Earlier this year, as the second wave was subsiding in Nepal’s far-western mountains, I noticed the kind of dramatic change in the diet of families that I had earlier only seen in semi-urban settings.
In Achham district’s Bayalpata Hospital, I came across a one-year-old who weighed just 5kg. She was being breastfed by a mother who was herself undernourished. “The child only eats noodles and biscuits, that is why I am still breastfeeding,” said the mother.
The family has cows and a patch of land where they grow vegetables. There is enough lentil and flour at home. So why was the child not eating a healthier diet?
“Noodles have all the nutrition to give her strength but my baby is still losing weight which is why I have brought her to the hospital,” the young mother tells the doctor.
The traditional practice of growing and consuming locally grown lentils, soybean, millet and buckwheat is being replaced even in the remotest parts of Nepal by junk food in throwaway plastic wrappings.
Locals here have been misled by tv commercials that have glamourised noodles and biscuits, and convinced many parents that they contain vitamins and micronutrients that will make their babies healthy. The instant food in plastic packs are also convenient for parents who are usually busy all day in the fields.
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Child specialist Ramesh Kant Adhikari says that, on the other hand, most urban children who grow up on junk food tend to be obese and malnourished, and certain parents are proud that they are raising well-fed children.
“Parents don’t understand that such foods are harmful to the health of their children,” Adhikari told me. “They don’t believe me even when I try to explain.”
As long as tv commercials and social media ads continue and the government does not regulate, the problem will persist and continue to grow. Even in the food-deficit regions in the remotest corners of Accham and Doti districts where families cannot even get basic medicines, packaged junk foods are now easily available. This is evidence enough of the state’s misplaced priorities.
Children of subsistence farmers, already undernourished, are consuming low-nutrition junk foods. The children then suffer health consequences, which means expensive consultations with doctors who then prescribe costly bottled vitamins, further impoverishing the family, and thus completing the vicious cycle.
“There is absolutely no evidence that supplemental vitamins are good for growing children,” adds Adhikari. “All they need is a proper, balanced diet found in traditional home foods.”
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But parents are so swayed by unethical commercials that public health experts are fighting a losing battle to convince them of the dangers of junk foods. Indeed, some health care workers share part of the blame: they prescribe vitamin supplements to young children instead of counselling parents on the nutrition available in the traditional Nepali diet.
The Ministry of Agriculture has for decades been publishing booklets and posters to promote local produce such as buckwheat, millet, potato, lentils, latte, tarul, and beans. But lack of coordination between the health and agriculture ministries means that information rarely gets out into the hinterland.
The Health Ministry also distributes packets of Balvita at health posts to treat children with malnutrition, but it does not have the sense to inform parents that the same calories, proteins and vitamins are found in abundance in fresh homemade food.
Children everywhere are easily swayed by commercials, they demand what they see on tv, and parents often comply. There is also a status symbol associated with young students who take packets of instant noodles with them to school for snacks.
Junk food commercials can be countered by attractive infomercials about a healthy diet. Following the pandemic, some television and radio stations started to broadcast programs on nutrition, but their reach is limited.
When I was working in East Africa 10 years ago, an Ethiopian doctor shared his experience of combating childhood malnutrition in his country. “We made flour from dry-sprouted soya beans and chickpeas so that it had protein, vitamins, calcium and other micronutrients. It was cheap, easily available, and very easy to disseminate information about.”
I keep sharing this information with health workers all over Nepal. But there is resistance because the Health Ministry in Kathmandu is not serious about promoting local food products aggressively enough.
For example, sesame seeds have good fat, calcium, and mineral content, and can be given to children and pregnant mothers. Flax seeds contain omega-3 fatty acids and fibre. But we do not advertise these locally available superfoods, or use them in fighting malnutrition. Instead doctors prescribe imported capsules packaged by multinationals that contain the very same ingredients.
Federal Ministries, especially Agriculture and Health, must coordinate with their provincial and municipal counterparts to fight malnutrition. It is not an exaggeration to say that the epidemic of junk food in Nepal is now emerging as a public health crisis.
Aruna Uprety is a public health specialist and author of the 2017 book on nutrition, खाना खानुभयो?
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