Dietary guidelines for Indian’s by National Institute of Nutrition

Few weeks back I got a chance to download and start reading dietary guidelines for Indian’s  provided by NIN , click here to download (P.S : its about 126 pages document) some of the recommendations were blindly followed from AHA from USA.  Given below were my review and they should have better done the research and written the final draft.

for example on page 14 for fats

Adults need to be cautioned to restrict
intake of saturated fat (butter, ghee and hydrogenated fats) and cholesterol (red meat, eggs,
organ meat). Excess of these substances could lead to obesity, diabetes, cardiovascular
disease and cancer
.

on page 17

Adults should choose low-fat, protein-rich foods such as lean meat, fish,
pulses and low-fat milk.

on page 45

Diets that provide excess of calories, fats and cholesterol elevate blood lipids
(cholesterol and triglycerides) and promote blood clotting.
Excessive fat in the diet increases the risk of obesity, heart disease, stroke and
cancer.

on page 48

Saturated fatty acids are known to increase serum total and LDL cholesterol
levels, reduce insulin sensitivity and enhance thrombogenicity and increase CVD
risk.

 

cholesterol intake should be maintained below 200 mg/day. One
can reduce both saturated fat and cholesterol intake by limiting the consumption of
high-fat animal foods like butter, ghee, meat, egg and organ meats and consuming
low fat (skimmed) milk instead of whole milk. However, consumption of eggs (3
eggs/ week) is recommended in view of several nutritional advantages

on page 61

High intake of salt (sodium chloride) is associated with high blood pressure
and stomach cancer.

on page 62

There is a strong association between salt intake and blood pressure.
Prevalence of hypertension is low in populations consuming less than 3 g salt per
day. The usual increase in blood pressure with age is also not seen with such
intakes. The amount of salt consumed is reflected in urinary sodium. Drastic
restriction of dietary salt decreases the risk of hypertension. However, this effect is
not uniform as only 20-30% of population are salt sensitive

Most of the above points from the draft has not been proven and in some places they were contradict their statement itself for example above they were asking people to reduce intake of salt but not sure that taking more salt directly co-relates to  get blood pressure. In my honest opinion they should have done better job by spending more time on research and validate their assumptions and write the guidelines and publish to public

Book review – Freedom from diabetes manual & recipe handbook by Dr.Pramod Tripathi

I have recently bought the ebook released by Dr.Pramod tripathi on manual & recipe handbook of freedom from diabetes , given below were some of the notes from the book.

· Dr Neal Barnard for bringing to the forefront the role of fat in insulin resistance and publishing his research papers that reversal is possible

· Type 2 diabetes happens because

o Excess fat interfering with the action of two major hormones – Insulin & leptin

§ Major cause of diabetes is not sugar but FAT

§ Excess fat inside muscle cells causing insulin resistance

§ Leptin hormone produced by fat cells

· Responsible for communicating with brain to give a signal to stop eating food

· Making the fat move from storage

· Tell the brain to start burning fat whenever there is more fat cells there is more leptin and consequently the body becomes leptin resistance

o Acidic and inflamed system interfering with repair mechanisms

o Lack of micro nutrients interfering with energy production and repair

· More fat = more insulin resistance = more work for pancreas and exhaustion of pancreas = blood sugar raise = Diabetes

· Diabetes is primarily not a disease of carbohydrate metabolism but fat metabolism

· Our blood and most body bards are alkaline and continuously being in a sea of acid doesn’t help the system to recover so shit to diet which will be more on alkaline i.e. low on fat , acid and high on micronutrients

· Our body is largely alkaline so when you through the diet [tea is acidic, milk is acidic, all animal products are acidic] supply a regular dose of acid there is subtle inflammation continuously present and this advances the diabetic disease

· The inner lining of stomach is totally new every 3-4 days, the top layer of tongue is totally new in 7-10 days, red blood cells are totally new in 120 days , liver is totally new in 5-6 months, 90% bone is new in 1 year and 100% in 3 years

· First kill the fat entering your system

o Stop taking milk, curd, ghee, oil, egg, poultry, and meat.

o Food items that are high in acid and ruthlessly cut them off

§ Cheese, red meat, poultry , fish, eggs

§ Milk and dairy products

§ Tea , coffee

§ Wine, alcohol

§ Vinegar, salt

§ wheat

o Once you stop milk blood sugar start falling within 2-3 days and we have to reduce the medications / insulin immediately

§ Milk is 49% fat so it adds to the fat load increasing the intramyocellular lipid [inside muscle cell fat] thus increasing insulin resistance

§ Milk contains IGF [insulin like growth factor] which blocks the insulin receptors and consequent rise in sugar levels

§ Homogenization of milk reduces the size of fat globules and its gets more readily absorbed in the intestines

§ If you are serious on reversal quit milk immediately and completely

· People wake to a hot cup of tea or coffee , it is acidic , kills natural enzymes doesn’t supply the minerals and vitamins the body would love to have first thing in the morning and shoots up your stress hormones which work against insulin we start diabetics on a special juice / smoothie first thing in the morning and they start reversing .. its alkaline gives wonderful vitamins, minerals, enzymes.

· A low in Glycemic index , low glycemic load and low insulin index diet ensures optimal sugar levels and space for healing pancreas , liver, kidneys , mobilization of fat and reduction of fat from muscle cells

· A diabetic who gets convinced of our approach and follows it diligently actually gets free of all medicines / insulin within 4-8 weeks

· Chlorophyll is your greatest friend in reversal since chlorophyll and hemoglobin have same molecular structure expect that magnesium is at the Centre of chlorophyll and iron is the at the Centre of hemoglobin

· Fruits are never to be had with cooked food or after meal

My Feedback:

1. Excess carbohydrate will be converted into Fat and stored inside our cells so eating FAT doesn’t get stored as FAT. So fundamentally wrong hypothesis which will lead into one wrong assumptions to another etc

2. More fat = more insulin resistance = more work for pancreas and exhaustion of pancreas = blood sugar raise = Diabetes it should be More carbs=more IR=Beta cell destruction=BS raise = diabetes

3. To simply promote vegan don’t throw unproven and wrong things on FAT, Milk etc but in recipes you were telling people to use VCO or VOO even coconut gratings so its contradicting what has been written and what has been actually asking people to take so lot of flaws , unproven assumptions not sure how do we take this book ?

More salt or fat is Ok

As I started writing blog post about the research on fat & salt , the food industry and regulatory houses keep advising people with out evidence that if you have more salt or more fat in your diet you will get hypertension (aka blood pressure) and Heart disease but they don’t have clinical evidence to prove the same but there were no of clinical studies which contradict the same.

Salt

Recently  A new study published in the American Journal of Hypertension analyzed data from 8,670 French adults and found that salt consumption wasn’t associated with systolic blood pressure in either men or women after controlling for factors like age.

the authors write, is that the link we all assume between salt and blood pressure is “overstated” and “more complex than once believed.” It should be noted, however, that even though the study found no statistically significant association between blood pressure and sodium in the diet, those patients who were hypertensive consumed significantly more salt than those without hypertension—suggesting, as other research has, that salt affects people differently.

As for the factors that did seem to influence blood pressure, alcohol consumption, age, and most of all BMI were strongly linked to a rise. Eating more fruits and vegetables was significantly linked to a drop.

yet another big study indicates that the fear of salt is highly exaggerated, When they examined the salt habits of over 100,000 people, it turned out that people who salted more than the recommended amount had the lowest risk of cardiovascular disease. Those who salted a lot less – according to official guidelines – had a higher (!) risk of disease.

Fat

TIME-600x800

I have written more about fat is good for our health in my previous posts so here I am going to leave two links from time’s magazine.

The paradigm shift continues and the outdated fear of fat is on its way out faster and faster.

Its perfectly Ok to have fatty and salt foods in raw nature not from processed food though.

Obesity documentary Fed UP

Have you seen the movie? What did you think?

Fed Up

The blame is clearly put on the real culprit: sugar and addictive junk food. Here’s the movie’s strengths… and its fatal weakness: Among the experts who get the most exposure in the movie are noted, Robert Lustig, science journalist Gary Taubes and author Michael Pollan – and former president Bill Clinton.obesity is not about calories, it’s about sugar and addictive junk food.

The movie mainly focus on vegetables but forgot to add proteins and other good stuff while eating fat and meat , looks like they don’t want to get into controversial items of fat

Insulin resistance causes type 2 diabetes–part 2

This is the follow up post of my previous post about insulin resistance ,  much inner detailed view of insulin resistance that insulin itself causes insulin resistance i.e. the levels of insulin resistance goes up and up. This is a protective mechanism and a very good thing, which is why the body does it.

not-functioning-insulin-receptor1

If the body did not develop resistance to insulin, the high levels of insulin would rapidly lead to very, very low blood sugars.  This severe hypoglycemia would quickly lead to seizures and death.  Since we don’t want to die, the body protects itself by developing insulin resistance.  This is a good thing but the bottom line is – high levels of insulin cause insulin resistance ,Taking away the high insulin levels reverses the insulin resistance

What is driving up insulin?

insulin levels are way up the body gains weigh, reducing calorie intake doesn’t matter since the body only further reduce caloric expenditure to match and make the body gain weight. The carbohydrate-insulin hypothesis assumes that carbohydrate intake drives insulin but insulin itself will drive insulin resistance which will increase insulin in a self reinforcing cycle which will be like fat get fatter

vicious-cycle2

 

central part of treating diabetes should be more on how do we reverse that patient from insulin resistance. lets see insulin reaction to macronutrients as follows

glucose-insulin-reaction-to-macronutrients

as you can see clearly when we take carbohydrate insulin spikes which is not we want all we want was to reduce the resistance and utilize the insulin.  Based on the above both insulin and carbohydrate are toxic to the body but dietician will prescribe 1500 calorie diet to Type 2 diabetic patient what a strange.

HbA1C test reliable enough to diagnose T2DM

Red blood cell was the most common type of blood cell , its principal work was to delivering oxygen to body tissues via blood flow through the circulatory system, its structure as shown below

cell-structure-and-organisation-23-728

 

Life time : 100 to 120 days after that new cells will be developed from bone marrow

Hemoglobin : iron containing oxygen transport protein in red blood cells

Glycated Hemoglobin:  Due to non-enzymatic glycation pathway  by hemoglobin’s  exposure to plasma glucose . As average amount of plasma glucose increases  the fraction of glycated hemoglobin also increases in predictable way so to measure average glucose level over 3 months this will be useful to find out the control of blood glucose level in type 2 diabetic patients.

Hb_HbA1c_Comparison_2

 

Is HbA1C is good candidate to diagnose T2DM ?

The answer might be sometimes false positive due to various reasons or other conditions people might face that might require additional test such as Post prandial blood sugar might be needed to confirm.

Given below were some of the cases HbA1c may be spuriously elevated or depressed

  • Recent transfusion
  • Hemolysis or blood loss
  • asplenia
  • Anemia
  • Hemoglobin C disease
  • Chronic alcohol [Skew]
  • ingestion of large amount of vitamin C & E [Skew]

since HbA1c measurement was crucial one so its good to be familiar with factors affecting the test  in general and limitations.

HbA1c was the gold rule to find out the control mechanism of diabetes in that no one has doubt but when it comes to diagnose new diabetic patients that test might interfere with other conditions which will falsify the test result so if there was skewed / elevated result of HbA1c its worth to measure PPBS to confirm or diagnose Type 2 diabetes.

Are we treating type 2 diabetes right?

I am planning to write series of blog posts on what is diabetes , how do we get , prevention, treatment and so on . In this blog post lets see what is Type 2 diabetes and its consequences

Diabetes Mellitus Type 2 or adult on-set diabetes is a metabolic disorder that is characterized by hyperglycemia i.e. high blood sugar in the context of insulin resistance. Pictures worth more than words given below picture will explain difference between normal people and people with diabetesim-1

Symptoms

im-2

Diabetic Epidemic

Due to urbanization and fast moving world diabetic become epidemic due to following reasons

  • Fast food / high sugar items accessibility at ease and cheap
  • Lack of physical activity
  • environmental and other economic factors
  • Genetic i.e. family history

home

  • Diabetes, heart disease and stroke cost $237 Billion in loss on national income during 2005 –2015 (WHO)
  • 25% family income devotes to diabetic are for single diabetic family member
  • Premature deaths +5 million / year
  • diabetic patient dies every 6 sec while 2 new patients are diagnosed
  • Accumulated lifetime cost of diabetes
    • 20-30% – control & monitor
    • 70-80% – Complications
    • Medicines – ???

so based on above picture now you will understand the magnitude and public health crises we are facing .

How do we get diabetes?

  • Change in standards of diagnosis[1997 ADA lowered the per se standard for diagnosing diabetes from a fasting blood glucose level of 140 mg/dL to 126 mg/dL]
  • Insulin resistance
  • Obesity
    • too much deposit of white adipose tissue associated with obesity
    • insufficient mass of functional beta cells
    • glucagon
  • gastric emptying
  • Genetic family tree

in my next blog post we can see how do we get diabetes in detail.

Insulin resistance causes type 2 diabetes

As per my previous post here I am writing follow up post on how people will become diabetes.

Insulin resistance was the most important factor people will become diabetes, lets dig deeper how and why treatment of diabetes might be wrong. lets run through simple case for example if get hurt in leg and you will get swelling around that area and you also get little fever so to treat this case what will be treatment option i.e. you will take pills for hurt or reduce swelling or fever the correct treatment will be to understand the root cause and treatment. so have to take treatment for hurt not for fever !!! 

bottom line was that treatment for real cause not for symptom

since the body auto immune system fight against all hurts we get into via various means.

how this will resonate into treatment of diabetes ?

real culprit for diabetes was Insulin resistance nothing else, so lets find out more on this.

Insulin is peptide hormone produced by beta cells in pancreas, its regulates the metabolism of carbohydrates and fats by promoting the absorption of glucose from the blood to muscles and fat tissues, this also causing fat to be stored rather than used for energy.

Insulin resistant [IR] is a condition in which cells fail to respond to the normal actions of the hormone insulin 

insulin-resistance

    • exposure to excess nutrients causes cells to produce excess reactive oxygen species which in turn shutdown insulin signaling
    • Mitochondria were overloaded with energy i.e. excess nutrients , particularly free fatty acids causes IR
    • suppressing free fatty acids levels restores insulin sensitivity in obese & T2DM
    • if cell takes up more energy than it burns energy accumulates typically in the form of fatty acid metabolites in cytoplasm this causes IR

Hormonal-Obesity-theory-step-2

The bottom line is this – high levels of insulin cause insulin resistance.

 

how do we get excess nutrients to tissues ?

Consuming energy in excess of what the body can constructively use

Fat tissue main work was to accumulate circulating energy excess to keep away from damaging other tissues , once it started accumulating  over the period of time it begins to do its job less efficiently

Increase in energy in cause IR in parallel with fat gain so to speak the weight gain  that’s the very reason for type 2 diabetic patients hard for them to loose weight .

so from the above to treat the diabetic patient should target how to reduce  insulin only not to reduce the blood sugar , people who practice long term calorie restriction for life extension have very low fasting insulin & glucose  suggesting high insulin sensitivity

Big fat mistake behind 40 years of dietary advice

on Feb I was travelled to UK for Startup training program there I have found that in article written in “The Independent” on 10th Feb by Cahal Millmo on dietary advice given to Britons that healthy diet should be limit saturated fat to just a tenth of daily calorie intake , given below was the image snap I took it from my Nexus 5

 

IMG_20150210_085054 

As I was writing earlier here, here and here  about the myth created by academic and industry lobbyist now slowly accepting truth and started publishing accepting thesis. these dietary guideline issued by ADA/ AHA and other parts of the world started followed and now ever reacting over the truth , more over to convince doctors and dietitians about this truth is becoming much harder  since they read / follow their curriculum after all , how do we change this ? please share you guys thought as well.

Sweet truth numbers were wrong

On sep 19th there was an article written in Times of india news paper about “Diet, Exercise reduce diabetes heart disease by 75% study” as shown below image

IMG_20140919_094551

did you guys find any mistakes ?  its not easy to find out though , OK  let me tell you what is there was box with title SWEET TRUTH in that the numbers provided for diabetes and pre-diabetes were wrong i.e. its flipped, the actual number will be as follows

62.4 million people has diabetes

77.2 million people have pre-diabetes

Ref: ICMR-INDIAB study 2011.

I have contacted the author to correct that mistake at least in online version of it  on that day itself via email but still now I haven’t got any reply from her. why I am bring this here means this case was a typical example of media’s ignorance and dump wrong / unverified information to public , media should be more responsible than ever before.