Soybean is the richest source of protein among plant sources. It contains around 35g of protein per 100g. It is said to be a complete protein as it has all 9 essential amino acids. It is also low on carbohydrates (12g/100g) and high in fibre (21g/100g). Then why is it that this superfood has become a topic of controversy in the recent times? Read to learn more about soy, its origin, uses, benefits and controversies surrounding it.

About soy
Soybean the “king of beans” serves as a key source of high quality protein among plant sources. Since the 1950s, global soybean production has increased 15 times over. The United States, Brazil, and Argentina together produce about 80% of the world’s soy. Soy which was traditionally consumed in Asian countries, is now consumed all over the world. It is very versatile and can be used to produce soy milk, tofu, tempeh, soy sauce, natto, soy chunks, etc. Soy and its benefits in chronic disease prevention have been researched upon for over 25 years now.
 
What is the connection between soy and Oestrogen?
Oestrogen is an important sex hormone, produced by the endocrine system, that is responsible for the development of female body and the secondary sexual characters. It is responsible for the growth of breasts, hips being wider in women than in men, regulation of menstrual cycle, among other functions. For this reason, it is termed as a “female sex hormone”. Men also have oestrogen receptors and oestrogen in their bodies but to a much lower extent compared to women. 
Soy has a type of phytoestrogen called isoflavones (genistein and daidzein) that is similar to oestrogen in terms of chemical structure. Phytoestrogen can bind to oestrogen receptors in humans and can have a relatively weaker oestrogenic or anti-oestrogenic effect i.e. have an effect similar to but weaker than that of oestrogen or act against oestrogen. Due to this property of soy, it has become the topic of controversy with myths associating soy with disruptions in hormone levels in men, development of male breasts, etc. First let us look at the benefits of soy and then discuss the truth about these controversies.
 
Benefits of soy for women

  1. PCOS- Soy may be beneficial to women with Polycystic Ovarian Syndrome, commonly known as PCOS. It is a metabolic, endocrine and reproductive disorder seen in women of reproductive age. PCOS is characterized by a variety of signs and symptoms. Menstrual irregularities, obesity or excess androgen could be a sign of this disease. In a study that administered soy isoflavone to women with PCOS for a period of 12 weeks. Significant improvement was seen in insulin resistance, hormonal status, triglycerides level and biomarkers of oxidative stress in the women studied. 
  2. Breast cancer– Oestrogen hormone stimulates the growth of secondary sexual characteristics including breasts in women. It also stimulates the growth of breast cancer cells. Some studies on soy consumption in women show a protective effect against breast cancer (due to the anti-oestrogenic effect of soy in premenopausal women).
  3. Menopause- It is a widespread belief that soy is beneficial to postmenopausal women and that the phytoestrogen in soy (which has weak oestrogenic effects in humans) helps in regulating oestrogen level after menopause as there is a decline in oestrogen production. Some studies have reported a reduction in the intensity and frequency of hot flashes during menopause in women given soy isoflavone supplements.

 
Other benefits of soy for all

  1. Cardiovascular diseases- Many studies have reported beneficial effects of the isoflavones in soy on blood pressure, glycemic control, obesity and inflammation. A study in which participants included soyfoods in their diet (total quantity corresponding to 30g/day protein) for 12 weeks, a significant improvement was observed in biomarkers associated with cardiovascular risk.
  2. Cholesterol- Soy protein has been proven to have a hypocholesterolemic effect in both normocholesterolemic and hypercholesterolemic people. It lowers LDL cholesterol level and is also associated with a significant decrease in the ratio of plasma LDL cholesterol to HDL cholesterol. Therefore, soyfoods are beneficial for lowering cholesterol levels.

 
Why men fear soy
It is a common misconception among men that eating soy-based foods will lead to lowered testosterone levels or gynecomastia which is the development of male breasts. This fear is rooted in the fact that soy contains phytoestrogen which is perceived as an equivalent of oestrogen, the “female hormone”. Therefore consuming soyfoods is associated with the fear of reduced masculinity in men. But studies conducted on humans have shown that this is not the case. The effect of eating soy in both groups were studied but there were no significant changes in Testosterone levels in men. Consumption of soybeans or soy-based products on a daily basis did not cause any compromise in the virility or reproductive health in men. Nor did it have any other feminizing effects on the men involved in the studies at an intake level that was equal to or even considerably higher than the amount typically consumed by Asians.
 
Soy and thyroid
Recent studies have found an association between soy and thyroid function. There is a lot of confusion surrounding this and whether consuming soybeans are safe or not as studies are yielding mixed results. Let’s take a look at the existing evidence we have so far.
Soy is suspected to interfere with thyroid function but in whom? Animal studies have shown that when animals with pre-existing compromised thyroid function (such as hypothyroidism) and/or low iodine intake consume soy foods, there could be some disruption in their thyroid function. The exact component in soy responsible for this goitrogenic effect is still unclear. However, studies done on humans have not observed the same effect and the result is still inconclusive as to whether people with impaired thyroid function should avoid soy. Therefore, it is suggested that people with an underactive thyroid and those taking thyroid medication consume soy with caution. It is advisable to get sufficient iodine through the diet if consuming soy products. 
A healthy individual with an optimum thyroid function can consume soy products without any fear as long as the iodine intake is sufficient. It is important to meet your iodine requirement if you are consuming a lot of soy products.

References

  1. Effects of Soy Protein and Soybean Isoflavones on Thyroid Function in Healthy Adults and Hypothyroid Patients: A Review of the Relevant Literature
  2. Effects of soy isoflavones on estrogen and phytoestrogen metabolism in premenopausal women.
  3. Goitrogenic and estrogenic activity of soy isoflavones.
  4. Soybean isoflavone exposure does not have feminizing effects on men: a critical examination of the clinical evidence
  5. Clinical studies show no effects of soy protein or isoflavones on reproductive hormones in men: results of a meta-analysis.
  6. The Effects of Soy Isoflavones on Metabolic Status of Patients With Polycystic Ovary Syndrome.
  7. Effect of soy on metabolic syndrome and cardiovascular risk factors: a randomized controlled trial.

What is Collagen?
Collagen is the most abundant protein in mammals forming about 25% of the total protein content in the body. It is an essential part of the connective tissues in the body. The main components of collagen are 3 non-essential amino acids namely, glycine, proline, and hydroxyproline. The different arrangements of these amino acids results in different varieties of collagen leading to different functions and site of incorporation.

What are the types of collagen?
A collagen molecule is formed by twisting together 3 long chains of amino acids to form a tight coil giving it a great tensile strength. Many of these long collagen chains join together to perform their specific function. The way these chains join at specific sites results in different types of collagen giving it specific characteristics and functions. More than 20 types of collagen have been identified so far. Some of the common types of collagen are:

I Most abundant collagen of the human body; present in scar tissue, the end product when tissue heals by repair; found in tendons, the endomysium of myofibrils, and the organic part of bone
II Articular cartilage and hyaline cartilage
III Collagen of granulation tissue; produced quickly by young fibroblasts before the tougher type I collagen is synthesized; reticular fiber
IV Basal lamina; eye lens
V Most interstitial tissue; associated with type I; associated with placenta

 
What are the functions of collagen?
Collagen in majorly secreted by fibroblast. It is sometimes referred to as the body’s scaffolding. The word collagen is derived from Greek and means “glue producer.” 
Collagen fibers support body tissues, it is a major component of the extracellular matrix that supports cells. Collagen and keratin give the skin its strength, waterproofing, and elasticity. Loss of collagen is a cause of wrinkles.
Connective tissue consists primarily of collagen. Collagen forms fibrils that provide the structure for fibrous tissue, such as ligaments, tendons, and skin. Collagen also is found in cartilage, bone, blood vessels, the cornea of the eye, intervertebral discs, muscles, and the gastrointestinal tract.
 
How can I get collagen naturally?
Since collagen is found in connective tissues, foods such as chicken skin, pork skin, beef and fish are great sources of collagen. Collagen obtained by this method is usually broken down to individual amino acids and are used up for formation of other proteins. There are not enough studies to show if collagen levels increase in humans upon consumption of these foods.
Another natural source of collagen is gelatin, a substance commonly used in cooking and derived from cooking collagen.
 
What are the types of Collagen Supplements available?
Collagen initially became famous as injectable solutions to help tighten skin and remove wrinkles. This fell out of trend as it didn’t last long and incited allergic reactions.
However, in recent years hydrolysed collagen supplements have flooded the market. Hydrolysed collagen are collagen threads broken into smaller peptides and chains to aid in easy absorption. Hydrolysed collagen is available majorly as powders. It’s also seen in the form of skin creams or tablets.
A thing to note here is that these supplements are generally marketed as Type-I Collagen or any of the 20 odd collagen types but it doesn’t make a difference which one you pick. While this is talking about the location from which the collagen was extracted, the hydrolysed collagen is already broken and used to form the different forms of collagen as required by the body.
 
Who would benefit from collagen supplementation and does it really work?
Although the body naturally produces collagen, the rate at which it is produced drops as we age. After a point, the rate at which collagen is produced is not enough to keep up with the body’s demand. Since collagen forms an essential part of the connective tissue, there are multiple benefits for taking collagen supplements.
SKIN HEALTH: Collagen production reduces as you age and this leads to dry and wrinkled skin. Studies have shown that supplementing collagen has improved skin elasticity and reduced dryness. The general conclusion is that collagen slows down skin ageing however more studies are needed to confirm the sole role of collagen in this process.
Joint Health: Ageing leads to deterioration and breakdown of joints. Studies have shown that collagen supplementation not only helps promote joint health but also helps alleviate joint pain.
Muscle Mass: Collagen is also a part of the muscle tissue and forms about 10% of muscle tissue. Multiple studies have shown that people taking collagen supplementation while exercising tend to put on more muscle mass and strength.
Heart Health: Collagen fibres line the inner walls of arteries and are shown to lead to weaker arterial walls. Studies have shown an improvement in arterial wall elasticity and reduction in stiffness when supplemented with collagen.
 
Are collagen supplements safe to take for vegans?
Collagen for manufacture of supplements is majorly obtained from animal sources such as bone broth and protein. However, a few vegan and vegetarian alternatives have started appearing online.

References

  1. Lodish H, Berk A, Zipursky SL, et al. Molecular Cell Biology. 4th edition. New York: W. H. Freeman; 2000. Section 22.3, Collagen: The Fibrous Proteins of the Matrix. Available from: https://www.ncbi.nlm.nih.gov/books/NBK21582/
  2. High Yield Orthopaedics. JavadParviziMD, FRCS, Gregory K.Kim MD Associate Editor. https://doi.org/10.1016/B978-1-4160-0236-9.00064-X
  3. Zdzieblik D, Oesser S, Baumstark MW, Gollhofer A, König D. Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial. Br J Nutr. 2015;114(8):1237–1245. doi:10.1017/S0007114515002810
  4. Proksch, E., Schunck, M., Zague, V., Segger, D., Degwert, J., & Oesser, S. (2014). Oral Intake of Specific Bioactive Collagen Peptides Reduces Skin Wrinkles and Increases Dermal Matrix Synthesis. Skin Pharmacology and Physiology, 27(3), 113–119. doi: 10.1159/000355523
  5. Kumar, S., Sugihara, F., Suzuki, K., Inoue, N., & Venkateswarathirukumara, S. (2014). A double-blind, placebo-controlled, randomised, clinical study on the effectiveness of collagen peptide on osteoarthritis. Journal of the Science of Food and Agriculture, 95(4), 702–707. doi: 10.1002/jsfa.6752
  6. Sibilla, S., Godfrey, M., Brewer, S., Budh-Raja, A., & Genovese, L. (2015). An Overview of the Beneficial Effects of Hydrolysed Collagen as a Nutraceutical on Skin Properties: Scientific Background and Clinical Studies. The Open Nutraceuticals Journal, 8(1), 29–42. doi: 10.2174/1876396001508010029

 

Rice has been the staple food for us in India for ages and also for the most part of Asia. Though this has been the natural trend, a lot of fear and speculation have risen over this wonderful crop due to misinformation and twists of truth. I plan to outline the basics and bust some myths in this blog post.


What are the origins of Rice?
Based on archaeological evidence, the earliest occurrence of Rice can be traced back along the Yangzi River Valley of China dated back to 11,000–12,000 BC (1).Two of the most common domesticated sub-species of Rice are indica and japonica. Rice plays a major role in India and is cultivated in more than a quarter of the agriculture land in the country. There has been an explosion in the variety of rice cultivated in India and includes but is not limited to Basmati rice, Ponni Rice, Hansraj, etc.,
Where are we going wrong?
Though we’ve been consuming Rice as a staple for centuries, there’s been a sudden boom in speculation over the consumption of rice and its link to lifestyle diseases such as Obesity and Diabetes. But have you heard of the Okinawa Diet?
People belonging to the Okinawa Island and a few surrounding islands of Japan have some of the highest recorded life expectancy in the world (2). But the fact remains that rice is a daily staple for the people belonging to this region. The highlight here is the proportion of rice to vegetables and other macros. The Okinawa Diet is not about including or excluding certain food items but it is an eating style.
The important takeaway here is to make sure you practice good portion control and include enough vegetables and good protein souces in your diet along with the right amounts of rice.
What are the types of Rice and how do I choose? 
From the 2 subspecies of rice, there are siad to be over 40,000 varieties of rice. The most commonly known forms of rice are White Rice, Brown Rice and Red Rice.
The rice grain consists of 3 parts – the bran, the germ and the endosperm. Brown Rice is unprocessed rice that contains all three parts of the grain while white rice is processed to remove the bran and the germ giving it a cleaner whiter look. Brown rice is slightly higher in dietary fiber and certain micronutrients and contains a much lower glycemic index than white rice (4,5).
Red rice is another variety which is high in a compound known as anthocyanins. This compound confers antioxidant properties to red rice. It is also commercially available as hulled and unhulled grains. 
So which one do I choose? Although each of these rice have their pros and cons, it all comes down to your personal choice. Even if a few varieties have a few nutritional benefits, it doesn’t outweigh the other choices as long as you’re maintaining portion control and getting all the nutrients you need from other sources.
Now I’d like to address some of the common myths associated with rice starting with the most common one:
Will eating rice after 6 pm cause me to put on more weight than usual?
There is no link between eating certain foods after a certain time and putting on weight. Whether you’re eating at 6 am or 6 pm the energy content of rice and all other food items remain the same. What you need to ask yourself is whether this cup of rice I’m about to eat fits within your day’s macro requirement or you’re going overboard.
Is it ok to eat rice when you’re diabetic?
Another common misconception is that it’s a sin to eat carbs if you’ve been diagnosed with diabetes and you should avoid rice at all cost. This makes no sense as the alternative given is rotis and other such options which again are full of carbs. What’s important in such conditions is to practice portion control by reducing your rice intake and substituting with vegetables. There is no need to avoid rice altogether.
Are Dosa and Idlis better alternatives to rice?
Here’s another simple thing that people get confused about. The fact remains that one of the major components for making these dishes is rice. Not just that, the dal used to make these batters aren’t just a source of protein. They are also loaded with carbs! Not saying that either is better or worse. The fact is it doesn’t really make a huge difference.

References

1) Megan Sweeney, Susan McCouch, The Complex History of the Domestication of Rice, Annals of Botany, Volume 100, Issue 5, October 2007, Pages 951–957
2) Boyle, Marie A.; Long, Sara (2008), Personal Nutrition (7 ed.), Stamford
3) https://farmer.gov.in/cropstaticsrice.aspx
4) Glycemic index for 60+ foods
5) Glycaemic Index (GI) of an Indian Branded Thermally Treated Basmati Rice Variety : A Multi Centric Study

Athletes are a group that use supplements for a myriad of reasons



We are back with our supplement series for the month! So far, we have covered protein and protein related supplements and commonly used vitamin and mineral supplements. While the former is still a never ending list, this article aims to cover more performance oriented supplements. Athletes use supplements for a variety of reasons:

    • To aid in faster recovery from training
    • General health benefits
    • For performance benefits
    • To treat illnesses
    • To compensate for a poor diet



Athletes are always on the lookout for something to boost their performance. This article will cover supplements whose efficacy is backed by science. These supplements have been extensively researched and have been found to benefit different types of sports. If you are an athlete, why not give this a read!

Nitrate:

What is Nitrate?
Nitrate is a molecule that plays an important role in the nitrogen cycle and also in cardiovascular health, blood pressure and exercise performance.

Where do you find nitrates and how does it actually work?
Dietary sources of nitrates include fruits, vegetables and processed meats (1). Vegetables such as beetroot, celery, spinach, rocket (argula) and lettuce are rich in nitrate. High amounts are also found in cabbage, kohlrabi,parsley and fennel (1). Dietary nitrate is converted to nitrite (by bacteria in the mouth and gastrointestinal tract) and further reduced to nitric oxide (1). This nitric oxide is what causes vasodilation (widening of the blood vessels) and results in decreased blood pressure. Nitric oxide also seems to play a role in calcium handling, glucose uptake, neurotransmission and muscle force production.

Why would athletes find supplementation beneficial then?
The content of nitrate found in green leafy vegetables and beetroot vary with soil conditions, time of year and even storage. Hence, like any other supplement, as the specific dose of nitrate is known, athletes would benefit from its usage. This is beneficial when performance is a goal. It has been shown that dietary nitrate supplementation lowered oxygen uptake during moderate to heavy intensity exercise in healthy participants (2). A recently published systematic review and meta-analysis concluded that dietary nitrate supplementation can positively impact endurance exercise capacity (3).

What about the dosage?
About 5-9 mmol of nitrate ingested 2-2.5 hours before an exercise session for about 1-28 days is effective (4,5).

Would only athletes benefit from nitrate?
Not only does dietary nitrate help in performance, since nitrate lowers blood pressure (6), it could potentially help in the general population as well. Not everyone needs to supplement with nitrate! Inclusion of good amounts of beetroot and green leafy vegetables into your daily diet is a great starting point!

Caffeine

What is caffeine and where is it found?
Caffeine is the most widely used psychoactive drug or stimulant. Yes! It is a drug! Like we all know, it is found in coffee beans, tea leaves and cocoa beans. Infact, as you would have all noticed caffeine is also added to energy drinks and soft drinks. However, the amount of caffeine in these sources vary. Caffeine is now available as pills, gels and even gums!

How does it act as a well known stimulant?
We all know that drinking a cup of coffee is the best wake me up drink! The stimulatory effects of caffeine are attributed to its effect on the central nervous system. Caffeine is a competitive inhibitor of adenosine which is responsible for relaxation. Caffeine thus binds to the adenosine receptors in the brain and stimulates the nervous system. (7)

Is caffeine a fat burner?
Caffeine does seem to increase metabolic rate and fat oxidation (8). However, as a standalone supplement it is not effective in reducing body weight. While it does boost fat metabolism marginally (9), the effects of caffeine are highly variable from person to person.

Why do athletes supplement with caffeine?
Caffeine has been shown to improve performance across a variety of sports. Endurance performance (7, 10) and team sports (11) performances have seen an improvement with caffeine supplementation. Infact, the position stand on caffeine from the International Society of Sports Nutrition (12) recognises its performance benefits on strength, sprint and power based sports as well. Acute ingestion has also been shown to increase pain tolerance and perceived effort (13).

What is the dosage and duration of caffeine supplementation?
The suggested dosage for caffeine supplementation ranges from 3-6 mg/kg body weight about 30-60 minutes before the onset of exercise (12).

Are there any side effects of caffeine consumption/supplementation?
Excessive caffeine consumption, greater than the recommended dosage could result in dependency, anxiety and gastrointestinal discomfort. Caffeine consumption in the evenings might interfere with sleep quality later at night as well.

Caffeine and nitrate are two supplements that have extensive research backing their efficacy. In fact, any supplement that you choose should be effective for the particular sport you are using it for! It is evident that caffeine works well across sports while nitrate might work best for an endurance based sport. With the supplement series, our aim is to ensure you all are educated and make an informed choice when it comes to nutritional supplements.

References

1) Hord N, Tang Y, Bryan N. Food sources of nitrates and nitrites: the physiologic context for potential health benefits. The American Journal of Clinical Nutrition. 2009;90(1):1-10.
2. Pawlak-Chaouch M, Boissière J, Gamelin F, Cuvelier G, Berthoin S, Aucouturier J. Effect of dietary nitrate supplementation on metabolic rate during rest and exercise in human: A systematic review and a meta-analysis. Nitric Oxide. 2016;53:65-76.
3) McMahon N, Leveritt M, Pavey T. The Effect of Dietary Nitrate Supplementation on Endurance Exercise Performance in Healthy Adults: A Systematic Review and Meta-Analysis. Sports Medicine. 2017;47(4):735-756.
4) Jones A. Dietary Nitrate Supplementation and Exercise Performance. Sports Medicine. 2014;44(S1):S35-45.
5) Naderi A, de Oliveira E, Ziegenfuss T, Willems M. Timing, Optimal Dose and Intake Duration of Dietary Supplements with Evidence-Based Use in Sports Nutrition. Journal of Exercise Nutrition & Biochemistry. 2016;20(4):1-12.
6) Siervo M, Lara J, Ogbonmwan I, Mathers J. Inorganic Nitrate and Beetroot Juice Supplementation Reduces Blood Pressure in Adults: A Systematic Review and Meta-Analysis. The Journal of Nutrition. 2013;143(6):818-826.
7)Graham T, Spriet L. Metabolic, catecholamine, and exercise performance responses to various doses of caffeine. Journal of Applied Physiology. 1995;78(3):867-874.
8)Acheson K, Zahorska-Markiewicz B, Pittet P, Anantharaman K, Jéquier E. Caffeine and coffee: their influence on metabolic rate and substrate utilization in normal weight and obese individuals. The American Journal of Clinical Nutrition. 1980;33(5):989-997.
9) Jeukendrup A, Randell R. Fat burners: nutrition supplements that increase fat metabolism. Obesity Reviews. 2011;12(10):841-851.
10) Pasman W, van Baak M, Jeukendrup A, de Haan A. The Effect of Different Dosages of Caffeine on Endurance Performance Time. International Journal of Sports Medicine. 1995;16(4):225-230.
11) Stuart G, Hopkins W, Cook C, Cairns S. Multiple Effects of Caffeine on Simulated High-Intensity Team-Sport Performance. Medicine & Science in Sports & Exercise. 2005;37(11):1998-2005.
12) Goldstein E, Ziegenfuss T, Kalman D, Kreider R, Campbell B, Wilborn C et al. International society of sports nutrition position stand: caffeine and performance. Journal of the International Society of Sports Nutrition. 2010;7(1):5.
13) Duncan M, Stanley M, Parkhouse N, Cook K, Smith M. Acute caffeine ingestion enhances strength performance and reduces perceived exertion and muscle pain perception during resistance exercise. European Journal of Sport Science. 2013;13(4):392-399.

Our body is regulated by a wide variety of hormones that ensure optimal functioning of the body.
What is insulin and what is its function?
Insulin is a hormone produced by the pancreas that is needed for the use or storage of body fuels (1). For this very reason, insulin is known as an anabolic hormone. Anabolic hormones are those that help in building new tissue. Insulin also regulates blood sugar levels in your body. For example, when you eat a meal, the meal is digested and broken down to glucose. In response to the rise in glucose, the pancreas secretes insulin which ensures the glucose enters the fat, muscle and liver. As blood glucose levels drop, insulin levels also respond similarly. 
In addition to regulating blood glucose, insulin also plays a role in the creation of fat and inhibits the breakdown of fat. This is the reason why insulin is feared by most, which will be addressed later on.

What is insulin resistance and insulin sensitivity?
Insulin sensitivity  tells us how sensitive the body is to insulin. This varies from person to person. Physical activity and eating choices have a positive effect in increasing insulin sensitivity. 
Insulin resistance is known as decreased responsiveness to insulin (1). That is, the tissues have decreased sensitivity to insulin. If the body is resistant to insulin, the body tries to counter the situation by producing more insulin. Insulin resistance can be caused by several factors including excess adiposity and even a sedentary lifestyle. Insulin resistance is also observed in those with Polycystic Ovarian Syndrome (PCOS).
Do carbohydrates spike insulin, and thus increases storage of fat?
This is the biggest myth with regards to insulin. Fat is created through a process known as lipogenesis and is broken down through a process known as lipolysis. Insulin is known to stimulate lipogenesis and inhibit lipolysis. This means that increased levels of insulin leads to fat storage right? Wrong. 
There exists another enzyme known as Hormone Sensitive Lipase (HSL) whose main function is to break down stored triacylglycerols in the adipose tissue i.e., lipolysis (2). Insulin inhibits the action of HSL. So once again, increased insulin levels must be the issue right? What is interesting to note here is, even consumption of fat can suppress HSL activity (3), when insulin levels are low in the body. The study concluded that insulin was not needed to suppress HSL. Hence, if you are overeating beyond your required energy intake, you will still not see weight loss changes, despite insulin levels being low.
Does only carbohydrate stimulate insulin release?
In healthy individuals, insulin is released in response to meals.  Infact, only few people are aware that protein stimulates insulin too! A study by Boelsma et al. (4) measured the insulin response to two meals,one Low Protein High Carbohydrate (LP/HC) and the other High Protein Low Carb (HP/LC). They found that the protein rich meal stimulated insulin as well!
Another study (5) assessed the insulin response of four different types of protein shakes, egg, tuna, whey and turkey. They found out that the insulin response was the highest after the whey protein meal. The whey protein shake also reduced appetite to a greater extent compared to the rest of the test shakes. 
How does insulin play a role in diabetes?
Diabetes is classified into two types;
Type 1 diabetes: In this case, the pancreas does not produce insulin or is producing very little. We know insulin is needed to regulate blood sugar levels, So in this case, blood sugar builds up in the bloodstream, which can be dangerous to health. This is also known as juvenile diabetes.
Latent Onset Type 1 diabetes: This is a condition that presents itself in adulthood. This is characterised by insulin requirements to treat hypogylcaemia and prevent ketogenesis (6).
Type 2 diabetes: The cause for type 2 diabetes is most likely associated with Insulin Resistance. As a result, the pancreas secretes more insulin like mentioned before. This increases blood sugar leading to prediabetes and consequently diabetes. 
There are several diet plans focussing on lowering carbohydrate intake in order to ensure that insulin levels are normal. These plans are rigid and keep carbohydrates to a bare minimum, while focussing on fat and protein intake. Little are they aware that protein spikes insulin too! Besides, the actual issue to address is the overall diet and other behaviour modifications of the individual. This along with adherence will ensure a sustainable lifestyle to follow.

References:

1) Mahan L, Raymond J. Krause’s food & the nutrition care process. 14th ed. Elsiever.
2) Kraemer F, Shen W. Hormone-sensitive lipase. Journal of Lipid Research. 2002;43(10):1585-1594.
3) Evans K, Clark M, Frayn K. Effects of an oral and intravenous fat load on adipose tissue and forearm lipid metabolism. American Journal of Physiology-Endocrinology and Metabolism. 1999;276(2):E241-E248.
4) 10. Boelsma E, Brink E, Stafleu A, Hendriks H. Measures of postprandial wellness after single intake of two protein–carbohydrate meals. Appetite. 2010;54(3):456-464.
5) Pal S, Ellis V. The acute effects of four protein meals on insulin, glucose, appetite and energy intake in lean men. British Journal of Nutrition. 2010;104(8):1241-1248. 
6) Lasserson D, Fox R, Farmer A. Late onset type 1 diabetes. BMJ. 2012;344(apr30 1):e2827-e2827.

We are back with our supplement series for the month! Incase you haven’t read our previous article, click here. This month we will be covering some supplements that are seen very commonly in households. Do you and your family take these supplements? If so, are they really necessary?

1) Multivitamins: Multivitamins are supplements that usually contain a combination of vitamins and minerals and sometimes, other ingredients as well (1). While they’re available in several forms, the most commonly observed mode is through tablets or capsules. These supplements are easily available in  local pharmacies and even online platforms. Each essential vitamin and mineral have a preset requirement, known as the Recommended Dietary Allowance (RDA), which varies with age and gender. Most of the constituents in multivitamins are close to these recommended amounts. However, is it mandatory that everyone takes a multivitamin? Not necessarily. Those who are at risk of deficiencies and the dosage from the multivitamin supplement is sufficient to reverse it, benefit from its consumption. Even in these cases, purchasing the individual vitamin/mineral supplement might be better. Why does everyone consume them though? People consume multivitamins with an attempt to improve ‘health’. A good indicator of this is mortality, or the ability to live. A 2013 meta-analysis concluded that multivitamins had no significant effect on mortality risk (2). Further, there is insufficient evidence to conclude the role of multivitamins in preventing cancer and chronic diseases (3). In terms of health, multivitamins play a bleak role. Targeted supplementation seems to be more beneficial. Although, if you do plan on buying a multivitamin because the dosage does negate your deficiency, this link will provide tips on how to buy a good one (4) 
2) Vitamin D: Vitamin D is a fat soluble vitamin. The sources of vitamin D are primarily exposure to sunlight and foods such as egg yolks, fish like salmon and fortified foods. This particular vitamin is extremely important for calcium metabolism, which is in turn responsible for maintaining healthy bones and even nerve conduction. The RDA for vitamin D is 400-800 IU/day. However, a particular review reports that vitamin D deficiency in Indians range from 50-94% in healthy individuals (5). So, what causes the deficiency? Decreased exposure to sunlight and insufficient sources of vitamin D from the diet are the primary causes. So do you need to supplement with Vitamin D? If your blood tests indicate you have a deficiency or sub optimal levels, then yes. These supplements must be taken along with a fat source or meals. Our advice would be to go get yourself tested and then take a call!
3) Iron: Iron is a very essential mineral that enables your red blood cells to carry oxygen to your tissues. Iron is found in a wide variety of plant and animal sources such as green leafy vegetables, beans, lentils, nuts, seeds and meat. The iron from animal sources is more bioavailable (better absorbed) than those from plant sources. Vegetarians, worry not! Combining an iron source with vitamin C sources increases the bioavailability of iron. So keep that in mind! Do you need to supplement with iron? This again depends. Only if you are deficient, iron supplementation is necessary. Iron deficiency causes anemia, which seems to be seen primarily in premenopausal women who do not consume enough iron through their diet and also lose iron through menstruation (6). Iron deficiency anemia is just one type of anemia. We will be covering this in depth in our upcoming articles. Iron deficiency manifests through symptoms like fatigue, weakness, pale skin and shortness of breath. If you have been feeling very tired and exhausted, you might know where to look at. Get a blood test done to check your iron levels. To prevent yourself from a deficiency or sub optimal levels, ensure your diet has iron rich food!
(4) Fish oil:  Omega 3 fatty acids, eicosapentanoic acid (EPA) and docosahexanoic acid (DHA) are commonly referred to as fish oil. These are essential fatty acids, which means that your body cannot make them and must be obtained from diet. They’re found in fish and phytoplanktons. Our staple diets are rich in omega-6 fatty acids which are found in eggs, meat and oils. To balance the ratio between Omega-6 and Omega-3 in the body, consumption of fatty fish like salmon is encouraged. While you would have heard that seeds like flax and chia contain omega-3, they actually contain alpha-linolenic acid (ALA), which is a precursor to EPA and DHA. However, research suggests that ALA does not provide the same benefits as supplementing with EPA and DHA (7). However, the link between fish oil and cardiovascular disease is debatable. For those who do not consume fish (ie; vegetarians and vegans) supplementation of fish oil or microalgae (phytoplankton) might be beneficial.
This article covered commonly used household supplements. While this list is exhaustive, we will aim to cover more in the coming series and keep you informed.

References:

  1. National Institutes of Health. Multivitamin/mineral supplements.
  2. Macpherson, H,Pipingas,A, Pase, MP. Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition.2013;97(2):437-444.
  3. Huang HY, Caballero B, Chang S, Alberg AJ, Semba RD, Schneyer CR et al. The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference. Annals of Internal Medicine.2006;145(5):372-85.
  4. Examine. Do you need a multivitamin?
  5. P Aparna, S Muthathal,Nongkynrih, B,Gupta, SK.Vitamin D deficiency in India. Journal of Family Medicine and Primary Care.2018;7(2):324-330.
  6. Fernández-Gaxiola, AC, De-Regil, LM.Intermittent iron supplementation for reducing anaemia and its associated impairments in menstruating women. The Cochrane database of systematic reviews. 2011;10: CD009218.
  7. Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B et al. n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. The American Journal of Clinical Nutrition. 2006;84(1):5-17.
  8. National Institues of Health. Omega-3 fatty Acids.
  9. Can I eat flax seeds instead of fish or fish oil for omega-3s?

With several people engaging in fitness and sports, the belief that supplements are the magical key to improvements in performance is making the rounds. Vitamin and mineral supplements are widely used by the general population, which we will address later. This article will cover supplements commonly used by fitness enthusiasts and athletes. Are you using supplements backed by evidence for its efficacy or are you just burning a hole in your wallet? You’ll find out now!

To begin with, what are supplements? Supplements are defined as “a concentrated source of nutrients or other substances with a nutritional or physiological effect.” (1). Like the name suggests, they are to be used to correct nutritional deficiencies or support specific physiological functions. To put it in simple terms, in the absence of food providing adequate nutrients, supplements can be used. That is, to supplement a diet. Supplements are commonly sold as pills, powders, tablets or capsules with a specific dose. The nomenclature of ‘supplements’ varies globally. While in Europe, they are termed as food supplements, in USA they are known as dietary supplements. The Food Safety and Security Act in India have also listed ingredients that a product should contain in order to be classified as a supplement. (2)


(1) Whey Protein: Whey is a milk protein and the water soluble part of milk. Whey protein by itself is marketed in three main forms. (3)

  • Whey isolate: Contains higher percentage of protein (~85-90% or more) since lactose and fat are removed.
  • Whey concentrate: Lower percentage of protein (~80% or more) compared to isolate since lactose and fat are not removed.
  • Whey hydrolysate: Partially pre digested to aid rapid absorption.

Why whey protein? Do we really know why it is this popular? Or are we just consuming it because everyone else is? Whey protein is rich in essential amino acids compared to its counterparts such as eggs, soy and meat. In specific, it is rich in branched chain amino acids (BCAA) which play an important role in muscle protein synthesis. In fact, whey protein has a biological value (BV) that is greater than the BV of an egg by 15%! (3). BV denotes how fast and how well our body can use the protein consumed. Apart from this, one scoop of whey protein gives anywhere between 20-25g of protein (or more based on the brand)! Convenient isn’t it? its property of rapid digestion, concentration of amino acids and convenience is what makes it popular.

How does whey fare when compared to other protein sources? A study by Tang et al. in 2009 (4) compared the effects of whey hydrolysate, casein (another milk protein) and soy protein isolate on mixed muscle protein synthesis (MPS). It was found that whey protein stimulated mixed MPS to a greater extent compared to soy and casein, both at rest and after exercise. However, soy stimulated mixed MPS greater than casein in both scenarios.

Do you have to consume whey? That depends! Like I mentioned before, whey protein provides 20-25g of high BV protein per scoop and if you are unable to meet your daily protein requirements through your diet, then go ahead. Vegetarians who find it difficult to incorporate complete protein sources into their diet or those involved in strength and endurance training who require higher levels of protein will find supplementing beneficial. You can still consume whey otherwise, simply because it is convenient and light on the stomach. In fact, whey can be added to oatmeal and smoothies to increase the protein content. At the end of the day, it is a matter of personal preference. Remember, it is a supplement.

(2) Casein : Casein is also a milk protein like whey and is a complete protein. The difference between whey and casein lies in their digestion. Contrary to whey which is rapidly digested, casein is a slow digesting milk protein. Casein, like any other protein can be used to meet daily protein requirements but whey seems to be the ideal post workout protein of choice.
However, casein releases amino acids at a much slower rate, so ideally it can be taken before bed, to aid in recovery.

(3) Branched Chain Amino Acids : Branched Chain Amino Acids or commonly known as BCAAs are a group of three amino acids Leucine, Isoleucine and Valine. They are also Essential Amino Acids which means they need to be obtained from the diet. Supplementing BCAAs are popular as it is thought to stimulate muscle protein synthesis (6). Contrary to this, a recent review concluded that BCAA supplementation alone cannot promote muscle protein synthesis (6).

Does BCAA consumption help in preventing fatigue? Serotonin regulates feelings of arousal, sleep and mood and is thought to be linked to central fatigue after vigorous exercise (7). The amino acid Tryptophan is a precursor to serotonin production. Post a bout of exercise, there is a decrease in BCAAs in the plasma and an increase in free tryptophan, thus increasing the free tryptophan/BCAA ratio. It is thought that supplementing with BCAA could balance this increase and delay fatigue (7). However, most studies provided a combination of BCAAs and carbohydrates during exercise (8). Although BCAAs are thought to reduce markers of muscle damage and soreness after strenuous exercise, its efficacy in doing so post high intensity exercise is questionable (9). Further, there is no direct positive link between BCAA supplementation and reducing markers of muscle damage.

Do you need BCAAs? Honestly, no. If you are able to maximise your daily protein intake and meet them via complete proteins, supplementation with BCAA is not necessary. Complete proteins such as eggs, meat, dairy, whey protein, tofu and other soy products already have BCAAs. Maximise your protein through food/other supplements everyday and save some $$$ on the BCAA!


(4) Glutamine : L-glutamine is an amino acid that is found in protein rich foods like meat, eggs, dairy and tofu. Our body can make glutamine, but there are times when our requirements exceed how much our body produces. So, it is a conditionally essential amino acid. It is to be noted that it does become an essential amino acid only during critical illness or injuries (10).
If you are taking glutamine to build muscle or improve body composition, then hold on to your money. Studies have consistently shown that consuming glutamine does not affect body composition (11). In fact, glutamine does not augment rates of muscle protein synthesis in healthy individuals either! Studies have used doses up to 900 mg/kg lean mass and noticed no increase in lean mass or muscle protein synthesis (12). If you are perfectly healthy, with no serious injury or illness, then glutamine isn’t for you.

What about recovery? Glutamine is widely recommended for aiding recovery post training. A recent study did find that co-ingestion of glutamine and leucine (another amino acid) did in fact lead to faster recovery compared to a placebo. Muscle soreness did not differ between the two. (13). Besides strength recovery, it could help in reducing muscle soreness after strength exercise (14,15). Supplementation of glutamine around exercise does seem to enhance strength recovery and possibly reduce muscle soreness.


Like mentioned before, glutamine becomes an essential amino acid in the critically injured or sick individuals. Although exercise also acts as a stressor, immunosuppression observed after exhaustive exercise is not due to plasma glutamine (16). But, what glutamine could benefit is the intestine. Glutamine is thought to be more relevant than glucose as an energy substrate for the gut (17). Hence it could help in reducing exercise induced dysfunctions of the gut.

Thorough research is needed before starting supplement usage. First, it is imperative to understand if there is evidence for the efficacy of the supplement. Second, think about what the use of the supplement is and if it is applicable to your sport/physical activity. Finally, make sure you purchase your supplements directly from the manufacturer’s website. Make sure that the brand you buy is authentic and widely used. Supplements from third party websites could be adulterated/contaminated. The ‘informed sport’ icon on the product is one way to ensure that it is safe. With this in mind, always tell yourself that these are just supplements to a well balanced diet.

References:

 
(1) EFSA. Food supplements.
(2) Health Supplements and Nutraceuticals Emerging High Growth Sector in India
(3) Smithers, GW. Whey and whey protein- from ‘gutter to gold’. International Dairy Journal. 2004; 18(7): 695-704
(4)Tang, JE, Moore, DR, Kujbida, GW, Tarnopolsky, MA, Phillips, SM. Ingestion of whey hydrolysate, casein, or soy protein isolate: effects on mixed muscle protein synthesis at rest and following resistance exercise in young men. Journal of Applied Physiology. 2009;107(3): 987-992.
(5) Examine. Casein protein.
(6) Wolfe, RR. Branched-chain amino acids and muscle protein synthesis in humans: myth or reality? Journal of the International Society of Sports Nutrition. 2017; 14(1): 1-7.
(7) Blomstrand, E. Amino acids and central fatigue. Amino Acids. 2001;20 (1):25-34.
(8) Blomstrand, E. Role for Branched-Chain Amino Acids in reducing central fatigue. The Journal of Nutrition.2006;136(2):544S-547S.
(9)Fouré A, Bendahan D.Is Branched-Chain Amino Acids Supplementation an Efficient Nutritional Strategy to Alleviate Skeletal Muscle Damage? A Systematic Review. Nutrients.2017;9(10):
(10) Lacey,JM, Dr. PH, Wilmore, DW. Is glutamine a conditionally essential amino acid?Nutrition Reviews. 1990;48(8):297-309.
(11) Ramezani Ahmadi, A, Rayyani, E, Bahreini, M, Mansoori, A. The effect of glutamine supplementation on athletic performance, body composition, and immune function: A systematic review and a meta-analysis of clinical trials. Clinical Nutrition. 2018;1-16
(12) Candow, DG, Chilibeck, PD, Burke, DG, Davison,KS, Smith-Palmer,T. Effect of glutamine supplementation combined with resistance training in young adults. European Journal of Applied Physiology. 2001; 86(2):142-9.
(13)Waldron,M, Ralph C, Jeffries O, Tallent J, Theis N, Patterson SD. The effects of acute leucine or leucine-glutamine co-ingestion on recovery from eccentrically biased exercise. Amino Acids.2018;50(7):831-839.
(14) Street,B, Byrne,C, Eston, R. Glutamine Supplementation in Recovery From Eccentric Exercise Attenuates Strength Loss and Muscle Soreness. Journal of Exercise Science and Fitness. 2011;9(2):116-122.
(15) Legault, Z, Bagnall, N, Kimmerly, DS. The Influence of Oral L-Glutamine Supplementation on Muscle Strength Recovery and Soreness Following Unilateral Knee Extension Eccentric Exercise. International Journal of Sports Nutrition and Exercise Metabolism. 2015;25(5):417-426.
(16) Hiscock,N, Pedersen, BK. Exercise-induced immunodepression- plasma glutamine not the link. Journal of Applied Physiology.1985; 93(3): 813-822.
(17) Cruzat,V, Rogero, MM, Keane, KN, Curi, R Newsholme, P. Glutamine: Metabolism and Immune Function, Supplementation and Clinical Translation. Nutrients. 2018; 10(11):1-31.

With a variety of new diets making the rounds, it becomes difficult to gauge which is the right one for you as an individual to follow. A lot of information is available, but which is actually factually correct is the bigger question!  Off late, fasting diets have been making the rounds, with intermittent fasting in the spotlight. This article aims to provide an unbiased view on intermittent fasting, so you can decide if it is sustainable to follow!

What is intermittent fasting? How is it different from the conventional weight management strategies?
Intermittent fasting (IF) involves cycling normal daily caloric intake (feeding) with periods of fasting or severe energy restriction. The period of fasting is not a true fast where food and/or water is not allowed (1).  In comparison, the conventional weight management strategy, continuous energy restriction (CER) that is, a calorie deficit, is used to induce weight loss by creating a daily energy deficit.
How does it work?
There are several fasting regimes and modified fasting regimes being practiced. The most popular IF methods are:

  • 5:2 diet, which involves 2 days (consecutive or non consecutive) of ‘fasting’ (energy intake of ~500kcal and ~600kcal are allowed for men and women respectively) and 5 days of regular eating patterns per week (1)
  • The Alternate Day Fast (ADF) involving alternate days of fasting and feeding (1)
  • The 16/8 diet, characterised by fasting for 16 hours a day and eating within an 8 hour feeding window.


What does the science say?

Weight loss: Intermittent fasting, like the media has portrayed, is not a magical diet to help induce weight loss. Rather, it is a tool to induce an energy deficit. However, if you compensate for the meals skipped during the feeding period, you wouldn’t observe results. A recent meta analysis of 4 studies concluded that IF methods are suitable for inducing short term weight loss, however, the variability between the study duration and participant characteristics (2) . Rather, intermittent fasting methods have been found to induce similar weight loss (3, 4) or no significant difference in weight loss (1) when compared with CER. This further strengthens the argument that while IF can induce weight loss, it is merely a tool to induce an energy deficit.
Metabolic outcomes:  You must think, if not weightloss maybe IF has an effect on metabolic outcomes like triglycerides, glucose and cholesterol among others? A systematic review and meta analysis of IF and CER found no significant differences  in glucose, HbA1c, triglycerides, HDL and LDL cholesterol (3).  Further, another systematic review showed that insulin and insulin sensitivity was comparable between IF and CER methods (5). However, definite conclusions cannot be drawn due to the varying methodologies of the individual studies. Further research is needed in order to understand this completely.

Should I try it?
Intermittent fasting is not for everyone. That is, if you are pregnant, breastfeeding, have a history of or an existing eating disorder, are extremely underweight or are on medication that require food intake, kindly avoid practising this regime.
If you are  person that does well without a meal and are comfortable with periods of fasting, you could give this a shot!

References:

(1) Harris L, Hamilton S, Azevedo L, Olajide J, De Brún C, Waller G et al. Intermittent fasting interventions for treatment of overweight and obesity in adults. JBI Database of Systematic Reviews and Implementation Reports. 2018;16(2):507-547. 
(2) Ganesan K, Habboush Y, Sultan S. Intermittent Fasting: The Choice for a Healthier Lifestyle. Cureus. 2018;10(7):e2947.
(3) ioffi I, Evangelista A, Ponzo V, Ciccone G, Soldati L, Santarpia L et al. Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials. Journal of Translational Medicine. 2018;16(1):371.
(4) Sundfør T, Svendsen M, Tonstad S. Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial. Nutrition, Metabolism and Cardiovascular Diseases. 2018;28(7):698-706.
(5) Barnosky A, Hoddy K, Unterman T, Varady K. Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: a review of human findings. Translational Research. 2014;164(4):302-311.

Over the past few years, it is evident that fitness has become popular. People are consciously trying to change their eating habits and adopt a better lifestyle. However, only a small population is actually aware of what they are eating. Most of us assume that exercising is the easiest way to shed some weight and become ‘healthy’. (Why weight loss is not necessarily healthy, is a story for another day). While exercising certainly has its benefits, majority of us do not know what is on our plate. Diet and exercise are interrelated.
We’ve grouped foods into ‘good’ and ‘bad’ or ‘healthy’ and ‘unhealthy’ without knowing its function or how it would affect us. We eliminate food groups for the sake of weight loss and aesthetic goals. We are willing to take shortcuts even if it means compromising health.
The purpose of this article is to educate and bust some myths surrounding the essential nutrients we need to function. Some may surprise you, so sit tight!

The Macronutrients:

Macronutrients are nutrients that are required in large amounts by the body. These nutrients perform several essential functions from providing energy to regulating hormones. The macronutrients along with their roles are described below:
Carbohydrates: Carbohydrates are a food group whose main function is to provide energy to the body. They are broken down into glucose, which is then utilised to perform several functions by the body. Carbohydrates are commonly classified into simple and complex carbohydrates.
Simple carbohydrates: These are quickly absorbed into the bloodstream and thus provide a rapid source of energy. For example, fruit juices, refined sugar and candies are some sources of simple carbohydrates.
Complex carbohydrates: These are slowly released into the bloodstream and keep you full for longer. Whole grains, vegetables, beans, fruits and pulses are some examples.
It isn’t uncommon for someone to cut out carbohydrates from their diet when they’re trying to shed some weight. For every gram of carbohydrate consumed, the body holds onto three grams of water. So, the initial weight loss seen when carbohydrates are eliminated is actually just loss of water! There exists a belief that carbohydrate rich food hinder a person’s weight loss, while protein and fat rich food keep one satiated. However, contrary to this, it was found that in obese and overweight individuals, high carbohydrate diets were perceived to be more satiating than high fat diets. In fact, hedonic appeal (pleasure) for high fat foods were suppressed compared to high carbohydrate foods. It was also found that participants consumed close to 990 calories more on an average on the high fat diet (1). This means, that switching to high carbohydrate diets may actually help in regulating appetite in the short term.
Protein: We would have studied back in school, that proteins are the building blocks of the body. This is absolutely correct! Protein is a constituent of everything from our hair and nails to hormones and muscles. The building blocks that make up protein are called amino acids. Of these amino acids, there is a group called essential amino acids, which our body cannot make. Hence, it needs to be obtained from the diet. Complete proteins (containing all 9 essential amino acids) include meat, poultry, dairy, soy and quinoa. Incomplete proteins (do not contain all essential amino acids) include mostly plant based sources such as pulses and beans. Hence, for a plant based eater, a combination of a vegetarian protein source and a dairy source might help completing the amino acid profile.
A healthy human being needs about 0.8-1g/kg body weight of protein every day. But, do we Indians really consume enough protein? Before anyone gets defensive and talks about how an Indian diet is balanced and the most ‘healthy’, let me point you toward some evidence that isn’t anecdotal. In 2015, the Indian Market Research Bureau (IMRB) conducted a survey (2) to determine protein consumption of adults in the country. They recruited 1260 participants from over 7 cities. They concluded that close to 9 out of 10 Indians consume a protein deficient diet. In fact, 91% of the vegetarians and 85% of non vegetarians were consuming an insufficient amount of protein.
But is consuming high amounts of protein harmful? No, not at all. A recent meta-analysis has concluded that consuming a high protein diet (≥1.5g/kg body weight) did not adversely affect kidney function in healthy adults (3). Similarly, in a year long study in healthy resistance trained males, it was found that a high protein diet (>3g/kg body weight) did not have harmful effects (4). However, those with preexisting renal conditions need to be cautious with their protein intake.
Fat: Fat is an extremely important macronutrient which we often neglect or fear. However, fat also acts as a source of energy and helps in absorption of fat soluble vitamins. Fat rich food are sources of essential fatty acids (those which your body cannot make). These fatty acids are classified as omega-3 and omega-6. While we do get a good amount of omega-6, we often forget the importance of omega-3 fatty acids. Omega-3 fatty acids help in maintaining heart health and brain function. Further, there needs to be a certain balance between the two fatty acids. While we get omega-6 sources very easily from cooking oils like sunflower or corn oil, our consumption of omega-3 sources are fairly low. Inclusion of fatty fish like salmon, flax seeds, chia seeds and walnuts help in reversing this.
But does eating fat make you gain weight? Nope. If you control for your overall daily requirement of food, consuming fat rich food will not hinder your weight loss. So eat your eggs with the yolk! But wait. Does eating whole eggs increase cholesterol? It depends. There are hypo and hyper responders to cholesterol. For the majority of the healthy population, consuming eggs only shows a mild alterations in plasma cholesterol, or in fact none at all! (5). If you are a hyper responder and you have poor dietary habits to begin with, then you must be a little cautious. This excellent summary of egg consumption and cholesterol will give you better insight (6).

The Micros:

Micronutrients, like the name suggests are nutrients that are needed in fairly smaller amounts in comparison to macronutrients. Despite this, they play several important roles. Micronutrients are vitamins and minerals found in a wide variety of food items from fruits and vegetables to whole grains and seeds. We often tend to turn a blind eye towards inclusion of micronutrients in our diet, without knowing their importance.
For example, Vitamin D, a fat soluble vitamin plays an extremely important role in absorption of calcium and bone health. Vitamin D deficiency is prevalent throughout the country, with 70-100% in the general population (7). Cheese, egg yolks and fortified dairy products are some food sources of vitamin D. However, milk and dairy products in India are rarely fortified with vitamin D. In addition to this, calcium intake is also far below the recommended intake (7). While sunlight is also a good source of vitamin D, it is not solely the solution for reversing the deficiency. Hence, supplementing vitamin D should not be viewed as a taboo. Do consult your nutritionist or doctor for more details.
Despite supplements being easily accessible, a food first approach must be employed. If you are deficient in a certain vitamin or mineral, then yes you will need to bring your levels back to normal. But to prevent deficiency, ensure you include a wide variety of fruits and vegetables in your diet. In addition to this, also add whole grains, legumes, nuts and lean protein into your diet. The more diverse your diet is, the more micronutrients you get!
Water: One more addition to the ‘neglected’ basket is water. Why do we need water? Water makes up about 60% of your body. Water is essential for almost all functions from transporting nutrients (blood is also composed of water) to excretion! With India’s temperature soaring most of the time, the chances of dehydration are highly likely.
How do you identify if you are dehydrated (or need more water)? Physically, one can rely on thirst as a cue to drink water. Dry mouth, dizziness and exhaustion are some symptoms of dehydration. However, your urine colour can be one way to assess your hydration status. The more pale your urine is, the more hydrated you are. Similarly, the darker it is, the less hydrated you are. Ideally, your urine colour should be around 5-6 in the image attached below. However, this isn’t an assessment set in stone as different foods you eat can also influence your urine colour.

Some of these were a shocker to you weren’t they? Every nutrient has a role to play in helping the body function. When we cut out whole food groups for the sake of losing a couple of kilos, we are in some way, compromising our health. A handy tip to remember to ensure that you prioritise health is ‘balanced meals with rainbow colours’. The more colours you add to your plate, the more variety of nutrients you include!
Hope this gave you all an insight into how important it is to know what you eat and how they help you perform your daily activities.

References:

1) Hopkins, M, Gibbons, C, Caudwell, P, Blundell4,JE, Finlayson, G. Differing effects of high-fat or high-carbohydrate meals on food hedonics in overweight and obese individuals. British Journal of Nutrition. 2016;115(10):1875-1884
2) Mahajan, M. Protein consumption in diet of adult Indians : a general consumer survey (PRODIGY). Indian Medical Gazette.2015;149(4):149-150
3) Devries, CM, Sithamparapillai, A, Brimble, KS, Banfield, L, Morton, RW, Phillips, SM. Changes in Kidney Function Do Not Differ between Healthy Adults Consuming Higher compared with Lower- or Normal-Protein Diets: A Systematic Review and Meta-Analysis. The Journal of Nutrition and Disease. 2018; 148(11): 1760-1775.
4) Antonio, J, Ellerbroek, A, Silver T, Vargas, L, Tamayo, A, Buehn, R, Peacock, CA. A High Protein Diet Has No Harmful Effects: A One-Year Crossover Study in Resistance-Trained Males. Journal of Nutrition and Metabolism.2016;1-5
5) Fernandez, ML. Dietary cholesterol provided by eggs and plasma lipoproteins in healthy populations. Current Opinion in Clinical Nutrition and Metabolic care. 2006;9(1):8-12
6) Examine. Will eating eggs increase my cholesterol? Available from:
7) G, R, Gupta, A.Vitamin D Deficiency in India: Prevalence, Casualties and Interventions. Nutrients.2014;6(2):729-775

“Sorry, I can’t eat cake I’m on a diet”
By definition, a “diet” is the sum of energy and nutrients obtained from foods and beverages consumed regularly by individuals. To put it in simple terms, it is what you eat and drink on a day to day basis. Somewhere along the way, the meaning shifted to something more specific. Something that people dread. You guessed it right – Weight loss.
As a generation, we are used to quick results. Everything from groceries to electronics can be bought with a click. Unintentionally (or not) we have begun to channel that into how our bodies respond to an external stimulus, such as food and exercise. We expect results within a short span of time and will go to great lengths to ensure that it happens! Ever completely cut off a food group or had just juices for a week to shed some weight? That is exactly what I’m talking about.
This is what we call a ‘fad diet’. It’s nothing but a trend that claims to guarantee rapid weight loss and have an upper hand over our perfectly normal balanced diet. Most of the claims around fad diets might seem appealing.
“Guaranteed weight loss in a week!”
“Helps in removing harmful toxins from your body”
“Carbohydrates are stored as fat. Switch to fat as your primary source of energy.”
Sounds familiar? Although these claims might seem appealing, the diet by itself is extremely restrictive. Every single nutrient has a role to play in our body and nothing in isolation is inherently bad. Any ‘diet’ that you choose to follow is completely based on individual preference. But, is it sustainable? Is it personalised to help achieve your goals? It is imperative that everyone is informed of the pros and cons of these diets and make an informed choice. For that reason, here is a compilation of the most popular diets:
(1) Ketogenic diet: Both carbohydrates and fat can be used as a source of energy by the body. The body relies on glucose (broken down from carbohydrates) when one consumes their normal diet (1). In the complete absence or reduced amount (<20g) of carbohydrates in the body, the body enters a state of ketosis, wherein it relies entirely on stored fat for energy. Signs of ketosis can be identified by increased ketone bodies in the blood, headaches and fatigue due to extremely low carbohydrate intake and bad breath. Breakdown of fat results in the rise of ketone bodies in the blood, which are used as an alternate source of fuel. The ketogenic diet involves consuming minimal to no carbohydrates (~5% from diet) and using fat (~75% from diet) as a source of energy. It encourages consumption of copious amounts of fat from sources like bacon, ghee,butter,nuts,cheese etc. Starch, grains, beans and legumes, fruit and starchy vegetables are avoided. The sources of fat usually consumed in a keto diet are low chain triglycerides (LCT’s). Off late, consumption of fat sources that contain Medium Chain Triglycerides (MCT’s) like coconut oil are observed. Although they do not contain concentrated amounts of MCT’s, it is suggested that MCT’s generate more ketone bodies and may be more beneficial to incorporate in a keto diet (1).
Pros: A ketogenic diet was developed for children diagnosed with epilepsy. It was said to be therapeutic as fats do not spike insulin. It works by stabilising various mechanisms related to synaptic functions and thus has an anti-seizure effect. So you know who it actually benefits (2). Although, consumption of high amounts of fats can induce better satiety (3), thus reducing food consumption in subsequent meals. This can potentially help in losing weight. In order to adapt a ketogenic diet to the current lifestyles and improve adherence, a cyclical keto diet came into the picture. This involves following a keto diet for 4-5 days and increase carb intake for 1-3 days. There is currently no evidence to support the validity of a cyclical ketogenic diet.
Cons: A ketogenic diet can be extremely restrictive. Cutting all sources of carbohydrates can lead to irritability, ‘brain fog’, mood swings, headache and even constipation, due to lack of fibre in the diet. Although it might result in weight loss (provided you’re in a caloric deficit), it may not be sustainable in the long run. I mean, how long are you going to stay away from a good slice of pizza? On a more serious note, the exclusion of whole grains, fruits and vegetables could lead to deficiencies of B vitamins, iron, zinc etc. Further, the long term effects of such a high fat diet haven’t been studied.

(2) Paleo Diet: The Paleolithic diet or paleo diet resembles what hunters or cavemen ate several years ago. This diet primarily revolves around what our ancestors had access to – Whole foods. And by that, I literally mean, whole foods only. Sounds easy? Not really. You see, cavemen didn’t cultivate their food. So what they ate was what they could find. So on this diet, the idea is to avoid anything that could be made in a factory. What this diet would comprise of would be meat, free range eggs, fruits, vegetables, nuts and seeds. In order to adapt it to the current scenario, consuming spices/condiments and olive/coconut oil are acceptable. It has been speculated that they did have access to grains. However, evidence for a paleo diet to be superior than a balanced diet is still in question (4).
Pros: Any food that is ‘processed’ such as aerated beverages, most dairy products, legumes/beans, vegetable oils and even grains are not to be consumed on this diet. Since you will be consuming an abundance of fruits and vegetables, there lies an advantage. The focus on whole foods does steer us away from a conventional diet primarily filled with calorie dense foods of low nutrient content. In fact, studies have shown that a paleo diet improves insulin sensitivity, blood pressure and cholesterol (5).
Cons: To start with, the diet is pretty restrictive. More than it, it also creates a list of ‘good food’ and ‘bad food’. That by itself creates a sense of fear of food and is problematic. Further, we can follow a perfectly wise diet even with the inclusion of dairy, starch and legumes. The exclusion of dairy might lead to a deficiency in calcium(4).
(3) Detox diet: A detox diet is used to eliminate toxins from the body and assist with weight loss. These are also commonly known as juice cleanses. However, it can also involve consuming vitamins, minerals, laxatives and other ‘cleansing foods’ (6). While most commercial detox diets do not specify the ‘toxins’ they claim to remove, it should be noted here that the dose of the said toxin determines its harmfulness (7). For example, even an essential mineral like Iodine when present in excess can lead to thyroid disorder. Does that mean iodine in isolation is a toxin?
Various organs in our body, and in specific the liver are involved in eliminating potential toxins from the body. Commercial detox diets lure the masses promising rapid weight loss, but there is no scientific evidence to support this claim.
Pros: Well. This is a tough one. In a recent review on detox diets (7), it was highlighted that some plant based foods like coriander, citric acid (found in citrus fruits) and malic acid (found in grapes) can help in removing toxic metals from the body. However, most of these studies were performed on animals and can’t be generalised to the human population. While these detox diets may be successful in inducing weight loss in the short term, they may not be sustainable in the long run.
Cons: Detox diets involve severe energy restriction and might lead to nutrient deficiencies. For example, by just drinking juices for a week, one may not meet their recommended protein intake! Further, detox dieters could potentially be over consuming supplements/laxatives (7). A variety of nutrients need to be consumed on a daily basis, which a detox diet may not be able to provide.
(4) GM diet: A diet that was initially created for the employee of General Motors (GM), the GM diet allows you to eat a certain combination of foods each day. For example, on day one you eat only fruit (except bananas). On day two, only vegetables. This pattern of consuming specific foods continues for a period of 7 days. Since fruits, vegetables and other items allowed in the diet are low calorie, it has been shown to induce weight loss. However, as much as it is popular, there isn’t any research to support the claims of this diet.
Pros: Although a GM diet does include some whole foods, it follows a restrictive and specific pattern.
Cons: We need a variety of nutrients on a daily basis. By consuming just fruits throughout the day, other nutrients such as protein, fat and several other micronutrients available in whole grains, fruits and vegetables are neglected. Moreover, tendency to feel hungry might be prevalent. The weight lost on a GM diet may be temporary. Since it isn’t something you can follow lifelong (fight me!), there lies a possibility of regaining the weight lost.
Do you sense a pattern with all these diets? All of these diets involve restricting either all your food or a specific food/food group. Do you think that’s sustainable and that you can follow it life long? Not really right? In an ideal scenario, for a diet to be sustainable, it needs to be personalised to suit you and your goals. There isn’t one specific diet that is applicable to everyone. As mentioned before, all nutrients play a specific role in your body. Completely cutting yourself off from one for the sake of losing weight does more harm than good. Always make an informed decision when it comes to your fitness goals. The shortcuts might seem tempting, but remember health is wealth.

References:

1) Walcyzk, T, Wick, JY. The ketogenic diet: making a comeback. The Consultant Pharmacist. 2017; 32(7), 388-396.
2) Rho, JM. How does the ketogenic diet induce anti-seizure effects? Neuroscience Letters. 2017; 637, 4-10
3) Paoli, A. Ketogenic diet for obesity: Friend or foe?. International Journal of Environmental Research and Public Health. 2014; 11(2),2092-1207.
4) Pitt, CE. Cutting through the Paleo hype: The evidence for the Paleolithic diet. Australian Family Physician. 2016; 45(1): 35-38.
5) Tarantino, G, Citro, V and Finelli, C. Hype or Reality: Should Patients with Metabolic Syndrome-related NAFLD be on the Hunter-Gatherer (Paleo) Diet to Decrease Morbidity?.Journal of Gastrointestinal and Liver disease. 2015; 24(3): 359-368.
6) Allen, J, Montalto, M, Lovejoy, J, Weber, W. Detoxification in naturopathic medicine: a survey. Journal of Alternative and Complementary Medicine. 2011;17(12):1175-1180.
7) Klein, AV, Hiat, H. Detox diets for toxin elimination and weight management: a critical review of the evidence. Journal of Human Nutrition and Dietetics. 2014; 28(6): 675-686.
8) Healthline. What is the Cyclical Ketogenic Diet? Everything you need to know.
9) Medical News Today. What are the signs of ketosis?
10) Harvard T.H. Chan School of Public Health. Diet Review: Ketogenic Diet for weight loss.
11) Masharani, U, Sherchan, P, Schloetter, M, Stratford, S, Xiao, A, Sebastian, A, Nolte Kennedy, M and Frassetto, L. Metabolic and physiologic effects from consuming a hunter-gatherer (Paleolithic)-type diet in type 2 diabetes. European Journal of Clinical Nutrition.2015; 69(8), 944-948.
12) Harvard T.H. Chan School of Public Health. Diet Review: Paleo diet for weight loss.
13) Precision Nutrition. The Paleo problem.