Tuesday, January 11, 2011

Welcome to Nauru! The Fattest Place on Earth

Kim is a treasured reader of mine. She is consistently reading my posts and often leaves some lengthy and really thought provoking comments. I love that. She, by the way, did not know that I was going to write this today. So sorry for busting up your spot. I don't actually know you so I couldn't contact you to ask you if this is okay. Let me know if you're pissed. I hope you aren't!!

Anyway, on New Years Day Kim left me a very well thought out comment on my recent post Food is a Socio-Economic Problem: Part Two. Only, now I am not sure that it ever got published, so sorry, Google can be a hassle. I made mention at the end of the article that if you are poor in America you have a greater risk of becoming a Diabetic. Kim pointed out that Diabetes is in fact genetic and that genetic predisposition for Diabetes is what makes you develop Diabetes, both Type One and Type Two. Kim went on to say that diet is a major contributing factor but that people with the genetic predisposition for diabetes would most likely develop the disease later in life regardless. The comment really made me think. The truth is, I didn't know alot about Diabetes. And I shouldn't make claims that are unresearched. It turns out, we are both right.

According to Diabetes.org Kim is right, Diabetes is genetic in both it's forms. But it is also aggrivated by factors like diet. The site states "Type 2 diabetes has a stronger genetic basis than type 1, yet it also depends more on environmental factors. Sound confusing? What happens is that a family history of type 2 diabetes is one of the strongest risk factors for getting the disease but it only seems to matter in people living a Western lifestyle.
Americans and Europeans eat too much fat and too little carbohydrate and fiber, and they get too little exercise. Type 2 diabetes is common in people with these habits. The ethnic groups in the United States with the highest risk are African
Americans, Mexican Americans, and Pima Indians." So while eating a Western Diet, only some of us will develop Type Two Diabetes. Just as only some of us will develop Type One Diabetes. However, if we all adopted a non-processed or traditional diet, it is likely that we can all avoid the disease altogether. The site even continues to say: "In contrast, people who live in areas that have not become Westernized tend not to get type 2 diabetes, no matter how high their genetic risk." This last part is key, because is sets up the idea that the diet is the problem. People can eliminate their risk for the disease by eating unprocessed foods like vegetables, whole grains, legumes and pastured meats.

The site doesn't mention anything about Non-Western populations that adopt a Western Diet in a relatively short time period. Michael Pollan addresses it a little in In Defense of Food. And his assertion was that Non-Western Populations that adopt a Western Diet are more likely to get Diabetes because they have not evolved to eat all the processed foods. It turns out that it is a little more complicated than just that... I found an interesting academic paper about NIDDM, or Non-Insulin Dependent Diabetes Mellitus. But in short it states that certain populations naturally evolved to overeat and secrete insulin excessively in order to survive food shortages. These populations live in regions that might not get dependable food because they are on small islands, or they lived hunter gatherer lifestyles. Populations noted in the paper are the American Indians and the Polynesians. It is these populations that are seeing a greater occurance of Type Two Diabetes in their people now that more and more regions are eating a Western Diet. Fascinating, right?

Many people want to paint the United States as the Fattest Country on Earth. And it is kind of not true and kind of true at the same time. I will explain.

Recently Forbes put out it's 2010 list of the fattest countires on Earth. The United States was Number 9. Kuwait was Number 7 (that was surprising to me) and every other country in the top ten were in tiny islands in Polynesia. The tiny island of Nauru is the fattest place on Earth. In Nauru 95% of the adult population is overweight. And a third of the population has Type Two Diabetes.

Nauru is a super tiny island in the South Seas. Their closest neighbor is Kirbati, about 300km away. The island is about 8 square miles and has less than 10,000 inhabitents. The story of the island reads like a depressing novel. Phosphate deposits of fossilized marine life were discovered on the island early in the 20th century. After German colonization in the late 19th century, and some Japanese occupation during World War Two, and finally a UN trusteeship, the island declared independence in 1968. After independence, Nauru boasted the highest per capita income of any nation in the world, because of the mining. Phosphate mining continued until the 1980s when the phosphate reserves were exhausted. These once rich islanders are today returning to their poor state. But sadly, one thing that has stayed even when industry has left, is the Western Diet.

Ancient pictures show a trim population that survived on wild caught fish and other island delacasies like fruit and coconuts. But today there are more SPAM cans and bags of sugar than anything else. Food imported from New Zealand and Australia makes up the main diet of these islanders. And they are paying the price. Like I said, 95% of the population is overweight and a third have type two Diabetes. Like the paper I mentioned above, the people of Nauru have evolved to weather food shortages. And so it is likely that they have this "Thrify Person's Gene" that now makes them more likely to develop T2Diabetes. But while the government has been organizing aerobic workouts to encourage people to trim down, what they should really be targeting is the processed food diet!

I watched this video from ABC News last week and it made me so sad. Western Food has raped a once beautiful island paradise.

So you see, Type Two Diabetes is genetic. But crappy high fat, high sugar, high carb foods have exacerbated and even triggered the problem. And the cases have risen almost ten fold in the last 20 years. And ironically, Europeans and those of European decent have the least risk!! Our diet is sickening the rest of the world. I am deeply upset by this, because I am so proud of being a citizen of the United States. We are a good people. But this food has GOT to stop. Or, do you think we will ever evolve to eat these processed foods?



  1. Thank you for this post! It's really interesting. I find the Forbes list fascinating because they only take account of BMI,not other factors that determine health- ie. blood pressure, heart health, cholesterol, level of illnesses, dental health, etc... The thing is, those Polynesian countries have been studied extensively through the years by many Drs and scientists, Dr. Weston Price and Gary Taubes among them and they are not (or were not when Price studied them) fat because they were unhealthy. Both Price and Taubes discuss about how different ethnicities may appear large, but are no more unhealthy than a slim European. In fact they often eat identically in calories (thus debunking the calorie in, calorie out theory) as slimmer ethnicities. It is simply a factor of their ethnic makeup and their naturally available food (coconuts and fish are awesome choices). I have absolutely no idea if their current size is still due to solely their ethnic makeup and natural food, but I think it is sadly typical of the Western way of thinking to equate weight to health, as Forbes Magazine did. I do realize the list is only for the fattest people, but far too many people see the word fat and think unhealthy. I'd like to see the list of the most unhealthy countries in the world as determined by a host of factors. I have a hunch the US would be closer than number 9, followed by Nauru and many of the 3rd world developing countries who have just gotten their hands on McD's, KFC, and Pizza Hut. I'm guessing that a lot of the Middle Eastern countries listed on Forbes list can attribute their weight to the western diet, but I'm not so sure about Polynesia would be listed so high.

  2. Great comment. I knew about the Weston Price studies in the South Seas, but not about Gary Taubes. I need to read his book.

    I hear what you are saying about the relationship between fat and health. However the situation in Nauru is definitely not just related to genetics. Watch the video, it is intriguing. The population is no longer living on an unprocessed diet. The population today looks vastly different than pictures takend 100 years ago, when the people looked trim and 'normal'. And there are a large amount of health problems on Nauru today. I admit I assumed (there I go again), that the other 8 countries in the top ten were in similar situations. I assumed that because some of those places had been influenced by the US like the Cook Islands or Samoa. But also, tourism. Beautiful islands tend to have a strong tourism business, and with tourists come 'vacation food' and western tastebuds.

    You are right, fat doesn't always equal unhealthy. But so many places are westernized at this point, my bet is that the weight of the people of the Islands South Seas has more to do with french fries and sodas, complicated by genetics, than genetics alone.

  3. Christa,
    (The "M" in stands for Mellitus.) Also, I was going to give you this additional information regarding Type 1 Diabetes Mellitus-"T1DM" (used to be called Insulin Dependent DM for Juvenile Diabetes). I had the information typed out and then found a more succint description on Wikipedia (my Pathophysiology professor would not be happy about that).

    "Type 1 diabetes is partly inherited and then triggered by certain infections, with some evidence pointing at Coxsackie B4 virus. There is a genetic element in individual susceptibility to some of these triggers which has been traced to particular HLA genotypes (i.e., the genetic "self" identifiers relied upon by the immune system). However, even in those who have inherited the susceptibility, type 1 diabetes mellitus seems to require an environmental trigger."

    So, people can have the genetic disposition for Type 1 DM and whether they are 2, 12 or 20, they can get an infection or illness, which weakens the immune system and "turns-on" the Diabetes gene. T1DM patients will almost always need insulin....usually forever, because the body can't effectively produce insulin. On the other hand, Type 2 DM (T2DM--formerly known as Non-Insulin Dependent DM) is the body's resistance to insulin. The insulin receptors in the body become overwhelmed and desensitized and start to shut down. T2DM patient's don't always need insulin, just when the disease process progresses. This is why patients with T2DM who are overweight can lose weight with diet and exercise and then (sometimes) get rid of their diabetes! Because their body isn't overwhelmed with insulin and the receptors can more effectively utilize the insulin and manage the glucose. Kids that I take care of with T1DM are skinny kiddos, whereas those at higher risk for T2DM are usually overweight. I hope this little bit of clarification helps.

  4. Thi is also a great comment. Thanks for the clarification. I have gone back and added Type 2 before each mention of Diabetes. Let me know if I missed one. I was intending this post to be just about Type Two Diabetes, but I should have been more specific.
    Thanks for the info, I had no idea that there were environmental triggers for Type One Diabetes.

  5. You must understand it's not the genes. The genes have not changed. It's the genetIc expression based on lifestyle choice. Do you honestly think the people of nareu's genes changed in one generation? Look up epigenetics.

  6. @ Anonymous April 16th, In the article I added the links showing the research that Diabetes is in fact genetic. I am under no circumstances saying that diabetics who eat lousy food are blameless. Diet is the main reason T2 Diabetes occurs. And I know a little about epigenetics. It is also fascinating. I am sure that that plays a role in the development of disease as well.

    However, the research that i cited shows that over the course of several generations, the genes of the people of the South Seas have evolved to withstand food shortages. Thus their bodies cannot handle an overabundance of food. I am actually trying to say that their genes have NOT changed in one generation, but their food availabilities have. This is seen in other ethnicities who have more recently lived hunter gatherer lifestyles, including Africans and Native Americans, who are also populations at greater risk of developing T2 Diabetes.

  7. And more to my point, some people can gain 500 pounds and will not become Diabetic. Diabetes is not an absolute, and genetics plays a big role in wether you develop the disease at all.