A western friend once told me that when a Nepali says you look 'very healthy', he euphemistically means you are morbidly obese. Obesity is an increasing problem in Nepal, and besides giving us a prosperous look, the extra weight adds to chronic medical problems.
The 'X' syndrome is known by a more mundane name - the metabolic syndrome - and obesity is one of its key characteristics. Experts say that the presence of abdominal obesity is more highly correlated with metabolic risk factors than one's body-mass index (BMI). A measurement of a patient's girth size indicates potential risk factors for diabetes or cardiovascular problems like strokes and heart attacks.
The numbers to remember are: more than 102cm (>40 inches) for a male adult waist, and more than 88cm (>35 inches) for a female adult waist. Male patients can develop multiple metabolic risk factors with only a slight increase in their abdominal girth, and those with a waist measurement of 94-102cm may have a strong genetic contribution to insulin resistance. This means they have diabetic problems. Guess what, diabetes is a common condition in south Asia.
The other 'non-blood test' parameter to be tested for the 'X' syndrome is blood pressure. And blood pressure levels >130/> 85mm of Hg are deemed risky. Blood tests can look at three things: levels of fasting glucose, HDL, and triglycerides. Levels of fasting glucose >110mg/dl are suspect, and you're at higher risk for strokes and heart attacks with low levels of HDL ('good cholesterol') and high levels of triglycerides.
These five parameters - waist size, blood pressure, blood glucose, HDL, and triglyceride levels - make up the clinical identification of the metabolic syndrome. However, any deranged single parameter is a risk factor. At least three abnormal values will identify a patient suffering from the full-fledged metabolic syndrome, and this will increase a patient's risk for cardiovascular illnesses many times over.
The good news is that a healthy lifestyle including exercise, not smoking, and moderate to no alcohol intake will definitely have a positive impact on waist size, blood pressure and blood glucose. Lifestyle changes, then, are one way of not appearing 'too healthy' in Nepal.