A critical determinant of keeping good health is one’s diet. Modern lifestyles have brought several comforts, but at the cost of ushering in associated ailments, the most common of which is obesity. Obesity has a causal link with a wide variety of lifestyle diseases, chief being hypertension (high blood pressure), diabetes, high blood cholesterol, coronary artery disease (heart attacks) and strokes.
The last few decades in Medicine have been spent in trying to control or prevent obesity and related diseases. Few human endeavours have met with greater failure, obesity has multiplied several-fold since the 1970s. This march of obesity is closely matched with human attempts to avoid or overcome it. Thousands of books and articles have been published on techniques around diet and exercise as a ‘treatment’ of obesity. However, hardly 5% of individuals can maintain any substantial weight loss they’ve achieved for more than a year.
Animals with IQs much lower than an average human being can remain fit, something that we cannot seem to do despite so much help. What is the paradox here! We must be missing something!!
The US Senate Select Committee on Nutrition and Human Needs in 1977 first came out with guidelines around a suitable diet. They recommended that the fat in our intake be reduced significantly (as that was thought to be associated with obesity and heart disease) and be replaced by carbohydrates (carbs). This unleashed the spate of low fat, high-carb diet and snacks, which only resulted in an epidemic of obesity and heart disease.
Though a discussion on why these guidelines were issued is beyond the scope of the present article, it is obvious that there is a correlation here. It would suffice to say that the greater calorie content of fats (9 kcal per gram, compared to approximately 4 kcal per gram for carbs and proteins) and the supposed role in promoting heart disease worked against them. Obesity was defined as being ‘a disorder of caloric balance’, reducing it to a simple case of mismatch between calories consumed and spent (“calorie in calorie out” hypothesis).
[Listen in to understand some broad thumbrules around good Nutrition and Fitness from Dr Chopra.]
Let us first understand the basics of nutrition. The components of a normal diet include proteins, fats, carbs (simple and complex, including fibre), vitamins and minerals. To comprehend what constitutes a healthy and balanced diet, we first need to know which of these components are “essential”. These are compounds that are not made in our body and must be consumed as food i.e. essential fatty acids (fats), essential amino acids (proteins), fibre (complex carbs), vitamins and minerals. You will notice that simple carbs are not mentioned here. This is because they are not “essential”. Interestingly, they form the biggest chunk of our daily diet, indicative of something fundamentally wrong in our intake.
Now lets us look at what we actually consume. An average Indian’s diet comprises 50-75% carbs, 20-30% fat and only 10-15% proteins. Though it is difficult to give precise fractions of a healthy diet for the whole population, it is obvious that we are taking a small amount of proteins and compensating it with carbs, and mostly simple carbs – wheat, rice, corn, cereals and sugars.
Wheat is one of our staple foods and has had a significant contribution in saving millions of Indians from famines. But the wheat produced after the Green Revolution had a different composition of proteins from the one available before. Wheat produced post the Green Revolution is more allergenic (increasing allergies and coeliac disease) and has a higher glycemic index (resulting in a rise in blood sugar post consumption).
The consumption of fruits has increased manifold, along with genetic modifications that have made them sweeter (higher glycemic index) and available all-round the year. Fruit juices, often considered healthy, are usually artificially sweetened.
Salty savouries and biscuits are part of our daily tea rituals, occurring several times a day. Popular foods like pizza, burgers, noodles, sweets, ice creams, samosas and pooris are all loaded with simple carbs and often lots of fat as well. Chapattis are made from refined white flour, with high glycemic index, though not as high as that of bread. No wonder despite multiple attempts at diet control and exercise (gyms are flourishing in urban India), we have been unable to slow down the weight gain.
What can be done? We need to alter our basic understanding of what is a balanced diet – one where protein and healthy fats are eaten preferentially, while simple carbs are reduced markedly. That is the secret sauce.
Though fats are more calorie dense, they also take much longer to be digested and so cause better appetite suppression as do proteins. Hence taking more of these helps keep snacking at bay.
Sugar and sugary drinks like sodas and canned juices should be avoided. Salads and green vegetables should be encouraged to provide fibre in addition to vitamins and minerals. Exercise, though useful, cannot be used as a replacement for a healthy diet. There is little evidence to show major weight loss occurs with exercise alone, unless accompanied by dietary adjustments.
Over the course of the next few weeks, we shall discuss these principles in greater detail, reach a better understanding of nutrition, healthy lifestyle, and be in Ship Shape.
This is a recurring column published every Sunday under the title: What is Nutrition. Next week I will do a deep-dive on “Spotting the Right Carbohydrates, Proteins, and Fats for a Healthy Diet”. Stay tuned.
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