Indian diet to prevent chronic disease
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The prevalence of chronic diseases is rapidly increasing worldwide. Cardiovascular diseases, obesity, and diabetes are the most common chronic which already affecting a large number of people and has started to appear earlier in life. Chronic diseases are largely preventable diseases.

Inappropriate dietary habit is a major risk factor for chronic diseases. Replacement of traditional plant-based diets with high-fat, energy-dense diets containing a substantial amount of animal foods increases the risk and prevalence of chronic diseases. A sedentary lifestyle and physical inactivity in developing countries as much as in industrialized countries play a key role in developing chronic diseases [1].

What is a healthy diet?

A healthy diet includes the consumption of whole-grain foods, legumes, vegetables, and fruits and limits the intake of refined starches, red meat, full-fat dairy products, and foods and beverages high in added sugars. Such diets have been associated with decreased risk of several types of chronic diseases [2].

Maintaining certain basic principles of a healthy diet are effective to reduce the risk of chronic diseases, helps to good maintain general health, ensure immunity, and thus reduces the risk of infections.

Basic Principles Of Healthy Diet

1. Avoid a monotonous diet to become a healthy person.

Don’t eat a monotonous diet. Incorporate all types of foods in your daily recipes but don’t consume an excessive amount of a single food.[3], [4].

Scientific studies confirmed that increased dietary diversity reduces the chance of getting micronutrient deficiencies, cancer, cardiovascular disease, and all causes of mortality. To increase dietary diversity you may follow the basic tips-

  • Introduce variety in nutrients to prevent micro-nutrient deficiency

Consume different types of vegetables, (dark green, orange, legumes, starchy vegetables), fruits (citrus, berries, melons, stone fruits), dairy products (low-fat milk, curds, etc), and fishes throughout theweek[5].

  • Introduce variety in colours in your daily diet.

Try to make your recipes more colorful by using natural colors of fruits and vegetables. But be aware don’t use artificial colors in your cooking. Judicious use of beat paste, tomato paste, spinach paste, turmeric, curds, or milk in cooking can impart bright red, green, yellow or white color to your recipe. Such recipes are healthier, tastier, and more nutritious than the plane recipes.

  • Make your food more attractive and tasty by using seasonal vegetables.

The use of seasonal vegetables introduces more varieties in our cooking and increases our micronutrient intake. Tomato rice, palak paratha, carrot halwa, and lemon rice can be prepared in season.

  • Increase the flavour of your daily recipes by using easily available herbs and spices.

You can cultivate your herbs in your small kitchen garden or you can purchase dried herbs from the market.

Table-1: Types of natural flavouring agents

 Types Examples Sources
Fresh leaves Tulsi patta or holy basil leaves, Fresh Mint leaves or pudina patta, Fresh coriander leaves or dhania patta, Ajwain leaves Kitchen garden
Dried leaves Kasurimethi, Bay leaves (whole or powder) Purchased from the local market
Spices Amchur powder, Cinnamon powder, Cardamom powder, Oregano  
Juices Lemon juice, Imli juice Freshly extracted juices
Vegetables (grind) Ginger paste, Garlic paste, Tomato paste, Coriander paste, Spinach paste Freshly ground at home using domestic mixer grinder
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2. Limit your caloric intake to prevent obesity and overweight

To prevent weight gain, overweight, and obesity total calorie intake should be just adequate. Excessive intake of foods and calories causes excess accumulation of fat in the body. Restricting the consumption of sugar-sweetened beverages is important to limit calorie intake. Desirable weight for most people should be within the BMI range of 18.5 to 25.0, and preferably less than 23[6].

BMI = Weight (kg) / Height (m)2[5]

Benefits of a healthy body weight [5]

  • Feeling energetic
  • Looking better
  • Reduced risk of disease
  • Increased immunity
  • Improved general health

Table-2:  Tips for overweight individuals for reducing their body weight[5]

Do’s Do not
Take more fruits and vegetables.

Increase the intake of high fiber foods like whole wheat flour, oats, pulses, fruits, and nuts.

Reduce the portion size, as it helps to reduce the total calorie intake.

Do moderate physical exercise on regular basis.

Take more protein foods.

Take fermented milk products like curd, yogurt, buttermilk, etc.
Restrict the intake of high-calorie foods
like cakes, pastries, chocolate, desserts, etc.

Avoid sugar-sweetened beverages

Decreasing the dietary glycemic load (large amounts of rapidly absorbed carbohydrates from refined starches and sugar).

Excess consumption of foods having a high glycemic load may also contribute to obesity.

Restricting the consumption of refined grains, sugar, and cooking oil (vegetable oils).

Reduce the portion size, as it helps to reduce the total calorie intake.

Table-3: Tips for underweight individuals for increasing their body weight[5]

Do’s Do not
Eat at least five small meals and
snacks each day.

Try to increase energy intake by-Increasing intake of cereals foods like rice or roti

Increase the intake of high protein foods like milk, egg, fish, poultry, cheese

Drink healthy high-calorie beverages like whole milk, home-made fruit juices, milkshakes, etc.

Include a handful of groundnuts in your daily menu.

Maintain regularity in your mealtime.

Ensure adequate sleep.
Avoid stressful conditions.Avoid smoking

Avoid those foods which may create your digestion problem.

3. Modify your fat intake in terms of quality and quantity to reduce the risk of cardiac diseases and other chronic ailments

  • Reduce your total fat intake

Total fat intake should be restricted. Since the frequency of outdoor eating is restricted due to the COVID-19 outbreak, so the intake of fat through fast foods and restaurant food decreases. But the preparation and cooking of new foods, particularly snack items increase. These home-made fast foods like cakes, fried foods, chips, etc. are rich in fats. We should limit the use of fat in cooking as far as possible[4].

  • Include more foods rich in omega-3 fatty acids. 

Polyunsaturated fatty acids (PUFA) are of 2 types, omega-3 fatty acid (α-linolenic acid) and omega-6 fatty acid (Linoleic acid). Both are essential fatty acids that are they are required for normal human health but our body can not synthesize them. So, they must be supplied through our diet [7].

We should be careful to include more foods rich in omega-3 fatty acids in our daily diet.

Table-4: Alpha-linolenic acid (omega-3 fatty acid) content of selected vegetable oils, nuts and seeds

Oils, nuts and seeds Alpha-linolenic acid (g/tablespoon)
Flaxseed (linseed) oil 8.5
Flaxseed 2.2
Walnut oil 1.4
Canola oil 1.3
Soybean oil 0.9
Walnuts 0.7
Olive oil 0.1
  • Replace saturated fats with unsaturated fats

It is not only important to reduce the quantity of fat intake, it is essential to keep attention on the intake of quality of the fat consumed. Our diet should be balanced in terms of saturated fatty acids (SFAs), monosaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs).

A moderate intake of saturated fat (under 8% of daily calories) is not harmful but the intake of higher amounts increases the risk of cardiovascular diseases[2].

Replacing saturated fats with polyunsaturated fats[2]-

  1. lowers harmful LDL
  2. elevates protective HDL
  3. improves sensitivity to insulin
  4. stabilizes heart rhythms.
  5. decrease the risk of coronary artery disease

Table-5: Sources of MUFA, PUFA and SFA in our Diet[2], [7], [8], [9], [10], [11].

Types of Fat Examples Plant sources Animal sources
Polyunsaturated fatty acids (PUFAs) omega-3 fatty acid (α-linolenic acid)     Vegetable oils like rapeseed and canola oils, Green leafy vegetables, Nuts, Linseed or flax seeds.   ScombridaeClupeidae, and 
Salmonidae families of fishes including-Mackerel, Tuna, Herrings, Shads, Sardines, Hilsa, Menhadens, Salmon, Trout, Char, Freshwater whitefishes, and graylings.
  omega-6 fatty acid (Linoleic acid) Vegetable oils, Nuts, Seeds Meats, Eggs.
Monosaturated fatty acids (MUFAs) Oleic acid (>90%) Palmitoleic acid (minor MUFAs) Vegetable oils, Nuts, Avocado, Olive oil Red meats, High-fat dairy products, Eggs
Saturated fatty acids (SFAs)   Coconut oil, Coconut milk, Palm oils, chocolate Dairy foods, Red meat  
https://wellnessmunch.com/a-guide-to-pick-the-best-cooking-oil-in-india/

Tips for judicious choice of fats [5]

  1. For cooking purpose, unsaturated vegetable oils like olive, sunflower, canola, corn and soy oils are preferred than animal fats, palm oil or coconut oil, hard margarine or clarified butter (ghee).
  2. Drink low-fat milk (1%–2% fat) milk and dairy products.
  3. Restrict the use of cream, chocolate, ghee and butter in cooking.
  4. Select lean cuts of meat and discard the fat portion before eating.
  5. Restrict the intake of sausages and processed meats.
  6. Do not consume more than one egg in a single day.
  • Avoid consumption of trans fatty acids

Trans fatty acids are produced by the partial hydrogenation of vegetable oils. They are more dangerous than saturated fats. Since partially hydrogenated soybean oil is a comparatively cheap cooking fat available in many developing countries, trans fat consumption is high in these regions. In South Asian countries, vegetable ghee largely replaced traditional ghee and it contains around 50% trans fatty acids. Regular use of foods containing trans fat may cause abnormal lipid profiles, heart diseases, and diabetes mellitus [6].

4. Modify your Protein intake in terms of quality and quantity to achieve good immunity

 

  • Ensure adequate protein intake

Adequate protein intake is essential for all persons. For maintaining good immunity, you should include an adequate amount of proteins in your daily diet. Protein deficiency compromises immunity. During any type of infection, protein requirement increases. You should include the adequate quantity of protein in your daily diet. For a healthy person, 1g  protein per Kg of body weight is required.

  • Take more plant protein foods

The dietary protein should come from both animal protein (meat, fish, egg, poultry, and dairy products) and plant protein (pulses, nuts, etc.)

Consume the liberal amount of plant protein foods like pulses, nuts, seeds and beans.

Eating more plant protein foods help to fulfil your appetite and at the same time reduces the risk of heart disease[2]. 

  • Restrict the intake of animal protein foods

Animal proteins contain all the essential amino acids and thus very helpful for sustaining the rapid growth of children and adolescents. So, they can be liberally included in the diet of growing children. But, animal protein foods are also a good source of saturated fats and cholesterol and they are devoid of any dietary fiber, so their intake should be restricted to 1/3rd of the total protein intake.

  • Replace full fat milk with skimmed milk

Milk is a very good source of protein, but at the same time, they are also rich in fat. So, to achieve maximum health benefits you should take a liberal amount of milk and dairy products, but use low-fat skimmed milk instead of full-fat milk.

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5. Ensure regular intake of probiotics rich foods

Consume curd (Dahi) and buttermilk regularly. These dairy products contain probiotics, which help to maintain the overall health of the digestive system and prevents constipation. Consume fermented foods like dosa, idli, overnight soaked rice, etc which act as prebiotic.

https://www.youtube.com/watch?v=j129vWbY8hw

6. Modify your Carbohydrate intake in terms of quality and quantity to reduce the risk of Obesity and Diabetes

  • Restrict the intake of foods having a high Glycemic Index

The glycemic response refers to the increase in blood glucose level after consuming carbohydrates. The greater the postprandial spike in glucose a food generates, the greater that food’s glycemic index.

Highly refined grains cause a more rapid and greater overall increase in blood sugar than less-refined whole grains. Greater glycemic responses are accompanied by increased plasma insulin levels, which increases the risk of obesity, diabetes, coronary artery disease, and women’s infertility. 

On the contrary, high fiber foods like whole grains and their products, fruits, vegetables, and beans, provide slowly digested carbohydrates and thus low glycemic index. Regular intake of foods having a low glycemic index reduces the risk of cardiovascular disease and type 2 diabetes[2].

  • Reduce your sugar intake to prevent obesity, diabetes and heart diseases

Sugar has no nutritional value except for calories. It has several negative health implications. Sugar contributes to the high dietary glycemic load, which increases the risk of metabolic syndrome, diabetes, and CAD. WHO limits the upper limit of sugar intake, a maximum of 10% of energy can be obtained from sugar, but lower intakes are desirable [6].

Sugar is a very commonly used food ingredient, used extensively in modern society to increase the taste of recipes. Excessive consumption of sugar is one of the main foods inviting several lifestyle diseases such as [12], [13], [14]

  • Obesity and overweight
  • Diabetes
  • Dyslipidemia
  • Elevated blood pressure
  • Non-alcoholic fatty liver disease
  • Cardiovascular diseases etc.
  • Cancer

It is good for our general health to reduce the intake of sugar as far as possible [3], [6].

Since the addition of sugar makes the recipes more palatable, excessive sugar is a component of several commercial health drinks, soft drinks, fast foods and desert.

Sugar consumption can be reduced by following certain do’s and do not

Table-6:Tips for reducing daily sugar intake[5], [15]

Do’s Do not
Reduce the use of sugar in making your
favorite desserts.
Do not add sugar to your day-to-day recipes like  dal, sabji etc.
Take more whole fruits. Avoid consumption of commercially available preserved fruit crush.
Prepare home-made fruit juice without adding any sugar. Serve the
freshly extracted fruit juice to your
kids as a refreshing drink.
Avoid all types of commercially available fruit juice.
Serve home-made nimbu pani instead of serving soft drinks. You may also serve healthy and tasty chaas or lassi. Avoid all types of cold drinks
(soft drinks).
Prepare home-made sweets like
gajar halwa, Sandesh, etc. with using a restricted amount of sugar.
Reduce the frequency of purchasing sweets. Restrict the amount of sweet intake.
Prepare snacks using restricted
amounts of salt and sugar.
Avoid snacks from outside.
Prepare nutrient-rich health drink
mix in your home, using milk powder,
roasted cashew, almond, and groundnut.
Avoid commercially available sugar rich health drinks.
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7. Include more fibre in the diet.

The inclusion of a good amount of dietary fiber in our daily diet is a good approach to reduce the risk of many lifestyle diseases like obesity, hypertension, CAD and type 2 diabetes, etc. Fruits, vegetables, whole grain cereals, pulses, and nuts are good sources of fiber [6].

Fresh fruits and vegetables provide lots of vitamins and minerals as well as fiber that we need to prepare a healthy diet[3].

Table-7:Tips for increasing our daily fibre intake

Do’s Do not
Take more fresh fruits Avoid commercially available
fruit juice.
Take more green leafy vegetables Do not discard the nutritious, high fiber
part of the vegetables like watermelon
rind or cauliflower leaves during cooking.
Use whole grains. Encourage the use of whole wheat flour. Discourage the use of refined f
lours like maida (refined wheat flour)
Take combinations of grains as staple foods. Avoid depending on single type of grain.
Try traditional breakfast recipes like roti sabji, doa, idli, mik and puffed rice, poha etc. Avoid processed foods like
instant noodles, corn flakes, etc.
Take whole fruits, without discarding their fibre part.
Whole pomegranate is more nutritious than pomegranate juice.
Change the habit of taking fruit juice
instead of the whole fruit. You may try home-made fruit crush prepared from fresh whole fruits without discarding their fiber part.

8. Reduce your salt intake to prevent hypertension and other cardiac ailments

Hypertension is a common health problem among Indians. High blood pressure is a major risk factor for stroke and coronary disease. The presence of pre-existing hypertension increases the severity of COVID-19. So, we should try to control our blood pressure. Habitually we are taking excess salt which is the main culprit behind the widespread prevalence of hypertension (high blood pressure).

Restriction of salt is the easiest way to control our B.P. WHO has suggested an upper limit of 1.7 grams of sodium per day (5 grams of salt per day). High salt intake is a bad habit. Try to change your habit to avoid lifestyle disorders[4], [6], [16].

You can reduce your salt intake by simply following certain basic changes in your shopping, cooking and eating habits. Some tips are given in the table-2.

Table-8: Tips for reducing daily salt intake [15]

Tips Do’s Don’t
Shopping tips: Use freshly prepared, home-made, low-salt sauces like chilli sauce, tomato sauce etc.

Encourage family members for home-made breakfast like roti, puri, Dalia, poha, etc.

Purchase freshly slaughtered animal foods like mutton, chicken, pork, beef, etc.

Prepare home-made low salt pickles
Limit purchasing sauces like pasta sauce, tomato sauce, soy sauce, chili sauce, etc.

Reduce purchasing of “instant” products like including flavored rice, instant noodles, and ready-made pasta. 

Reduce the frequency of purchasing processed breakfast cereals.

Reduce the intake of cured, salted, smoked, and other processed meat.

Avoid commercially available pickles.
Cooking tips Reduce the use of salt in cooking gradually. 1g of black salt contains less sodium (390 mg of sodium/ g of sodium chloride) than in the present 1g of common salt (378.3 mg of sodium/ g of sodium chloride). So mix an equal proportion of black salt and common salt, shake well, and use it for your daily cooking.

Reduce the use of salt in making salad and soup

Use salt substitutes like garlic, citrus juice, salt-free seasonings, or spices in the cooking.
Do not add salt to atta or maida during preparing chapati or roti.

Don’t add salt in freshly cut fruits like cucumber or banana.  
Eating tips Eat unsalted nuts

Consume more milk, yogurt, and
panner.

Eat smaller portions of salty foods. 

There is no need to eliminate your
favorite high-sodium recipes like
soy sauce, salted pickles, and fish,
or cheese but reduce the frequency and quantity.

Consume more fresh fish.      
Avoid taking any extra salt to foods while eating.reduce taking salted buttermilk, cheese as far as possible as both cheese and buttermilk are rich sources of sodium chloride.

Limit the intake of bread and biscuits which are rich sources of sodium.

Reduce the intake of fast foods that are rich in sodium but poor in other nutrients.

Reduce eating outside food as restaurant foods usually contain more salt than homemade foods.

Avoid salted and dried fish, commonly called “sutkimach”. 
Formation of healthy habits Habituate your child with low salt from early childhood. The tendency
of high blood pressure starts to
develop from childhood due to excess
salt intake and an unhealthy lifestyle.
Don’t let the taste buds of children to get adjusted with high salt.    

9. Increase the intake of antioxidant contents of your diet

Oxidative stress is a major causative factor of several lifestyle diseases, like obesity, cardiac disease, hypertension, diabetes, and many more. So, we should try our level best to reduce oxidative stress. Citrus fruits, lemon, guava, amla, etc are rich sources of vitamin-C. We should take two servings of vitamin-C rich fruits. Vitamin-C is effective to improve our immunity against infection, particularly respiratory diseases.

10. Hydrate your body and avoid dehydration.

Adequate hydration is essential for all. Water is needed for the smooth operation of body functions. Staying well-hydrated, mainly through drinking ample amounts of plain water (6-8 glasses a day for most adults) helps to–

  • maintain good immunity[3].
  • prevent kidney stones [17].
  • prevent obesity.

Reduce the consumption of sugar sweetend beverages and alcoholic beverages.

11. Avoid all types of processed foods

Processing of foods removes fiber, healthful fats, and an array of vitamins, minerals, and phytonutrients from the raw ingredients, degrading the quality of processed foods. For this reason, whole grain cereals (i.e. whole wheat flour or brown rice) is healthier than white flour or white rice

Consumption of a diet rich in highly processed grains increases the blood triglyceride level and reduced the protective HDL level[2]. 

So, yes always depends on our traditional diet, don’t go instant foods, fast foods, instant breakfast.

https://wellnessmunch.com/5-toxins-you-are-feeding-your-child-daily/

12. Maintain good hygiene to prevent gastrointestinal infections

Maintenance of personal hygiene, preparation of foods in a clean kitchen, and drinking safe water help to reduce the risk of food poisoning and chronic digestive problems[3].

Bottom Line

Chronic lifestyle diseases like cardiac ailments, obesity, and diabetes, are major health problems that can be prevented by dietary modifications and changes in lifestyle. Our diet should be balanced in terms of calories, protein, carbohydrates, vitamins, and minerals. We should hydrate our bodies by drinking adequate water and liquid foods. We should avoid foods having a high glycemic index, saturated fats, cholesterol, trans fats, and high sugar content. We must include enough amounts of whole grains, pulses, nuts, fresh vegetables, and fruits. Consumption of processed foods and beverages should be avoided. Smoking and alcohol consumption is bad for our health. We should take a variety of foods to ensure adequate intake of vitamins, minerals, dietary fiber, and antioxidants.

References (retrieved on 4. 2.21)

  1. http://www.fao.org/3/AC911E/ac911e04.htm#bm04.1
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3471136/
  3. http://www.fao.org/3/ca8380en/CA8380EN.pdf
  4. http://www.fao.org/nutrition/education/food-dietary-guidelines/regions/countries/india/en/
  5. https://applications.emro.who.int/dsaf/emropub_2011_1274.pdf?ua=1
  6. https://www.ncbi.nlm.nih.gov/books/NBK11795/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827073/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875103/
  9. https://www.sciencedirect.com/topics/medicine-and-dentistry/monounsaturated-fatty-acid
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3650500/
  11. https://www.sciencedirect.com/science/article/pii/S0735109720356874
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133084/#:~:text=Consumption%20of%20added%20sugars%20has,decline%20and%20even%20some%20cancers.
  13. https://pubmed.ncbi.nlm.nih.gov/26376619/
  14. https://pubmed.ncbi.nlm.nih.gov/23493538/
  15. https://www.who.int/news-room/fact-sheets/detail/healthy-diet
  16. https://juniperpublishers.com/jocct/pdf/JOCCT.MS.ID.555634.pdf
  17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908954/

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Dr. Sagarika Chakraborty was awarded her doctorate in Food and Nutrition from University of Calcutta (C.U.) in 2017. She is an experienced Researcher, working in the field of Food Science for more than 12 years and published papers in international and national journal. She has also presented papers in national conferences.

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