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What is Nutrition: Popular FAQs on Health, Diet, Weight Loss and Exercise

Director Cardiology, Fortis Escorts Hospital
Sep 9, 2018 4:24 AM 11 min read

Dear readers, over the last couple of months we have discussed the basics of living a healthy, fit and balanced life. We have closely examined topics such as the right diet plan, the appropriate weight loss exercise and the keto diet. Busted popular myths around breakfast ideas, eggs and dairy and much more. The next leg would have us discuss everything you need to know about exercising right. But before we do that, this week I have attempted to answer some popular queries which have popped up over the course of these months. 


Diet Nutrition FAQ

1. Are three major meals i.e. a slightly heavy-healthy breakfast, a moderate lunch and a light dinner, enough? Should there be absolute no to snacking? Is there any way to improve metabolism or is it all constitutional?

Three meals a day are enough for normal adults; occasional snacking is also acceptable. Also, to ensure that the routine is sustainable, you can include one cheat day a week when you are free to eat anything you fancy.

5-6 ‘small’ meals are neither healthy nor required by the body; 2-3 daily meals should be enough to make us comfortable through the day.


2. Is it okay to pursue a small frequent meal plan if one only takes low carb snacks?

Most snacks are high carbs so it is difficult to execute an effective small frequent meal plan. Secondly it is important to ensure that one’s insulin levels are low for insulin resistance to decrease. From that perspective, fasting or long gaps between meals are better. To the best of my knowledge, there are no studies supporting a weight loss effect with frequent meals.


3. Isn’t prolonged fasting unhealthy? Doesn’t it lead to slowing of metabolism?

A potential downside of long-term fasting is the rate of detox. Fat is the body’s storage organ for everything, including any toxins that may have accumulated over the years. When you lose weight, all these toxins have to be removed through your bloodstream, which can be extremely uncomfortable. During fasting, these symptoms are even more pronounced, since the rate of fat burning is so rapid – many people feel nauseous, sick, or otherwise unwell. That’s why it’s better to ease into fasting rather than jumping into it.

One can start with a meal-free interval at night for 10-12 hours, and then increase it gradually to become comfortable with the new plan; gradually longer fasts become comfortable. One can then choose between a 16/8 diet plan (16 hours fasting and a 8 hours feeding window per day) 1-2 days per week or on most days of the week, or a 5/2 program (5 days normal diet, 2 days of fast with < 600-800 calories), depending on one’s goals and tolerance. It’s a great method to kickstart fat loss if one is stuck on a plateau, as often happens when one tries to restrict calories.

Research suggests that intermittent fasting has little negative effect on one’s metabolism compared to traditional dieting. Evidently the metabolism slows down much more in response to prolonged low calorie diets than to intermittent fasting as outlined above. The reason why many think intermittent fasting improves metabolism is due to less loss of lean body mass and greater fat burning.

It's impossible to lose weight without losing a little lean body mass, but research suggests that a lower percentage of lean body mass is lost when losing weight with intermittent fasting than with traditional dieting. Preserving more lean body mass means the body's calorie-burning slows less. At the same time, short fasting periods cause the body to tap into fat stores and burn a greater percentage of fat mass for energy.


4. Why can’t I follow Keto diet all the time? I gain weight every time I go back to a normal diet?

A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. However, it is often hard to follow a Keto diet in the long term because of the heavy consumption of meat and fats involved.

Long-term research on the keto diet is limited, so there’s no telling for sure what cutting out certain major food groups and cutting carbs will eventually do to your body. Registered dieticians warn that nutrient deficiencies may be possible if you’re on it for too long. Further, it is very hard to give up carbs completely for the rest of your life; sooner or later, one is tempted to cheat, which leads to raid weight gain. 


5. Are bananas fattening?

Not really. Bananas are rich in fiber, carbs, potassium and other vital vitamins, while being low in protein and fats. However, most of the carbs in a banana are in the form of sugars – Fructose, glucose and sucrose. Bananas are extremely rich in fiber, which help in reducing weight, because intake of adequate amount of fiber helps you feel full for longer, which helps to reduce intake of calories in the long run.


6. How many eggs should I consume in a day and in what form? How can vegetarians substitute egg in their diet?

It is quite safe to eat an Egg daily, even two. If one regularly consumes more than 1 Egg a day, it should be in the setting of an overall healthy diet and lifestyle. Studies are available for regular consumption (for a few months) of upto 4 eggs a day-which appear to be safe.

Vegetarians can take other sources of healthy protein and fat, like milk, curd, cheese, nuts and seeds.


7. How many eggs in a week and in what form would you recommend for heart patients who have undergone PTCA (bypass surgery) or CABG (angioplasty) or are on medicines but leading a normal lifestyle otherwise?

The currently available data on safety of eggs is 2-4 per day, which has been shown to have no major effects on the lipids. No data is available for >4 eggs so far. So, higher consumption should be selective, in the setting of a healthy lifestyle and in consultation with a doctor. And post PTCA or CABG patients can consume eggs in a similar quantity, as they are not associated with risk of heart attacks and may lower the risk of stroke, especially hemorrhagic stroke.


8. Could you throw some light on the GM diet?

The GM or General Motors diet was promoted earlier, eventually turning out to be a damp squib. It requires eating only one type of food per day (e.g. only vegetables except potatoes, only fruits except banana or only bananas and milk or only meats). One is supposed to lose up to 7 kgs in 7 days, with the diet to be repeated with 1-week intervals. It is unlikely to be useful in the long run and is difficult to sustain due to its very restrictive nature. Medical benefits could accrue from the heavy consumption of fruits and veggies which is advisable even otherwise.


Exercise Nutrition FAQ

9. How crucial is the role of exercise in maintaining a healthy physique?

Exercise plays a crucial role in maintaining a healthy physique. Exercise helps to burn calories, even when you are resting, as exercise increases your metabolism rate. Regular exercise maintains the health of your heart and blood vessels which makes sure blood is pumped efficiently throughout the body. Without exercise, the body will slowly lose bone mass and muscle mass after the age of 35 (at about 1% per year), which makes the body frail in the long run. Exercise also maintains hormone levels in the body and reduces the risk of developing any cancers. 


10. Could you throw some light on High-intensity interval training

High Intensity Interval Training, also known as HIIT, is a very effective way of burning fat quickly while adding muscle (if you wish to do so). HIIT helps build aerobic and anaerobic endurance (Aerobic endurance is endurance to do exercises which can be done under normal oxygen supply like cardio; anaerobic endurance is endurance to do exercises which need more oxygen than required and can cause loss of breath like sprinting, rock climbing etc) as well. The idea of HIIT is to perform small, explosive workouts with minimal rest time in between with a few rounds in total ( around 8-10). The workout-to-rest time ratio can vary from 1:1 (30 seconds each) or 3:1 (45 seconds:15 seconds) depending on your endurance. Weightlifting can also be done with HIIT protocols where a single work set of an exercise  is done to failure. In the next section, we shall have full article on HIIT to clarify it’s nuances further.


11. Morning exercise regime or evening exercise regime-which one is best?

What really matters is what exercise you do (And what follows it). It won’t help that you do a great workout in the morning and follow the day with sugars, fats, etc. However, there are some minor advantages. Morning workouts produce more testosterone, more fat loss (by 20% almost) and induces a better sleep at night. Evening workouts enable maximum strength and more anaerobic activity in the body. Hence morning workouts are better for weight loss, while evening workouts are better for strength.


12. How many hours a day exercise should be done?

If you wish to attain basic physical fitness, 30 minutes of exercise per day is required. However, if you wish to add more body goals like losing weight or adding muscle, more time can be added. According to Department of Health and Human Services (USA), one should do 150 minutes of moderate aerobic activity per week, or 75 minutes of vigorous aerobic activity per week. We shall discuss exercise protocols at length in the next few weeks.


Nutrition FAQ

13. Can paranthas made of non-wheat flour (like chana, bajra, jwar, soya) be considered healthy? Is Besan Chilla a healthy breakfast option? What about Idli and Dosa or Poha?

Paranthas are like other foods made of wheat – moderate to high GI, but this is lowered by adding vegetables, oil and butter. Occasionally they are acceptable but not advisable for daily consumption. Other non-wheat flours are definitely healthier, one can even lower the GI of wheat by mixing bran or some of these flours and have reasonably tasty but less unhealthy rotis.

Besan chilla would be much better option when compared to paranthas and bread. Besan has a lower GI and more nutrients. Definitely, a good choice.

The glycaemic index of Idli, Vada and dosa is in the 65-70 range – not as healthy as usually claimed. However, eating them with sambhar lowers the effective GI of the meal due to protein and vegetables.

The GI of rice is high around 70. I haven’t been able to find the GI of poha, but it will be somewhat lesser owing to the added ghee / oil and veg or peanuts.

The risk of diabetes is higher with fresh juice as mentioned above, so fresh fruits are to be preferred over juices, whether fresh or canned (even worse).


14. If cereal and bread are bad, what do we eat for breakfast?

Popular carb-rich breakfast comprising cereals, bread and juices should be avoided; eggs, dairy, salads, sprouts, whole fruits, nuts and seeds are much better options. Tea and coffee can be safely consumed (best taken unsweetened and black), along with water.


Sugar Nutrition FAQ

15. I am diabetic. Do you advise the use of stevia as a substitute for sugar? Is the intake of diet coke advisable?

Stevia is better than sugar and other sweeteners and can be used occasionally. Largely, it would be better to avoid sweets (except the cheat day) to get over the sweet taste.

Generally, all sweeteners promote insulin resistance (with the possible exception of stevia) and therefore are bad for diabetics and overweight people, both of whom have insulin resistance. Diet Coke or similar soft drinks are therefore not advisable.


16. Are potatoes, which are considered complex carbs, okay for consumption as far as their Glycemic Index (GI) is concerned?

Potatoes are technically complex carbs, but get broken down in our body to glucose effectively. So, their GI is very high unless they are consumed with lots of other vegetables and oil.


17. How much carbs should I take in a day?

The amount of carbs one can take in a day depends upon one’s carb sensitivity and activity level. So the intake will depend upon age, gender, current body weight and activity levels, apart from one’s dietary goals.

Thus, if one is slim, active and young, one can afford to enjoy carbs and get away with it. However, if one is overweight, diabetic, sedentary and/or over 40 years of age, it is prudent to restrict refined carbs as discussed in earlier articles. Family history is important too; if everyone in the family is overweight it means that they have insulin resistance and should restrict refined carbs. As discussed earlier, complex carbs like salads, green leafy vegetables and a moderate consumption of fruits is advisable for everyone on a daily basis.


18What are your views on statins?

Statins are very effective cholesterol lowering drugs. They are proven to be very useful in lowering the risk of heart attacks and strokes in people at high risk, especially those who have already suffered some such event in the past. However, they should be advised wherever appropriate for the proper indications.

Recently, lots of controversies have been raging on social media about their possible harms, including risk of liver and muscle damage (which are rare) and diabetes (which is uncommon). Here, we have to understand a disconnect: the restriction of dietary fat is not proven to lower the risk of heart disease, but lowering cholesterol levels with statins is proven to reduce the risk of heart disease in high risk individuals. I hope that makes the point clear.


Oil Nutrition FAQ

19. Is the use of virgin coconut oil in meals advisable? Is the use of desi ghee as cooking oil healthy?

Coconut oil has become controversial due to its rich saturated fat content. There are no concrete studies showing harm associated with it, but none showing safety either, we have to be careful. For years, fat in general and saturated fats in particular have been demonized in dietary guidelines, but recent reviews reveal that there is no solid data proving the association of saturated fat with heart disease, and even lesser data demonstrating benefit with restricting fats. So, my suggestion would be to use it occasionally, especially for frying (as it has a high smoking point). Some data is coming up regarding its benefits in delaying senile dementia, though this is yet to be proven.

Desi ghee is ok for frying once. The trouble is that repeated frying (a common behaviour among Halwais) leads to increasing generation of trans fatty acids, thus increasing risk. Occasional consumption of butter and ghee is acceptable, as discussed in the article on cooking oils.


20. How many fish oil capsules one can safely have in a day?

Fatty fish is the variety of fish which is healthy for the heart. Since this variety is often not available, one can consume fish oil capsules or Krill capsules instead, in the dosage mentioned in the prescribing information.


This is a recurring column published every Sunday under the title: What is Nutrition. Stay tuned.


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