Eat, Drink & Be Merry? No, It’s Time To Worry

Cigarette smoking is injurious to health but so is the sweetened soft drink, processed foods like noodles and chips with loads of salt and fried snacks that are part of any normal evening. Over the years, the harmful effects of consuming tobacco in any form have become clear to the masses and there has been a fall in the number of people taking up smoking. However, there is an alarming lack of awareness about the effects of fat, sugar and salt on the body, or the addiction that they lead to.

We thus have parents who are mortally scared of their children getting addicted to smoking due to peer pressure, but do not hesitate before putting on an extra spoonful of chocolate spread on their toasts; buying them another bottle of cola or its supposedly healthier alternative, packaged fruit juice; or packing noodles and chips for lunch. This high intake of fat, sugar and salt — FSS, as the deliciously deadly trio is commonly referred to — has a significant long-term impact on public health, but there has not yet been any study or survey conducted on the Indian population in this regard.

There are, however, enough indicators that reveal worrying details. According to the World Health Organisation, non-communicable diseases (NCDs) are estimated to account for 60% of total deaths across all age groups in India. Now, the country has one of the largest number of people with diabetes, figures that shot up from 11.9 million persons in 1980 to 64.5 million in 2015 (study by Lancet released in 2016). Experts say the excess intake of fat, sugar and salt are the main causes for the rising incidence of NCDs like diabetes, cardiovascular diseases and hypertension — these three alone cause an alarming 40% of deaths in India. Much of these are preventable. For instance, the WHO says that as many as 1.7 million deaths worldwide could be prevented every single year if salt consumption is reduced to the recommended level of fewer than 5 grammes a day.

From a health perspective, salt, doctors say, is a needless ingredient, as sodium is present in almost everything that we eat. “From vegetables to meat and fish, sodium is there in everything we eat. We may add a little for enhancing flavour but most people add a lot more than required. For instance, salt is added while cooking rice in Tamil Nadu,” said Dr Milly Mathew, senior consultant nephrologist, Madras Medical Mission Hospital. This extra sodium can lead to hypertension, cardiovascular diseases, kidney problems, stroke, diabetes and many other complications, she said. “Diet plays a major role in preventing NCDs,” added Dr Mathew.

This excess is at its worst when it comes to processed food. In most cases in the West, says WHO, the excess quantity of sodium comes from salt in processed food. This could be true in the case of most in urban India as well. A few food items that Express checked left little for doubt. The smallest packet of instant noodles has 1.424g of sodium. That is about 60% or a third of the daily allowance from just one tiny, 79g packet of noodles that can be termed ‘single-serving’ only. Similarly, a 100gm pack of potato chips has 0.742g of sodium, while it is 0.946g in the case of another popular potato based snack, aloo bhujia.

Processed food, savouries, pappad, pickles, nuts, pizza and other bakery foods are also packed with a high content of sodium, said Meenakshi Bajaj, head dietician at Government Multi Super-Speciality Hospital in Omandurar Estate, Chennai, pointing out how most people end up consuming much more than a day’s allowance of sodium by eating these foods.

The WHO strongly recommends that sodium intake should not exceed 2g (equivalent to 5g of salt a day). Remember that this quantity is for an adult; it is correspondingly less for children based on energy requirement. That is where a small pack of noodles pumps enough sodium into your child, making even the natural sodium in regular food excess. Put another way, this is the equivalent of nicotine tar inside the lungs but without the dark and sticky poison’s repulsiveness.

Equally dangerous is sugar. “There are no studies here to prove that high consumption of sugar has a direct effect on diabetes. However, sugar, both in the form of plain sugar and mixed in food, is harmful to those in pre-diabetic stage and children,” said Dr V Mohan, director, Madras Diabetes Research Foundation. The normal diet — vegetables, fruits, milk, and carbohydrates in chapati, rice etc — have the necessary amount of sugar required for the body. Anything above that could be excess, more so in the case of aerated drinks.

“One cup of coffee or tea will not harm anyone, but consuming soft drinks that are loaded with sugar is dangerous. A 330ml drink of the popular cola contains 33g of sugar. This is one of the leading causes of obesity in children,” added Dr Mohan, who is also the chairman of Dr Mohan’s Diabetes Specialities Centre in Chennai.

This is particularly significant in Tamil Nadu where the incidence of diabetes is alarming. In the State, 10% of adults in the rural population are diabetic. It is higher — 15% — in urban areas excluding Chennai. “In Chennai, 25% of adults above the age of 20 years are diabetic, and about 40% of diabetics are under 50 years old,” said Dr Mohan, adding that the number of pre-diabetic persons would be double these numbers.

The prescribed limit as per the basic calculation is that a person should consume about 30 calories for each kg of body weight, explained Dr K Kannan, president, Chennai Chapter Cardiology Society of India. A teaspoon of sugar is about 5g, which would give you 20 calories.

It thus is no wonder that the bottles of cola that you drink are firmly deposited around the belly, leading to obesity, diabetes and heart diseases before long. Among the FSS trio, fat is an exceptional one as recent research has shown. There have been studies about the dangers of fat, and there is also better awareness when compared to sugar and salt. But what research has proven now goes beyond this layman understanding.

When researchers at the University of Washington, Seattle added sugar to different types of dairy products ranging from skimmed to heavy cream mixed with safflower oil, the test subjects preferred the skimmed one the least. It had little or no fat. When mixed in the right measure with sugar and/or salt, fat becomes the X factor that takes the combination to the next level, the “bliss point”, the palate version of hitting the spot. It also creates an effect similar to any narcotic addiction.

Compared to tobacco and alcohol, the dangers of FSS are evident but almost unacknowledged in the country. While there is a ban on advertising tobacco and liquor, there is no such restriction on advertising these FSS-rich foods that primarily target children.

There is enough anecdotal information as well as direct conjunctures that raise concerns. But in the absence of scientific data, a policy decision cannot be taken, said Dr Soumya Swaminathan, Director General of Indian Council of Medical Research (ICMR).

“We in India lack good data on the dietary pattern of consumption of fat, salt and sugar, and there is no data available on trans-fat consumption or its level in the blood. This is really a risk,” she added. The council is moving towards surveying the dietary pattern of the population for a better understanding of the effect of FSS. That would be the starting point.

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Compared to tobacco and alcohol, the dangers of FSS are evident but almost unacknowledged in the country.

While there is a ban on advertising and liquor, there is no such restriction on advertising these FSS-rich foods that primarily target children.

There is enough anecdotal Information as well as direct conjunctures that raise concerns. But in the absence of scientific data, a policy decision cannot be taken, said Dr Soumya Swaminathan, Director General of Indian Council of Medical Research (ICMR)

Information as well as direct conjunctures that raise concerns. But in the absence of scientific data, a policy decision cannot be taken