That was the view expressed by Dr Sumanto Haldar, senior research fellow at the Clinical Nutrition Research Centre (part of A*STAR's Singapore Institute for Clinical Sciences).
He was speaking at the first Healthy Ageing APAC Summit, organised by NutraIngredients-Asia and FoodNavigator-Asia in Singapore.
He said, "We all know that when it comes to increased adiposity, age is one of the biggest risk factors. Our energy intake as well as appetite decreases, but with increasing age, we actually tend to put on more weight.
"From our 30s onwards, we tend to put on more weight. Lower total energy expenditure explains part of this observation, but it doesn't actually explain everything. What's more important is how our body fat — the excess adiposity — is distributed."
Asian adiposity a pressing issue
Chronic age-related illnesses include obesity, diabetes, heart disease and cancer, and in Singapore alone, the BMI of over 50% of the population poses a moderate to high risk of such conditions.
Haldar said that even in the same BMI bracket, Asians tend to have a much higher percentage of body fat than Europeans, a prominent factor in understanding the Asian phenotype that warranted more extensive scientific research.
"The consequences of increased adiposity in Asians is much greater. Taking a BMI of 23, for example, Asian Indians tend to have three times as much risk of developing diabetes at that BMI as compared to a European Caucasian. This is quite alarming and shows why Asia-specific research is needed."
Even in a study on Asian adolescents aged 14 to 19 — who tended to have smaller waist circumferences and lower BMI than their non-Asian peers — their triglyceride levels and likelihood of insulin resistance were higher.
Haldar said: "This demonstrates that the association between increased risk and increased adiposity actually starts quite early on in our lifespan.
"For a higher waist-to-height ratio, the curve is actually steeper for Asians than it is for non-Asians. That applies to triglycerides and other factors, like insulin resistance."
Better function, better form
One of the main dietary factors contributing to obesity and its related issues in Asia is the high consumption of refined grains and high-GI (glycaemic index) foods, such as white rice.
Haldar said a study of over 2,000 Individuals in the region found refined grain intake to be directly proportional to waist circumference, blood pressure and fasting blood glucose, as well as triglyceride and LDL cholesterol levels.
An effective solution, he added, would be to increase the production of functional foods and encourage people to replace their regular staples with these more nutritious alternatives.
A crossover RCT involving type 2 diabetes patients aged 35 to 70 showed that mixing legumes such as kidney beans, pinto beans and black beans with white rice, as opposed to just eating white rice, led to a reduction in postprandial glucose.
Additionally, noodles fortified with beta-glucan, a soluble fibre derived from oats and barley, also have a lower GI than refined grains, resulting in minimal increases in blood glucose when consumed.
Haldar also highlighted an alternative to sucrose, which comes from sugarcane and has a GI of 65 — isomaltulose, which comes from honey and has a GI of 32.
He said he was "particularly interested in plant-based bio-actives", referring to a study on the effect of plant protein isolates on glucose homeostasis, which found pea protein to have a more beneficial effect on insulin and glucose, in comparison to oats and rice.
Another promising factor that warranted more research, he said, was polyphenol intake: "Cocoa flavonols, for instance, are well known to be beneficial to vascular blood flow, as well as for those who are insulin-resistant."
Furthermore, polyphenol-rich spices and base vegetables used as curry ingredients had been shown in a study to improve postprandial glucose control in a dose-dependent manner.
Not just about calories
Haldar said that although calorie restriction could lead to short-term weight loss, "the biological relevance may be limited".
Since obesity and associated cardiometabolic diseases have a multifactorial and multicomponent aetiology, simply fixing energy imbalances would not solve the problem in the long term.
"We need to explore beyond the staple crops and look at other foods that are widely available in Asia, in order to find new ways to decrease disease risk," said Haldar, who pointed out that of the 300,000 known plant species in the region, only a third were being used in food.
But beyond the importance of functional ingredients, Haldar said: "Adherence to dietary choices that are more nutrient-dense rather than energy-dense should be encouraged. My overall recommendation is to focus on beneficial dietary patterns as opposed to specific nutrients."