Why are most Chinese people heading towards diabetes?

A thin man in China

A thin man in China

China is heading towards a diabetes disaster, that could bankrupt the whole health care system, according to a new study that was recently published.

Twelve percent of adult Chinese are already diabetic and an additional 50 percent are pre-diabetic, a state that is a precursor to diabetes where blood sugar levels are abnormally elevated.

In other words: Six out of ten Chinese have, or are about to get, diabetes! This is surprising given that Chinese people on average are not nearly as overweight as Westerners. But a closer look explains the problem.

In China it’s culturally quite OK for men to roll up their shirts, exposing the tummy, when it’s hot. Here are thirty examples:

BuzzFeed: 30 Chinese Men Beating the Heat

Something’s different. If you were to put these thirty men on a scale, most of them would with good margin end up of normal weight, according to BMI. But only a few have a slim waistline.

Chinese people, like many Asian peoples, generally have genes that predispose them to having beginning obesity show only at the waistline. Behind their often still “normal” weight, according to Western standards, more and more metabolic problems lurk. Incipient abdominal obesity, fatty liver, hypertension, abnormal cholesterol numbers… and for many also abnormally sweet blood (diabetes).

By all accounts Asians seem to be more sensitive to modern junk food with lots of sugar in it than Westerners are. The disaster will be felt even more in Asia.

Do You Have a Normal Blood Sugar?

If you are a little round around the middle you too may be at risk of type 2 diabetes. Want to check your blood sugar? You can do this with your primary physician. You can also test it at home yourself.


Surprise: More Sugar, More Diabetes

Dr. Attia at TEDMED: What if We’re Wrong About Diabetes?

Failed Attempt to Cure Diabetes at Subway


  1. Ted Hutchinson
    While I'm certain the increase in fast food/colas availability and consumption is a major factor in Diabetes incidence in China, I suspect there will be other contributory factors.

    Air Pollution is linked to Diabetes incidence and
    Air Pollution in China is linked to other health problems

    Urban Air pollution reduces UVB penetration to ground level so reducing the potential to create vitamin D3.
    Low vitamin D levels are associated with higher uric acid.
    Serum uric acid levels linearly increase with increasing serum insulin levels and can be used to predict diabetes incidence.

    Magnesium Intake is related to Type 2 Diabetes incidence it is likely the changes to food production/processing that have reduced magnesium intakes in the West will also be impacting on the foods in China. Magnesium intake also directly impacts on Vitamin D status and your ability to use Vitamin d effectively. Low magnesium, like Low Vitamin D, levels also precede diabetes incidence.

    It is suggested here Chinese T2DM patients increase their long chain n-3 PUFA intake from fish or fish oil while decrease n-6 PUFA intake. Omega 3 also enhances the potential for Vitamin D3 to resolve inflammation.

    It's also probable that Shift work has increased in China and is also disrupting the production of the natural anti inflammatory agent melatonin and so affecting Diabetes incidence and progression.

    So in common with Western Society it's a combination of increased pro-inflammatory inputs (diet and environmental) in the context of reduced levels of natural anti-inflammatory reserves.

    Reply: #38
  2. Karen Davies
    Could it also be linked to Chinese people consuming more of an "American diet" ie high wheat consumption (see Wheat Belly by Dr W Davis) as well as other highly processed carbs, sugar, fructose etc ?
    Reply: #3
  3. Ted Hutchinson
    This is fairly up to date and shows wheat consumption has dropped between 2000~2010.
    Food Consumption Trends in China April 2012"The per capita consumption of staple foods, chiefly rice and wheat, has continued to decline"......"While per capita direct consumption of grains has declined, the indirect consumption of grains has increased, chiefly, maize".

    This study Survey of American food trends and the growing obesity epidemic also points the finger at CORN. That's not to say Dr Davis is wrong to point out the damaging consequences arising from changes in modern wheat production ~ processing.

    One of the trends that struck me from the China data is the recent increase in the amounts now spent by richer Chinese on meals eaten away from home.
    They also point to rapid urbanisation and changes in lifestyle which drive consumption higher, with the impact of urbanisation becoming even stronger.

    Reply: #4
  4. Ted Hutchinson
    China Is Using More Corn for Industrial Products
    "Production of all these corn products has grown rapidly.
    A 2008 conference presentation by an official from one of China’s largest agribusiness
    companies reported fourfold growth in industrial use of corn in China over
    1998-2007 The largest single categories of use were starch sugars (glucose, lactose, dextrin, maltose, HFCS, and oligosaccharides) and alcohol for beverage and industrial uses

    Looks like Lustig may well be on the right track.
  5. Tom Welsh
    Has anyone dared to tell T Colin Campbell?
  6. George Henderson
    And don't forget this sort of thing:

    traditional cooking fats, mainly lard being displaced by omega 6 oils, often of low quality.
    Also epidemic of hepatitis C which is diabetogenic.

    See http://hopefulgeranium.blogspot.co.nz/2013/09/the-elegant-solution.html

  7. FrankG
    Uh Oh... post about China and now someone mentions T. Colin Campbell... pound to a penny we are due for another visit from the vegan pharma-troll :-P
    Reply: #9
  8. Jeferson Ferreira
    you must take in account, that for chinese, to have a round belly to expose is a sign of fortune and helth. I've heard from womans that they even look for mens with a small belly to get married, because they tend to be richier.

    I'm a westerner and I'm in China now about 1,5 year and I became a low carber because I was gettting fat and sweet blooded not because western food, but because chinese food mainly, full of its rice, noodles, cakes, xiaolongbao - dumplings....and so on.

    I really think they are facing a disaster, and maybe even worse because the belly culture.

    Reply: #10
  9. Paul
    Vegan Pharma-Trolls are busy harvesting and gathering fruits and making hay for winter. One of my favorite vegan saying is: 'fruits are live energy food'. When asked to elaborate they say: " well, you are not a vegan so you won't understand it". The other one is that "raw fruits and vegetables are full of enzymes, which greatly help in digestion." - my question is, if you eat raw fruits and vegetables, what is there to digest?? - it is 95% water, 4% sugar and 1% some poorly absorbed proteins, minerals and vitamins. !
  10. Paul
    "...you must take in account, that for chinese, to have a round belly to expose is a sign of fortune and health....".

    I 100% agree and I say that it follows from Jeferson's observation that T. Colin Campbell studies showed only one thing, that all those skinny and healthy chinese were/are so skinny and healthy not because they eat "healthy" low animal, high plant based foods, but simply because they are half-starved all the time. We know that calories restriction presents number of health benefits. Personally I say that chinese cuisine is one of the most un-healthiest there is.

  11. Jeferson Ferreira
    Actually I believe that one good thing of the chinese cousine is the variety of food they are used to eat. For sure this is a good thing itself, they eat everything that moves or grows, that is of course more "paleo" than western diet, but lately this is changing, maybe this is the firt time in modern history that china have abundance of food, besides despite what the "researchers" may say, chinese food is full of sugar, starches, pasta, most of the vegetables are stir fried in canola oil, normally vegetables are not eaten in raw state.

    I don't understand much, but I can say about the effects this diet had on me, as a westerner living here and most of time in the countryside, which means I don't have access to western food most of time, even though i was getting fat with the so called healthy chinese food, despite all the control I tried to do regarding portion size.


  12. Fernán
    The same thing happens to me and I'm not Asian... normal weight but belly, even with a normal blood sugar.

    I hope these people will figure out soon the changes they need to make in their diet.

  13. Xum
    normal blood sugar doesn't mean you have normal blood insulin, which is what makes your body store fat.
  14. Ted Hutchinson
    The level of endocrine disruptor's detectable in the water supply could also be having an impact on obesity, metabolic syndrome and diabetes incidence.

    Detection and Occurrence of Chlorinated By-products of Bisphenol A, Nonylphenol and Estrogens in Drinking Water of China:

    Relationship between urinary bisphenol A levels and prediabetes among subjects free of diabetes.

    Bisphenol A Impairs Hepatic Glucose Sensing in C57BL/6 Male Mice

    The fact that BPA increases in amount related to glucose, NaCl and expiration date. and Chinese canned foods may well be prepared using ingredients washed in BPA containing water further increases the BPA load.
    Maybe worth checking if any of the canned foods in your supermarket are sourced from China.
    Foods preserved in glass jars should be better.

  15. Wade Henderson
    As we see, there are many potential causes for the rise in Chinese diabetes.

    Fast food, sugars, more food overall, perhaps more oils, weight gain, less exercise.

    However it is simply amazing that the growth in the consumption of meat is left out the discussion as possibly being part of the problem.

    "As China's economy has grown, the way of life for many Chinese has changed, especially diet. Per capita, consumption of meat has quadrupled in China over the last 30 years"


    According to a UN report, meat consumption in developed countries increased from 76.3 kg to 82.1 kg between 1980 and 2005.
    In China during that same 25 year period, meat consumption per capita went from 13.7 kg to 59.5 kg.
    Of course that only takes us up to 2005. As we all know, that dramatic rise has only increased in China over the past 8 years.

    To exclude this dramatic change and to focus only on the other parts is ....well, incredible.

    The amazing ability of people with one mindset, to only see what they choose to see.
    (of course we see the same narrow focus from the China Study groups opposite view)

    Reply: #16
  16. Ted Hutchinson
    The link Food Consumption Trends in China April 2012
    Provides detailed breakdown of the Chinese meat consumption.

    They say for Poultry Urban consumption did not show a consistent upward pattern, perhaps due to more consumption away from home (restaurants like Kentucky Fried Chicken are popular in urban China).
    I'm no expert on Kentucky Fried Chicken But Wiki has some information on Chinese Kentucky Fried chicken that may be relevant.

    Reply: #17
  17. Ted Hutchinson
    It's too late tonight to research it but it's possible the problems with Kentucky Fried chicken may also apply to intensive pork production.
    I think it's highly likely that intensively produced pork/chicken is a likely source of antibiotic resistant bugs, consumption of which is likely to be associated with chronic inflammation hence higher risk of diabetes.
    Reply: #18
  18. Wade Henderson
    I see Ted, so its the "antibiotic resistant bugs" that are the problem. But for the bugs, the 400% increase in meat consumption would not be a factor to even be considered as a factor in the rise of diabetes.
    Replies: #20, #22
  19. Sean
    Close to 15% of Australians have diabetes or pre-diabetes. 35% of the calories an average Australian consumes come from junk food and fizzy drinks. Aussies are among the highest consumers of red meat per capita, almost all red meat in Australia is grass fed. Australians are among the fattest people on the planet. In 1980, around 60% of Australian adults had a healthy weight, today this has almost halved to around 35%. These people are not binging on fruit and vegetables.
  20. Ted Hutchinson
    If you looked at the data provided earlier you will see that beef and mutton consumption are not a major part of the Chinese diet.

    However pork is.
    Superbug in Chinese pork raises questions on Smithfield deal—but not the ones US politicians are asking
    "China has a “huge burden of antimicrobial-resistant bacteria in livestoc"

    Human gut microbiota changes reveal the progression of glucose intolerance.

    It may be a different story all the increased meat consumed in China were being sourced from outdoor Pasture raised livestock.
    The Grass Diet Zoe Harcombe, author of The Obesity Epidemic, shows how pasture fed foods can keep you slim and how farmers can benefit.

    Reply: #21
  21. Ted Hutchinson
    Continuing the idea that altered gut microbiota may be involved in Diabetes incidence.
    Gut Bacteria Offers Clues About Risk of Developing T2DM

    It's interesting to note Chinese caesarean section rates are high
    The cautionary tale of how China came to have the world's highest C-section rate.

    and breast feeding rates are low
    How China Plans To Raise Breastfeeding Rate 50 Percent In 7 Years

    So it's likely the gut microbiome's of many Chinese people have low bacterial richness even before the impact of modern intensively produced meat.

  22. Paul
    As it has been said countless times on the pages of this blog: "with what do they consume this meat." I doubt that with the increase in meat consumption chinese decreased carbohydrate intake. Thus people who blame increase meat/fat consumption in such a setting for rise in diabetes (or obesity e.g. in Australia) simply do not understand basic principles of low carbohydrate high fat life-style.
    And I agree with Ted, microbiome plays pivotal role in our physiology.
    Reply: #23
  23. Wade Henderson
    The ability of the human mind to see only what it chooses to see never ceases to amaze.

    This incredible ability runs across the entire range of intellect and is often well supported by "facts".

    Right, when we consider the elements in the Chinese diet and lifestyle that have led to a surge in diabetes, the 400% increase in meat consumption should be #147 on the list of potential suspects. Clearly it had no role.

    Replies: #25, #30
  24. Ted Hutchinson
    In China In 1978, per capita consumption of beef was negligible, being a mere 0.32 kg. By 2007, however, it increased to over 4 kg .

    Australians ate around 31.4kg beef per person in 2011-12.

    If increasing beef consumption is the main cause of the rise in diabetes incidence in China wouldn't we expect to find a higher percentage of diabetics in Australia than China?

    4% of Australians have diabetes. This rate has risen from 1.5% in 1989. The rate of diabetes remained stable between 2007–08 (4.1%) and 2011–12 (4.2%).

    As 12 percent of Chinese adults (about 113.9 million people) are suffering from diabetes does anyone else apart from Wade think that main cause is likely to be the increase in beef consumption?,

    Reply: #26
  25. Pierson
    Wade, the starches being eaten with the CAFO-raised meat (which was fried in canola oil) probably has more to do with metabolic derangement than just the meat itself. Remember, confounds do exist
  26. Wade Henderson
    Gawd Ted, you can't be that distorted about "BEEF" "BEEF" and only "BEEF"

    Go back up and re-read my posts.

    Where do I say anything about "that main cause is likely to be the increase in beef consumption"

    I never mention beef, either in China or Australia or else where.
    That you grab that and run with it is just more proof of the human mind seeing only what it chooses to see.

    I said there are many causes of diabetes. More calories in general. More sugar. More fast food. More oils. and yes, more meat. But I never singled out "BEEF".

    Up to 2005 the amount of "meat" consumed rose 400% to 59.5 KG per capita.

    You, in your myopic world, choose to say that such a huge increase has absolutely no possibility of being a portion of the causation of the large increase in diabetes.

    You are the classic example of a person so wed to one perspective that you can see nothing else. You are the flipside of the coin wherein the other surface is the China Study.
    Equally fixated on their own particular vision. Allowing that fixed view to remove from consideration all other facts or possibilities.

    That you probably can't even see this is just more proof of its powers over the mind.

  27. Ted Hutchinson
    I thought maybe we could start with beef and work through the list to work out which meat you think the increased consumption of is most likely to be producing the increased diabetes incidence.

    It's unlikely to be mutton as that constituted only 1.35 kg per capita in 2000 and has dropped to 0.80 kg in 2010

    That leaves pork and chicken both of which are mainly raised indoors and with the use of huge amounts of antibiotics.

    If we compare US to China per capita meat consumption China’s Growing Hunger for Meat Shown by Move to Buy Smithfield, World’s Leading Pork Producer it still doesn't support the idea that it's the increase in meat consumption alone that is the main driver of diabetes incidence or countries where total meat consumption is higher than China would have higher diabetes incidence rates.

    There has to be something else about Chinese intensively produced meat or about the Chinese population that makes them particularly vulnerable to whatever it is about their intensively raised meat that is producing the exceptionally high level of diabetes.

    I've already stated the some of the reasons why the Chinese population have poor gut flora.

    There is a lot more to say
    on average each Chinese person consumes 138 g of antibiotics per year — 10 times the amount consumed per capita in the U.S.
    and that's only a drop in the ocean compared to the antibiotic use on Chinese farms.
    Half of China's Antibiotics Now Go to Livestock

    When you have this amount of antibiotic usage, on farms and in humans the effluent that enters the water supply that is used to grow vegetables will also be contaminated with antibiotic resistant bacteria..
    Antibiotic-resistant endophytic bacteria were widely detected in celery, pakchoi, and cucumber with the highest rate of resistance to cephalexin.

    I'm happy to agree with you that there is something suspect about Chinese intensively produced chicken and pork that could be implicated in the increase in diabetes incidence but I disagree with your idea that it's the increase in total meat consumption alone that is the driver.


  28. Wade Henderson
    Ted, your reading skills leave something to be desired.

    "it still doesn't support the idea that it's the increase in meat consumption ALONE that is the main driver of diabetes"

    "but I disagree with YOUR IDEA that it's the increase in total meat consumption ALONE that is the driver"

    You seem to have a one track mind. You have a idea of what you want the answer to the question to be and you corral all the things that fit that theme. Exclude those that don't.

    Sounding more and more like T. Colin Campbell patterns of thought every day.

    I wonder, have you traveled the world at all. China, Japan, Indonesia, Tonga?
    Have you spent a few months in any of these or other nations?
    There is some value in that.

    Perhaps your antibiotic theory has some merit, but you really need to keep your mind open to other possible causes. Including the possibility that 4x meat consumption,, with or without excess antibiotics" may play some role.
    Along with several other causes.

  29. Ted Hutchinson
    4x meat consumption, may play some role.
    then surely countries with higher total meat consumption would have higher diabetes?

    I have already set out far more possible factors contributing to Chinese Diabetes incidence than anyone else in this thread.

    The only person with a closed mind here is you as you seem to be obsessed with the idea that it's the increase in Chinese meat consumption that is the determining factor despite the fact that other countries, with higher total meat intakes, have lower diabetes rates.

    Reply: #34
  30. Paul
    instead of being so aggressive for no reason (unless you are vegan) why don't you take a piece of paper, a pen, sit down and work out, say five scenarios of an individual consuming: a) 20% animal protein, 75% fat, 5% carbs; b) 35% protein, 60% fat, 5% carbs; c) 20% protein, 5% fat, 75% carbs; d) 20% protein, 40% fat, 40% carbs; e) 35% protein, 15% fat, 50% carbs. Start with each macronutrient entering individual's mouth all the way through digestion/energy/mass conversion (enzymes, hormones all the works) and excretion. After that tell me at which point, in your understanding, increase in meat consumption may cause insulin resistance/diabetes. I am open to the new insights all the time. If you find something, which I will find new and interesting I will take my hat to you and than you can say:

    "..."The ability of the human mind to see only what it chooses to see never ceases to amaze....".

    BUT until such time you have no reason to call me close minded, because you simply 1) do not know me, 2) well, let's stop at that.

  31. Jeferson Ferreira
    I think in the last 30 years chinese didn't increased only the meat consumption, they increased the food consumption itself.

    if you think the americans, australians, portuguese or russians eat too much you should really visit china for some months. People here is addicted to food, and not only by meat. Of course something has changed in the lest decades besides the amount of meat and the amount of food itself. I believe it is the availability of more processed food, including the fast food.

    one way to remove the doubts is to compare the diabetes rates in cities like Shanghai and Beijing with some rural areas, where the food is less processed. But don't be naive, in rural areas they eat a lot of meat too. I travel a lot in countryside here, they have pork every day, is common to eat pork meat with 2 fingers height of fat on it, when there is no pork, there is chicken, if there is no chicken there will be fish, or frog, or dog, or any see food. The only meat I think is not fried in canola oil is the pork, because its own fat.

    Another point, I really don't think we can rely on data about meat production, you must have in mind that 500 million people live in rural area and it is common to raise your own animals for consumption, and it has been like that much before the statistics. I truly believe that the amount is higher and is not recent. In small cities is common to see street butchers selling what they have in excess (you cannot imagine the hygiene), do you really this this is in the statistics?

    I repeat, besides the meat, you must consider that here people eat a lot of bread, noodles, rice, cakes, flour, sugar (many of meats are fried with sugary or caramel dressing, the only pork meat not sweet is bacon), fried noodles, fried rice, dumplings, too many different kinds of pasta / pancakes normally fried.

    the problem in china is more complex then the statistics could predict

    Reply: #33
  32. Paul
  33. Ted Hutchinson
    Rivers of blood: the dead pigs rotting in China's water supply

    Shanghai's drinking water is under threat after 16,000 diseased pig carcasses are found in tributaries of the Huangpu river

    There does seems to be a discrepancy between the official pork sales statistics and what actually has been happening in practice.

    China's Hunger For Pork Will Impact The U.S. Meat Industry

    Given the state of hygiene, quality control and the influence of the black market. we really should pay more attention to Also epidemic of hepatitis C which is diabetogenic.

    See http://hopefulgeranium.blogspot.co.nz/2013/09/the-elegant-solution.html

    We shouldn't give readers the impression that such things don't happen in the UK/EU.

    Hepatitis E increase points to foodborne source - Food ality News

    Hep E also can have a nasty impact on pancreatic function.

    The problem isn't confined to intensively raised pork meat.
    Antibiotic Use in Chickens: Responsible for Hundreds of Human Deaths?
    BY MARYN MCKENNA 08.09.13

    Each exposure to antibiotics reduces the variety of gut flora and provides opportunity for more antibiotic resistant pathogenic gut flora to take advantage or the situation and gain territory in the gut.
    More detail here
    Diabetes & Gut Microbiota"

  34. Wade Henderson
    Ted, there you go again---

    "The only person with a closed mind here is you as you seem to be obsessed with the idea that it's the increase in Chinese meat consumption that is the determining factor"

    Ted, please read my original post as follows--

    "As we see, there are many potential causes for the rise in Chinese diabetes.

    Fast food, sugars, more food overall, perhaps more oils, weight gain, less exercise.

    However it is simply amazing that the growth in the consumption of meat is left out of the discussion as possibly being part of the problem."

    Ted how is it that you continue to suggest that I blame the increases meat consumption as the only, or primary causation?
    You on the other hand, seem duty bound to prove that meat consumption plays no role in the increase of diabetes.

    I'm not a vegan nor a vegetarian. I traveled many months in China back in 1984 and 1985 and have made subsequent trips. I have seen the changes first hand.
    I have seen the changes in meat consumption and overall food consumption from all categories.
    I have seen the drastic change in body shapes among the average population.

    Many factors go into the changes. To exclude increased meat consumption as one of those factors is to blind one's mind from all the facts.
    The Chinese are not identical to every other population. Smaller increases in BMI seem to affect their conversion to Type 2 diabetes.
    One of the most pronounced changes in their diet since 1980 is a large increase in meat consumption. One of many factors that cannot and should not be ignored.

    To totally exclude it or to totally blame it seems to be the business of those who are wed to their own religion. T Colin Campbell included.

    BTW, my close friend married a Chinese woman and they run a cheese, sour cream, yogurt plant in China. So I do follow that small but growing trend as well.

  35. Ted Hutchinson
    Community-spread MRSA infections related to pig manure Liz Szabo, USA TODAY 4:07 p.m. EDT September 16, 2013
    Living near pig farms or where pig manure is used increases the risk of superbug infections, a new study says.

    Just living near any farm field fertilized with hog manure increased the risk of a MRSA infection.

    Antibiotics make animals fat by killing off natural bacteria in the animals' guts that would otherwise help prevent weight gain.

    Same thing happens in humans.
    Infant antibiotic exposures and early-life body mass.

    Remember Chinese humans consume 10X the amount of antibiotics compared to USA and their meat producers use even more.

    Application of Antibiotics in China Animal Husbandry Industry

    As the water supply is contaminated with antibiotic resistant bacteria then so will all crops produced/processed using that water.

    Occurrence and sources of antibiotics and their metabolites in river water, WWTPs, and swine wastewater in Jiulongjiang River basin, south China.

    Individuals will not avoid the problem by refraining from consuming intensively produced pork/chicken.
    We need to reduce both human and animal antibiotic consumption.

  36. Ted Hutchinson
  37. Dariusz
    Air Pollution is linked to Diabetes incidence this study look at mortality not diabetes develop factors Here. http://www.ncbi.nlm.nih.gov/pubmed/23632126 from Ontario where there is highest PM2.5 pollution in Canada odds ratio 1.11 other research from http://ehp.niehs.nih.gov/ehbasel13/p-1-25-01/ find assocation only to PM10 and NO2 "Among CHIS 2005 respondents, increases in PM10 and NO2 were associated with 3% and 8% respective increases in odds of receiving a type-2 diabetes diagnosis.". "It's also probable that Shift work has increased in China and is also disrupting the production of the natural anti inflammatory agent melatonin and so affecting Diabetes incidence and progression." and here you are wrong according of your study Odds Ratio for Diabetes is 1,07 you think this results give us strong proof? i dont think so. One research look assocation in diabetes and melatonin in nurse who work in night shifts and they concluded that is likely that diabetes cause low lvl metalotin (diabetic have offen trouble in sleep) not the opposite and one study found that people who take melatonin suplements have highest ratio of diabetes.
  38. Ted Hutchinson
    Obesity in the United States – dysbiosis from exposure to low-dose antibiotics?
    The rapid increase in obesity prevalence in the United States in the last 20 years is unprecedented and not well explained.
    Here, we explore a hypothesis that the obesity epidemic may be driven by population-wide chronic exposures to low-residue antibiotics that have increasingly entered the American food chain over the same time period. We propose this hypothesis based on two recent bodies of published reports – (1) those that provide evidence for the spread of antibiotics into the American food chain, and (2) those that examine the relationship between the gut microbiota and body physiology.
    The livestock use of antimicrobial agents has sharply increased in the US over the same 20-year period of the obesity epidemic, especially with the expansion of intensified livestock production, such as the concentrated animal feeding operations.
    Observational and experimental studies support the idea that changes in the intestinal microbiota exert a profound effect on body physiology.
    We propose that chronic exposures to low-residue antimicrobial drugs in food could disrupt the equilibrium state of intestinal microbiota and cause dysbiosis that can contribute to changes in body physiology.
    The obesity epidemic in the United States may be partly driven by the mass exposure of Americans to food containing low-residue antimicrobial agents.
    While this hypothesis cannot discount the impact of diet and other factors associated with obesity, we believe studies are warranted to consider this possible driver of the epidemic.

    It it is reasonable to hypothesise that gut bacterial dysbiosis is implicated in obesity, it's also reasonable to also link it to increases in diabetes Type 2 rates..

    Effects of short chain fatty acid producing bacteria on epigenetic regulation of FFAR3 in type 2 diabetes and obesity.

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