Not long ago, several local Nepali friends talked about their parents’ recent diabetes diagnoses. Intrigued, I Googled “white rice diabetes Nepal,” and learned that 18% of Kathmandu’s urban population over 40 has type 2 diabetes (with an additional 10% showing pre-diabetic symptoms). By dramatic contrast, only 3-4% of Nepal’s rural population suffers from the disease. I discovered that the shocking urban trend has a lot to do with the city dwellers’ new addiction to processed, machine-hulled white rice… and their greatly increased inactivity. D’oh! Diet and exercise again.
As a result, I was interested – and not surprised — to see a story in the February 14, 2012 edition of the online journal MedicalXpress. It reconfirmed the trend my Nepali friends had told me about with this headline: “Diabetes risk factors in young Sri Lankans much higher than previously thought.”
Conducted jointly by King’s College-London and Sri Lanka’s National Diabetes Center, the study surveyed 22,507 people aged 10-40 in Sri Lankan cities. Researchers tested for early risk factors for type 2 diabetes, including high body mass index (BMI), raised waist circumference, high levels of physical inactivity, and family history of diabetes.
What we have found in this report really confirms that South Asia is becoming the centre of a worldwide diabetes epidemic. We were expecting the levels of risk factors to be high, but we were still surprised at just how high they were. The fact that we found such a high prevalence in children has not been shown in Sri Lanka before, or anywhere else in South Asia, and is of great concern. This dramatic rise is clearly linked to a decline in physical activity and mirrors global trends of rising childhood obesity. Being overweight in childhood means people are much more likely to become obese as adults and will have a greater risk of developing type 2 diabetes and cardiovascular disease. Now that we know how widespread the problem is, we can take steps towards identifying high risk groups to evolving preventive strategies.
About the study, Professor Jean Claude Mbanya, President of the International Diabetes Federation, said: “These figures reflect the disturbing rise in risk factors for type 2 diabetes among young people being seen worldwide….. This is an example of good-quality scientific research that will bring solutions to the global epidemic of diabetes.…”
The World Diabetes Foundation (WDF) recently reported on its efforts in Nepal, where 15-22% of Kathmandu valley residents are thought to be diabetic, according to the WDF (similar to the percentage reported by the Nepal Diabetes Association).
In the past, diabetes has gotten short shrift in Nepal, because of other national priorities, insufficient facilities and medical personnel, poverty, lack of educational programs, difficulty of terrain, and lack of transportation. That is changing now, with the development and activity of well-informed teams of doctors, social workers, paramedics, and other healthcare personnel offering educational camps and workshops across Nepal.
Specific project elements include:
- Full day diabetes camps in the communities. Follow up camps at regular intervals
- Direct awareness and education programs in the local communities on (un)healthy lifestyles and detection and prevention of diabetes and its complications
- Education for youth in clubs and schools about diabetes, its complications and preventive measures
- Preventive measures in families with a history of diabetes, encouraging a healthy lifestyle
- Training of local health care providers in basic diabetes care and management
- Increasing awareness among government, NGOs and institutions through publications and seminars
The Problem with Polished Rice
Increasing inactivity is a big problem in Nepal (and almost everywhere else). But in Nepal, a major culprit in recent years is rice. Polished rice.
We live in a highly developed country. We have easy access to mind-boggling volumes of information, and many of us find healthcare within easy reach. Still, if there’s a nation that vies for top honors in the percent of citizens with Metabolic Syndrome, it’s the USA. Obesity is on parade all around us. The unseen risks – like high blood pressure – are rampant, too.