Desperate Times Call For Brown Rice

A decade into the twenty-first century, it is the environment of our very own 'development' and 'progress' that is breeding the largest public health crises of modern times. Obesity, high blood pressure, type 2 diabetes (herein referred to as diabetes), cardiovascular (heart) disease, cancer and gastrointestinal disorders are non-communicable diseases (NCDs) and illnesses that are quickly overtaking today's urbanizing world. In India, the incidence of NCDs is believed to have surpassed that of communicable and infectious diseases (CDs)—previously the main public health threat in the developing world. In 2003, South Asia had the largest diabetic population with 46.3 million people affected by the disease, with India alone, the "king of diabetes", accounted for over 31.7 million people. With a projected doubling in these numbers by the year 2030, the World Health Organization has called type 2 diabetes an epidemic of potentially devastating proportions.

The behavior and environmental risk factors of these diseases are well known: lack of physical activity, stress, alcohol and tobacco consumption combined with an improper diet. Excess refined carbohydrates like white flour and white rice and sugar (simple carbohydrates) is a main dietary cause along with too many refined and saturated fats, and salt. Such a diet tends to also be deficient in fresh fruits and vegetables, unrefined whole grains, and dietary fiber (complex carbohydrates). Dietary and lifestyle changes are widely recognized as being more effective than allopathic medicine for both treatment and prevention of metabolic syndrome and diabetes.

As a Fulbright fellow in Kathmandu, Nepal for the last year I studied food habits and the health impacts of dietary change in Nepal's capital city. To conclude my research I distributed brown rice, although unpopular in Kathmandu an important and extremely healthy, whole grain praised by doctors and chefs alike for its rich flavor and ability to help prevent and manage NCDs. Giving the brown rice along with surveys, it was my aim to understand whether switching from eating refined white rice to unrefined brown rice was a possible habit change for average people to make. As summarized near the end of this article, my results were largely favorable.

Here in Kathmandu, studies show that 18% of the adult population over the age of 40 has diabetes and an additional 10-40% of people suffer from a pre-diabetic state called Impaired Fasting Glycaemia and/or metabolic syndrome. This is compared to diabetes rates of only 3-4% in the Nepali rural adult population. While rural Nepalis are generally physically active and eating relatively wholesome fresh foods, Kathmandu's urban population is increasingly sedentary and eating more and more processed foods.

Globally, non-communicable diseases cause 60% of deaths, 80% of these being among middle and low-income families. In South Asia, the annual direct medical costs of diabetes alone total an estimated $1.2 billion. In 2000, for a low-income household in India, 34% of family income would be drained if one of the household members needed diabetes care. But diabetes is only a fragment of the big picture, cardiovascular disease causes 50-80% of deaths in diabetic patients and is now the leading cause of death in the world accounting for over 6.4 billion deaths per year—30% of total deaths. By the year 2010 India is predicted to host 60% of the world's total heart disease burden which, combined with other chronic diseases, could cost the country up to $237 billion in the next ten years.

Considering the enormous shift of the health care burden taking place in developing countries, one would expect international development agencies and governments to react to such trends accordingly. However this is not the case. In 2006, of $26 billion Official Development Assistance provided by the international community (OECD/DAC/EC), only 100 million supported basic nutrition and no funding was allocated specifically for prevention and control of NCDs. Instead most attention remains directed towards CDs.

One reason no significant shift of focus has taken place is because NCDs are commonly labeled "lifestyle diseases" of the rich and elderly. Obesity, diabetes and heart disease were once called "diseases of affluence" because in the recent past only wealthier people were eating refined foods and privileged enough to not do physical labor and hence were contracting these NCDs. Today younger and younger groups are being affected and upper, middle and low class people share an environment extremely conducive to being sedentary and eating mostly processed foods. In fact, NCDs pose a greater threat and burden in poor and disadvantaged communities for whom fresh fruits and vegetables are relatively more expensive and good education is a rare commodity.

Labeling metabolic syndrome, diabetes, and cardiovascular disease "western diseases" is a more appropriate term than "diseases of affluence." It is in fact the environment molded by "progress" and "development" originally brought from the western world that is kindling the fire of the current NCD pandemic. The extraordinarily harmful nutritional transition taking place throughout the world and underpinning the NCD pandemic is largely the product of the widespread industrialization of food production. The growth of sophisticated supply chain management on a global scale coupled with the expansion of market economies and the growing concentration of global food manufacturers explain why the cheapest and most widely available foods bought by a rapidly urbanizing population are energy (calorie) dense, nutrient-poor foods rich in simple carbohydrates and unhealthy fats. Quite ironically however, it is this so called "sophisticated" global food system that is greatly responsible for much unnecessary illness and loss of human life on the planet.

Throughout our history, humans have lived by eating primarily vegetables, fruits, whole grains, and legumes that provide plenty of complex carbohydrates, micronutrients, protein, and dietary fiber. Our bodies are therefore biologically best suited for such unrefined, whole and natural foods. Only during the last century—most dramatically in the past 50 years—have people started to eat refined carbohydrates and fats as the basis of their diet. This short period is also the first time in which metabolic illness and NCDs have emerged in pandemic proportions, providing a good indication that such processed foods are not nutritionally suitable for good human health.

The nutritional science behind diabetes and Metabolic Syndrome is simple enough. Carbohydrates in the food we eat are converted into glucose, a type of sugar that is used to provide energy to the body. The complex carbohydrates found in vegetables, fruits, legumes, and whole grains like brown rice, corn, millet, buckwheat, and barley are converted into glucose relatively slowly because the composition of these foods is naturally rich in micronutrients and dietary fiber—essential elements for proper metabolism and good health. (Moderate amounts of whole grains, fruits, vegetables, legumes and healthy fats in the diet are associated with low risk of developing NCDs like diabetes and heart disease.) Processed simple carbohydrates like white sugar, white rice, and white flour on the other hand are converted to glucose very quickly because they lack any significant amount of micronutrients or dietary fiber, which are stripped away during the refining processes.

Insulin, a hormone produced by the pancreas, acts as a 'key' to open the 'doors' of our body's cells, allowing glucose in the blood to enter cells and be utilized as energy. When we eat simple carbohydrates in large quantities over long periods of time, the body becomes overwhelmed and loses its ability to deal with so much glucose. The pancreas eventually becomes tired, no longer producing good keys (insulin), the cells' doors' become worn out, becoming jammed. Glucose that thus does not enter cells stays in the bloodstream where it is a harmful substance that attacks the body and creates disease. This circumstance, called "insulin resistance", is the underlying cause of "metabolic syndrome"—a term that refers to a host of interrelated symptoms including obesity, high blood pressure, high cholesterol and high blood fat (triglyceride) levels. Left unmanaged, the conditions of metabolic syndrome pave the road to NCDs like diabetes, cardiovascular disease, kidney failure, eye damage, blindness and limb amputation.

In Kathmandu most people consume a towering portion of white rice two to three times every day. Compared to the rice, curried vegetables and dal (watery lentil soup) are taken in much smaller quantities. This great proportion of grain on the plate is suitable for the traditional agrarian lifestyle of rural Nepal, but transplanted into modern Kathmandu all of this white rice is a recipe for disaster. Today's most popular snack foods are also almost entirely simple carbohydrates, all being made from refined white flour combined with unhealthy amounts of refined oils: chowmein, chow chow packaged noodles, samosas, naan, puri, sweets, sodas, fried chips, donuts, white bread, and of course the quintessential sugar sweetened Nepali chiya (tea) served with white flour biscuits that some people will take up to 15 times per day in the winter season.

It was not long ago that white sugar, white flour and white rice were rare and expensive commodities in Kathmandu's capital city. At that time people were consuming unpolished brown rice with vegetables fresh from their garden. Besides rice people enjoyed (and still do in rural areas) bread and other dishes prepared from a diverse array of whole grains like corn, millet, buckwheat and barley.

Unfortunately, for most of Kathmandu's residents today, the only thing synonymous with real food is white rice. Even while recognizing the great healthfulness of food items made from different whole grains, people tend to associate dhido, roti, and even brown rice with the "poverty" and "backwardness" of village life. Many people come to Kathmandu from their village trying to abandon hardship and seeking the facilities and comforts of modern life. White rice and white flour are items that "look good", are "easy to eat" and "soft to chew". Brown rice "looks dirty" people say, "we eat rice that has been cleaned". Really, only by calling micronutrients and fiber dirty can we call white rice cleaner. It is a lack of these micronutrients and fiber that is not only partially responsible for the current NCD pandemic sweeping the world, but also for the increasing number of people suffering from constipation, gastritis, mouth sores, and pain and tingling in the limbs.

Besides the conceptual reasons I have mentioned, market availability, cost, and advertising from processed food producers are major factors accounting for the attractiveness and overwhelming consumption of refined foods. With such a vast subject of food and health at hand, I eventually focused my research on one topic alone. Assuming that some change in diet is necessary for improved health in Kathmandu, seeing rice as the most common food in the diet, and recognizing brown rice—naturally rich with important dietary fiber and micronutrients—as the healthiest form of the grain, I decided to research whether switching from eating white rice to brown rice was a habitual transition people are capable of making.

Initially, while talking to people about their conceptions of brown rice, I found people with a previous habit of eating it said that they really like it. On the other hand, people who had neither eaten nor heard of it before tended to respond negatively when ask about the rice, usually assuming that brown rice would be hard to eat and unpalatable on top of looking bad. For my final research, I distributed brown rice to over 200 random research subjects to be eaten over two weeks. After analyzing peoples' responses to eating the rice written in a simple survey that was given with the rice, I found that only about 23% of people indeed did have a negative experience the first time eating the brown rice opposed to 41% of people who had a positive first experience. Of those people with initial negative experiences however, and similarly for the subject group as a whole, about 55% of people said that their experience improved as they continued eating the brown rice—it become tastier and more enjoyable to eat with time. Overall 56% of people said that they found the brown rice "good", "tastier" or "better" in comparison to white rice.

Most of the research subjects had been eating white rice for their entire lives. My research concludes that however deeply rooted that habit of eating white rice may be, most people can switch to eating brown rice: by the end of only two weeks 51% of the research subjects said that they had gained the habit of eating brown rice, an additional 11% saying that they were trying to gain the habit. 57% of people said that they wanted to buy the brown rice again. By the end of the two-week period only 7% of people said that they disliked the rice. Over one quarter of the research subjects (27%) said that they found it to be "extremely delicious" ("dherai mitho"). About half of the people said that they would serve the brown rice to guests.

An even larger portion of people, 67%, subjectively found some positive effect on their health. Of those who commented, 26% said that their body or stomach felt lighter, 20% said that their constipation was lost, 13% said that they felt their diabetes managed (two people reported fasting glucose levels dropping from over 150 mg/dl to under 100 while eating the brown rice germinated), and 36% reported a great amount of strength and energy. Other people had sores in the mouth lost, improved digestion and appetite, and limb pain reduced, along with other benefits. Another good thing about brown rice, as 63% of people commented, is that it is filling; thus it can be eaten in smaller quantities and prevents one from feeling hungry very quickly.

My research indicates that changing eating habit is not necessarily an easy thing to do—it takes some effort. As one subject wrote on their survey, "at first I did not like the taste and found this rice hard to eat. Learning how to cook it well, and with a little bit of time, now I really like it and I only want to eat this kind of rice." I found a positive correlation between the amount of times people ate the rice and the how much they enjoyed it or created a habit of eating it. While among people who ate the brown rice four or more times per week (101 people), 71% enjoyed the taste, 80% had a positive health experience, 62% created a habit of eating it, and 70% wanted to buy it again; those who ate the brown rice 2 or less time per week (52 people), only 32% enjoyed the flavor, 36% had a positive health impact, 8% created a habit of eating it, and 37% of people wanted to buy it again.

"I feel great, you should give information about brown rice to everyone" writes one subject. Indeed, from the grassroots to the international community level, it is essential that coordinated efforts exist to provide education and awareness about the dangers of modern refined foods while making wholesome foods more widely available. "I am worried that this kind of rice wont be available in the future and that I will have to eat white rice again" writes another person.

Brown rice is not a sole solution to the NCD crisis in the Indian subcontinent, there is a diverse variety of wholesome foods being lost from the urban diet that need to be recovered in proper balance. My research indicates that no matter how dark the horizon may seem, humans are very adaptable creatures capable of changing their habits for the better. Undoubtedly, such change is necessary and must be supported from all levels of society.

Afu Puja, Health is Wealth

Written by Fulbright Researcher Alden Towler and originally published by The Republica Newspaper of Nepal on April 30, 2009.

While researching food habits and health in the Kathmandu Valley on a Fulbright Scholarship is the reason I have been living and studying in Nepal for the last seven months, I have also become very fascinated by local religious culture.  This past Tihar I was invited by a Newari friend to his home for mhapuja, or ‘worship of the self’.  While I am no expert on the religious culture of Nepal, I would love to share what such a celebration and worship of the self means to me in the context of eating and being healthy here in Kathmandu.

No matter what religion you follow, your world would not exist without the living tissues that you call your own body.  Whether or not we say that god exists within ourselves, can we not agree that this body, this self of ours is an astonishingly beautiful thing that deserves much respect and celebration?

We can respect and worship ourselves everyday by eating the foods that our body will thank us for. In this sense, you do not really have to be Newari to do mhapuja. And really, eating healthily should not be such a hard thing do to. However, in our modern circumstance this is not the case considering that the lifestyles and food available today are often at odds with the lifestyles and foods for which our bodies are best suited. 

Health professionals speaking from both classical Ayurvedic and modern scientific perspectives agree that the food which is healthiest for humans today is the same food which our ancestors have been eating for millennia. Of course having some sort of physical activity/exercise in one’s daily life is the backbone of good health. In America, where I was born and raised, many people have become extremely confused about what they should be eating and have forgotten what to eat.  The foods and recipes from our ancestors have been largely replaced by the advice from doctors and magazines who seem to change their minds every other year about what foods are best to eat.  Food becomes fad instead of staple.  As a consequence, the USA leads the world in its number of people suffering from what I will call ‘metabolic illnesses,’ which include obesity, insulin resistance, Type 2 Diabetes, Heart Disease, and high blood pressure, with over 50% of our population affected.

India and China combine to host a quickly increasing number of 60 million Type 2 diabetics.  Kathmandu falls geographically just between those two countries. Today close to 30% of urban Nepal’s population suffers from metabolic illness according to a recent study.  While sedentary lifestyle is also to blame, diet plays a very important role creating illnesses. Today’s modern world has become plagued with the fruits of industry–overly refined foods.   

Here in Kathmandu people have not forgotten what to eat—in fact Nepalis know exactly what to eat and prepare it exceptionally well, Daal, Bhaat/Dhido, tarkari nai khaau—but instead the problem is more that the foods people are eating have changed their form and have lost most of their most vital nutrients. The main three issues I generally see are too many refined grains and refined oils, and too few fruits and vegetables in the diet. 

Refined grains such as white rice (as opposed to ‘pura polish nabhaeko chamal’- brown rice) and white flour (‘maida’ as opposed to ‘atta’- whole wheat flour) that have been stripped of their vitamins, minerals and fiber are now the main ingredients of Kathmanduites’ diet.  Such over-processed carbohydrates, which are quickly converted to sugar upon ingestion, can be a main cause of both metabolic illness and malnutrition. Processed vegetables oils like soybean and sunflower oil along with dalda (margarine) have an unhealthy ratio of omega 3 to omega 6 fatty acids (their ratio is 1:10 while 1:3 is the preferred healthy ratio) and can also contain trans-fatty acids which are becoming outlawed in the USA (these oils also often go rancid during industrial production).  So let me say this simply: fresh, pure mustard oil (toriko tel) is exceptionally healthy (and tasty) with a perfect omega 3 / omega 6 ratio of 1:3.

Since when did ultra-polished white rice become the only thing synonymous with food or ‘khaanaa’ in Nepal?  So many people have told me that this omnipresent white rice is preferred because it is pleasing to the eyes, it is good to look at.  Do our eyes eat rice?  If so, the habit of eating a mountain of white rice twice a day would be a wonderful puja to the eyes. But because this is not the case, I am afraid that such rice is partially to blame for many of Nepal’s health problems. (And by the way what ever happened to buckwheat (‘phapar’), millet (‘kodo’), corn (‘makai’) —acknowledged widely by all Nepalis as the most nourishing grains?  Will these completely disappear from the diet as white flour becomes everything we eat—biscuit, momo, chowmein, chowchow, pauroti, dunot, naan, samosas, mithai…?  I hope not.)

It is the essential vitamins, minerals, and fiber which are stripped away from rice and wheat which could otherwise be properly nourishing all people—students, businesswoman, fathers, and mother alike—the way they had been for millennia before the recent advent of the machine mill. Essential micronutrients are found in the bran of grains, the layer residing under the hull (‘buss’/‘bokra’) known in Nepali as ‘chokar’.  Today chokar sells on the market for 15 rupees per kilogram so that it can be fed to animals.  I love animals too, but don’t you think we should be feeding the most nourishing part of our food to ourselves?  Afulai puja garnu pardaina? 

The foods which the people of Kathmandu avoid like brown rice, dhido and sisnu (partially because people associate such foods with the antiquity and ‘poor backwardness’ of the village) are actually the best foods there are for our bodies!  The reasons behind the prevalence of the overly refined foods I have mentioned are too complex to summarize here.  But people from all walks of life should recognize the beauty of the self and work to overcome the silly social constructs which get in the way of the most important puja of all, afupuja.   

Information on Germinated Brown Rice

Information on Germinated Brown Rice- Unpolished Rice which has been Soaked in Water Overnight (or 6+hours) before cooking
Compiled by Alden Towler – aytowler@gmail.com
“Rice compound reduces diabetes
Researchers have found that a compound that helps rice seed grow, springs back into action when brown rice is placed in water overnight before cooking, significantly reducing the nerve and vascular damage that often result from diabetes.
"You have to let it grow, germinate a little bit," says Dr. Robert K. Yu, director of the Institute of Molecular Medicine and Genetics and Institute of Neuroscience at the Medical College of Georgia. "Some of the active ingredients generated as a result of the germination process are beneficial to you."
Germinated brown rice's ability to help diabetics lower their blood sugar has been shown but how it works remained unknown. New research, published online in the Journal of Lipid Research, shows the growth factor acylated steryl glucosides or ASG, helps normalize blood sugar and enzymes that are out-of-whack in diabetes.”

Source: 1) http://www.scientistlive.com/European-Food-Scientist/index.php?allUrl=Ingredients/Rice_compound_reduces_diabetes/20801/&category=Ingredients&articleTitle=Rice_compound_reduces_diabetes&articleId=20801&action=viewPollResults/germinate
2) http://www.physorg.com/news136467430.html

Useful Germinated Brown Rice
By Dr. Hari Bahadur KC

RICE is the most important food crop of Nepal. It has high economic as well as social value. Rice has supported a greater number of people for a longer period of time than any other crop since it was cultivated.
Benefit
The new way of eating rice may change the diet in the next century. The potential health benefits of germinated brown rice have attracted public attention and challenging the deep-seated prejudice against brown rice.

Germinated rice is brown rice soaked in water until it just begins to bud. The outer bran layer becomes soft and more prone to water absorption, making it easier to cook. Enzymes produced during the budding process break down sugar and protein, giving the rice a sweet flavour. Experts say, the germinated rice may enhance brain functions and reduce levels of lipids, or fats, in the blood. Studies have found that germinated brown rice contains three times as much gamma amino butyric acid, an amino acid that works as a neurotransmitter, as conventional brown rice, and five times as much as white rice. Known to promote blood flow in the brain, the chemical has long been used for treating the after effects of brain injuries and strokes. It is also known to help stabilise blood pressure and reduce lipid levels in the blood. In addition, compared to ordinary brown rice, germinated brown rice is twice as rich in lysine, one of the essential amino acids that makes proteins in the body and contains a higher level of soluble fibber. Researcher reported that, dietary fibber has been found to be more beneficial in its soluble form.Source: http://www.nepalnews.com.np/contents/englishdaily/trn/2003/apr/apr09/features.htm

Traditionally, grains have almost always been soaked, sprouted or fermented before eaten.
In Japan there has recently been renewed interest in sprouted rice thanks to a number of recent scientific studies done on gamma-aminobutyric acid (GABA), a naturally occurring amino acid created during the germination process. The consumption of GABA is credited with important health benefits that range from lowering cholesterol and blood pressure, boosting the immune system, improving sleep, and inhibition of cancer cells. So it makes good sense to soak and sprout your rice. Both from the perspective of tradition and science. Today even the typical Japanese housewife knows to soak her rice before cooking
Source: http://radishboy.blogspot.com/2008/05/sprouted-brown-rice.html

Better nutrition, enhanced digestion, less allergic potential – WOW, who could refuse sprouted foods?
More research validating sprouting comes from Japan at the Shinshu University in Nagano. A group of scientists recently found that soaking brown rice turbocharged its nutritional value. Soaking the rice over night stimulates the early stages of where a tiny sprout (less than a millimeter tall) grows from the grain. “The birth of a sprout activates enzymes in the brown rice all at once to supply the best nutrition to the growing sprout,” They found that sprouted rice is not only more nutritive with higher amounts of vitamins and minerals than non-germinated rice, but it is also sweeter and easier to cook. I can confirm these cooking results from personal experience.
Written by Jen Allbritton, CN
(Copyright © 2003 Vitamin Cottage Natural Grocers, Inc.)

A Burning Desire

The black sooty fumes of a thousand torches raced to meet the already blackened air above a downtown Kathmandu street.  Thick wooden sticks, the carriers of kerosene soaked cotton, hosted raging flames to burn hundreds of incandescent cries into the back of my photographic mind. An unforgetable image, to see the shadows of a thousand marching torch bearers taking their city by critical mass.

That day I had gone to a swimming pool with a group of Nepali friends.  We enjoyed ourselves whether or not we could all swim, and after a cup of overly sweetened milk tea we parted ways. I stayed with my two Tamang bhais (little brothers/friends- see previous blogs for acquaintance stories), Suraj and Kusal, 14 and 9 year old kids I greatly adore. Walking along the road just next to the “Police Health Club”, where we had been learning to swim, my chlorine-singed eyes read a sign: “International Indigenous Film Festival”.  Today was the last day of the festival and the last film of the day was scheduled to play at the current time–5pm.  “Has the film already started?” I asked someone at the information desk.  “No it will be a bit late- wait half an hour please” came the response.

 

Back outside I scrupulously searched for the best place for us to eat.  The tents at the festival where serving typical Nepali snack foods from different ethnic groups–thukpa

(white flour) noodles, seasoned meat, potatoes, sweetly spiced rice flour donuts. The two boys and I found a nice mat woven from corn husks under a shady tent to sit on; our hosts were a group Newari woman dressed in remarkable black and red dress (these are the traditional dress of the Jyapuni, i.e. the female members of the Maharjan, the Newari farming caste).

The Newari people are indigenous to the Kathmandu Valley, Nepal’s capital and home to the biggest and most artisanal urban areas in Nepal.  We ate typical Newari snack food: crunchy flattened rice called chiura; succulent buffalo meat barbequed over dried rice stalks and rubbed with toasted mustard seed oil, ginger, garlic and plenty of chili; black eyed peas; sautéed greens; chickpeas; chili potatoes; a condiment of peas, carrots, daikon radish and green hot peppers smothered with lime juice and toasted sesame seed paste; a thick, crunchy-on-the-outside soft-on-the-inside black lentil pancake with an egg cracked on top.  What I love about Newari food is the healthy variety of tasty items given in smaller quantities to fill the plate opposed to the usual Nepali habit of filling the whole plate with white rice or noodles- leaving very little room for vegetables and legumes 

The movie, ‘The Long Journey,’ started an hour later than scheduled, Nepali time for sure.  It was about the situation of indigenous people in Nepal and their long struggle to proclaim and realize their social, environmental and political rights.  A very long story short: Prithvi Narayan Shah was a Hindu King in the 18^th century who shed much blood conquering the Kathmandu Valley and ‘unified’ what became the Nepali Kingdom.  What ensued was the creation of an autocratic monarchical system which privileged high caste Hindus (Aryan in ethnic origin) while oppressing and exploiting lower caste Hindus, women, and especially the dozens of indigenous tribal groups of Nepal, most whom have Tibeto-Mongol ethnic origins and are Buddhist and animists, not Hindus.  Indigenous communities were infiltrated, their community-based self governing structures uprooted and their natural and human resources exploited without any sign of profit or benefit to local peoples.  Today, 250 years later, Nepal is attempting to instate democracy (starting in the 1950’s) and the right of tribal groups are finally being recognized (on paper) by a mostly dysfunctional Nepali government.  The film documents one human rights success in Nepal, which actually did succeed in becoming the second country in South Asia to ratify the United Nations treaty on the rights of indigenous peoples.  And yet this is only the beginning to a long process of bringing justice and equality to the ethnic groups that have been largely ignored by the high-caste Hindu-dominated government for the past few centuries here in Nepal.

After the movie I walked along one of the central streets of Kathmandu with the Tamang kids who had learned about some of these issues in school but still couldn’t quite wrap their heads around these big ideas.  They are Buddhist Tamangs, a diverse ethnic group, some of whom once served as slaves to the king.  Both of these boys’ fathers are abroad in the Gulf now, working low-pay jobs in order to make ends meet.  In their village the educational opportunities are lacking and hence they live here in the city, where the streets are overflowing with trash and drinking water is a rare commodity. 

The sidewalk is filled with people selling t-shirts, mangoes and bananas, nail clippers, Ayurvedic herbs and umbrellas. Pedestrians walk through a maze of themselves and street vendors, overflowing into streets raging with the horns of a half dozen different kinds of motor vehicles.

As we climb the stairs of a pedestrian bridge I see a voracious mass of torch-bearers simultaneously sworming and marching toward a small cluster of policemen who seem absolutely terrified by the group that they were both fleeing from and trying to control.  The three of us reached the top of the pedestrian bridge to meet a crowd of people staring and whipping out their cell phones to take photos.  I asked a someone what was going on, “It’s the Maoists” one man said, “No, it’s the Newars, they are protesting for the creation of a state which recognizes them as the original people of Kathmandu and thus gives them their proper rights as indigenous people.  Tomorrow the city will be closed in a strike.”

Behind us the sky was glowing deep neon pink hues, the sun already set behind our capital city, this concentrated carnal congestion of concrete. I put Kusal on my shoulders so he could see the scene below. Before us a sea of torch carriers bellowed their cries of anger and dissatisfaction with their smoky voices.  The narrow street soon became as filled as it could be by the procession of flames, burning their message into the air and into peoples’ minds anywhere they went.  We must be seen.

Indeed today the entire city is shut down in strike.  Every shop is closed, not a single bus is running, not even motorcycles dare to take the streets, and youth yell at the few cyclists who pass by telling them to dismount.  Torches have been replaced by burning tires throughout the city, burning even blacker messages into the masses.  Such protests are not uncommon in Nepal and have detrimental consequences for average people who somehow pay for more expensive vegetables and cooking gas, closed roads jacking up prices; or they simply eat their rice without lentils or vegetables. For me it’s quite pleasant: I walk down the street without honking horns and black exhaust fumes in my face kicking a ball with kids in the open streets, pay a few extra cents for my vegetables and indulge the privilege of my white skin and green dollar.  

Recent trip to lake of the sun god

Om SuryaKunda

Processing Polished Rice: A Reflection on Diet and Health in Kathmandu

While Nepal has become famous for the Himalayas, no less impressive is the mountain or rice that most Nepalis eat as the centerpiece of their twice-daily meal. 

Not long ago the shades of wholesome varieties of rice in the market and on peoples’ plates ranged from reds to dark and light browns.  The machine-polished rice oftoday is as white as the snow capping the Himalayas themselves.  While Kathmandu’s rapid modernization has left the agricultural hardships associated with hand-hulled, less processed red and brown rice behind, the consequences of a new addiction to overly processed foods includes a Type 2 diabetes epidemic which affects close to one third of the Kathmandu Valley’s population.

According to a study conducted by the Nepal Diabetes Association, while only 3-4% of Nepal’s rural population is affected, 18% of Kathmandu’s urban population over the age of 40 has Type 2 Diabetes, and an additional 10% suffer from a pre-diabetic state called Impaired Fasting Glycaemia1 underpinned by insulin resistance. The term “Syndrome X” or “Metabolic Syndrome” has been coined to refer to a host of interrelated symptoms including obesity, high blood pressure, and high blood fats levels—the underlying cause of these symptoms being insulin resistance.  The conditions of Metabolic Syndrome pave the road to diabetes and other related conditions like heart disease, eye problems, kidney failure, and limb amputation, just to start the list. Over the last five months, through interviews and informal conversations, I have been researching the dietary habits and conceptions of food in Kathmandu that I relate to the onset of Metabolic Syndrome in Nepal.

The body converts most foods we eat into glucose. Whereas sugar, along with processed carbohydrates like white rice and white flour, convert very quickly, whole grains like brown rice, wheat, corn, and millet are converted more slowly, and vegetables and beans are slower still. Over the course of years, as people continue to overdose on highly refined, rapidly digested carbohydrates like white rice, the body’s ability to deal with so much glucose wears out.Overwhelmed by too much insulin (produced to lower otherwise harmfully high blood sugar levels), glucose-burning cells become resistant to insulin, thus inducing the complications of Metabolic Syndrome.

Until quite recently people in Kathmandu spent much more time walking, doing physical house and agricultural work, and playing outdoors.  Although peoples’ physical activity has dramatically decreased, the average amount of food and total calories people eat has remained the same if not increased. Daal-bhaat, the traditional Nepali meal usually consisting of a staggering amount of rice and a far smaller portion of lentil soup and vegetables, is relatively well-suited to someone engaged in physical activity—as it provides an abundance of energy for a hard worker—but it is a recipe for disaster for those who live sedentarily and also indulge in a lot of meat, alcohol, and modern junk foods.

Considering how deeply ingrained rice is in Kathmandu, eating rice in its healthier less processed forms should become a priority. The dhiki is a device traditionally used for hulling rice in Nepal actively present even in central Kathmandu until about 45 years ago.  The dhiki’s physically intensive process of beating rice with a heavy beam of wood removes the inedible hull of rice but leaves partially intact the nutrient-rich bran and germ layer below which give the whole grain its distinctive flavor, color, and health benefits.  The modern machine mill processes rice with far greater speed and with hardly any physical effort but strips away the bran and germ leaving only almost entirely plain starch remaining. White rice lacks the vitamins, minerals, and fiber found in the bran and germ that are necessary for proper and slow digestion of the whole grain.  As one Nepali woman told me “We no longer have the hardships of the past, but we suffer with new diseases.”

White rice of course, is not the only problem. White flour, as opposed to whole-wheat flour, has become the main ingredient of most snack foods found in Kathmandu

—momos, chowmein, chow-chow/ wai-wai noodles, naan, puri, samosas, biscuits, and bakery products. Sugar-sweetened Nepali tea with biscuits is of course a quintessential Nepali snack. The increasing popularity of these junky snack foods among the city’s youth threatens public health even more severely than the mountains of white rice synonymous with daal-bhaat.

Everyone I have talked to about rice hulled by the dhiki says that it is incredibly tasty, filled with flavor and healthier than that milled by the machine.  What most Nepalis do not know, however, is that machine mills can produce brown rice (unpolished rice), which is in fact available at many stores in Kathmandu. Unfortunately brown rice is relatively hard to find and nearly twice the price as the fully polished varieties, from which the removed bran and germ have been sold and added to animal feed.

When I talk to Nepalis about this sort of unpolished rice it does not seem very appetizing to them. “It isn’t tasty,” many say, because they think the rice would be “hard” texturally and “bland” in flavor.  

The irony is that many of the city-people who say this have never tasted unpolished rice before, so how would they know? Regardless, the habit of eating white rice, like any deeply rooted habit, is a very hard one to change.  The same Nepali health professionals who explain how difficult it is to make vegetables a more prominent proportion on the dinner plate, simply because of habit, also tell me how once they started eating brown rice, white rice was never as satisfying again—neither for their taste buds nor their stomach.

The attitudes taken towards unpolished rice by many people living in Kathmandu are similar to those that they take toward dhido, a traditional staple food of Nepal. Dhido is cooked with the flour of whole grains such as buckwheat, millet, corn, and wheat. Those who have a habit of eating it enjoy its more complex flavors and its hearty nature.  

Dhido is widely recognized by nearly all Nepalis to be more filling (after eating you don’t get as hungry as soon), and healthier for the body.  (It is also the exact kind of whole grain food that dieticians recommend for the prevention and treatment of Metabolic Syndrome.) Those who don’t have a habit of eating it however don’t seem to take any interest in it at all.  When I ask some people whether they eat dhido, an almost disgusted and shocked look comes over their face as if to say ‘me? Eat that stuff?’  They reply “No, not really,” “I eat it every once in a while, a few times a year,” “it’s too hard to cook,” “dhido is bland, I prefer rice.”

In many ways, while unpolished rice and dhido symbolize the antiquity of village life and a way of eating that has nourished hundreds of generations who never suffered from insulin resistance, white rice symbolizes the modernity born from industry and an era of unprecedented metabolic illness.  I am not suggesting that everyone in Kathmandu beat their rice with a dhiki, but my research shows that the wellbeing of urban Nepal depends upon a shift of consciousness and habit.  The foods from the past (and present for the millions who still enjoy whole grain foods regularly) should not become relics, but rather the keystones of a modernity that champions wholesome awareness instead of refined ignorance.

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1 Singh, Dr. D.L; Diabetes- Care and Management; “Understanding Diabetes Mellitus”; Nepal Diabetes Association, Rotary Club of Nepal, 2006.