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Dangerous Diets

Overfed yet malnourished, palate-pampered yet bulimic, an entire generation of urban Indians is launching a system-starving assault on health

CHEW on this one—you are what you eat. And you’ve been eating a lot of junk food lately.... Blame it on Diwali, or some other equally incidental, trite excuse, but there’s a good chance you’re going to continue your mindless gluttony unhappily ever after. Letting fickle taste-buds triumph over cholesterol-clogged arteries. Taking on an anaemic pallor as you pucker your nose at the greens. Beating hunger with a candy and letting diabetes win the day. Or else, you add regular inches to that ungainly potbelly of yours with irregular gorging sessions. Then you diet yourself to sickness in the hope that you’ll look your anorexic best one day. Bilge-bingeing and starving by turns. Picking up a bite here, a mouthful there and a host of bad eating habits everywhere.

You aren’t the only one. This is the age of the palate-pamperers, victims of urban India’s new dietary anarchy who have joined the assault on health through bad food choices. Not just with oodles of fats and sugars, but also system-starving with meagre supplies of fibres, proteins and minerals. Result: an unbalanced diet that leaves the body vulnerable to what are fashionably called Diseases of Civilisation: chronic stomach ailments, diabetes, hypertension, heart problems, even cancer. Ever wonder why Digene sales are going up? Blame it on a new disease: gastro-exititis, simply put, eating out.

For Bhuvesh Madan, 22-year-old student at Delhi College of Engineering, breakfast is coffee and lunch is two oil-bathed bread pakoras and yet more coffee at the canteen. Banker Sailaja Chowdhary has milk and bread for breakfast and forgets about lunch every other day. "But I do have some wafers when I feel hungry," she qualifies. Dinner is either a micro-waved burger picked up on her way home or a couple of shami kababs served with drinks at a party. "Yes, I suppose I really am eating badly. Frankly, I never gave it much thought.... But then, I suppose everybody is eating badly. I have a five-year-old niece whose staple food is Pepsi and chips! Her mother does nag her about the chips, but is absolutely fine with the Pepsi."

"What the upbeat, upmarket Indian is eating today is a far cry from what his parents did. And it shows on his health. His choice of food and knowledge of nutrition is pathetic," says Vijaya Venkat, a Mumbai-based health activist. Vijaya, who markets over 200 packages of her health-meals to various offices in the megapolis, observes that West-inspired notions about food have rendered almost an entire generation of post-liberalisation urban Indians unhealthy. "Throwing away granny’s wisdom, he (the urban Indian) has picked up a fancy for tinned and tetra-packed food full of preservatives and additives. Kellogs for breakfast, McDonald’s for lunch and Perk to pacify the hunger pangs in between will ruin him," warns the food guru.

Food and nutrition are now way down on the priority menu, says Bangalore-based food historian and nutritionist K.T. Achaya. A result, he believes, of today’s changing family structures and hectic schedules which are increasingly forcing people to eat out. Concurs C. Gopalan, director of the capital’s Nutrition Foundation of India (NFI): "The urban Indian, who constitutes only 5 per cent of the population, consumes about 40 per cent of the total available edible fat in the country. His diet was always fat-rich, but eating out has aggravated the problem. He gathers more fat round the girth and picks up chronic illnesses on the way."

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So, while an All India Institute of Medical Sciences survey places 33 per cent adults in an upmarket south Delhi colony under the ‘fat’ category, another study by nutritionist N. Gopinath indicates that the obese are twice as likely to suffer cardiac ailments, diabetes and even hypertension. There are more surveys for the cynics. The book Towards Better Nutrition, brought out by NFI, links high occurrence of coronary heart disease among urban Indians to their high intake of ghee and edible oils. Heart diseases in urban Delhi, it indicates, are over six times more than in suburban villages.

Not that fat is the only villain in the theatre of absurd eating. A complete disregard or ignorance of the roles of other important actors often results in their being dangerously miscast. Not surprisingly, the National Nutritional Anaemia Prophylaxis Programme found 87.5 per cent of all pregnant women in India anaemic because they had starved their bodies of an iron-sufficient diet.

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 Unfortunately, growing children with their new-found thirst for Coke and devil-may-care eating habits bear the brunt of malnutrition. A recent statement issued by the Brihanmumbai Municipal Council reveals two-thirds of Mumbai civic schools’ students are malnourished and "faint from hunger, suffer from low-weight, vitamin A deficiency, dental problems, and TB". Another study conducted at Baroda’s M.S.University found 51 per cent of its upper-crust girl students anaemic. Their bodies had less than one-third of the iron recommended for their age.

But the harshest indictment of our bad eating choices came last month, with the release in the capital of the first global report compellingly linking diet and cancer. The report claims that three to four million cancer cases could have been prevented by intake of healthy food and nutrition. Cautioned Dr Kamala Krishnaswamy, director of Hyderabad-based National Institute of Nutrition (NIN): "Cancer is a growing problem in the country and a major reliance in combating this dreaded disease must be through better dietary habits and lifestyles." Citing 4,000 studies worldwide that explore the role of diet in the dreaded disease, the report states that those who consume vegetables, fruits or fermented foods such as buttermilk daily and fish more than once a week are protected against various cancers. The study cautions that excessive consumption of red chilli powder and eggs could lead to oral cancer. And that mouldy foods and vegetables containing nitroso compounds and mycotoxins may cause cancer of the oesophagus.

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Says Ishi Khosla, nutritionist in Escort’s hospital: "The link between food and disease is complex. But it wouldn’t be too presumptuous to suggest that poor eating habits may affect the body and mind in subtle ways. Say, for instance, triggering depression, disturbing concentration and memory, upsetting sleep patterns, thinning hair, disrupting menstrual rhythms, even flagging libido."

DIETING, snacking, nibbling, power-lunching and food-fadding in turns, we seem to have forgotten how to Eat. With national statistics saying one-third of the world’s malnourished children are in India, we’ve got to be a country of bad eaters—some as hapless victims of food shortage, others by choice.

 The malnourished urban Indian is a recent phenomenon—a contrast to that well-recognised figure from famine-prone rural belts who has always been malnourished simply because not enough food was available. This partly explains why urban eating mores have hardly been documented. With the rise of the city and the consequent dissolution of age-old family structures, the traditional dinner table—which had a well-structured, even religious aspect—is becoming passé. An increasing number of urban Indians don’t have the faintest idea about what and how they should, or rather shouldn’t, be eating. But they do know they want to be eating out.

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With the rise of the culture of eating out has come about the subversion of the established logic of appetite. Eating at home usually meant you ate a variety of foods at regular hours, assimilating more or less the required quota of essential nutrients. Now you don’t eat when hunger beckons but rather when the tongue tempts, or when company warrants. Which, more often than not, means stuffing yourself with an overdose of fat, oil, salt, sugar, food additives and preservatives at the expense of fibre, proteins, vitamins and minerals. And at moments when the body is probably enjoying its metabolic siesta.

Blame it, like everything else, on economic liberalisation, which has brought in its wake not only money-making opportunities, but also a whole new culture of materialism that has opened up a magic box of desires to the avaricious Indian eye. Turning him into the quintessential, unthinking consumer of most things, including food, which is today no more nor less than a commodity.

"Thai one day, then Mughlai and perhaps Chettinad next. Both my husband and son love variety in food. I don’t remember cooking a staple dal-roti-subzi continuously for an entire week in a long time," says 31-year-old Mumbai housewife Sukanya Shanmugam. Distressed mother Sujata Maheshwari complains of the dietary habits of her school-going daughters. Nothing but wafers, cold-cuts, chocolates and cokes satisfy their appetites, she frets. "Our parents forced us into having leafy vegetables and dals but try forcing today’s children. They have much pocket money and will buy whatever you are unwilling to supply them with," she says. Added to this is the child-targeted marketing by fast-food giants like McDonald’s, Pizza Hut and KFC.

But, in the market of ill-health, the West is not the sole seller. We have a indigenous junk food industry here, churning out oily chhole-bhature, fibre-starved pao-bhaji and dusty dal-badis dished out in dirty dhabas and filthy roadsides. A recent study by NFI reveals that most samples of street foods—the staple diet for a large section—were contaminated with pathogens like E Coli, Klebsiella and Porteus, all harbingers of serious health problems. Says Dr Rakesh Tandon, head of the department of human nutrition at AIIMS: "Food poisoning is quite common in Delhi. Because we don’t care where or what we are eating." We do seem to be treating ourselves to the worst party in town—couch-potato television times, popcorn-Pepsi cinema house trips, street rendezvous with chhole-kulches, deep-fried cutlet breaks at college canteens. "By the time I am back from office I have stuffed myself with so much fattening junk that I skip dinner," says Meenakshi Saith, photographer with an advertising firm.

The desperate desire to be slim only worsens things further. After going through four diets picked up from different magazines, 22-year-old Arpita Dutta recently visited the doctor with a disrupted menstrual cycle. "I also discovered I had anaemia and low-blood pressure because of the torture I put my body through. But, frankly, the need to be slimmer still exists and I’m always on the lookout for a better diet," she says.

Arpita is one of a growing legion of anorexics who starve themselves to emaciation in pursuit of the body-ideal. A recent survey by the National Institute of Mental Health and Neurosciences revealed that a growing of number of schoolgirls in Bang-alore were suffering from either of two eating disorders—anorexia or bulimia. Signifi-cantly, the report indicated that the emerging new idols for the Bangalore adolescent were Sushmita Sen and Aishwarya Rai.

NOT that lifestyle choices are wholly to be blamed for our unhealthy diets. Traditionally too, our cooking habits haven’t been without fault. The excessive use of ghee and oil in traditional cooking is probably why, genetic predispositions notwithstanding, pot-bellies and diabetes loom large on the Indian health-scape. Variations in taste, availability of food and economics also dictate the balance-sheet of food. South Indians, for instance, eat a lot of rice but fewer vegetables and fruits. "This," surmises Tandon, "probably explains why they get more stomach cancers. Likewise, Punjabis eat a lot of ghee and sweets, making them more susceptible to diseases of the heart." Moreover, cooked lingeringly on the stove for better taste, many Indian preparations end up with "disfigured" vitamins and minerals.

The pressure to produce more is depleting our soils, and in turn our food, of essential nutrients such as copper, iron and zinc. And then there are the chemical contaminants. What do you do if the vegetables in the market are doped with pesticides and insecticides? Studies by the Indian Agricultural Research Institute revealed, depressingly, that Delhiites have high levels of DDT—a pesticide banned only recently—in their bodies.

Processed foods pose another potential hazard. Unlike in the US and other advanced countries, it is not mandatory that the Indian manufacturer mentions the ingredients on the package. So when you buy tinned bean salads, packaged flour, frozen peas, bottled soft drink, or frozen meat, you can never be sure just how safe these foods are.

Yet, till illness actually strikes, it’s a sad minority that treats their plate with the seriousness it deserves. And that too, only when major illness like cancer, heart disease or diabetes get a grip on the body. Says Khosla: "Alarmingly, people tend to overlook minor disorders such as heart burn, headache, fatigue, forgetfulness, and constipation, that bad eating does instigate."

Unfortunately, however, eating a balanced diet is not quite that easy. For one, prejudices of the palate are hard to shed. For another, with the accelerating pace of modern life, who has the time to figure out whether the body is getting enough calories, let alone nutrition? The tantalising variety of foods now available in the market makes things even more difficult. Earlier, people had no choice but to eat what was served on the dinner table. And the fare, except probably for ghee, had all the elements of a healthy diet—lots of vegetables, dals, rice, roti and curd. Says K.T. Achaya: "We are eating less pulses, less fibre, more refined sugar and too much fat and oil. " Indeed surveys reveal that in cities the consumption of fibre goes down by 50 per cent while that of fat goes up by 30 per cent.

Even the informed, well-intentioned consumer has been left not a little confused with the conflicting information about good and bad foods. In fact, the not-so-well-understood link between food and well-being has led to all kinds of wrongheaded notions about food, including food fads.

 So, what does the food imbibed really do to us? Is it merely fuel for the body or does it affect, as it were, the soul too? As renowned French anthropologist Levi Strauss once remarked: "Food must not only be good to eat, but also good to think." A food culture, a culinary system, provides us with a way of doing precisely that, putting order to the universe internal.

The Vedas did that perfectly. Classifying various foods as Satvik, Rajsik, and Tamsik, they ascribed to them qualities that were passed on to the eater. For example, if you ate a lot of ghee, sugar and spices, you acquired a Rajsik nature marked by anger, lust, and ambition. Essentially, you became what you ate. This Vedic gastronomy was, and still is in many Indian homes, very much part of Indian ethos till the arrival of the market-driven, Mammon-inspired, culture-conscious modern urbanite who looks westwards for Food Fundaas. And curiously enough, the confused but awakened consumer in the West is fast shunning modern junk foods in favour of healthier foods from cultures like ours.

Precisely because food patterns in the West have already gone haywire, culminating in what French food philosopher Claude Fischler calls nutritional cacophony. It would appear that, for the perplexed modern consumer, there is no definitive guide to good eating. Though there is a reckoner called the Recommended Daily Allowances (RDA), it hasn’t really helped the consumer choose better. And for most, it is not easy to think of calories, proteins and vitamins as they buy their daily rations.

THE confusion is real: How much should I eat? How should I structure my meals? Should I eat when hunger strikes or should I follow a pre-ordained rhythm? Is fat completely taboo? Is meat really bad? How should I choose a vegetarian diet so that I get all the essential nutrients in the right proportion? Do spices cause ulcer? Is a little wine or beer OK? There must be hundreds of such questions for which there are no unequivocal answers. But there are as many opinions as there are tongues. Dieticians, psychiatrists, consumer groups, alternative medicine practitioners, food industry, cooks, and, of course, the food-enthusiast who loves to experiment on himself, all offer varying advice on what healthy eating all is about.

So, exasperated with this cacophony of opinions, the average consumer reconciles his dilemma thus: "Damn it, I shall enjoy while it lasts". Or, as Epicure philosophised: "Eat, drink and be merry for tomorrow you die." The eating binge goes on till diabetes or hypertension strikes. Whereupon the hedonist-cum-cynic-cum-sceptic suddenly becomes a food faddist, turning either to folk food-wisdom or modern, scientific dietetics. So he eats nothing but fruits. Guzzles 20 glasses of water every day. Fasts three times a week. Licks a jar of honey a day. Buys only organic food. Shuns spices, abhors fat, eschews sugar. Consults an alternative healer. Does music therapy. And picks up a whole lot of eating oddities—branded by some as ‘good eating habits’, and others as ‘unnatural’.

For, like sex, food easily lends itself to moral judgments and ideological bias—as is borne out by the long string of medical theories and popular beliefs on such topics as meat, sugar, fat and, most vividly, cholesterol.

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