Dietary guidelines for Indians: A path to balanced nutrition

 Dipak Kurmi

(The writer can be reached at dipakkurmiglpltd@gmail.com.)

The Indian Council of Medical Research (ICMR) would certainly disagree
 with the notion that “the secret of success in life is to eat what you like and let the food fight it out inside.” The ICMR’s focus isn’t on life success but on promoting health through proper nutrition and guarding against deceptive practices in the food industry, such as the incorrect use of the term “organic.” For a product to be truly “organic,” it must be free of artificial preservatives and made from organically grown ingredients. To ensure authenticity, look for the “Jaivik Bharat” certification logo.

Whenever possible, it’s wise to avoid relying on packaged foods. Instead, start from the basics by purchasing fresh ingredients and preparing nutritious, homemade meals. This approach not only rejuvenates you, your family, and your friends, but also helps prevent obesity, laziness, and illnesses like diabetes, hypertension, heart disease, and clogged arteries. Opt for steaming over frying and roasting instead of grilling. Pair these healthy eating habits with regular, moderate exercise—yoga is a globally popular choice—as well as walking, jogging, or simply doing household chores. This routine can help you maintain a trim waistline as you approach middle age and slow down muscle loss in your senior years.

In an effort to promote nutritional awareness in India, the National Institute of Nutrition, part of the ICMR and based in Hyderabad, has been releasing “Dietary Guidelines for Indians” (DGI) since 1998. The latest edition was published this month, following a significant hiatus since the previous version in 2011. This raises the question: how have India’s health metrics evolved during this period?

The encouraging news is that from 2016 to 2021 (with data post-2011 not provided), there was a significant reduction in chronic energy deficiency among adults. Specifically, the number of men affected dropped by 31% and women by 19% from the troubling baseline, where about one-fourth of adults were impacted.

Even more promising is the reduction in abdominal obesity, with 14% fewer men and 11% fewer women affected compared to the previously alarming rates—over half of men and two-thirds of women. This raises the question: why the disparity between genders? Perhaps more men accessed the ICMR website and adhered to the 2011 guidelines, which were available for download and storage on a desktop. The current guidelines, however, are only available online and span 148 pages, making them somewhat challenging to navigate.

ICMR recognizes that diet is influenced by cultural habits. Take the widespread addiction to salt and sugar, for example. Although everyday foods already contain sufficient sodium (the primary component of salt), it’s common to add more for flavor. The importance of salt in Indian culture is highlighted by the fact that it was taxed during colonial times, while gold was not. Mahatma Gandhi famously initiated his civil disobedience movement in 1930 by making salt at Dandi in Gujarat, directly challenging the colonial salt tax. This cultural affinity for salt continues today. ICMR highlights the rising consumption of packaged fast foods, snacks, and sugary drinks, which often contain excessive salt and sugar, harming health. While sugar provides energy, so do cereals, millets, pulses, nuts, dairy products, meat, eggs, and fish, which naturally offer ample energy.

Maintaining a delicate balance between the macrominerals sodium and potassium is crucial. Sodium is abundant in cereals, pulses, vegetables, and milk, while potassium is plentiful in beans, lentils, bananas, and nuts. Minerals, in general, are vital nutrients that nourish the body. Dried fish is the richest source of calcium, with milk products offering half as much, followed by seafood and green leafy vegetables. Iron is most concentrated in dried fish, followed by green leafy vegetables, pulses, and nuts. For magnesium, the best sources are nuts, followed by millets, pulses, and meats.

A staggering 56.4 percent of the disease burden (both mortality and morbidity) stems from unhealthy diets and insufficient exercise. Maintaining dietary balance is crucial, especially for children. Unfortunately, poor dietary habits established early in life lead to a lifelong disease burden. Alarmingly, 40 percent of children aged one to four are anaemic, and 14 to 32 percent lack essential micronutrients like zinc, folate, iron, and vitamins. Among children aged five to nine, 24 percent are anaemic and micronutrient-deficient, a condition that persists in 28 percent of those aged 10 to 19. This indicates that early dietary deficiencies can permanently impair nearly 40 percent of the future workforce, imposing a substantial social cost on the economy and causing significant personal anguish for the affected individuals.

Like its predecessors, the latest edition of the DGI meticulously tailors nutritional guidance to various demographic groups, including infants, children, young adults, women, pregnant and lactating women, men, and seniors. Detailed meal plans are provided for each group, featuring both vegetarian and non-vegetarian options. The cover page itself features eggs and meat, referred to as “flesh foods” in accordance with vegetarian terminology. While vegans abstain from all animal products, including eggs and milk, ovo-vegetarians enjoy them. ICMR recommends consuming two to three well-balanced meals daily, adjusted according to age and body composition, with adequate intervals between meals to facilitate optimal nutrient absorption by the body’s fluids and organs.

Tea and coffee consumption during meals is discouraged, a recommendation that may disappoint cultures where tea serves as a cornerstone of conviviality and connection.

Ultimately, the critical question remains: How many Indians have the means to afford a well-rounded diet?

Is it a lack of nutritional knowledge or simply economic constraints that lead many families to consume unhealthy diets? The Union government allocates Rs 2 trillion towards an unvaried, cereal-centric, free food programme for low-income households. A step in the right direction would be to align these handouts with the balanced diet recommendations from the ICMR. Alternatively, an even more effective approach could involve calculating the cost of these meals and directly transferring the funds into the bank accounts of the 110 million beneficiaries.