Turning the Tide: Lifestyle Medicine – Burmese experience does not support ‘carb’ theory
I was surprised to hear they ate rice for breakfast, lunch, and supper, together with plenty of fruit and vegetables and legumes.
In 2015 my wife and I had the privilege of visiting our son and family, who were working for a non-governmental agency in Myanmar, South-East Asia. For two weeks we travelled extensively in the southern half of that amazing country.
We saw thousands of local citizens going about their lives – shopping, selling their produce, working on their farms, relaxing in the parks, worshipping in their pagodas, or interacting with often oversize overseas tourists. A striking feature was the general lack of excess weight or obesity amongst the local population. The only place I saw obese Burmese was in one of the few pizza restaurants – an import from the Western world, frowned upon by the Myanmar government.
Fascinated by this very different population dynamic (especially coming from South Africa, the heaviest nation in Africa) I inquired about the normal Burmese diet. I was surprised to hear they ate rice for breakfast, lunch, and supper, together with plenty of fruit and vegetables and legumes.
They used animal products more as flavouring rather than making a meal of a big piece of roast chicken or steak. Of course, the people are very physically active – walking, cycling, working their fields with great energy. But if ‘carbs’ are blamed as the main cause of obesity in our country, the Burmese experience did not support that theory.
According to a World Health Organisation (WHO) fact sheet on obesity and being overweight dated June 9, 2021, worldwide obesity has nearly tripled since 1975. The regions most affected are the Americas, Europe, and Oceania. Africa is lower down on the list, but Asia is the least affected.
It would seem as if the Western diet and lifestyle is the most significant factor – and globalisation of this lifestyle is having a universal effect. As people move away from the predominantly plant-based traditional diets to adopt a diet high in ultra-processed foods and animal products, together with decrease in physical activity, it is inevitable that average weights go up.
Of course, there are complex factors involved – marketing, subsidisation of unhealthy foods, food addictions, affluence, processing resulting in foods being more energy-dense, genetic predispositions, environmental influences on genetic expression (epigenetics), cultural norms, and decrease in physical activity. Does that mean that we are just victims of our environment, and thus condemned to follow the pathway to obesity? Is there no way that we can buck the trend?
The good news is that it is possible – and in a manner that leads to general improvement in health and well-being both for us, our family, and the environment. In our next article we will present what lifestyle medicine specialists offer as the best way to counter the obesity pandemic without starving ourselves.
Dr David Glass
MBChB, FCOG(SA), DipIBLM
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