A Growing Problem
Jan. 25, 2016
As Vietnam’s economy takes a leap forward, people’s lifestyles are changing...not always for the better. Obesity is a growing problem in the Southeast Asian nation, and those most affected are the young.
In Ho Chi Minh City, one in every three young people is said to be overweight. Diabetes was once a rare condition, but now it is fast becoming an epidemic.
Diabetes can be genetic, but the biggest concern for Vietnam's health officials is the form associated with the modern lifestyle. One Hanoi hospital that used to treat about 100 diabetes patients a day now has more than 1000 diabetics pass through its doors every 24 hours.
Diabetes is known as a silent killer, and in its early stages, many people do not recognize the symptoms. By the time they visit a doctor, the disease has already begun to destroy organs and limbs.
“We're overwhelmed. 64 percent of diabetic patients don't know that they have the illness because they never get tested. So we have a lot more patients to come in the future,” says Dr Phan Huong Duong, Vice Director of Vietnam’s National Hospital of Endocrinology.
One reason for the health crisis is what is being served at the dinner table. Traditional Vietnamese cuisine consists of tofu, vegetables, and fish. But everywhere you look in Vietnam there is fast food from the developed world, like pizzas and hamburgers.
Diets are changing, and young people especially have developed a taste for fast food.
“I like spaghetti and pizza,” says a young child. "I don’t like this kind of food, but I came here because my grandchild likes it,” says a grandfather. People do not have to go far to satisfy their cravings, with a relentless march of outlets selling hamburgers and fried chicken.
One main challenge is the shortage of doctors. Specialist Dr Nguyen Huy Cuong has been treating patients for more than 20 years, but he is one of only a few hundred doctors capable of treating diabetes. There are 5 million patients nationwide.
“There are more patients but not enough doctors and hospitals. We can’t spend as much time as we'd like to on each patient,” says Dr Cuong. He explains that the shortage of experts makes it even more critical to educate the public.
He makes television appearances and writes books about healthy diets and lifestyle, and there is even a smartphone app that has caught Dr Cuong’s attention. App users can search for the closest diabetes specialists and locate hospitals.
The app also keeps track of blood sugar levels and exercise, and eventually, it will allow patients to send the data to their doctors, so they can be treated without visiting a hospital. The project is still in the early stages, and Dr Cuong meets often with the app developer to give advice. For the project to succeed, it needs to be easy to use for both doctors and patients.
“We have been working together to improve the app,” says ZinMed founder and CEO Hoang Chu Duc. “I hope we’ll be able to provide easy-to-understand and accurate information to doctors and patients."
"ZinMed built a technical platform to allow patients to contact a doctor anytime, anywhere. It will be an effective app, because patients will be able to manage diabetes on their own,” says Dr Cuong.
In the meantime, health officials are working to train more experts. The government set up Vietnam’s first nutrition course in 2013 at the prestigious Hanoi Medical University. Graduate nutritionists will be sent to medical institutions and schools to spread the word about the importance of a nutritious diet.
“Doctors are busy treating patients. Nurses takes care of the patients, but not diet. So we need someone who takes care of the diet of patient. We need people to take care of the community as well,” says Dr Le Thi Huong, a professor in nutrition at Hanoi Medical University.
Awareness is growing, and some people are becoming more proactive about healthier lifestyles. At a weight loss program for children, 50 participants exercise four times a week. "I want to lose weight to get healthy and be more attractive,” says one girl. Instructors also offer tips on eating better.
The course operator says enrollment has doubled over the last few years. "We used to send trainers to homes, but with all the clients we're getting lately, we decided to set up gyms like this one,” says gym owner Pham Oanh.
While some youngsters have a chance to make a fresh start, there are no quick cures for the diabetes epidemic facing their country. For Vietnam's health authorities, the hard work is just beginning.
Nutrition expert Professor Shigeru Yamamoto of Jumonji University joined Newsroom Tokyo presenters Sho Beppu and Aki Shibuya in the studio to discuss the problem. Dr Yamamoto is a specialist in worldwide eating patterns who played a key role is setting up the nutrition course at Hanoi Medical University.
Shibuya: We've been seeing an increase in the number of people diagnosed with diabetes in Southeast Asian countries like Thailand and Malaysia. That pattern's reached Vietnam now. Why has this situation come about?
Yamamoto: The economic situation has been improving in these countries and the working style has been changing from physical work to sedentary work. With such a background, diabetes has been increasing. Vietnam is no exception to this development. The difference in diabetic patients in Vietnam and those in the USA and many other countries is that Vietnamese can develop this disease even with low BMI. BMI stands for Body Mass index and is used for to determine obesity. Vietnamese had a hard life before the end of the Vietnam War in 1975. However, their economic situation has improved dramatically. Because of that, their life-style has also been changing rapidly. That drastic change may be causing many diabetics to appear even when they have a low BMI, so they really need to watch their lifestyle and what they eat.
Beppu: We see the problem is not limited to adults, and we're seeing more children becoming overweight. That must be a big concern.
Yamamoto: There are some unique reasons behind the increasing number of obesity among children. The major reason for child obesity is the perception of parents and guardians. They think fat children are beautiful and healthy. Children, of course, like sweet snacks, fast foods and sweet beverages, however, most of the people around them do not think this is a problem. Also, poor school meal programs accelerate the problem. In Japanese schools, there are school nutrition professionals, who are licensed dietitians, and they make tasty, nutritious, sanitary meals that are different every day. But in Vietnam, school meals are monotonous and not delicious, and children do not eat everything. When school ends for the day, many vendors are waiting for the children with sweet foods and children do not hesitate to buy such foods and beverages. These are common problems in most of the South East Asian Countries.
Beppu: So what are the keys to solving these problems?
Yamamoto: I think that the perception of parents and others has to be changed. To establish good dietary habits is also important. For this to happen, school lunches are one of the keys. Regardless of the differences at home, school can help to establish good dietary habits and a knowledge of nutrition. I am sure that the nutrition education program started at Hanoi Medical University can play an important role in this.