Do Sri Lankans need to change their traditional diet for healthier living?

Written by harold Gunatillake-Health writer

“My concern is that when I visit Sri Lanka annually to avoid winter in Australia, my wife is obliged to purchase reluctantly processed food ingredients from the local super-market. Foods from eateries and restaurants are also cooked mainly from processed grains.

Incidentally, whole grain foods like brown and red rice, gain less weight than those who fill up on refined grains like white rice.

Though added sugars are considered ‘unhealthy’ world-wide, Sri Lankans add at least 4 teaspoons of sugar in their cup of tea or coffee. People indulge in sweetmeat most pleasurably, and obesity among the old, young, school children, and among saree clad ladies seems to be more visible”.

The incidence of Type 2 diabetes, coronary heart disease, stroke, obesity and hypertension is among some of the non-communicable chronic diseases that are progressively on the increase yearly in Sri Lanka, and diet may be a major factor causing them

Honorary Director National Diabetes Centre and Secretary Diabetes Association of Sri Lanka, Dr Mahen Wijesuriya, at a recent conference said, “The prevalence rate is 10.3% for the over 20-year population, which is 2.1 million. In addition there are 2.3 million persons who have pre-diabetes. This makes a grand total of 4.4 million persons who have dysglycaemia (Diabetes + pre diabetes) in Sri Lanka”.

This figure shows 1 in 5 persons have abnormal blood sugar levels in the country, with the figures likely to go up in the near future.

Carbohydrate based diets: The traditional high carb diet with modest protein from meat or fish, fibre from the mallum (cut fried vegetables) may not provide a balanced nutritional diet for daily consumption, and may partly be responsible for the ill-nourished situation among most people in Sri Lanka.

In a ‘bath (rice) packet’ purchased from street vendors contains white boiled rice as the main ingredient with little bits of meat or fish, a leafy vegetable, would not be considered a well-balanced modern day diet. Consuming rice of that quantity is inevitably needed to supply quick energy especially for the working class people.

Eating brown rice lowers your weight, as the rice is kept in your stomach and gut longer, so you’re less likely to fill up on junk foods. The texture of the rice gives a flavour that is satisfying to the taste buds, too

Incidentally, fast food consumption is very high among the young living in big cities. In Rajagiriya area in Colombo there are over 25 hot food joints within a mile. These foods will have disastrous health effects on the body, long term.

How can we change the traditional diet to a reasonably healthier balanced diet for Sri Lankans living in Sri Lanka, affordable within the reach of the average person?
We need to divert our discussion to review healthy diet patterns of other more develop countries to find solutions in comparison.

Mediterranean diet is well considered universally as the best healthiest diet, composed of fresh fruit, vegetables, wholegrain cereals, nuts, fish and dairy and olive oil, with no bulk quantities, including rice or flat bread as in the sub-Asian diets.

British Dietetic Association spokesperson, Anna Daniels, told The Independent: “the Mediterranean diet is one of the most evidenced based diets for heart health and longevity.”

She added that extra virgin olive is rich in monounsaturated and polyunsaturated fatty acids known to increase good cholesterol which protects the heart. Among Sub Asian and Pacific Islanders coconut oil and meat (kernel) are consumed daily in the cooking process, increases the good cholesterol (HDL) in your blood and heart friendly. Saturated fat in coconut being medium chained triglycerides (MCT), among other health benefits, seems unlikely to influence the increase in the bad cholesterol (LDL).

Eating a combination of varying foods is linked to better overall health leading to reductions in chronic illnesses… Such combinations are restricted for those consuming rice and curry. Many studies have highlighted the benefits of eating such available combination of foods.

Recently, it has been shown that eating berries and strawberries can protect against Alzheimer’s disease. These fruits contain high levels of antioxidants and flavones to fight such diseases. They are not tropical fruits and unfortunately not much grown in the hills in Sri Lanka.

Pineapple is one of the best tropical fruits having flavonoids and antioxidants akin to the above fruits, but unfortunately they are not within the reach of the average wage earner. A wayside vendor’s rice packet would be cheaper than buying a pineapple fruit.

Other fruits that are high in phenolic content and antioxidants are pomegranate, Ceylon dates, miracle berry, star fruit, sugar apple and gooseberry. But unfortunately, these fruits are not freely available at a price the average man can afford, and as a result consumption of fruits is very low.

Sri Lankans love eating fruits, but the situation is that due to the high cost of these fruits, it may be not possible to eat daily. In most rural areas the families grow their own fruits in their gardens.

Japanese Diet

Life expectancy is high in Japan unlike the sub-Asian countries. Their diet is composed of carbohydrates, mainly rice, but the quantities eaten are much smaller than the rice eating Asians. Cooked rice is made into small balls with fish, shellfish on top. It is called ‘Nigiri’ Sushi rice and seafood is rolled in dried seaweed sheets. There are other similar preparations -osushi rice, ‘Tamaki’, Gunkan rice, and so on.

They eat plenty of steamed vegetables, fish, and meat. Overseas Japanese and others visiting friends in Japan take frozen meat from countries like Australia to be given as gifts, quite a popular practice. Japanese people love fresh fish, particularly sushi. They use very little oils and salt in the cooking process. The emphasis is on the small quantity of rice Japanese eat unlike the Sub-Asians, eating full plates of cooked rice. Taking the Japanese example, Asians need to cut down on the rice consumption for better health and longevity.

The average, Japanese diet is composed of raw fish, vegetables and rice, containing lower fat than the Western diets. Their heart disease incidence is low as a result.
Sri Lankans don’t get the opportunity to eat fleshy white fish like salmon, tuna, and daily as it is not within the reach of the average person’s purse. Eating fish in Sri Lanka is the privilege of the rich, and even they too don’t eat fish daily.

When the island is surrounded by the sea one fails to understand why big fish is so dear in Sri Lanka. The average Japanese consumes around 100grams of fish every day as sushi sashimi or tempura.

So what we learn from the Japanese diet is that we should eat less white rice, preferably eat more unprocessed brown rice and plenty of fish and vegetables, adding fruits, pulses and nuts, for health and longevity.

French diets: The French paradox has baffled many nutritionists. They consume foods with high saturated fat content, such as cheese, bread and drinking wine instead of water, have no obesity problems, less heart disease and over all a healthy nation.

The secret is they eat only small quantities of food in small plates. Restaurants in Paris serve dishes containing 277g of food whilst in Philadelphia in US gave customers plate filled with around 346g of food.

Eating lot of cheese can suppress your hunger pangs, and consuming smaller amounts of food is quite satisfying. They eat 25kg of cheese per person, making them the largest cheese consumers in the world. They eat lot of fresh fruit and vegetables.

Sri Lankans cannot mimic French style of eating. Cheeses are expensive, even the locally manufactured ones, and are out of the reach of the average citizen. Though red wine consumed quite heavily by the French adding to their health and longevity is not a good proposition in a poor tropical country.

The ultimate solution for the right type of suitable diet for the Sri Lankans may be eating little unprocessed cooked rice, with plenty of vegetables, fish, meat, nuts, and pulses daily, adding a fruit to eat after a meal. Consumption of processed foods should be minimised at all costs. Many varieties of nuts are not available in the island. Cashew nuts, pea nuts and the gram nuts provide sufficient micronutrients as much as most varieties of nuts available in other countries.

Awareness of the health benefits of consuming unprocessed foods needs to be emphasised through the health authorities and the mass media.