Are there "north-south differences" in the occurrence of chronic diseases? Why are people in the north more likely to suffer from hypertension and diabetes?

Are there "north-south differences" in the occurrence of chronic diseases? Many studies have found that diseases such as diabetes, hypertension, stroke, and obesity are more likely to affect northerners.

Are hypertension and diabetes more likely to occur in northerners?

Northerners are more likely to suffer from diabetes

A large-scale "Epidemiological Survey on Diabetes Prevalence in the Chinese Population" published in the British Medical Journal in 2020 showed that the overall prevalence of diabetes in the north of my country is significantly higher than that in the south. Among them, the region with the highest prevalence of diabetes in my country is Inner Mongolia (19.9%), and the region with the lowest prevalence of diabetes is Guizhou (6.2%), the former is three times the latter. ①

Northerners are more likely to suffer from high blood pressure

According to the "Guidelines for the Prevention and Treatment of Hypertension in China (2023 Edition)", northerners are more likely to have high blood pressure than southerners, and the prevalence of hypertension increases from south to north. A high-sodium, low-potassium diet, smoking, social and psychological factors, overweight and obesity, excessive drinking, and advanced age are important risk factors for the onset of hypertension in the Chinese population.

Northerners are more likely to suffer from stroke

A study published in a journal under The Lancet in 2023 found that northerners are more susceptible to stroke than southerners, and the Huaihe-Qinling Mountains are a clear dividing line. The high risk of stroke in northerners may be related to body mass index (BMI), blood pressure, and drinking.

Northerners are more likely to be obese

According to the "Chronic Disease and Risk Factor Monitoring Data" report released by the Chinese Center for Disease Control in 2017, compared with the south, there are more obese people in the north, and 9 of the top 10 provinces with the highest overweight rates are in the north.

A study published in Diabetes, Obesity and Metabolism in 2023 showed that 34.8% of the population in my country is overweight, and 14.1% is obese. The proportion of overweight/obesity in the north is generally higher than that in the south. The top three provinces with the highest overweight proportion are Inner Mongolia (37.1%), Shandong (37.1%) and Hebei (36.6%). In addition, the prevalence of fatty liver, prediabetes, dyslipidemia, hypertension, etc. is higher among overweight/obese people. ⑤

Health Times

Why do northerners have a high prevalence of chronic diseases?

Kang Zhiqiang, chief physician of the Department of Endocrinology at Zhengzhou Central Hospital affiliated to Zhengzhou University, said in an article published on his hospital's official account in 2023 that northerners are more susceptible to chronic diseases such as diabetes. In summary, there are three main reasons:

1. The taste is a bit strong

Many northerners eat unhealthily. First of all, northerners eat larger bowls and larger portions of food. Not only that, northerners’ diets contain a higher proportion of carbohydrates, and their dishes are heavier, high in salt and oil, and often require thickening.

2. Drinking too much

If you ask where people drink the most, the answer is always in the northern regions such as Inner Mongolia, Shandong, and Northeast China. However, excessive drinking (more than 60 grams of alcohol per day for men and more than 50 grams for women) increases the risk of chronic diseases such as diabetes and hypertension.

3. Less exercise

Insufficient physical activity is also an important risk factor for chronic diseases such as diabetes. Many southern regions are mountainous, and more people like to walk than in the north. This also reflects from the side that southerners generally exercise more than northerners. In addition, the cold season in the north is long, and people have less outdoor activities than in the south. ⑥

Northerners, do these things well in your life!

1. Eat lighter

Change your heavy taste and learn to eat lighter like southerners. Liang Qianfang, a nutritionist at the First People's Hospital of Guangzhou, Guangdong Province, said in an article published in Health Times in 2017 that compared with northerners, southerners have lighter eating habits and tend to cook by blanching or steaming. Once the greens are cooked in a hot pot, they can be fished out and served with a little sesame oil and salt.

Less oil is used, the taste is light, and it reduces the burden on the stomach. Compared with the fat accumulation caused by eating a lot of greasy and fishy food, light food is easier to digest and absorb. ⑦

2. Eat less

Northerners are known for their generous nature. They like to eat big chunks of meat and drink big bowls of wine. However, it is precisely these eating habits that can easily cause excessive burden on the stomach and intestines and indigestion over time.

Southerners eat less and pay attention to savoring their food slowly, which prolongs the time that food stays in the mouth, giving enough time for initial digestion and reducing appetite. Liang Qianfang reminds that a vegetarian diet is not necessarily healthy, and a balanced diet is a light diet with a combination of meat and vegetables. ⑦

3. Eat Slowly

Li Chengpeng, deputy chief physician of hepatobiliary and pancreatic surgery at Peking University Cancer Hospital, said in an article published in Health Times in 2016 that chewing slowly can reduce the burden on the stomach, prolong the time food stays in the mouth, and promote the initial digestion of food.

Eating quickly and not chewing food thoroughly can easily damage the digestive tract mucosa, causing chronic inflammation and decreased gastric motility, which can cause digestive tract damage and even cancer over time.⑧

4. Don’t drink too much

Fan Huimin, chief physician of cardiac surgery at Shanghai Oriental Hospital, said in an article published in Health Times in 2016 that long-term and heavy drinking will increase the risk of diseases such as type 2 diabetes, hypertension, dyslipidemia, and gout. In addition, eating too much greasy food and drinking alcohol are also the culprits of esophageal cancer and liver cancer.

In areas with a large number of long-lived people, such as Guangxi, Guangdong, Sichuan, and Hainan, people's eating habits focus on nourishing nutrition, pay attention to the variety and cooking methods, and prefer low-alcohol rice wine, and generally do not drink excessively. Most southerners like to drink tea, and green tea is a famous anti-cancer drink.⑧

5. Eat more fruits, vegetables and seafood

Fan Huimin said that vegetables, fruits, marine fish and seaweed products are abundant in South China, and eating more of these foods is good for health and longevity.⑧

6. Don’t be too hot-tempered

Zhang Liting, chief physician of the Rheumatology and Immunology Department of Shandong Provincial Hospital of Traditional Chinese Medicine, said in an article published in Health Times in 2016 that northerners are often impetuous and impatient, which can easily lead to a surge in liver qi and disorder of qi, causing disorder in the functions of the internal organs and easily causing a variety of diseases.⑧

7. Exercise in cold weather

Yan Yageng, chief physician of the Nutrition Department of the First Affiliated Hospital of Harbin Medical University, said in an article published in Health Times in 2017 that compared with the south, the cold season in the north lasts for 4-6 months, and eating more high-calorie foods can store fat to keep out the cold.

However, in winter, fat is stored, and people exercise less than in summer, forming a habit of eating more and moving less. To lose weight, northerners must exercise twice as much as southerners.

This article is compiled from:

①Li Y, Teng DI, Shi X, et al. Prevalence of diabetes recorded in China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study[J]. bmj, 2020, 369.

②National Health Commission "Guidelines for the Prevention and Treatment of Hypertension in China (2023 Edition)"

③Association between genetic predisposition and disease burden of stroke in China: a genetic epidemiological study. The Lancet Regional Health - Western Pacific. Published: May 21, 2023.

④2017 China Center for Disease Control and Prevention "Chronic Disease and Risk Factor Monitoring Data"

⑤Chen K, Shen Z, Gu W, Lyu Z, Qi X, Mu Y, Ning Y; Meinian Investigator Group. Prevalence of obesity and associated complications in China: A cross-sectional, real-world study in 15.8 million adults. Diabetes Obes Metab. 2023 Aug 17.

⑥2023-11-04 Zhengzhou Central Hospital Affiliated to Zhengzhou University "Diabetes loves us northerners more! The most heartbreaking "North-South Difference" is here..."

⑦2017-07-07 Health Times "There are more fat people in the north than in the south"

⑧2016-01-11 Health Times "There's a reason why southerners live longer than northerners"

Source: Health Times