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.
Everyone ought to worry about diabetes. States like Oklahoma are pretty badly off by national standards. It seems to be the result of longevity, lots of rich food, sedetary workstyle and noo exercise. Workout like no one is watching, as often as possible. Cut out smoking and limit the booze. There are no guarantees, but at least you could try
My experience is that cutting carbs really works–I have gone from 130 lbs. to 100 lbs. since cutting radically rice and bread to near zero.
I don’t really think this is a case of Americans exporting our food culture so much as it is Indians and Chinese, having been accustomed to food being dear for the past several thousand years, suddenly not really coping well with all the high-carbohydrate, high-fat diet that we used to consider “good” only because we ate it too scarcely to feel the ill-effects. Now, with money, they can eat that way all the time, so the stuff that used to be a treat is now standard. Once you get used to basmati rice and butter chicken, it’s hard to go back to millet.
Japan, for instance, always ate pretty simple meals, so even after getting rich their heart disease rates didn’t go nuts. It will probably take some time for the Indian diet to slowly move away from foods fried in ghee. It will be a sad day for the world when it does though.
To answer your question-Yes Indians should be very scared.
According to the International Diabetes Federation, a press release from October 19th 2009 suggests that 285 million people worldwide have diabetes. The majority of all diabetes is type 2 which in many cases can be prevented through diet and exercise.
“India is the country with the most people with diabetes, with a current figure of 50.8 million, followed by China with 43.2 million. Behind them the United States (26.8 million); the Russian Federation (9.6 million); Brazil (7.6 million); Germany (7.5 million); Pakistan (7.1 million); Japan (7.1 million); Indonesia (7 million) and Mexico (6.8 million).”
“India, which has the largest diabetes population, spends US$2.8 billion or 1% of the global total. In most LMCs, people with diabetes must pay for their care out of their own pocket because public medical services and insurance are lacking. The diagnosis of diabetes in a low or middle-income country can often drag entire families into poverty.”
According to http://www.sharan-india.com there’s quite an easy solution:
“There are other harmful aspects of dairy consumption to human health. Animal milk also contains growth hormones and other hormones that stimulate early adolescence as well as a variety of cancers (specifically breast, ovary and prostate cancers). Furthermore, cow’s milk contains casein, a glue-like substance that lines the intestines and obstructs the absorption of certain nutrients, notably iron, resulting in anemia. Milk also contains IGF-1, (Insulin like growth factor) which promotes diabetes.
Milk is not easily digestible by adults (because of the lack of enzymes in the stomach) resulting in gas and abdominal discomfort and constipation or diarrhea. The cholesterol in milk is responsible for high blood pressure and heart disease. The high fat content contributes to obesity. The consumption of dairy is also linked to exacerbation of allergies and acne.
Today cow’s milk is a cocktail of pus (due to a disease common in cows called mastitis which results from being milked by humans), hormones secreted by the cow, pesticides (from the foods fed to them) and the antibiotics needed to keep the mastitis under control. Despite these facts, it takes a lot of willpower – or, sadly, a very severe disease – for most people to stop using milk products.”
Ena,
That “solution” is not a viable option for many vegetarian desis, since dairy products are their only source of protein.
From the land of Kamasutra to the land of sugar mamas….
Diabetes is a tricky condition. Diagnosis can take ten years even in the UK – given that there are really no easily perceptible symptoms. The only way out is to ensure that everyone over the age of 35 with a waist size of over 31 (35 or men) inches gets tested once in two to three years to pick up glucose levels that are out of the specified range. The earlier you pick up diabetes the easier it is to deal with it – especially as it results in other complications.
But there’s another issue at hand – Turkish/ Cypriot/ Indian/ Afro-Caribbean people tend to have a genetic tendency to develop diabetes that is 5 times as likely as in Caucasians. Plus the thousand myths – excess sugar consumption causes diabetes, drinking bitter gourd will combat diabetes and what not. Sigh – long way to go…
On the contrary, people work out more when people are watching. A guy is more likely to take exercise seriously if there are women around.
So these desis don’t eat daal or any legumes to speak of? Even spinach contains protein.
Shilpa- I know what you’re talking about. It DOES work in terms of reducing, but not many rural folks have the luxury of eating nil-carb diets…rice is the staple. What needs to be eliminated is junk/overprocessed food. Ayurvedic diets anyone?
Saying that China and India have the most diabetic people in the world really doesn’t mean much, seeing as how they are also the two populations with the largest populations in the world. That is like saying a town of 65,000 has more diabetics than a town of 650.
neha wrote:
Drinking bitter gourd is not a myth– it’s actually been proven by researchers at the Jawaharlal Institute.
First, I don’t think most Indian milk has added hormones like in the U.S…. much of India’s milk is still produced by small farmers. It is also usually a mix of cow and buffalo milk. Lactose intolerance rates vary by population– some cultures have included milk as part of their diet for eons, others do not (such as Chinese and Japanese diets– these areas do not eat very many milk products and also have a high rate of lactose intolerance). Indians eat a good amount of milk products– such as milk in tea, yogurt, added to some sauces and sweets, and paneer, but honestly, I think western societies eat a lot more milk products– so many types of cheeses, snacks with cheeses, flavored yogurts, milk drinks, in breakfast cereal, cheese sandwiches, ice cream.
I don’t think milk is as bad as you say for Indians– Indians eat way more veggies and homemade food than Americans. Vegetarian Indians don’t really need to worry about cholesterol– milk would be the ONLY place they get cholesterol, unless the eat eggs. The vast majority of Indians do not need to worry about obesity. The ones who DO are generally upper class and milk is not there problem– it is the McDonalds, Pizza Hut, etc that they can afford, that other Indians cannot eat regularly. The people having diabetes and obesity problems in India are the ones eating like Americans, not the one’s eating normal Indian food.
Something tells me the folks subsisting on rice aren’t the ones we worry about when discussing diabeetus.
If you’re willing to buy that I’ve got a dam to sell you in China. My cereal this morning was pus-free, thank you very much, and the fat in milk isn’t any different from the fat anywhere else. To eat healthy Michael Pollan’s three rules work fine: Eat food, not too much, mostly plants. If you have a good variety of foods in your meals and you eat slowly and enjoy your food, you’ll be fine. Other random rules about carbs or sugar or milk or meat or whatever might offer you some kind of spiritual fulfillment, but don’t think it’s going to somehow make you healthy by itself. Even if a low carb diet works, it’s not because it’s a magic formula, it’s just because most people can’t eat that much non-carb food before they become full. It’s just a roundabout tool for calorie restriction because protein and fiber generally makes you feel fuller than carbs do.
I’m curious, any eggetarian/vegetarians here, who’ve successfully eliminated rice/wheat and milk from their diets? I really want to go vegan but cannot imagine getting up and cooking breakfast every morning. Cereal is so easy…
Indians should be terrified. All my relatives at home, who grew up naturally skinnier than me, are now carrying spare tires around (in their early-mid thirties). All the men have blood pressure issues and a few have high cholestrol. It’s ridiculous.
N
Every now and then we would visit my grandparents in my father’s old village and they used to make us this thing called ragi mudde. Apparently this is what normal Indians, at least in that part of Karnataka, used to eat back in the day. The thing is, though, it’s kind of flavorless and it’s basically like swallowing a handful of clay. A ball half the size of your fist will keep you full for most of the day. The point of this story is that our idea of “normal” Indian food has kind of changed over time. The stuff people would eat normally kind of became associated with being a poor farmer so the upper crust Indians start eating the ghee-loaded curries and rice that used to be food for special occasions. I suppose the same thing was kind of true in the US. I don’t imagine the pioneers or the farmers in Grapes of Wrath had the luxury to kill, bread, and fry a chicken every day.
Soy milk?
If you substitute olive oil for ghee and soy-based dairy for milk I think Indian food can be pretty amenable to being vegan. A Tamil doctor in my hometown went vegan a few years ago (for ethical reasons) and as far as I know he’s still at it. He picked this up in his 50s too, so I guess that thing about teaching new tricks to old dogs isn’t always true.
Too bad soy-based dairy tastes like chalk though. And no ice-cream? No lassi? Think about what you’re doing to yourself man!
Exactly. So the small proportion of “upper crust” Indians need to worry about what they eat. I have seen upper crust families taking their obese toddler to McDonalds in Delhi for example, in sparkly expensive clothes.
But the vast vast majority of Indians are not the “upper crust”. As the middle class grows, there will problem be more of a problem as people will have more money to spend on fast and processed foods.
Yoga Fire, I think that’s part of it, but low-carb has additional benefits–see Metabolic Syndrome.
Or loaded with sugars and/or salt to mask the chalk taste. Too much soy is a bad thing, too, esp if it’s GMO.
Definitely. You lose sugar cravings, minimize alcohol, and usually end up with clearer skin. And that’s not even taking into account the metabolic stuff. Of course, most people cannot stand to give up sugar and starch…just one of those things.
Shilpa,
Great about going from 130 to 100…just don’t drop carbs to 0….carbs have a huge role in proper organ function…..unless you’re talking about replacing white carbs with brown…in that case no worries!
In my mother’s family agriculture is recent memory (her grandad was a farmer till the last in 1956 – yane ke, he owned land and lived in a village). In my dad’s family it is a forgotten thing, from about 200 years ago. So as I spent several years with my mum’s parents, I have had ragi and other “coarse grains”. It is a deep satisfying meal, every which way you can have it. With milk and sugar or with buttermilk and some salt and/or nimbu, onion, chillies, or with last night’s sambhar, koottu – and even with chole, matter panneer etc., Much later, years later, I had awesome ragi mudde and chicken curry in N. Karnataka and Ragi/Jowar bread with ghosht, visiting Konkan. My children are used to having ragi porridge once in while, and have sort of developed a taste for it like they have for whole grain bread. You can buy ragi/jowar/bajra flour at most Indian groceries in the US – at least in the larger cities. It is much cheaper than quinoa (which is awesome in its own way) and can be supplemented with any leftover gravy. Ragi is also easy on the gut – if you know what I mean!
Last time I had it I was a teenager, and dare I say I think my tastes have evolved considerably since then to where I can pick out subtleties. I’m not sure whether this will improve my appreciation of the ragi or not, but all I remember is that my father loved it, my mother had no end of frustration while trying to make it, and I was just wondering why we were eating a ball of mud.
Yoga it is a taste that grows on you.
Re incidence of diabetes. Indian popl’n is equal if not >China’s and am taking China’s most latest estimate. Diabetes seems clearly a problem of affluence, although I am puzzled why in recent years Indian diabetologists have concluded that the incidence is no longer correlated with income.
Be v.v.afraid – US and Germany(?!!)
Country Population Diabetics % China 1,336,910,000 92.4 6.91 India 1,336,910,000 50.8 3.80 US 309,055,000 26.8 8.67 Rus 141,927,297 9.6 6.76 Brazil 192,755,000 7.6 3.94 Germany 81,882,342 7.5 9.16 Pakistan 169,223,000 7.1 4.20 Japan 127,530,000 7.1 5.57 Indonesia 231,369,500 7.0 3.03 Mexico 107,550,697 6.8 6.32
Cut out booze, rice, sugar? That’s a tall order. Indians are at higher risk than other races for heart disease too. Even skinny Indians. Apparently, it’s not how obese you are that counts but where the obesity is – belly fat is the most dangerous.
Milk is not easily digestible by adults (because of the lack of enzymes in the stomach) resulting in gas and abdominal discomfort and constipation or diarrhea.
a minority of the world population produces lactase as adults, so they can digest lactose. a minority of south asians fall into this category, particularly from the northwest.
Turkish/ Cypriot/ Indian/ Afro-Caribbean people tend to have a genetic tendency to develop diabetes that is 5 times as likely as in Caucasians.
turks are “caucasian.” anyway, obviously diet has an effect. one thing that i have noticed is that south asians have a rather well developed culinary tradition of sweets. in the past these were, i assume, consumed on special occasions. today i suspect many affluent people are consuming sweets more often.
but yes, there is a genetic tendency. the data on british asians i’ve seen suggests that it is worse in bangladeshis than punjabis as well. the easiest way to know if you have the tendency is to look at your family. also, if you live in the state be aware that medical doctors may not known that as a south asian you probably need to lighter (lower BMI) than whites to get equivalent odds ratios for type 2 and the like (that is, the “normal healthy” weight for south asians as defined by risk for various diseases has to be lighter than whites if you want to equalize risk).
as a commenter above noted, have your glucose levels checked out in your yearly blood work check up.
Or you could just ask them to determine your body-fat percentage rather than relying on such a poorly calibrated metric of dubious validity. Medical research these days basically focuses solely on the means without any regard for variance. This means we end up committing the ecological fallacy almost all the time and fail to tailor treatments to individuals as ofter as we ought.
You have to try hazelnut milk, if it’s available where you are. It makes the best hot chocolate. I haven’t tried it on cereal, though.
And there are soy and other types of ice-creams if you really want to give up dairy. Whole Foods and similar stores have a good selection. I’ve also made mango lassi with soy yogurt and it was great.
Yup, I remember when visiting India as a teenager my aunt/uncle had to go out of their way to get the amount of milk that I drank regularly (which was pretty standard by north american standards). They didn’t really drink a whole lot, and much of it was in the form of milk powder. And this is coming from a vegetarian family. But maybe it’s a south indian thing, since i know places like Punjab are much more pastoral.
It does seem that, especially compared to western europe/ north america, that milk as a whole isn’t consumed as much in india. If you look at lactose intolerance, though India has nowhere near the amount of intolerance as say south-east asia (I believe some countries there are almost 99% lactose intolerant amongst adults), it’s still much higher than western europe.
There are some theories that people who have alot of belly flab relative to the rest of thier bodies tend to have a disposition towards diabetes. Sound like any race of people you know? The amount of skinny Indians with huge guts is huge.
When we get better at gene therapy I bet you this will be among the first things they figure out how to fix. (Right after they figure out how to lighten your complexion and give you blonde hair and blue eyes.)
Westsoy unsweetened Organic soy milk. I drink it every day.
That’s me. So if I workout and lose the belly fat, will my risk for diabetes go down? It does run in my family unfortunately.
Not sure, but for heart disease, yes the risk will go down. Perhaps the 2 diseases are related. Like I said, booze, white rice, sugar is what to watch out for. All the ultra processed stuff. There are good carbs and bad carbs. My doc said I could substitute brown rice or boiled (ponni) rice for basmati and jasmine. And sugar – he mentioned stevia as a non-cancer causing substitute. Booze – is actually good for the heart in moderation, esp red wine. But the downside is it has a lot of calories and increases your appetite so you put on weight!
Don’t advice it to Men, it probably messes up their hormones.
If i assume an average woman’s height of 5.3, I think 130 lbs is healthy (BMI would be around 23). 100 lbs would make you underweight
Earlier people used to eat lots of Ragi(Finger millet), now they eat rice, which is not so healthy.
re: lactase persistence, follow the links in this post. you can see the numbers.
I haven’t checked it out but here’s something I just got:
DR. TONY ALMEIDA (Bombay Kidney Speciality expert) discovered a successful treatment for diabetes.
Ingredients: 1 – Wheat flour 100 gm 2 – Gum of tree (gondh) 100 gm 3 – Barley 100 gm 4 – Black Seeds (kalunji) 100 gm
Method of Preparation: Put all the ingredients in 5 cups of water. Boil for 10 minutes. Let it cool. Filter the seeds and preserve the water in a bottle. Take one cup every morning on an empty stomach. Continue for 7 days. Next week repeat the same but on alternate days.
Yes, it will.
so ronnieboy, where’s Dr. Almeida’s research? By which mechanism does this diet work?
the emphasis on belly fat is key. a little personal information, i’m a thin guy, but i have to really keep trim to keep the belly fat away. it’s gonna be a lifetime’s effort, and harder and harder as i get older. but i have relatives with type ii, and i don’t want to experience that quality of life (i also avoid stuff with high glycemic load, workout and take pre-diabetic supplements which smooth out my insulin spikes when i do eat carbs, which are always whole grain). if i recall correctly if you have a parent with type 2 you increase your odds by 4 times, all things equal. therefore, there’s a choice you have: don’t make all things equal! weigh the die in your favor.
First off, I want to clarify that I am vegan and for those cribbing about soy milk and soy products, I completely agree with you. I hate soy anything. Try almond milk, rice milk, hazelnut milk, coconut, or hemp milk. As far as cheeses go, cashew and rice cheeses are amazing. No you won’t be able to eat paneer or drink lassi but if you read on, you’ll understand where I’m coming from.
I am currently living in Bangalore and am part of the Vegan Society here. Not pulling this stuff out of no where.
Firstly, TTCUSM: You’ve got to be joking that milk is the only source of protein for most Indians. Lentils, soybeans, spinach, black beans, kidney beans, chickpeas, pinto beans, peas, broccoli. You think that doesn’t exist in India? Sorry, but I grew up on Rajma Chawal. By the way, all this talk about protein is bs. A high protein diet is harmful because it increases acid in the body. To neutralize this acid calcium is leached from the bones resulting in osteoporosis. Even though cow’s milk contains a high percentage of calcium our body cannot retain much of it because of it’s high protein content. Osteoporosis is more prevalent in countries with a high milk intake, like the USA and Sweden.
LinZi: You don’t think that Indian milk has hormones and other toxins? Do you KNOW for sure?? Are you basing this statement upon a drive through rural India where you saw “happy cows” grazing the field? Have you seen this video? Welcome to the modern day Indian factory farm:
http://action.petaindia.com/ea-campaign/clientcampaign.do?ea.client.id=111&ea.campaign.id=2856
Also, quite plainly you can see in cities and rural areas across the country, cows here eat garbage. It was a tradition to let cows graze as the please, but many places don’t have enough grass. Therefore the cows eat garbage and it’s common for them to die after eating a ton of plastic bags. A seminar through Sharan India showed a dissection of a dead cow that had over 40 plastic bags in it’s stomach. The toxin level in the milk is really high but the government doesn’t care.Also, there aren’t refrigerated trucks to transport milk, so urea (fertilizer grade) or earthworms are added to milk to keep it from curdling. Also, oxytocin is given to a lot of cows (it’s pretty much over the counter), so that ends up in the meat and milk.
Another thing: Calves are the by-products of the milk industry. Dairy cows are repeatedly impregnated since they produce milk only for their young (and not continuously as many people believe). They are bred to produce 10 times the normal amount of milk; even so, male calves are deprived of any milk since they are useless to the industry. Dairy cows are kept in small spaces in barns most of their lives, since it is more productive to milk them without letting them move around.
So what about the cows that we do see in the fields? These are beef cattle. As with chicken, there are cows that are bred for milk, and cows bred for beef. The beef cows are bred to grow extra fast and fat for slaughter. They are fed various hormones and growth enhancers to quicken the process. Their last feed before they are sent to slaughter is a different feed called finishing feed. It contains cement dust and such, to increase their weight, as they will not have to digest it anyway. Those extra pounds give the broker a little more money.
N: I’ve recently turned vegan and after moving to India, I find it quite easy. There’s no need to eliminate wheat and rice from your diet. Just substitute it with brown rice and whole wheat and you would be fine. Unless you are allergic to gluten??
I felt comfortable in India at 130–here in the US, I felt uncomfortable given what I perceive as the norms in educated circles (accentuated by “less-modest” clothing norms), thus precipitating my low-carb diet. Guilty of social-climbing? I guess so, but who amongst us isn’t? I’m a full 5’7″ in my stilettos!
I felt comfortable in India at 130–here in the US, I felt uncomfortable given what I perceive as the norms in educated circles (accentuated by “less-modest” clothing norms)
BMI is still positively correlated with socioeconomic status in india, right? the inverse of the USA. that being said, indian american students around where i live seem plumper than indian students (distinction made by accent).
Yes, razib, you are right, insofar as my experience goes. My parents back in India think I am silly to have taken the trouble to have lost the weight–I have seen it lead to better treatment/attention here in the US.
shilpa, i visited bangladesh in 2004. some of my relatives who were plump (though not obese) seemed rather self-satisfied with their softness (though others seemed to find their girth silly too, so it was mixed). i found it very curious, but it makes sense when the poor are quite clearly malnourished and the movie actresses seemed to be plump. my mother recently visited bangladesh and complained that there was an obesity epidemic among the middle and upper middle classes. she, having lived in the USA for 30 years, was quite disgusted by it and seems to have started hectoring people about diet and exercise, to their confusion and curiosity.
razib, yes–your experiences with Bangladesh sound like my thoughts on india vs. usa on this topic! I had a few friends at university (in India) from South Bombay–they were more like my American experience in terms of higher class = thin.
Ena, thanks for sharing. My comments were based on my experiences in Bihar, Jaipur, etc where I see people having small “farms” of like 2-7 cows and buffalos and then go around delivering milk in the morning on their bicycles/bikes to customers. I am sure the larger companies like Amul use larger cow farms.
P.S. I don’t drink milk, I’m lactose intolerant.
Are you talking about India or the U.S. here? I thought that people just turn all the poor bulls out in the street in India… since they are always roaming around the city streets.
It’s a good point about them eating garbage. Lots of cows in India end up sick and dying because their stomachs are full of plastic bags.
Razib, What’s that pre-diabetic supplement you take?
I have cut my weight from 74 kg to 65 kg over the last six years thru exercise and portion control. In 2007 my weight went as low as 63 kg, but after that I have struggled to maintain my weight. although now I have become habituated to exercise and feel very out of sorts every time I miss my exercise. It gets harder as you grow older, and there is the problem of loss of muscle mass. The three weeks I spent in India last winter were awful, because I couldn’t work out (so I made it a point to walk and take the bus to the extent possible) and I burst a blood vessel looking at people eat. I have recently moved to a college town here, and the difference between town and gown is v.noticeable. The puffed up ones and the buff ones! I feel more energetic simply looking at people working out, jogging etc., No such luck in India. Chinese friends tell me that portion control and exercise are forgotten things back in the old country. no more meat, rice and veggies – it’s pizza, burger, fries and ice cream.
Horsehockey. The USA and Sweden have high incidences of osteoporosis because people here tend to live long enough to get it. Prevalence of osteoporosis seems to be about the same per capita between the US and India (with a large undiagnosed population in India.) But the Japanese, who don’t drink much milk at all, have WAY more per capita than India or Bangladesh.
I suppose it’s too much to ask that you buy your milk from reputable sources huh? All of this seems to be more a failing of the Indian regulatory system than any issues with the milk. Also, I’d really like to see some kind of studies supporting the idea that BGH and other things given to cows end up in their milk in appreciable amounts.
Ena, The idea is to be vegan at home and bindaas socially :). My natural tastes make me almost vegan already and I am trying to lose a bit of weight so my only options at this point are to lose the dairy altogether and cut out starch. But my starches are already brown rice + whole wheat pitas so…..Anyway, I’m not sure coconut milk is going to help that cause! So my skim milk will have to stay I guess.
The whole skinny with a big belly thing is why using weight and body mass index is not a good indicator of someone’s true health. Someone can be considered to be at an acceptable weight, however the way the fat is distributed on his body can make them at higher risk for diabetes, cardiac disease.