Eat more of this, but not these: What India's top nutrition body recommends for your diet

CHENNAI: Changing lifestyles and eating habits of Indians have made it necessary to highlight the link between balanced nutrition and holistic health. The guidelines published by the Indian Council of Medical Research (ICMR) aims to achieve just that, while combating the rising numbers of diet-related diseases like obesity, diabetes, heart-related ailments, etc.

The ICMR report reveals that 56.4% of the total disease burden in India is due to unhealthy diets. A combination of healthy diet and physical activity can reduce a substantial proportion of coronary heart disease and hypertension, and also prevent up to 80% of type 2 diabetes. Additionally, a significant proportion of premature deaths can be averted by following a healthy lifestyle.

As under-nutrition and anaemia remain a public health concern, the guidelines report observes a rising prevalence of obesity in several States, creating a dual burden where both under-nutrition and obesity co-exist within the same communities and even within households.

Keep it fresh, wholesome

The guidelines say that non-starchy fresh vegetables, green leafy veggies and at least 30 grams of fruits should be included in every meal.

At least 50% of cereals and other grains should be consumed whole. Consumption of nuts, oilseeds, fatty fish and cooking oils should be restricted to 25-30 gm per day. Meal frequency should be 2-3 times a day, with sugar restricted to 20-25 gm per day. Snacking should be avoided and healthy beverages can instead be consumed.

There are many food items such as milk and milk products, cereals, pulses and their products, edible oils and spices that are frequently adulterated with non-food material or inferior quality products. Spoilt, stale and poor-quality food is made attractive and fresh by adding harmful colours or other chemicals.

The different classes of adulterants include non-permitted colours like metanil yellow, non-edible oils like castor oil, extraneous matter like husk, sand and sawdust in spices, and metal contaminants like aluminium foil on sweets or iron filings in tea.

Reduce oil, sugar, salt

Regular consumption of saturated fats and trans fats spikes calories, thereby increasing the risk of heart diseases and stroke. Cooking methods such as sautéing, steaming, grilling, boiling or baking should be used instead of frying.

Saturated fatty acids are known to increase serum total and LDLcholesterol levels, which increase inflammation, reduce insulin sensitivity and enhance the tendency of clot formation. This can lead to an increased risk of cardiac issues.

Cut down on the consumption of trans fatty acids as they alter lipid profile, endothelial dysfunction, decrease insulin sensitivity and increase risk of diabetes, breast cancer, colon cancer, preeclampsia, disorders of nervous system and vision in infants. To enhance flavour, oil seeds and nuts-paste can be used in place of extracted refined oils or fats, as the former is more nutritious.

Though salt is a source of sodium, excess intake in the daily diet can lead to several health problems. All kinds of salt, including pink and black salt, should be restricted as they all contain almost the same amount of sodium.

Existing evidence reveals a deleterious impact of high salt intake on blood vessels, blood pressure, bones and gastrointestinal tract. BP usually spikes with age but prevalence of hypertension is low in populations consuming less than 3 gm/day.

As the ratio of sodium to potassium in the diet is important, you must eat potassium-rich foods such as fresh vegetables and fruits as it helps to reduce BP. Excessive salt may also affect stomach mucosa and increase the risk of gastritis, atrophy and gastric cancer.

Foods high in fat and sugar have very high calories and lack vitamins, minerals and fibre. These items can not only lead to weight-gain and obesity but can also deprive you from eating healthy foods that provide essential macronutrients (amino acids and fats), fibre and micronutrients such as vitamins, minerals, phytonutrients, bio-active substances. Lack of these essentials can cause anaemia, affect cognition, learning ability, memory and also increase the risk of NCDs.

Read food labels

With the popularity of packaged food, it’s important to understand food labels and stay cautious of misleading claims by manufacturers.

The ingredients are displayed in descending order with the ingredient that is highest in quantity appearing first.

Nutrition claims like ‘low calorie’, high fibre’, ‘low fat’, and ‘low sodium’ are not complete information. Side-effects of consuming a certain food item, or claims that it reduces a particular ailment should be substantiated by providing the actual nutritional facts or scientific data as proof.

The public should be careful when buying food items that are labelled ‘natural’ as it may have added colours, flavours or artificial substances. Real fruit juices might only have 10% or less of real fruit, and may have more sugar and other additives. The ‘whole grain’ food does not mean that the items are not tertiary or ultra-processed.

Many low-fat or non-fat foods may still have a lot of calories. Often, these foods have extra sugar, refined flour or starch thickeners to make them taste better.

Protein powders, supplements

The popularity of protein powders is growing with advertisements for various types of fitness diets. However, certain protein supplements and powders can harm the body, especially causing renal damage.

Protein powders are made from either eggs or dairy milk or whey or plant sources such as soya beans, peas and rice. Some powders, marketed in packages as supplements, contain protein from multiple sources. They may also contain added sugars, non-caloric sweeteners and additives such as artificial flavouring. And, hence, they must not be consumed regularly.

Recent evidence suggests that Branched-chain amino acids (popularly called BCAA) may increase the risk of certain non-communicable diseases. Adequate non-protein energy from carbohydrates and fats is essential for dietary proteins to be utilised for synthesis and related functions in the body. Consuming high levels of protein, especially in the form of supplement powders, is therefore not advisable.

ICMR’s dietary guidelines:

1. Eat a variety of foods for a balanced diet: Nutrient-rich foods including fresh foods and animal-origin foods should be chosen as per your age, gender, physiological state and physical activity to get the right amount of nutrition.

2. Extra food and healthcare mandatory during pregnancy and lactation: Ensure adequate intake of protein, minerals, vitamins, essential fatty acids and essential amino acids, while maintaining healthy dietary habits and exercises.

3. Breastfeed exclusively for the first six months; continue till 2 years and beyond: Early initiation of breastfeeding and exclusive breastfeeding for the first six months is important for the growth of the newborn.

4. For babies after 6 months, homemade semi-solid complementary foods advisable: Complementary foods such as fruits, vegetables, eggs and meat, should be introduced soon after six months of age, in addition to breastfeeding.

5. Appropriate diet to be followed for kids and adolescents: Include pulses, nuts, oilseeds, vegetables, seasonal fruits, eggs and flesh foods in regular diet, while restricting ultra-processed foods, and foods high in fat, sugar and salt.

6. Plenty of vegetables and legumes: Include fresh vegetables and fruits, which are store houses of micronutrients. Fruits and vegetables are sources of phytonutrients and fibre which are of vital health significance.

7. Use oil/fats in moderation; choose a variety of oil seeds, nuts etc., to meet daily needs of fats and essential fatty acids: Limit the use of high saturated-fat containing oils or fats such as ghee, butter etc. Minimise consumption of ready-to-eat fast foods, bakery foods and processed foods which may contain trans fats and saturated fats.

8. Good equality proteins, essential amino acids crucial. Avoid protein supplements to build muscle mass: Combining cereals with pulses in the ratio of 3:1 will improve the quality of protein in a meal. The use of protein powders should be avoided as it has potential health risks.

9. Abdominal obesity, overweight and overall obesity must be prevented: Obesity leads to several health problems and increases the risk of diabetes, hypertension, heart diseases and others. Slow and steady reduction in body weight is advisable and extreme approaches for weight loss can be risky.

10. Be physically active, exercise regularly: Regular exercises can help in maintaining desirable body weight, muscle strength, bone health, flexibility of joints and appropriate body mass composition.

11. Restrict intake of excess salt: Food high in salt can lead to an increased risk of hypertension, stroke, heart problems and vascular illnesses.

12. Consume safe and clean foods: Keep a check on the presence of environmental contaminants and adulterants in foods as they can be health hazards. Unsafe foods can lead to foodborne illnesses, intestinal damage as well as undernutrition.

13. Follow correct pre-cooking and cooking methods: Good precooking practices help in retaining nutrients and reducing contaminants. Avoid cooking in non-stick pans and metal pots, prefer earthen pots and stainless steel cookware.

14. Drink plenty of water: Drink adequate quantities of safe water to meet the daily fluid requirements. Soft drinks are not substitutes for water and therefore should be avoided.

15. Minimise consumption of high-fat, sugar, salt and ultraprocessed foods: Regular intake of these food items can lead to a high risk of non-communicable diseases like diabetes, hypertension, cardiovascular diseases, and more. Avoid deep fried, fatty, sugary and salty foods and bakery products.

16. Include nutrient-rich foods in the diet of the elderly: To remain healthy and active, elderly people need foods rich in vitamins and minerals along with adequate physical activity.

17. Read food labels to make healthy choices: Always read food label information to know about content of foods inside a pack. Food label should display the name of the food, brand name, list of the ingredients, date of manufacture, useby/expiration dates, allergen declaration, etc. Public should exercise caution by cross-checking the claims with ingredients and nutrition information on the label.

Food Pyramid

Nuts & seeds (35g)

Fats & oils (27g) 

Milk/curd (300 ml)

Pulses & legumes (85g) (30g of pulses substituted with fish/flesh foods)

Cereals & Nutricereals (250g)

Vegetables (400g) & Fruits (100g)

Diet for kids, adolescents

1. Iron-rich food 

•  Plant foods like green leafy vegetables, pulses and dry fruits contain iron
• Iron is also obtained through meat, fish and poultry products.
• Vitamin C rich fruits like guava, amla, pineapple and citrus fruits or chutneys made with coriander and green chillies improve iron absorption from plant foods, when consumed aspart of a regular meal 
• Beverages like tea should be avoided for at least an hour before, during or soon after a meal

2. Calcium-rich foods

• Children require higher level of calcium for growth and bone development
• Milk, curd, sesame seeds, ragi and GLVs like amaranth are good sources of calcium
• Regular exercise reduces calcium loss and strengthens bones.
• Exposure to sunlight maintains Vitamin D status which helps in calcium absorption.

During illness 

• Energy-giving nutrient-rich diet such as cereals, pulses, milk, mashed vegetables and fruits during recovery and post illness
• Feed small quantities at frequent intervals
• Give plenty of water and other fluids

MOVERS & SHAKERS 

Activity                                                                             Duration (minutes)

Sleep                                                                                  480 (7 hrs)

Occupation (work)                                                                 480

Household chores                                                                  220

Personal care/eating/watching TV                                        180

Leisure time physical activity                                                   60

Exercises (brisk walking, running, swimming, cycling etc)      20

SUGGESTIONS