Nutrition and diabetes in the Asia-Pacific region with reference to cardiovascular disease.

In many parts of the Asia-Pacific region, diabetes prevalence is increasing and seems destined to become a major risk factor for cardiovascular disease. The phenomenon seems predicated on insulin resistance (IR), partly attributable to an early impact of abdominal (visceral) adiposity than in Caucasian populations. Food intake along with physical activity and emotional stress are all determinants of glycaemic status. The glycaemic index (GI) of foods indicates that a number of food factors other than glucose content are important for good glycaemic response to foods and meals. These include (i) low GI foods could also be ones low in fat, (ii) foods that have the lowest GI which include lentils, pasta, noodles, multigrain breads and some fruits (e.g. grapefruit, plums) and (iii) fruits are to be preferred to their juices. The nutritional management of diabetes is best served by counselling changes in a sociocultural context and step-wise fashion by negotiation rather than prescription. It needs to be accompanied by advice to engage in regular physical activity, both aerobic and strength training. The same concept applies to the prevention of abdominal adiposity and diabetes mellitus type II in the Asia-Pacific region, but with particular reference to protective regional food.