Yes. I think so. They should be absolutely terrified by what it implies
According to this graphic, India is doing pretty well in avoiding packaged food (but also eating a lot less total food…not always by choice) relative to America and some other western cultures. Yet here is the inescapable fact about where India is headed (and China as well):
After an extensive nationwide survey, China has more than doubled the estimate of its diabetic people to 92.4 million from 43.2 million in 2009, thus replacing India as the country with the maximum number of diabetics in the world.
India has 50.8 million people with diabetes.
The China study, published in New England Journal of Medicine on Thursday pushes up the global diabetes estimates from 285 million to 334.2 million.
Diabetes was almost 1.4 times more common among urban residents than rural ones, the study found, sampling 46,239 adults above the age of 20, from 14 provinces and municipalities.
“The ageing of the population, urbanisation, nutritional changes and decreasing levels of physical activity, with a consequent epidemic of obesity, have probably contributed to the rapid increase in the diabetes burden in the Chinese population,” wrote Yang Wenying, head of endocrinology, at the China-Japan Friendship Hospital in Beijing, who carried out the study between June 2007 and May 2008. [Link]
We Americans are likely to continue to export our food culture around the world. Or rather, countries like India and China will continue to enthusiastically import it and are probably even less equipped than us to deal with the repercussions.
This article published today is rather disturbing as it shows how resources are being diverted away from health care from the poor to tackle the lifestyle diseases of the rich.
“Paradox in India as mass obesity joins malnutrition as a killer” http://www.smh.com.au/lifestyle/wellbeing/paradox-in-india-as-mass-obesity-joins-malnutrition-as-a-killer-20100414-se5b.html
carlson nutra-support. i read a book on how to prevent diabetes, and it reviewed a variety of micronutrients known to “soften” the insulin spike you get after you eat something with carbs or sugar. i’m not pre-diabetic according to my glucose levels, but seeing the way my dad lives I DO NOT WANT TO GET TYPE 2. (i don’t like sweet things much so that isn’t an issue)
also, re: that link. you can find bulk rates for that online. i usually get 3 120 gels at a time.
I think we’re forgetting the exercise factor. India’s becoming more sedentary in many ways. For example, my father (who’s now in his 60s) rarely ever rode in buses or rickshaws when he was a boy. He walked or bicycled everywhere. Yet my little cousins in India, who are all under 10 years old, don’t walk or bicycle anywhere. They’re always in cars or rickshaws. And they are all overweight, despite their youth.
Add that to a diet that is becoming steadily saltier, fattier and meatier/milkier and you have a real problem. Indian vegetarian food might be “fresh” but it’s also heavily cooked, often times with lots of oil, and I wonder how many nutrients are left in a bell pepper or an eggplant when it’s become a soggy mush in a curry.
Also, the use of whole grains is already rare in India. I lived in rural Maharastra for over a year and had to hunt extensively to find wholewheat flour to make roti or other breads. White flour is king in India.
I NEVER found brown rice in rural areas. Even in cities, finding brown rice was extremely difficult, and also expensive. My aunt (who is also in her 60s) had never eaten brown rice until I came home with a bag of it.
For the record, I am vegan and I’m convinced that if I weren’t, I’d have a large Indian-uncle belly right now. I see it on my parents and my relatives. But I’ve taken proactive measures to exercise daily, eat only whole grains (I hate the taste of white rice and white flour anyway), and, of course, eat no animal products (but not for my health—I’m an ethical vegan). I’d say 50% of Indian food is vegan by default, especially in the south. The only stuff you have to worry about is paneer and cream/yogurt/butter in some North Indian curries and naan, but otherwise, chana masala is ALWAYS vegan by default, and roti and puri are also always vegan.
I can endorse the BJP’s anti-cow slaughter platform (I am a practicing Hindu, and am pragmatic/willing to compromise about politics to put together a winning coalition) but my family has always (well, insofar as I know!) eaten meat (not beef though). I guess it’s because we have been involved with the military for many generations? I eat a lot more meat (especially fish!) in the US than I did in India, though, that’s for sure. I find the Americans who are into India as a “vegan” or “vegetarian” “nirvana” vaguely off-putting–though of course at the end of the day they should do what they want.
Hey LinZi: Sure no problem! I am actually referring to India….everything comes from http://www.sharan-india.org There is some really interesting info compiled by Dr. Nandita Shah on there if you are interested.
YogaFire: Osteoporosis and age do not work hand in hand. Losing bone as you grow older does not equal osteoporosis. Therefore, your statement about USA and Sweden having higher rates because people live longer does not make sense. In the chart that you linked, the fact that India has a high rate of osteoporosis just proves my point further. It is a milk consuming country so therefore the protein and calcium ratio is not right. Countries like Japan and China that also have high rates, are high animal protein consuming countries. No, they do not consume as much dairy but their animal protein intake is very high thus doing the whole protein leeching off calcium in the body cycle. What reputable sources are you talking about to get your milk? When people go to an Indian wedding and eat that Makhni Daal and Shahi Paneer-do people know where the hell that cream and cheese came from??? Or South Indians-when they eat Rava Dosa or Curd Rice you think anyone thinks to look into where the mattha and yogurt originated from? People who offer that argument about “reputable sources” are lying to themselves. Don’t tell me you never eat out or only eat at organic places. YOU may well be able to afford “organic”, “free-trade”, “happy”, “free-range” stuff, but not everyone can or has the option to especially here in India. It is not a solution for the masses. If you’re interested in the studies of the milk content here, then research it.
N: Sorry you cannot be vegan when you want and then eat whatever you want socially! 🙂 Either you completely give it up or you are a meat eater or vegetarian that likes to eat vegan meals every now and then. It sounds like you are doing it for health reasons and there are tons of great diet books out there to guide people in the transition. As soon as I became vegan, I lost about 8 pounds within the first month of unnatural weight. It was amazing. Even now I feel better and the thought of dairy products makes me vomit. Good luck with whatever you decide to choose!
Ena, if you are against taking benefit from the product of the cows (for ex., milk) I am guessing you are not Indian? No offense meant, just an attempt to clarify why you have this view, which strikes me as odd (yet, I am only one of more than one billion Indians, after all).
Hey Shilpa I am Indian! Born in Delhi…brought up in New York..and just recently moved to Bangalore! I am against milk and other animal products for the benefit of people. Cows are not being treated well in India and the U.S. in increasing numbers. If Indians consider the cow “sacred”, we must cut them out from our diets.
“Doctors advise milk because of what they have heard from their mothers and grandmothers. Most modern medical curriculums do not teach how to promote health but rather how to deal with disease.
I think by not consuming milk, beef, and other non-veg products I am doing the best that I can for my health, environment, and animals-all very ahimsic ideals in India.
Oops that last post was by me. I typed in your name Shilpa, because I was trying to write Hey Shilpa lol. It’s been a long day….
“More sedentary”?? I realize that people are walking around a lot less, but India never really had much of a sports culture to begin with (except for cricket).
Although that’s changing now. When I visited in 2004, basketball was catching on…
I thought “atta” which is normally used to make roti is whole wheat and that maida is refined flour?
Ena– thanks for sharing this website… I am always interested to check out organic-minded things in India.
How hard is it to find organic food in Bangalore? Is it a lot more expensive than non-organic labeled food like int he U.S.? When I was living in Delhi I really wanted to check out this organic restaurant, but unfortunately, it just never happened.
I understand what you are saying about over consumption of milk, but I am curious what you think about the general diets of the poor in India? When I worked in Bihar, my students (who were very poor and from small villages) would eat a large plate of rice with a tiny spoonful of daal/veggie in the middle, with lots of salt. At the school, they had more resources available but were used to eating that way and didn’t want to add more veggies and lentils. Wouldn’t something like milk help their diets because they are hardly getting any protein or fat to begin with? (and generally doing hard manual labor all day?).
Ena, I might be more inclined to believe you if you could link me to some kind of peer reviewed study backing up your assertions. As it stands I have no idea who your are or what your credentials are aside from being a vegan evangelist and some of the stuff you’re saying betrays a misunderstanding of basic facts.
For one, when you say ‘Losing bone as you grow older does not equal osteoporosis’ you’re flat wrong. Osteoporosis is defined as having your bone mass below a specified threshold. Once you get past 30 the osteoblasts, the cells that produce bone tissue, start to slack off while the osteoclasts, which reabsorb it, don’t slack off as much. As a result, you lose bone mass. In a lot of people, especially ones who were malnourished when they were growing and didn’t build up as much bone (India) and ones with diets low in calcium, this disparity can make your bones porous, brittle, and prone to breakage. Age and gender play a huge role in this.
For another, you might want to check out this article.
What other people are eating is not my problem, and the butter and cream loaded foods people eat present significantly higher health risks simply from fat content than they do from any effect of factory farming or protein interference you would care to name. If you have an issue with the treatment of these animals the only way to improve it is to exert political pressure on regulators to crack down on inhumane practices and economic pressure on bad producers by patronizing good ones. Inasmuch as I’m probably going to end up eating some inhumanely created foodstuffs at some point in my life it also doesn’t concern me too much. If I shed a tear for every injustice committed around the world as a butterfly effect of my actions I’d be a dessicated pile of dust by now. If you personally have trouble sleeping at night at abuses towards cows feel free to refrain from drinking their milk, but don’t get on a moral high horse over it. I don’t get on your case about all the mice, voles, birds, snakes, and spiders that get eaten up by the mechanized threshers as they harvest your grains do I? And while there are some doubts about whether hormones and other chemicals that cows are exposed to might leach into their milk, there are very few doubts about where the pesticides they spray on our crops go. Face it, eating food means causing ecological damage and hurting a lot of animals. That’s the nature of the business. We can minimize the harm done through prudent regulation, but strutting around on a abolitionist crusade against food doesn’t help anyone eat healthier or pull the poison out of our ecology.
LinZi: Sure no problem! In Bangalore it’s really easy to find organic. There are organic supermarkets everywhere and around 10 or so organic restaurants. I’m always amazed at the progress in this country despite the McDs, Taco Bells, and KFCs opening up. Unfortunately, it is tons more expensive. For eg. one organic avocado is Rs. 50. That’s actually more than Trader Joes in the U.S. It’s hard because who will buy it when they’re used to buying a kilo of potatoes for Rs. 15. Your question is a really interesting one about the rural diet. Just like Bihar, in the south too they eat tons of rice with a little bit of rasam. If they are drinking unpackaged, raw, fresh milk from a happy cow, I guess it’s better than not having it at all and just substituting their nutrition with rice. I also think that the poor don’t tend to abuse dairy as much because they simply cannot afford to. They’re not eating milk breads, cakes, ice creams, pastries, ras malai, paneer, etc. The middle and upper class have these food items multiple times a day. There are some great organic farms out here where you can live for free and volunteer a few hours of work everyday….if you ever h
YogaFire: First off, it baffles me that you replied to this thread if “what other people eat does not concern” you. This entire post is about how a whole population is eating. I thought that was obvious by the graphic. Bizarre!
Here is a great link from the American Dietetic Association (non-biased and not vegan): http://www.eatright.org/About/Content.aspx?id=8357 (You can download the PDF)
My knowledge and opinions come from “The China Study” by Dr. Colin Campbell. He talks about osteoporosis in it quite a lot. http://www.amazon.com/China-Study-Comprehensive-Nutrition-Implications/dp/1932100385 . Also from Indian politician and activist Maneka Gandhi who studied the findings of the Indian Council of Medical Research (not vegans) http://www.icmr.nic. They did research on milk for seven years and took thousands of samples from across India. You can search for all the articles on their website. They found large amounts of DDT, poisonous pesticides called HCH. Under the food adulteration act only 0.01mg/kg of HCH is allowed. They found 5.7 mg as an average. They found arsenic, cadmium and lead.Other things were sewage water, vegetable oil and liquid soap. This was actually a huge thing in the Indian media and was all over the news last year. (http://www.business-standard.com/india/news/spurious-milk-products-flood-diwali-market/373387/) (http://timesofindia.indiatimes.com/news/city/pune/Milk-adulteration-racket-busted-at-Daund-Pimpri/articleshow/5024463.cms) The Indian Agricultural Research Institute (IARI http://www.iari.res.in) has also found various contaminants. Lastly, I follow Dr. Nandita Shah religiously: http://www.nandita-shah.net/.
Lastly, I haven’t even BEGUN to talk about animal rights. This is a post about health and nutrition…let’s keep it at that? If the videos or links I put up had animal cruelty in them, that’s not my fault. It was simply to show what goes into our food. One great blog once said:
You can’t save everyone and everything, but you can try your damn hardest. If you think I’m on a high horse because of it, so be it…it’s not like every vegan hasn’t heard that before.
Yoga Fire: I think you offer sensible and thought out opinions on all this. The osteoporosis debate is especially exasperating and you point out salient facts. You hear of it being more common in milk-drinking countries, when in fact it’s pretty common in east Asia, where milk is not a major part of the diet. Indians and Americans are both prone. It is rare in Africa, and Africans don’t drink milk (except for the pastorals) but also uncommon among American blacks whose diets are American. There is a genetic component. As far as milk substitute, there’s more bad than good about soy milk. In countries where soy is a tradition, it was consumed as a condiment, or side dish, in small quantities, not as a major portion of the calories. Nut and grain milks would be better.
A bit late to this discussion! I live abroad but visit India often and see two trends: (a) the rise of obesity (b) the rise of health-consciousness. To my FOB mind, this is the same paradox as in the West.
In my family and community (south-indian brahmin), the rise in obesity is not due to packaged food or western foods–these are only consumed by the young. It’s just prosperity. When I was young, traditional fried things and sweets were eaten only during festivals. Butter, milk and sugar were expensive. Nowadays, buying sweets seems to be a weekly affair and even then they are much richer in terms of ingredients.
But then, I was quite surprised when I visited in 2007 to find almost everyone going to the gym. My family is rather diverse in habits (western vs. indian) and disposable income, but almost everyone my age or younger had a regular exercise or gym routine–there are hundreds of gyms mushrooming across indian suburbs, quite like internet cafes and telephone booths!
I also found that it was no longer considered good to be plump. My aunts and grandparents still think I should eat “well”, but have started adding that I should exercise and burn it off to look good.
Irrelevant, while the consumption of processed food will increase, so will health-consciousness and frequency of exercise
As I understand it, what one eats, exercise and weight control are important factors in reducing the amount of insulin needed by the body – whether produced by the pancreas or from external sources. Diabetics are those whose pancreas are defective, not producing enough insulin, or non-functioning. Is there any evidence in the medical literature that life-style sins CAUSE the pancreas to fail? Perhaps Razib might care to answer this question. Short of an irrefutable causality, I maintain that diabetes is unavoidable – in the sense that if you are destined to get it, you will get it. Eating fewer sweets, avoiding carbs, being skinny does not guarantee anything. Diabetes is an incurable condition whose long term effects can be staved off through medication and a controlled lifestyle. I have stopped thinking of it as a disease. The only response to it is access to testing, doctors and insulin. The fear factor in government publicity is meant to scare you into awareness and improved lifestyles. This works in affluent countries where doctors and medicine are easily available and affordable, and where lifestyle choices may be taken for granted. What can be done in India and China and other poorer countries? Get richer, get diagnosed early, get medicine! Apart from this, most non-diabetics’ knowledge about the condition is the stuff of urban legends (including that of doctors, from my experience). Reading between the lines of the post and some of the comments, I sense that ignorance.
Type I Diabetes is when there is an acute LACK of insulin (i.e. the pancreas is not working, or not producing enough insulin)
Type II Diabetes is a relative insulin imbalance, relative insulin excess, ineffectual insulin or insulin resistance.
In Type I something can just trigger the body, and the Beta cells of the pancreas (where insulin is produced) are destroyed. Type I diabetes lack insulin completely and need life-long treatment.
Type II Diabetes is when the demand of the body for insulin (i.e. diet) is outweighing the supply. (The pancreas cannot make enough insulin to support the sugar intake). The pancreas will try to increase the supply, but is unable to keep up with the demand (It is like if you use your car everyday the parts will wear out faster than if you use it once a week). In addition, insulin resistance often occurs– where the insulin is no longer having the same effect as previously. Type II diabetes is progressive (Type I is usually very sudden) and if someone is starting to have the symptoms for type II, lifestyle changes can halt or reverse the progression.
There is a third type of diabetes that can occur which is gestational diabetes (in pregnant women) which I won’t go into here.
Diabetes has a lot more to it then testing,doctors and insulin. Testing blood sugar levels and taking insulin (I’m sure taking many shots a day would not be a problem for you?) is one aspect, but there are MANY more problems with Diabetes. Insulin injections are not a cure.
Other problems with Diabetes include poor circulation with leads to sores and lesions, especially on feet and legs. The changes in sugar levels, especially high sugar levels- destroy nerves in the body, creating neuropathy in a person with Diabetes– this results in loss of sensation, especially in legs and feet but it can spread elsewhere. Loss of sensation can lead to injury and also pressure ulcers (When you do not feel pain and adjust your body your skin can begin to breakdown and form into a ucler or wound).
People with Diabetes are also more likely to have cardiac concerns as they get older.
I have seen an elder diabetic patient who has both of his legs amputated, has a stage 5+ pressure ulcer on his bottom (he cannot feel well and he cannot move). Stage 5+ means the ulcer is down into the bone and muscle.
Narayan, the information you have on diabetes is highly inaccurate.
Also, with more sugar in the blood, Diabetics are more prone to infection.
Your first response neither negates nor adds much to my statement about the pancreas. As for the last sentence of your second response, I take umbrage and will cut you some slack only if you are an insulin dependent diabetic as I am, or an endocrinologist with several years of practice.
At 65, after 15 years on insulin, I have yet to experience any of the effects you describe (sounding as if quoted from literature). The fact that I need to inject large amounts of insulin lead me to believe that my pancreas doesn’t produce any. If my sugar levels are not under control it is because I am not a disciplined person, often fall off the wagon, and don’t exercise enough.
It is clear from your response that you know all the bad effects and their extreme manifestations, however, I must disagree with your implied conclusion that those prognoses are inevitable no matter what. Early diagnosis and aggressive insulin therapy is the only solution generally available and I have my endocrinologist’s assurance that ‘it works’. Diabetics, today at least, can hope to live long with no symptoms more dire than those of other older people. Whether that goal is attainable depends entirely on the individual’s commitment and resolve. You have to take my word that the regimen is irksome at best and impossible for most mortals at worst – and I belong to the latter category.
I have also seen and heard of individuals who upon being diagnosed have stopped going to their doctors from some warped rationalization that they can fix ‘it’ on their own – quacks, home remedies, herbals, do-nothing-about-it, and the like. Your words of wisdom are best spent on them.
I suppose what was on my mind when I posted my comment was frustration with the manner in which information and warnings about diabetes is promulgated. Terror / horror / fear approaches distort the nature of the beast and can have unintended effects besides the predictable ones of terror / horror / fear (as evinced by the opening sentence of this post and your second comment). Every one of the growing handful of depictions of diabetics and insulin use I have seen on TV or film have got some or all of it wrong, which further exacerbates public misunderstanding.
Where’s the message of hope in all of this? I got mine from my endocrinologist. My primary physician, in stark contrast, is a self-avowed pill pusher who is, in my book, no more diabetes-wise than the general educated public.
Thanks for your concern regarding ‘many shots a day’. When I was on that regimen I didn’t find it onerous. Famously, the film ‘Memento’ shows a diabetic taking insulin intravenously – as an addict might take heroin. Frightening, no? Irresponsible, yes! A better depiction is in the film ‘Cobb’, if you can see past Ty Cobb’s manic state in the scene. The film ‘Panic Room’ has an extended scene of dubious authenticity that might promote misconceptions.
For the past five years I have been on an insulin pump so I need break skin only once in four days. Were I richer I’m sure I could have fancier gadgetry that might provide autonomous control and make life easier. Or perhaps futuristic islet transplants.
Still, none of what I’ve said is of any relevance to the Third World poor. I am amazed to see the nutrition labeling on some packaged Indian foods with the words ‘at least XX g’ for carbs per serving, and servings expressed in ‘g’ as if that made life any simpler. An eminent doctor in my family maintains that sugar is the only source of food energy readily available to the Indian poor!
If you still think my information on the subject is inaccurate, I will have to insist that you show your own credentials in the matter.
For those who have only vague notions about lactose intolerance, the whys and wherefores are explained in layman’s language by the anthropologist Marvin Harris in his excellent, informative and readable book The Sacred Cow and The Abominable Pig : Riddles of Food and Culture. It’s been a long while since I read it so I won’t paraphrase the chapter on lactose intolerance. It was an eye opener for me as a sufferer. Curiously, I don’t feel the effects on visits to Bangalore, possibly because low-lactose buffalo milk is a major component of packaged milk. I read an article about an Israeli who was marketing camel milk products as having no lactose. The enzyme lactase nullifies the lactose in milk. The lactase pills that are marketed in the US are hopelessly ineffective. Lactase in liquid form works very well but has disappeared from the market, probably sequestered by the dairy industry that then sells lactose-free milk at unconscionably inflated prices. I get my year’s supply of liquid lactase from a Punjabi owned laboratory in Canada! There are few other sources in North America.
From your description can I am guessing that you have type I diabetes (your pancreas no longer produces ANY insulin)?
None of my comments contradict your second statement, if you are talking about type I diabetes. Type I cannot be altered or changed through lifestyle changes, because the pancreas is not producing any insulin. Type I is NOT caused by obesity, bad diets, etc, it is a random (often following flu like symptoms) and a trigger event (it happens suddenly and is irreversible).
Type II diabetics have MANY more options for treatment than Type I. In addition to insulin, there are oral medications that can be used such as Avandia (which increased cellular response to insulin by decreasing insulin resistance), or Glucophage (which reduces the production of glucose by the liver and increased the muscles’ glucose uptake and use). These types of treatments can (with life-style changes such as diet and exercise) prevent a Type II diabetic from becoming insulin dependent and can also reverse some of the diabetic process. They can also be used in conjunction with insulin to more effectively manage diabetes for Type II Diabetics.
Where I disagreed with your first statement was when you suggested that nothing besides insulin effects diabetes. It depends on what kind of Diabetes you have (I or II) and other factors specific to each person.
The fact that you do not have any other symptoms (such as neuropathy) may be because a.) you are lucky b.) you are managing your sugar levels well (if they are more steady and do not have a lot of peaks and valleys, you will have less adverse effects on your body or c.) you just have not gotten them yet (unfortunate, but true).
Unfortunately, many people with diabetes do have many more complications.
I don’t say I am an expert on the subject, but I am a MSN student who is working with diabetes patients in the hospital and also studying the pharmacology and pathophysiology of diabetes as we speak (for a test I need to take later today). If you would like to know my sources they are: Pharmacology and the Nursing Process by Lilley, Rainforth Collins, Harrington, and Snyder, 2011), and Pharmacology for Nursing, version 4.2 by ATI. p. 441-459).
Diabetes in of itself is a massive epidemic growing more massive than a one-headed serpent. You can only blame the US for it’s fast food culture that is rearing its head the world over. Not only the processed foot itself but the sugar (as soda) being consumed. With every fast food chain comes soda, the more soda consumed, the more sugar your body has to process. Eventually your body can’t keep up ultimately giving way to insulin resistance. Let’s not forget that every great health epidemic has a drug company ready to profit so goes the vicious corporate circle of greed. Take the drug Avandia or Actos for example. FDA approved then years later, finding out they cause heart attacks, stroke, kidney and bladder cancers. Go figure, can’t the doctor community prescribe a dose of good food diet and exercise? According to this infographic, the world’s health is withering away, http://www.actosinjurylawyers.com/infographic-diabetes-around-the-world/ – Roberto @ Actos bladder cancer
I think that every nation should have an amount of food directly proportional with the number of people. India is one of the most populated countries in the world and there should be a lot of food. Until the leaders of the world won’t work together to reach a state where everybody is happy, there will be a lot of poverty and starvation.