# Fast Food Growth and Cardiovascular Disease in China

Part
01
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Part
01

## Heart Disease and Cancer Cases - CHINA

In China, over the past 30 years, the incidence of cardiovascular disease (CVD) has increased to a great extent. According to the Journal of Geriatric Cardiology, 2017, "in 2014, the mortality rate due to cardiovascular disease was 295.63 per 100,000 people in rural areas and 261.99 per 100,000 people in urban areas". Cardiovascular diseases (CVDs) are commonly known as heart disease.

In China, cancer is the leading cause of death with increasing rate of incidence and mortality each year. As per A Cancer Journal for Clinicians, 2016, the total number of estimated new cancer cases in China was 4,292,000 in 2015. The number of cancer deaths was estimated to be 2,814,000, with lung cancer being the most common cancer as well as the leading cause of death due to cancer.

I have filled the figures based on my findings and calculation in the google spreadsheet.

### Heart Disease cases in China

Number of patients with heart disease or Cardiovascular Disease (CVD)

In 2010 = 230 million or 230,000,000
In 2014 = 290 million or 290,000,000

There are no hard data available for the years the 1990s and 2000s. So, I have drawn rough estimation for the years 1995 and 2005 with the help of population statistics in China.

China population in

According to the World Heart Federation, "it is estimated that one in five adults in China has a cardiovascular disease".

And, according to the figures for China Demographics Profile 2018, the total number of adults in China,

So, the total percentage of adult population, age 15 & above would be = 82.85%
Keeping the above percentage as fixed, I have used this data to estimate a rough figure for the number of adults (age 15 & above) in China for previous years (1995 & 2005).
The number of adults in China in the
year 2005 = 1,321,623,490 x 82.85% = 1,094,965,000
year 1995 = 1,239,940,004 x 82.85% = 1,027,290,000
As we know that one in five adults in China has a cardiovascular disease, the total number of people with cardiovascular disease for the year
2005 = 1,094,965,000 / 5 = 218,993,000
1995 = 1,027,290,000 / 5 = 205,458,000
Also, I have estimated the figures applying the above method for the year 2010 to check the validity of the estimated figures.

The number of cases with cardiovascular disease came about 225,311,400 for the year 2010 using the above method which seems to be fine as a rough estimate.

### Cancer cases in China

I found the total number of cancer patients in the year 1998 whereas, the data for the years 2000s and the year 2010 to 2017 could not be found in research papers or reports and articles by health organizations. However, after an extensive search, I found the number of newly diagnosed cancer cases in the year 2000 and year 2015. Additionally, during my research, I have analyzed that in case of cancer, each year the number of newly diagnosed cases and the number of deaths due to cancer have been estimated and not the total number of patients carrying cancer. I found several articles and research studies revealing the number of newly diagnosed cancer cases and the number of deaths due to cancer in a particular year.

Number of patients with cancer,
In 2015 = 4,292,000 (newly diagnosed cases)
In 2000 = 2,100,000 (newly diagnosed cases)
In 1998 = 1,395,000

### Conclusion

As requested, I have filled the spreadsheet with required statistics for the number of diagnosed heart disease and cancer cases in China.
Part
02
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Part
02

## Heart Disease and Cancer Cases - PHILIPPINES

The following brief provides information on how the number of diagnosed cases of cancer and heart disease in the Philippines has evolved over the past 30 years. The data which has been gathered from research from the Philippine Cancer Society and morbidity statistics from the Philippines Department of Health, is compiled under columns B and C of the Philippines tab of the spreadsheet accompanying this brief.

### Findings and Conclusion

The Philippines Department of Health has been tracking the ten leading causes of morbidity in the country annually since 1955. Since morbidity relates to the prevalence of an illness in a group of people, it is a good indicator of the number of diagnosed cases of the illness. As such, according to statistics from the Department of Health, the morbidity rate for heart disease in the Philippines stood at 37,589 in 2010. From 2000-2004 heart disease morbidity averaged 43,945 while the average was 97,600 from 1990-1994. In 2010 heart disease was the tenth leading cause of morbidity, down from seventh for the 2000-2004 period and sixth for the 1990-1994 period.

Heart disease morbidity numbers after 2010 have however not been published by the Department of Health because by 2014, heart disease ceased to rank amongst the top ten leading causes of morbidity. This shows that the trend of heart disease ranking lower from 1990 to 2010 continued. It is nevertheless interesting to note that mortality statistics from the same Department of Health indicate that as of 2013, heart disease continued to be the leading cause of death in the Philippines.

The Philippine Cancer Society publishes periodic cancer facts and estimates for the Philippines. According to their most recent estimates, the number of new cancer cases in 2015 was 48,138 for men and 61,142 for women, up from 44,072 for men and 50,056 for women in 2002. The 2002 numbers had also increased from 1998 when they stood at 33,828 for men and 37,628 for women. Of note, is the higher incidence of cancer amongst women in all three time periods.
Part
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Part
03

## Type 2 Diabetes and Alzheimer's Cases - CHINA

Cases of Alzheimer's disease and type 2 diabetes have increased dramatically in China over the last 30 years.

Alzheimer's diagnoses in China have risen from 1.93 million in 1990 to 3.71 million in 2000, and 9.5 million in 2017. About 1 million new cases of Alzheimer's are being diagnosed each year.

Type 2 diabetes is also on the rise. In April of 2016, an estimated 110 million people in China were reported to be diabetic. Worldwide, 90% of diabetes cases are type 2. If we assume that China's rates of type 1 vs. type 2 diabetes are similar to the global pattern, we estimate that 99 million of these cases are type 2 diabetes. This is a significant increase over 2009, when it was reported that 92.4 million people in China were living with diabetes, of which we assume 83.16 million cases were type 2. Looking back to 1995, the growth in diabetes cases is even more dramatic. In 1995, an estimated 2% of the Chinese population had diabetes, 23.44 million people. We again assume that 90% of those cases are type 2, or 21.1 million cases.

Prevalence of both Alzheimer's disease and type 2 diabetes are expected to continue to climb. Researchers project that 150 million people in China will be living with diabetes by 2040, and that 45 million people in China will be living with Alzheimer's by 2050.

Part
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Part
04

## Type 2 Diabetes and Alzheimer Cases - PHILIPPINES

According to the Philippine Journal of Internal Medicine, 2017, the prevalence of diabetes in the Philippines was 7.2% (or 6.377 million diabetics) in 2008. Till 2025, the projected prevalence of diabetes will be 7.8%.
In the Philippines, the number of people with diabetes is estimated to be 2.7 million in the year 2000 and it will reach 7.7 million by 2030.

Alzheimer's disease is the sixth leading cause of death in the Philippines.

I have presented the figures based on my findings and calculation in the google spreadsheet.

### Type 2 Diabetes Cases in Philippines

For the type 2 diabetes, most of the reports provide data for the total number of people with diabetes and not for the type 2 diabetes specifically. As we know that type 2 diabetes accounts for 90 -95% of all diabetes cases, we may assume that the figures for diabetes majorly belong to the type 2 diabetes, the most common type of diabetes.

According to the 2008 survey, in the Philippines, one out of every five people or 20% of the population have diabetes whereas, in 1998, the incidence rate was only 4%.

Total population in 1998 in Philippines = 74,693,700
Therefore, people with diabetes in 1998 would be
= 4% of the total population 74,693,700
=2,987,748

According to the study published in Annals of Global Health, 2015,

the number of cases diagnosed with type 2 diabetes in the Philippines in the year 2014 = 3.2 million or 3,200,000

and the number of diabetes cases in 2017 = 3.7 million or 3,700,000

### Alzheimer's Cases in Philippines

There are no hard data available for Alzheimer's disease in the Philippines. So, I have drawn a rough estimation of the number of Alzheimer's cases in the year 2003-2004 & 2014-2015. The data for the years the 1990s could not be found.

Alzheimer's disease accounts for approximately 50 to 60% of all dementia cases.

As per an article published in Press Reader, in the Philippines, the number of people with dementia,

In 2003-2004 = 289,884
In 2014-2015 = 490,000
Therefore,
in 2003-2004, the number of people with Alzheimer’s disease would be about
= 50-60% of 289,884 = 144,942 to 173,930
In the Philippines, in 2014-2015, the no. of people with Alzheimer’s disease would be about
= 50-60% of 490,000 = 245,000 to 294,000

### Conclusion

As requested, I have filled the spreadsheet with required statistics for the number of diagnosed type 2 diabetes or total diabetes and Alzheimer's cases in the Philippines.
Part
05
of six
Part
05

## Western / American Diet - CHINA

### Findings:

Over the past 30 years the prevalence of the Western diet in China has gained popularity. It started off with a modest revenue of around \$13 million in the late 1990s, and has since sky-rocketed to over \$100 million and is projected to reach \$190,099 million by 2030.

Our findings can be found in a Google Sheet here.
Part
06
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Part
06

## Western / American Diet - PHILIPPINES

To give you as much consistent data as possible for this request, we looked at the following data sets:

— Annual sugar consumption
— Annual spending on fast food
— Annual spending on prepared foods

Below, please find an explanation for each data point, so you can better understand how and why we found this information. Totals have been added to the shared spreadsheet (Column F) for your convenience.

Please note: when determining per capita consumption in any data set below, I use the equation: Per capital consumption = total consumption / population

Please also note: some sources gave information in USD, while others gave is in pesos (Philippines' currency). To provide consistent data, I converted all numbers to USD using this converter on Feb 20, 2018. Conversion rates do vary slightly over time, but the numbers presented will be consistent since they used conversion rates from the same day.

### SUGAR CONSUMPTION

As a global commodity, sugar consumption is tracked by a number of entities and markets around the world. This makes it the most reliable data we could find for this request.

With charts available from Index Mundi, which uses data from the Department of Agriculture, we can determine the total amount of sugar consumed annually in the Philippines by adding the total for each year.

1990s: 1446+1499+1575+1656+1852+1849+1970+1900+1918+1900= 17,565 (1000 metric tons)

2000s: 1930+1940+1950+1980+2010+2010+1950+1950+1900+1900= 19,520 (1000 metric tons)

1800+1850+2150+2150+2250+2155+2140+2200+2250= 18,945 (1000 metric tons)

From there, we can divide by the number of years of data we have (10 in the 1990s, 10 in the 2000s, and 9 in the 2010s) to determine an average per year.

1990s:
1,756,500 metric tons of sugar consumed annually during the 1990s in the Philippines, on average

2000s:
1,952,000 metric tons of sugar consumed annually during the 2000s in the Philippines, on average

2010s:
2,105,000 metric tons of sugar consumed annually during the 2010s in the Philippines, on average

Because population numbers have been growing, raw consumption numbers do not paint the full picture. By using population numbers for each year, we can determine per capita consumption using our per capita equation above, which gives us a more accurate picture.

1990s:
.0254 metric tons, or 25.4 kg annual per capita consumption

2000s:
.0229 metric tons, or 22.9 kg annual per capita consumption

2010s:
.0214 metric tons, or 21.4 kg annual per capita consumption

So, as you can see, although total consumption of sugar is rising, the amount eat per person is actually dropping in the Philippines.

### FAST FOOD SPENDING

Fast food spending was a bit trickier to find, given that no per-year breakdown exists as it does for sugar consumption. However, I was able to find data for certain years within each decade, in order to give you a snapshot of how much fast food is eaten annually in the Philippines.

1990s:

Jollibee is a national fast food company in the Philippines, so we can look at sales to see growth in fast food in the absence of other stats to figure out consumption.

According to the company itself, Jollibee recorded \$64,372,450 USD in sales in 1992 and this was the year they passed the threshold to account for more than 50% of the fast food market.

Based on population numbers from 1992, we can determine that per capita spending at Jollibee alone was \$1.01 USD annually. Assuming that they commanded just over 50% of the market (since this was the first year they hit that threshold), we can estimate that total fast food per capita spending was around \$2.00 USD annually.

2000s:

A government report tells us that total spending at cafes and fast food restaurants was 80,937,690,000 pesos in 2003. We can use our population numbers for 2003 to determine per capita spending of 974.78 pesos or \$18.65 USD annually. This number does include spending at cafes as well, which may or may not qualify as "fast food" for your needs, but it is the best data available.

2010s:

A report from the AAFC on consumption in the Philippines tell us that the total spending on fast food in 2012 was \$2.9 billion USD. Given our population numbers for 2012, we can determine per capita spending was \$29.94 annually.

So, fast food is quickly on the rise. These are rough estimates based on the assumptions listed above, and because we could not find data for a single source as with sugar consumption, they may not be as precise. However, these numbers can give you a snapshot of what is happening in the fast food market in this country.

### PREPARED FOOD SPENDING

Lastly, we looked at prepared food spending to better understand processed food consumption in the Philippines. Because "processed foods" is a more vague term, looking just at prepared foods is a better way to produce more accurate numbers. Obviously, not every processed food is a prepared food and vice versa.

For this data set, we were unfortunately unable to find any authoritative data from the 1990s. However, we were able to find data from years within the 2000s and 2010s to show growth in this market.

A study by the AAFC tells us that total prepared food spending for 2009 was \$11,038,800 USD. By using 2009's population numbers, we can determine that total per capita spending in 2009 was \$0.12 USD.

The same report tells us that 2017 spending was \$17,587,400 USD. By using 2017's population numbers, we can determine that total per capital spending in 2017 was \$0.17 USD.

So, this data tells us that although spending on prepared foods isn't nearly as high as spending on fast food, it is on the rise.

### Conclusion

In short, our data shows that sugar consumption is decreasing, while both fast food and prepared food consumption is increasing. All information with sources can be found on the shared spreadsheet in Column F.
Sources
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