camp survivor, when Mum met him he was about 6st in weight and couldn't eat. Over the years his health became very, very poor, heart attacks, strokes, asthma, COPD, emphysema, obesity. I don't think he ever had blood tests either, he just got repeat prescriptions for his breathing all the time.

I was married to a Spaniard, we lived in UK but we ate lots of Spanish dishes. He has never put any weight on over the years, he drinks tea with sugar and is as fit as a fiddle with loads of energy, but he's getting a bit absent minded in his 60's.

I think most developed countries eat carbs of some sort - bread, rice, pasta etc but these days we don't know how GM it is or how that effects our ability to process it. We also don't really know how we're evolving as a human race in response to the various food changes that have taken place over the past 50 years or so. Even in my own childhood 50 years ago, there wasn't the level of processing involved in our food as there is now. No ready meals, the only packet food I remember was Maggie's Soups and Heinz Beans and Soups. Everything else was fresh. Maybe our kids and grandkids have evolved to cope with the changes but maybe my generation hasn't.

The reported prevalence depends on the source of the data and how they adjust it.
This is from the IDF.
It's data for all types of diabetes. They do have a separate map for diabetes in the young (under 14)
comparative prevalence/ national prevalence

[ The comparative prevalence has been calculated by assuming that every country and region has the same age profile (the age profile of the world population has been used). This reduces the effect of age differences between countries and regions, and this figure is appropriate for making comparisons between countries. The comparative prevalence should not be used for a single country or region who have diabetes]

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Italy 5.3% /7.8%
Greece 5.3%/7%
Spain 6.5%/8.1%
Portugal 9,8%/ 12.7%
UK 5.4%/6.8%
US 9.6%/10.9%
Highest comparative prevalence:
Kiribati 25.7%
Marshall Islands 22.2%
Kuwait 21.1%
Lowest:
Mali 1.5%
Benin 1.7%

The accuracy of the data will be dependent on the health care systems (screening/number undiagnosed) and the source of the National statistics .
http://www.idf.org/atlasmap/atlasmap

see also http://www.idf.org/diabetesatlas/5e/the-global-burden

Maybe its not about food or location.

Maybe its genetic and different types of people have different types of illnesses.

Find that surprising about Spain. Sitting here in the sunshine (23 degrees -sorry everyone)and LCHF has been easy. Ham and cheese for breakfast. Last night had a regional dish of scrambled egg and black sausage (mixed together and black - bit strange). Main course of Langoustines - split, fried and lettuce but NO chips/potatoes automatically served with it. Plenty of steak and salad. Even the Paella in this area is made with low GI noodles rather than rice. And of course, lots of red wine, to wash it down!

China has a huuuuge diabetes problem too. Think India is not far behind.

dawnmc said:

China has a huuuuge diabetes problem too. Think India is not far behind.

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Wow - now that IS disconcerting. I've always thought of the traditional foods of China and India as being quite healthy.

The more I hear, the more I begin to think this is some kind of evolutionary change that's happening - a bit like losing our little toe eventually, perhaps we're losing the ability to process ****?

We had a discussion about this a few months ago. The counties with the worst problems seem to be China and India with Africa becoming a huge problem by 2030.

However China is the only country that successfully implemented a regime that controlled T2 to any large extent. It was pretty dictatorial and was driven through the workplace so I would guess it would never be accepted as a solution in any Western democracy.

If you use the IDF atlas and filter just for high income countries and use the comparative prevalence values that are more accurate then the best are

Iceland
Sweden
Luxembourg
Norway

The Icelandic diet is predominently low carb for example see http://www.foodandwine.com/articles/should-you-eat-like-an-icelander

The Swedes "invented" low carb high fat as far as I'm concerned and its roughly the regime I try to follow. The dietdoctor site that many people on this forum give as a useful link is just an English version of a Swedish site see http://www.kostdoktorn.se/

Again the Norwegians seem to have no problem with a low carb high fat diet although that traditional diet is gradually being corrupted by highly processed high carb foods see.

http://www.thehealthyhomeeconomist.com/butter-scarce-as-norwegians-embrace-traditional-diet/

No idea what people in Luxembourg eat but it has such a small population maybe it shouldn't be treated separately anyway.

The Mediterranean countries of Italy and Greece then do better than the UK but Spain and Malta do worse. Overall the standard Mediterranean diet is seen as a reduced carbohydrate regime (or at least the one advocated by the Swedish Health Service is)

I was originally trained as a biological scientist and I suspect that if something like T2DM is found in clusters, it's likely to have a big genetic component.
Hana

Well there is a thought that these diseases may be caused by all the pollutants, plastics etc.

I seem to remember seeing a TV program about a doctor in India who is linking birth weight of babies and later development of Type 2 diabetes, but can't remember all the details. Drat my failing memory

We lived in Spain for a bit. I wonder if the traditional healthy way of life/eating is being corrupted. While we were there we couldn't believe the unhealthy breakfasts we saw being eaten or sold in supermarkets. Churros (fried pastries), croissants or similar, breakfast cereals such as Special K all made with chocolate and white bread/rolls with chocolate spread. We remarked at the time that we didn't understand how the Mediterranean diet could be recommended if the breakfasts were anything to go by!

Re Birth weight - my son was 9 1/2 lbs when he was born and we were kept in hospital for him to be tested for diabetes (which he does not have). I remember several doctors discussing anecdotal stories of birth weight/diabetes Type 2.

Hi all

It is interesting to see the low incidence of diabetes in Benin where the diet is based on starchy roots (cassava, yams) and cereals - i.e. carbohydrates. Given the comments made about carbohydrates and, occasionally, on our bodies inability to deal with them, as we were not made to eat them, I wonder why those from Benin don't have a huge problem with diabetes? The world is a mystery.

Regards

Doug

Osidge said:

It is interesting to see the low incidence of diabetes in Benin where the diet is based on starchy roots (cassava, yams) and cereals - i.e. carbohydrates. Given the comments made about carbohydrates and, occasionally, on our bodies inability to deal with them, as we were not made to eat them, I wonder why those from Benin don't have a huge problem with diabetes? The world is a mystery.

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75% of the population of Benin lives in poverty (defined as living on less than $2 per day).
47% of the population of Benin live in extreme poverty (defined as living on less than $1.25)
The average life expectancy is 59.
Before 1980, less than 30% of the population had access to primary healthcare.
Benin is the 19th poorest country in the world (judged by % of people on <$2 a day)
(Mali, which has the second lowest incidence, is the 13th poorest country in the world).

1. Since most of the population is living in poverty, you wouldn't expect that the overconsumption of anything (including carbohydrates) is an issue.
2. Starchy roots such as cassave and yams are part of our ancestral diet, and are generally much less harmful than refined carbohydrates such as cereal grains and sugar. Among the Paleo community these are generally referred to as "safe starches".
3. Many people don't live long enough for diabetes to be a problem.
4. Given the level of poverty and healthcare, it is unlikely that the diabetes estimates are very accurate.

Diabetes is a disease of affluence. It rarely manifests itself among the poor and hungry.

Osidge said:

It is interesting to see the low incidence of diabetes in Benin where the diet is based on starchy roots

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Looks like its because something else kills them off first Doug. The average lifespan is 54 if you're a man and 60 if your a woman if you believe the World Health Organisation. Perhaps a change in diet might be a good thing to recommend to their government by the sounds of things don't you think?

http://www.who.int/countries/ben/en/

Far better to go and live in low carb high fat Sweden their life expectancy is 79 for men and 83 for women

http://www.who.int/countries/swe/en/

or even better low carb high fat Iceland men 80, women 83

http://www.who.int/countries/isl/en/

or try low carb high fat Norway which is again 79 for men and 83 for women

http://www.who.int/countries/nor/en/

I find it very interesting how those 3 countries are the top 3 lowest diabetes countries in the industrialised nations based on the IDF's comparative diabetes rates.

Osidge said:

Hi all

It is interesting to see the low incidence of diabetes in Benin where the diet is based on starchy roots (cassava, yams) and cereals - i.e. carbohydrates. Given the comments made about carbohydrates and, occasionally, on our bodies inability to deal with them, as we were not made to eat them, I wonder why those from Benin don't have a huge problem with diabetes? The world is a mystery.

Regards

Doug

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Do they eat processed carbs in Benin? Stuff like bread with all the preservatives and **** in it and pasta and pastries and cakes etc? Or are they eating natural carbs that haven't been interfered with by processing?

GraceK said:

Do they eat processed carbs in Benin? Stuff like bread with all the preservatives and **** in it and pasta and pastries and cakes etc? Or are they eating natural carbs that haven't been interfered with by processing?

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From Doug's description they're eating unprocessed "safe starches" plus refined cereals. When they're not starving that is.

Benin:

The per capita supply of starchy roots is very high; its share in the dietary energy supply has decreased slightly over the last four decades to the advantage of cereals. The country is relatively self-sufficient in cereals (with the notable exception of rice) and starchy roots, but it is heavily dependant on imports of foods of animal origin for which the per capita supply remains very limited.

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http://en.wikipedia.org/wiki/Inuit_diet

My son sent me that link this morning. I've been telling him about the LCHF diet and about this forum. I haven't wanted to bombard him with information because obviously me being diabetic also gives him something to be concerned about where his own health is concerned so I've waited until he asks me questions. He eats a good diet but he does get fatigued after meals and today he asked me about how my energy was being affected by not eating carbs so I told him it was much improved and gave him the diet doctor website.

He then sent me the link about the Inuits and I really loved this part in particular -

Beliefs in diet
Main article: Inuit mythology

Inuit choose their diet based on four concepts, according to Borré: "the relationship between animals and humans, the relationship between the body and soul and life and health, the relationship between seal blood and Inuit blood, and diet choice." Inuit are especially spiritual when it comes to the customs of hunting, cooking, and eating. The Inuit belief is that the combination of animal and human blood in one's bloodstream creates a healthy human body and soul.[12]
Hunting beliefs

One particular belief that Inuit strongly believe in is the relationship between seal and Inuit. According to Inuit hunters and elders, hunters and seals have an agreement that allows the hunter to capture and feed from the seal if only for the hunger of the hunter's family. Borré explains that through this alliance "both hunter and seal are believed to benefit: the hunter is able to sustain the life of his people by having a reliable source of food, and the seal, through its sacrifice, agrees to become part of the body of the Inuit."[12]

Inuit are under the belief that if they do not follow the alliances that their ancestors have laid out, the animals will disappear because they have been offended and will cease to reproduce.[12]
Healing beliefs

Borré tells of a time when she saw an Inuit woman fall ill who blamed her sickness on the lack of seal in her diet. Once receiving seal meat, the woman felt better within hours and explained that her quick recovery was due to the consumption of seal meat and blood. Borré experienced this many times among many different members of the group and they all attributed their sickness to the lack of Inuit food.[12]

A commonality seen among hunters and young men is that they very rarely fall ill because of their high consumption of seal meat to maintain strength to hunt.

I really feel that way about the food I eat too. I have quite deep spiritual beliefs about the food chain and about honouring the whole process. It's quite a profound feeling and yet at the same time there's a simplicity about it.

Might sound daft but I always silently bless and also thank everyone involved in bringing my food to my table - veryone from the animal itself to the people who reared it, killed it, packaged it, delivered it to the shops, placed it on the shelves and served me with it. I've always mentally said 'Grace' since I was a small kid. Anyone else do this?