Diabetes in tribes of India

Dr Jency Thomas has been researching the prevalence of diabetes in remote Indian tribes.

The spread of a western lifestyle of highly processed, sugary foods and a decrease in exercise carries a great risk for developing disease, particularly heart disease, hypertension, obesity and type-2 diabetes. India is home to more than 62 million diabetics, second to only China, and like many  countries that number is growing.

“Indians are particularly susceptible to diabetes,” says Dr Jency Thomas. “Diabetes has strong family related risk factors, and genetic disposition to it can be found throughout the Indian subcontinent.”

Dr Thomas is a lecturer in La Trobe University’s Department of Physiology, Anatomy and Microbiology, and a fellow at the Australian India Institute. Her PhD focused on the link between diabetes and memory loss.

“The effects of diabetes on the kidneys, heart, and obesity are well established, but the impact on mental health and memory is less well established, she says. “It is a critical emerging area.”

Dr Thomas’ research took her to the Nilgiris hills, a mountain range in the western-most part of  the state of Tamil Nadu in India. Working with her colleagues Dr Colleen Thomas and Dr Markandyea Jois, she undertook a qualitative study amongst six local tribal populations, looking at diet, lifestyle and general health.

“Most of the tribes we surveyed have lived in isolation with little contact with urban populations until the last decade,” says Dr Thomas. “They have simple lifestyles with very low rates of diabetes and other illnesses.”

“In urban populations the prevalence of diabetes is 4.7%, whereas in tribal populations it is less than half of this. We wanted to examine why there was this difference.”

For the most part the tribes lived simple lives and largely maintained an independent lifestyle with their own languages, culture and food. Food was organically farmed, consisting of rice, millet, fruit and vegetables, and buffalo milk. There was plenty of physical activity, with up to 20km of walking a day.

“The increased contact with urban populations have led to food and lifestyle changes for these tribes, and that has had a big impact on their health,” says Dr Thomas. “Many of them have changed their diet to white rice provided by the Indian government, and processed supplies from the local shop. Public transport is also more accessible, which leads to decrease in walking and exercise activity.”

Another problem tribes are facing is the number of youth moving to urban areas. Their diets change as they eat hamburgers, pizzas, and other processed foods, and they exercise less.

“If they return to their tribes they find their health has changed dramatically,” says Dr Thomas. “At one time the biggest health complaints were infectious diseases, fevers, and headaches. With a changing diet the tribes are now seeing instances of malnutrition, hypertension, diabetes and heart attack. It’s still well below the national average, but rising.”

In addition to interviewing tribal elders and observing village practices, Dr Thomas will work with PhD student Narayanankutty Nair to fit physical activity monitors to tribal members living in both rural and urban areas. This will allow direct comparisons within a tribe as to the extent of the difference between the two lifestyles.

Dr Thomas’ study has been presented at medical schools in India, and she has made recommendations which could improve the situation for tribal members. Increased education regarding the health benefits of good nutrition, government initiatives like free school meals, and even changes to the administration of the public grocery distribution system could all make a difference in health.

“There’s a lot of good intentions in the work the government has done to provide assistance to tribes in India, but I believe the methodology needs to be reevaluated,” says. Dr Thomas. “Initiatives such as providing medical support or implementing a weekly local market will not only encourage the economy of the tribes, but help with their diet as well.”

She also encourages the local tribes to retain their traditional culture and food habits as much as possible, and increase efforts to pass on traditional wisdom to the next generation.

“Traditional knowledge is the greatest weapon these tribes have in fighting the rise of lifestyle diseases like diabetes,” says Dr Thomas. “The western world could learn and benefit a lot from their simple diet habits and the way they live.”