If you find homely comfort in a meal of rice, roti, dal and veggies, for all its simplicity and popularity, think again. A recent study conducted by the Indian Council of Medical Research (ICMR), in collaboration with the India Diabetes Association (INDIAB), has found that the Indian staple diet is far more carb-heavy than is healthy, and is resulting in metabolic and other health risks.
According to the study, Indian diets are characterised by low-quality carbohydrates, including white rice, milled whole grains and added sugar, with high levels of saturated fat and low protein. This leads to a heightened risk of non-communicable diseases, particularly metabolic concerns in India. While a balanced diet should contribute 45-55% of the day’s calories from carbohydrates, in the Indian diet, carbs make for 65-75% of the calorie intake.
According to Dr AK Jhingan, senior director, Centre for Diabetes, Thyroid, Obesity & Endocrinology, BLK-MAX Super Speciality Hospital, New Delhi, “Carbohydrates have traditionally formed the backbone of the Indian diet because they are affordable, easily available, and provide quick energy.” “However, lifestyle changes have drastically reduced physical activity, while the diet has remained largely the same. A regular Indian meal – two chapatis, one bowl of rice, dal, and two vegetable curries – can easily contain 70-100 gm of carbohydrates per meal, which can exceed daily needs for someone with a sedentary lifestyle,” he adds.
According to the ICMR-INDIAB study, higher intakes of total carbohydrates were associated with a 14-30% higher metabolic risk among Indians.
Dr Bimal Kumar Sahu, senior consultant unit in-charge, gastroenterology, Artemis Hospitals, Gurgaon, elaborates: “Rice, wheat and lentils are staples that make up most meals because they give you quick energy and are a big part of how people eat in many cultures. A normal Indian thali, which has roti, rice, dal and two curries, can get 65-75% of its calories from carbs.” Unfortunately, most Indians are not aware that this meal can have an adverse impact on the calorie intake for the day, and consequently translate to metabolic risks.
The ideal intake
For most people, carbohydrates should make up 45-55% of their daily calories, offers Dr Sahu. “That means that an average adult who eats 2,000 calories a day should get about 225-275 gm of carbs,” he explains. “But the Indian diet usually goes above this, with 65-75% of total calories coming from carbs. Due to this imbalance, meals don’t have as much protein, healthy fats and micronutrients and make many people full of energy but low in nutrients.” A diet high in carbs may fill you up but it can hurt your health in the long run, shares Dr Sahu. “It raises insulin levels which makes the body store fat and slows down metabolism. This raises the chances of getting diabetes, high blood pressure and heart disease over time.” He says that an excessive amount of refined carbs can upset the gut microbiome and hurt digestion and immunity, while fluctuating blood sugar levels can impact mood, energy and focus as well.
Speaking of the risky characteristics of the typical Indian meal, Deepak Jolly, chairperson of the Indian Food and Beverage Association, says, “Even the government policies and public food distribution systems have historically subsidised rice and wheat making them even more accessible to the general populace and reinforcing their central role in the diet.” According to Jolly, individuals must devise their diets to meet the nutritional requirements in accordance with the recommended dietary allowances (RDAs) specified by the Indian Council of Medical Research – National Institute of Nutrition (ICMR-NIN). “Key strategies include consumption of a balanced diet and exercising portion control to meet respective nutrient requirements on the basis of gender, age and work type,” he adds.
Short- & long-term implications
“In the short term, excessive carbohydrate intake can cause energy crashes, fatigue, bloating, and frequent hunger due to fluctuating blood sugar levels,” says Dr Jhingan of Max Hospitals. He further lists out, “In the long term, it leads to insulin resistance, weight gain, type 2 diabetes, fatty liver, high triglycerides, and cardiovascular disease. Over time, it also reduces metabolic flexibility, making it harder for the body to burn fat efficiently.”
He explains that watching the glycemic index (GI) can help to moderate and portion meals based on calorie intake. The GI is a rating system for foods based on how quickly they raise blood sugar levels of an individual after consumption. “Foods with high GI have the potential to rapidly raise and drop blood sugar levels,” he says. While items with low GI (below 50) include millets and lentils, those with moderate GI (within the range of 56-69) are brown rice and sweet potato. Meanwhile, food items with high GI (above 70) include white rice, potatoes, maida and sugar.
Dr Sahu from Artemis Hospitals shares a few food myths that drive people to make mistakes in determining balanced meals with healthy carb contents. “Brown bread, for instance, may sound healthy but it often has sugar and refined flour added to it. Poha, idlis and upma are light but high in carbs and low in protein and fibre. Fruit juices, although natural, are just concentrated sugar with no fibre. It is a myth that traditional and natural foods are the same as balanced nutrition,” he adds. According to Dr Sahu, “Eating the right amount of carbs, proteins, fibre and healthy fats can help keep future generations from getting metabolic disorders that can be avoided,” he adds.
Awareness first
“Consumers can be better guided by awareness campaigns that show the risks of eating too much, food labels that are clear and front-of-pack labels that show how much sugar and refined carbs are in the food,” suggests Dr Sahu. “The FSSAI (Food Safety and Standards Authority of India) could also work with schools, food brands and restaurants to promote balanced meal choices and encourage fortified and high fiber versions of common foods.” Speaking of the FSSAI’s responsibility, Jolly of the IFBA opines, “The FSSAI is actively involved in promoting improving eating habits and maintaining an active lifestyle through their initiatives like the Eat Right India Movement that aim to promote safe and healthy diets for all citizens.” Spokesperson for the FSSAI, echoes the same. “The FSSAI cannot regulate the carb intake of individuals from their regular meals.
However, the FSSAI has steadily tried to push for healthy eating habits, even outside of its regulatory roles,” he says, adding: “We have been heavily advocating for the adoption of millets over white rice, which has a very high glycemic index. We are also working on clearer guidelines for labelling and regulation of added sugars and salts to food items.”
According to Dr SK Panda, advisor to the FSSAI is also in the process of launching more methodical, intensive and transparent quality checks on rice before being sent to distributors or markets, he shared at a World Food Day event held in New Delhi.
Doing it right
“The goal is not to eliminate carbs, but to choose the right type and amount,” says Dr Jhingan. Last but not the least, he advises people to try the ‘half-plate rule’. He explains, “Fill half your plate with vegetables, one-quarter with protein, and one-quarter with complex carbs. Practise portion control and stay active through regular exercise or walking.”
Healthy food myths
- Brown bread is healthier than white bread (GI: 65-70)
- Boiled potatoes are natural, and therefore healthy (GI: 80-90)
- Mangoes and grapes are natural sugars, and hence harmless (GI: 55 & 59, respectively)
- Flavoured yoghurts are a source of calcium (GI: 45-60)
- Fresh fruit juices are healthier than soft drinks (GI: 65-75 depending on fruit)
Balancing the meal
- Replace polished rice with whole wheat
- Practice portion control
- Go for balanced eating over carb elimination
- Add more protein, fibre sources
- Limit deep-fried sweets, snacks
