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HEALTH

 
Dal Bhat and other Diets

Obesity, once a problem confined to the Western world is clearly now a problem even of the impoverished countries of the East. Movies like “Slum Dog Millionaire” portray reed-thin kids running around the slums, but at the same time there are also adults truthfully portrayed by overweight policemen chasing these boys. Obesity has predisposed millions of people in South Asia to chronic diseases like cancer and diabetes with all its well-known complications.  These complications may be heart attacks, kidney failure, loss of eyesight, and strokes. Clearly these are problems we can do without because we are still stuck with our infectious disease problems which do not look like they are going to go away any time soon. Hence even to prevent these non communicable illnesses, losing weight for overweight and obese people is a good idea. Below we discuss some ways of losing weight primarily by changing our diet in the Nepali context. 

For overweight people losing even small amounts of weight and increasing physical activity can prevent plenty of medical complications.  Overweight is defined as a body mass index ( BMI = kg/m2) of 25 to< 30 and obesity is defined as BMI of 30 or more. Thankfully Nepal does not have too many obese people; but we together with the rest of South Asia are sure set to be an overweight nation.  Forget about having rippling,  abdominal muscles. Just keep your weight in the normal range.  Unfortunately once the weight is gained, losing itis a difficult proposition.

Patients on a diet generally lose about 5 % of their body weight  over the first 6 months, but by 12 to 24 months they are back to “mangal man” ( square one). The long term ineffectiveness of weight reduction diets may be due to compensatory changes in energy expenditure that oppose the maintenance of a lower body weight as well as genetic and environmental factors.Here are some common diets used for weight loss.

The Atkins diet which lets you eat fat and protein to your heart’s content with very low carbohydrate is probably impractical in Nepal because of the lack of variety of meat and fish. The LEARN ( Lifestyle, Exercise, Attitude, Relationships and Nutrition) diet is based on intensive lifestyle modification and may be too “idealistic” for many but very beneficial if you can bring about these changes in your life. The Zone diet comprises of 40 % carbohydrate and 30 % each protein and fat.

My favourite however is the Dal Bhat diet also known as the Ornish diet after Dr Dean Ornish, a professor of medicine from the University of Californiain San Francisco. However I think even the good doctor would be stunned at seeing the mountain of rice that many housewives consume here twice a day with a minimal exercise plan. Of course Nepali men also eat similarly, but they may have the advantage of being less sedentary. Probably the only group of people in Nepal that can efficiently deal with this vast amount of rice-eatingare porters along the Himalayan trails. The Ornish diet is vegetarian based and fat restricted.A modification of the Ornish diet with controlled rice consumption but plentiful dal and vegetables with a tasty  aachar to boot may be a very suitable and practical option for the Nepali palate.

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