A colorful approach to eating with new Indian guidelines

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The new dietary guidelines released by the National Institute of Nutrition have taken a commendable approach, employing visuals such as a plate featuring various healthy food groups on the first page, and concluding with a detailed food pyramid on page 148. Within these guidelines, comprehensive information is provided regarding healthy food choices, cooking techniques, the impact of processed foods, and guidance on interpreting food labels.

Even while most people are aware of the three macronutrients—proteins, fats, and carbohydrates—more conversation on these subjects is necessary. Since carbs are sometimes thought of as the main component of our diets, it begs the fundamental question of which kinds of carbohydrates we should focus on. Whole grains—like quinoa, oats, and millets—are prized for their nutritious content among them, but it’s important to understand their differences. For example, barley (jau) is a good option for people with diabetes or obesity because of its low glycemic index and high fibre content, which indicate a smaller rise in blood sugar after ingestion. Conversely, finger millet (ragi) is rich in calcium, which is beneficial for those with dietary calcium needs, but its relatively high glycemic index renders it less suitable for individuals with diabetes. Despite recent criticisms, wheat (gehun) remains a budget-friendly and nutritious option. A single medium-sized roti contains approximately 3 grams of fiber and 3.8 grams of protein. If one consumes four such rotis daily, they will fulfill about 12 grams of fiber (roughly one-third of the daily requirement) and 15 grams of protein (equivalent to 26% of the daily protein requirement). It would be best to have wheat mixed with jowar or besan to have the least sugar excursions after meals. These insights, integral to the metabolically friendly needs of Indians, warrant additional discussion within the guidelines.

The graphics featured in the chapter discussing oils and fats are impeccably crafted, providing valuable guidance on the limitation (or even better, avoidance) of oils rich in saturated fats such as ghee, coconut oil, palm oil, and butter. The bad effects of these oils are not limited to heart disease and stroke, as stated, but also fatty liver and liver damage, which we see widely today. Since they are rightly highlighted on the meal plate, the emphasis on “good fats” such as polyunsaturated fatty acids found in nuts, seeds, soybeans, fish, cereals, millets, green leafy vegetables, and fenugreek is praiseworthy. But it’s important to remember that monounsaturated fatty acids are another class of healthy fats that deserves just as much, if not more, attention. These fats, which are found in almonds, peanuts, avocados, and olive, canola, and mustard oils, among other foods, have a number of health advantages. It is important to emphasize their inclusion in the dietary guidelines in order to guarantee a thorough comprehension of the ideal consumption of fat.

One of the most well-articulated chapters in the dietary guidelines pertains to proteins. It is evident that Indians require increased protein consumption for the development of muscle mass and metabolic health. Our food should incorporate about 15% of calories from protein sources (about 0.8 gm/kg of body weight). The best distribution of protein is 25% with each major meal and the remaining 25% divided between two snacks. Interestingly, a protein snack before sleeping improves muscle building through the night. While there is often a tendency to turn to non-vegetarian sources (eggs, lean meats) for augmenting protein intake, the guidelines succinctly advocate for the combination of cereals (such as wheat and millets) with pulses (including lentils, chickpeas, green gram, rajma, soybeans, tofu, and cowpeas) in a ratio of 3:1 to enhance protein quality. Specifically, whole eggs are a good form of protein, are easily available, and should be consumed by all except those with markedly high cholesterol and heart disease. Emphasis on intake of eggs should be part of our guidelines too. 

There is an increased need for protein in children, pregnant women (requiring an additional 8-18 grams per day), the elderly, and individuals with chronic illnesses, cancer, or those recovering from surgery or a significant infection of COVID-19.On the other hand, protein should be judiciously taken and even reduced in people with kidney disease or with high uric acid levels. Such practical points regarding protein need enhanced discussion. 

The above approaches should provide enough protein from specified dietary sources and extra protein supplements are not required. In this context, cautionary advice against the prolonged intake of protein supplements is well-founded. However, statements such as the potential increase in the risk of certain non-communicable diseases due to the intake of Branched Chain Amino Acids (essential proteins found in whey protein) should be tempered, as the evidence supporting such claims is not yet conclusive.

It is suggested that the committee could benefit from additional insights by including a clinician as a member. Additionally, dedicating a small paragraph in certain chapters to address dietary considerations for patients with diabetes, heart disease, kidney and liver disease would enhance relevance. Furthermore, it is essential to include appropriate scientific references to support the information provided. The dissemination of the messages contained within these pages to the general population is crucial, and therefore, it is recommended to include easy-to-understand practical points specifically for laypersons to implement after each chapter.

These guidelines embody a significant endeavor, nicely crafted to engage and inform. They are well-illustrated with graphics and tables, conveying the vital message of embracing a diverse color and variety of fruits, vegetables, nuts, seeds, and whole grains. One should ask: what is the color of my diet? The answer lies in the concept of a “rainbow diet,” akin to the colorful plate depicted on the very first page.



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