Traditional food could help reverse Nepal’s ‘diabetes epidemic’, studies suggest | Global health

A return to traditional lentil and rice dishes that have nourished generations of Nepalis could save them from a diabetes epidemic brought on by the influx of Western junk food, doctors said.

In a country where one in five people over the age of 40 suffer from type 2 diabetes, foods eaten by grandparents have shown remarkable results in reversing the disease.

Diabetes medications are largely unaffordable in Nepal, and type 2 diabetes often triggers a cascade of complications that can include kidney disease, limb loss and blindness. Uncontrolled, it will ultimately lead to premature death.

“For many families, diabetes is not just a medical problem, but a long-term social and economic burden,” said Dr. Ashish Tamang, a resident physician based in Kathmandu.

A pilot study conducted in the Nepalese capital among 70 hospitalized patients with long-standing diabetes enabled 43% of them to enter remission by submitting them to a traditional calorie-controlled diet. An ongoing trial involving 120 people in villages and communities on the outskirts of cities has shown equal promise.

“It’s still very early days, but around half of people are diabetes-free after four months, with an average weight loss of just 4-5kg,” said Professor Mike Lean, an expert in diabetes and human nutrition from the University of Glasgow.

The approach is being rolled out more widely, as part of a four-year study led by the University of Glasgow in collaboration with Dhulikhel Hospital, Nepal. They hope to show that the diet can also prevent people at high risk of type 2 diabetes from developing the disease.

Type 2 diabetes is characterized by high blood sugar levels, caused by the body not producing enough insulin, or the insulin it produces not working properly. It is often triggered by excess weight.

Lean was part of a British team that showed in 2017 that putting patients on weight-loss diets of soups and shakes could reverse their diabetes. The program is now part of standard NHS diabetes care.

After the results were published, he was approached by doctors working in Nepal to see if a similar approach could work in the South Asian country. He says it could be even more effective there than in the UK.

People of Asian descent are genetically predisposed to type 2 diabetes. That means “they just have to gain less weight before they start to have diabetes,” Lean said. But it also means they “don’t need to lose much to get rid of it.”

While British patients might need to lose between 10 and 15kg to reverse their diabetes, “in Nepal it’s about half that”, Lean said. “It makes it a little easier.”

So the team decided to come up with a plan using local, inexpensive ingredients.

Participants were asked to follow a weight loss plan of 850 calories a day for eight weeks – typically a breakfast of yogurt and fruit, and main meals of lentils and rice, called dal bhat. They then switched to a higher-calorie version of the same diet to maintain their lower weight.

At the screening camps, people with diabetes or at high risk of diabetes were given a cup, measuring cup and weighing equipment along with a diet plan to ensure they stuck to specific serving sizes. They were also invited to attend regular support group sessions.

The idea was to carry out an intervention in communities, without the need for doctors or hospitals, with the help of female volunteers who constitute the backbone of the country’s health system.

The trial design documents describe the plan as one that “emphasizes a disciplined (traditional) eating pattern, avoiding snacking and processed Western-style foods high in fat and sugar.”

A 2025 study found that 87% of packaged foods sold in Kathmandu stores exceeded the World Health Organization’s recommended thresholds for contents such as sugar, fat and salt.

Lean said the approach was “not complicated.” But it was “much more effective than any medication or medicine, and than traditional medicines which do nothing.”

He also encouraged attendees to switch back to brown rice rather than double-milled white rice, which contains fewer nutrients, including lower levels of vitamin B1, which plays a role in how the body handles carbohydrates.

The expanded study initially secured funding from the British government, but fell victim to budget cuts. The Howard Foundation stepped in with £1.78 million to enable it to continue. The project will also create educational materials on the determinants of diabetes.

Lean attributes soaring rates of type 2 diabetes in Nepal to the importation of Western junk food. He spoke with Nepalese people who “remember the first bicycle to arrive in their village”. That bike was carrying candy and soft drinks, he said. And as transport links improved, junk food started arriving on motorbikes, then cars and vans “and now it’s everywhere”.

Lower activity levels, where technological advances make work less physically strenuous, are also a driver of rising rates, the study team said.

At conferences, Lean says he has been approached by officials from neighboring countries also facing rising diabetes rates. “They all said, ‘If it works in Nepal, it will work for us.’ »