It gives me great pleasure, to write this editorial for the journal of EC Endocrinology and Metabolic Research, for their first issue of the New Year, 2020. In the ancient health sciences of India and Tibet, diseases of altered metabolism were classified as ‘Doshas’ and the remedies prescribed, included restoring the balance of altered metabolism, by structured lifestyle education [1]. Metabolic diseases such as hypertension, excess weight, obesity, type-2 diabetes and vascular diseases, have increased in the incidence and prevalence to epidemic proportions worldwide [2-5]. Despite this observation, we do not have a regional, ethnic-specific guideline, for the prevention and management of these chronic diseases. China has been declared the capital of diabetes and India is competing for that position again. Chinese, Indians, and Japanese, consume rice as a major source of their daily diets. Chinese, Indians and Japanese have been eating rice as their major diet for thousands of years. It is hard to suggest a change of diet at the population level. Japanese claim that eating brown rice, fish and lots of vegetables has protected them from diabetes. They also claim, that use of vinegar with their rice (sushi), also offers protection from metabolic diseases. However, recent trends suggest that this nation of healthy people are no exception to this worldwide trend in the increase in the incidence of diabetes. Japan ranks 8^th worldwide, in the number of individuals with type-2 diabetes (International Federation of Diabetes).

References

1. Patwardhan B., et al. “Ayurveda and Traditional Chinese Medicine: A Comparative Overview”. Evidence-Based Complementary and Alternative Medicine 2.4 (2005): 465-473.
2. Bhupathiraju SP and Hu FB. “Epidemiology of Obesity and Diabetes and their Cardiovascular Complications”. Circulation Research 118.11 (2016): 1723-1735.
3. Leitner DR., et al. “Obesity and Type 2 diabetes: Two diseases with a need for combined treatment strategies-EASO can lead the way”. Obesity Facts 10.5 (2017): 483-492.
4. “Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration: Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment”. Lancet Diabetes and Endocrinology 2.8 (2014): 634-647.
5. “Global, regional, and national comparative risk assessment of 79 behavioral, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study”. Lancet 386 (2015): 2287-323.
6. Shen X., et al. “The diabetes epidemic in China: An integrated review of national surveys”. Endocrine Practice 22.9 (2016): 1119-1129.
7. Ezzati M., et al. “Determining the worldwide prevalence of obesity-Author’s reply”. Lancet 391 (2018): 1774.
8. NCD Risk Factor Collaboration (NCD-RisC). “Worldwide trends in body-mass index, underweight, overweight and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents and adults”. Lancet 390 (2017): 2627-2642.
9. Siegel K., et al. “Finding a policy solution to India’s Diabetic Epidemic”. Health Affairs 27.4 (2008): 1077-1090. 
10. Puska P. “Successful prevention of non-communicable diseases: 25-year experience with North Karelia Project in Finland”. Public Health Medicine 4.1 (2002): 5-7.
11. Yusuf S., et al. “Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study”. Lancet 364 (2004): 937-952.
12. Khera AM., et al. “Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Artery Disease”. New England Journal of Medicine 375 (2016): 2349-2358.
13. Alwan A., et al. “Proposed policy priorities for preventing obesity and diabetes in the Eastern Mediterranean Region”. WHO (2017).
14. Kumanyika S., et al. “Obesity: Strategic Action to Combat the Obesity Epidemic”. Report of the WISH Obesity Working Group (2013).