In the first article in a new a series examining Indian diets and health, a British dietitian urges India not to make the same mistakes that were made in her country, but instead safeguard the health of future generations.
India is almost unrecognisable today from the country I visited in 1988 when I studied briefly at the Sri Venkateswara University College in Tirupati.
Then, it was rare to see anyone who was overweight. Back then, cars were not as abundant as they are today, and cheap meals of delicious pulses and chapatti or dosa with potato masala could be purchased in small, noisy restaurants. Garam chai was everywhere, to be savoured in small, clay cups that were then thrown away to become part of the dust once more.
Nowadays, India is a modern, thriving country, although the slums remain as a guilty reminder that the wealth of the twenty-first century has bypassed many in the population.
Western foods and soft drinks abound, sold in glossy outlets at increasingly affordable prices for the new middle classes. However, the traditional side of Indian dietary culture isn’t far away as evidenced by the views about children’s weight, ghee and other Indian delights expressed by the Diabetes Foundation of India survey .
Parents may believe that ghee and saturated fats are good for their children and that a bit of plumpness is healthy. But, this is not reflected in the shocking disease statistics coming from India every few years.
Whatever Indians may think about their own diets and lifestyles, the facts suggest that these are, in fact, making them less healthy. Rates of type 2 diabetes, cancer, obesity and heart disease are soaring, particularly in urban areas where residents have a two- to threefold greater risk of developing these conditions compared to rural dwellers.
The reasons are not fully understood but there is a growing belief among nutrition scientists that the genetic profile of Indians—favouring the so-called “thrifty gene”— combined with the higher-energy, higher-fat and lower-fibre diets of richer populations, is driving the phenomenon.
The traditional Indian diet is one characterised by little meat, plenty of pulses, vegetables, rice and wholegrain wheat, making it low in fat and high in fibre.
In the past, ghee tended to be used sparingly as it was expensive for less-wealthy families. Dairy products were available but back then these were watered down. Indian sweets and jaggery were given as a treat, not something to be eaten daily.
Now, as incomes steadily rise, Indians want to combine the best of the past with new, Western foods and drinks. Out go the pulses and vegetables, replaced with higher intakes of ghee, meats, soft drinks and fast foods. The end result is a diet that is driving India’s health problems.
In the UK, we blindly ignored our dietary problems until the Committee on Medical Aspects of Food Policy (COMA) produced a report in the 1980s that blamed our high-fat, sugary, low-fibre diet for rising levels of cardiovascular disease.
Since then, fat intakes have dropped from 40% to 35% of total dietary energy, and heart disease rates have fallen. But health problems remain.
These are largely due to low vegetable and fibre intakes, refined foods with a high glycemic index that stimulate insulin levels and promote diabetes, and low intakes of omega-3 fatty acids, found in oily fish.
Obesity levels have also increased in line with the many hours we spend in front of the television or on the Internet, while alcoholic drinks are all too popular with young adults.
Let us hope that India does not make the same mistakes. Government health promotion has focused on encouraging Indians to keep the best of their traditional diets, such as pulses, vegetables, fish, wholegrains, spices and fruit, while avoiding excessive levels of saturated fats from ghee and dairy products. This could turn around the diabetes and cardiovascular disease timebomb waiting to go off.
Parents need help to identify when their children are becoming obese so diets can be monitored and physical activity promoted.
It is astonishing that children attending Indian private schools are fatter than children at state schools. In the UK, it is the other way around as private schools offer more sport and healthier school meals.
I would love to return to India someday and see a country that is bold, thriving and most of all healthy. Indians should not accept these rising rates of lifestyle-related diseases but should take action now while something can still be done to ensure the health of their children.
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