What India eats

Over recent years, most Indians have moved away from a healthy diet and are eating their way into chronic lifestyle diseases through junk and fast food By Anu Jain Rohatgi

Published: 15th April 2017 10:00 PM  |   Last Updated: 14th April 2017 03:04 PM   |  A+A-

After Prime Minister Narendra Modi expressed his concern about food wastage last week, the NDA government is preparing to fix portion sizes of dishes served in star hotels and restaurants. While the Prime Minister is worried about food habits, people don’t seem to be too bothered about what and how much they eat or how it affects their life in the long run.

Dheera weighed 92 kg and found it difficult to walk, forget hitting the gym for a tough workout. She never realised that over the years, her gorging on burgers, parathas, aaloo tikki, oily food and aerated drinks would slowly but surely make her obese and endanger her life. In just five to six years, a 45 kg Dheera shot up to 92 kg. She was just 18.

“Those years were a nightmare for me. Because of my weight-related complex, I gradually lost my friends. I couldn’t face relatives who would comment on my weight. Obesity restricted my physical activities and disturbed my menstruation cycle. I used to be embarrassed, depressed and totally isolated,” says Dheera.

She is not alone. Nikhil from Gorakhpur in Uttar Pradesh weighed 145 kg when he was 17. “I consumed a litre of cold drinks every day. Burgers, pizzas and fried potatoes were my favourite food,” he says. Nikhil’s obesity caused him respiratory problems, joint pain and borderline diabetes.

Fortunately for Dheera and Nikhil, there was hope. They underwent bariatric surgeries to cut their fat. Dheera lost 35 kg while Nikhil now weighs 84 kg.

Bariatric surgery was also a life changer for Egyptian Eman Ahmed Abdulati, once the world’s heaviest woman weighing 490 kg. Since her arrival in Mumbai on February 9, she has lost 242 kg after a laparoscopic sleeve gastrectomy—removal of
75 per cent of her stomach to limit her food intake—after which her weight dropped to 340 kg. She now weighs 248 kg.
Medical journal Lancet stated in a recent article that India is the third most obese country in the world. Here, 46 million people suffer from obesity, which in turn causes lifestyle diseases. According to World Health Organization, obesity in India rose one-and-a-half times in the last quarter-century. Heart diseases and diabetes together result in 28 per cent of all deaths in India.

A March 2017 study by the Cognitive Neuroscience Society says that continuous sleep deprivation makes the brain more sensitive to food smells. People with such sleeping patterns are more likely to eat unhealthy snacks and junk foods—such as pizza, chocolate, packaged cookies, ice cream, French fries, cheeseburgers, soda, cake, cheese, bacon, fried chicken, rolls and popcorn—which have been found to be the most addictive high-calorie foods by the National Centre for Biotechnology information, the US.
For the study—which was shared at the Cognitive Neuroscience Society's annual meeting in San Francisco—researchers analysed adults who had slept just four hours a day. When tired (sleep deprived), participants showed greater brain activity in two areas involved in olfaction (the sense of smell) in response to food smells. When they were rested, this activity diminished.

“Dheera and Nikhil were not the only ones who had suffered being overweight and had problems due to unhealthy food habits. This problem is part and parcel of the masses, especially amongst the adolescent and middle-aged,” says Dr Pradeep Choubey, head, Department of Bariatric Surgery, Max Hospital, Delhi. “In the last five years, the number of adolescent cases in the age group of 11-18 years has increased by 15-20 per cent. More than 50 per cent of cases coming for surgery are in the age bracket of 40-50 years. Bariatric surgery cases have increased 12-fold in the last decade in our hospital. Nearly 87,000 bariatric surgeries have been performed across in the same period. In 60 per cent of cases, unhealthy food habits are the main contributing factors.”

Experts believe more people are eating unhealthy food. Over the years, food habits have also changed. Instead of dal-sabzi, people prefer to eat pizzas, burgers or spicy chicken at food outlets. Complex carbs have been replaced by refined foods and oil. Water intake has been replaced by beverages rich in sugar and chemicals. People are eating less cereals, replacing them with more fat and snacks,” says Ritika Majumdar, head, Nutrition Department, Max Hospital.
Higher consumption of alcohol and aerated beverages is another major factor for obesity.
Doctors advise concentrating on a balanced diet with moderate regular exercise instead of spending more time in the gym. “Burning off a barfi after a meal needs 30 minutes of brisk walking,” says Dr Majumdar.

Just one pizza along with an aerated drink and a couple of sweets fulfils the requirement of total calories required per day.
“People who lead a light and sedentary lifestyle category require 1,500 to 1,800 calories per day. Those who are in field jobs and exercise require 2,000 to 2,200 calories per day, and people who are into heavier work such as rickshaw pullers or construction workers need at least 3,000 to 3,200 calories,” says Sonia Narang, a senior dietician in Delhi.
Fast and processed food contain lots of salt, sugar and saturated unhealthy fats. Regular and over-
consumption of this food makes us fat and prone to diseases.

Proteins, considered the body’s building block and a repair agent, should be consumed at about 1 gm/kg of a person’s weight. Indians consume excess starch and fat but less protein. “Around 50-60 per cent of vegetarians and 10 per cent of non-vegetarian patients coming to us for dietary counselling have protein deficiency. They are aged 25-47. About 40 per cent of patients suffer from deficiency of micro nutrients such as potassium, zinc, iron, magnesium and vitamins,” says Dr Majumdar.

A consumer survey conducted by Indian Market Research Bureau (IMRB) across seven major cities says that nine out of 10 Indians consume less than adequate proteins daily. It added 91 per cent of vegetarians and 85 per cent of non-vegetarians were found deficient. Protein intake of 88 per cent people was less than the ideal amount, indicating a huge gap in protein requirements and consumption for each individual. The survey added that Mumbai had the lowest protein gap of 68 per cent, in contrast to Delhi’s high gap of 99 per cent. They interviewed 1,260 respondents, which included males and females between the age of 30 and 55 years.
“There has been a drastic change in our dietary pattern over the years. On one hand we are eating unhealthy food, and on the other, we have sedentary lives, which directly increases lifestyle diseases,” says Dr T Lomgava, director, National Institute of Nutrition, Hyderabad. “Due to this, we are struggling with the problem of under nutrition (38 per cent among children) and over nutrition among children.”

A few years ago, a study conducted by AIIMS, Delhi, revealed that children from the elite class suffer from over nutrition. They eat more fats and calories in the form of fast and processed food, but their intake of vitamins and micro nutrients are far less than required. A study in Vadodara’s elite schools revealed that dietary practices and physical activities were found unhealthy among these children, who were overnourished. Another study stated that overnutrition is emerging as an epidemic in the country and may increase the risk of diabetes and cardiovascular diseases when these children turn adults.
A consumer survey conducted by IMRB broke the myth that vegetarians are  healthier than non-vegetarian. Almost half the participants surveyed were lifelong vegetarians, and yet the rates of obesity and cardiac disease were found similar to those among non-vegetarians. More vegetarians than non-vegetarians were diabetic. This was because vegetarians eat large amounts of high-glycaemic carbohydrates, potatoes and fried food, and frequently reuse cooking oil.

Their diet does not include enough raw foods, salads and fruits, considered essential to a good vegetarian diet.

Another study by the World Health Organization (WHO) says Indian consumers across all income groups are consuming less than the recommended quantity of at least 400 gm (or five daily servings with an average serving size of 80 gm, recommended by WHO) of fruits and vegetables. People, especially youngsters, are resorting to cheap and unhealthy food options that are mostly snacks. On an average, the Indian diet pattern is skewed towards cereals, and fruits and vegetables account for only 9 per cent of the total calorie intake (NSSO 2014).

Their lifestyle is the topmost reason for their inability to meet the recommendation, the WHO study says. Lifestyle is a key reason for low consumption across all age groups but more so among the younger lot (18-35 years).

Losing 5-10 per cent of weight can reduce chances of developing heart disease and having a stroke. Increasing cases of diabetes, knee and joint problems are also directly linked to being overweight. Few know that consumption of fast food also hits our brain functioning. Excess consumption of trans fats in fried and processed foods can send mixed signals to the brain, which makes it difficult to process what and how much you have eaten and how hungry you are.

Studies indicate that eating foods high in sugar and fat changes the chemical activity of the brain, making it more dependent on such foods. When these foods are discontinued, it creates withdrawal symptoms, which can lead to inability in dealing with stress and make you depressed. It has also been proved that eating junk food for five days per week regularly can deteriorate memory.

Too much fatty food and sweets can substantially increase insulin levels and cause Type 2 Diabetes. With higher insulin levels, the brain stops responding to this hormone and becomes resistant to it. This can restrict our ability to think, recall or create memories.

“With an increasing per capita income, people have more purchasing power and now opt for easy and quick food. Opening of a number of fast food chains also provides easy options to have junk food. People new in cities prefer fast food; so do working couples,” adds Dr Lomgava.
India's fast food industry has doubled between 2013 and 2016, and is estimated to be worth $1.12 billion. Unlike China, which saw a decline in fast food sales last year, India’s market is expected to grow due to changing consumer preferences and large young population.
Experts say Indians need to change and improve their food habits. According to them, snacking is one of India’s biggest health problems. While the world sits down for dinner in the evening after work, most urban Indians reach home between 6 and 8 p.m. and having tea with snacks.

A survey by global information, data, and measurement company A C Nielsen reported that the highest consumption of unhealthy snacks such as biscuits, chips and namkeens takes place pre-dinner in India. The aftermath of eating high-carbohydrate and large meals late at night puts us at a hormonal disadvantage and favours easy fat deposition. Each tea break increases the consumption of added sugars. Snacks are low in protective nutrients such as minerals, vitamins and antioxidants; this increases our risk of developing metabolic abnormalities and obesity.

The right foundation to good health is to choose food products rich in nutrients with a balanced amount of nutrients such as vitamins, minerals, protein, carbohydrates and a little bit of fat as well.

Unfortunately, the concept has been changing. “Over the years, there is transmission in nutritional values. It’s time to address problems related to our food habits and changing food patterns of food,” says Dr G S Toteja, head, Department of Nutrition at Indian Council of Medical Research. “We need proper scientific data on food changing patterns in Indians to persuade the government to make strict rules on unhealthy food.” In July 2014, the government increased taxes on sugar-sweetened beverages by 5 per cent to reduce their consumption.

To combat unhealthy eating habits, the government is considering raising taxes on junk food and sugary drinks through a ‘fat tax’. An 11-member team constituted by the government has suggested that the money collected from these taxes should go to the health services. “FSSAI (Food Safety and Standards Authority of India) is working on mechanisms to regulate consumption of junk food,” says Health Secretary C K Mishra, who is part of the team.
Indians are eating their way into death, blissfully unaware of the ticking bomb in them. They need to act fast on cutting down ‘bad’ food before they jump from the frying pan into the fire of deadly diseases.

Bariatric Surgery
A surgical option for overweight people to lose weight. The surgery is of four types: Laparoscopic Gastric Band surgery, Laparoscopic Vertical Sleeve Gastrectomy Gastric Bypass, and Bilopancreatric Diversion with Duodenal Switch. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestine to a small stomach pouch (gastric bypass surgery).

Balanced Diet
In which the required intake of calories is in fixed proportions, of which 50-60 per cent calories should come from complexed carbs such as wheat, ragi, oats, etc., and 15-20 per cent from proteins such as dal, curd, paneer, milk. For non-vegetarians, egg, chicken, mutton and fish should comprise 20-25 per cent.
Meals should include fruits.

Nikhil, now 84 kg
From Gorakhpur in Uttar Pradesh, Nikhil weighed 145 kg when he was 17. “I consumed a litre of cold drinks every day. Burgers, pizzas and fried potatoes were my favourite foods,” he says. Nikhil’s obesity caused him respiratory problems, joint pain and borderline diabetes.

Dheera, now 57 kg
She weighed 92 kg and found it difficult to walk. She never realised that her gorging on burgers, parathas, aaloo tikki, oily food and sodas would slowly but surely make her obese and endanger her life. In just five to six years, a 45 kg Dheera shot up to 92 kg. She was just 18.

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