The Health Thread

Introduction

Nepal is facing a silent but dangerous shift in its public health landscape. While undernutrition remains a critical issue, a new epidemic is emerging: adolescent obesity. My recent research conducted among 72 students at a Kathmandu school revealed that 11.1% were obese and 9.7% overweight—a troubling trend that mirrors global patterns of worsening metabolic health among youth (Sitaula et al., 2023). This article explores the root causes of this crisis, its long-term consequences, and evidence-based solutions to safeguard Nepal’s next generation.

The Dietary Crisis: How Modern Eating Habits Are Harming Youth

One of the most alarming findings from my study was the dramatic shift in adolescent diets. 71.34% of students regularly consumed fast food, while a staggering 91.97% drank sugary beverages (Khatri et al., 2021). These foods, high in refined sugars and unhealthy fats, contribute directly to weight gain and metabolic disorders. Equally concerning was the prevalence of chocolate consumption—79.2% of students ate chocolates frequently, with 26.4% indulging four or more times per week.

The decline of traditional Nepali meals—rich in whole grains, lentils, and vegetables—has been replaced by processed snacks and calorie-dense foods. Equally problematic is meal skipping, reported by 13.9% of participants, with breakfast being the most frequently missed meal (31.97%). Research shows that skipping breakfast slows metabolism by 15-20% and leads to overeating later in the day (American Journal of Clinical Nutrition, 2019).

Why does this matter? Poor dietary habits in adolescence set the stage for lifelong health problems, including type 2 diabetes, heart disease, and fatty liver disease (WHO, 2020). Without intervention, Nepal risks a surge in preventable chronic illnesses.

The Sedentary Lifestyle Epidemic: Screens over Sports

Physical inactivity is another major driver of adolescent obesity. While 90.3% of students claimed to exercise, deeper analysis revealed that 51.4% engaged in less than 30 minutes of daily physical activity—far below the WHO’s recommended 60 minutes per day.

A key contributor to inactivity is excessive screen time. My study found that 52.8% of students spent at least one hour daily on phones, TVs, or computers, with 4.2% exceeding three hours. Research from Harvard University confirms that each additional hour of screen time correlates with a 2% increase in BMI (Harvard School of Public Health, 2021).

Even though 86.1% of students walked to school, this activity alone was insufficient to offset the sedentary behaviors dominating their free time. Only 15.3% participated in school sports, highlighting a critical gap in structured physical education programs.

The consequences? Inactive youth face higher risks of obesity, poor bone development, and mental health struggles like anxiety and depression (Journal of Adolescent Health, 2022).

Family and Socioeconomic Factors: Hidden Influences on Obesity

My research uncovered surprising links between family structure and obesity risk. Students from nuclear families (58.3%) had higher obesity rates than those from joint or extended families. This may be due to:

• Fewer shared household chores, reducing daily physical activity
• Greater reliance on convenience foods in busier, smaller households
• Less communal eating, which traditionally encourages balanced meals

Socioeconomic status also played a role. Wealthier students were 2.3 times more likely to be obese, likely due to:

• Higher pocket money expenditure on junk food (UNICEF Nepal, 2021)
• Increased access to smartphones and streaming services, promoting sedentary behavior
• Attending private schools, where canteens often sell more processed snacks

The Consequences: A Lifetime of Health Risks

Adolescent obesity is not just a cosmetic issue—it’s a ticking time bomb for Nepal’s healthcare system. Obese teens face:

Metabolic Disorders

Type 2 diabetes risk increases by 30% (WHO, 2020)

Higher blood pressure and cholesterol levels, leading to early heart disease

Psychological Harm

Lower self-esteem and higher rates of depression (Journal of Pediatrics, 2021)

Social stigmatization and bullying, affecting academic performance

Economic Burden

Lifetime healthcare costs for obese individuals are 42% higher (The Lancet, 2022)

Lost productivity due to obesity-related illnesses

Solutions: A Multi-Pronged Approach

1. School-Based Interventions

• Replace junk food in canteens with affordable, nutritious options like fruits and nuts
• Mandate 30 minutes of daily physical activity (e.g., morning exercises or sports periods)
• Integrate nutrition education into science and health curricula

Example: Japan’s school lunch program, which provides balanced meals and nutrition lessons, has kept childhood obesity below 5% (UNICEF, 2023).

2. Family and Community Actions

• Revive family meals with traditional, home-cooked dishes like dal-bhat-tarkari
• Limit screen time to under 2 hours/day and encourage outdoor play
• Community cooking workshops to teach quick, healthy recipes

3. Policy Changes

• Tax sugary drinks and junk food, as Mexico did (reducing soda consumption by 12%)
• Improve urban walkability with sidewalks and safe parks
• Ban junk food ads targeting children, following Chile’s successful model

Conclusion: A Call to Action

Nepal stands at a crossroads. Without urgent action, adolescent obesity will escalate into a public health disaster. But the solutions are clear:

• Schools must lead with healthier meals and daily exercise
  Parents can model better habits by reducing screen time and cooking nutritious meals
  Policymakers should legislate changes, from junk food taxes to improved sports facilities

The time to act is now. By working together, we can ensure Nepal’s youth grow up healthy, active, and free from preventable diseases.

Kamala Shrestha is a public health researcher with a focus on nutrition and lifestyle behaviors among healthcare professionals. She holds a degree in Home Science and has a passion for exploring the intersection of work environments, dietary habits, and health outcomes. This article is based on the findings of her thesis, which she submitted as part of her academic journey.

Healthcare professionals (HCPs) are often seen as the torchbearers of health and wellness, guiding patients toward better dietary choices and healthier lifestyles. Yet, behind the scenes, many HCPs struggle to maintain their own nutritional well-being. This article is the article version of the thesis I submitted, and I am sharing what I found during my research. A study conducted among 171 healthcare professionals in Nepal sheds light on this paradox, revealing alarming trends in dietary patterns and nutritional status that demand immediate attention.

The study, conducted across three healthcare institutions in Gokarna Municipality, found that more than half (52.03%) of HCPs worked grueling shifts of 8-12 hours daily. This demanding schedule took a toll on their eating habits, with 72.73% admitting to occasionally skipping meals. Breakfast, often hailed as the most important meal of the day, was the most frequently missed, with 31.97% of participants forgoing it altogether.

The consequences of these irregular eating patterns were evident in the dietary choices of the participants. A staggering 71.34% reported regular consumption of fast food, while an overwhelming 91.97% admitted to consuming sugary drinks. These habits, coupled with limited water intake and high stress levels, contributed to a concerning nutritional profile. Nearly half (48.17%) of the participants were classified as “Overweight” or “Pre-Obese,” and 50.84% faced high health risks based on their Body Mass Index (BMI).

The Hidden Struggles of Healthcare Professionals

Healthcare professionals are often perceived as paragons of health, but the reality is far more complex. Their jobs are inherently stressful, involving long hours, emotional strain, and physically demanding tasks. These factors, combined with irregular shifts, make it difficult for HCPs to prioritize their own health. As one nurse participating in the study shared, “When you’re rushing from one patient to another, grabbing a quick snack or skipping a meal becomes the norm rather than the exception.”

This sentiment is echoed globally. A 2023 study by Gołabek et al. found that midwives working shift schedules in Poland faced similar challenges, with irregular meal patterns and high consumption of processed foods being common. The study also highlighted the impact of such diets on micronutrient deficiencies, which can further exacerbate fatigue and reduce cognitive function.

The Role of Sociodemographic Factors

The study also highlighted the role of sociodemographic factors in shaping dietary patterns and health outcomes. Younger HCPs, particularly those aged 20-25, were more likely to exhibit unhealthy eating behaviors and face obesity-related risks. This aligns with findings from Karthijekan and Angela (2020), who noted that younger individuals often prioritize convenience over nutrition, leading to poorer dietary choices.

Marital status also played a significant role. The findings of this research indicated that married HCPs were found to be obese, with a higher waist-to-hip ratio and  single HCPs, especially those living alone, were more prone to relying on fast food and skipping meals. Smoking and low water intake were additional risk factors, with both behaviors significantly associated with higher BMI and Waist-to-Hip Ratio (WHR) risks.

Interestingly, gender differences were also observed. Female HCPs had a higher prevalence of WHR-related health risks, consistent with findings from Gupta (2017) and the Chinese Nutrition Society (2020). This could be attributed to biological factors, such as differences in fat distribution, as well as societal pressures that may lead women to adopt restrictive or unhealthy diets.

The Caloric Conundrum

One of the most striking findings of the study was the imbalance in caloric intake among HCPs. Over 40% of participants consumed either insufficient or excessive calories, both of which can have serious health implications. Insufficient caloric intake can lead to fatigue, weakened immunity, and impaired cognitive function, while excessive intake is a key driver of obesity and metabolic disorders.

This caloric imbalance is not unique to Nepal. A 2022 study by Ydyrysheva et al. found that medical workers in shift-based roles often struggle with maintaining a balanced diet, leading to similar patterns of over- or under-eating. The study also noted that shift work disrupts circadian rhythms, further complicating dietary habits and increasing the risk of metabolic syndrome.

The Ripple Effect on Patient Care

The implications of poor nutrition among HCPs extend far beyond individual health. Research by Lemaire et al. (2010) has shown that inadequate nutrition can impair cognitive function, reduce energy levels, and negatively impact decision-making abilities. For healthcare professionals, whose jobs require precision, focus, and empathy, these effects can be particularly detrimental.

In low-resource settings like Nepal, where healthcare systems are already under strain, the well-being of HCPs is critical to sustaining effective healthcare delivery. As Dr. Chen (2021) aptly noted in his study on the dietary health of medical workers, “When healthcare professionals are unhealthy, the entire healthcare system suffers.”

A Call to Action: What Can Be Done?

The findings of this study underscore the urgent need for interventions at both the individual and institutional levels. Workplace wellness programs that prioritize nutritional education, stress management, and access to healthier food options could go a long way in improving dietary habits among HCPs. For example, hospitals could establish on-site cafeterias offering balanced meals, or provide HCPs with meal vouchers for healthier options.

Policies that encourage regular meal breaks and reduce time constraints are also essential. As Simkhada et al. (2011) noted in their study on civil servants in Nepal, even small changes in workplace policies can have a significant impact on employees’ health and productivity.

Moreover, future research should incorporate comprehensive nutritional assessments, including laboratory tests for micronutrient levels, lipid profiles, and glucose levels, to provide a more holistic understanding of HCPs’ nutritional status. Such data could inform targeted interventions, such as personalized nutrition plans or supplementation programs.

The Bigger Picture: A Healthier Future for Healthcare Professionals

The study serves as a timely reminder that healthcare professionals are not immune to the challenges of maintaining a healthy lifestyle. In fact, their unique circumstances—long hours, high stress, and irregular shifts—make them particularly vulnerable to poor dietary habits and their associated health risks.

Addressing these challenges is not just a moral imperative but a practical necessity. Healthier healthcare professionals mean healthier patients—and a healthier society. As the study concludes, “Ensuring the well-being of HCPs is not just an investment in their health, but an investment in the health of the communities they serve.”

In a world where HCPs are often too busy caring for others to care for themselves, this study is a wake-up call. It’s time to prioritize the health of those who dedicate their lives to healing others. After all, a healthier healthcare workforce is the foundation of a healthier world.

Plants have long been a cornerstone of traditional medicine and nutrition, with their bioactive components contributing significantly to their medicinal value. One such plant genus with notable bioactive phytochemicals is Linum usitatissimum, commonly known as flax. Flax is an ancient crop primarily cultivated in the northern hemisphere, where it thrives in colder climates. Canada is currently the world’s largest producer of flaxseed, followed by China, Russia, the USA, India, Nepal, and several European countries. This plant is grown for both its fiber and its nutrient-rich seeds, known as flaxseeds or linseeds.

Flax fibers are used to produce the renowned textile linen, a material with a history spanning over 5,000 years [1]. Egyptian priests wore linen garments daily, and even the mummies of pharaohs were wrapped in fine linen fabrics, many of which have been preserved to this day. Linen is believed to offer several health benefits, such as improving blood circulation and enhancing sleep quality, while its unique frequency is currently being studied for its potential healing properties [2].

Given that the seed is the most utilized part of the plant, the whole plant is often referred to as the flaxseed plant. Flaxseed has been valued for centuries for its nutritional and therapeutic properties. Initially prized by indigenous communities, it has recently gained popularity among contemporary populations for its health benefits. In Ayurvedic medicine, flaxseed is renowned for its medicinal properties and healing potential. The gel derived from flaxseed is traditionally applied externally for healing bone fractures and treating skin conditions, while flaxseed oil is believed to enhance memory, improve blood circulation, boost immunity, and reduce bad cholesterol levels.

Flaxseed is an abundant source of proteins, lignans, omega-3 fatty acids, and other phytochemicals, providing numerous health advantages. It is reported to contain a high percentage (87.8-89.8%) of unsaturated fatty acids, making it an excellent source of healthy fats [3]. Research has shown that flaxseed oil is rich in alpha-linolenic acid (ALA), an omega-3 fatty acid essential for neuron myelination and memory formation [4]. Furthermore, flaxseed is a rich source of protein, comprising 23% of its total weight, and is considered a complete protein containing all essential amino acids. A comparative study revealed that flaxseed has a higher total protein content than soybeans, with a quality score of 82% [5].

The high fiber content in flaxseed helps absorb cholesterol and triglycerides, regulate blood sugar levels, and boost metabolism, thereby aiding in weight management [6]. Flaxseed is also rich in vitamins E and K, and essential minerals such as calcium, magnesium, and phosphorus, which support blood clotting, calcium deposition, and skin health [7].

Flaxseed’s antioxidant and anti-inflammatory properties make it particularly beneficial for overall health. It is often recommended by doctors for heart disease, obesity, bone deformities, and especially for treating hormonal imbalances in women. As a phytoestrogen, flaxseed naturally balances estrogen, the hormone responsible for regulating bone mass density, menstruation, and various other processes in females. It is especially beneficial for women over the age of 45 who are approaching menopause [8].

To utilize its diverse properties, flaxseed is formulated into tablets, emulsions, and powders to treat various ailments. The most common formulation is flaxseed oil capsules, which are rich in fatty acids and are effective for enhancing memory, improving skin health, and supporting weight loss. These capsules serve as an excellent alternative to fish oil for vegetarians and vegans. Additionally, flaxseed can be incorporated into daily meals by adding flaxseed powder to cooked foods or using it as a seasoning for salads.

Despite its well-documented nutritional benefits, flaxseed remains underutilized. Given its potential, it is crucial to raise awareness about this beneficial seed and encourage its wider use in daily diets.

Introduction

Historically, chili is one of the oldest domesticated crops in the world  Since they contain impressively beneficial chemical compounds such as capsaicinoids, carotenoids (provitamin A), flavonoids, vitamins (Vitamins C and E), minerals, essential oils, and aromas, they are consumed by a large section of the population throughout the world. In addition to their color, aroma, and characteristic pungency, they are widely used throughout the world as a flavoring and spice. Worldwide, chili is cultivated for its nutritional, medicinal, and economic properties. A good source of antioxidants and potent compounds with biological activities, including capsaicinoids and phenolic acids, is chilies (Chapa-Oliver et al 2016; Manju et al 2002).

History of chilli

Prehistoric humans used chili as a food source. Chilis are grown almost everywhere, regardless of the climate or environment. They are relatively easy to cultivate in nearly any climate or environment. From the terai to the mid-hills of Nepal, chilies are widely cultivated, varying in color, flavor, and pungency. As a spice crop, it occupies the fourth position with a productivity of 3.45 t/ha. Nepalese kitchens are incomplete without it. Both green and dried chilies are commonly used for various purposes (Thapa et al., 2009).

Chili in the food industry

From ancient times, chilies have been one of the most important spices or savory food additives. Besides serving as a vegetable, spice, and value-added processed product, chili has become the most important commercial crop in the world (Ochoa-Alejo & Ramirez-Malagon 2001). However, chilies are not consumed as stand-alone dishes; instead, they are processed into spice powders, oils, sauces, pastes, etc. for flavor and color. Chili is popular worldwide due to the combination of color, flavor, and nutritional value In contrast to synthetic food preservatives, spices are gaining popularity among consumers (Loizzo et al 2017).

Chilies medicinal properties

For centuries, chili powder has been used as a medicine in Ayurvedic preparations as oil extracts and as a major ingredient in therapeutic remedies (Thapa et al 2009). It has been reported that chilies contain compounds that can exert multiple physiological and pharmacological effects, such as analgesia, anticancer activity, anti-inflammatory activity, antioxidant activity, and anti-obesity potential (Abdurahman, 2016; Caporaso et al. 2013). Pain can be relieved with capsaicin topical ointments, nasal sprays, and dermal patches (Ashwini et al. 2015; Prakash et al. 2017). In addition to treating asthma, coughs, sore throats, toothaches, and shingles, chili is used to relieve pain in rheumatoid arthritis, nerve damage, and diabetic neuropathy. (Goci et al., 2014). Studies have shown that chili reduces the likelihood of developing atherosclerosis by reducing blood cholesterol, triglyceride levels, and platelet aggregation as well as increasing fibrinolytic activity (Chopan & Littenberg 2017).

Chilies anti-oxidant properties

Capsaicinoids, carotenoids, and phenolic compounds in chili give the fruit an antioxidant property (Leonor et al 2016). Chili shows antioxidant activities because of the presence of the groups in the phenolic ring (a methoxy group in ortho position to OH) of capsaicinoids and ferulic acid ester, which influenced the antioxidant properties (Viktorija et al 2014). 

Chili and its antimicrobial properties

Chili contains bioactive compounds that have been known to act as a defense mechanism in them. It has been proven to show antimicrobial activity against Staphylococcus aureus, Salmonella typhimurium, Listeria monocytogene, Helicobacter pylori, Pseudomonas aeruginosa, and Bacillus cereus, (Grande-Villanueva et al 2015; Marini et al 2015).

Nutrients in chilies and their health benefits

Chili consists of an equally rich mix of phytonutrients which are the products of secondary metabolism that tend to exhibit ecological functions like plant defense against microbial and fungal pathogens and insect pests(Blanco-Rios et al 2017). Certain studies have proved that the consumption of these phytonutrients confers health benefits such as protection against oxidative damage to cells, preventing the development of common degenerative diseases and risk of coronary heart disease, stroke, and ocular diseases, cardio-protective, anti-microbial, anti-inflammatory, anti-mutagenic agents and possess the ability to scavenge singlet oxygen, inhibit free radicals, decompose peroxide and chelate metals (Salehi et al 2018). They also prevent the oxidation of essential fats within the cells of the brain that are considered necessary for its optimal functioning (Blanco-Ríos et al 2013).

Active constituents present include carotenoids, phenolic compounds, vitamins A, B, and C, volatile oils, flavonoids like β-carotene, α-carotene, lutein, zeaxanthin, and cryptoxanthin, minerals like potassium, manganese, iron and magnesium and other bioactive compounds such as sinapic acid, ferulic acid, violaxanthin, etc. (Baenas et al  2019).

Both sweet and hot varieties of capsicum are rich in vitamin C, and able to satisfy the RDI (Recommended Daily Dose) of 90 mg/100 g (FDA, 2020) in a single cup serving. Vitamin A is found in the form of β-Carotene. Chilis also find their use in the production of synthetic drugs for pain because of the neuroprotective activity of some phenolic compounds. Most forms of chili are rich in many minerals, vitamins, and amino acids essential for human health and growth. They are very high in potassium, magnesium, manganese, and iron, rich in calcium and phosphorus, and are good sources of vitamins K and B in addition to lycopene, flavonoids, and trace metals. A combination of these rich nutrients and antioxidant properties of the phytochemicals inherent in the C(Oǧuzkan 2019).

Their attractive colors are due to the presence of carotenoid and flavonoid pigments. β-carotene with pro-vitamin A activity and oxygenated carotenoids such as capsantine, capsorubin, and cryptocapsin are exclusive to chili. They also contain large quantities of neutral phenolic compounds or flavonoids called quercetin and luteolin(Lu et al., 2017).