INDIAN HEALTH - PART 3 - DIET

This is a summary of a great book and provided as community service to you. Your feedback is appreciated.  My advice: Buy the book and use it as a constant reference.

Book: The South Asian Health Solution

Author: Ronesh Sinha, MD

ISBN: 978-1-939563-05-7

Note: This summary is to quickly get us moving in the right direction and is not a substitute for reading the book which abounds in case studies and much greater detail than what is presented here.

PROBLEMS OF TYPICAL INDIAN DIET

Excess Carb: The key number is Net Carb defined by

NC = Total Grams of Carb – Total Grams of Fiber

(MyFitnessPal.com provides NC values for most Indian food for free.  Surprise or shock yourself as the case may be by playing around. 1 home made dosa=34g !)

If you meet the metabolic six-pack, limit carbs to 150g/day.  May need to move to 80-100g to burn fat depending on how far you are from the norm.

    For someone meeting the criteria given in Part 2, the recommended NC per day is in the range of 100-150 grams, although the very physically active may tolerate more.  Those who are challenged with respect to obesity measures will have to drop down to 80-100 grams of carb per day to achieve fat burning.  But most Indians routinely consume 300+ grams per day; most don’t even know that.  They chase some other numbers like total calories or total fat etc. incorrectly.  They also harbor many myths and do not understand that certain fats (like coconut oil and ghee), in the absence of excess carb, are not harmful but become fattening with excess carb. Excess carb leads to insulin resistance and unhealthy visceral fat lining internal organs (abdominal fat is a sign of that) that generates inflammatory agents.  The book recommends carb control as the most important step in controlling many of the metrics associated with the metabolic six-pack.  Patients are seen to show significant progress even in 3 months with proper carb control and exercise.

Warnings: (i) You must avoid too much loss of fluids and sodium if you are moving from a high carb to a low carb diet.  Typically, people may need only a cup of broth.  (ii) If you have a health condition like high BP, diabetes, or a heart problem, you must consult your doctor or a trained nutritionist before you make drastic reductions of carb. (iii) Those engaging in over 1 hour of intense exercise or games (not casual strolls) can take an extra dose of carb in the form of a sweet potato or a serving of rice 30 to 60 minutes later to replenish the glucose store in the muscles.      

RECOMMENDATIONS

1.    Flat Breads: Avoid or severely limit high carb foods (Paratha=47g; Naan=35g, chapatti=24g, masala-dosa=30g, 1 bread slice=15g; all numbers approximate and can vary with brand etc.)  Replace with low carb food (Coconut Flour chapatti=3g; almond toast =1 g; almond flour pancake =2g; romaine lettuce=0g).  Try chopped cauliflower for masala in place of potato.  Try adai or pesarettu instead of dosa high in rice content with more lentils.

2.    Starchy Vegetables:  Substitute starchy vegetables (aloo sabji=40g/cup; aloo paratha=40g; corn 1 cup=30g; peas 1 cup=20g; pumpkin and squash = 20g/cup) with (cauliflower=2g/cup; crunchy leafy vegetables; sweet potato; finally, spaghetti, zucchini, summer squash=5g/cup)

3.    Rice etc.: Intake in the Chinese population of rice is apparently 600g/day of carb (won’t be surprised if it is so for many in South India).  Substitute high carb items (1 cup white rice=40g; 1 cup basmati=76g; 1 cup spaghetti=40g; 1 cup brown basmati=68g) with  alternatives (cauliflower rice =4g; shredded cabbage=4g; Shirataki rice and noodles = 1g.  Other alternatives are chopped broccoli, carrots).

4.    Lentils etc.: Substitute high carb items (cooked dal=30g/cup; kidney beans=30g; chickpeas=30g) with (rasam 5g+vegetables; add volume with protein foods like paneer and nuts; add richness with toasted almonds topped with extra virgin olive oil, ghee, or coconut oil.)

5.    Sweets: Avoid high fructose corn syrup, liquid sugar like juices and sodas, designer coffee drinks, mango lassi, fruit smoothies.  (1 raw mango=30g; 1 cup pineapple=20g; 1 banana=24g; 1 cup prunes=60g; 3 dates=50g) .  Instead, use berries (1 cup blue berries=15g; raspberries=7g; strawberries=10g).  (There is not even a need to mention Indian sweets which are sugar high.  A strategy adopted in parties successfully by someone I know is to either take the desserts first so as not to overload oneself after the meal, or to consciously make room for some and go easy on the main courses.)

Breakfast: The author recommends having breakfast after an exercise, so that the muscles draw their glucose from the accumulated belly fat.  Those, who can, should consider an omelette, soft-boiled eggs or scrambled eggs for protein.  Avoid cereal from boxes laden with carbs as well as oatmeal-banana.  Instead, he suggests almond meal, almond flour, or coconut flour pancakes, low carb Greek yogurt, berries and nuts.  For him, skipping breakfast altogether is not as sinful as some make it out to be either, and many may find themselves feeling less hungry as they do around ten or eleven after a glucose heavy breakfast.  He also recommends intermittent fasting by those who can do that.

Protein: Lentils are the main source of protein for vegetarians, but unfortunately they come laden with carbs.  A couple of eggs is highly recommended by the author who asserts that will increase your cholesterol less than a bagel or high fiber cereal we normally eat.  Nuts and seeds (almond, macademia, sun flower seed) are good sources of protein, minerals, fiber and healthy fats as are butters made from them.  Quinoa is high in protein, calcium, phosphorous and magnesium but be aware of its NC.  Almond flour or coconut flour breads,  a bowl of lentils with ¾ vegetable content (don’t overcook vegetables) is a good choice.  Protein shakes with regular or coconut milk as base with some added nut butter is a good choice.  Avoid fruits and prefer vegetables for shakes.  Vegetables with high protein content are: asparagus, broccoli, Brussel sprouts, cauliflower (do not overcook!).

Fat: Saturated fats found in dairy (milk, butter) and in coconut (oil, butter, flakes, milk) are good when not consumed with excess carbs. Monounsaturated fats (olive, extra virgn olive oil, avocados, macadamia, almonds) are heathy; don’t heat the oils in this class to high heat.  In the case of Polyunsaturated fats, Omega-3 is good, but avoid Omega-6 (vegetable oils are big offenders) which creates inflammatory effects.  Transfats and partially hydrogenated fats are unsuitable for human consumption.

Additional Remarks: Indians tend to exhibit Vitamin D deficiency.  A daily vitamin supplement is worth considering if the daily diet is not providing enough vitamins and minerals.  Indians according to the author lead a highly oxidized lifestyle, which accounts for high rates of inflammation. (We take early AM, as first thing in the morning 15 minutes before anything else, the anti-oxidant 'nutraMetrix Isotonic OPC-3' on the advice of our own doctor and have found it to be very helpful. A capful is supposed to have anti-oxidants equal to several glasses of red wine.)

Please read the book for more information on food for children, pregnant women, etc. as also for understanding better the rationale.  At its price, the book is a great investment.  Treat this set of blogs only as a quick refresher or summary of the bare minimum facts.

Other parts of this can be found by searching through the right panel.  Have you seen my book, "Innovation by India for India, the Need and the Challenge" available through amazon.com and flipkart.com ?