Health issues are on the rise among Asian youth with many starting to develop non-communicable diseases at a younger age. In this article, Simon Sum shares insights and recommendations on how HCPs can engage with and promote health among this age group
Asian countries are struggling to battle health issues affecting their youth population, with non-communicable diseases (NCDs) on the rise in recent years. Based on United Nation statistics in 2019, Asia contains most of the world’s youth population (15-24 years). A report from the Population Reference Bureau has also shown that people are starting to develop NCDs at a younger age. The four main NCDs defined by the World Health Organisation (WHO) are cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases. The main risk factors – unhealthy diet, physical inactivity, tobacco and harmful alcohol use – are typically established during adolescence and young adulthood. The recent rise in these risk factors among youths in Asia indicate the region’s uphill battle to improve health outcomes for this group.
Diet shifts and sedentary lifestyles have contributed to the rapid increase in obesity rates. Economic growth in Asian countries over the years has led to diet changes from healthier traditional diets to an over-dependence on convenient diets high in calories, sodium, added sugar and fats. Such diets increase the risk of obesity for Asians, including the youth. Moreover, studies have also highlighted that youths prefer junk food that is nutrient deficient. As such, malnourishment from insufficient vitamin and mineral intakes have also become an issue along with overweight and obesity – the double burden of malnutrition.
In addition, there is some evidence suggesting that the lack of physical activity, other than the consumption of high-fat foods, is also a significant cause of obesity. Decreased physical activity due to occupational and recreational changes is hence viewed as a major contributor to the growing health crisis. A study discovered high prevalence of physical inactivity (80.4 per cent) and sedentary behaviour (33.0 per cent) among school going youths (13-15 years) in the Association of Southeast Asian Nations (ASEAN) countries.
Unfortunately, this trend has been aggravated in the past year, as countrywide measures like lockdowns and school closures have been implemented in response to the ongoing COVID-19 pandemic. A report has shown that these circumstances resulted in decreased physical activity, increase in sedentary lifestyle and screen time for youths. During this period of uncertainty, youths may also engage in stress-induced indulgence such as high-calorie foods containing fats and added sugars.
As a result, Asia is currently facing increased challenges in controlling youth obesity. Statistics showed that among 13-to-15-year-old boys in secondary schools, 32 per cent in Taiwan, 25 per cent in Malaysia, and 24 per cent in Thailand are either overweight or obese. The rates are lower for girls in most Asian countries, though they are also increasing. Many low- and middleincome Asian countries are also facing the double burden of an emerging epidemic of overweight and obesity added to persistent undernutrition.
Obesity is strongly linked to diabetes, as reports suggest that obesity is believed to account for 80-85 per cent of the risk in developing type 2 diabetes. In the last three decades, we have seen an epidemic level rise in the number of people diagnosed with the disease. In South Asia, the rise of type 2 diabetes is estimated to be more than 150 per cent between 2000 and 2035. Statistics also show that over 60 per cent of the people with diabetes live in Asia, with almost one-half in China and India combined.
Furthermore, Asian people tend to develop diabetes at a younger age. A review study showed that Asians have a strong ethnic and genetic predisposition for diabetes and have lower thresholds for the environmental risk factors. The reasons are likewise linked to socioeconomic changes, urbanisation and lifestyle changes as the major factors.
Many of the health challenges faced by youths today can be mitigated with the right diet consisting of the necessary nutrients. Eating habits and preferences developed during adolescence and young adulthood can have a big and long-term impact on the health and fitness for individuals. Therefore, it is essential for youths to improve their nutrition intake to help them prevent the onset of any NCDs and achieve better overall health outcomes. Some of the key nutrients required by youths include complex carbohydrates, protein and micronutrients.
Complex carbohydrates are generally higher in fibre, vitamins, minerals, and lower in glycemic index when compared to simple carbohydrates. Carbohydrates are an essential source of energy for the body and the fibres in complex carbohydrates can help maintain digestive health and keep healthy blood cholesterol levels. Youths can opt for more complex carbohydrates by switching from refined grains to wholegrains and consume fibre-rich starches like peas, beans, and vegetables.
Protein is essential for important bodily functions including muscle maintenance, cell renewal, wound healing and immunity. While the amount of protein needs depends on different factors like gender, age, height and weight, the general recommendation is about 52 grams for teenage boys and 46 grams for teenage girls. To add more proteins into their diets, youths can easily switch certain foods in each meal for more low-fat milk, eggs, lean meat, poultry and fish.
Finally, micronutrients that include vitamins and minerals are necessary for optimal health. Micronutrient needs differ slightly according to gender and lifestyle. Young men and women who are more active may require extra electrolytes like sodium, potassium, and magnesium. Males require a little more of vitamins C and K, along with thiamine, riboflavin, and niacin, while females require extra iron due to menstruation. The best source of micronutrients are whole grains, fruits and vegetables such as pomelos and dragon fruit, which are vitamin-rich and spinach, long beans and broccoli which are iron-rich.
NCD risk factors such as unhealthy diet and physical inactivity continue to be a growing health concern for the youths in Asia. To battle these health challenges, it is imperative for healthcare groups, associations and healthcare practitioners (HCPs), especially dieticians, to play a part by working together, as key stakeholders of youth health.
We know that the young generation wants healthcare to be as convenient as the technology that they grow up with, and that they prefer receiving updated or even real-time health information. With patients becoming more proactive in seeking health information online, digital healthcare in Asia-Pacific is predicted to be one of the fastest-growing industries in the world and many will benefit significantly from this advancement.
There are several ways that healthcare associations and HCPs can leverage technology to effectively reach out to this younger group:
Connecting through social media platforms
As youths are highly active on social media platforms, these platforms have become their main source for news and information. Social media is the best avenue to share nutrition related tips and facts, and HCPs can consider posting more educational and engaging content on their social media pages.
Building an online community
Aside from social media platforms, microsites such as Twitter, blogs, and health forums have gained in popularity as a source for health and nutrition related content. HCPs can consider building online communities and share health and nutrition materials with their followers.
Utilising technology through apps
More people will turn to advanced technology to assist their weight management progress and calorie intake counting. HCPs can encourage patients to download appropriate interactive apps that can aid their weight loss programmes while also provide beneficial health contents.
Installation of youth fitness and consultation booths
Hospitals can make medical services more accessible by installing Youth Fitness and Consultation booths in areas frequently visited by youths, such as Universities and shopping malls. The booths can have trendy decorations and include virtual kiosks where youth can spend time to find out more health information about their age group and get practical diet and nutrition tips.
Taking consultations online
The pandemic has led to patients turning to telehealth platforms and applications more in the Asia Pacific region with the increased adoption of digital health tools. Asia Pacific consumers are also increasingly interested in preventive health, convenience and ownership of their healthcare with digital health platforms in countries like Singapore, Indonesia and Australia.
As millennials and Gen Z like to have choices and prefer convenience, telehealth continues to be an increasing alternative method for HCPs to provide consultations. HCPs can consider setting up telehealth consulting services for ongoing nutrition, diet and weight management recommendations. These can also involve assessment of nutritional intake, monitoring changes in lifestyles and providing personalised dietary counselling.
To conclude, youths in Asia are facing various health issues, which pose severe challenges to countries in the region. To prevent the detrimental impacts of poor health among youths, healthcare groups and HCPs will have to rethink how information can reach and be received by the younger generation. This will be a first step towards combating an impending health crisis affecting this age group.