What’s wrong with the Indian diet?

With delectable flavours and fragrant spices, Indian cuisine is certainly popular around the world. In addition to its wide variety of rich flavours, a traditional Indian diet also boasts of a wide variety of nutrients in a balanced quantity. However, on the flip side, obesity and diabetes still continue to be a significant public health concern for India.
According to the medical journal Lancet, the burden of diabetes is rapidly increasing in India and there is an estimated 72.96 million cases of diabetes in the adult population of the country as of now. Infact, India has been deemed as the world’s capital of diabetes. So, for a nation that boasts of lentils, fresh and fruits and vegetables as an integral part of its diet, where exactly did we go wrong?

Is our growing inclination towards western food (pizza, burger, fries etc.) to be blamed or is there more to the Indian diet? We connected with a renowned cardiologist and famous author Dr Aseem Malhotra and asked him to shed light on the same. In this riveting conversation, Dr Aseem touched upon several eye-opening facts and misconceptions about the Indian diet that continue to plague our minds even today. Here is an excerpt from the conversation:

The role of comorbidity and death from COVID-19

Dr Aseem emphasized on the fact that even as the novel coronavirus continues to wreak havoc across the globe, it is the people with underlying chronic metabolic diseases including high blood pressure, obesity and type 2 diabetes which are affected the most. India has the highest prevalence of type 2 diabetes in the world, which on an average reduced the life expectancy by up to 10 years.

The relationship between Indians and chronic metabolic syndrome

In India, 43 per cent of people with normal BMI (Body Mass Index) are metabolically unhealthy. This means that a huge proportion of people are living in this illusion of protection thinking that they are not overweight or unhealthy.

Dr Aseem spoke at length about metabolic syndrome and how 1 in 3 adults in India are suffering from this syndrome. He defined metabolic health using these 5 parameters:

Your blood pressure should be ideally less than 120 over 80 mm Hg

You should not have pre-diabetes or type 2 diabetes

Your triglyceride levels should be less than 1.7 millimoles per litre

Your good cholesterol (HDL) should be greater than 1 millimoles per litre.

If you are a man your waist circumference should be less than 90 cms and for a woman, it should be less than 85 cms.

This essentially means that even if your BMI is ideal, if you have excess fat around your body or any of the above-mentioned parameters, you are probably not as healthy as you may think.

Extra sugar, fried snacks and refined carbohydrates: Everything wrong with the Indian diet

Quite appropriately, when talking about the word ”diet”, Dr Aseem linked it to its greek origin ‘diaita’, which essentially means ‘lifestyle’. Surprisingly, 70 per cent of Indian diet calories come from consuming carbohydrates and most of them are not necessarily from the best quality of carbohydrates. These poor quality carbohydrates include a lot of sugar, flour-based products, snacks loaded with starch, loaves of bread, and white rice. Another shocking finding shared by Dr Aseem is that an average Indian consumes at least 15 teaspoons sugar in the form fruit juices, sweets, sugar-laden drinks and snacks. He underlined the fact that while one does not need any amount of sugar to stay healthy, the World Health Organization has drawn the upper limit on five teaspoons of sugar per day. This essentially means, Indians are probably consuming 3-4 times of sugar then they should.

Your diet can reverse type-2 diabetes

Contrary to popular beliefs, Dr Aseem explained that it is never too late to change your dietary habits as it can help you reverse type 2 habits within weeks. This can be done by carefully monitoring your diet and changing the needful. For the uninitiated, Dr Aseem has been working with type 2 diabetes patients and empowering them to reverse the same with the help of lifestyle and dietary changes.

While he did not advise the patients to instantly stop taking the medications, he did recommend dietary changes for type-2 diabetes patients. He stated that medications and insulin for type-2 diabetes do not work on increasing the lifespan or reducing the chances of a heart attack and they also come with their side-effects.

When you work on reversing type-2 diabetes, you not only take away the immeasurable suffering of the patients and the impact this disease has on their nerves, eyes, kidneys etc but it also adds years to their lives, he added. Since the patients of type 2 diabetes tend to have a particular sensitivity to the sugars and refined carbohydrates, when they begin to cut down the sugar, rice, bread, potatoes etc, their blood glucose level may start to go down in a span of few weeks.

As a result, they may end up reducing the medication dosage when advised by their doctor. He pointed out that type 2 diabetes is a condition of carbohydrates intolerance, so shunning the glucose and carbohydrate-laden products like rice, breads, pasta, sugar etc can do wonders for the patient. Additionally, junk and processed food items should be replaced with whole foods including fresh fruits and vegetables. He also said that fruit juices should be avoided as they are full of sugar and whole fruits should be added to the diet instead.

The relationship between the Keto diet and managing type-2 diabetes

The cardiologist underlined that whole food-based Keto diet can be very beneficial for those battling type-2 diabetes. On the other hand low-sugar, low refined carbohydrate, a Mediterranean inspired diet with lots of vegetables or unprocessed meat like lamb, chicken and fish can also be a part of a healthy diet.

He also busted the prevalent myth of eating as frequently as every two hours and said that there is no legitimate need for the majority of the people to eat every two hours, no matter what is being propagated on the internet.

The goodness of Intermittent diet

When you cut down the sugar and starch in the form of junk food, snacks and packaged food items, you actually eat to fullness and don’t feel as hungry as before. Speaking about Intermittent diet, Dr Aseem agreed that there are emerging pieces of evidence which back the claim that it can be good for your metabolic health. He also underlined different methods of doing the intermittent diet and explained that for two or three times a week, he fasts for 16 hours a day and eats in a window between 12 to 8 pm.

The lack of protein in the average Indian diet

As per a statement by the Indian Dietetic Association, a whopping 84 per cent of Indians are protein deficient! This is not surprising considering the fact that meat inadvertently remains one of the best sources of protein, which doesn’t find its place in an average Indian thali. He pointed out that protein deficiency poses a big threat to the elderlies as they lose muscle mass and strength with age.

He listed down some of the best sources of protein which included eggs, paneer (cottage cheese), lentils etc and pointed out that Indians need to consume more of these protein-rich products in their diet instead of flour-based products and rice.
Eggs remain one of the best sources of protein, including the yolk. The cardiologist reiterated the fact that the cholesterol present in egg yolks does not raise our cholesterol and will not give you a heart attack.

Move over vegetable oils, it is time to bring back desi ghee

The vegetable seed oils used for cooking in the Indian households including the sunflower oil, canola and soybean oil are not exactly healthy. Dr Aseem suggests swapping them with desi ghee, coconut oil and extra virgin oil. Since these oils remain quite stable even after they are heated up, they make for a healthier alternative to the vegetable oils that become toxic after heating.

He also reiterated that the adoption of the modern western diet through these fast food joints is actually increasing the consumption of toxic food items and should be avoided as much as possible.

Why you need to quit smoking and start walking

It is important to note that the reduction in smoking remains one of the biggest reasons for lowering the death rate from heart disease in the UK and US. Infact, he points out that quitting smoking can be more powerful than all the medications given for reducing the risk of a future heart attack combined together.

Dr Aseem also simplified the whole formula of physical activities and nudged the people to take out 30 minutes every day from their daily routine and go for a brisk walk, at least five times a week. The need to get up and get moving for at least 30 minutes is all the more important in this work from home era where we stay glued to our laptop screens for an immeasurable about of time.

If you have trouble getting sound sleep at night, Dr Aseem advises cutting down on tea and coffee (due to their caffeine content) after midday as they act as stimulants. Incorporating yoga and meditation in the daily routine is another important part of calming down your mind and sleeping well at night. It also helps to dial down the stress levels.

The truth of Vegan and Vegetarian diet

When it comes to the diet you are following, it is never a good idea to go to any extremes. So, if you have switched to a Vegan or Vegetarian diet, it is important that you include more vegetables in your daily meals when compared to white rice, bread or other flour-based products. Since protein deficiency seems to be more common in vegetarians, closely monitor your protein intake for the day and include pulses, lentils, chickpeas, paneer (cottage cheese) and spinach. As a rule of thumb, you should consume 1 gram of protein per kilogram of your weight.