Our son was doing humanitarian work in Myanmar for some years. We had the privilege of visiting him and his family in that politically challenging country. After decades of oppressive rule it was exciting to see the dynamic development in those few years of peace. But one of the most obvious differences between Myanmar and the rest of the world was the size of its people. I was hard-pressed to find an overweight person among the general population, apart from the tourists from the West. With obesity and overweight increasing dramatically in most parts of the world, including South Africa, I was keen to establish why this was not happening in Myanmar. Genetics is claimed to be a major factor in the rest of the world, but the fact that there is so little obesity in Myanmar suggests that this is not true.
What lifestyle factors contribute to the normal weights of Myanma (Burmese)? The government has restricted the entrance of foreign fast-food chains. Although street food is quite oily, the people eat a great deal of fresh fruits and vegetables. Rice is the staple. (This puts paid to the claim that “carbs” cause obesity). Consumption of ultra-processed foods like sugar-sweetened beverages and snacks has not yet taken on. Abundant fresh fruit and vegetables are readily available from affordable farmer’s markets. Small-scale farming is flourishing and water and fertile soil are abundant. Private transport is expensive so most people walk a lot. Animal products are sparingly consumed.
We decided to try traditional food in a local restaurant. One person ordered chicken curry. The individual’s dish arrived with a large bowl of rice and a small platter of curried vegetables sporting three small cubes of chicken. Someone else ordered a fish curry.
Again the basis of the meal was rice with a small platter of curried vegetables flavoured with a few “guppies”. A slaughtered chicken will last one week for a whole family, such is the economy of utilisation of animal products.
What can we learn from Myanmar to control the growing size of people in our country, and around the world? Eating an abundance of whole foods like fruits, vegetables, legumes and minimally processed grains is ideal. We need to drastically reduce the intake of ultra- or highly-processed foods and sugar-sweetened beverages. If we consume animal products, use these more as a flavouring than the main focus of our meal.
Other established interventions to control weight include making mealtimes a social event instead of eating on the run, incorporating plenty of physical activity all through our daily programme; obtaining sufficient restorative sleep at night, and dealing with stress in appropriate ways.
We were taken out to one of the very few pizza restaurants in the city for a special meal. Surprise, surprise! That was the only place I saw overweight local citizens, which speaks volumes about the causes of the obesity pandemic. In our next article we will look at the science.
- This health column is written by Dr Dave Glass, a retired obstetrician/gynaecologist living in Somerset West. He is also chairperson of the South African Lifestyle Medicine Association (Salma). Glass, with an MBChB, FCOG(SA) and DipIBLM, has a passion for preventing and addressing the root causes of chronic diseases.
