Nepali Times
Life Times
Looking too healthy?

DHANVANTARI by BUDDHA BASNYAT, MD


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.



1. Disappointed
Nepali times could utilize its space better by replacing Dr. Basnyat with someone who can come up with genuine, informative and educational writings. Most of the author's articles are impractical, inadequate and Wiki-pasted. 

2. Anonymous
I think the above remarker just didn't get it...nothing could be far from the truth.  I have been following what Dr. Basnyat has to say for quite sometime now through his articles. I must say it has brought about a lot of key changes in my lifestyle. The contents are uptodate and practical  for even a medical person like me. I wish I could write with such lucid style. Wiki-pasted???....you sir must be subscribing to a different version to the one that we, the public, have access to. Keep up the good work Dr. Basnyat...we are with you!


3. harrisons
@dissaponted:how can u say its impractible..r u a doctor!!!if u r not also see uptodate Dr.buddha has come to a point where western doctors do the lab diagnosis as that...and if u have somethng do it on your research..dont say so much to a veteran doctor!!thank u...i hop u wont b writing this thng again in this mass crowd in internet....

4. Lancet
I think Dr. Basnyat is doing a fine job. Not only does he write fluidly, he has all the right facts down. (I went back to the textbooks just to double check). No worries Dr. Basnyat we are with you! As for Mr. Disappointed...what's your problem?


5. jange

A daily morning or evening walk for an hour or so should result in a vast improvement for most people.

Another option is to simply walk instead of using the motorbike or car or tempo or bus. �A lot of people use their bikes for even short trips of around a kilometer or less. �Walking would not only reduce stress but also save money and provide additional exercise.�




6. ananda
hey disappointed, you really disappoint me because you are bashing one of the best doctors in Nepal and not to mention a well renowned physician/researcher in the world. You should see all he has accomplished before saying something ignorant like that.
I think Dr. Basnyat has a a great writing style. I mean anyone could regurgitate some facts in an article, but he goes above and beyond by writing in a way we understand...with a funny twist at times.
Wiki! Ha! you serious?? maybe you're not smart enough to understand. I suggest you log on to uptodate, emedicine, nelsons or read articles in the lancet or new england journal of medicine. I'm not even a doctor, but I still love reading Dr. Basnyat's article!
Keep up the good work Dr. B! I enjoy reading nepali times more now that you're writing!


LATEST ISSUE
638
(11 JAN 2013 - 17 JAN 2013)


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