Kazakhstan sounds alarm on dietary health

ALMATY – Kazakhstani nutritionists are sounding the alarm about the effects of not eating right.

In the past decade, the incidence of gastrointestinal diseases has nearly quadrupled (19,490 people out of 100,000 had chronic gastrointestinal disorders in 2011, up from about 5,000 in 1998). And in the country’s most populous city, Almaty, a fifth of residents are overweight, according to the Health Ministry.

Such problems make people “candidates for endocrine disorders,” a more serious long-term problem, said Almaty Health Department Director Roza Kuanyshbekova, and the country is trying to stem the tide.

Raising nutritional awareness is a challenge

The problem did not arise out of thin air; Kazakh cuisine relies heavily on meat and lard, nutritionists say. And the trendiness of fast food is exacerbating the problem.

Healthy eating must include a variety of cereals, fish, dairy products and no less than 0.4 to 0.5kg daily of fresh vegetables and fruits daily, said Dr. Sofia Kalashidi, a dietician.

To raise awareness about eating right, the Kazakh Academy of Nutrition and the National Association of Gastroenterologists (NAG) pushed for the celebration of World Digestive Health Day. World Digestive Health Day was first observed in 2005 and about 50 countries celebrate it annually May 29. However, this year was the first time Kazakhstan marked the day.

But changing people’s habits is an uphill battle.

Almaty resident Alma Musatayeva, 53, for example, has become a frequent patient at the local clinic lately.

“I understand it’s my fault,” said Musatayeva, who is overweight and suffers from stomach pain and high cholesterol. “As a housewife in a large Kazakh family, I have to constantly cook, and we’re used to our dishes from childhood – besparmak (horse meat and noodle stew), plov (pilaf), manti (meat dumplings) and kuyrdak (meat stew with dough dumplings).”

Musatayeva knows about the concerns nutritionists have but has been slow to embrace change. “I would like to support this campaign, but then I’d upset my family by not cooking their favourite dishes,” she said.

And the younger generation seems to be putting dietary concerns on the back burner.

Alisher Karimov, a student from Almaty, for example, said he eats fast food almost every day. “It’s fast, tasty and relatively cheap,” he said. “I understand that it can be bad for you, but cooking in a dorm is inconvenient, and only restaurants, which I can’t afford, have healthy food.”

He said he has nothing to worry about until he gets older. “I will think about healthy food after about age 40,” Karimov said.

But Kazakhstani nutritionists would like people to follow more positive examples, such as that of Tatyana Starovoitova.

“I re-examined my lifestyle as soon as I started having health problems – heartburn, pain, a constant heavy feeling in my stomach,” said Starovoitova, 45, of Karaganda. “The doctor gave me a diagnosis, and I got treatment, but I decided to change my life and my family’s life.”

She no longer takes sugar with her tea and abstains from lard, fried foods or fast food.

“We live in a multi-ethnic country, and my family used to eat greasy Russian borscht and fatty beshparmak, but now we just have light healthy food, a lot of vegetables, especially in season,” she said.

And her family didn’t fight the change.

“They all support my idea of healthy eating, which benefits everybody – children and adults," Starovoitova said.

Upgrading existing efforts

Post-Soviet countries almost completely lack a system to teach healthy eating, said Oleg Babek, a professor and the director of the Gastroenterology Department at the Ukrainian Institute of Therapy.

“But primary care starts precisely with this – understanding the principles of a healthy diet,” he said. “Disease prevention is much cheaper than treatment.”

Kazahkstan has made changes in its approach to nutritional education. In 2011, Kazakhstan adopted Salamatty Kazakhstan, a 2011-2015 nationwide health development initiative that provides healthy food to Kazakhstanis.

And NAG started publishing a health journal that offers articles about eating right. NAG also plans to organise several scholarly conferences to teach local doctors to better convey the principles of sensible eating to patients, NAG President Roza Bektayeva said.