Obesity's 'rising tide' adds Type 2 diabetes challenges worldwide

Disability rates worldwide from illnesses and injuries such as Type 2 diabetes and low-back pain are declining more slowly than death rates, a new study suggests.

Monday's publication of the Global Burden of Disease study in The Lancet focuses on years of healthy life lost due to illness such as impaired mobility, hearing, vision or pain in 188 countries between 1990 and 2013.

Many countries around the world have made progress in addressing fatal diseases, but nonfatal illnesses pose the next major threat in terms of disease burden, said Prof. Theo Vos of Institute for Health Metrics and Evaluation, the study's lead author at the University of Washington.

This need to meet the challenge of nonfatal diseases and injuries only becomes more urgent as the population increases and people live longer, the researchers said.

Diabetes went up in the rankings from #10 in 1990 to #7, Vos said. About 60 per cent of the diabetes in the world can be attributed to rising exposure to obesity and excess weight.

While Type 2 diabetes leads to heart disease and stroke, doctors have become good at preventing deaths from those cardiovascular diseases.

"I think the biggest challenge is to do something about the rising tide of obesity and there we probably are not so successful," Vos said.

He pointed to Vietnam as one of the few countries that has so far escaped the tide of obesity. Less than one per cent of the population of Vietnam is considered obese, unlike in nearby countries such as Thailand, China and Indonesia.

"Some people have postulated that's because Vietnam until very recently has kept all the fast food chains at bay. Of course it's hard to prove that, but certainly the more traditional diet in Vietnam is protective against obesity compared to high-density fast food."

The researchers called for countries to take a close look at health policies and spending to target nonfatal illnesses.

Globally, only 4.3 per cent of the population had no burden of disease or injury in 2013, up from 4.2 per cent in 1990.

Leading sources of disability in Canada

In 2013, musculoskeletal disorders such as low back pain, neck pain, and arthritis and mental and substance abuse disorders (mainly depression, anxiety, and drug and alcohol use disorders) accounted for almost half of all health loss worldwide.

Other leading causes of disability worldwide were schizophrenia, iron-deficiency anemia and age-related and other hearing loss.

Vos said low-back and neck pain, major depressive disorder and other musculoskeletal disorders were the main sources of disability in Canada after taking age into account.

To prepare for the rapid transition brought by the burden of multiple diseases and disability will require a radical rethink of health systems, Rifat Atun of Harvard University in Boston said in a journal commentary published with the study.

The research was funded by the Bill & Melinda Gates Foundation.