Tadias Magazine
By Dr. Asqual Getaneh & Dr. Adam Waksor

Updated: Saturday, August 23, 2008

New York (TADIAS) – Every few years a new fad diet, which promises to slim, beautify, energize and prolong life hits the media and ends up on the shelves and kitchen tables of America. It is a staggering 30 billion dollar market. Paradoxically, Americans continue to expand and suffer significant obesity related morbidities. Ethiopians in the U.S. usually ridicule the folly of these diets. We also do not heed the numerous sound directives from the U.S. Surgeon General on healthy diet, tobacco cessation and exercise. Celebrating one of the most complex cuisines in the world, most of us continue to indulge in the sinfully rich kitfo, downing it with a stiff Black Label as often and as much as possible and with humor. Some of us finish off with a well-branded cigarette [or Shisha].

True, a few of us might choose the heart friendly red wines; and humor does contribute to healthy arteries. The effect, even so, is an ever growing mid-riff, inflamed and clogged arteries and the associated health problems. Anecdotal information shows that the prevalence of diabetes, high blood pressure and high cholesterol are on the rise both among Ethiopians living in the West and the affluent urbanized population in Ethiopia. These conditions, individually and together with tobacco, are the leading causes of heart attacks and strokes. Among Ethiopians in the U.S., a coronary artery bypass surgery after an unexpected heart attack in a man in his 40’s is no longer a rare occurrence. In fact he is considered lucky to have survived.

Ethiopians living in the West (or the urbanized in Ethiopia), in general, have undergone a nutrition transition. In content, our diet has changed from a relatively diversified menu, which included legumes (shiro), vegetables (like gomen) and high fiber grains (teff) to an almost exclusively meat-centered (kitfo/tibs), refined carbohydrates (rice/wheat based injera) and animal fat diet (kibae). In quantity, we have subscribed to the American super sizing of food, or in Ethiopian restaurant parlance – a “combination plate”. Large quantities of rich food, which would have been eaten over several days in Ethiopia are consumed as a meal. Thanks to the many Ethiopian eateries and tireless family members who pack luggages full of food, there is easy access to a cheap, familiar and delectable meal every day. In addition, we have an appetite for fatty and spicy cooking. The preference for fat might be biological and not unique to Ethiopians. The key however is our conscious contribution to a sustained fat consumption, which in itself leads to changes in our brain. As a result, our appetite cues and energy expenditure are negatively influenced. In a nutshell fat begets fat through a complex neurological and chemical regulation.

Not only are we consuming high fat and large portions of food, but also our lifestyle has not kept up with our energy consumption. Unless expended, the body stores all excess energy from dietary fat, alcohol or vegetables as body fat for use in time of caloric need. In affluent societies there is no time of need if it is not artificially introduced, for example as aerobic exercises. A high-energy diet requires a consciously planned parallel program of energy expenditure. Admittedly, having an exercise plan and adhering to it is difficult in the era of long-commutes, parking garages, office jobs and the rush to attain the trappings of life in the West. Our relaxation and socialization also revolves around elaborate meat-centered feasts and alcohol and not enough around physical activity.

Besides its many direct toxic effects on brain, blood and liver cells, drinking moderate to heavy alcohol limits one’s exercise capacity. It increases the risk of dehydration through its diuretic effect and reduces endurance and blood sugar levels limiting the duration of physical activity. Heavy alcohol use also contributes to weight gain, which in turn limits exercise capacity. However, it has been shown that low to moderate consumption of alcohol has beneficial effects on energy intake and on lipid (cholesterol) profile.

We admit that Kitfo and alcohol together do not have as much devastating effect as cigarette smoking on health. Sporting Marlboro Light, Camel or Winston reeks havoc on the human body from skin changes, to cancers to heart attacks and strokes. If one were to do only one thing today to benefit his health, smoking cessation will be the most important step towards better health. However, we will leave this main health hazard for a later issue.

So, our beef with kitfo is its frequent and excessive use, its high content of butter, its frequent coupling with heavy alcohol and smoking in many cases, and the lack of any mitigating lifestyle habits such as exercising, a balanced diversified diet and normal weight.

A few tips…

*Keep kitfo and other heavy fat meals as delicacies, for special occasions.

*Keep your midriff slim without plastic surgery. Plastic surgery does not have beneficial effect on health as loss of abdominal fat. Know your waist to hip circumference ratio and keep at goal. This ratio should be less than 0.8 for women and less than one for men.

*Know your body mass index (BMI) and keep at goal: BMI is calculated as follows. Weight in kilogram divided by height in meters squared. A BMI between 18.5 and 24.9 refl ects normal weight. Between 25 and 29.9 is considered overweight. Over 30 is in the obese range, which is associated with a significant risk for developing diabetes, high blood pressure and their complications, arthritis, liver and gall bladder diseases.

*If the portion of meat is more than the size of your palm (3 ounces or 85 grams), it is too much. And, in general you should not have more than two of these a day.

*A gram of fat has 8 calories, a gram of protein and carbohydrates have 4 calories and a gram of alcohol has 7 calories (one teaspoon of butter has 5 grams of fat).

*If your plate does not contain more than one color, you are not getting adequate nutrition and are most likely consuming more calories than you need. Different colors in fruits and vegetables are a low caloric source of various vitamins and minerals.

*If you are having more than 5 drinks a week, your body is taking too much. More than two units for women and three units of alcohol a day for men are excessive.

*Cigarettes are passé and no longer chic or cool.

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