In recent years, parts of the Middle East have been experiencing a food-related public health crisis: an extreme rise in type-2 diabetes in the Arabian Peninsula region.
The rate of diabetes in parts of the Arabian Peninsula is over twice the global average rate, and much higher than some other areas of the Middle East and North Africa (MENA). And cases of type-2 diabetes outnumber cases of type-1 diabetes by a ratio of 10:1.
According to the International Diabetes Federation Atlas, 19.3 percent of adults aged 20 to 79 in the United Arab Emirates are diabetic. In Bahrain, the percentage rises to 19.6—and the statistic jumps to 20 percent for Kuwait, Qatar, and Saudi Arabia. These five nations all rank within the top 15 nations in the world for highest rate of diabetes per capita.
Also ranking within the top 40 are the MENA countries of Egypt, Oman, and Lebanon, though diabetes rates there are much closer to the global average. In contrast, diabetes prevalence for this age range is only five percent in the Gulf nation of Yemen.
Qatar, Kuwait, the United Arab Emirates, Bahrain, and Saudi Arabia also rank in the top 15 countries for obesity; Qatar ranks highest, at number six. Additionally, high rates of smoking have led to increased rates of heart disease and high blood pressure. Last year, in Bahrain, nearly 50 percent of men over age 15 used tobacco products—and the percentage is expected to rise to 86.1 by 2025. Experts, concerned about the rapid increase in lifestyle diseases in this region, have looked to history and environmental factors to identify the cause.
According to The Wall Street Journal, “the cause of the high prevalence of diabetes in the region is clear. Unhealthy lifestyles and urbanization are to blame—particularly in the Persian Gulf where the discovery of oil has created wealth that has decreased physical activity, according to doctors and analysts.” Bahrain, Kuwait, Qatar, Saudi Arabia, and the UAE together own almost 50 percent of the world’s oil fields. And all of these, save for Saudi Arabia, were British Protectorates until the 1960s and 70s—a colonial influence that cannot be discounted. Today, these are some of the wealthiest countries in our world, and the lifestyle of the average citizen is dramatically different from that of the pre-oil, pre-colonial era.
Unhealthy diets and sedentary lifestyles are on the rise. Faisal Hasan, a physician at the Heart & Vascular Institute at Cleveland Clinic Abu Dhabi, has explained: “The UAE has seen tremendous economic and industrial development in recent years, resulting in a shift in social behaviours towards those often seen in developed countries. For many, sedentary lifestyles and seemingly endless fast-food options have replaced the traditional ways of work, travel, and cuisine, making way for the increase of diseases.” These observations may hold true for other countries in the region, as well.
Research from New York University Abu Dhabi (NYUAD) also suggests that Emiratis, and perhaps others, may have an underlying genetic predisposition to diabetes—one that only presents once other factors caused huge changes in diet and lifestyle. NYUAD professor Youssef Idaghdour is one of many researchers currently exploring the field of epigenetics—the study of how genetic traits can vary based on external factors—to understand how environmental factors can influence gene expression: “The genetics didn’t change that much, but the environment changed. The hypothesis is that it has to be an interaction: there must be some genetic predisposition to develop diabetes, but then it’s the environment that triggers the disease.”
For the most part, Gulf countries have sophisticated medical facilities and highly-trained specialists for patients with diabetes. The issue seems to lie in a lack of public awareness, preventative care, and primary treatment of risk factors such as obesity. Lack of screening is also posing a problem: it has been estimated by the MENA Diabetes Leadership Forum that approximately 50 percent of diabetics in the region are undiagnosed.
Governments and healthcare providers are well aware of this problem. Back in 2009, the UAE government declared an “Anti-Diabetes Year,” which involved rolling out a ten-year plan to fight the disease including increased diabetes research, public awareness campaigns, and updated medical facilities. Other diabetes societies across the region are working to create public health campaigns, as well.