Introduction

  This study examined the diets of Nepalese people at the food/dietary level and nutrient level using a scoping review method. We clarified the transition in nutritional balance between the traditional Nepalese diet, “dal bhat tarkari” and the modern diet and considered the impacts on health (especially diabetes).

Method

  For the literature review, PubMed, Science Direct, and the Japanese database “Ichushi-web” were used, and 23 references that reported the Nepalese diet at food/diet and nutrient levels were adopted. Because no Nepal-specific indicators were available to assess the diet, we used the standards for healthy diet published by the WHO and Japan’s Ministry of Health, Labour and Welfare.

Results

  “Dal bhat tarkari” is a combination of beans, rice, and curry-flavored vegetables. At the food/diet level, we found more cereal content and less meat, legumes, vegetables, and fruit contents compared to the WHO reference values. In terms of nutrients, according to Japanese standards, it is high in carbohydrates and low in protein and fat. However, with the additional and increased intake of modern foods, the intake of carbohydrates and fats has become excessive. These excessive intakes, combined with inadequate vegetable intake in some seasons, can put people at risk for non-communicable diseases (NCDs).

Conclusion

  “Dal bhat tarkari” has always tended to have a high percentage of carbohydrates, and the amount and quality of carbohydrates must be carefully monitored. It is important to understand the overall picture of the local diet and then consider a well-balanced diet with a good combination of legumes and meats as protein sources, vegetables, and fruits. Nepal is no different from other countries in that modern food is becoming more prevalent, and it is necessary to pay more attention to the combination of traditional and modern foods.

  It is known that men who have sex with men (MSM) are highly vulnerable to human immunodeficiency virus (HIV) and other sexually transmitted infections (STI). However, social stigma withholds them from necessary health services. Therefore, a workshop was designed to promote condom use and prevent HIV and other STIs among MSM.

  The workshop was developed based on the Health Belief Model, and covering topics such as anal intercourse and common practice among MSM. Furthermore, MSM self-support group members took a role of facilitators.

  A total of 13 workshops were conducted from November 2013 to February 2014 in Kilifi County, Kenya. The venue was a public hospital where the MSM self-support group usually held activities. The workshops would last 2 hours and were completed in one session. A total of 170 MSM were recruited using a snowball sampling method. Participants voluntarily answered the survey before and after the workshop.

  Data from 139 individuals was analyzed, with the mean age of 26.8 years (standard deviation ± 6.69), where 33 participants identified as gay, 90 as bi-sexual, 15 as others and 1 not responded. Significant positive changes observed in the mean scores of participants regarding self-esteems (p＝0.0123), safer sex intention (p＝0.0006), and knowledge on safer sex (p＝0.0024). Some participants also acknowledged that the workshop helped them gain knowledge and was beneficial to the MSM community.

  The workshop successfully recruited 170 MSM and improved self-efficacy, attitude, and knowledge of the participants. This intervention implied several tips for successful MSM recruitment were employed a follows:; 1) offering a secure environment for MSM 2) involving peer facilitators, 3) using a snowball sampling method, 4) presenting several choices of workshop dates, and 5) explaining safe anal intercourse and offering content unique to MSM. This framework can be applicable to interventions involving marginalized populations in other regions.