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Summary: Background: The increasing prevalence of diet-related non-communicable diseases (NCDs) in South Asia is concerning, with type 2 diabetes projected to rise to 68%, compared to the global increase of 44%. Encouraging healthy diets requires stronger policies for healthier food environments. Methods: This study reviewed and assessed food environment policies in Bangladesh, India, Pakistan, and Sri Lanka from 2020 to 2022 using the Healthy Food Environment Policy Index (Food-EPI) and compared them with global best practices. Seven policy domains and six infrastructure support domains were considered, employing 47 good practice indicators to prevent NCDs. Stakeholders from government and non-governmental sectors in South Asia (n = 148) were invited to assess policy and infrastructure support implementation using the Delphi method. Findings: Implementation of food environment policies and infrastructure support in these countries was predominantly weak. Labelling, monitoring, and leadership policies received a moderate rating, with a focus on food safety, hygiene, and quality rather than obesity prevention. Key policy gaps prioritized for attention included front-of-pack labelling, healthy food subsidies, unhealthy food taxation, restrictions on unhealthy food promotion, and improvements in school nutrition standards to combat NCDs. Interpretation: Urgent action is required to expand food policies beyond hygiene and food security measures. Comprehensive strategies targeting NCD prevention are crucial to combat the escalating burden of NCDs in the region. Funding: This research was funded by the NIHR (16/136/68 and 132960) with aid from the UK Government for global health research. Petya Atanasova also acknowledges funding from the Economic and Social Research Council (ESRC) (ES/P000703/1). The views expressed are those of the authors and not necessarily of the NIHR, the UK government or the ESRC.

Objectives Our study aimed to systematically review the literature and synthesise findings on potential associations of built environment characteristics with type 2 diabetes (T2D) in Asia.Design Systematic review of the literature.Data sources Online databases Medline, Embase and Global Health were used to identify peer-reviewed journal articles published from inception to 23 January 2023.Eligibility criteria Eligible studies included cohort, cross-sectional and case–control studies that explored associations of built environment characteristics with T2D among adults 18 years and older in Asia.Data extraction and synthesis Covidence online was used to remove duplicates and perform title, abstract and full-text screening. Data extraction was carried out by two independent reviewers using the OVID database and data were imported into MS Excel. Out of 5208 identified studies, 28 studies were included in this systematic review. Due to heterogeneity in study design, built environment and outcome definitions, a semiqualitative analysis was conducted, which synthesised results using weighted z-scores.Results Five broad categories of built environment characteristics were associated with T2D in Asia. These included urban green space, walkability, food environment, availability and accessibility of services such as recreational and healthcare facilities and air pollution. We found very strong evidence of a positive association of particulate matter (PM2.5, PM10), nitrogen dioxide and sulfur dioxide (p

Aims and Objectives: Diabetes is a chronic health condition proving to be a major health challenge globally. Being a lifestyle-related disorder, psychosocial and behavioral factors are critical for its management, among which stress plays a contributory role. Diabetes is associated with increased risk of depression, anxiety, and stress due to its debilitating nature and complications. Stress not only affects glycemic control through biological pathways but also leads to unhealthy behavior such as binge eating, smoking, and alcohol. This study attempts to fill the lacuna between clinical and psychosocial aspects of stress and thereby determines the prevalence and impact of stress among type 2 diabetes individuals in a clinic population. Materials and Methods: This is a cross-sectional, case–control study that includes individuals with type 2 diabetes mellitus (T2DM) as well as those with normal glucose tolerance. Assessment of stress was done using a validated tool, the Depression Anxiety Stress Scale-21 (stress component). Sociodemographic characteristics, anthropometry, blood pressure, and biochemical parameters were collected in all the participants. Data were analyzed using Statistical Package for Social Sciences statistical software. Results: The prevalence of stress was significantly higher in T2DM compared to normal glucose tolerance (NGT; 43% vs 13%, P < .001). Both among T2DM and NGT, stress levels were higher in younger individuals with higher education, higher income levels, and professionals. Stress scores decreased with age at diagnosis of T2DM (16.6 [≤25 years] vs 15.6 [≥26–40 years] vs 12.7 [≥41 years], P < .001). T2DM was significantly associated with stress after adjusting for confounding factors. Conclusion: Individuals with T2DM had significantly higher prevalence of stress. Regular screening of stress could lead to better glycemic control.