Student – Dear Lama la, the results of the recent screenings for non-communicable diseases (NCDs) in Bhutan were alarming, but not totally unexpected. Some people say that this is the consequence of modernization and so there is little we can do about it. Lam, what do you think about the situation and do you believe there is nothing we can do? As a young mother living with my parents, what practical steps can I take to adapt my household’s typical urban Bhutanese lifestyle?
Master – I agree. The results indicate that non-communicable diseases (NCDs) significantly affect Bhutan’s population, but as you mentioned, these findings weren’t entirely unexpected.
Is modernization the cause of the problem? Partially, especially with people adopting a more sedentary lifestyle and consuming more processed junk food.
However, if a modern lifestyle were the sole cause of increasing NCDs, then every economically developed country would suffer the same health-related consequences, but they don’t. For example, Japan, Taiwan, Italy, Norway, and Sweden are developed countries whose populations don’t experience a significant burden of NCDs. In fact, these countries all have long life expectancies, with Japan boasting the longest lifespan of any country in the world.
On the other hand, the United States has a high rate of NCDs, primarily driven by the overconsumption of junk food and lack of exercise. In some states, such as Alabama, Mississippi, Oklahoma, and Kentucky, over a third of the population is classified as obese, leading to conditions such as cardiovascular disease, renal failure, and type 2 diabetes. Similarly, countries like the UK, Australia, Canada, and Germany also face high rates of NCDs.
So, while a modern lifestyle has undoubtedly contributed to the increase in NCDs worldwide, it is not entirely to blame for this phenomenon.
To help reduce the risk of NCDs, here are a few strategies that have been successfully implemented in a number of countries:
- Promote healthy eating: Through formal education and social media campaigns, encourage the consumption of more fruits, vegetables, and whole grains while reducing the intake of processed foods, sugary drinks, and trans fats. Implementing taxes on sugary beverages or offering subsidies for healthier food options provide financial incentives for people to adopt a healthier diet.
- Encourage regular physical activity: Create safe spaces for exercise, such as subsidized or free baseball and futsal facilities, bike lanes, and walking trails. Public campaigns can also help motivate people to be more active.
- Innovative strategies to reduce smoking and excessive alcohol consumption: Implement taxes and organize public awareness programmes.
- Increase access to preventive healthcare: Routine screenings and check-ups can help catch potential health issues early on.
Additionally, it would be beneficial to research the causes of NCDs that are particularly prevalent in Bhutan, such as renal failure.
Although hypertension is a known factor, other underlying causes may need to be addressed. Investigating these factors and tackling the root causes would not only relieve many individuals from the need for dialysis or kidney transplants but also save the government significant healthcare costs in the long run.
We know that nothing lasts forever and that everything is in a constant state of flux, so no matter how well we eat or how much we exercise, we will still experience sickness and eventually death. However, adopting a healthy lifestyle can help us avoid NCDs at a young age, prolong our lives, and promote a higher quality of life for the elderly.
As a mother, your diet and lifestyle not only affect you but your entire household. Introducing your children to a healthy lifestyle will help them enjoy a healthier adulthood. Additionally, your parents would benefit if you could encourage them to adopt a balanced diet and to engage in regular exercise.
As you mentioned wanting to adapt your typical urban Bhutanese lifestyle, I understand that you wish to make meaningful changes to your diet and daily habits without completely overhauling your routine or becoming a health fanatic.
Reducing starch, which contributes to the risk of type 2 diabetes, would be a good place to start. You can achieve this by adjusting the ratio of rice to vegetables, favouring the latter. Buckwheat, in the form of khule or putta, and quinoa can be substituted for rice, at least occasionally.
Additionally, it’s crucial to eliminate or significantly reduce foods that are high in sodium and low in nutritional value, such as instant noodles, potato chips, and bread made with refined flour, from your diet. Similarly, sugary soft drinks should be removed from the fridge and cupboard and consumed only occasionally.
How can we replace these items? Fresh or dried fruit can be eaten as snacks. Alternatively, you can bake your own biscuits from wholewheat flour and sweeten them with dried fruit. Thick Greek yogurt makes an easy-to-prepare and delicious dessert, especially when combined with chopped bananas or raisins. For bread lovers, wholegrain or sourdough bread makes a healthy and tasty alternative to white bread.
Moreover, foods that contain artery-clogging and inflammatory trans fats, such as French fries, fried chicken, and processed meats, should be avoided.
As for lifestyle changes, young adults may enjoy jogging, yoga, and cycling. Children can learn hip-hop dance and be encouraged to participate in sports, while the elderly may enjoy circumambulating chortens. Additionally, children should have mobile phone and laptop time restrictions and be encouraged to play games and enjoy outdoor activities instead.
For lifestyle changes to work long-term, they need to be fun and sustainable, not an arduous task. I believe the suggestions above maintain the enjoyment of meals, while the activities are also pleasurable.
However, combating NCDs on a large scale requires a concerted and combined effort from various departments, including health, media, and education, along with city authorities and NGOs. The underlying motivation for these changes should be rooted in an understanding of interdependence. When we recognize that everything is connected, we acknowledge that a healthy, safe, and educated society benefits everyone. Conversely, we all suffer if those we live and work among are unhealthy.
In conclusion, while a modern lifestyle has contributed to the rise in NCDs, it is not the sole cause of the problem. However, with a united effort, the rise of these diseases can be reversed, paving the way for Bhutan to embrace a healthier and more sustainable future.
However, efforts should begin early. Once an unhealthy lifestyle becomes ingrained in a population, changing the habits that support it becomes significantly more difficult.
Finally, in Buddhism, we recognize that being born as a human is a rare and precious opportunity, one through which we can benefit others and awaken to the truth. Therefore, we should strive to make the most of it by avoiding unhealthy habits that could lead to ill health and shorten our lives.
