Indians are more prone to diabetes, but we can beat it by eating right
As we near the end of another year, it’s time to put the spotlight on diabetes — a disorder that has without doubt taken the shape of a debilitating epidemic in India. In 2017, like the years before it, the numbers of diabetics have only increased in the country — exponentially, and what is even more worrying is that the disease is getting younger, too often surfacing in people still in their 20s and 30s. And the earlier one gets diabetes, the more chances of damage to blood vessels and complications of the heart, brain, legs, feet, kidneys, eyes and nerves.
So, why do we attract diabetes like a magnet? The reasons are all startlingly clear:
We are unfortunately born with a thrifty gene phenotype — rampant fetal under-nutrition and micronutrient deficiencies alter our metabolism and predispose us to syndrome X (a cluster of risk factors for diabetes).
Genetically, Indians have the propensity to accumulate fat (adiposity) in the abdominal region and the liver, which leads to higher levels of hidden — deep belly visceral inflammatory — fat compared to the rest of the world. This fat produces all the ingredients necessary to cause damaging diseases, including diabetes.
Here, the scary bit is that even seemingly thin people may be prone to it, if they have high hidden belly fat.We also have difficulty processing sugars in our body as a result of the slow and ineffective action of insulin, and this makes us more prone to insulin resistance, even with lower rate of intake of carbohydrates (as compared to other populations).
The food factor
But it doesn't stop here, the main problem — according to me — is that on top of all the above mentioned risk factors, we habitually consume a very high carbohydrate diet and that further accelerates the process (of getting diabetes).
In fact, in my practice I have observed that vegetarian Indians are more at risk because mostly they are more grainetarians (grain eaters) rather than being true vegetarians. The bulk of their meal is made up of cereal (wheat, rice, millets) and lentils (these have high carb levels, too, along with protein), with vegetables actually forming a very small part of their plate. That is why even if they are not eating much fat, and absolutely no saturated fat-rich meat, they are still at a huge risk as this overload of carbs goes straight to the liver and skyrockets the triglyceride levels. High triglycerides are a huge, known risk factor for developing diabetes.
Secondly, being overweight is a common problem — we eat with abandon, gain weight and thus our metabolic numbers go haywire. Typically, the problem starts in childhood as we tend to deliver low birth weight babies and then make it our lives’ task to over-feed the baby; metabolically, this sets the template for heart disease and diabetes later in adult life.
Right feeding in the first few months of childhood is very critical.
This situation is worsened by the fact that Indians are also one of the most sedentary groups in the world, who get little structured or non-structured exercise. Add severe sleep deficiency, and really severe Vitamin D deficiency (I see many clients with Vitamin D levels in single digits as opposed to the required 50ng/dl) to the mix and the surefire recipe for a disaster is ready.
Change the plate
I usually work at it by reducing dependence on carbohydrates for all meals via innovative menu planning (for example, a salad and a soup instead of the regular roti subzi in at least one meal every day), using copycat carbs (cauliflower rice, zucchini pasta) more often, reducing the quantity of carbs smartly by adding more vegetables, tofu, nuts et al to the cereals (rice, pasta, poha, upma), adding soya or almond flour to the wheat flour, and adding more protein (meat, egg, soya or dairy) and vegetable meals (for example, paneer stir fry or nutri nugget stir fry).
I also insist that the lentils be cooked the same way too — dal palak, lauki dal, kidney beans (rajma) chaat, et al. My simple rule is 50:50; 50 per cent lentil or cereal and 50 per cent vegetables. This is a no-fail, very effective way to eat.
Secondly, I suggest increasing non-structured activity. I tell them to walk 8,000 steps per day (and you can eat more rice). I very often advise alternate fast-slow walking for 20 minutes three times a day, as the results are very good.
As another year comes to an end, I feel time is running out and we seem to losing the battle against diabetes.
The fact is that we have to begin modelling the “stay-safe-from-diabetes” behaviours right away, so that our children can learn and follow, and then their children can do that too. Eventually, we might be able to change the metabolic template a bit too. So how about making a resolution this year to try and defeat diabetes? Won’t that be a fabulous family (and community) legacy to leave!