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November is Diabetes Awareness Month.
Our health vastly depends on what we eat. We Indians have certain eating habits that make us more prone to various health issues than our Western counterparts. According to WHO, by the year 2025, India will be the diabetes capital of the world. The International Diabetes Federation states that every sixth diabetic in the world is an Indian. Such staggering figures scream for a change in our dietary habits. In order to do so, we need to know where we are going wrong. One of India's top nutritionist Ishi Khosla, in her book 'The Diet Doctor: The Scientifically Proven Way to Lose Weight', tells us more on where the Indian diet and eating habits fall short. Here's an excerpt from the book:
High-carbohydrate and high-glycaemic diets
While most traditional diets globally are centred on carbohydrates, particularly through cereals, Indian diets tend to have multiple staples rice, wheat, potatoes, pulses coupled with high levels of sweets and sugars through sweetened drinks and bakery. With the advent of modernization, cereals now undergo processing, which robs them of protective nutrients and fibre. A sharp increase in the consumption of refined carbohydrates since the 1960s has contributed to the epidemic of obesity in India.
On top of this, the high glycaemic index (GI) of Indian diets a necessity for our ancestors' lifestyles is not serving us well. GI ranks foods on the basis of their ability to raise blood sugar levels.
Pure glucose has the highest GI that is, 100 and raw, uncooked vegetables have among the lowest GI. High-GI foods are associated with obesity, metabolic syndrome, diabetes, dyslipidemia (abnormal cholesterol levels) and heart disease.
The myth of the Indian vegetarian diet
Vegetarians worldwide are far fitter, with normal lipid profiles andlow rates of heart disease, than Indians. In a large-scale scientificstudy, nearly half the participants were lifelong vegetarians and yet therates of obesity and heart disease were similar to those found amongnon-vegetarians. In fact, the rates of diabetes were actually higheramong the vegetarians.4 This is because the concept of vegetarianismis different among Indians, who eat large amounts of high-glycaemiccarbohydrates, potatoes, fry food frequently and reuse the oil, and donot include enough raw foods, salads and fruits, which must be centralto a good vegetarian diet. (Read: Vegan diet - good or bad for health?)
Sugar and sweetened products
In India, our intake of sweets and sweetened drinks (sherbets, lemon water [nimbu-pani], etc.) is naturally very high. Additionally, our towns and cities are big consumers of aerated drinks. Read more about sugar-free sweets and find out if they are any better.
Poor quality and nature of fats
Trans fats (also known as trans-fatty acids or TFAs), the most harmful kind of fat, have entered our diets in a big way through commercially available snacks, biscuits, cookies, fried foods and refined oils. The high intake of trans fats is associated with insulin resistance and weight gain around the abdomen. Indians, like most other Asians, have a tendency to accumulate girth around the abdomen, possibly due to diminished tolerance for trans fats.
Snacking is a big part of the Indian diet. Traditional Indian snacks such as samosas, namkeens and bhujias are made out of highly refined and processed foods like refined flour (maida), polished rice, refined sugars, refined oils, etc., and many use oils with trans fats. We are also a nation of biscuit eaters. These foods, being easy to digest and low in satiety, make us feel hungry faster, thus increasing our risk of obesity. They are also low in protective nutrients like minerals, vitamins and antioxidants; this further increases our risk of developing metabolic abnormalities and obesity. While small, frequent meals with snacks are a good thing, the nature of those snacks makes all the difference. Read more about healthy snacks you can have in the office.
While the world sits down for dinner in the evening after work, most urban Indians reach home to a snack with tea or drinks between 6 p.m. and 8 p.m. A 2007 survey by ACNielsen reported that the highest consumption of unhealthy snacks such as biscuits, chips and namkeens takes place pre-dinner. According to most diet recalls, people report peak hunger at this time. The consumption of unhealthy food and extra calories around this time ends up creating dietary disasters.
We also entertain in a very particular way quite differently from how people entertain in the West. Socializing in India usually involves a few hours of drinking and unhealthy snacking, followed by a very late and heavy dinner. Eating high-carbohydrate and large meals late at night puts us at a hormonal disadvantage and favours easy fat deposition. Those who are insulin resistant are more vulnerable.
While food is the symbol of love and affection globally, in India it is even more so. The more you force a person to eat, the more warmth and affection you show. The traditional Indian khaatir or hospitality is so much a part of us that saying 'no' to food is often seen as rudeness.
There never seems to be a dull moment in the festival calendar either. There are approximately 140 festivals celebrated across the country in a year, perhaps the most any nation can boast of.
Celebrations always include high-calorie, high-carbohydrate and high-fat sweets and savouries. Aloo-puri-halwa, kheer and the many mithais are the most typical north Indian foods of celebration. Then there are the several fasts, which are followed by feasts. Marriage itself is such an elaborate event, particularly in north India, with food as the central theme.
Our domestic staff often outnumbers family members at home, and even in offices, there are plenty of clerks and peons to do the groundwork. A white-collar executive will have a chauffeur who not only drives him or her to the doorstep but also carries the laptop, lunch box and other baggage right into the cabin. Even schoolchildren from affluent families often follow the same routine. We rarely have to lift a finger if we don't want to. Read about some household chores that can help you lose weight.
A young mother, for example, will almost always have an exclusive maid and sometimes even a nurse to help her cope with her newborn baby. She may even be exempt from the burden of routine domestic chores quite unlike the situation in the West. Alongside this, she is often advised to eat high-calorie foods like ghee, butter, cream, milk, nuts, etc. to regain her strength. No wonder most young mothers are found to be overweight in India.
Nor do we have a culture of walking or cycling through our cities, what with the broken footpaths and the hot weather. Mechanized means of transport, be it cars, elevators or escalators, have replaced walking, riding and biking almost completely. All these factors have radically reduced caloric requirements to a fraction of what they used to be as little as a generation ago.
This explains why India a nation in transition has become the world capital of diabetes and heart disease, and the rates of obesity are comparable to those found in the developed world.
Reference:4 Enas A. Enas and Sudesh Kannan, 'Heart Disease in Particular Populations: Cracking the Indian Paradox' in How to Beat the Heart Disease Epidemic amongSouth Asians: A Prevention and Management Guide for Asian Indians and Their Doctors (Illinois: Advanced Heart Lipid Clinic, 2005), 122.
Excerpted with permissions from Penguin Books India from the book'The Diet Doctor: The Scientifically Proven Way to Lose Weight'authored by Ishi Khosla. Buy the book here.
Ishi Khosla is a practising clinical nutritionist, consultant, writer, researcher and an entrepreneur. She is actively involved in clinical practice at the Centre for Dietary Counseling in Delhi, where she deals with a wide range of nutrition-related health problems including obesity, cardiovascular disease, diabetes, gastrointestinal problems, allergies, etc. She has recently developed the first fully Web-based weight-management programme in India: www.theweightmonitor.com. Passionate about nutrition and a strong believer in the power of foods, she has spearheaded a path-breaking health food company, Whole Foods India, which produces health foods and operates health cafes.
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