The food we eat is vital to our health, but “moderation is the key.” A balanced diet of fruits, vegetables, lean proteins, and whole grains promotes well-being. Overconsumption of certain foods, however, can lead to severe consequences.

A Thai dish, Koi Pla, is especially dangerous, causing about 20,000 deaths annually. Made with raw fish, lemon juice, herbs, and spices, it appears harmless. Yet, the fish is often contaminated with parasitic flatworms from Mekong waters. These parasites attack the liver, causing liver cancer, which is prevalent in East Asia.

Dr. Narong Khuntikeo is raising awareness about Koi Pla’s dangers, driven by personal loss—his parents died of liver cancer after eating the dish. Despite his efforts, many locals in Laos and Isan refuse to abandon the tradition.

In 2017, Dr. Khuntikeo and scientists tested villagers who consume Koi Pla daily. “Around 80 percent” of participants showed signs of infection. He described the health crisis as severe yet largely ignored: “They die quietly, like leaves falling from a tree.”

Even when presented with evidence, many remain indifferent. One villager remarked, “Oh well, there are many ways to die.” Another admitted, “I’ve been eating (koi pla) since I was little,” accepting the risks as unavoidable.