April 7, 2020 10:00:56 am
As we battle coronavirus, it is important to know that chronic ailments such as diabetes, heart diseases and obesity continue to increase at an alarming rate in India. Indianexpress.com caught up with physician and award-winning nutritionist Dr Vishakha Shivdasani on World Health Day for her perspective and advice on treating chronic illnesses and building immunity.
On this World Health Day, what health conditions (other than coronavirus) concern you the most?
The fact that diabetes and obesity are the fastest-growing epidemics in human history, and not very much is being done at a preventive level to change that.
Amongst the chronic diseases which one are the most widespread in India? Which ones are growing at an alarming rate?
Well, we are the diabetic capital of the world, though China seems to be beating us at that one. Besides Type 2 diabetes, other chronic ailments growing at an alarming rate are obesity, heart disease, polycystic ovarian disease and certain cancers.
What in your opinion has lead to this rapid increase in diabetes , obesity, and other chronic ailments?
Lifestyle. From the way we eat (high carbohydrates and omega 6 fats) to lack of exercise, to high levels of stress and inadequate sleep. All lead to chronic disease.
Can you elaborate more on the role of processed foods and refined sugar?
Processed foods kill. It is what causes chronic disease, and chronic disease puts us at risk for acute disease too.
Firstly, it’s a combination of sugar that’s added to the processed carbs that in turn cause inflammation and compromises your immune function. Sugar is the enemy of a strong immune system.
Secondly, omega 6 fats that are added to processed food cause inflammation, resulting in chronic disease.
Most processed ‘foods’ should not be labelled as ‘foods’. They should be called processed ‘substances’. Yes, a very small percentage of them might retain the whole grain and not use refined sugar. But most are first stripped off their original nutrients, through processing, then they are ‘fortified’ with artificial vitamins and added chemicals used to increase their shelf life and make them taste good. Which is why they are so addictive. They also are often high in cheap omega 6 fats, refined vegetable and seed oils like soya oil and sunflower which are often hydrogenated and turn into trans fats. Those are the ones that cause heart disease. Not the consumption of good fats like olive, avocado and ghee. As a result, all fats get a bad name, which is wrong.
They can also be high in one of the worst forms of sugar-hfcs (high fructose corn syrup), which is the real trigger for inflammation and, therefore, of heart disease, diabetes and PCOS. Because these conditions are all inflammatory in origin, these sugars are also ‘empty calories’ which mean they have zero nutritional value, but they cause sugar spikes, make you more hungry, and trigger weight gain, cause insulin resistance and diabetes. Yet you yet crave them. It’s a vicious cycle.
Would you say Indians are less reliant on processed foods since we do believe in cooking fresh meals everyday, unlike the West? Or do you see a vast number of chronic diseases here as well, related to processed foods?
Post-lockdown, I went to the supermarket to get my ‘essential’ groceries. It was so odd that the veggies and fruits and milk etc were freely available, but the aisles of Maggi and pasta, biscuits and bread and sodas were completely empty. Stocking up on junk food is not going to help us survive a pandemic. Let’s rethink this strategy.
And sure we don’t eat as much of processed meats, frozen foods and sodas as the West on a regular basis, but the consumption of breakfast cereals and white and brown breads, and specially biscuits is huge here. And pizzas, pasta and noodles consumption in urban India is also huge.
Which processed foods are the most harmful to consume?
The ones that are loaded with HFCS — high fructose corn syrup — obviously, but sugar has 56 different names. And most of the ones that say ‘sugar free’ have sometimes not one but multiple forms of these sugars and the common man does not identify them as sugar but these are the ones that cause the most damage and lower immunity.
Foods which contain Omega 6 are also harmful as these are pro inflammatory’. These are the ones that can cause heart disease.
‘Low-fat’ processed food is nothing but a big con. The only one benefiting from that is the food industry, so the first thing I do is take my patients off everything ‘low-fat’ or ‘fat-free’.
Apart from being a GP – you specialise in nutrition. Do you feel you can reverse some of these chronic ailments, often caused by lifestyle, using nutrition alone?
Most chronic illness can be reversed completely with lifestyle alone. So yes, I am not the pharma industry’s favourite doctor and I am known as the doctor who reduces patients medication. But I’m qualified to know when and how to do that and because the patient is directly under my supervision. I can change the medication if I spot a red flag. We have reversed so many Type II diabetics, PCOS cases and made patients drop up to 50 kg just with lifestyle interventions.
For diabetes or insulin resistance, how would you keep it under control with nutrition?
It’s quite simple really. You just need to reduce the intake of carbohydrates significantly and make sure you have reasonable amount of protein but not too much (like several fads suggest) and have a good amount of good fats. Don’t fear them, just make sure they are not hydrogenated vegetable oils and that they are good fats like ghee, olive oil or avocado oil.
In these days of coronavirus, diabetics, asthmatics and those with cardiovascular disease are more at risk, why is that?
Covid-19 seems to affect people with compromised immune systems the most. Which is the case with most patients with these conditions. And these are also morbidities, which means you are unhealthy. And one is more likely to be hit hard if unhealthy.
What advise would you give them at a crucial time like this?
Up your immunity. Eat real food. It’s your best natural defence to fight any pathogen, be it a bacteria or a virus. It may not stop you from getting the virus but it’s certainly your best chance to survive if you do get it. Drop the sugar. Add supplements like zinc, vitamin C, Omega 3 and Vitamin D. Also add natural anti-inflammatory foods which is available in every Indian kitchen like turmeric, black pepper, ginger, garlic and cinnamon. Drink lots of water, sleep well, exercise, but don’t over-exercise. Over-exercising can backfire and reduce immunity.
Does our healthcare systems have the infrastructure to deal with the growing number of chronic diseases?
Nobody does. I think chronic lifestyle ailments are a huge financial burden on any government and from the looks of it, it’s only going to get worse. We are focused on medicine for symptoms not on prevention and lifestyle.
What would your advice be to the health ministry?
Let’s form a governmental task force of doctors who practice functional medicine and incorporate lifestyle as first-line approach and develop programmes to make people healthy and not wait for them to fall sick and then treat them. It’s really about preventative medicine.
📣 The above article is for information purposes only and is not intended to be a substitute for professional medical advice. Always seek the guidance of your doctor or other qualified health professional for any questions you may have regarding your health or a medical condition.
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